Evaluation of a surgical training programme for clinical officers in Malawi.

BACKGROUND: Shortages of specialist surgeons in African countries mean that the needs of rural populations go unmet. Task-shifting from surgical specialists to other cadres of clinicians occurs in some countries, but without widespread acceptance. Clinical Officer Surgical Training in Africa (COST-Africa) developed and implemented BSc surgical training for clinical officers in Malawi. METHODS: Trainees participated in the COST-Africa BSc training programme between 2013 and 2016. This prospective study done in 16 hospitals compared crude numbers of selected numbers of major surgical procedures between intervention and control sites before and after the intervention. Volume and outcomes of surgery were compared within intervention hospitals between the COST-Africa trainees and other surgically active cadres. RESULTS: Seventeen trainees participated in the COST-Africa BSc training. The volume of surgical procedures undertaken at intervention hospitals almost doubled between 2013 and 2015 (+74 per cent), and there was a slight reduction in the number of procedures done in the control hospitals (-4 per cent) (P = 0·059). In the intervention hospitals, general surgery procedures were more often undertaken by COST-Africa trainees (61·2 per cent) than other clinical officers (31·3 per cent) and medical doctors (7·4 per cent). There was no significant difference in postoperative wound infection rates for hernia procedures at intervention hospitals between trainees and medical doctors (P = 0·065). CONCLUSION: The COST-Africa study demonstrated that in-service training of practising clinical officers can improve the surgical productivity of district-level hospitals.

Post-transfer outcomes in cultured bovine embryos supplemented with epidermal growth factor, fibroblast growth factor 2, and insulin-like growth factor 1.

This work examined the downstream fetal and placental outcomes of introducing a cocktail of uterine-derived growth factors during bovine embryo culture. Abattoir-derived bovine oocytes were matured and fertilized in vitro. On day 4 post-fertilization, ≥ 8-cell embryos were harvested, pooled and exposed to an embryokine mix, termed EFI, which contained recombinant human epidermal growth factor (10 ng/ml), bovine fibroblast growth factor-2 (10 ng/ml) and human insulin-like growth factor 1 (50 ng/ml) or to a carrier-only control treatment (CON). On day 7, individual, transfer-quality embryos were transferred to recipients. Timed ovulation was completed in mature, non-suckled commercial beef cows. Cows either were artificial inseminated (AI) or received an embryo (ET) on day 7 post-estrus (n = 23-31 cows/treatment over 4 replicate studies). The percentage of grade 1 and 2 morulae and blastocysts was greater (P < 0.05) for EFI-treated embryos than CON. The percentage of pregnant cows diagnosed by transrectal ultrasonography did not differ among the AI and ET groups on days 28, 42 and 56 post-estrus. There also were no differences in the ratio of male to female fetuses determined on day 60 post-estrus by transrectal ultrasonography. On day 21 post-estrus, the relative abundance of three interferon-stimulated gene (ISG) transcripts in peripheral leukocytes were not different based on AI/ET group or the sex of the conceptus. Circulating pregnancy-associated glycoprotein (PAG) concentrations differed (P < 0.05) among days. Also, a difference in PAG concentrations (P < 0.05) were detected between male and female pregnancies in the CON-ET group but not in the AI or EFI-ET groups. Crown-rump length was not affected by AI/ET group on day 42 but were less (P < 0.05) in the CON and EFI-ET groups than the AI group on day 56. These findings implicate EFI supplementation as a means for improving transferable embryo production in a bovine IVP system, but it is not clear if this treatment improves embryo competency after ET.

Exposure to maternal obesity alters gene expression in the preimplantation ovine conceptus.

BACKGROUND: Embryonic and fetal exposure to maternal obesity causes several maladaptive morphological and epigenetic changes in exposed offspring. The timing of these events is unclear, but changes can be observed even after a short exposure to maternal obesity around the time of conception. The hypothesis of this work is that maternal obesity influences the ovine preimplantation conceptus early in pregnancy, and this exposure will affect gene expression in embryonic and extraembryonic tissues. RESULTS: Obese and lean ewe groups were established by overfeeding or normal feeding, respectively. Ewes were then bred to genetically similar rams. Conceptuses were collected at day 14 of gestation. Morphological assessments were made, conceptuses were sexed by genomic PCR analysis, and samples underwent RNA-sequencing analysis. While no obvious morphological differences existed between conceptuses, differentially expressed genes (≥ 2-fold; ≥ 0.2 RPKM; ≤ 0.05 FDR) were detected based on maternal obesity exposure (n = 21). Also, differential effects of maternal obesity were noted on each conceptus sex (n = 347). A large portion of differentially expressed genes were associated with embryogenesis and placental development. CONCLUSIONS: Findings reveal that the preimplantation ovine conceptus genome responds to maternal obesity in a sex-dependent manner. The sexual dimorphism in response to the maternal environment coupled with changes in placental gene expression may explain aberrations in phenotype observed in offspring derived from obese females.

