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This article describes a variety of food signs in musculoskeletal radiology. The review includes discussions of the underlying pathology responsible for these specific radiographic signs and relevant differential diagnoses. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: (1) Describe multimodality imaging of cubonavicular coalition (CNC) with magnetic resonance imaging (MRI) focus, (2) evaluate CNC associated foot and ankle pathology, (3) examine clinical presentation/symptoms associated with CNC, (4) record CNC treatment., Materials and Methods: Retrospective Institutional Review Board (IRB) approved study. Picture Archiving and Communication System (PACS) databases searched for CNC. Final study population: 34 cases in 27 patients. Each CNC was reviewed for: coalition type (osseous versus non-osseous- cartilaginous versus fibrous), tendon and ligament pathology, bone marrow edema at CNC and adjacent joints, presence and severity of degenerative changes at CNC and adjacent joints, fractures, additional coalitions, laterality, and pes planus. MRI planes and radiographic views on which coalitions were best identified were recorded. Each CNC EMR was reviewed for: symptoms, trauma, management, patient demographics. Inter-reader reliability was performed for type of non-osseous coalition., Results: Final cohort included 34 cases in 27 patients (average age: 34.7, range: 10-76; 71% female). No CNC was completely osseous. On MRI, 89.5% of coalitions were non-osseous and 5.3% were partially osseous. 76.5% of patients had referable symptoms including pain, limited motion, inability to bear weight. 23.5% of patients were surgically managed/pathologically proven. On MRI, 36.8% of patients had tendon pathology, 52.6% had ligamentous pathology, 100% had bone marrow edema-like signal abnormality about the CNC, and 88.2% had CNC degenerative changes. There was bone marrow edema-like signal abnormality at bones adjacent to the CNC in 52.6% and adjacent joint degenerative disease present in 50%. CNC was best identified on oblique radiographs and axial MRI. Inter-reader reliability for non-osseous coalition type was poor, Cronbach's alpha 0.554., Conclusion: CNC is subtle and findings of osteoarthritis or bone marrow edema-like about the cubonavicular articulation should raise suspicion for underlying coalition., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Peripheral nerve sheath tumors comprise a significant percentage of both benign and malignant soft tissue tumors. The vast majority of these lesions are schwannomas and neurofibromas, which most radiologists are familiar with including the well-described multimodality imaging features. However, numerous additional often under-recognized benign entities associated with nerves exist. These rarer entities are becoming increasingly encountered with the proliferation of cross-sectional imaging, particularly magnetic resonance imaging (MRI). It is important for the radiologist to have a basic understanding of these entities as many have near-pathognomonic MR imaging features as well as specific clinical presentations that when interpreted in concert, often allows for a limited differential or single best diagnosis. The ability to provide a prospective, pre-intervention diagnosis based solely on imaging and clinical presentation is crucial as several of these entities are "do not touch" lesions, for which even a biopsy may have deleterious consequences. To our knowledge, the majority of these benign entities associated with nerves have only been described in scattered case reports or small case series. Therefore, the aim of this article is to provide a radiopathologic comprehensive review of these benign entities that arise in association with nerves with a focus on characteristic MRI features, unique histopathologic findings, and entity specific clinical exam findings/presentation., (© 2022. The Author(s), under exclusive licence to International Skeletal Society (ISS).)

Aim: To review clinical and magnetic resonance imaging (MRI) features of patients with glomus tumour of the knee, and compare the present findings with cases from the English literature., Materials and Methods: The orthopaedic oncology and pathology databases at The University of Chicago were reviewed for cases of glomus tumour and small subcutaneous anterior knee masses. For all glomus tumours, the site of the tumour and age and sex of the patient were recorded. For those tumours arising in the knee, the symptom profile and MRI characteristics were recorded. The English literature was reviewed for cases describing glomus tumours in the knee., Results: Thirty-four patients with glomus tumour were recorded. Five glomus tumours occurred in the anterior knee, all in men aged ≥30 years, four of whom had a several-year history of pain prior to diagnosis. MRI showed small (<2 cm) nodular enhancing masses. Review of the English literature supports the anterior knee as a common location for lower-extremity glomus tumours, with a male predominance and several years of pain preceding diagnosis., Conclusion: Although rare, glomus tumours occur in the knee. Unlike the classic description of glomus tumours occurring in the fingers most typically in women <30 years of age, those that occur in the knee tend to do so in men >30 years, and many years of pain can precede diagnosis. The astute radiologist may be the first to suggest this diagnosis if a small, painful, enhancing, nodular subcutaneous mass is noted on knee MRI examinations., (Copyright © 2022 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)

