Periosteal Osteosarcoma of the Distal Shaft of Fibula: Case Report on Rare Entity.

Introduction: Periosteal osteosarcoma is a rare, intermediate-grade, malignant tumor arising on the surface of the bone. There are only a few numbers of periosteal osteosarcoma of fibula reported. However, there has never been a case concerning distal fibula recorded so far. Wide surgical removal is the commonly advised treatment. In the present report, we describe a case of periosteal osteosarcoma localized to the distal fibula, which was treated by wide resection and reconstruction of ankle mortise with the ipsilateral proximal fibula. Case Report: The patient was a 48-year-old female who presented with ankle pain and swelling. A surface lesion, with "hair on end" periosteal reaction but without obvious medullary involvement, was seen on the distal fibular shaft by imaging studies. The diagnosis of periosteal sarcoma was confirmed with tru-cut biopsy. Wide resection and ankle mortise reconstruction with ipsilateral proximal fibula were done and 1 year of follow-up shows a good outcome. Conclusion: Periosteal osteosarcoma is a well-defined pathological entity with characteristic radiological and histological features. It is essential to distinguish it from other surface osteosarcomas as treatment modalities are different. Controversy remains about the appropriate treatment of periosteal osteosarcoma. Reconstruction of ankle mortise with reversed proximal fibular autograft is a good option in low-to-intermediate-grade periosteal osteosarcoma of the distal fibula rather than going for extensive radical procedures or adding chemotherapy to the treatment regimen.

Current status quo on COVID-19 including chest imaging.

With each day the number coronavirus disease 2019 (COVID-19) cases continue to rise rapidly and our imaging knowledge of this disease is expeditiously evolving. The role of chest computed tomography (CT) in the screening or diagnosis of COVID-19 remains the subject of much debate. Despite several months having passed since identifying the disease, and numerous studies related to it, controversy and concern still exists regarding the widespread use of chest CT in the evaluation and management of COVID-19 suspect patients. Several institutes and organizations around the world have released guidelines, recommendations and statements against the use of CT for diagnosing or screening COVID-19 infection and advocating its use only for those cases with a strong clinical suspicion of complication or an alternate diagnosis. However, these guidelines and recommendations are in disagreement with majority of the widely available literature, which strongly favour CT as a pivotal tool in the early diagnosis, management and even follow-up of COVID-19 infection. This article besides comprehensively reviewing the current status quo on COVID-19 disease in general, also writes upon the current consensus statements/recommendations on the use of diagnostic imaging in COVID-19 as well as highlighting the precautions and various disinfection procedures being employed world-wide at the workplace to prevent the spread of infection.

Ultrasound-guided peripheral nerve interventions for common pain disorders.

There are a number of common pain disorders that can be managed effectively by injections around or ablation of peripheral nerves. Ultrasound is a universally available imaging tool, is safe, cost-effective, and is excellent in imaging many peripheral nerves and guiding needles to the site of the nerves. This article aims to present an overview of indications and techniques of such procedures that can be effectively performed by a radiologist.