PURPOSE: To evaluate the characteristic MRI findings of pubic insufficiency fracture. MATERIALS AND METHODS: In nine cases of pubic insufficiency fracture, the findings of plain radiography (n=9), MRI (n=9), and bone scintigraphy (n=8) were reviewed. We retrospectively analyzed, with regard to fracture site, the destructive pattern revealed by plain radiography, and uptake by other pelvic bones, as demonstrated by RI bone scanning. The MR findings evaluated were the fracture gap and its signal intensity, the site and signal intensity of the soft tissue mass, and other pelvic bone fractures. RESULTS: Plain radiography revealed osteolysis and sclerosis of pubic bone in eight of nine cases (89%), and parasymphyseal fractures in seven (78%). RI indicated uptake by the sacrum in six cases (66%), and by the ilium in three (33%). MR findings of fracture gap (seven cases, 78%) were hypo to isointensity on T1WI, hyper-intensity on T2WI and the absence of contrast enhancement. Soft tissue masses were found in seven cases (78%); in four of these the location was parasymphyseal, and in three, surrounding muscle was involved. Hypo to isointensity was revealed by T1WI, hyperintensity by T2WI, and there was peripheral enhancement. Other associated pelvic bone fractures involved the sacrum in seven cases and the ilium in four. CONCLUSION: The characteristic MR findings of pubic insufficiency fracture were parasymphyseal location, fracture gap, peripherally enhanced soft tissue mass formation, and fractures of other pelvic bones, namely the sacrum and ilium.
Fractures, Stress* ; Ilium ; Magnetic Resonance Imaging* ; Osteolysis ; Pelvic Bones ; Pubic Bone ; Radiography ; Radionuclide Imaging ; Retrospective Studies ; Sacrum ; Sclerosis

No abstract available.
Bone Marrow Cells/pathology ; Bone and Bones/radionuclide imaging ; Female ; Humans ; Lung Neoplasms/diagnosis/radiography ; Middle Aged ; Multimodal Imaging ; Multiple Myeloma/*diagnosis/pathology/radiography ; Tomography, X-Ray Computed

One hundred and sixty patients having bronchogenic carcinoma were evaluated for bone metastasis by means of 99mTc-monodiphosphate bone scanning, correlative radiographic bone survey and their clinical findings. In all patients, diagnosis was histologically proved. Bone scan demonstrated the possible evidence of bone metastasis in 75 patients (46.9%) and radiography, in 29 patients (18.1%). False negative was noted in 1 patient-Bone scan correlated with radiography in 37.3%, and with accompanying bone pain in 52% of the patients. But there was no correlation with the level of serum calcium, inorganic phos- phorus and alkaline phosphatase. In connection with their clinical stages before scanning, bone scans were positive in 33.3% of clinical stage I, 10.8% of clinica1 stage II and 54.1% of clinical stage III. Our Study suggests that bone scanning with 99m-monodiphosphate detected early bone metastasis in patients with bronchogenic carcinoma before their lesions became evident clinically or radiographically, and also important to determine operability.
Adult ; Aged ; Bone Neoplasms/radiography ; Bone Neoplasms/radionuclide imaging ; Bone Neoplasms/secondary* ; Bone and Bones/radionuclide imaging* ; Carcinoma, Bronchogenic/radiography ; Carcinoma, Bronchogenic/radionuclide imaging* ; Comparative Study ; Female ; Human ; Lung Neoplasms/radiography ; Lung Neoplasms/radionuclide imaging* ; Male ; Middle Age ; Technetium/diagnostic use ; Tomography, Emission-Computed

Psoriatic arthritis (PsA) is an inflammatory arthritis associated with psoriasis. There are no generally accepted diagnostic criteria for PsA. Indeed, the diagnosis of this inflammatory arthritis is made by exclusion of other possible diseases and based upon immunologic, radiologic, and clinical features which are consistent with the diagnosis. Inflammatory arthritis in a patient with psoriasis can be an important clue for the diagnosis of PsA, but the possibility for diagnosis of other inflammatory arthritides ever remains. Herein we report a case of a female patient who was not diagnosed with PsA, but with rheumatoid arthritis, even though she had psoriasis.
Adult ; Arthritis/classification/*diagnosis/*immunology ; Arthritis, Psoriatic/classification/*diagnosis/*immunology ; Bone and Bones/radiography/radionuclide imaging ; Diagnosis, Differential ; Female ; Humans ; Skin/pathology

Osteoarthritis (OA) is a chronic joint disease that involves degeneration of articular cartilage, limited intra-articular inflammation manifested by synovitis and changes in the subchondral bone. After the articular cartilage's stability and complex structure in the framework of pressure-proof were destruct, the ability to repair by itself was weak. Therefore early diagnosis in the treatment of osteoarthritis is a focal ponit. This paper addressed on the characteristics of diagnosis of OA in the relevant objective diagnostic methods.
Adult ; Aged ; Bone Density ; physiology ; Bone and Bones ; diagnostic imaging ; pathology ; Calcification, Physiologic ; Cartilage, Articular ; diagnostic imaging ; pathology ; Female ; Humans ; Joints ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Osteoarthritis ; diagnosis ; epidemiology ; Osteoarthritis, Knee ; diagnosis ; diagnostic imaging ; Radiography ; Radionuclide Imaging ; Synovial Membrane ; diagnostic imaging ; pathology ; Ultrasonography

