Bilateral primary xanthoma of the humeri with pathologic fractures: A case report.

Xanthomas are rare bone tumors that occur more often in the appendicular skeleton and typically appear radiographically benign, with a narrow zone of transition and a sclerotic rim. We report the case of a 57-year-old woman with hyperlipidemia presenting with bilateral shoulder pain after minor trauma. Radiographic and histopathologic investigation demonstrated intraosseous xanthoma with atypical features, including multifocality, a wide zone of transition and pathologic fractures-characteristics more commonly associated with aggressive lesions such as multiple myeloma or metastasis. The diagnosis, imaging, and histological appearance of xanthoma of bone are reviewed.

Gallery of uncommon orthopedic implants: a guide for emergency radiologist.

The purpose of this gallery of orthopedic implants was to provide a reference for emergency radiologists to quickly identify uncommon devices in the shoulders, hips, and extremities. The cases presented in this exhibit will include unusual arthroplasties and prostheses as well as bone graft implants (including allograft and autograft). Bone grafts are frequently used for the treatment of bone defects, which may be caused by trauma, infection, or avascularity. Autogenous cancellous, corticocancellous, or cortical bone grafts are often used, either free or vascularized. Alternative bone graft substitutes are also used. An obvious complication of bone grafts is the failure of incorporation. Joint arthroplasty is the most frequently performed orthopedic procedure after fracture fixation. Major indications include degenerative joint disease, inflammatory arthropathy, avascular necrosis, and complicated fractures. Custom orthopedic implants are frequently used for less common indications or for patients with bone tumors. The common hardware complications are infections, loosening, small particle disease/osteolysis, periprosthetic fracture, hardware fracture or dislocation, and recurrent disease, especially in patients with tumors. Many of the devices used by orthopedic surgeons are infrequently seen in everyday radiology practice. With such variations, correct recognition of the prosthetic devices and their complications is very important. The goal of this exhibit was to familiarize the radiologist with both the normal and abnormal appearance of many atypical orthopedic implants. It is important to understand the purpose and proper function of a device, but not necessarily important to describe every device by its proper brand name. Although this exhibit is not meant to be inclusive of every unusual orthopedic implant, we will present multiple examples of orthopedic hardware involving the shoulder, humerus, elbow, forearm, wrist, hand, pelvis, hip, femur, knee, tibia, ankle, and foot that are not likely seen in everyday practice.

Emergency joint aspiration: a guide for radiologists on call.

Septic arthritis is a disabling and possibly life-threatening disease that requires early diagnosis for optimal management. It is important that clinical and imaging features of septic arthritis be promptly identified. In addition, because other disease entities may have characteristics similar to those of septic arthritis, analysis of a needle biopsy specimen may be necessary for differential diagnosis. Radiologists may be asked to perform emergent aspiration of a possibly infected joint. It is important that those who perform aspiration procedures be familiar with a safe and effective imaging-guided arthrocentesis technique that is tailored to the individual patient and the specific joint affected.