Maternal obesity alters the expression of embryonic regulatory transcripts in the preimplantation ovine conceptus.

The influence of exposure to overfeeding-induced maternal obesity around the time of conception on early embryogenesis was examined in the day 14 ovine conceptus. The relative abundance of FGFR2 and DNMT1 was influenced by maternal obesity status and conceptus sex, and the abundance of PPARG and PTGS2 transcripts was greater in male conceptuses regardless of the obesity status of the ewe. These observations demonstrated that short-term exposure to maternal obesity impacts early conceptus transcript patterning.

Respiratory infection risk in athletes: association with antigen-stimulated IL-10 production and salivary IgA secretion.

The purpose of this study was to examine factors influencing susceptibility to upper respiratory tract infections (URTI) in 18-35-year-old men and women engaged in endurance-based physical activity during the winter months. Eighty individuals (46 males, 34 females) provided resting blood and saliva samples for determination of markers of systemic immunity. Weekly training and illness logs were kept for the following 4 months. Thirty subjects did not experience an URTI episode and 24 subjects experienced 3 or more weeks of URTI symptoms. These illness-prone subjects had higher training loads and had ∼2.5-fold higher interleukin (IL)-4 and IL-10 production by antigen-stimulated whole blood culture than the illness-free subjects. Illness-prone subjects also had significantly lower saliva S-IgA secretion rate and higher plasma IgM (but not IgA or IgG) concentration than the illness-free subjects. There were no differences in circulating numbers of leukocyte subtypes or lymphocyte subsets between the illness-prone and illness-free subjects. The production of IL-10 was positively correlated and the S-IgA secretion rate was negatively correlated with the number of weeks with infection symptoms. It is concluded that high IL-10 production in response to antigen challenge and low S-IgA secretion are risk factors for development of URTI in physically active individuals.

Is it necessary to use a noseclip in the performance of spirometry using a wedge bellows device?

There is no current consensus among published guidelines on whether noseclips are required during spirometry testing. This study investigated the effect of noseclips on spirometric measurements in patients with a range of disease. Fifty-two patients (30 male; mean age 58.0 years, range 19-78; mean FEV1 82.6% predicted, range 23.8-128.3%) performed measurements of VC, FVC and FEV1 according to ARTP/BTS guidelines (1994) using a wedge bellows spirometer (Vitalograph Model S, Bucks, U.K.). All patients performed two sets of measurements (with and without noseclips) in random order (Group 1 = noseclips first; n=30; Group 2 (without noseclips first, n=22). Tests were conducted by qualified physiologists. Measurements obtained with and without the use of noseclips were similar (mean differences FEV1 -0.030 L SD 0.210 and -0.005 L SD 0.093 for Groups 1 and 2 respectively; FVC -0.007 L SD 0.109 and -0.040 L SD 0.117; VC 0.036L SD 0.137 and -0.040 L SD 0.150) and were not dependent on patient group or previous test experience. Four patients had differences outside the 95% confidence limits for each parameter. There were no significant correlations between the differences with and without noseclips and severity of lung disease, age, smoking history, BMI or lung volume (all P > 0.100). The within patient coefficient of variation did not depend on the testing method. Use of noseclips during spirometry does not systematically affect the results obtained or the within-subject repeatability. Marked individual differences highlight the importance of maintaining consistency in the method adopted for a particular patient.

Families' perception of the value of timed daily "family rounds" in a trauma ICU.

Daily communications between the ICU trauma patients' families and the trauma team are often limited due to the unpredictable nature of subsequent patient admissions and operative procedures. In order to improve the lines of family-physician communication and educate residents regarding family communication, our level I trauma center instituted daily "Family Rounds" (FR). FR occur at the same time every day, in the patient's ICU room. The purpose of this study was to determine whether families valued the scheduled daily FR, to establish whether FR improved the family-physician relationship, and to delineate strengths and weaknesses of the present structure of our FR. We mailed surveys to family members of trauma patients hospitalized in the trauma ICU for > or = 3 days. A total of 55 (22%) families responded. Combining "excellent" and "good" responses, 86.5 per cent of families looked forward to having a specific time of day to meet with the trauma team, and 90 per cent liked having rounds in the ICU room with the patient. However, 36 per cent did not like having only scheduled time for FR. The majority, 75 per cent, believed that all concerns were addressed during FR, and 84.9 per cent rated their overall experience as either excellent or good. Scheduled FR appear to improve communication between trauma surgeons and patients' families, enhance the family-physician relationship, and strengthen our surgical residency teaching program.

