Fibrous dysplasia complicated by aneurysmal bone cyst formation affecting multiple cervical vertebrae.

Fibrous dysplasia is a well-known benign dysplastic process of bone. However, fibrous dysplasia is very uncommon in the spine. Further, to our knowledge, coexistence of fibrous dysplasia and aneurysmal bone cyst in the spine has not been reported. This manuscript presents a patient who had both processes involving the cervical spine.

Computed tomographic imaging of the foot and ankle. Developmental and congenital anomalies.

Computed tomography is a primary imaging technique for evaluating congenital and developmental anomalies of the foot and ankle. Other imaging modalities have special capabilities, but computed tomography is a fast, safe, and effective method of assessing the anatomy. To demonstrate this point, the authors present and discuss imaging findings of common anomalies of the foot and ankle.

Comparison of 4 computed tomographic imaging protocols for lateral tibial plateau fractures.

OBJECTIVE: Many computed tomographic (CT) imaging protocols are used for pretreatment assessment of tibial plateau fractures. This study compares the diagnostic capabilities of 4 CT protocols. METHODS: Lateral tibial plateau fractures were induced in 19 knee specimens and CT scans were obtained with the following protocols: 1) 3-mm collimation, axial acquisition, 2) 3-mm collimation, helical acquisition, 3) mixed-increment collimation, axial acquisition, and 4) 3-mm collimation, helical acquisition with 50% overlap reconstruction of raw data. Two-dimensional coronal and sagittal reformations and 3-dimensional surface reconstruction images were analyzed for maximum fragment depression, peripheral fragment displacement, fracture pattern classification and quality of image. Specimen dissection established maximal articular surface depression, fragment displacement and actual fracture pattern. RESULTS: None of the 2-dimensional reformations from the 4 protocols proved statistically superior for determining maximal fracture depression, fragment displacement, or fracture classification. There was a trend toward more accurate fracture classification with the mixed-increment axial protocol and the overlap protocol than either of the 3-mm protocols, but this was not statistically significant. All protocols were statistically equivalent in predicting fracture pattern classification using 3-dimensional images. However, the 3-dimensional images were of significantly higher quality when obtained with either the mixed-increment axial protocol or the overlap protocol. CONCLUSIONS: There were no statistically significant differences in the objective assessment of tibial plateau fractures among the 4 different protocols. The 3-dimensional images derived from the mixed-increment axial protocol and the 3-mm helical protocol with 50% overlap reconstruction were of superior quality.

Radiologic case study. Fractures of the foot masquerading as ankle injuries.

An ankle radiographic series frequently is obtained when a patient presents with an acute ankle and foot injury. Although many fractures are confined to the ankle and are readily apparent, fractures of the foot can mimic ankle injuries. It is important to differentiate these fractures of the foot from the more common ankle sprain. Most ankle sprains are treated with ice, compression, and elevation, followed by range-of-motion exercises and progressive weight bearing as tolerated. When foot fractures are not identified, however, lack of appropriate treatment can result in late complications. Concentration on key areas as described here will reduce the incidence of missed fractures of the foot in these patients.

Enlarged peroneal process with peroneus longus tendon entrapment.

A 50-year-old man was treated conservatively for chronic bilateral ankle pain for several years. Plain radiographs obtained following exacerbation of symptoms showed bilateral enlarged peroneal processes. CT and MRI demonstrated bony detail of the unusual processes and also showed isolation of the peroneus longus tendons and associated tendinitis and partial tears.