Usporedba različitih dijagnostičkih protokola kompjutorizirane tomografije u dijagnostici udruženoga prijeloma lica i baze lubanje [Comparison of different computed tomography diagnostic protocols in the diagnosis of associated fractures of the face and skull base]

INTRODUCTION: The proposed MSCT protocol allows early detection of associated facial and skull base fractures, while the classification of the fracture patterns can help in the selection of therapeutic treatment. OBJECTIVES: To determine the value of a defined radiological CT protocols and the incidence of radiologically diagnosed cranial base fractures associated with facial fractures, describe the imaging features of the associated fractures and to classify certain types of fractures in the fracture patterns SUBJECTS AND METHODS: The study included 180 patients with associated fractures of the face and skull base diagnosed by CT. The group of respondents consisted of 158 men and 22 women, median age 41 years, range 18 years to 88 years. For the purpose of comparing different diagnostic computed tomography protocols, the study included 109 patients who have had an examination done on SSCT and 16-slice CT device. For the purpose of the classification of fractures in the fracture patterns, the study included 180 patients with associated face and skull base fractures who have had an examination done on 16-slice CT device. RESULTS: The incidence of associated facial fractures and skull base in patients with blunt head injury int he study is 45.2%. Multislice CT, in 99.4% of patients with craniofacial fractures, adequately shows the extent of the fracture. Statistical analysis singled out three fracture patterns of the associated facial and skull base fractures. CONCLUSION: MSCT is better in depiction and localization of the associated face and skull base fracture than SSCT, and thus better for the diagnostic method. The analysis of this type of imaging display enables development oft he new fracture patterns or classifications. Clearly defined MSCT protocol applied in all patients with blunt head injury and a suspicion of craniofacial fracture enables the systematic standardization of the diagnostic treatment of patients with such indication

Isolated traumatic proximal tiobiofibular joint dislocation: clinical-radiological correlation and literature review

Disrupcija proksimalnog tibiofibularnog zgloba je rijetka i neuobičajena ozljeda uz do sada nekolicinu slučajeva opisanih u literaturi. Četiri tipa instabiliteta ili disrupcije proksimalnog tibiofibularnog zgloba klasificirana su u literaturi kao subluksacija, anterolateralna dislokacija, posteromedijalna dislokacija i proksimalna dislokacija. Ovo je prikaz slučaja 26-godišnjeg nogometaša ozlijeđenog tijekom nogometne utakmice. Dijagnoza anterolateralne dislokacije proksimalnog tibiofibularnog zgloba postavljena je tijekom kliničkog pregleda i potvrđena radiološkom obradom. Cilj ovoga rada je opisati mehanizam ozljede, konzervativno liječenje, kirurške tehnike, plan rehablitacije i povratak sportu nakon dislokacije proksimalnog tibiofibularnog zgloba.A disruption of the proximal tibiofibular joint has been considered a rare and uncommon condition with only few cases reported in literature. Four types of instability or disruption of the proximal tibiofibular joint are classified in literature as subluxation, anterolateral dislocation, posteromedial dislocation, and superior dislocation. We report a case of a 26-year-old soccer player injured during a match. The diagnosis of the anterolateral proximal tibiofibular joint dislocation was established after clinical examination and was also confirmed radiologically. The objective of this paper is to elaborate the mechanism of injury, nonoperative protocols, surgical techniques, rehabilitation schedules and sports guidelines after proximal tibiofibular joint dislocation

Osteoid osteoma of the foot : Presentation, treatment and outcome of a multicentre cohort

