L1 vertebral density on CT is too variable with different scanning protocols to be a useful screening tool for osteoporosis in everyday practice.

Objective: To determine whether a single L1 density threshold can be used to screen all patients undergoing CT at a busy tertiary referral centre for those at risk of osteoporosis.

Methods: 200 patients, who had been randomly selected for an audit of CT reporting of incidental vertebral fractures, had their L1 density measured on 864 routine CT examinations. These had been performed with a variety of kVp and intravenous (i.

A Comprehensive Single Institutional Review of 2 Years in a Designated Fast-Track Sarcoma Diagnostic Clinic Linked with a Sarcoma Specialist Advisory Group: Meeting the Target but Failing the Task?

Background. National guidelines prompted the implementation of a designated two-week wait referral pathway to facilitate the early diagnosis of sarcomas, to improve treatment outcomes. Methods.

Foreign body granulomatous reaction associated with polyethelene 'Fiberwire(®)' suture material used in Achilles tendon repair.

Repair of acute Achilles tendon rupture is a common procedure. There are many accepted surgical techniques; suture selection is largely due to surgeon preference. We present a case report of a granulomatous reaction to suture material following Achilles tendon repair.

Validation of clinical examination versus magnetic resonance imaging and arthroscopy for the detection of rotator cuff lesions.

Limited evidence exists regarding the validity of clinical examination for the detection of shoulder pathology. We therefore wished to establish the sensitivity, specificity, positive predictive value and negative predictive value of clinical tests and magnetic resonance imaging (MRI) in the diagnosis of rotator cuff disorders against findings at arthroscopy. Using recognised tests for specific shoulder lesions, 117 patients with shoulder symptoms awaiting surgery were examined in a standard manner.

Multicentre trial of weekly risedronate on bone density in adults with cystic fibrosis.

Background: The aim of this study was to assess the efficacy, tolerability and safety of risedronate in adults with CF.

Methods: Patients with a lumbar spine (LS), total hip (TH) or femoral neck (FN) bone mineral density (BMD) Z-score of -1 or less were randomised to receive risedronate 35 mg weekly or placebo, and calcium (1g)+vitamin D(3) (800IU).

Results: At baseline, BMD Z-scores in the risedronate (n=17) and placebo (n=19) groups were similar.

MR-guided direct arthrography of the hip.

Purpose: To develop an MR-guided technique for direct magnetic resonance arthrography (DMRA) of the hip using a conventional 1.5 Tesla (T) MRI scanner.

Materials And Methods: Interactive versions of standard single-shot fast spin echo, coherent gradient echo, and fully balanced steady-state free precession sequences were developed, together with the ability to operate the scanner from within the magnet room.

Imaging modalities in the evaluation of soft tissue complaints.

A number of imaging modalities are available for the assessment of soft tissue complaints. The strengths and advantages of each modality must be seen in the context of any corresponding weakness or disadvantage. The sensitivity and specificity of the imaging technique must also be understood.

MRI of the ankle: effect on diagnostic confidence and patient management.

Objective: The purpose of our study was to quantify the impact that MRI of the ankle has on a surgeon's diagnosis and diagnostic confidence and on patient management.

Subjects And Methods: A prospective controlled observational study was performed with 91 consecutive referrals (53 males, 38 females; age range, 13-76 years; mean age, 40.6 years) from a single orthopedic foot and ankle surgeon to a regional teaching hospital for ankle MRI.

Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy.

Background: Rheumatoid arthritis (RA) is associated with increased cardiovascular risk, which is not explained by traditional cardiovascular risk factors but may be due in part to increased aortic stiffness, an independent predictor of cardiovascular mortality. In the present study, our aim was to establish whether aortic stiffness is increased in RA and to investigate the relationship between inflammation and aortic stiffness. In addition, we tested the hypothesis that aortic stiffness could be reduced with anti-tumor necrosis factor-alpha (TNF-alpha) therapy.

Soft-tissue masses in the shoulder girdle: an imaging perspective.

We discuss the radiological assessment of soft-tissue masses presenting in the shoulder girdle and emphasise the relative strengths and weaknesses of the different imaging modalities available. The appearances of the common benign and malignant soft-tissue tumours are presented together with conditions that present with specific imaging features around the shoulder region.

Can 16-detector multislice CT exclude skeletal lesions during tumour staging? Implications for the cancer patient.

Current imaging guidelines recommend that many cancer patients undergo soft-tissue staging by computed tomography (CT) whilst the bones are imaged by skeletal scintigraphy (bone scan). New CT technology has now made it feasible, for the first time, to perform a detailed whole-body skeletal CT. This advancement could save patients from having to undergo duplicate investigations.

Giant atypical ossifying fibromyxoid tumour of the calf.

We present a case of giant atypical ossifying fibromyxoid tumour (OFMT) of soft tissue, occurring in the calf, in a 77-year-old woman. The patient presented with a history of bleeding ulcer over a calf lump that had been present for over 4 years. Clinical presentation, radiological features and histopathologic findings are described, and the relevant literature is reviewed.

Ultrasound of the male anterior urethra.

Ascending and descending techniques are used to demonstrate the male anterior urethra. The authors developed an ultrasound approach with the patient compressing his own urethra manually during voiding to achieve distension of the urethra with urine. The subsequent sonourethrography is more accurate than conventional fluoroscopic contrast studies in defining urethral filling defects and is as accurate for the demonstration of strictures.

Significant and persistent loss of bone mineral density in the femoral neck after haematopoietic stem cell transplantation: long-term follow-up of a prospective study.

Reduced bone mineral density (BMD) has been reported following allogeneic stem cell transplantation (alloSCT) but the effects of autologous SCT (autoSCT) are less well characterized. We performed a prospective study of BMD changes and its determinants in 44 SCT recipients (38 auto and six allo; 30 peripheral blood SCT and 14 bone marrow transplantation). Serial measurements of BMD at the lumbar spine and femoral neck were performed at baseline and at 3, 6, 12 and 24 months, and spinal radiographs were performed at baseline and 12 months.

Lack of effect of intravenous pamidronate on fracture incidence and bone mineral density after orthotopic liver transplantation.

Background/aims: Increased rates of bone loss and fracture have been reported after liver transplantation. The aim of this study was to investigate the effects of a pre-transplant infusion of pamidronate on fracture incidence and bone loss during the first year after transplantation.

Methods: Ninety-nine adults awaiting orthotopic liver transplantation (OLT) were randomised to pamidronate or no treatment.