[Pneumorachis: report of three rare causes]. / Pneumorachis: illustration de trois étiologies rares.

The presence of gas in the spinal canal or pneumorachis is a rare imaging finding, typically incidental. Pneumorachis may be due to several degenerative, traumatic, infectious, tumoral or iatrogenic etiologies. We report three cases of pneumorachis in patients with lumbar back pain. A case occurred in a patient with advanced degenerative disk disease. Another was in a patient with posterior facet synovial cyst. The last was in a patient with locally advanced rectal carcinoma complicated by perforation. Pneumorachis was detected on MRI in two cases and on CT in all three cases.

[Spontaneous spinal epidural hematoma: a report of 3 cases]. / L'hématome spontané épidural rachidien: à propos de 3 cas.

We report MR imaging features in 3 cases of spontaneous spinal epidural hematoma, a potential neurosurgical emergency.

[Myositis ossificans circumscripta: the contribution of imaging]. / La myosite ossifiante circonscrite: apport de l'imagerie.

OBJECTIVES: Illustrate the specific and nonspecific aspects of myositis ossificans circumscripta (MOC) in standard imaging, cross-sectional imaging (sonography, CT, and MRI), and bone scintigraphy. PATIENTS AND METHODS: Eight patients presenting with MOC (three men and five women) were explored using standard radiography (eight cases), sonography (seven cases), scintigraphy (four cases), CT (six cases), and MRI (four cases). RESULTS: Standard x-rays and sonography of the soft tissue showed a well-defined mass containing calcifications in 75% of the cases. The CT scan diagnosed MOC in four cases, showing calcified masses separated from the adjacent bone by a clear radiotransparent border or afferent peripheral tumoral calcifications highly suggestive of MOC. MRI was nonspecific. Bone scintigraphy showed hyperfixation in the four cases imaged. CONCLUSION: Standard x-rays were useful to demonstrate the calcifications of MOC and to identify their relation with the subjacent bone. Sonography and bone scintigraphy were interesting in monitoring the lesion's maturation. In addition to early detection of calcifications, CT can precisely localize the lesion before surgical ablation. MRI is a very sensitive technique in detecting small lesions at an early stage, but it is nonspecific and does not remove the necessity of biopsy to eliminate the possibility of a malignant disease.

[Cerebral hydatid disease: imaging features]. / Hydatidose cérébrale: aspects en imagerie.

Cerebral hytatid cysts (HC) are extremely rare, forming 2% of all intra cranial space occupying lesions even in counties where the disease is endemic. HC diagnosis is usually based on a pathognomonic computed tomography (CT) pattern. In order to assess the value of MR we reviewed the CT (n=25) and magnetic resonance (MR, n=4 including diffusion and proton magnetic resonance spectroscopy in 1) imaging of 25 patients with pathologically confirmed cerebral hydatid disease. 19 HC were seen in children under 16 years. All were supra tentorial with 22 in the middle cerebral artery territory. HC was solitary in 18 cases, unilocular in 23 and multi-vesicular in 2 with heavily calcified pericyst in 1. 2 cysts were intra ventricular and 1 intra aqueducal. The most typical features were well defined, smooth thin walled spherical or oval cystic lesions of CSF density and/or signal with considerable mass effect (20/25). Surrounding oedema with complete or incomplete rim enhancement was seen in 3 cases which were labelled as complicated and/or infected cysts. Although CT is diagnostic of hydatid disease in almost all cases (22/25), MRI including diffusion and spectroscopy precisely demonstrate location, number, cyst capsule, type of signal and enhancement and allows diagnosis of atypical or complicated HC and appears more helpful in surgical planning.

[Atypic radiologic aspect of a renal cell carcinoma in children]. / Présentation radiologique atypique d'un carcinome à cellules claires du rein chez l'enfant.

Renal cell carcinoma is rare in children and is usually found in late childhood. The authors report on an exceptional case of renal cell carcinoma in a 10-year-old girl. The radiological aspect is misleading and has not been previously reported in the literature. Renal cortex was thin because of congenital megalo-ureter, so the tumor developed entirely into excretory cavities (to the proximal ureter), while a primitive urothelial disease (tumoral or inflammatory) was first evoked. The atrophied cortex was the tumoral starting point which prolapsed into excretory cavities, upraising the urothelial epithelium.

[Discoid menisci in children: ultrasonographic features]. / Le ménisque discoïde chez l'enfant: aspects échographiques.