Superovulation and embryo recovery from peripubertal Holstein heifers.

The use of peripubertal donors in embryo transfer (ET) programs presents significant opportunity to accelerate genetic gain in domestic livestock by reducing the generation interval. These studies were designed to evaluate feasibility of superovulation and embryo recovery in peripubertal heifers (starting at 7.8 months of age), and to determine whether subsequent reproductive and lactational performance of donor heifers were impaired. Study 1 utilized 10 pairs of contemporary full-sibling heifers in which one heifer in each pair was assigned to receive a superovulation regimen and her full-sibling contemporary received placebo. Treated heifers were artificially inseminated at estrus and embryos were flushed transcervically 4-6 days later. Based on recovery of oocytes and/or embryos, 9 of 10 heifers responded to the hormonal regimen and 12 total embryos were recovered. Seven embryos (58%) were transferred into recipients resulting in five pregnancies. Control and treated heifers remained in the herd and were bred at a natural estrus by AI at 15 months of age. Lactation records, i.e., 305 days mature equivalent (305 d ME) were obtained, and all animals were evaluated for udder conformation traits between 32 and 38 months of age. Reproductive traits (age at first calving and days to conception) and lactational traits of heifers subjected to embryo transfer and their non-treated full-siblings did not differ (P > 0.05). Study 2 was conducted to establish the commercial feasibility of hormonally programming peripubertal heifers ranging in age from 7.8 to 9.9; 10 to 11.9; 12 to 13.9 and >/= 14 months. In total, 3982 embryos were recovered from 520 heifers, with 2419 (60.7%) of those categorized as viable (transferable). The number of ova/embryos obtained per flush (5.6 +/- 1.0) and the number of transferable embryos (2.8 +/- 0.5) was reduced (P < 0.05) in heifers of age 7.8-9.9 months compared to all other age groups. There was no difference (P > 0.05) in the number of ova/embryos recovered (7.8 +/- 0.3), or the number of transferable embryos (4.8 +/- 0.2), among heifers that were >/=10 months of age. The number of unfertilized ova did not differ by age, however, more degenerate embryos tended to be recovered from heifers <10 months of age compared to heifers >/=14 months of age. These data indicate that transferable embryos can be safely recovered from heifers beginning at 10 months of age without compromising subsequent reproductive or lactational performance of the donor.

Effect of epidermal growth factor and insulin-like growth factor I on porcine preantral follicular growth, antrum formation, and stimulation of granulosal cell proliferation and suppression of apoptosis in vitro.

The object of this study was to investigate the role of epidermal growth factor (EGF) and IGF-I in the regulation of preantral follicular growth, antrum formation, and granulosal cell proliferation/ apoptosis. Porcine preantral follicles were manually dissected and cultured for up to 8 d in Waymouth's (Exp. 1) or alpha-minimum Eagle's essential medium (Exp. 2 and 3) supplemented with 10 microg/mL of transferrin, 100 microg/mL of L-ascorbic acid, and 2 mU/mL of ovine FSH, in the presence (Exp. 1 and 3) or absence (Exp. 2) of 7.5% fetal calf serum. According to the experimental protocol, IGF-I (0, 1, 10, or 100 ng/mL; Exp. 1), or IGF-I (50 ng/mL), EGF (10 ng/mL) and EGF+IGF-I (Exp. 2 and 3) were added to the culture media. In Exp. 1, follicles exhibited a concentration-dependent response (P < 0.05) to IGF-I, with the highest rates of granulosal cell proliferation, follicular integrity, and recovery rate of cumulus cell-oocyte complexes and lowest incidence of apoptosis occurring at the highest IGF-I dose. In Exp. 2 serum-free medium, granulosal cell proliferation was low (1 to 5%), irrespective of whether EGF and/or IGF-I were present and cellular apoptosis was increased (P < 0.05) on d 4 and 8 in the EGF+IGF-I group compared with the addition of either factor alone. In Exp. 3, granulosal cell proliferation was high in all follicles cultured in serum-containing medium for the first 3 d, but fell sharply (P < 0.05) on d 4, except in media containing IGF-I. Collectively, EGF and IGF-I increased granulosal cell proliferation, decreased apoptosis, and promoted follicular antrum formation. These results may provide useful information for developing a preantral follicular culture system in which the oocytes are capable of fertilization and embryonic development.

