Journal of the Belgian Society of Radiology最新文献

Teaching point: Combined MRI and ultrasound allow accurate identification of isolated digital Dupuytren's cords, thereby supporting diagnosis and surgical planning.

Ewing sarcoma (ES) is a high-grade osseous malignancy that typically occurs between 10 and 20 years of age. Prognosis is poor with a 30% five-year survival in the case of metastatic disease. This case describes a 20-year-old female patient with known lumbar vertebral ES developing a splenic metastasis years after primary treatment. To the best of our knowledge, metastatic spread to the spleen in ES has not been reported before. Teaching point: In patients with a history of Ewing sarcoma, new parenchymal lesions should always prompt consideration of rare metastatic disease, given its profound prognostic impact.

Intravenous leiomyomatosis is a rare benign uterine smooth muscle tumor with intravascular growth through pelvic veins or lymphatics. A case is reported of a 42-year-old woman with intermittent spotting and progressive abdominal enlargement. Pelvic magnetic resonance imaging showed a heterogeneous myometrial mass with serpiginous extensions along iliac veins. The lesion had high signal on high b-value diffusion-weighted images and high apparent diffusion coefficient values, indicating the absence of diffusion restriction. After surgery, histopathology confirmed the diagnosis of intravenous leiomyomatosis. Teaching point: Recognition of serpiginous intravascular extensions and the absence of diffusion restriction on magnetic resonance imaging should raise suspicion for intravenous leiomyomatosis.

Teaching point: Adrenal vein thrombosis should be considered in pregnant patients presenting with unexplained unilateral adrenal enlargement, even when the thrombus itself is not visualized, as early diagnosis allows effective anticoagulant management and prevention of adrenal insufficiency.

Teaching point: Albeit rare, IPMN-B should be considered and excluded when encountering a large hepatic cystic lesion, especially in the setting of associated biliary dilatation, because in contrast to 95% of other hepatic cystic lesions, it has significant risk of harboring invasive carcinoma and therefore mandates early accurate diagnosis and complete surgical resection.

Fracture of the polyethylene tibial post is a rare complication of posterior-stabilized total knee arthroplasty and is frequently missed on conventional radiography due to the radiolucent nature of polyethylene. We report a case of post-traumatic instability in which computed tomography demonstrated a displaced polyethylene fragment with characteristic low attenuation values. The diagnosis was confirmed intraoperatively, and isolated polyethylene exchange resulted in a good clinical outcome. Teaching point: CT attenuation measurements can aid in identifying displaced polyethylene fragments and facilitate the diagnosis of tibial post fracture in posterior-stabilized knee arthroplasty.

We report a case of calcaneal osteomyelitis caused by a retained foreign body-a coral fragment. The patient presented with nonspecific heel pain 12 years after the initial injury. MRI revealed an intraosseous lesion demonstrating the 'penumbra' sign, consistent with chronic osteomyelitis and abscess formation. CT demonstrated a foreign body embedded within the abscess cavity. Surgical exploration confirmed the presence of a coral fragment. Teaching point: Retained foreign bodies in bone can remain asymptomatic for many years, eventually presenting with signs of osteomyelitis.

Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora lesion, is a rare benign condition that can mimic other pathologies. A case is described of a 66-year-old man with a slowly enlarging nodule on his finger over five years. Imaging showed a parosteal lesion without continuity with the trabecular bone, strongly suggestive of BPOP. The diagnosis was histologically confirmed. This case highlights the importance of recognizing the characteristic imaging features of BPOP. Teaching point: BPOP may appear as a worrisome lesion on imaging, but its typical location and lack of continuity with the trabecular bone should raise awareness for BPOP.

Teaching point: Desmoid-type fibromatosis is a rare soft tissue tumor mimicking typical aggressive childhood malignancies, but with inability to metastasize, and with an essential role for imaging for diagnosis and therapeutic strategies.

Chronic ketamine abuse is a well-recognized cause of lower urinary tract injury. Hepatobiliary manifestations are less frequently reported. A case is presented of concomitant ketamine-induced uropathy and cholangiopathy in a young adult. This underscores the importance of considering ketamine toxicity as a multisystem disorder. Teaching point: Beyond the well-recognized urinary tract involvement, radiologists attention is drawn to hepatobiliary manifestations of chronic ketamine toxicity.