The efficiency of the real estate market is a major concern for homeowners, investors, lenders, policymakers, and researchers. Modern academic literature has mostly moved beyond an early emphasis on formal tests of informational efficiency. The Grossman and Stiglitz (The American Economic Review 70:393-408, 1980) paradox holds that perfect informational efficiency is impossible and the joint hypothesis problem implies that market efficiency is not even testable. Instead, researchers now commonly examine the speed, accuracy, and persistence of price movements in response to new information, as the allocative efficiency of a market ultimately depends on its degree of informational (and operational) efficiency. This special issue is devoted to exploring these issues., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.)

Gunshot wounds (GSWs) are an important cause of disability and death in the USA. Although radiography is limited in its ability to detect bullet types, a projectile introduced during the last decade, the R.I.P. bullet by G2 Research, consists of a base slug connected to 6 to 8 sharp trocars designed to diverge within soft tissue following impact, resulting in what we believe to be a unique imaging appearance that can be confusing to those not familiar with this particular projectile. Furthermore, this bullet is 100% copper, which may allow for safe imaging with magnetic resonance imaging if correctly identified prior to scanning.

Objective The goal of this survey-based study is to explore patients' knowledge of and expectations for radiologists in the outpatient setting.  Materials and Methods A comprehensive survey was distributed to adult patients undergoing knee magnetic resonance imaging (MRI) over a one-year period from September 2015 through August 2016 at an urban, quaternary care academic medical center. Results The survey results demonstrate that only a subset of patients undergoing knee MRI at the institution during the survey period are aware of the role of the radiologist, which is a well-documented fact described in the literature. Approximately one-third of patients expected to meet the radiologist during their visit to the department of radiology to undergo a knee MRI. The vast majority of patients surveyed wanted to be able to contact the person who read their exam, but only one patient actually contacted the radiologist during the study period.  Conclusion While the vast majority of surveyed patients wanted to be able to contact the person who read their knee MRI, only one patient actually did reach out to the radiologist to discuss findings. However, six of 36 follow-up respondents reported that they had contacted the person "who interpreted/read your exam:" two in person, one by email, three by phone, and one by other. Survey results demonstrated that only a subset of patients correctly understood the role of the radiologist (46% in the 1 st  survey and 63% in the 2 nd  survey, which does not represent a statistically significant difference), which suggests that perhaps the patients did have a conversation with a member of the radiology department staff whom they believed was actually the radiologist. The fact that patients expressed a desire to communicate with the person reading their reports, but then did not take advantage of the opportunity to contact the radiologist, suggests that the issue is more complicated than just a lack of a pathway for communication between patients and radiologists. Perhaps the lack of a clear understanding of the role of the radiologist hinders patients from contacting radiologists, as they feel uncertain as to whom they are actually attempting to reach. Or perhaps patients are sufficiently reassured by having a means through which they could contact the radiologist and do not require the actual communication in order to feel comfortable. There remains a significant amount of work to be done in understanding the barriers in patient-radiologist communications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Phillips et al.)

Imaging studies of the hands and fingers are common, and radiologists are generally comfortable with traumatic and degenerative conditions which arise frequently in daily practice. However, a variety of common and uncommon soft-tissue tumors also occur in the hand, the appropriate diagnosis of which can be a source of confusion for both clinicians and radiologists. These lesions often have overlapping imaging characteristics; however, a structured approach can help provide a focused differential diagnosis and impact further workup and management. We discuss several such tumors, categorizing them as cystic-appearing, noncystic masses along tendons and aponeuroses, adipocytic tumors, vascular lesions, and miscellaneous lesions with imaging features that can aid diagnosis.

Total knee arthroplasty (TKA) is the most common joint replacement performed. This article reviews the normal appearance of TKA including the most common types of arthroplasties as well as complications. Common complications at the present time are infection, aseptic loosening, and instability. Rarer complications such as polyethylene wear, periprosthetic fracture, and soft tissue pathology are also discussed. Although the mainstay of imaging is radiographs, newer techniques in TKA imaging such as computed tomography and magnetic resonance imaging are also reviewed., Competing Interests: Winnie A. Mar reports personal fees from Guerbet outside the submitted work. The remaining authors have declared no conflicts of interest for this article., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Objective: Voriconazole is an antifungal medication used primarily for the treatment of Candida and Aspergillus infections. A fairly newly described side effect of long-term voriconazole use is periostitis. The purpose of this article is to describe the main differential consideration-hypertrophic osteoarthropathy-and other differential diagnoses, including venous stasis, thyroid acropachy, and hypervitaminosis A., Conclusion: With knowledge of imaging appearance, clinical manifestations, and outcomes, radiologists can make an accurate diagnosis of voriconazole-induced periostitis, and clinical teams can initiate appropriate management.

