Lipoma arborescens of the shoulder: magnetic resonance imaging findings.

Lipoma arborescens is a rare intra-articular lesion that typically affects the knee. This condition represents villous lipomatous proliferation of the synovial membrane. The magnetic resonance imaging findings are diagnostic and include a frond-like, fatty synovial mass and associated joint effusion. The authors describe a 90-year-old woman with lipoma arborescens of the shoulder. To the authors' knowledge, lipoma arborescens has not previously been reported in this joint.

Lead "bursogram" and focal synovitis secondary to a retained intraarticular bullet fragment.

We present an unusual case in which retained lead bullet in the wrist joint dissolved and migrated into a synovial recess, producing reactive focal synovitis. The clinical presentation suggested a soft tissue mass or ganglion cyst. The radiologic findings of dense metallic fragments within a recess of the wrist joint established the correct diagnosis and excluded other causes of soft tissue masses. Radiologic recognition of retained intra-articular lead fragments is important, as the clinical features of systemic lead intoxication, lead arthopathy, or reactive focal synovitis may be subtle or misleading.

CT of the spine: value of reformatted images.

Recent improvements in CT software allow rapid and high-quality two-dimensional reformatting of scans of the spine. Reformatting involves computer interpolation of two-dimensional multislice images acquired during routine axial CT scanning in order to generate a three-dimensional volume of data. From this block of data, new images are created and displayed in any desired plane. Reformatted images are acquired within minutes following axial CT scanning.

Massive epistaxis due to pseudoaneurysm. Treated with detachable balloons.

A case of massive epistaxis refractory to nasal packing and bilateral surgical ligation of the internal maxillary and ethmoidal arteries is presented. Angiography revealed a pseudoaneurysm of the cervical portion of the internal carotid artery, and intravascular detachable balloons were used for epistaxis control. The appropriate use of intravascular diagnostic and therapeutic techniques is described.

Aberrant insertion of the common bile duct into an accessory pancreatic duct: cholangiographic demonstration.

Variations in the pancreatic ductal anatomy result from abnormalities in embryological development of the pancreas from ventral and dorsal buds. We describe a case in which cholangiography demonstrated insertion of the common bile duct into an aberrant pancreatic duct. To our knowledge, this finding has not been previously reported in the literature.

Detection of subarachnoid pleural fistula.

A case of subarachnoid-pleural fistula detected by radionuclide myelography is reported. Review of the literature shows that radionuclide myelography is proving to be more sensitive than contrast myelography in confirming the diagnosis.