Post-mortem findings and causes of death of harbour porpoises (Phocoena phocoena) stranded from 1990 to 2000 along the coastlines of Belgium and Northern France.

Between the years 1990 and 2000, an attempt was made to determine the causes of death of 55 harbour porpoises stranded along the Belgian and northern French coasts. From 1990 to 1996, only five carcasses were collected as against seven in 1997, eight in 1998, 27 in 1999 and eight in 2000. The sex ratio was normal and most of the animals were juvenile. The most common findings were emaciation, severe parasitosis and pneumonia. A few cases of fishing net entanglement were observed. The main microscopical lesions were acute pneumonia, massive lung oedema, enteritis, hepatitis and gastritis. Encephalitis was observed in six cases. No evidence of morbillivirus infection was detected. Pneumonia was associated with bacteria or parasites, or both. The causes of death and the lesions were similar to those previously reported in other countries bordering the North Sea. The cause of the increased numbers of carcasses in 1999 was unclear but did not include viral epizootics or net entanglement. A temporary increase in the porpoise population in the southern North Sea may have been responsible.

[Knee imaging: what is the best modality]. / Imagerie du genou: quel examen choisir?

A wide range of exams are available for imaging the knee: standard radiography, ultrasound, bone scintigraphy, CT scan, arthroscan, MRI, arthro-MRI. The radiologist must be aware of the performance capacities of each technique in order to orient the clinician's choice towards the most appropriate exam in a given clinical situation. In the first part of this paper, we examine the performances, advantages and disadvantages of each technique: exam conditions (patient position, incidence, slice thickness, sequence.) are detailed as required. The second part is a practical guide for some typical clinical situations with decision trees for ordering necessary and sufficient explorations.

[Imaging of the ankle and back of the foot in athletes]. / Imagerie de la cheville et de l'arrière-pied du sportif.

Imaging of the ankle and the hind-foot in sportmen includes plain radiographies that are often insufficient. When necessary, imaging modalities such as sonography, CT (arthroCT and tenoCT), and MR imaging are of valuable interest for trauma medical doctors and surgeons. The role of those modalities is emphasized lesion by lesion.

[Magnetic resonance imaging of tibial periostitis]. / Imagerie par résonance magnétique de la périostite tibiale.

Tibial periostitis frequently occurs in athletes. We present our experience with MRI in a series of 7 patients (11 legs) with this condition. The clinical presentation and scintigraphic scanning suggested the diagnosis. MRI exploration of 11 legs demonstrated a high band-like juxta-osseous signal enhancement of SE and IR T2 weighted sequences in 6 cases, a signal enhancement after i.v. contrast administration in 4. Tibial periostitis is a clinical diagnosis and MRI and scintigraphic findings can be used to assure the differential diagnosis in difficult cases with stress fracture. MRI can visualize juxta-osseous edematous and inflammatory reactions and an increased signal would appear to be characteristic when the band-like image is fixed to the periosteum.

Split lesions of the peroneus brevis tendon in chronic ankle laxity.

Between 1993 and 1995, we operated on 18 patients for split lesions of the peroneal brevis tendon associated with chronic ankle instability. Five patients were competitive athletes, seven were recreational athletes, and six were persons. Symptoms developed in three phases: ankle sprain, chronic instability, and posterolateral pain. The mean delay between sprain and posterolateral pain was 6 years. At the time of surgery the main complaint was retromalleolar pain in nine patients, pain and instability in eight patients, and instability only in one patient. Diagnosis of tendinous lesions was based on clinical examination in three cases, preoperative magnetic resonance imaging in eight cases, preoperative tenography in one case, and surgical exploration in six cases. The lesion was localized at the tip of the lateral malleolus and was visible only after opening the peroneal retinaculum. In three cases an accessory peroneal muscle was present. A Chrisman-Snook procedure was performed in 13 cases and a simple tendinous repair in 5 cases. The split lesion of the peroneus brevis tendon may be the result of chronic ankle laxity. This lesion needs a specific surgical treatment and the peroneal tendon must be checked in case of surgical procedure for ankle laxity. After ligamentous repair, residual pain can be due to a neglected peroneus brevis tear.

[Longitudinal splitting syndrome of the short fibular tendon. . Imaging and classification by MRI]. / Syndrome fissuraire du tendon court fibulaire. Mise en évidence et classification en IRM.

