Philip Jacobs

POST-TRAUMATIC OSTEOLYSIS OF THE OUTER END OF THE CLAVICLE

1. Two cases of post-traumatic osteolysis of the outer end of the clavicle are reported. 2. The essential features of the lesion are summarised. 3. The possible medico-legal importance of the condition is mentioned.

Osteo-articular tuberculosis in coloured immigrants: A radiological study

Summary Thirty coloured immigrants suffering from osteo-articular tuberculosis have been studied with special reference to unusual manifestations. Atypical features are presented and classified as follows:— o 1. Tendency to multiplicity of lesions. 2. Unusual distribution of lesions, e.g., cervical spine, high dorsal spine and foot. 3. Rare sites, e.g., ribs, vertebral appendages, pelvis, skull, shafts of bones. 4. Unusual reactions, e.g., florid and sclerotic. 5. Exceptionally large associated abscess formation. 6. Lack of involvement of disc in spinal lesions. 7. One example of disseminated bone tuberculosis is presented.

Parosteal lipoma with hyperostosis.

The author describes two cases of parosteal lipoma associated with a pronounced degree of hyperostosis. The exact site of origin of the tumour is not known, but it is probably not periosteal. The tumour is benign and amenable to surgical removal. It is of importance to the radiologist in that it produces a characteristic radiographic picture.

Multiple sesamoid bones of the hand and foot

The author emphasizes the great disparity in textbook descriptions of the possible situations of the sesamoid bones in the hands and feet. Without exception the anatomy and radiology books are incomplete to a greater or lesser extent. A patient is illustrated who has 6 sesamoids in one hand, but 9 in the other. She has very rare sesamoids related to both her 3rd and 4th metacarpo-phalangeal joints. She also has 8 sesamoids for the metatarso-phalangeal areas of each foot, symmetrically arranged. Such a picture is extremely rare.

Intra-epiphyseal gas in osteochondritis

The presence of intra-epiphyseal gas has recently been reported in the femoral head in early cases of osteochondritis. The author records further examples of this sign and reports its occurrence in the capitellum in osteochondritis of the elbow. It is believed that the sign has not previously been reported in the capitellum.

Osteochondritis dissecans of the hip

Summary The radiographic demonstration and radiological features of osteochondritis dissecans of the hip are described together with illustrative examples. It is thought that the condition occurs more frequently than is generally supposed and that it is frequently misdiagnosed. The importance of the frog view of the hip in the demonstration of lesions is stressed. Patients are illustrated showing how easily the lesion may be wrongly diagnosed or missed completely if one does not take a second view of the hip. An associated deformity of the acetabulum, occurring in the later stages in young subjects whose bones are still plastic, is described.

Case report 7

Fig. 1. In this AP film of the pelvis a large soft tissue mass overlaps the left innominate bone, extending medially well into the pelvic cavity across the midline and lateral to the innominate bone. The soft tissue mass obscures bony detail, but the trabecular pattern of the innominate bone appears coarsened and thickened. The presence of bone destruction is suggested. Tomographic studies yielded no further information

An intraosseous ependymal cyst

Ectopic glial tissue may be found in various sites, and it may assume tumorous characteristics. The authors describe a case of an ependymal cyst arising within the neural arch of a lumbar vertebra, a site in which such a lesion has not been previously reported.

CHRONIC PROGRESSIVE DISLOCATION OF THE TALO-NAVICULAR JOINT

1 . Two cases of chronic progressive dislocation of the talo-navicular joints are discussed. 2. Radiographs are presented showing the development of the lesions over a period of eighteen years. 3. It is thought that the lesion is caused by laxity of ligaments and subsequent osteoarthritic changes.

Osgood-Schlatter's disease: cause of a misleading radiographic sign.

Osgood-Schlatters disease often results in residual irregularity of the tibial tubercle with possibly loose or partially loose ossicles near the involved bone. This finding is of no clinical significance. The author, however, demonstrates that their images may be projected into the patello-femoral joint space in the tangential view of the knee. Under these circumstances, they may be confused with true loose bodies in the patello-femoral joint