Are pelvic radiographs needed in assault victims?

To determine the incidence of acute pelvic fractures in patients with a history of being assaulted. Retrospective review by two musculoskeletal radiologists of 357 consecutive patients in a 12-month period, (308 males, 49 females). Two hundred seventy-six patients also had pelvic CT scans done at the same time. There were no acute pelvic fractures in this group. One patient had a 12th rib fracture and two other patients had a total of three lumbar spine transverse process fractures at the L1, L2, and L5 levels. Pelvic radiographs are not needed as part of standard protocols for patients who present with a history of being assaulted.

Whole body radiography for bone survey screening of cancer and myeloma patients.

PURPOSE: To determine the utility of a rapid, low dose whole body radiographic system (Statscan) for the detection of focal metastatic deposits in cancer patients and multifocal disease in myeloma patients. MATERIALS AND METHODS: After IRB approval, 30 consecutive patients had a frontal and lateral whole body radiography done with the Statscan system as a substitute for conventional radiographic skeletal survey. Both whole body images were obtained in less than five minutes. Images were retrospectively reviewed, independently, by three musculoskeletal radiologists. Findings were compared to information from all other available imaging studies. Final determinations were by consensus. RESULTS: Of the 30 patients in the study group, there were 18 men and 12 women with an age range from 37 to 88 years, average 60 years. Diagnoses were MGUS/multiple myeloma in 18 cases, lymphoma/leukemia in two cases, and cancer in 11 cases. Eleven of the Statscan exams were interpreted by all three radiologists as normal. The remaining 19 Statscan exams showed a total of 117 lesions (96 osteolytic and 21 osteoblastic). Ninety percent of these (106/117) were confirmed as areas of suspected metastatic disease or multifocal involvement by a variety of other imaging studies (radiographic bone survey-7, CT-33, MR-13, bone scan-4, PET/CT-8). CONCLUSION: The Statscan whole body radiographic system is a useful method for detecting focal metastatic disease in cancer patients and multifocal involvement in myeloma patients.

Central skeletal sarcoidosis mimicking metastatic disease.

Sarcoidosis is a systemic disease that histologically typically shows non-caseating granulomas. The most common radiologic finding is hilar and mediastinal adenopathy. Patients with widely disseminated disease may show involvement of the peripheral appendicular skeleton in 1-13% of such cases. A primary skeletal presentation without other manifestations typical of the disease is rare. We present a case of sarcoidosis in a middle-aged Caucasian man in whom the disease presented with widespread lytic lesions in the axial skeleton and long bones, mimicking metastatic disease. There was no involvement of the peripheral skeleton, skin or lungs.