Synchronous large tumoral pseudoangiomatous stromal hyperplasia (PASH) in the breast and axilla with subsequent carcinoma in the contralateral breast: routine and strain imaging with histopathological correlation.

Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast disorder with the tumoral variety being extremely rare. We report a rare case of synchronous, massive axillary and breast tumoral PASH in a 55-year-old post-menopausal woman. Mammography, ultrasonography and sonoelastography features are illustrated with histopathological correlation. A high-grade invasive ductal carcinoma was detected in the contralateral breast on annual follow-up imaging. Radiologists need to be familiar with the imaging appearances of PASH and be aware of its association with subsequent cancer risk. To the best of our knowledge, the present case of synchronous tumoral PASH in the breast and axillary tissue is the second reported case till now.

Medial notch of the superior border of the scapula: a rare anatomical variation mimicking a bone tumour.

The scapula is a flat, triangular bone overlying the posterior chest wall and forming the posterior aspect of the shoulder girdle. To the best of our knowledge, there is no previous description of a notch of the medial aspect of the superior border of the scapula in the literature. The imaging findings of a supero-medial scapula border notch mimicking a bone tumour are presented in this case report.

MRI in necrotizing fasciitis of the extremities.

Necrotizing fasciitis is a life-threatening soft-tissue infection of bacterial origin, which involves mainly the deep fascia. Early recognition of this condition may be hampered by the uncommon nature of the disease and non-specificity of initial clinical signs and symptoms in less fulminant cases, making the role of imaging important. MRI is the most useful imaging modality in the diagnosis of necrotizing fasciitis. The presence of thick (>3 mm) hyperintense signal in the deep fascia (particularly intermuscular fascia) on fat-suppressed T2 weighted or short tau inversion-recovery images is an important marker for necrotizing fasciitis. Contrast enhancement of the thickened necrotic fascia can be variable, with a mixed-pattern of enhancement being more commonly encountered. Involvement of multiple musculofascial compartments increases the likelihood of necrotizing fasciitis. It is important to remember that T2-hyperintense signal in the deep fascia is not specific to necrotizing fasciitis and can also be seen in cases such as non-infective inflammatory fasciitis or muscle tear. In this pictorial essay, we aim to review the MRI findings in necrotizing fasciitis, discuss its limitations and pitfalls and identify differentiating features from non-necrotizing soft-tissue infections, such as cellulitis and infective myositis/pyomyositis, conditions which may clinically mimic necrotizing fasciitis.

Getting to know journal bibliographic databases.

A bibliographic database is an organised digital collection of references to published literature. A bibliographic database may be general in scope or may cover a specific academic discipline. There are many types of medical and general bibliographic databases. They cover biomedical and scientific literature, morbidity and mortality statistics, therapeutic regimens, medical records, images and reviews of evidence-based medicine. Getting to know these databases will help researchers and authors to enhance their writing and publishing endeavours.

Writing an invited commentary.

An invited commentary is a short article that describes an author's personal experience of a specific topic. Unlike a review article, the author gives his own opinions and perspectives. It typically addresses a current, hot and often controversial subject. It may take two formats, namely, provide an expert author's personal views of and insight into a current hot topic, or add balance to another paper being commented upon, with addition of the author's own perspective.

Writing a pictorial essay.

A pictorial essay is a type of educational article that aims to provide both textual and visual portrayals of a topical issue. It usually consists of a short unstructured abstract, brief introduction, subheadings to organise the material and a summary. The number of references is limited to a few key articles, typically, eight to 15, or fewer. The text is usually short, often approximately 1,000 to 2,000 words in length, with much of the message contained in the figure legends. This type of article allows for a large number of figures, typically up to 20 figures or 30 figure parts. The main criteria for publication are currency, educational value and high quality of illustrations.

Writing a technical note.

A technical note is a short article giving a brief description of a specific development, technique or procedure, or it may describe a modification of an existing technique, procedure or device applicable to medicine. The technique, procedure or device described should have practical value and should contribute to clinical diagnosis or management. It could also present a software tool, or an experimental or computational method. Technical notes are variously referred to as technical innovations or technical developments. The main criteria for publication will be the novelty of concepts involved, the validity of the technique and its potential for clinical applications.

