Apophysitis of the Ischial Tuberosity: A Case Report.

INTRODUCTION: Sports-related recurrent injuries (microtrauma and trauma) of the apophyses are common in children and adolescents and could result in specific pathologies. One of them is the apophysitis or apophysiolysis of ischial tuberosity (Valtancoli or Kremser's disease) due to contraction of hamstrings, in sports with sudden accelerations and decelerations. CASE REPORT: We present the case of a male athlete who complained of pain in the left buttock and difficulty walking after a 3months old reported trauma with pain and hematoma in his left thigh, during a kick with his contralateral leg. Due to a radiographic finding of a suspicious lesion near his left ischial tuberosity, an extensive investigation that included computed tomography, magnetic resonance imaging, bone scintigraphic scan, and blood analysis followed the diagnosis of apophysitis of the ischial tuberosity was determined and the proposed non-surgical treatment had satisfactory results. CONCLUSION: The diagnosis of apophysitis of ischial tuberosity is usually delayed but has a good response to the appropriate treatment.

Symptomatic splenoma (hamartoma) of the spleen. A case report.

Hamartomas of the spleen (splenomas) are very rare benign tumors composed of an aberrant mixture of normal splenic elements. Herein we present a unique case of a symptomatic non-palpable splenoma in a 64-year-old female patient presented with anemia and thrombocytopenia and we describe imaging findings in ultrasound, computed tomography and magnetic resonance imaging. To our knowledge, this is the first case of a relatively small splenic hamartoma (35 mm at histopathology) associated with thrombocytopenia and anemia that resolved completely several months after splenectomy.

Evaluation of popliteal arteries with CT angiography in popliteal artery entrapment syndrome.

BACKGROUND: Popliteal artery entrapment is an uncommon clinical entity that occurs due to compression of the popliteal artery by adjacent muscle and tendinous structures. Early diagnosis should be established through a combined approach of careful physical examination and history-taking, duplex ultrasonography, and CT angiography. PATIENTS AND METHODS: We have studied retrospectively 16 patients of popliteal artery entrapment syndrome, 9 men and 7 women. All patients were scanned with a scanner Picker PQ 5000 after bolus injection of nonionic contrast medium and they all underwent a two-part examination first, with the knee in a neutral position, and, second, with the knee hyperextended. RESULTS: At the second phase of the examination 3 patients showed normal findings, 10 patients have shown mild stenosis of the popliteal artery or more severe stenosis due to compression, 2 patients have exhibited bilateral stenosis and 1 patient has also showed popliteal venous compression. CONCLUSION: CT angiography images and three-dimensional images are useful not only for depiction of the arterial changes but also identification of the abnormal anatomic structures responsible for the entrapment.

Enhancement of virchow-robin spaces. An MRI evaluation.

Virchow-Robin spaces are enclosed spaces filled with interstitial fluid and covered with pia that accompany arteries, arterioles, veins and venules as they perforate the brain. They are round, linear or punctuate areas depending on the image that parallel cerebrospinal fluid attenuation or signal intensity. They are classically described as isointense to cerebrospinal fluid on images obtained with all pulse sequences. They appear hypointense relative to brain on T1-weighted MR scans and present a high signal intensity on T2-weighted MR scans. They also show complete signal suppression on fluid-attenuated inversion recovery (FLAIR) scans and no enhancement after intravenous contrast administration. However, many pathologic states result in abnormal dilation with an increased number of Virchow-Robin spaces visible on MRI imaging and many pathological conditions cause the spaces to enhance. The purpose of this study is to present the major causes of Virchow-Robin enhancement.

Enhancement of robin-virchow spaces MRI evaluation.

The perivascular spaces are normally microscopic. Even in normal brain some Robin-Virchow spaces are usually seen in the area of substantia innominata at the level of anterior commissure. Many pathologic states result in abnormal dilatation with an increased number of spaces visible on MRI imaging. Dilatation is most commonly associated with anterior abnormalities that arise due to aging, diabetes, hypercholesterolemia, smoking, hypertension and other vascular risk factors. The precise etiology of dilatation is currently unknown.

Falx Cerebri Ossification: CT and MRI Evaluation.

During the last three years, CT and MRI brain scans of 40 patients revealed falx cerebri partial ossification as an incidental finding. The patients had been admitted for brain CT and MRI for several reasons. In most cases, there was no problem in the differential diagnosis of falx cerebri ossification during interpretation of the cases. In a few cases, the lesion should be distinguished from calcified meningioma, small hematoma in the interhemispheric fissure and in one case there was also meningeal infiltration of breast cancer. In these cases both CT and MRI scans of the brain were evaluated and a definite diagnosis was made.

Extramedullary paraspinal hematopoiesis in thalassemia: CT and MRI evaluation.

We present a comparative CT and MRI study of the paraspinal extramedullary hematopoiesis in 32 thalassemic patients. The patients were classified into four groups according to the MRI and CT imaging findings. Active recent extramedullary paraspinal hematopoietic masses show soft tissue behavior in both CT and MRI. Older inactive masses reveal iron deposition or fatty replacement. Combined imaging findings of paraspinal extramedullary hematopoiesis revealed the phase of its evolution and the correct diagnosis.