An association between primary sclerosing cholangitis and ulcerative colitis is well known. But, primary sclerosing cholangitis with ulerative colitis has been rarely reported in children. The prevalence of primary sclerosing cholangitis among ulcerative colitis patiens is 3% in children. Primary sclerosing cholangitis is characterised by inflammation and fibrosis of the intrahepatic and extrahepatic bile ducts. The diagnosis of primary sclerosing cholangitis based on biochemical, histologic and cholangiographic criteria. A twofold or greater elevation of serum alkaline phosphatase is required to suspect this diagnosis. The definitive diagnosis of primary sclerong cholangitis can usually made by cholangiography. The prognosis varies. No adequate treatment exists although a number of potential treatments have been evaluated. We experienced a case of primary sclerosing cholangitis with ulcerative colitis in a 14 year old girl. She was admitted with a history of intermittent bloody diarrhea and jaundice over a two year period. Hepatosplenomegaly and cholestasis had been noted. Abnormal liver function tests were noted. AST was 117U/l, ALT 179U/l, alkaline phosphatase 603U/l, gamma-GT 366U/l, total bilirubin 5.5mg/dl. An endoscopic retrograde cholecystopancreatography showed evidence of strictures, beading, and irregularities of intra and extrahepatic biliary system. Liver biopsy showed histologic findings compatible with a sclerosing cholangitis and evidence of periductular fibrosis. She sufferred from persistent cholestasis and sign of portal hypertension. She had developed recurrent episodes of variceal hemorrhages which had been successfully managed several times endoscopic variceal ligations.
Adolescent ; Alkaline Phosphatase ; Bile Ducts, Extrahepatic ; Bilirubin ; Biopsy ; Child ; Cholangiography ; Cholangitis ; Cholangitis, Sclerosing* ; Cholestasis ; Colitis ; Colitis, Ulcerative* ; Constriction, Pathologic ; Diagnosis ; Diarrhea ; Female ; Fibrosis ; Hemorrhage ; Humans ; Hypertension, Portal ; Inflammation ; Jaundice ; Ligation ; Liver ; Liver Function Tests ; Prevalence ; Prognosis ; Ulcer*

PURPOSE: To investigate the role of 3D imaging in the sinonasal mass. MATERIALS AND METHODS: Twenty patients with sinonasal mass(squamous cell carcinoma[n=6], spindle cell carcinoma[n=1}, angiomatous polyp[n=1}, giant cell reparative granuloma[n=1}, non-Hodgkin's lymphoma[n=1}, melanoma[n=1}, angiofibroma[n=1}, pyocele[n=1}, inverted papilloma[n=1}) were studied with spiral CT. Reconstruction of surface rendered 3D images and segmentations were performed and compared with the 2D image. RESULTS: The 3D images enabled easy understanding of the characteristics of the mass in 12 casese. The 3D images displayed pathway of tumor extension in 5 cases and werehelpful in assessing the primary site of the mass in 3 cases. In two cases with encasement of ICA by the mass, assesment of relationship between the mass and vessels were possible through the segmentation. CONCLUSION: The 3D image, as an adjunct to the 2D image, can help to evaluate the virtual appearance of bony change, the degree of extension of mass, the spreading route, the evaluation of origin site. It also provides valuable 3-dimensional conception of the mass, especially for the surgeon.
Imaging, Three-Dimensional* ; Tomography, Spiral Computed

Tumor-mimicking lesions in the musculoskeletal system can be defined as lesions mistaken as tumors due to the presence of palpation upon physical examination or a tumor-like appearance upon radiological examination. Moreover, tumor-mimicking lesions show diverse etiologies and anatomic locations. We illustrated the various tumor-mimicking lesions involving bone and soft tissue. In this review, the tumor-mimicking lesions were classified into those based on clinical examination and those based on radiological examination in musculoskeletal radiology. Awareness of the various causes of tumor-mimicking lesions, correctly obtaining clinical information, and the proper selection of imaging modality are important for the differentiation of tumor-mimicking lesions from true neoplasms.
Bone Neoplasms/diagnosis ; Diagnosis, Differential ; *Diagnostic Imaging ; Humans ; Muscle Neoplasms/diagnosis ; Musculoskeletal Diseases/*diagnosis ; Physical Examination ; Soft Tissue Neoplasms/diagnosis

Fat tissue is a unique component of the soft tissue, and this fat tissue lies primarily in the spaces beneath the normal subcutaneous tissue, and within or around the organs. An entire lesion, or just a part of it, can be composed of these fat tissues. Therefore, it plays an important role in the diagnostic workup of suspected musculoskeletal diseases as well as in the differentiation between them. Fat tissue is shown as low density on plain radiographs, decreased attenuation on CT images, high signal intensity on T1-weighted images and it is hypoechoic on sonography. Because of its distinctive features, fat tissue is easy to verify on various modalities.?In addition, recent image studies like fat-suppressed imaging and STIR imaging provide more precise information of the lesion that involve fat tissue. In this article, we have reviewed the differentiation of musculoskeletal diseases, including the various tumorous lesion and tumor-like lesions involving the fat tissue.
Diagnosis* ; Musculoskeletal Diseases ; Subcutaneous Tissue

A giant-cell tumor of the tendon sheath (GCTT) predominantly affects the tendon sheaths or joints of the fingers and toes. Less common sites include large joints such as the ankle and knee joint. We describe a case of a 35-year-old female with a localized giant-cell tumor of the tendon sheath that uniquely originated from the deep infrapatellar bursa.
Adult ; Animals ; Ankle ; Female ; Fingers ; Humans ; Joints ; Knee ; Knee Joint ; Tendons ; Toes