[en] In Ewing sarcoma, the addition of preoperative and postoperative chemotherapy has dramatically raised the 5-year survival rate. Radiologic evaluation of chemotherapy response becomes important so that the treatment plan can be altered in cases of poor response. The authors evaluated sequential examinations, including plain radiographs, Tc-99m skeletal scintigrams, and CT scans in 48 patients with Ewing sarcoma of bone. In 31 patients, biopsy material was obtained for histologic grading of treatment response. Good tumor response (grades 3 and 4) led over the ensuing 1-3 months to disappearance of the soft-tissue tumor component, solid transformation of the previously lamellated or spiculated periosteal reaction, and filling in of the lytic regions. Insufficient tumor response (grades 1 and 2) demonstrated persistence of soft-tissue tumor component and lamellated or spiculated periosteal reaction as well as absence, filling in, or even enlargement of lytic regions

[en] Osteoarthritis (OA) is a common disease with a pathogenesis that currently is not well understood. Pathologic alterations involve hyaline cartilage, subchondral cortex, and marrow cavity structures. The authors studied 24 patients with osteoarthritis of the knee with MR imaging and correlation with conventional radiography (all cases; weight-bearing views), scintigraphy (16 to 24), and histopathologic findings (eight of 24; specimens from joint replacement surgery). They found the grade of OA on the MR images to be the same as or one grade more advanced than that on weight-bearing plain radiographs. A frequent zone of decreased signal in the subchondral region on the T1-weighted images usually corresponded to a smaller zone of decreased signal on the T2-weighted images, representing sclerosis and fat replacement by fibrosis surrounded by a reactive zone

[en] Synovial cysts in an intraspinal location, associated with facet joint osteoarthritis, have been diagnosed using CT. Surgical removal of the cyst, when believed to be the cause of radiculopathy, has resulted in symptomatic relief. The authors have applied a nonoperative treatment method consisting of CT-guided needle placement in the facet joint adjacent to the cyst, followed by injection of contrast material and corticosteroids. Three patients were treated without complications and with complete relief of symptoms in two cases and partial relief in one, although no decrease in the size of the cysts was demonstrated on follow-up CT scans. The preliminary results indicate a possible role for this treatment technique in patients with intraspinal synovial cysts

[en] The blood supply of bone is derived from nutrient arteries that are visualized on radiographs extending through foramina in the cortex. Such foramina have constant locations and typical morphology. Using patient material and pathologic preparations, the authors reviewed the appearance of nutrient foramina in tubular, flat, and irregular bones. The authors correlated the imaging characteristics of nutrient foramina with findings derived from specimen inspection and utilized Spalteholtz technique to define the configuration of the vascular grooves. Examples of foramina that are confused with pathology include the scapular and iliac foramina, the femoral diaphyseal foramina, and the foramina of irregular bones. Enlargement of the nutrient channels in bone marrow and vascular tumors may provide an important diagnostic clue

[en] Although superior, medial, and axial patterns of migration of the femoral head in osteoarthritis (OA) of the hip have been well described, it is not clear what anatomic and biomechanical factors determine the direction of migration. To define any relationships between migration in the coronal and the transverse planes, the authors evaluated 22 patients (total of 33 hips with OA) as well as 15 pathologic specimens by conventional radiography and computed tomography. Fourteen of the 19 superiorly migrated hips had an anterior migration component, and five of seven medially migrated hips had a posterior migration component. The authors' cases were also evaluated for femoral anteversion angle, femoral nick-shaft angle, acetabular anteversion, and acetabular inclination, but no correlation with specific migration patterns was evident

[en] Selective anesthetic arthrography was performed in 18 patients to define precisely the source of chronic posttraumatic hindfoot pain. A solution composed of local anesthetic and iodinated contrast material was injected into the hindfoot articulations, and the clinical response was determined. Although there was close correlation between pain relief and abnormalities depicted with both routine radiography and CT, both imaging methods tended to underestimate the severity of articular involvement, and plain film findings in five patients were misleading as to the site of pain origin. Long-term follow-up evaluation in nine patients who underwent arthrodesis on the basis of arthrographic findings indicated satisfactory results in eight

[en] Pericapitate involvement of the wrist has been described as characteristic of adult-onset Still disease, a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the diagnostic value of carpal radiography in cases of adult-onset Still disease, a retrospective blinded analysis of 48 patients, 16 each with adult-onset Still disease, juvenile chronic arthritis, and rheumatoid arthritis, was performed. Pericapitate articular alterations without radiocarpal involvement were found to be frequent in the setting of adult-onset Still disease but distinctly unusual among patients with rheumatoid arthritis. In juvenile chronic arthritis, severe pericapitate involvement was frequent, but generally occurred in conjunction with radiocarpal joint abnormalities

[en] It is suggested that there are differences in the radiographic appearance of rheumatoid arthritis (RA) in men compared with women. Bone proliferation, cysts, and well-defined erosions are reported more frequently in men, whereas osteoporosis, nodules, and deformities are more frequent in women. The authors blindly evaluated hand and wrist radiographs in 32 males and 32 match females with RA. The mean age was 56.4 years and mean disease duration, 10.5 years. The two groups were similar in disease distribution, symmetry, and severity. Cystic changes and well-defined erosions were present in 12 of 64 male and six of 64 female hands. Bone proliferation was present in 13 of 64 male and 13 of 64 female hands and in women related to disease duration. Previously reported differences relate to inadequate matching