[Importance of MRI in the diagnosis of meniscal ossicle. Apropos of 2 cases]. / Intérêt de l'IRM dans le diagnostic d'ossicule méniscal. A propos de 2 cas.

PURPOSE OF THE STUDY: To determine the contribution of magnetic resonance (MR) imaging in the diagnosis of meniscal ossicle. MATERIALS AND METHODS: Two cases of meniscal ossicle were evaluated by plain radiography and MR imaging. Sagittal and coronal T1-weighted (400/15), proton density and T2-weighted (2,000/20,80) sequences were performed with 0.5 T magnet. RESULTS: Plain radiography revealed a triangular ossified body in the postero-medial aspect of the knee joint. MR images demonstrated that these ossicles were located within the posterior horn of the medial meniscus. The signal of these ossicles was isointense with that of bone marrow in all sequences. CONCLUSION: MR findings allow the diagnosis of meniscal ossicle and help to differentiate it from osteochondral loose body.

Open synovectomy for the prevention of recurrent hemarthrosis of the ankle in patients with hemophilia. A report of five cases with magnetic resonance imaging documentation.

Hemophilic arthropathy is an incapacitating complication of severe hemophilia resulting from recurrent bleeding in the same joint. Open synovectomy has been used since 1969 to prevent recurrent hemarthrosis of target joints. Between 1988 and 1993 we performed open synovectomy of the ankle in five hemophiliacs aged 6 to 9 years with early-stage hemophilic arthropathy. Magnetic resonance imaging proved very useful for evaluating the severity of joint damage, usually underestimated on plain radiographs; for determining the degree of synovial membrane hypertrophy, which is a critical factor in the decision to perform synovectomy; for planning the surgical procedure and for explaining treatment failures. A decrease in the frequency of hemarthrosis episodes occurred in all five ankles. A repeat synovectomy was needed in one case and in another patient the frequency of hemarthrosis episodes increased somewhat after the fourth year. There was no loss of range of motion. Our data suggest that open synovectomy is effective and safe for reducing the frequency of hemarthrosis and that magnetic resonance imaging should be routinely performed before the procedure.

[MRI in infectious and spontaneous tumoral epidural hemorrhagic pathology]. / IRM et pathologie épidurale tumorale infectieuse et hémorragique spontanée.

Several studies have served to underline the interest of MRI in the diagnosis and assessment of epidural abscess and malignant extradural spinal tumors. In our work, one of the quantitatively greatest published to this day, 64 patients presenting epidural pathology were evaluated by means of MRI. All the explorations were brought about through weighted multiplaned sequences T1, T2 and gadolinium injection. The pathological spectrum encountered is comprised of: metastatic extradural spinal tumors (58%), primary extradural spinal tumors (7%), epidural localizations of hematological diseases (9%), epidural abscess (25%), and one case of epidural hematoma. Assessment was brought to bear upon behavior in relation to type of sequence, spread of disease, medullary effects, type of enhancement following gadolinium injection. Degree of correlation with clinical data and surgical findings was also appraised. As concerns tumourous epidural pathology, positive diagnosis due to a lesion hinges upon the T1 and T2 sequences. Gadolinium's contribution is restricted to analysis of perivertebral and vertebral spreading; it also facilitates recognition of the spinal cord in circumferential epiduritis. So much said, gadolinium appears to be essential in frequently less compressive forms of infectious epiduritis; it plays a pronounced role in both follow-up of their evolution and recognition of acute epidural hematoma.

[Luxation of a hypoplastic posterior arch of the atlas. Report of a case]. / Luxation sur hypoplasie d'un hémi-arc postérieur de l'atlas. A propos d'un cas.

A rare case of sagittal dislocation of the hypoplastic right semi-posterior arch of the atlas, complicating a cervical trauma, is described. The authors specify its radiographic and CT appearance. This is a congenital abnormality discovered accidentally, for which no specific surgical treatment was implemented.

[Adamantinoma of the tibia. X-ray computed tomographic and MRI study. Apropos of a case]. / Adamantinome du tibia. Etude tomodensitométrique et par IRM. A propos d'un cas.

Adamantinoma of the long bones in a very rare tumor that mainly affects the tibia. Its diagnosis is difficult both radiologically, as the lesion appears as a poorly specific metaphyseal lacuna with or without periosteal reaction, and histologically. Its prognosis used to be guarded because of recurrence and of possible metastatic diffusion, but it has been considerably improved by wide resection with reconstruction. On the occasion of a new case, the authors describe the appearance observed with MRI and the merits of this examination for the preoperative assessment.

[Intrathoracic chondrosarcoma arising at a rib in a patient with multiple exostoses]. / Chondrosarcome intrathoracique à point de départ costal chez un patient porteur d'une maladie des exostoses multiples.

A case of chondrosarcoma arising from the 7th left rib in a patient with multiple exostosis disease is reported. The initial CT scan feature is a purely intrathoracic mass with a parietal and pericardial junction and calcifications within the tumor. A review of the literature about the costal chondrosarcoma and their CT scan features is done and shows the uncommon initial aspect of this case.