CT Scan Incidental Findings in Head Trauma Patients - Yazd Shahid Rahnemoun Hospital, 2005-2015.

BACKGROUND: Incidental findings are presented in radiology reports. Many of these findings do not require further investigation; however, some require further investigation and repeated imaging. The aim of this study was to determine the frequency of incidental findings on CT scans of patients with head trauma from 2005 to 2015. METHODS: This analytical cross-sectional study was conducted in years on 5,193 CT scan reports referred to Shahid Rahnemoun hospital in Yazd, Iran. The images were evaluated by consensus agreement of two radiologists. The relationship between age, sex and incidental findings was analyzed using the SPSS 20 software. RESULTS: A total of 5,193 subjects with a mean age of 34.16 ± 21.17 were examined. About 64% of cases were male. The frequency of incidental findings was 10.9%. The most common finding was calcification with a frequency of 3.3% and the least was Dandy Walker finding at 0.02%. There was no relationship between age, sex and the frequency of incidental findings. No significant trend was found between IFs frequency during ten years. CONCLUSION: The results of this study indicated that most incidental findings were related to benign findings, but also malignant findings were diagnosed.

The Normal Value of Tibial Tubercle Trochlear Groove Distance in Patients With Normal Knee Examinations Using MRI.

Patellar instability is a multifactorial common knee pathology that has a high recurrence rate, and the symptoms continue and ultimately predispose the patient to chondromalacia and osteoarthritis. Tibial tuberosity-trochlear groove distance (TTTG) is very important in the assessment of patellofemoral joint instability. The purpose of this study was to report the normal value of TTTG in males and females in different age groups and to assess the reliability of MRI in measuring TTTG. All patients presenting with knee pain and normal examinations of the knee joint, with a normal MRI report, referring to Shahid Sadoughi hospital of Yazd, Iran, from April 2014 to September 2014, were included in the study. MR images were studied once by two radiologists and for the second time by one radiologist. Mean value of TTTG was reported for males and females and in three age groups. Intra- and inter-observer reliability was calculated. A total of 98 patients were eligible to evaluate during 6 months (68 male and 30 female). Mean TTTG was 10.9±2.5 mm in total, which was 10.8±2.8 mm and 11.3±2.3 mm in males and females, respectively (P>0.05). Mean TTTG in males ≤30 years, 30-50 years and, ≥51-year-old were 10.8±2.6 mm, 10.8±2.7 mm, and 10.8±2.6 mm, respectively; that was 12.1±3.4 mm, 11.4±1.9 mm, and 10.5±1.7 mm in females ≤30 years, 31-50 years and, ≥51-year-old, respectively (95% CI). The coefficient of variation was <10% for both intra- and interobserver analysis. The results of the present study showed no significant difference in TTTG value between males and females in different age groups. In addition, it demonstrated that MRI is a reliable method in assessment of TTTG and identified normal value for TTTG at 10.9±2.5 mm.

Proliferating Myositis: An Inflammatory Lesion often Misdiagnosed as A Malignant Tumor.

Proliferative myositis (PM) is a rare inflammatory disease. Most commonly, the lesion occurs in the extremities. Regarding its fast growth and bizarre shape of the cellular components this entity commonly misdiagnosed and the patients undergo improper therapeutic approaches. In other words, it is often misdiagnosed as sarcoma. The diagnosis can only be made by the microscopic examination, so biopsy is mandatory. Here the authors report a patient with PM who was initially misdiagnosed as pleomorphic sarcoma of the lower extremity and explain this rare entity. Proliferative myositis should be taken into account if a fast growing, intramuscular mass occurs in the extremities.

Subungual Ewing sarcoma/PNET tumor family of the great toe: a case report.

Ewing's sarcoma is seen mainly in patients less than 18. This aggressive tumor generally affects the axial skeleton and only rarely involves the acral regions. Ewing's sarcoma in the foot is inordinately scarce. Clinical features are uncertain and can imitate other common diseases. This paper presents a case of 62-year-old malewith complaints of pain and swelling of the subungual area of his right great toe. The lesion was excised, and histopathological diagnosis of Ewing's sarcoma was made. Histopathological examination, supported by immunochemical methods, remains the mainstay of diagnosis. Surgical ablation along with chemotherapy is the therapy of choice. To our knowledge, this is the first report of Ewing's sarcoma involving the nail bed of the great toe without bone erosion. The key messages of this case report is "Subungual Ewing sarcoma is a rare case, and Ewing's sarcoma must be kept in mind for acral lesions, especially in the adult population."