[Cross-sectional imaging of peripheral involvement in ankylosing spondylitis]. / Imagerie moderne des atteintes périphériques dans la spondylarthrite ankylosante.

Ankylosing spondylitis is the most common spondyloarthropathy. It is characterized by enthesopathy (inflammation at the insertion of ligaments, tendons or fascia to bone). The os calcis is most frequently involved. Additional peripheral manifestations include synovitis and dactylitis. Unlike radiographs that demonstrate late manifestations of the disease, ultrasound and MRI demonstrate early inflammatory changes of bones and soft tissues. Multiple sites of involvement may also be detected on a single examination. Both imaging modalities facilitate early diagnosis, a crucial element for patient management. Both modalities may also monitor lesion regression during treatment.

[Imaging of the postsurgical spine]. / Imagerie du rachis lombaire opéré

Some early complications (hematoma, spondylodiscitis, pseudomeningocele) can occur with all types of surgery while late complications vary with the type of surgery. After discectomy, postsurgical changes (osseous and ligamentous defects, scar tissue, granulation tissue) should be distinguished from postsurgical complications or recurrent disease (recurrent disc herniation, arachnoiditis, spondylodiscitis). Following spinal decompression and fusion procedures, standard radiographs and CT can confirm the adequate position of the fusion devices, the presence of fusion, and the development of late osseous complications: pseudarthrosis, instability and recurrent stenosis.

[Diffusion-weighted MR imaging of liver pathology: principles and clinical applications]. / Imagerie par résonance magnétique de diffusion (IRMD) en pathologie hépatique: principe et applications cliniques.

Due to ongoing technological advances, the range of clinical applications for diffusion-weighted MR imaging has expanded to now include abdominal pathology. Current applications for liver pathology include two main directions. First, oncologic imaging with detection, characterization and follow-up of lesions. Second, evaluation of diffuse liver diseases, including hepatic fibrosis. The diagnostic impact and role of diffusion-weighted MR imaging remain under investigation, but appear promising. Because of its short acquisition time, sensitivity, and additional information it provides, diffusion-weighted MR imaging should be included in routine liver imaging protocols.

[Reactive synovitis: MRI features with arthroscopic correlation]. / Synovites réactionnelles: aspects en IRM et corrélations arthroscopiques.

OBJECTIVES: To evaluate MR imaging in detecting and characterizing secondary reactive synovitis and correlate the results with arthroscopy. MATERIALS AND METHODS: Retrospective study of 10 patients referred for MR imaging and arthroscopy of the knee or shoulder. The diagnosis of reactive synovitis was confirmed by arthroscopy and pathological examination. Synovial thickening was graded at MRI as follows. Grade 0: normal; grade 1: diffuse synovial thickening; grade 2: nodular synovial hypertrophy; grade 3: pseudotumoral synovial mass. RESULTS: Synovitis was described at MRI in 8 cases. There were 2 false negative results on MR imaging for the knee. Synovitis was secondary to knee trauma and rotator cuff tear or surgery of the shoulder. On arthroscopy, all synovial lesions were detected and confirmed at pathology. Synovitis was not detected at MRI (grade 0) in 20% of cases. Synovitis appeared diffuse (grade 1) in 30%, nodular (grade 2) in 30% and pseudotumoral (grade 3) in 20%. Bony erosions were adjacent to synovial thickening in 5 cases. CONCLUSION: Reactive synovitis can occur after trauma. MR imaging is useful in detecting and evaluating secondary reactive synovitis. Arthroscopy and synovial biopsy are necessary to exclude infectious or tumoral synovitis.

[Adductor muscle pyomyositis simulating acute appendicitis: CT and MR imaging findings]. / Pyomyosite des muscles adducteurs mimant une appendicite aiguë: aspects tomodensitométriques et irm.

Pyomyositis is a primary bacterial infection of skeletal muscle. This infection tends to occur in the large muscles of the lower extremity. Pyomyositis of the proximal muscles of the thigh can simulate acute abdominal disease. Early diagnosis improves the outcome. Delayed diagnosis may lead to septicemia and shock. We report the CT and MRI findings in a patient with pyomyositis of the proximal muscles of the thigh.

[Hajdu-Cheney syndrome: an unusual cause of acro-osteolysis]. / Le syndrome d'Hajdu-Cheney: une cause rare d'acro-ostéolyse.

We report a case of Hajdu-Cheney syndrome. This cranioskeletal dysplasia is characterized by band-like acro-osteolysis of the tufts middle thirds. Differential diagnosis of band-like acro-osteolysis are discussed.

[Interventional lumbar spine radiology]. / Radiologie interventionnelle du rachis lombaire.

Three different techniques will be discussed. The first procedure is the biopsy of the lumbar vertebra or lumbar intervertebral disc for patients with tumors or infections of the lumbar spine. The different needles that can be used in function of consistency and location of the lesion will be shown. The transpedicular and posterolateral techniques will be described. Cementoplasty for tumors and selected patients with osteoporotic vertebral collapse generates much interest. The transpedicular and posterolateral techniques will be described. Indications and complications, more frequent in patients with tumors, will be reviewed. Finally, foraminal injections of steroids in patients with radicular symptoms secondary to degenerative change will be discussed. Techniques for needle placement will be reviewed. Results from these injections will also be reviewed.

[MRI appearance of a primary leiomyosarcoma of bone with epiphyseal involvement]. / Aspect IRM d'un cas de léiomyosarcome osseux primitif de localisation épiphysaire.

Primary leiomyosarcoma of bone is a rarely reported tumor of elderly subjects. It usually shows an aggressive osteolytic pattern on plain radiographs and involves predominantly the metaphyses of long bones. We report a case of primary leiomyosarcoma of bone, which is atypical by its epiphyseal location, a non-aggressive pattern on plain radiographs and its MR imaging features.

[D-Dimer determination combined with clinical probability for the diagnosis of leg venous thrombosis]. / Association en pratique clinique du dosage des D-Dimères et d'une probabilité clinique pour le diagnostic de thrombose veineuse des membres inférieurs.

OBJECTIVE: To evaluate the results of combination of D-Dimer test and simple clinical model for the diagnosis of deep vein thrombosis (DVT). MATERIALS AND METHODS: Inclusion: clinical suspicion of DVT. Non inclusion criteria were Clinical model performed by the referring physician included probability varying from high to low. D-Dimer test was performed by five different rapid techniques. Standard of reference was Doppler ultrasonography (DU) performed by a senior radiologist. RESULTS: Eight hundred and fifty-four DU were performed on a 14 months time period, including 206 suspicion of pulmonary embolism, 109 postoperative time period, 120 non-included or excluded patients, 278 incomplete observations, 141 complete observations. DVT was present in 33 cases and absent in the other 108 cases (prevalence 23%). Sensitivity and negative predictive value of the five tests were between 82 and 97% and 90 et 97%. The most sensitive test had a specificity of 36% and a positive predictive value of 32%. Combination of clinical model and D-Dimer test did not improve the diagnostic accuracy. CONCLUSION: None of the test evaluated in the present study, even when combined with the clinical model results, did allow the exclusion of DVT.