PowerPoint software (Microsoft, Redmond, WA) has become a popular tool for creating and displaying electronic presentations. The "hyperlink" function in PowerPoint allows users to advance from one slide to another slide in the presentation when they click on a predetermined word, shape, or image, thereby allowing for a more dynamic and interactive experience than can be obtained with serial presentation of slides alone. The objective of this article is to provide a tutorial describing the necessary steps to create hyperlinks and incorporate them in a variety of ways into a PowerPoint presentation. Hyperlinks can turn a passive learning experience into an active one by allowing the participant to become more engaged with the presentation., (Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Objective: The objective of our study was to characterize infarct-associated bone sarcoma and its imaging features., Materials and Methods: Our databases were searched for instances of sarcoma arising in association with osteonecrosis. Demographic and imaging data were recorded. The imaging studies of 258 patients with sarcomas were reviewed to determine whether underlying osteonecrosis was present. Radiographic and MRI studies of patients with bone infarction were reviewed to categorize the various appearances of infarction and to determine if sarcomas tended to arise in a particular pattern. A literature review was performed., Results: Nine infarct-associated bone sarcomas were found in eight patients: seven malignant fibrous histiocytomas (MFHs) and two osteosarcomas. All occurred in the femur or tibia; multifocal infarction was documented in all patients except one. Sarcomas were commonly associated with a so-called "mature"-type pattern of osteonecrosis-that is, with well-defined calcified margins. Osteolysis of infarct-associated MFHs was often overlooked at initial presentation and was often detected only after pathologic fracture. CT and MRI revealed cortical penetration in all cases; infarct margin disruption was evident, but preservation of fat within the infarct was typical. Increased radiotracer activity with relative central photopenia was characteristic of large infarct-associated bone sarcomas on scintigraphy. All lesions, including those treated at our institution and those found in the literature, were metaphyseal or diaphyseal, and although epiphyseal extension of sarcoma from a metadiaphyseal infarct was common, no purely epiphyseal lesions were encountered., Conclusion: Radiologists must remain vigilant for this rare occurrence, especially in patients with new pain in an area of known bone infarction.

Objective: Tumors and tumorlike lesions of the tubular bones of the hand, often incidentally discovered lesions, present a unique but challenging differential diagnosis., Conclusion: Imaging, including both radiography and cross-sectional imaging, can allow the radiologist to generate a clinically useful differential diagnosis based on the distinguishing features of these entities. Recognition of these lesions is important because clinical management and treatment by orthopedic oncologists vary depending on the diagnosis.

Osteoma of long bone is an extremely rare, benign bone-forming surface lesion with the largest published case series consisting of only 14 patients. The most important and often most difficult lesion to differentiate from osteoma of long bone radiographically is parosteal osteosarcoma, which is a rare, low-grade surface osteosarcoma with the potential for dedifferentiation. Reports of imaging studies of osteoma of long bone depict a well-defined ossified mass arising from the surface of the diaphysis or metadiaphysis of a long bone. A characteristic feature is the homogeneity of the mass, with uniform density near or equal to that of cortical bone from the base of the lesion to its periphery. The 45-year-old female in this case presented with left hip fullness and was subsequently found to have a proximal femoral osteoma, which was unique in that it contained large fatty marrow spaces that corresponded to bands of relatively low density on plain radiography and computed tomography, giving it a heterogeneous appearance atypical of osteoma of long bone. Furthermore, the osteoma reported here was associated with a small but separate nodular focus of ossification in the adjacent soft tissue. These findings led to a presumptive diagnosis of parosteal osteosarcoma with a local soft tissue metastasis or satellite nodule resulting in radical resection of the tumor. Definitive diagnosis of osteoma was made on histology of both the parent lesion and ossified nodule as no neoplastic spindle cell proliferation was present to establish a diagnosis of low-grade osteosarcoma. This represents, to the best of our knowledge, the first such presentation of osteoma of long bone.

