Problems in aseptic bone necroses diagnostic imaging.

Aseptic bone necroses are a diverse group of diseases, where the bone necrosis is caused without participation of infectious factor. We can divide osteochondroses and aseptic bone necroses brought about by physical factors, some drugs and systemic disorders. Some locations are more frequent than others, although necrosis can be situated in the every bone. The knowledge of typical location, typical age, risk factors and clinical data usually allows to evaluate changes on the plain film and to make a diagnosis. MRI allows detecting the disease in the very early stage; also it is the conclusive examination, when the pathology on the plain film is invisible. On the basis of the MRI some new aseptic bone necroses classification systems were done, which allow planning the therapy. The radiologist - clinicist cooperation is always necessary to make the proper diagnosis.
The proper use of diagnostic imaging allows making quick and proper diagnosis.

The diabetic foot - diagnostic difficulties.

Foot disease is the most common complication of diabetes leading to hospitalization.
Pathologic processes that develop in the diabetic foot depends on:
- vascular problems - septic diabetic foot
- neurologic problems - aseptic diabetic foot
- both vascular and neurologic problems - mixed diabetic foot.
Diagnostic imaging has a great importance in establishing the diagnose, staging of foot changes and plan the treatment. The first choice in the study is still conventional plain x-ray, as a second procedures the US, CT, MRI and scintigraphy should be used.
Authors presents diagnostic difficulties in assessment of diabetic foot lesions.

Diagnostic problems in long bones bending assessment.

Some metabolic disorders and local affection processes taking place in long bones may generate their deflection. It can appear when bones grow irregularly or comes to deformations in consequence of partial or general diminishing of their resistance. Differentiation ot those two cases among other things is the problem of imaging. In our study we have chosen cases of the changed long bones axis making analysis of the reasons based on dihedral pictures.

The radiological image of Paget's didease.

Background. Paget's disease is a metabolic bone disease characterized by excessive bone resorption and activated osteoclasts. The aim of the present study was to examine the localization and extent of lesions, radiological traits, and complications.
Material and methods. During the period 1981-2001. 24 patients (14 women, 10 men) with Paget's disease were examined, using x-rays of the skull, spine, pelvis, and the long bones of the limbs, and computer tomography (1 patient) of the skull and pelvis.
Results. In 15 patients (62,5%), the disease was monoostotic, while in 9 cases (37,5%) it was polyostic. The most common places for changes were in the vault of the skull (9 cases), the tibia (7 cases), the pelvis (5 cases), the femur (3 cases), and the lumbar spine (3 cases). Osteosclerotic changes dominates in the radiological picture. Three of the patients were in the osteolitic phase of Paget's disease.
Conclusions. The radiological picture of fully developed Paget's disease is very characteristic. It is possible to make a diagnosis on the basis of conventional radiography.

Osteomyelitis: always a timely topic.

The present atudy analyzed the usefulness of particular imaging methods in the of non-specific inflammatory lesions in bone tissue. Examples are given osteomyelitic changes in unusual locations and unique courses of illness in patients referred to the Orthopedics Department for diagnosis or treatment.