Theodore W. Parsons

MR imaging of musculoskeletal tumors and tumor mimickers with intravenous gadolinium: experience with 242 patients

Abstract Purpose. This pictorial essay reviews our experience with MR scans with gadolinium in patients with musculoskeletal tumors and tumor mimickers. Design. Review of 242 MR scans obtained in the initial evaluation of a possible primary musculoskeletal neoplasm. All scans included a T1-weighted, fat-suppressed sequence following intravenous administration of gadolinium. Results. MR scans with gadolinium did not contribute to differential diagnosis or patient management in 89% of the patients in this series. However, intravenous gadolinium did assist in guiding the biopsy of bulky lesions and evaluating treated tumor beds for possible recurrence. MR scans with gadolinium were sometimes helpful when the differential diagnosis included synovitis, Morton’s neuroma or intramuscular myxoma, and when it was important to differentiate cystic from solid lesions. Conclusions. Routine use of gadolinium in every initial MR examination of a possible musculoskeletal mass is not warranted. However, there are appropriate selected indications for gadolinium administration as outlined above.

Radiographic Imaging of Musculoskeletal Neoplasia

BACKGROUND Imaging is an integral part of the diagnosis, staging and evaluation of outcomes for bone and soft-tissue neoplasms. Each of the available imaging tools has a different role. METHODS The authors reviewed the efficacy of the current imaging modalities in the diagnosis, staging, and follow-up of patients with musculoskeletal neoplasia. RESULTS Plain-film radiography remains the gold standard in the differential diagnosis of bone lesions. Bone scintigraphy is an excellent screening modality, and computed tomography is especially useful in evaluating lesions of the axial skeleton. The superior soft-tissue resolution and multiplanar capabilities achieved with magnetic resonance imaging, however, has replaced the need for CT scans in many cases. CONCLUSIONS The technological advances seen in recent years in all areas of imaging have improved the capabilities of these modalities to assist in the diagnosis, definition of tumor extent, and accurate staging of musculoskeletal tumors.

Acetabular paralabral cyst: an uncommon cause of sciatica.

Abstract. The association between tears of the acetabular labrum and paralabral cysts has been well documented, and magnetic resonance imaging (MRI) has been shown to be the most accurate noninvasive method of depicting not only the normal anatomic structures of the hip, but also the common pathologic processes such as labral tears and paralabral cysts. We present the case of an acetabular paralabral cyst that resulted in clinically symptomatic compression of the sciatic nerve.

Extraskeletal osteochondroma of the foot.

Abstract A case of pathologically proven extraskeletal osteochondroma is presented with magnetic resonance imaging (MRI), computed tomography (CT), bone scan and radiographic findings. The diagnosis of extraskeletal osteochondroma should be considered when a discrete, ossified mass is localized in the soft tissues of the distal extremities. Nomenclature surrounding this entity is controversial and is discussed.

Primary periosteal lymphoma: an unusual presentation of non-Hodgkin's lymphoma with radiographic, MR imaging, and pathologic correlation

This report describes a primary periosteal location of non-Hodgkins lymphoma, without nodal disease, and without adjacent intramedullary disease at presentation. The clinical and imaging appearance of periosteal lymphoma simulates other neoplastic osseous surface tumors more than that of lymphoma in other locations. Consideration of this rare presentation of non-Hodgkins lymphoma in the differential diagnosis of periosteal bone lesions can be helpful to ensure proper diagnosis and treatment.

Operative Treatment of Pelvic Tumors

Hideaki E. Takahashi, Tetsuro Morita, Tetsuo Hotta, and Akira Ogose, editors. Tokyo: Springer-Verlag; 2003. 216 pages.

Osseous Change Adjacent to Soft-Tissue Hemangiomas of the Extremities: Correlation with Lesion Size and Proximity to Bone

119.00. This concise textbook on the operative treatment of pelvic tumors represents the thirty-year experience of the senior editor and author, Dr. H.E. Takahashi, at the Niigata University Medical Hospital in Japan. Dr. Takahashi (who has some forty years of experience in the operative treatment of musculoskeletal tumors) and his contributors have done a very nice job of organizing a concise, readable, and generally well-illustrated surgical text. This single-volume textbook is tastefully constructed …