Writing a case report.

A case report is a description of a single case with unique features. This includes a previously-unreported clinical condition, previously-unreported observation of a recognised disease, unique use of imaging or diagnostic test to reveal a disease, previously-unreported treatment in a recognised disease, or previously-unreported complication of a procedure. Case reports should be short and focused, with a limited number of figures and references. The structure of a case report usually comprises a short unstructured (or no) abstract, brief (or no) introduction, succinct but comprehensive report of the case, and to-the-point discussion.

Imaging of giant cell tumour of the tendon sheath.

Giant cell tumours of the tendon sheath (GCTTS) and pigmented villonodular synovitis (PVNS) are part of a spectrum of benign proliferative lesions of synovial origin that may affect the joints, bursae and tendon sheaths. This review article describes the clinicopathological features and imaging findings in patients with GCTTS. GCTTS usually presents as a soft tissue mass with pressure erosion of the underlying bone. Magnetic resonance (MR) imaging of GCTTS typically shows low to intermediate signal on T1- and T2-weighted spin-echo sequences due to the presence of haemosiderin, which exerts a paramagnetic effect. On gradient-echo sequences, the paramagnetic effect of haemosiderin is further exaggerated, resulting in areas of very low signal due to the blooming artefact. Ultrasonography shows a soft mass related to the tendon sheath that is hypervascular on colour or power Doppler imaging.

Publication ethics and scientific misconduct.

To maintain the readers' trust and to uphold the journal's reputation, it is paramount for the entire research, peer reviewer and publication process to follow ethical principles and decisions. Studies involving humans, animals, medical records and human tissues/organs need to be conducted ethically, and the appropriate approvals obtained. The privacy and confidentiality of patients, authors and reviewers should be respected. When required, rights and permissions should be sought. Common forms of scientific misconduct include misappropriation of ideas, violation of generally accepted research practices, failure to comply with legislative and regulatory requirements, falsification of data, and inappropriate behaviour in relation to misconduct. Authors can expect editorial action to be taken, should duplicate publication, plagiarism and other forms of scientific misconduct be attempted or detected.

Dealing with returned manuscripts.

It is useful for authors to learn to deal with returned manuscripts with a rejection decision or a request for revision. Common reasons for rejection include contents outside the scope of the journal or inappropriate for the journal, incomplete submission, poor methodology, faulty experimental design, major flaws in the interpretation of results, extremely poor writing, and duplicated or plagiarised work. Authors should use the editor's and reviewers' comments to improve their manuscripts and resubmit elsewhere. Common reasons for revision requests include minor faults in the methodology, minor inaccuracies in data, inconsistencies among different sections of the manuscript, faulty deductions, data that do not support the conclusions, excessive data or text, poor or excessive illustrations, and poor but salvageable writing. A request for revision should be viewed positively, as it means that there is a possibility that the manuscript may still be potentially publishable, provided that all the editor's and reviewers' comments are addressed.

Clinics in diagnostic imaging (129). Posterior cruciate ligament ganglion cyst.

Ganglion cysts arising from the posterior cruciate ligament (PCL) of the knee are rare. We describe a 21-year-old Chinese woman who presented with right knee pain following a twisting injury six months prior. Her pain was exacerbated by squatting, although her range of knee motion was full. Magnetic resonance imaging showed a lobulated, well-defined, T1-hypointense and T2-hyperintense, septated cystic mass arising from the posterior aspect of the PCL. The diagnosis of a PCL ganglion cyst was confirmed by computed tomography-guided aspiration of the cyst. Due to persistent mild knee pain, the patient eventually underwent arthroscopic decompression of the ganglion cyst. The clinical features, diagnosis and management of PCL ganglion cysts are discussed.

Role of the manuscript reviewer.

