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International audience; BACKGROUND: Aneurysmal bone cyst (ABC) is a benign, locally aggressive tumour that arises predominantly in long bones and spine. Following the encouraging results of denosumab use in Giant Cell Tumors (GCT) and the histological similarities between ABC and GCT, the interest on the role of denosumab in the therapeutic arsenal of the most advanced ABC is growing. The purpose of this literature review is to investigate the current state of knowledge about the use of denosumab in ABCs. METHODS: A literature research was conducted through PUBMED, COCHRANE and GOOGLE SCHOLAR using the keywords "aneurysmal bone cyst" AND "denosumab". Seventeen articles were included. RESULTS: A total of 43 cases were reported in the literature. There were 23 males, 20 females. The mean age was 15,9±8,1 year. Pain relief and neurological improvement were rapid and sustained. Radiological assessment showed ossification and/or volume reduction in 36/39 patients. Eight patients (18,6%) presented a recurrence after or during denosumab therapy of whom 7 were adults. Adverse events occurred in 11 patients, 5 of them were admitted to the intensive care unit due to hypercalcemia. CONCLUSION: Denosumab use in non-surgical ABCs has shown a positive impact in pain and neurological symptoms. The oncological outcome remains unclear with a recurrence rate of 18,6% during/after denosumab therapy, mostly in adults. However, regarding the potential clinical benefits, its use might be discussed in the most advanced cases. Further research and clinical trials are mandatory to precise its belonging in the therapeutic arsenal.

The function of the abductor mechanism (AM) of the hip can be disturbed, or even compromised, following tumor resection in the hip area. The consequences are instability (limping, dislocation), pain and altered walking ability. Several reconstruction techniques can be used for the same AM sacrifice. After defining the AM, this lecture will discuss the best technique for a given type of bone and muscle resection. These reconstruction techniques depend on exactly where the AM was sacrificed. For zone 1 resections of the ilium and/or iliac gluteal insertions, reconstruction is often optional. When muscle from the AM is resected, especially when the gluteal tendon is detached from its trochanteric insertion, isolated reconstruction can be done or reconstruction in combination with a tendon allograft or an allograft and/or tendon transfer from the surrounding area. This sacrifice, whether followed by reconstruction or not, in most cases leads to a good functional outcome, except when a complete musculotendinous unit or the superior gluteal nerve is sacrificed. Isolated resection of the greater trochanter is rare; however, this completely disrupts the continuity of the AM and justifies reconstruction, often using a bone-tendon allograft. Proximal femur resection is the most common scenario. The extent of the trochanteric resection and the gluteal tendon attachments drives the type of prosthesis used. The two most used techniques consist in an allograft sleeve over a long cemented femoral stem (allograft prosthesis composite – APC) or a modular proximal femoral endoprosthesis (megaprosthesis) with a specific AM fixation system (small plate or wire cerclage, resorbable or metal wire, synthetic reattachment tube). These two techniques yield nearly identical long-term functional outcomes with complications specific to each: osteolysis and fracture for APC, failure of tendon reattachment for megaprosthesis. Beyond these technical considerations, one must consider the poor availability of massive bone allografts. This is a highly relevant issue in France, and partially explains the shift to reconstruction with a megaprosthesis. Lastly, we will look at the different clinical and diagnostic tests used to evaluate the function of the AM in an oncology context and the outcomes of the various types of reconstruction.

One of the major problems in the many applications of transfer, and storage of medical images is the availability of quality data (image). This article discusses various ways of overcoming this difficulty of processing all medical imaging sources (analogue and digital). This technique of connection is analysed in terms of quality, availability and cost. A large section is devoted to introduction of the ACR-NEMA DICOM V3.0 standard, which is the tool for exchange of images between image suppliers, processing stations, storage centre and printing peripherals. In conclusion, this article presents a standard plan of connection between image sources and user services by introducing the concept of an "intelligent" universal interface allowing connection of digital and analogue sources which "standardizes" image formats for user services.