Objective: This article reviews the neoplastic and nonneoplastic abnormalities of the musculoskeletal system that contain high signal intensity on T1-weighted MRI. The physical properties accounting for the increased signal intensity as well as the key clinical and imaging characteristics of each entity are discussed., Conclusion: Recognition of high signal intensity within musculoskeletal lesions on T1-weighted MRI can limit the differential diagnosis and can also have important clinical implications.

The patellofemoral (PF) joint is a complex articulation, with interplay between the osseous and soft tissue structures to maintain the balance between knee mobility and stability. Disorders of the PF joint can be a source of anterior knee pain (AKP). In this article, radiographic and magnetic resonance imaging of the PF joint are reviewed, including normal anatomy, imaging techniques, and imaging-based measurements. Common imaging findings associated with AKP are reviewed, including symptomatic normal variants, tendinopathy, apophysitis, osteoarthritis, chondromalacia patella, trochlear dysplasia, excessive lateralization of tibial tuberosity, patellar maltracking, patellar dislocation and fractures, anterior bursitis, Morel-Lavallée effusions, and fat pad edema., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Accessory ossicles are common incidental findings on radiographs of the ankle and foot. While typically asymptomatic and of no clinical significance, they are sometimes associated with local pain or even mistaken for pathological conditions such as fractures. Given the potential for misinterpretation, it is important to understand their typical locations and appearances. This case highlights an exceptionally rare accessory ossicle called the os cuboideum secundarium, located adjacent to the cuboid and calcaneus. Interestingly, this case demonstrates the potential for this rare ossicle to mimic a mass on magnetic resonance imaging (MRI). Furthermore, despite the significant improvements in the understanding of musculoskeletal pathology afforded by advancements in cross-sectional imaging techniques, this case is a reminder of certain pitfalls that remain. Lastly, it highlights the importance of radiographs as an initial diagnostic study in evaluating foot pain.

Athletic injuries to the hand are common and encompass a diverse spectrum of injuries. These injuries can include fractures, soft tissue injuries, or both. Athletic injuries to the hand can be due to a variety of mechanisms and can be seen with a variety of sports. Prompt attention and accurate diagnosis should be provided to patients with athletic injuries to the hand to allow for appropriate treatment and to prevent serious complications that may preclude further athletic activity. This article discusses the radiographic evaluation of hand fractures seen in athletes and presents brief descriptions of the clinical management of these injuries., (Copyright © 2013. Published by Elsevier Inc.)

With advances in imaging technology, there has been a significant increase in the number and range of interventional musculoskeletal image-guided procedures. One of the most commonly performed image-guided musculoskeletal interventions is the diagnostic and therapeutic percutaneous aspiration and drainage of multiple types of intra-articular, juxta-articular, and intramuscular pathologic fluid collections. These procedures may be performed under fluoroscopic, ultrasound, computed tomography, or even magnetic resonance guidance depending on the location to be accessed, type of pathology, patient characteristics, and operator preference. Musculoskeletal image-guided aspiration and drainage procedures are minimally invasive and generally very safe while offering valuable diagnostic information as well as therapeutic benefit. This article focuses on the appropriate indications, contraindications, and general technique for accessing the major joints via imaging guidance. For each joint, we discuss pertinent anatomy, appropriate imaging modalities, and preferred approaches to gaining intra-articular access. Additionally, the article discusses some of the more frequently encountered juxta-articular and intramuscular fluid collections that can be accessed and aspirated via percutaneous intervention, with mention of the importance of recognizing extremity sarcomas that can mimic these benign collections.

Objective: We will describe and illustrate various musculoskeletal manifestations of neurofibromatosis type 1 (NF1) encountered on imaging studies., Conclusion: Because NF1 is one of the most common genetic disorders, radiologists should be familiar with its imaging manifestations.

Soft tissue tumors range from benign subcutaneous lipomas to malignant deep high-grade sarcomas. Patients are evaluated with a thorough history and physical examination followed by imaging studies. Magnetic resonance imaging is the modality of choice, although radiographs, computed tomography, and other modalities may be of value. Open or closed biopsy can be performed to establish a diagnosis. Treatment depends on the diagnosis and includes observation or marginal excision for benign lesions and wide resection for malignant masses, with radiation therapy or chemotherapy for large, high-grade tumors. An algorithm for the evaluation, diagnosis, and treatment of soft tissue tumors is presented., (Copyright © 2011. Published by Elsevier Inc.)

