Clip migration after vacuum-assisted stereotactic breast biopsy: a pitfall in preoperative wire localization.

Vacuum-assisted stereotactic breast biopsy has become an irreplaceable instrument in the management of suspicious mammographic lesions. If the initial mammographic lesion becomes obscured or absent following the biopsy, a clip is commonly placed by interventional breast radiologists at the biopsy site. This enables future wire localization if atypical or malignant histology warrants excision. Currently, clip malposition or migration has become increasingly recognized in the literature as a possible complication of stereotactic breast biopsy. As in this case, recognition of migration of the clip was crucial in the planning of the patient's subsequent wire localization procedure. This article aims to increase the awareness of radiologists and surgeons of this potential pitfall to prevent false-negative biopsies and minimize positive surgical margins after wire-guided breast conservation surgery. Routine evaluation of pre- and postbiopsy mammograms and prospective identification of inaccurate clip placement before stereotactic wire localization and excision should be performed.

Tumors and tumor-like lesions of the jaw: radiolucent lesions.

Radiolucent lesions within the jaws represent a whole variety of lesions. Generally, they can be classified into two categories. The first category comprises well circumscribed lesions, either unilocular, multilobular or multilocular. They may be further subdivided into odontogenic or nonodontogenic lesions. The key feature that distinguishes these two subgroups is the relationship with the underlying dentition. Poorly circumscribed radiolucent lesions are the second category and consist of acute infectious disease and primary or metastatic malignancies. Although many of these lesions may present with non-specific imaging characteristics, careful analysis of a combination of imaging parameters may suggest a presumptive diagnosis. This article discusses the imaging features on different imaging techniques that may be useful in the characterization of these lesions.

Tumors and tumor-like lesions of the jaw mixed and radiopaque lesions.

Radiopaque lesions and lesions of mixed radioopacity are far less frequent than their radiolucent counterparts. Included in this spectrum are infectious and metastatic disease, inherited and developmental disorders and rare tumoral lesions. This article deals with the imaging features that may assist in the (differential) diagnosis of these lesions. in many instances, the radiological characterization is typical (osteoma, enostoma, fibrous dysplasia, Paget disease...), obviating the need for further invasive histological confirmation. Other lesions may share overlapping clinical, radiological and pathological features. In these cases, correlation of histopathological diagnosis with clinical findings and imaging features is of utmost importance for a correct diagnosis.

Conventional dental radiology: what the general radiologist needs to know.

This article aims to provide an overview of intraoral and orthopantomographic radiographs, including technique, indications, artefacts, relevant anatomy, current notation and common dental pathology. The normal anatomy is emphasised, because it is required for effective radiographic interpretation. Dental pathology, i.e. caries, periodontal disease, periapical inflammatory lesions and dental anomalies are illustrated.

The role of dental CT imaging in dental implantology.

The jaw has traditionally been evaluated by dentists and oral surgeons using conventional panoramic and intraoral films. During the past decade, dental computed tomography (CT) has become the method of choice for preimplantation assessment of jaw anatomy. This has urged the radiologist to take a more active role in evaluating the jaw. The aim of this article is to provide the reader with knowledge that should facilitate him to evaluate implant sites, dental related inflammatory diseases and augmentation procedures on dental CT scans.

Imaging approach for differential diagnosis of jaw lesions: a quick reference guide.

The radiologists will be frequently consulted to evaluate a variety of maxillomandibular lesions or may incidentally encounter these lesions on routine plain films, computed tomography (CT) or magnetic resonance (MR) studies. This article provides the reader a diagnostic approach pattern when confronted with an unknown jaw lesion. The radiologic analysis for differential diagnosis primarily depends on specific cardinal and additional radiographic criteria on plain film studies. Cardinal radiographic criteria include the density of the lesion and the location with regard to the adjacent tooth structures within the jaw. Additional criteria in the evaluation of jaw lesions are demarcation, morphological characteristics, cortical involvement, periosteal and soft tissue changes.

Value of magnetic resonance imaging in early assessment of proximal femoral focal deficiency (PFFD).

