Radiological imaging for the diagnosis of bone metastases.

Primary neoplasms of the skeleton are rare, but metastatic involvement is, unfortunately, a common occurrence. This is particularly true for certain primary tumors. Skeletal metastases are clinically significant because of associated symptoms, complications such as pathological fracture and their profound significance for staging, treatment and prognosis. Detection of bone metastases is, thus, an important part of treatment planning. The frequency with which metastases are detected varies considerably with the type of primary tumor and with the methodology utilized for detection. Four main modalities are utilized clinically: plain film radiography, CT scan, nuclear imaging and magnetic resonance imaging. In this discussion, we will review literature on the radiology of skeletal metastases with respect to lesion detection, assessment of response to treatment and possible therapeutic implications. The bulk of the discussion will focus on MRI and nuclear studies since most of the recent advances have been made in these areas.

Atypical angiographic appearance of a superficial femoral artery mycotic aneurysm.

An unusual presentation of mycotic aneurysm is described. In this case, a large thrombosed mycotic aneurysm of the superficial femoral artery was associated with segmental occlusion of the adjacent artery. Small vessels were delineated in the periphery of the aneurysm on angiography.