Oviduct-specific glycoprotein modulates sperm-zona binding and improves efficiency of porcine fertilization in vitro.

Oviduct-specific glycoprotein (OGP) displays estrus-associated regional and temporal differences in expression and localizes to the zona pellucida, perivitelline space, and plasma membrane of oviductal oocytes and embryos, suggesting that it may have a role in regulation of fertilization and/or early embryonic development. The aims of this study were to evaluate the effect of exogenous OGP on in vitro fertilization (IVF) and embryo development in the pig using a defined serum-free culture system. In vitro-matured porcine oocytes were incubated with homologous OGP (0, 1, 10, 20, and 40 microg/ml) for 3 h and then washed prior to IVF. Exposure of oocytes to 10 or 20 microg/ml porcine OGP (pOGP) significantly reduced the incidence of polyspermy compared with the control (P < 0.01) while maintaining high penetration rates. When oocytes, spermatozoa, or both were preincubated with 10 microg/ml pOGP prior to IVF, the incidence of polyspermy was similarly reduced (P < 0.01) by all three treatments without affecting penetration rates. The ability of spermatozoa to undergo calcium ionophore-induced acrosome reaction was similar with or without exposure to pOGP. However, significantly fewer spermatozoa (P < 0.01) bound to the zona pellucida when oocytes were preincubated with pOGP. To evaluate the effect of pOGP on embryo development, embryos were cultured in pOGP-supplemented medium for 48 h or 144 h. Both transient and continuous exposure to pOGP significantly enhanced cleavage and blastocyst formation rate compared with the control (P < 0.01). These data demonstrate that exposure of either in vitro-matured oocytes or spermatozoa to pOGP decreased polyspermy and spermatozoa binding while maintaining high penetration rates of pig oocytes fertilized in vitro. Furthermore, pOGP exerted an embryotrophic effect independent of effects demonstrated on spermatozoa and oocytes at fertilization.

Clinical imaging of articular cartilage in the knee.

Assessment of articular cartilage has become an essential part of magnetic resonance (MR) evaluation of the knee. This has occurred because of recent advances in treatment along with improved accuracy of MR image evaluation of articular cartilage. Detection of articular cartilage defects can provide an explanation for symptoms and allow identification of patients for cartilage therapy and is an important factor for predicting prognosis of patients with knee injury. This review describes the most easily implemented MR techniques for evaluation of articular cartilage and the normal and abnormal appearance of cartilage seen using these techniques. The influence of imaging findings on treatment is described.

Magnetic resonance imaging of articular cartilage.

Magnetic resonance imaging is the optimal modality for assessing articular cartilage because of superior soft tissue contrast, direct visualization of articular cartilage, and multiplanar capability. Despite these advantages, there has been disagreement as to the efficacy of magnetic resonance imaging of articular cartilage. The reason for this controversy is multifactorial but in part is attributable to the lack of the use of optimized pulse sequences for articular cartilage. The current authors will review the current state of the art of magnetic resonance imaging of articular cartilage and cartilage repair procedures, discuss future new directions in imaging strategies and methods being developed to measure cartilage thickness and volume measurements, and propose a magnetic resonance imaging protocol to evaluate cartilage that is achievable on most magnetic resonance scanners, vendor independent, practical (time and cost efficient), and accepted and used by a majority of musculoskeletal radiologists.

Magnetic resonance imaging of articular cartilage of the knee.

Recently developed magnetic resonance (MR) imaging techniques allow accurate detection of moderate- and high-grade articular cartilage defects. There has been increased interest in MR imaging of articular cartilage in part because it is useful in identifying patients who may benefit from new articular cartilage replacement therapies, including chondrocyte transplantation, improved techniques for osteochondral transplantation, chondroprotective agents, and cartilage growth stimulation factors. The modality also has the potential to play an important role in the follow-up of patients during and after treatment. Detection of articular cartilage defects is beneficial for patients undergoing arthroscopy for other injuries, such as meniscal tears, because the presence of articular cartilage injury worsens prognosis and may modify therapy options.

