Vladimir Sopov

Bone Scintigraphic Findings of Os Trigonum: A Prospective Study of 100 Soldiers on Active Duty

PURPOSE: To determine the clinical significance of an increased uptake of 99mTc methylene-diphosphonate (Tc-MDP) in the os trigonum region seen on bone scintigrams of soldiers on active duty. PATIENTS AND METHODS: Radionuclide whole-body skeletal imaging and physical examination of the foot were carried out in 100 consecutive soldiers on active duty referred for evaluation of suspected stress-injury of the lower limbs, back pain, and different skeletal trauma. Lateral radiographs of the foot were performed in those with increased uptake of Tc-MDP at the site of os trigonum. Radiographic, scintigraphic, and clinical findings were correlated. RESULTS: Among 200 feet, 27 (13.5%) showed an increased uptake of Tc-MDP in the os trigonum region. The right side was affected in six patients, the left side in 11 and five patients had bilaterally increased uptake. On X-rays, 31 of 44 feet showed the os trigonum. Only 10 of these 27 feet (37%) had a symptomatic os trigonum. CONCLUSIONS: Our results suggest that increased uptake of Tc-MDP in the os trigonum region is a frequent finding among active soldiers and is of limited value in detecting symptomatic os trigonum.

How accurate is helical CT volumetric assessment in renal tumors

Abstract. The aim of this study was to evaluate the accuracy of tumor size measurement on CT studies of renal tumors. Sixteen patients with tumors of the kidneys were imaged by helical CT prior to surgery. Assessment of tumor volume was made by two radiologists on the CT images with the summation of area method, then compared with the resected specimen water displacement volume. Intra- and interobserver agreement for CT measurements were also assessed. There were substantial differences between the CT volume measurement compared with the tumor post-operative volume (mean of differences 30.05±91.6, 95%CI: 31.45–91.55). The inter- and intraobservation agreements for tumor measurement by CT was found to be satisfactory (ANOVA: p<0.0001; t-test: p<0.05). The CT volumetric measurement by area summation is a method with good inter- and intraexamination reproducibility but not an accurate technique for tumor volume assessment.

Stress-induced osteolysis of distal clavicle: imaging patterns and treatment using CT-guided injection

Abstract Osteolysis of distal clavicle (ODC) may occur in patients who experience repeated stress or microtrauma to the shoulder. This entity has clinical and radiological findings similar to post-traumatic ODC. We describe a case of successful treatment of stress-induced ODC with CT-guided injection of corticosteroid and anesthetic drug into the acromioclavicular joint.

Spectrum of Focal Benign Musculoskeletal 18F-FDG Uptake at PET/CT of the Shoulder and Pelvis

OBJECTIVE The purpose of this article is to illustrate the spectrum of common benign intraarticular and extraarticular disorders associated with focal (18)F-FDG uptake in the shoulder and pelvic areas in oncology patients referred for PET/CT. CONCLUSION A wide spectrum of benign musculoskeletal disorders associated with focal FDG uptake may be detected in cancer patients. This incidental uptake usually does not seem to be a clinically significant finding, but it can affect quality of life.

Bilateral Distal Tibial Osteochondral Lesion: A Case Report

Osteochondral lesion of the talar dome is a well-known clinical and radiographic entity. Less known is osteochondral lesion of the articular surface of the distal tibia. A case report, which demonstrates bone-scintigraphy and MRI findings of bilateral osteochondral lesion of tibial plafond and related literature, is presented.

99mTc-RBC scintigraphy showing portal vein aneurysm.

99mTc-RBC scintigraphy demonstrated extrahepatic portal vein aneurysm as an incidental finding in a 47-yearold asymptomatic woman with chronic elevation of aminotransaminases (Figure). The patient had been referred for scintigraphic study to evaluate the vascularity of an extrahepatic mass, detected by ultrasonography in the hilum of the liver. The early filling of the lesion in the dynamic phase was compatible with an increased blood flow inside the mass. The diagnosis of portal vein aneurysm was confirmed by CT angio examination.

Prostatic bone metastases associated with multifocal Paget's disease.

It is usually possible to differentiate between Pagets disease and metastatic disease. However, some diagnostic difficulty can arise, particularly when a patient with a known primary tumor has a bone scan performed and Pagets disease is found incidentally. We report a case of subsequent bone scans done to assess response to therapy for bone metastases caused by prostate cancer associated with multifocal Pagets disease.