Usual clinical presentation of bizarre parosteal osteochondromatous proliferation (BPOP) with unusual histology.

Bizarre parosteal osteochondromatous proliferation (BPOP) or Nora's lesion is a unique, bony lesion that most often arises in the small bones of the hands and feet. The lesion was first described by Nora et al. in 1983, and documented cases have now shown the lesion to arise in the long bones, skull, maxilla and mandible.

A randomized phase III comparative trial of immediate consolidation with high-dose chemotherapy and autologous peripheral blood progenitor cell support compared to observation with delayed consolidation in women with metastatic breast cancer and only bone metastases following intensive induction chemotherapy.

The prognosis for patients with metastatic breast cancer remains poor. Metastatic breast cancer confined to the bones may have a better prognosis, especially hormone receptor-positive disease. We performed a prospective, randomized clinical trial to compare immediate consolidation with high-dose chemotherapy and hematopoietic support versus observation with high-dose consolidation at the time of disease progression in women with metastatic breast cancer and only bone metastases.

Thoracic and lumbar spine trauma.

Complete thoracolumbar trauma evaluation incorporates radiographs, computed tomography, and magnetic resonance imaging. Primarily to localize the level of injury, diagnosis of thoracolumbar spine trauma begins with radiographs. Computed tomography with sagittal reformatted images is more sensitive for identifying the full extent of injury and the degree of involvement of the bony posterior elements.

Reliability and reproducibility of radiographic interpretation of proximal humeral fracture pathoanatomy.

Recent studies have demonstrated inconsistencies in the use of certain images for classifying proximal humerus fractures. Our purpose was to determine whether three-dimensional computed tomography or the level of expertise of the observers would improve the reliability and reproducibility of identifying specific anatomic fragments in proximal humerus fractures. Two groups of observers, nonexperts and experts in shoulder surgery, were asked to review the radiographs and three-dimensional computed tomography scans of 12 patients with proximal humerus fractures.

Impotence following pelvic fracture urethral injury: incidence, aetiology and management.

Objective: To evaluate the potency status of patients undergoing delayed perineal repair following a pelvic fracture urethral injury to determine the incidence and aetiology of impotence.

Patients And Methods: Long-term potency (> 6 months post-operatively) was subjectively evaluated in 92 patients and correlated with their pre-operative and intra-operative findings. The management of their impotence was aso reviewed.

A new type of dislocation of the first metatarsophalangeal joint: a case report.

We are reporting a case of traumatic dislocation of the first metatarsophalangeal joint that does not correspond to any previously reported type. This new type of dislocation was associated with a rupture of the lateral short sesamophalangeal ligament/plantar plate, partial rupture of the intersesamoid ligament, and separation of a previously bipartite tibial sesamoid. Closed reduction was easily performed; however, the distal portion of the tibial sesamoid remained trapped within the joint.

Bone metastases from breast cancer: value of CT bone windows.

A pilot study was organized to compare the utility of scintigraphy, radiographic bone surveys, and conventional CT bone windows (CTBWs) in judging therapeutic response of bone lesions in patients with metastatic breast carcinoma. Twenty-six patients with stage IV disease and documented bone metastases were evaluated over a 2 year period. Discordance in the assessment of therapeutic response was greatest (56% discordance) between bone scans (BSs) and conventional CTBWs.

Coalition of the hallux sesamoids: a case report.

Multiple variations in partition of the hallux sesamoids have been described; however, to our knowledge, a coalition of the hallux sesamoids has never been presented. A case of coalition of the hallux sesamoids is presented and the literature is reviewed with respect to the possible significance of this anomaly.

The relationship of the intrapelvic vasculature to the acetabulum. Implications in screw-fixation acetabular components.

The use of screw-fixation acetabular components in total hip arthroplasty could increase the incidence of vascular injury because of the increased use of drills and screws placed into the acetabulum in close proximity to major vessels. Analysis of two illustrative case studies, anatomic specimen cross sections, and computed tomographic scans demonstrate which vessels are at risk of injury should the inner cortex of the pelvis be penetrated. The iliac vessels are at risk of injury when penetration of the inner cortex of the pelvis occurs in the anterosuperior region of the acetabulum.

Radiology of the cervical spine in trauma patients: practice pitfalls and recommendations for improving efficiency and communication.

Trauma constitutes a significant portion of emergency department practice. Such patients often have suspected cervical spine injury necessitating cervical spine radiographs. The importance of detecting cervical spine injury is obvious because failure to do so can lead to tragic consequences for patient and physician alike.

Anaphylactoid reaction to zomepirac.

Circulatory collapse and respiratory arrest occurred in a young woman shortly after taking 200 mg of zomepirac for relief of headache. She had no history of drug hypersensitivity and had tolerated zomepirac without adverse effects 18 months prior to this reaction. The patient was successfully treated and suffered no sequelae.