Globe trauma.

In the United States, it is estimated that 3% of all emergency room visits are the result of eye injury, with many seen in combination with other orbital injuries. These often result from motor vehicle accidents and sports-related injuries. Clinical ophthalmologic examination is the key to rapid and accurate diagnosis of most ocular injuries. Imaging, in combination with the ophthalmologic examination, can be a powerful tool in the evaluation of traumatic injury to the globe. We review the roles of computed tomography, magnetic resonance imaging, and ultrasound in the evaluation of these patients and illustrate common and uncommon traumatic ocular pathology.

Postsurgical imaging of the globe.

Interpretation of globe imaging after ophthalmologic surgical intervention, just like postoperative imaging in any location, can create a diagnostic dilemma if the radiologist is not familiar with the type of surgery performed and the nature and location of any implanted devices. Certain implants and devices may create artifacts on computed tomography or magnetic resonance imaging, and some contain ferromagnetic components that may be damaged if inadvertently placed in the magnetic resonance imaging. We review several common ocular surgical procedures, as well as a few orbital surgical procedures and discuss many implants and devices and their appearance on cross-sectional imaging. Familiarity with these procedures and their imaging appearance can diminish the chance of misinterpretation.

MRI Appearance of Nerve Regeneration in a Surgically Repaired Ulnar Nerve.

BACKGROUND AND PURPOSE: Magnetic resonance imaging (MRI) findings for surgical repair of a transected nerve have not been published. We describe the first reported postoperative MR imaging findings of a repaired transected ulnar nerve. METHODS: A patient presented to our institution following surgical repair of a severed ulnar nerve at the level of the forearm. MRI was obtained to evaluate postsurgical outcome and potential complications. RESULTS: Magnetic resonance imaging demonstrates the presence of nerve fascicles that are clearly depicted above and below the level of injury but appear indistinct at the level of transection. CONCLUSION: To our knowledge, the MRI appearance of a repaired transected nerve has not been previously described. We believe that the MRI findings may be used to assess the anatomic progress of nerve healing and, when combined with a series of progressively favorable results from a focused neurologic exam, provide convincing evidence of nerve regeneration.

Complex carpal malformation without a cause.

Carpal dislocation is an uncommon event. We present a 4-year-old male child who had the clinical appearance of a Madelung's deformity; however, he failed to fulfill the radiological criteria for a Madelung's deformity. The carpal bones had not yet ossified making it difficult to arrive at a diagnosis using radiograph alone. Magnetic resonance imaging was diagnostic because of the ability to delineate the carpal cartilaginous ossification centers. Chronic wrist dislocation should be considered in the differential diagnosis of a long-standing wrist deformity that clinically resembles a Madelung's deformity in a young child.

Three cases of benign giant cell tumor with unusual imaging features.

OBJECTIVE: Imaging findings for giant cell tumors (GCT) of the spine displaying aggressive characteristics have not been widely reported. MATERIALS AND METHODS: Patients with biopsy-proven GCT were included in the study. Three cases fulfilled these criteria. RESULTS: MRI and CT demonstrated disc space involvement and vertebral body compression. CONCLUSION: Acute fracture, subluxation, and extension through the disc space have not been previously described and, while atypical for benign lesions, may in fact be typical for GCT of the spine.

Ultrasound of ovarian sex-cord tumor with annular tubules.

Sex-cord tumors with annular tubules (SCTAT) have been extensively reported in the literature with great emphasis on the cytologic and histologic appearance. The association of Peutz-Jeghers syndrome (PJS) with bilateral benign, typically multifocal, small, and sometimes calcified SCTAT has also been reported. We present and describe the sonographic findings of bilateral SCTAT in a patient with PJS.

Multimodality imaging of an appendiceal intussusception.

Appendiceal intussusception is a rare entity. The majority of cases reported in the literature address surgical and colonoscopic approaches to treatment of the condition. The existing radiologic literature largely describes the sonographic and double-contrast enema findings of appendiceal intussusception. We present a case of appendiceal intussusception and describe the air-contrast enema, sonographic and CT findings.

Growing burr hole: enlarging pseudomeningocele at the site of a craniostomy.

BACKGROUND: Growing skull fractures and other enlarging skull defects are rare postoperative occurrences. We report here on a 10-month-old girl who presented with an enlarging burr hole and pseudomeningocele after an endoscopic third ventriculocisternostomy. METHODS: Evaluation of an enlarging subcutaneous mass at the site of the burr hole included computed tomography scans and magnetic resonance imaging, which revealed a pseudomeningocele. The patient underwent repair of the lesion, including dural closure and cranioplasty. CONCLUSIONS: Growing skull fractures or other enlarging bone defects may occur after burr hole placement, particularly in infants who require larger access sites for endoscopy.