Bone tumors are uncommon clinical entities that are often a source of diagnostic and therapeutic uncertainty. Evaluating these lesions starts with a patient history and physical examination Imaging then begins with radiographs, followed by advanced imaging modalities, such as magnetic resonance imaging, computed tomography, or bone scan. Biopsy can be performed to establish histologic diagnosis by either closed or open means. Treatment options range from observation to wide resection with reconstruction or amputation. Surveillance schedules vary depending on the type of tumor that is being treated. An algorithm for the evaluation, work-up, and diagnosis of bone tumors is presented., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Many benign nonneoplastic entities can mimic bone and soft tissue tumors on imaging examinations. Distinguishing between neoplastic and nonneoplastic entities depends on history and physical examination findings and imaging findings, and is an important early step in the patient's overall workup and treatment plan. This article describes some of the pseudotumors seen on imaging studies in our orthopedic oncology clinic, as well as mimics of bone and soft tissue neoplasms described in the medical literature. Tumor mimics resulting from anatomic and developmental variants, trauma, infection and inflammation, osteonecrosis and myonecrosis, articular and juxta-articular conditions, and miscellaneous causes are discussed., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Objective: This article about our initial clinical experience describes the novel application of radiofrequency ablation for the treatment of two cases of solitary eosinophilic granuloma of the bone., Conclusion: Technical success was achieved in both cases with a prompt clinical response and no treatment-related complications. To our knowledge, this is the first description of the application of radiofrequency ablation for the treatment of solitary eosinophilic granuloma of the bone.

The purpose of this review is to illustrate the pertinent clinical and imaging features of extremity sarcomas of uncertain differentiation, including synovial sarcoma, epithelioid sarcoma, clear-cell sarcoma, and alveolar soft part sarcoma. These tumours should be considered in the differential diagnosis when a soft-tissue mass is encountered in the extremity of an adolescent or young adult.

Patients referred to the authors' hospital for evaluation on suspicion of a bone or soft-tissue malignancy frequently present to the Orthopaedic Oncology Clinic with magnetic resonance (MR) images that show typical features of nonmalignant or nonneoplastic entities. The purpose of this article is to review the benign entities that may be mistaken by the radiologist for a malignancy and thus lead to needless referral to an orthopedic oncologist. Normal hematopoietic marrow and marrow edema due to a stress reaction may mimic a neoplasm at MR imaging, but knowledge of the typical patterns and locations of these features allows an accurate radiologic interpretation. The MR imaging appearance of osteonecrosis, Paget disease, benign bone lesions, and rheumatologic conditions may be confusing; in such circumstances, radiographic findings may help formulate a correct diagnosis. Knowledge of the common locations and appearances of bursae and ganglia is necessary so that radiologists do not misinterpret these benign entities as soft-tissue sarcomas. Soft-tissue trauma and inflammation also may mimic tumors at MR imaging, but a familiarity with the imaging patterns of nonneoplastic change in muscle allows the avoidance of misinterpretation. The clinical history, as always, is an important component of proper diagnosis. The radiologist can be especially useful to both the clinician and the patient by recognizing entities that are highly unlikely to represent malignancy and by confidently reporting those entities as benign, thereby sparing the patient an unnecessary trip to the orthopedic oncologist., ((c) RSNA, 2007.)

We report an unusual case of a woman who sought medical attention for a painful mass within her anterolateral left thigh. The patient's symptoms waxed and waned with her menses. Magnetic resonance imaging revealed a 3 cm mass isointense to muscle and surrounded by a rim of decreased signal intensity on T1-weighted images. T2-weighted images with fat saturation revealed a low signal intensity mass with a surrounding rind of high signal intensity edema. Based on its magnetic resonance imaging characteristics, the lesion was initially thought to represent the sequela of prior trauma or perhaps a small fibrous tumor. An excisional biopsy of the mass, however, revealed endometrial tissue, and a pathologic diagnosis of intramuscular endometriosis was rendered.

Objective: The radiologist plays an important role in the workup and staging of bone tumors. The purpose of this article is to review that role and to discuss recent changes to the primary malignant bone tumor staging system developed by the American Joint Committee on Cancer., Conclusion: Knowledge of staging parameters for the diagnosis and management of bone tumors will help the radiologist to generate meaningful reports for the referring physician.