OBJECTIVE: Discoid meniscus is a rare congenital pathology affecting mainly the lateral meniscus. Radiological diagnosis, initially based on arthrographic findings, is now established on well defined MRI criteria. In this study, ultrasonography (US) was the modality proposed for diagnosing discoid meniscus and compared to the normal sonographic meniscal pattern. Subjects and methods. 8 children aged from 6 to 11 years, with a symptomatology highly suggestive of meniscal pathology, were investigated by US of both knees, followed by MRI in 3 and arthroscopy in all cases. RESULTS: In all 8 cases, a meniscus was diagnosed as discoid when it no longer had its normal triangular shape, was abnormally elongated and thick and demonstrated a heterogeneous central pattern. Associated lesions (fracture, cystic degeneration) were well demonstrated on US. The lateral meniscus was involved in all 8 cases, the pathology was bilateral in 5 cases and MRI/US correlation was good in 3 cases. Arthroscopy confirmed US findings in all cases. CONCLUSION: US, a more widely available imaging modality, is a reliable technique for the diagnosis of discoid meniscus in children.

[MRI findings in the diagnosis of pseudotumoral humeral hydatid]. / Apport de l'IRM dans le diagnostic d'une hydatidose humérale pseudo-tumorale.

Hydatidosis of bone is rare. Vertebral localizations predominate. Standard imaging may be misleading, suggestive of a malignant tumor or infection. We present the case of a patient with a humeral hydatid. This localization is very rare and presents an unusual radiographic aspect. Computed tomography produces an image suggestive of a tumor. The correct diagnosis can be established with MRI, particularly with the STIR sequence. In our patient, MRI enabled us to establish the diagnosis preoperatively and evaluate extension. MRI has been found to be highly contributive to the diagnosis of hydatidosis of bone and for assessment of intra- and peri-osseous extension.

[Tuberculous mesenteric lymphadenitis: a case report]. / La lymphadénite mésentérique d'origine tuberculeuse: à propos d'un cas.

The authors report a case of mesenteric tuberculous lymphadenitis which mimic a pancreatic cystadenoma. They emphasize ultrasound and CT scan features which lead to the recognition of tuberculosis and permit a percutaneous fine needle biopsy. Laparotomy seems the most reliable method for a positive diagnosis. The place of different imaging methods is discussed.

[Subcapsular hematoma complicating acute pyelonephritis]. / Hématome sous-capsulaire compliquant une pyélonéphrite aiguë.

Spontaneous subcapsular renal hematoma is rare and essentially associated with malignant, or benign tumor vascular diseases, inflammatory processes. In few cases, no cause was detected. We observed one additional case in a diabetic women. She presented fever, and bilateral flank pain. Ultrasonography showed bilateral subcapsular hematoma. Computed tomography confirmed these findings and demonstrated multiple area of acute focal pyelonephritis.

[Abdominal actinomycosis. Report of 4 clinical cases studied with radiography]. / Actinomycose abdominale. A propos de 4 observations radiocliniques.

We report 4 cases of pathologically proven abdominal actinomycosis. US and CT demonstrated an infiltrative abdominal mass with ill-defined margins and heterogeneous enhancement after IV contrast. The ileo-cecal region was involved in one case; the mass appeared following cholecystectomy and recurred 3 years after surgical resection in one case; and no predisposing factor was identified in the 2 other cases. In one of these, recurrence was observed 12 years after the first episode. Actinomycosis must be included in the differential diagnosis of invasive abdominal lesions with "malignant" appearance.

[Ultrasonographic aspects of kidney pelvis tumors associated with infectious hydronephrosis of lithiasic origin]. / Aspects échographiques des tumeurs pyéliques sur hydronéphrose infectée d'origine lithiasique.

The ultrasonographic findings of 4 patients with surgically confirmed urothelial tumors associated with calculic pyonephrosis are presented. All the involved were markedly enlarged and hydronephrotic with obstructive calculi, stigmata of pyonephrosis and, an echoic pelvic mass, extending in calyceas in 2 cases. The sonographic appearance correlated well with the gross pathological findings. The histological types were 2 squamous cell carcinomas, 1 adeno-squamous cell carcinoma and 1 transitional carcinoma. The chronic calculic irritation was proved to induce squamous and glandular metaplasia. The subsequent squamous carcinoma and adenocarcinoma were documented in the literature. The preoperative diagnosis of the associated tumor was rarely done. The sonographic features reported are highly suggestive of urothelial tumor and may lead to an accurate preoperative diagnosis.

[Adrenal tumors in Beckwith-Wiedemann syndrome. Apropos of a case]. / Tumeurs surrénaliennes dans le syndrome de Beckwith-Wiedemann. A propos d'un cas.

A case of a neonate with Beckwith-Wiedemann syndrome is presented. Antenatal sonography detected a right adrenal cystic mass confirmed in post-natal which resolved spontaneously within 1 month. The child developed an adrenal adenoma detected by abdominal sonography at six months of surveillance. The authors review the different adrenal lesions possibly associated with Beckwith-Wiedemann syndrome and specially the pseudo-tumorous lesions. The value of abdominal sonography in the neonatal periods and in the surveillance of children with Beckwith-Wiedemann syndrome is emphasized.

[Acute pyelonephritis and subcapsular hematoma revealing nephroblastoma at the age of 15 years]. / Pyélonéphrite aiguë et hématome sous-capsulaire révélant un néphroblastome à l'âge de 15 ans.

BACKGROUND: Nephroblastoma' the most common renal tumor in children between 1 and 5 years, occurs rarely in the oldest child. CASE REPORT: A 16-year-old teenager suffered from acute pyelonephritis caused by Klebsiella pneumoniae. Renal ultrasonography showed a left subcapsular hematoma; the CT scan confirmed the finding and also showed renal scarring. However, a second CT scan showed pulmonary nodules suggestive of metastasis, a diagnosis that was confirmed by needle biopsy of pulmonary lesions. Recovery was obtained after chemotherapy and nephrectomy with a 3-year-follow-up. CONCLUSION: This nephroblastoma was particular because its development in an adolescent, its association with acute pyelonephritis and subcapsular hemorrhage.

[Esophageal mucocele: report of 2 pediatric cases]. / Mucocèle oesophagienne à propos de deux observations pédiatriques.

Two cases of esophageal mucocele in pediatric patients are reported: two children of 5 and 9 years respectively underwent surgical isolation of the esophagus and esophagocoloplasty for caustic stenosis related to accidental ingestion of caustic soda. Clinical pattern of mediastinal compression was proved with cervical fistulous tract in one case. In both cases, thoracic computed tomography was a sensitive imaging method to demonstrate the mucocele and its extension. Esophageal mucocele is rarely described in children, especially following esophageal corrosive stricture.

[Infection and rupture of a serous renal cyst]. / Infection et rupture du kyste séreux rénal.

The authors report two cases of acute infection of a renal cyst with rupture into the urinary tract. The diagnosis was made by excretory urograms and ultrasonography. Differentiating a ruptured cyst from congenital caliceal diverticulum may sometimes be difficult. Antimicrobial treatment can control the infection and exclusion of the cyst was obtained in one case. The mechanism responsible for infection and rupture of the cyst are discussed, as well as the management of such cases.

[Retroperitoneal lymphocele occurring in a child after nephrectomy and treated by percutaneous drainage]. / Lymphocèle rétropéritonéal apparu chez un enfant après néphrectomie et traité par drainage percutané.

Lymphocele is a rare complication of kidney surgery in pediatric practice. Recent treatment consists in long term percutaneous drainage. The case reported was diagnosed 9 years after nephrectomy and improved with 3 weeks percutaneous drainage.

Sternocleidomastoid pseudotumor of infancy: a report of thirteen cases.

UNLABELLED: Stemocleidomastoid tumor of infancy (SCMTI) is a rare cause of benign neck masses in neonates and infants. It has to be differentiated from other congenital space-occupying lesions in the cervical region. PATIENTS AND METHODS: The files of 13 infants with a mean age of 6 weeks, presenting with a lateral neck mass at Sahloul University Hospital in Sousse (Tunisia) between 2007 and 2009 were retrospectively studied. All of them underwent physical and ultrasonographic examination. MRI was performed in only one case. RESULTS: Ultrasonography (US) showed a soft tissue mass of sternocleidomastoid muscle (SCMM), or a homogenously enlarged muscle without any focal mass. MRI revealed a fusiform enlarged muscle. Diagnosis of SCMTI was established in all cases. Conservative treatment was recommended in all cases with physiotherapy in 2 cases. CONCLUSION: US is the best imaging modality for the diagnosis of SCMTI and the first one to be performed. Additional diagnostic imaging modalities are unnecessary in most of the cases.

[Herpetic meningoencephalitis and acute disseminated encephalomyelitis: magnetic resonance imaging sequence]. / Méningo-encéphalite herpétique et encéphalomyélite aiguë disséminée : séquence en imagerie par résonance magnétique.

We report a case of herpetic encephalitis in a 2-year-old girl. Diagnosis was made at 1st by clinical symptoms and MRI and confirmed by lumbar puncture. Forty days later, new neurologic symptoms appeared and MRI diagnosed acute disseminated encephalomyelitis. MRI better demonstrates CNS abnormalities in herpetic encephalitis and may play a major role as a 1st step in early diagnosis, in particular for acute disseminated encephalomyelitis.