The manuscript reviewer is a key player in the manuscript processing system and journal publication process. The peer review system is an important component of modern scientific publishing, and is a great help to editors in deciding whether or not a submitted manuscript is suitable for publication. The reviewer's responsibilities include protecting the integrity of his or her speciality or subspecialty, the reputation of the scientific journal, and the welfare of human and animal subjects, as well as treating the author's manuscript with respect, fairness and impartiality. The manuscript review should ideally be done in a systemic manner, with components comprising a brief summary and a tabulation of the manuscript analysis under the major headings of strengths, weaknesses, general comments and specific comments.

How a submitted manuscript is processed.

Processing of a submitted manuscript is a complex and time-consuming process. Authors should be aware of items in the editorial office checklist. The journal editors and peer reviewers are an essential part of the manuscript processing system. Copy editors serve as a link between authors and the printer/publisher, and aim to adapt the accepted manuscript to the journal house style and to improve readability of the article.

Preparing the references.

In a scientific paper, the references serve to provide background information and allow the researcher to compare and contrast the work of others in relation to his own study. Authors are responsible for the accuracy of all references cited. The references quoted should be easily accessible and retrievable by anyone wishing to obtain further information. There is a strong preference for citing journal articles listed in PubMed. The two major reference format systems are the Vancouver and Harvard systems, with increasing preference for the Vancouver system. Authors should adhere exactly to the instructions to authors of the target journal.

Preparing a manuscript for submission.

Good manuscripts are sought by journals and publication marks the endpoint of a scientific research project. In preparing a manuscript for submission, the material should be organised into a structure that best showcases the author's material. The manuscript should be written in a style that transmits the author's message with clarity. The author's material should be matched to the most appropriate paper category and the target journal. Having the help of an experienced mentor is invaluable. Authors need to prepare the manuscript meticulously and exactly according to the journal's "Instructions to Authors".

Clinics in diagnostic imaging (127).

A 82-year-old woman presented with left buttock pain radiating to the left anterior knee for four weeks. Magnetic resonance imaging of the lumbar spine showed a rim-enhancing mass in the spinal canal at the level of L3 vertebra suggestive of a sequestered disc, which was subsequently confirmed on decompression laminectomy. The clinical and magnetic resonance imaging features of a sequestered disc and its mimics are discussed.

Authorship and acknowledgements.

All persons designated as authors of a scientific manuscript should qualify for authorship, and all those who qualify should be listed. Each author should have participated sufficiently in the work to take public responsibility for appropriate portions of the content, and have made substantial intellectual contribution to the submitted manuscript. All contributors who do not meet the criteria for authorship should be listed in the acknowledgements section. Ghost authors are undesirable while professional medical writers are helpful to authors who are not native English speakers, have language difficulties, or lack training or expertise in medical writing.

Radiological features of complications of laparoscopic adjustable gastric banding.

PURPOSE: Laparoscopic adjustable gastric banding (LAGB) is used to treat morbid obesity. We reviewed the associated complications with emphasis on radiological features and the role of radiology in suspected complications. MATERIALS AND METHODS: Between 30 January 2001 and 3 October 2006, 313 consecutive LAGB patients' data was entered into a prospective database. A contrast swallow was routinely performed on the first postoperative day, and port adjustments were done at variable intervals. Additional radiological studies were performed in patients with suspected complications. RESULTS: Of 313 patients who underwent LAGB, 46 had 51 complications (16.3%). The commonest complications were LAGB system leakage (5.1%), anterior band slippage (3.5%) and infected port (1.6%). Two mortalities (0.6%), one early and one late, occurred. CONCLUSIONS: LAGB is a relatively low-risk procedure widely performed for treating morbid obesity. Imaging plays a pivotal role in the early evaluation and detection of LAGB complications.

Preparing effective illustrations. Part 1: graphs.

Illustrations (also known as figures) are visual representations of the results obtained from a scientific study. Graphs are a common type of illustration that are often used in scientific papers to present information clearly and effectively, as well as to demonstrate relationships between variables in the data. Graphs also serve to reveal trends or patterns in the data. This article provides some basic guidelines to assist authors in preparing effective graphs for their papers.