A Rare Charcot Neuro-Osteoarthropathy of Hip with an Uncommon Cause.

Neuro-osteoarthropathy often called as Charcot joint results from decreased sensory innervations of the involved joint resulting in severely damaged and disrupted joints and involvement of adjacent soft tissues. Charcot joint is characterized by the "6Ds," which are i) distended joints, ii) density increase, iii) debris production, iv) dislocation, v) disorganization, and vi) destruction. Hip joint involvement is very rare probably because of rich nerve supply compared with other peripheral joints. To minimize the joint deformity and loss of function, early diagnosis is of great importance in which radiological imaging plays a major role.

"The unpredictable brain tumor".

Histiocytosis is a group of rare diseases with vast imaging findings, few of which are distinctive and characteristic that help to differentiate each one of them. Therefore, typical imaging appearances must be recognized to include the possibility in the differential diagnosis, whenever considered pertinent. Hereby, we present one such unique case of histiocytosis in a 26-year-old female, which involved intertwined and overlapping features of radiological findings.

Cranial nerve schwannoma - A pictorial essay.

Schwannomas are peripheral nerve sheath tumours arising from cranial, spinal or peripheral nerves. Most of the schwannomas are benign with the rare possibility of malignant transformation. Cranial nerve schwannomas can be seen along the course of any cranial nerve in the intracranial region or head and neck location. Although a majority are solitary sporadic lesions, multiple schwannomas can be seen in syndromes like neurofibromatosis type 2 and rarely in type 1. Since intracranial schwannomas are slow-growing, clinical presentation varies between no symptoms to cranial nerve palsy. Most of the times, the symptoms are due to mass effect over the adjacent structures, foraminal widening, compression of other cranial nerves, denervation injury or hydrocephalus. Familiarity with the course of the cranial nerves, imaging appearances and clinical presentation of schwannomas helps in accurate diagnosis and possible differential diagnosis, especially in uncommon clinical and radiological appearances. In this pictorial review, we illustrate relevant anatomy of cranial nerves, imaging features of schwannomas of most of the cranial nerves, clinical presentation and differential diagnosis.

PET-CT upstaging of unilateral operable breast cancer and its correlation with molecular subtypes.

CONTEXT: Prognosis and survival rates for breast cancer vary greatly depending on the cancer stage of the patient. Instead of a step-by-step approach using multiple investigations, we can get all the information about the metastatic load of the disease in PET-CT imaging by one single investigation. There is also a correlation between prognosis, FDG uptake, and molecular subtype of breast cancer (Luminal A, Luminal B, Human epidermal growth factor receptor 2 (HER2) positive and Triple-negative). Pre-treatment baseline PET-CT scan was done in 156 unilateral early and operable breast cancer patients from November 2017 to April 2019 in our prospective observational study. AIMS: To evaluate the utility of PET-CT in staging and upstaging of early and operable breast cancer by detection of unsuspected lymph nodes and distant organ metastases.To determine the prognostic association between SUVmax of the primary breast lesion in the upstaged cases and the molecular subtypes. RESULTS: Thus, PET-CT can serve as one-stop imaging in unilateral operable early breast cancer patients for upstaging and prognostication based on the correlation of SUVmax with molecular subtypes of breast lesions in patients who will surely benefit from whole-body imaging.Out of 156 patients, approximately 27 patients were upstaged after pre-treatment PET CT.Six patients were upstaged to stage IIIC and 21 patients were upstaged to IV.Regional nodes like internal mammary and supraclavicular nodes were detected in 7 patients and 5 patients, respectively, out of 156 patients.Non-regional distant nodes and organ metastases were detected in 11 and 18 patients out of 156 patients.Most common molecular subtype detected in the upstaged cases in our study was Luminal A (13 patients) followed by Triple negative (6), Luminal B (3) and HER2-neu-positive subtypes (1). CONCLUSIONS: FDG PET-CT is a substantial modality to provide information on regional, non regional lymph nodes and distant metastases in early operable breast cancer.It helps in evaluating the whole body metastatic burden in a single sitting, therefore, reducing the need for multiple investigations.SUVmax association of the index lesion with molecular subtype in the FDG PET scanning can serve as a prognostication factor in operable early breast cancer patients.

The unforeseen orbital tumor.

Inflammatory myofibroblastic tumor is a rare group of neoplasms showing a mixture of spindle-shaped myofibroblasts or fibroblasts and a variable amount of inflammatory cells (eosinophils, plasma cells, and lymphocytes). They are not usually included in the differential diagnosis of nodules and masses because of their rarity, therefore, remaining an underdiagnosed entity. We report one such rare case in a 3-year-old female.