[The Lemierre syndrome: a complicated oropharyngeal infection]. / Het Syndroom van Lemierre: een gecompliceerde orofaryngeale infectie.

The Lemierre syndrome or 'necrobacillosis' is a post angina sepsis caused by an acute oropharyngeal infection with a secondary thrombophlebitis of the internal jugular vein. There are often septic emboli in the lungs, although intestinal organs can also be affected. This syndrome is caused by the strictly anaerobic gram-negative pathogen Fusobacterium necrophorum, sometimes in combination with other pathogens. The patient typically presents with high fever, pain in the neck, malaise and dyspnoea one week after the start of an angina. Plain chest radiograph shows bilateral nodular infiltrates, ultrasound reveals a thrombophlebitis of the internal jugular vein. CT scan can be useful to confirm the diagnosis and possible complications. In the beginning there is often a transient hyperbilirubinemia with toxic inflammatory blood results. Under the correct antibiotic regime complete recovery can be obtained.

MR imaging of intra-osseous hemophilic pseudotumor: case report and review ofthe literature.

Hemophilic pseudotumor (PT) is a very rare complication of hemophilia consisting of a chronic, encapsulated, hemorrhagic fluid collection occurring both in the soft tissues and/or bone. Radiological features of osseous hemophilic PT are nonspecific and mimic several other benign or malignant bone tumors, or infectious processes. Magnetic Resonance Imaging (MRI) findings of PT involving the bone are only rarely described. The appearance on MRI seems non-specific, but invariably there are heterogeneous low- and high-signal intensity areas on both pulse sequences, reflecting the presence of blood products in various stages of evolution. Although the diagnosis is usually made on the location of the lesion and by the knowledge of the underlying disease, the radiologist should be aware of the imaging characteristics, in order to avoid misinterpretation as a tumoral or infectious lesion, as biopsy of these lesions is contraindicated.

The role of the reversed oblique radiograph in trauma of the foot and ankle.

The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected.