Imaging spectrum of facial nerve lesions.

The facial nerve is affected by a wide variety of pathologies, including congenital, traumatic, inflammatory, and neoplastic conditions. Imaging plays a vital role in the diagnosis of these pathologies. The facial nerve has a complex anatomy and course. A strong grasp of normal facial nerve anatomy is essential for the radiologist to maintain a high level of diagnostic sensitivity. This article details the normal imaging anatomy of the facial nerve and the imaging features of common facial nerve pathologies.

Sarcoidosis of the thoracic and lumbar vertebrae, mimicking metastasis or multifocal osteomyelitis by MRI: case report.

Sarcoidosis is a notoriously protean disease, but vertebral involvement is a rare entity. This is a case report of biopsy-proven thoracic and lumbar vertebral sarcoidosis in a 48-year-old Hispanic female with low back pain. Although this patient had normal plain films and computed tomography of the spine, her disease was first visualized by magnetic resonance imaging. The imaging findings were nonspecific, and the initial impression was hematopoietic malignancy vs disseminated infection.

Bisphosphonate-related osteonecrosis of the mandible and maxilla: clinical and imaging features.

OBJECTIVE: Bisphosphonate-related osteonecrosis of the jaws is a rare, but morbid, condition. We present the clinical and imaging features of 19 patients. METHODS: A review of 19 bisphosphonate-related osteonecrosis patients was performed. Patient demographics, diagnosis, dental procedures, symptoms and clinical findings, location and pattern of involvement, and presence of fractures, sequestra, and fistulae were documented. RESULTS: Patients included 14 women and 5 men aged 48 to 80 years. Diagnoses included breast carcinoma (n = 11), multiple myeloma (n = 4), osteoporosis (n = 4), prostate carcinoma (n = 2), and lymphoma (n = 1). Seventeen patients received intravenous and 2 received oral bisphosphonates for 2 to 5 years. Bone involvement was noted in the mandible (74%), maxilla (16%), and both (10%). A lytic and sclerotic pattern was most common (58%). Additional findings included fractures (n = 5), sequestra (n = 4), and oroantral fistulae (n = 2). CONCLUSIONS: Bisphosphonate-related osteonecrosis is a rare, but morbid, condition, and imaging features can mimic other conditions. It is important for the radiologist to consider this entity in the appropriate clinical setting.

Congenital and acquired lesions of the nasal septum: a practical guide for differential diagnosis.

Many different types of lesions may involve the nasal septum, and some can destroy it. Congenital nasal septal anomalies are rare and tend to have fairly typical imaging features, which, when considered alongside the imaging appearance of the normal anatomy, help determine the correct diagnosis in most instances. By contrast, many acquired lesions have nonspecific imaging features, and their diagnosis therefore must be based also on the patient's age and the histologic findings. Acquired nasal septal abnormalities may be caused by trauma, infection, toxicity, inflammation, or tumors. Traumatic lesions may result from surgery or from repetitive behaviors such as rhinotillexomania. Frequent use of decongestants and cocaine also may erode the nasal septum. Bacteria, mycobacteria, and fungi may cause infections of the nasal septum, particularly in immunocompromised patients. Inflammatory diseases that may affect the nasal septum include sarcoidosis, reparative granuloma, and Wegener granulomatosis. Last, the tumors that may arise in the nasal septum or may involve it secondarily include carcinomas, Pindborg tumor, sarcoma, angiofibroma, hemangioma, neuroendocrine tumor, and schwannoma.

Accessory hepatic lobe mimicking an intra-abdominal tumor.

We present an accessory hepatic lobe case in which the axial computed tomographic images were mimicking an intra-abdominal tumor. The multiplanar reconstruction, 3-dimensional, and maximum intensity projection images suggested the diagnosis of an accessory hepatic lobe connected to the sixth liver segment through a highly irrigated pedicle. The diagnostic impression was confirmed by surgery and pathological examination.