Central osteophytes in the knee: prevalence and association with cartilage defects on MR imaging.

OBJECTIVE: The objective of this study was to determine the prevalence and location of central osteophytes in patients referred for MR imaging of the knee and the relationship of central osteophytes to articular cartilage defects, marginal osteophytes, meniscal tears, and anterior cruciate ligament tears as seen on MR imaging. MATERIALS AND METHODS: Two hundred consecutive patients referred for MR imaging of the knee were evaluated for central osteophytes, articular cartilage defects, marginal osteophytes, meniscal tears, and anterior cruciate ligament tears. A 1.5-T scanner was used, and assessments were made by consensus of two experienced musculoskeletal radiologists. Seven patients were excluded, leaving 193 patients in the study population. RESULTS: The prevalence of central osteophytes in the knee was 15% (35 central osteophytes in 29 patients). Patients with central osteophytes were older (mean age, 52 years versus 38 years), weighed more (mean weight, 204 lb [92 kg] versus 174 lb [78 kg]), had more articular cartilage defects (mean, 4.3 versus 1.3), and had more marginal osteophytes (mean, 3.9 versus 1.1) than patients without central osteophytes (p < 0.0001, Student's t test). Patients with central osteophytes were more likely to have a meniscal tear (p = 0.004, chi-square test), but they were not more likely to have an anterior cruciate ligament tear. All central osteophytes were associated with articular cartilage defects at the same location, which were full or near-full thickness on MR imaging for 32 of 35 central osteophytes. CONCLUSION: Central osteophytes are common in patients referred for MR imaging of the knee. When central osteophytes are seen in the knee there is a high likelihood of an associated full thickness or near-full thickness articular cartilage defect.

Identification of a heparin-binding protein in bovine seminal fluid as tissue inhibitor of metalloproteinases-2.

Presence or absence of three distinct bovine seminal heparin-binding proteins (21-31 kDa) recognized in sperm extracts by a monoclonal antibody, M1, is a diagnostic indicator of fertility differences among bulls producing normal semen. We recently identified a 31 kDa fertility-associated antigenin bovine seminal fluid as a unique DNase I-like protein. We now report purification and identification of a 24 kDa seminal heparin-binding protein (HBP-24) recognized by M1. N-terminal microsequence analysis of HBP-24 purified from seminal fluid yielded 20 amino acid residues that displayed 90% identity to the N-terminus of a bovine metalloproteinase inhibitor identified as tissue inhibitor of metalloproteinases-2 (TIMP-2). A single immunoreactive band migrating at 24 kDa was detected in Western blots of cauda epididymal sperm extracts following incubation with purified seminal heparin-binding proteins and subsequent washing in vitro, indicating TIMP-2 bound to sperm membranes. Expression of TIMP-2 mRNA was detected by RT-PCR in bovine bulbourethral gland, prostate, and seminal vesicles. Mobility of the 24 kDa heparin-binding protein increased under nonreducing SDS-PAGE to approximately 21 kDa, characteristic of the reported molecular mass of TIMP-2. To our knowledge, this is the first report of TIMP-2 binding to spermatozoa and of TIMP-2 mRNA expression in bovine accessory sex glands. These results corroborate previous reports regarding the site of production of heparin-binding proteins that are related to bull fertility, and suggest that TIMP-2 influences fertility of bulls, either through inhibition of metalloprotease activity in semen or via undefined activities independent of matrix metalloproteinase (MMP) inhibition.

Superior labral anterior posterior (SLAP) lesions of the glenoid labrum: reliability and accuracy of MR arthrography for diagnosis.

PURPOSE: To determine the reliability and accuracy of magnetic resonance (MR) arthrography for the diagnosis of superior labral anterior posterior (SLAP) tears. MATERIALS AND METHODS: The MR arthrograms in 80 patients who underwent arthroscopy and MR arthrography during a 54-month period were retrospectively reviewed. MR arthrograms were independently scored by three observers for the presence and type of SLAP lesion. Type I SLAP lesions were regarded as negative as they most often are not clinically relevant. Interobserver agreement for detection of SLAP lesions was calculated by using kappa coefficients. The differences in areas under the receiver operating characteristic (ROC) curves were assessed with a univariate z score test. RESULTS: At arthroscopy, there were 25 SLAP tears: type II (n = 22), type III (n = 2), and type IV (n = 1). Sensitivity, specificity, and accuracy of each reader were 92%, 84%, and 86%; 92%, 82%, and 85%; and 84%, 69%, and 74%, respectively. Interobserver agreement for SLAP tears was substantial (kappa = 0.77) to moderate (kappa = 0.52, kappa = 0.44). The areas under the ROC curves for each reader were 0.94, 0.93, and 0.83, which were not significantly different. CONCLUSION: MR arthrography of the shoulder is reliable and accurate for detection of SLAP tears.