We present a series of 38 cases of longitudinal splitting of the peroneus brevis tendon revealed by MR imaging (12 lesions were confirmed at surgery). MRI enabled classification in four surgical grades. The frequency of such lesions in chronic ankle instability as observed in our series is often reported in the literature. Bilateral cases are common. Asymptomatic cases do occur, especially in grades I and II. MRI has been shown to be a very effective investigation for demonstrating this tendinous lesion; the proton density weighted sequence in the axial plane is the most adequate sequence.

[MRI of the rotator cuff: evaluation of a new symptomatologic classification]. / IRM de la coiffe des rotateurs: évaluation d'une nouvelle classification sémiologique.

The different classifications use for the rotator cuff pathology seem to be incomplete. We propose a new classification with many advantages: 1) Differentiate the tendinopathy between less serious (grade 2A) and serious (grade 2B). 2) Recognize the intra-tendinous cleavage of the infra-spinatus associated with complete tear of the supra-spinatus. 3) Differentiate partial and complete tears of the supra-spinatus. We established this classification after a retrospective study of 42 patients operated on for a rotator cuff pathology. Every case had had a preoperative MRI. This classification is simple, reliable, especially for the associated intra tendinous cleavage.

CT and MRI evaluation of tenosynovitis of the rheumatoid hindfoot.

Thirty-nine patients with rheumatoid arthritis who had presented with tarsitis before, were investigated at the level of the rearfoot. The first 17 patients had CT with previous tenography when it was possible; the following 22 patients had MRI with gadolinium injection. Tendon involvement appeared in 52.9% of the cases on CT, and in 90% of the feet on MRI; therefore, in case of clinical or radiological signs of tarsitis, it appears that tendon involvement must be suspected. With the two procedures the tibialis posterior tendon lesions were very predominant. In the majority of the patients (31/39), there was associated involvement of two or more tendons. If there is a ruptured tendon, the authors think that one must be cautious with surgical tendinous transfer; indeed, the long-term results of this surgical procedure present a strong probability of being compromised in rheumatoid arthritis which is a progressive disease.

[Imaging of spinal osteochondroma of neurologic nature. Apropos of 7 cases]. / Imagerie des ostéochondromes rachidiens à expression neurologique. A propos de 7 cas.

In this work, on 7 cases of spinal neurological, the authors analyse the use of imaging in the diagnosis and pretherapeutic approach, as well as for the post-operative follow-up. They insist mostly on the value of tomographic imaging methods, in particular: computed tomography, which allows the study of mineral structures, and determines the site of implant pedicle; magnetic resonance imaging important to precise the connections between tumor and spinal canal contents. They prove that other imaging methods still possess some interest, particularly standard X-ray, useful in estimating the characteristics of exostosis and identifying spinal lesions.

Case report 801: Osteoid osteoma of the coccyx.

In summary, a typical osteoid osteoma in the coccyx in a 13-year-old boy has been presented-a unique location. The clinical, radiological, and pathological aspects of osteoma are summarized. The relationship of osteoid osteoma to osteoblastoma is stressed; it is also stressed that the occurrence of osteoid osteoma in the coccyx is most unusual.

Haemorrhagic complications of intracerebral cavernomas: value of MRI.

The authors report a retrospective series of 10 cases of intracerebral haematomas consecutive to cavernomas and studied with MRI. The factors that led to the MRI study were the patients' age and clinical history, the site of the haematoma, the persistence of CT images and a negative arteriography. MRI showed that the haematoma was in contact with the cavernoma in 4 cases and at a distance from it in one case. In 5 cases only the cavernoma was seen at the site of the haematoma. Three patients had multiple cavernomas. In all cases, the diagnosis of cavernoma was confirmed at surgical excision.

MRI and CT in a case of pituitary abscess.

We report the case of a woman admitted for hypopituitarism of sudden onset, in whom conventional radiography, CT and MRT suggested a pituitary tumour with supra- and intrasellar extensions. The surgical findings and the clinical course under antibiotic therapy transformed this diagnosis into one of pituitary abscess by a pyogenic micro-organism. Pituitary abscess is an exceptional lesion. Despite the advent of CT and MRI, its preoperative diagnosis remains difficult. However, the presence of an intrasellar expansive process with liquid centre and contrast-enhanced outline should suggest the possibility of an abscess, particularly when the pituitary lesion is associated with a sphenoidal sinus effusion.

[A rare bone abnormality: intra-bone synovial cyst. Apropos of a case]. / Une anomalie osseuse rare: le kyste synovial intra-osseux. A propos d'un cas.

One case of intraosseous ganglion is reported and compared with a review of the literature. The clinical findings, the physiopathological and radiological patterns are discussed as well as the differential diagnosis.