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Background The nerve root sedimentation sign is a magnetic resonance (MR) sign, shown to be present in central lumbar spinal stenosis. The lack of sedimentation of the nerve roots to the dorsal part of the dural sac is consistent with the positive nerve root sedimentation sign. Purpose To validate the reliability of the nerve root sedimentation sign in diagnosis of different grades of lumbar spinal canal stenosis. Material and Methods This study was a retrospective review of 101 consecutive MR imaging (MRI) studies obtained on patients with clinically suspected lumbar canal stenosis. Based on the minimum anteroposterior (AP) diameter of the dural sac the study sample was classified into two groups: a group with morphological lumbar spinal stenosis; and the group of patients free from stenosis (AP > 12 mm). Patients with stenosis were further subclassified based on its severity: severe stenosis (AP ≤ 10 mm); and moderate stenosis (AP > 10 mm to ≤ 12 mm). Results Positive sedimentation sign was identified in 81% of patients with severe lumbar spinal stenosis and 14% of patients with moderate stenosis. No patients without lumbar spinal stenosis had a positive nerve root sedimentation sign. Of patients with a positive nerve root sedimentation sign, 89% presented with neurological claudication. Conclusion The nerve root sedimentation is a useful tool for identification of patients with both severe clinical and morphological lumbar spinal stenosis; however, its performance in the diagnosis of patients with moderate morphological spinal stenosis is poor.

Computed tomography is a modern technique producing high quality image of scanned organs. It plays a significant role in diagnostic work-up on orthopedics wards. This paper presents an analysis of management of two cases of Hawkins type I talar neck fracture with ankle joint rotation. In both patients, the diagnosis was based on conventional radiographs of the ankle joint in two projections and was subsequently verified with CT scans. The findings of a CT scan of the talus had a significant impact on further treatment and physiotherapy. Non-surgical treatment consisting in immobilization with a short leg cast combined with medication and magnetic field therapy produced a positive therapeutic outcome. A follow-up CT scan of the talus revealed bone union with remodelling in both patients. The functional outcome according to the AOFAS scale should be regarded good. Computed tomography is the radiological modality for detecting talar neck fractures and determining the presence of displacement. Follow-up CT scans evaluate the natural process of bone healing, which is crucial for treatment decisions regarding weight-bearing status. A correct diagnosis based on CT helps to prevent the development of necrosis and posttraumatic (secondary) degenerative changes as well as advanced physical disability, especially among youn­ger patients, in whom the injury is most common, consequently helping to avoid a long and costly treatment.

Summary An osseous Bankart lesion is commonly seen in patients with an anterior shoulder dislocation. It is defined as a detachment of the anteroinferior labrum associated with a glenoid rim fracture. Radiological studies are crucial not only for detecting glenoid bone defects but also for measuring the amount of bone loss. The precise quantification of the bony defect is crucial for the therapeutic desicion-making and clinical outcomes. Although we know that major glenoid bone loss requires surgical intervention, none of the studies performed so far answered the question what size of the defect should be an indication for open surgery procedures. Moreover, there is still no consensus on the exact percentage of glenoid loss that results in a higher risk of re-dislocations. In our opinion, there is a strong need for a consensus on universally accepted measuring techniques of the glenoid defect as well as on algorithms with validated glenoid bone loss threshold values for therapeutic decision-making. In this study, we review the techniques described so far in the literature and try to assess if any of these techniques should be treated as a leading method of detecting and quantifying osseous glenoid lesions.

Snapping hip syndrome is an audible or palpable snap in a hip joint during movement which may be accompanied by pain or locking. It is typically seen in young athletes performing activities requiring repeated extreme movements of the hip. It may also follow a physical trauma, intramuscular injections or surgeries. There are two main forms of snapping hip: extra- or intra-articular. Extra-articular snapping hip is elicited by an abnormal movement of specific tendons and is divided into two forms: internal and external. The internal form of snapping hip syndrome is attributed to an abrupt movement of an iliopsoas tendon against an iliopectineal eminence. Radiograph results in patients with this form of snapping tend to be normal. Dynamic ultrasound is the gold standard diagnostic technique in both forms of extra-articular snapping hip syndrome. The objective of the following text is to describe a step-by-step dynamic ultrasonography examination in internal extra-articular snapping hip syndrome in accordance to the proposed checklist protocol. To evaluate abrupt movement of an involved tendon, the patient needs to perform specific provocation tests during the examination. With its real-time imaging capabilities, dynamic ultrasonography detects the exact mechanism of the abnormal tendon friction during hip movement in a noninvasive way. It also allows for a diagnosis of additional hip tissue changes which may be causing the pain.

Guz Frantz (lity pseudobrodawkowaty nowotwór trzustki, guz Hamoudiego) jest rzadkim, zwykle łagodnym guzem o nieznanej etiologii, występującym głównie u młodych kobiet. Guz ten jest zazwyczaj bezobjawowy, może być jednak przyczyną bólu lub dyskomfortu ze strony jamy brzusznej. W opisywanym przez nas przypadku guz był przyczyną bólu brzucha u 14-letniej, zdrowej dotychczas pacjentki. W wykonanych badaniach obrazowych – ultrasonografii oraz tomografii komputerowej – uwidoczniono dużą masę guza w nadbrzuszu i śródbrzuszu lewym, którego punktem wyjścia była najprawdopodobniej trzustka. Wykonano biopsję metodą laparoskopową, potwierdzającą wstępne rozpoznanie. Guz wraz z ogonem trzustki usunięto metodą laparotomii bez powikłań. Opisany przez nas przypadek pokazuje, iż lity pseudobrodawkowaty guz trzustki może być rzadką przyczyną bólu brzucha u pacjentów pediatrycznych.