Metastatic bone disease: evaluation by functional imaging in correlation with morphologic modalities.

The diagnosis of presence, location and load of metastatic, bone involvement has important implication on patient management and prognosis. This requires collection of data obtained using different imaging modalities. Bone scintigraphy is a highly sensitive and cost-effective screening modality. However, to overcome its lower specificity and its limitation in evaluation of vertebral metastases, CT, PET or MRI can be utilized to verify the nature of suspicious lesions. Expansion of SPECT/ CT may fine tune the highly sensitive bone scintigraphy. PET has an emerging and leading role in many tumors, occasionally obviating the need for bone scintigraphy, particularly in evaluation of response to therapy. PET and whole body MRI offers a potentially important tool to provide the earliest clue of bone marrow metastasis. The value of F-18 PET as a sensitive bone imaging tool needs to be further evaluated on a larger scale in different setting including treated and untreated cancer patients and to evaluate also whether potentially better resolution would lead to more benign lesions detection mimicking metastasis such as fractures, inflammatory, infection, and degenerative involvement of bone. The added value of PET-CT is also to be further examined with this regard.

Multifocal post-traumatic scintigraphic changes mimicking bone metastases in a battered adult.

Several pathologies have been reported to cause scintigraphic patterns similar to multiple bony metastases. Heterotopic bone formation is known to mimic several inflammatory and neoplastic conditions including recurrent tumors. However, no reports on multifocal heterotopic bone formation simulating the typical pattern of randomly distributed foci of increased uptake of metastases on bone scan were found in literature. We present a case of a young adult who was repeatedly assaulted by others over a period of one month and on bone scan had a pattern similar to bony metastasis due to multiple foci of heterotopic bone formation and fractures.

Attitudes of Kuwaiti parents toward physical punishment of children.

OBJECTIVE: The major aim was to describe parental attitudes to physical punishments and examine their sociodemographic correlates. A related aim was to assess the association of parents' own experience of physical punishment with attitudes to punishment of children. METHOD: A cross-sectional survey was conducted during the second week of December, 1996 in five general clinics covering the major administrative areas of Kuwait: 337 Kuwaiti mothers and fathers with at least one living child were contacted; 95% were successfully interviewed using a structured questionnaire. RESULTS: Eighty-six percent of parents agreed with physical punishment as a means of child disciplining. Agreement with punishment was higher in case of serious misbehaviors such as stealing (63%), sniffing glue and using drugs (77%). Multiple regression results showed that parent's lower level of education and Bedouin ethnicity were positively associated with agreement on physical punishment. Larger percentages of parents who had experienced physical punishments themselves agreed with such punishment to discipline their children, but this was not statistically significant. CONCLUSIONS: In recent years education has become widespread for both sexes. An inverse association between educational level and agreement on physical beating suggest that attitudes to this form of child disciplining are changing. Those with a Bedouin ethnic background still adhere more strictly to the traditional forms of child disciplining including physical beating. There is a need for conducting research on the possible negative psychosocial impacts of physical punishment in view of findings from other countries.