We report a case of multifocal metachronous giant cell tumor (GCT) that involved the fibula, tibia, and sacrum of a 15-year-old boy. Multifocal GCT of bone presenting in children is an exceedingly rare phenomenon; however, there is evidence that multifocal GCT presents, on average, at a younger age than solitary GCT. Pediatric radiologists should be aware of this when encountering a single lesion with characteristic radiographic features of GCT and when encountering multiple lytic skeletal lesions.

This review illustrates the radiographic and magnetic resonance imaging (MRI) appearances of a variety of entities that result in surface contour abnormalities of the distal femur. Such abnormalities may result from developmental variants expressed in the growing skeleton, from trauma, or from cortically-based tumours. As the number of MRI examinations of the knee performed annually to exclude internal derangement increases, the frequency with which these variants and pathological entities are encountered will likewise increase. In most cases, the location of the lesion, as well as its specific imaging characteristics, will allow an accurate diagnosis.

The poor prognosis for patients with osteosarcoma skip metastases has been established in the literature; however, most of the data in the literature concerning osteosarcoma skip metastases were collected before routine use of magnetic resonance imaging and before the use of modern multiagent chemotherapy regimens. This retrospective multiinstitutional study was done to evaluate the efficacy of magnetic resonance imaging to detect skip metastases and to evaluate the prognosis for these patients when treated with modern multiagent chemotherapy protocols. In a group of 155 patients who were younger than 26 years when diagnosed and treated for high-grade osteosarcoma of the long bones, 10 (6.5%) patients with skip metastases were identified. Eight of the 10 lesions were detected on pretreatment magnetic resonance imaging scans and two were detected only from the surgical pathology specimens. Five patients had concomitant pulmonary metastases at presentation and five patients had no other known site of diseases. All 10 patients died, with an average survival of 32.5 months (range 11-71 months). The five patients with only skip metastases at presentation survived an average of 27.2 months (range 15-44 months). Despite advances in the treatment of patients with osteosarcomas, those with skip metastases continue to have a poor prognosis, and they should be counseled regarding the limitations of current therapies.

A retrospective study of 250 patients treated at one institution was done to evaluate the prognostic significance of the new American Joint Committee on Cancer staging system compared with the Musculoskeletal Tumor Society staging system for patients with sarcomas of bone. Regarding the Musculoskeletal Tumor Society system, there were significant differences in survival among patients with Stage I, Stage II, and Stage III disease. There were no significant differences between patients with Stages I-A and I-B disease, nor between patients with Stages II-A and II-B disease. Similarly, regarding the new American Joint Committee on Cancer staging system, there were significant differences among patients with Stage I, Stage II, and Stage IV disease. No significant differences were seen between patients with Stages I-A and I-B disease, between patients with Stages II-A and II-B disease, nor between patients with Stages IV-A and IV-B disease. A significant advantage in the ability to predict prognosis for one staging system over the other staging system was not shown with the relatively small number of patients in this study.

Background: To define the speed and accuracy of two different reconstructive techniques using computed tomography (CT) cystography for the detection and measurement of urinary bladder masses and determine the overall ease of use., Methods: Ten patients scheduled for cystoscopy for the evaluation of hematuria or bladder masses were studied by means of thin-section CT of the air-distended bladder. Two techniques were employed by two radiologists to blindly interpret the data: conventional two-dimensional data with interactive three-dimensional problem solving (2D3DPS) and surface-shaded display (SSD) three-dimensional images. The results were compared with the data from cystoscopy., Results: Twenty-two (100%) of 22 masses detected on cystoscopy were visualized using the reconstructive techniques. Both modalities were shown to have high accuracy, but only the 2D3DPS had a sensitivity and specificity of 100% for both observers at the patient-level diagnosis. The sensitivities for detecting individual masses for the two observers were 100% and 64% for 2D3DPS and 64% and 70% for SSD., Conclusion: Both methods used to display the CT data had a high sensitivity and specificity for masses, but only the 2D3DPS had a sensitivity and specificity of 100% at the patient-level diagnosis, thus making it a feasible imaging modality for cystography. It was also preferred overall for ease of use, high accuracy, and relative low cost.

Scapular duplication is an exceedingly rare congenital anomaly. We present a unique case of left-sided duplication without additional malformations other than those involving the left upper extremity. Treatment of similar cases has been successful, and further work-up for additional anomalies should be undertaken. Other conditions in the spectrum of developmental deformities of the shoulder are discussed.