Valgus slipped capital femoral epiphysis with contralateral pre-slip.

Slipped capital femoral epiphysis (SCFE) is a common hip disorder in older children and adolescents, classically with medial and posterior slippage of the proximal femoral epiphysis. However, valgus SCFE is a very rare entity, where the proximal femoral epiphysis slips laterally and posteriorly. To our knowledge, valgus SCFE with magnetic resonance imaging (MRI) features of contralateral pre-slip has not yet been reported. We present a case of a 9 year old girl with symptomatic valgus SCFE on the left and asymptomatic contralateral pre-slip on the right with concurrent radiographic, sonographic, and MRI findings. Such findings include bilateral coxa valga, radiographic irregularity of the left proximal femoral physis, bilateral hip effusions, abnormal MRI signal and enhancement about both proximal femoral physes, and minimal posterolateral slippage of the left proximal femoral epiphysis. We highlight these pertinent imaging findings and review the importance of accurately diagnosing this rare entity for appropriate surgical management.

Morel-Lavallée lesion after falling down stairs, diagnosed with ultrasound: A case report.

The Morel-Lavallée lesion is an uncommon closed degloving injury that most often occurs in the setting of high-energy trauma and can be associated with other traumatic injuries, including fractures of the pelvis, acetabulum, or femur. The superficial soft tissues are forcibly separated from the underlying deep fascia, resulting in damage to penetrating blood vessels and lymphatics. A fluid collection consisting of lymph, blood, and/or necrotic tissue subsequently develops and is most common in the region of the greater trochanter. Awareness of this entity is important to prevent a delay in diagnosis and decrease the risk of potential complications such as pseudocyst formation, pressure necrosis of the overlying skin, chronic pain, and infection. We present the case of a 49-year-old man who noticed a fluid collection in his right lateral upper thigh 1 week after slipping and falling down half a flight of stairs. Ultrasound demonstrated a fusiform fluid collection between the subcutaneous fat and underlying deep fascia, consistent with a Morel-Lavallée lesion. After reviewing various treatment options, the patient elected to undergo nonsurgical management. The lesion persisted but substantially improved 6 weeks after the initial injury. This case underscores the need to consider Morel-Lavallée lesions in the appropriate clinical context.

Primary Carcinoid Tumor of the Ovary: A Case Report With Radiologic and Pathologic Correlation.

Ovarian carcinoid tumors are very rare entities that often mimic other ovarian neoplasms. A case of primary ovarian carcinoid in a 44-year-old woman is presented with emphasis on the magnetic resonance imaging (MRI) features of the tumor and pathologic correlation. Ovarian carcinoid tumors can be variable in their MRI appearance, presumably due to different tumor subtypes and tumor components, thus requiring pathologic diagnosis. It is imperative to accurately diagnose primary ovarian carcinoid tumors, as their prognosis is usually more favorable compared to other malignant ovarian neoplasms.

Mature cystic teratoma of the fallopian tube diagnosed preoperatively with computed tomography and ultrasound: A case report.

Mature cystic teratoma of the fallopian tube is extremely rare, with fewer than 100 cases reported in the English literature. Clinical symptoms are nonspecific, and the diagnosis is most often made after surgical resection. A preoperative diagnosis has the potential to aid with surgical planning and patient counseling. We present a case of a large completely intratubal mature cystic teratoma in a 40-year-old woman who presented to her primary care provider with the gradual onset of right lower quadrant/pelvic pain. The patient's symptoms prompted evaluation with computed tomography (CT) and ultrasound. Imaging showed a dilated right fallopian tube containing fluid, macroscopic fat, and calcifications, facilitating the preoperative diagnosis of mature cystic teratoma of the fallopian tube. Because of her symptoms, she elected to undergo salpingectomy and the diagnosis was pathologically confirmed. The patient's symptoms resolved following surgery.

A Rare Case of Sigmoid Colon Perforation in a Patient With Severe Acute Pancreatitis.

Severe acute pancreatitis can cause systemic inflammation and multiorgan failure. We present the case of a 60-year-old woman who presented with necrotizing pancreatitis and subsequently developed a sigmoid colon perforation. The perforation presumably occurred because of extravasation of pancreatic enzymes into the abdominal cavity, resulting in colonic wall injury. Our case highlights the rare colonic complications of severe acute pancreatitis.

Bilateral Myeloid Sarcoma of the Breast: A Case Report With Radiological and Pathological Correlation.

Myeloid sarcoma is a solid extramedullary mass of immature myeloid cells, often in patients with myeloid leukemia. Myeloid sarcoma of the breast is extremely uncommon, and bilateral involvement is even rarer. Myeloid sarcoma of the breast can mimic primary breast cancer, lymphoma, and other neoplasms. Differentiation between myeloid sarcoma and primary breast malignancy is imperative, as management and treatment are drastically different. We present a case of myeloid sarcoma of both breasts in a 63-year-old female with relapsed acute myelogenous leukemia (AML), a personal history of ovarian cancer, and a family history of both leukemia and breast cancer. This report highlights the need for high clinical, radiological, and pathological suspicion to diagnose myeloid sarcoma of the breast.

Dating and eating. How university students select eating settings.

People use cognitive scripts to decide to eat in particular settings, such as selecting where to eat on dates during courtship. We surveyed 562 university students about scripts for eating on dates. Public, formal eating settings were seen as more appropriate for first dates, but a broader variety of settings, including individuals' homes, was considered appropriate for dates in long-term relationships. Gender analysis revealed that women were more flexible than men about appropriateness of eating places for dates. These findings suggest that scripts may guide eating decisions and behaviors, particularly among women, and that eating scripts may become more flexible as relationships develop.

Dating and eating. Beliefs about dating foods among university students.

Dating is an important courtship activity in the U.S., and food consumption is part of dating events. Students use dating scripts to guide decisions and behaviors on dates, and perform scripts on dates to construct positive impression management. This study examined how students conceptualized dating foods. A questionnaire was administered in one large university class, and data from 301 students were analyzed. Students were asked to name three dating foods, three foods that are not dating foods, what makes foods dating foods, and what makes foods not dating foods. Findings revealed that both common and uncommon foods were named as dating and not dating foods. Alcoholic beverages were sometimes named as dating foods. Women often named feminine foods (considered appropriate for females) as dating foods, but men were not more likely to name masculine foods (considered appropriate for males) as dating foods. Neat and easy-to-eat foods were often named as dating foods, while pungent foods and foods causing bad breath were named as not dating foods. These findings support the conception that dating scripts guide thinking about food choices to enhance impression management. Dating food choices are important for current health and as potential precursors for long-term eating relationships like marriage.

Severe Hypercalcemia Related to Silicone Granulomas, as Discovered by FDG-PET.

Silicone injected for cosmetic purposes can provoke an inflammatory granulomatous response. In turn, silicone granulomas can lead to hypercalcemia, which is a rare, though potentially life-threatening condition. Hypercalcemia is a nonspecific laboratory finding with many potential etiologies. It may be difficult for clinicians to diagnose silicone-induced hypercalcemia, since the history of cosmetic silicone injections may not be elicited from the patient. Positron emission tomography using F-18-fluorodeoxyglucose (FDG-PET) can be used to evaluate patients with unexplained hypercalcemia as a means of searching for an occult malignancy or granulomatous process. FDG-PET findings may be the initial and perhaps only indication of silicone granulomas as the cause of hypercalcemia. Nuclear medicine physicians should have a low threshold for suggesting this diagnosis, particularly in the setting of unexplained hypercalcemia. This case report highlights the value of FDG-PET in diagnosing silicone granuloma-induced hypercalcemia.