Bone marrow edema in the greater tuberosity of the humerus at MR imaging: association with rotator cuff tears and traumatic injury.

UNLABELLED: The purpose of this study was to determine the prevalence of bone marrow edema in the greater tuberosity of the humerus on MR imaging, the association with other findings at MR imaging and the injury mechanism which can lead to this finding. SUBJECTS AND METHODS: MR reports from 863 patients referred for shoulder MRI over 74 months were reviewed to identify patients with marrow edema in the greater tuberosity. The MR images from patients with greater tuberosity marrow edema were reviewed by consensus of two radiologists for the extent of marrow edema and for associated injuries. Marrow edema in the greater tuberosity was seen in 11 of 863 patients (1.3%). Nine patients (82%) had associated rotator cuff tear by MR imaging (four full thickness and five partial thickness), one patient had avulsion of the greater tuberosity from the humerus, and one had no rotator cuff abnormality. History of trauma was reported by eight patients including fall without direct blow to the shoulder (6), car accident (1) and direct blow to the top of the shoulder (1). Marrow edema in the greater tuberosity is an infrequent finding. Marrow edema most often is associated with a history of trauma and with rotator cuff abnormalities including full thickness tears. The history of trauma without direct blow to the shoulder and the location of the edema indicates that marrow edema often results from avulsion injury by the supraspinatus tendon.

MR imaging of articular cartilage.

With the advent of new treatments for articular cartilage disorders, accurate noninvasive assessment of articular cartilage, particularly with MR imaging, has become important. Understanding the MR imaging features of articular cartilage has led to the development of two types of routinely available MR imaging techniques which have demonstrated clinical accuracy and interobserver reliability.

Articular cartilage defects: in vitro evaluation of accuracy and interobserver reliability for detection and grading with US.

PURPOSE: To determine the accuracy and reliability of detecting and grading articular cartilage defects in porcine and human knees by using ultrasonography (US). MATERIALS AND METHODS: US was used to evaluate 175 porcine and 16 human knee surfaces with a linear 5-12-MHz transducer. Porcine defects of varying diameter and depth were surgically created. Each porcine surface was independently assessed in blinded fashion by two radiologists for the presence and severity of defects. Accuracy of detection, interobserver reliability, and concordance between US and surgical grades were determined. Human specimens were retrieved from knees of patients who underwent joint arthroplasty. Defects in human knees detected with US were correlated with defects seen at direct surface visualization. RESULTS: Sensitivities for detection of porcine defects were 94% and 93% for readers 1 and 2, respectively; specificities were 90% and 77%, respectively; positive predictive values were 98% and 95%, respectively; and negative predictive values were 78% and 73%, respectively. Interobserver agreement was high (weighted kappa = 0.80), and concordance between US and surgical grades for both readers was high (weighted kappa = 0.90 and 0.78). In human cartilage, the distribution of cartilage denudation determined at US was the same as that determined at direct visualization. CONCLUSION: High-frequency US was accurate and reliable for detection and grading of knee articular cartilage defects.

Chondroblastoma: MR characteristics with pathologic correlation.

PURPOSE: The purpose of this study was to describe the MR findings of chondroblastoma with pathologic correlation. METHOD: In 22 patients with pathologically proven chondroblastoma, MR signal characteristics were correlated with pathological findings. RESULTS: On T2-weighted images, 12 (55%) lesions were hyperintense with hypointense areas in 9 lesions, whereas 10 (45%) were hypointense. Therefore, 19 of 22 (86%) lesions with pathologic correlation had hypointense areas entirely (n = 10) or partly (n = 9) on T2-weighted images. On gadolinium-enhanced images, 13 (59%) lesions showed lobular enhancement and 9 (41%) showed marginal and septal enhancement. Low signal intensity on T2-weighted MR images was most strongly associated with an abundance of immature chondroid matrix, hypercellularity of the chondroblasts, calcifications, and hemosiderin on histology. CONCLUSION: Chondroblastoma was found to show hypointense portions on T2-weighted images. Signal intensity on T1- and T2-weighted MR images in chondroblastoma was dependent on the amounts of histopathological components.