The accurate staging of Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) is an important aspect of treatment. In this study, the authors undertook to prospectively evaluate the clinical value of 2- (fluorine-18) fluoro-2-deoxy-D-glucose position emission tomography (FDG-PET) for the staging of malignant lymphoma as compared with computed tomography and 67Ga scan. Thirty consecutive cases with biopsy-proven lymphoma (4 HD, 26 NHL) were examined by FDG-PET for the initial staging and the restaging work-up between September 2000 and April 2001. The FDG-PET and conventional study, including a CT of the neck, chest, abdomen, and of the pelvis, a bone scan, a 67Ga scan, and a bone marrow study were undertaken to investigate nodal/extranodal manifestations and bone marrow infiltration. In terms of the detection of nodal lymphoma manifestation, the sensitivities and specificities of the PET, CT, and 67Ga scan were determined to be 93.3%, 98.9%, and 25.8%, and 100%, 99.1%, and 99.8%, respectively. In terms of the detection of extranodal lymphoma manifestation, the sensitivities and specificities of the PET, CT, and 67Ga scan were 87.5%, 87.5%, and 37.5%, and 100%, 100%, and 100%, respectively. The FDG-PET proved to be very accurate for the staging of malignant lymphoma and superior to Ga-67 scan. Although the results of PET and CT were substantially comparable, both imaging studies were found to complement each other in some cases with respect to the evaluation of lymphomatous involvement.
Adult ; Aged ; Aged, 80 and over ; Bone and Bones/radionuclide imaging ; Comparative Study ; Female ; Fludeoxyglucose F 18/*diagnostic use ; Gallium Radioisotopes/*diagnostic use ; Human ; Lymph Nodes/pathology ; Lymphoma/*pathology/radiography/radionuclide imaging ; Male ; Middle Aged ; Neoplasm Staging ; Prospective Studies ; *Tomography, Emission-Computed ; *Tomography, X-Ray Computed

OBJECTIVE: Insufficiency fracture (IF) occurs when normal or physiological muscular activity stresses a bone that is deficient in mineral or elastic resistance. We studied clinical characteristics of IF in patients with chronic inflammatory joint diseases in Korea. METHODS: Between Aug. 1997 and Feb. 2003, thirty five patients with 77 fractures were studied at the authors' institution when they were being treated for their rheumatic diseases. The clinical and laboratory data were collected by review of medical record retrospectively. RESULTS: All patients except four were postmenopausal women (mean age 63.0+/-10.0 years) with long disease duration (mean 14.2+/-11.6 years). Thirty three patients had rheumatoid arthritis, 1 ankylosing spondylitis and 1 systemic lupus erythematosus. Twenty nine patients (85.7%) were receiving regular steroid treatment (mean dose 4.0+/-2.3 mg/day, mean duration 6.1+/-4.2 years). Twenty four patients were treated with methotrexate. The significant reduction in their bone mineral density was found 27 patients based on BMD or QCT. Eight patients without osteoporosis were treated with steroid or MTX. Twenty three patients were ever used for osteoporosis treatment. Most patients except four presented with pain in the low back, groin, hip, pelvic, leg and knee. Initial simple radiography was positive in only 7 patients, with vertebral compression fracture in 11 patients and no effect on mobility except ten. Diagnosis was delayed (mean duration of symptom until diagnosis was 45.6+/-64.5 days). IF was confirmed using the bone scan. Sacrum and pelvic bone was most frequently affected site. The other sites were SI joint, iliac wing, symphysis pubis, acetabulum and femur neck. Twenty nine patients required in-patient stay (mean 17.4 days). All but one patient showed an uneventful recovery with conservative treatment. CONCLUSION: The low grade nature of symptoms, minimal effect on mobility, absence of significant trauma and missed on initial plain radiography make diagnosis difficult and delayed. IF should be suspected in cases of unexplained pain with local tenderness in patients of chronic inflammatory joint diseases. The technetium-99m diphosphonate bone scintigraphy was valuable diagnostic tool in the early recognition of IF.
Acetabulum ; Arthritis, Rheumatoid ; Bone Density ; Diagnosis ; Female ; Femur Neck ; Fractures, Compression ; Fractures, Stress* ; Groin ; Hip ; Humans ; Joint Diseases* ; Joints* ; Knee ; Korea ; Leg ; Lupus Erythematosus, Systemic ; Medical Records ; Methotrexate ; Osteoporosis ; Pelvic Bones ; Radiography ; Radionuclide Imaging ; Retrospective Studies ; Rheumatic Diseases ; Sacrum ; Spondylitis, Ankylosing