Anatomical variations of the trochlear notch angle: MRI analysis of 78 elbows.

BACKGROUND: Little is known about the anatomical variations of the trochlear notch angle, nor do we know whether the cartilaginous layer modifies the trochlear bony contour. Our aim was to assess the variability of the bony and cartilaginous trochlear notch angles. MATERIALS AND METHODS: We assessed 78 healthy elbows (39 patients, 19 females and 20 males) with a mean age of 28 years (range 21-32). High-definition MRI coronal scans at the level of the flexion-extension axis were performed. The cartilage thickness, the notch angle, and trochlear width were calculated at the level of the deepest point of the trochlear sulcus, the edge of the lateral and medial ridge. Patient height was used as indirect measurement of humerus length. Pearson correlation and Student's t tests were performed. RESULTS: Mean cartilage thickness was 1.00 mm (range 0.62-1.83), with significant differences between the medial trochlear ridge and the other landmarks. The notch angle ranged from 124° to 156° (mean 142°) with no differences between the bony and cartilage layers. Trochlear width ranged from 1.57 to 2.75 cm (mean 2.24) and correlated with humerus length. No correlation emerged between the trochlear notch angle, trochlear width, or humerus length. The only significant difference between sexes was the width value, with a wider trochlea in males. CONCLUSIONS: The trochlear notch angle varies considerably, determining anatomical variations in trochlear shape which ranges from less concave to more concave types. Moreover, the cartilaginous layer does not modify this angle at the level examined. These findings may be relevant to anatomical implant design for distal humerus hemiarthroplasty.

Aortic valve stenosis: non-invasive preoperative evaluation using 64-slice CT angiography.

AIM: In patients affected by aortic valve stenosis (AS) it is mandatory to rule out coronary artery disease (CAD). The role of retrospectively ECG-gated 64-slice CT angiography (64-SCTA) was assessed in patients with AS referred for surgical valve replacement. METHODS: Forty-two patients with AS underwent ECG-gated 64-SCTA of thoracic aorta, including the heart and coronary arteries, before surgical valve replacement. Images were evaluated by two independent readers and compared with surgical findings in terms of aortic valve calcification grading, valvular morphology, aortic valve annulus and sino-tubular junction diameters, and valvular area planimetry. Quantitative evaluation of cusps opening was also performed. Finally, the presence of CAD, thoracic aortic aneurysm and left ventricle hypertrophy were assessed. RESULTS: Visualization of the aortic valve without motion artefacts was possible in 38 patients (90.5%). Valvular morphology was correctly assessed in all cases (100%). 64-SCTA correctly determined aortic valve calcification grading and the aortic valve annulus and sinotubular junction diameters in 100% of cases. The aortic valve planimetric area was assessed in 38 cases (90.5%). Ascending aortic aneurysms requiring surgical replacement were detected in 12 patients (28.6%). Significant left ventricle hypertrophy was found in 30 patients (71%). CONCLUSION: Preoperative evaluation of patients undergoing surgical replacement for AS with 64-SCTA is feasible. 64-SCTA can rule out CAD and evaluate the status of the aortic valve and thoracic aorta in the same examination, obtaining relevant information for surgical planning.

Sarcoma botryoides of the uterine cervix in a young woman: a case report.

Among the rhabdomyosarcomas, which represent an uncommon neoplasm of mesoderm origin comprising about 1% of all female genital malignancies, sarcoma botryoides (SB) is an embrional variant usually found in the vagina of infants and young children under 16 years of age. The onset of SB from the uterine cervix is very rare with a peak incidence in the second decade; only a few cases have been published in the international literature so far. The authors report a case of embryonal rhabdomyosarcoma of the uterine cervix which occurred in a young woman treated by radical surgery, followed by adjuvant chemotherapy and radiotherapy.

Pseudomixoma peritonei: a case report.

Pseudomixoma Peritonei (PMP) is an uncommon neoplasm characterised by mucinous ascites and multifocal amorphous mucous substances involving the peritoneal surface, omentum and bowel loops. Although the origin of the Pseudomixoma Peritonei is still unclear, it could be due to the perforation of an ovarian mucinous cystoadenoma or an appendiceal mucocele. The further pelvic dissemination of the endotumor material, which adhere itself into the peritoneal surface, may induce an intra-abdominal transformation of the peritoneal mesothelium into mucin-producing tissue. A case of Pseudomyxoma Peritonei (PMP) which occurred in a young woman is reported.