Proximal femoral focal deficiency (PFFD) is a developmental defect of the proximal femur and acetabulum. PFFD includes a spectrum of findings ranging from mild femoral shortening with varus deformity to complete absence of both the acetabulum and the proximal femur. Most attempts to classify the severity of the abnormality are based on the radiographic findings. The most commonly used system is that of Aitken. This classification scheme is based upon the presence and location of the femoral head and neck on conventional radiography and provides an assessment of future limb function and plan treatment. Since this scheme however relies on conventional radiography for classification, it is difficult to classify a child until skeletal maturity which is often delayed in children with PFFD. Nevertheless, the earlier patients can be treated, the earlier normal growth can start. This case report illustrates the value of Magnetic Resonance Imaging (MRI) in addition to the standard radiographs, for early and more accurate assessment of the articular cartilaginous anatomy and soft tissue prior to ossification of the femoral capital epiphysis. As a consequence, the patient could be treated earlier to benefit treatment outcome.

Paraperitoneal indirect inguinal bladder hernia: MR demonstration.

Inguinal or inguinoscrotal herniation of the bladder is not uncommon and has been estimated to comprise 1% to 3% of all inguinal hernias. The appearance of hernias on ultrasonography, intravenous pyelography, cystography, and computed tomography has been described previously but no instance of correlation with magnetic resonance (MR) imaging has been documented. Nevertheless, herniated bladders can be encountered fortuitously during abdominal MR imaging, and the radiologist should be familiar with their appearance. We present a case of unsuspected paraperitoneal indirect inguinal bladder herniation demonstrated by MR. Appearance on MR is characteristic, and this modality may be useful for differentiating the several types of inguinal hernias of the bladder because of its superior soft tissue contrast. In addition, MR imaging can be used to perform imaging in any plane and dynamic examinations during straining.

Accessory navicular bone: not such a normal variant.

The accessory navicular is often erroneously considered as a normal anatomic and roentgenographic variant. Three distinct types of accessory navicular bones have been described. The type 2 and 3 variants have been associated with pathologic conditions such as posterior tibial tendon tear and painful navicular syndrome and therefore should not be arbitrarily dismissed as a roentgenologic variant in a symptomatic patient. The pathogenesis and radiologic findings are discussed and illustrated.

Tuberculosis of the central nervous system: overview of neuroradiological findings.

This article presents the range of manifestations of tuberculosis (TB) of the craniospinal axis. Central nervous system (CNS) infection with Mycobacterium tuberculosis occurs either in a diffuse form as basal exudative leptomeningitis or in a localized form as tuberculoma, abscess, or cerebritis. In addition to an extensive review of computed tomography and magnetic resonance features, the pathogenesis and the relevant clinical setting are discussed. Modern imaging is a cornerstone in the early diagnosis of CNS tuberculosis and may prevent unnecessary morbidity and mortality. Contrast-enhanced MR imaging is generally considered as the modality of choice in the detection and assessment of CNS tuberculosis.

Trauma of the pediatric ankle and foot.

This article presents a brief overview of the injuries to the ankle and foot encountered in children and adolescents. Trauma to the ankle or foot may result from acute, chronic, or repetitive forces. The role of the different imaging modalities in the assessment of ankle and foot trauma in the growing patient is discussed. Plain radiographs remain the mainstay in the diagnosis of most acute traumas, whereas CT may be helpful to unravel the complex anatomy of certain fractures like the triplane or juvenile Tillaux fracture. In the evaluation of chronic injuries, including osteochondrosis dissecans and osteonecrosis, MRI is evolving as the modality of choice.

Bare lymphocyte syndrome: imaging findings in an adult.

Bare lymphocyte syndrome (BLS) is a rare primary immune disorder characterized by defective expression of human leukocyte antigen (HLA) on lymphocytes, often resulting in extensive and recurrent multi-organ infections. We describe a previously undiagnosed case of an adult woman who presented with radiological findings of severe bronchiectases, near-total granulomatous destruction of facial bones, and osteomyelitis. Diagnosis of BLS should be considered when evaluating children with unexplained bronchiectases or adults with long history of chronic multi-organ infections.