Funding Information: The current study did not receive any funding. Publisher Copyright: © 2021, The Author(s).Background: Osteoid osteomas of the foot are rare, with a varying and atypical clinical as well as radiological presentation impeding early diagnosis and treatment. The aim of the present multicentre study was to 1) analyze epidemiological, clinical and radiological findings of patients with foot osteoid osteomas and to 2) deduce a diagnostic algorithm based on the findings. Methods: A total of 37 patients (25 males, 67.6%, mean age 23.9 years, range 8–57 years) with osteoid osteomas of the foot were retrospectively included, treated between 2000 and 2014 at 6 participating tertiary tumor centres. Radiographic images were analyzed, as were patients’ minor and major complaints, pain relief and recurrence. Results: Most osteoid osteomas were located in the midfoot (n = 16) and hindfoot (n = 14). Painful lesions were present in all but one patient (97.3%). Symptom duration was similar for hindfoot and midfoot/forefoot (p = 0.331). Cortical lesions required fewer x‑rays for diagnosis than lesions at other sites (p = 0.026). A typical nidus could be detected in only 23/37 of x‑rays (62.2%), compared to 25/29 CT scans (86.2%) and 11/22 MRIs (50%). Aspirin test was positive in 18/20 patients (90%), 31 patients (83.8%) underwent open surgery. Pain relief was achieved in 34/36 patients (outcome unknown in one), whilst pain persisted in two patients with later confirmed recurrence. Conclusions: As previously reported, CT scans seem to be superior to MRIs towards detection of the typical nidus in foot osteoid osteomas. In patients with unclear pain of the foot and inconclusive x‑rays, osteoid osteoma should be considered as differential diagnosis.publishersversionPeer reviewe

Combining targeted and systematic prostate biopsy improves prostate cancer detection and correlation with the whole mount histopathology in biopsy naïve and previous negative biopsy patients

OBJECTIVE: Guidelines for previous negative biopsy (PNB) cohorts with a suspicion of prostate cancer (PCa) after positive multiparametric (mp) magnetic-resonance-imaging (MRI) often favour the fusion-guided targeted prostate-biopsy (TB) only approach for Prostate Imaging-Reporting and Data System (PI-RADS) ≥3 lesions. However, recommendations lack direct biopsy performance comparison within biopsy naïve (BN) vs. PNB patients and its prognostication of the whole mount pathology report (WMPR), respectively. We suppose, that the combination of TB and concomitant TRUS-systematic biopsy (SB) improves the PCa detection rate of PI-RADS 2, 3, 4 or 5 lesions and the International Society of Urological Pathology (ISUP)-grade predictability of the WMPR in BN- and PNB patients. METHODS: Patients with suspicious mpMRI, elevated prostate-specific-antigen and/or abnormal digital rectal examination were included. All PI-RADS reports were intramurally reviewed for biopsy planning. We compared the PI-RADS score substratified TB, SB or combined approach (TB/SB) associated BN- and PNB-PCa detection rate. Furthermore, we assessed the ISUP-grade variability between biopsy cores and the WMPR. RESULTS: According to BN (n = 499) vs. PNB (n = 314) patients, clinically significant (cs) PCa was detected more frequently by the TB/SB approach (62 vs. 43%) than with the TB (54 vs. 34%) or SB (57 vs. 34%) (all p < 0.0001) alone. Furthermore, we observed that the TB/SB strategy detects a significantly higher number of csPCa within PI-RADS 3, 4 or 5 reports, both in BN and PNB men. In contrast, applied biopsy techniques were equally effective to detect csPCa within PI-RADS 2 lesions. In case of csPCa diagnosis the TB approach was more often false-negative in PNB patients (BN 11% vs. PNB 19%; p = 0.02). The TB/SB technique showed in general significantly less upgrading, whereas a higher agreement was only observed for the total and BN patient cohort. CONCLUSION: Despite csPCa is more frequently found in BN patients, the TB/SB method always detected a significantly higher number of csPCa within PI-RADS 3, 4 or 5 reports of our BN and PNB group. The TB/SB strategy predicts the ISUP-grade best in the total and BN cohort and in general shows the lowest upgrading rates, emphasizing its value not only in BN but also PNB patients

Comparison of different computed tomography diagnostic protocols in the diagnosis of associated fractures of the face and skull base

UVOD: Predloženi MSCT protokol omogućuje pravovremeno prepoznavanje udruženog prijeloma kostiju lica i baze lubanje, dok podjela u frakturne obrasce može pomoći u odabiru terapijskog postupka. CILJEVI: utvrditi vrijednost definiranog radiološkog CT protokola i pojavnost radiološki dijagnosticiranih prijeloma baze lubanje udruženih sa prijelomom kostiju lica, opisati slikovne karakteristike udruženog prijeloma i razvrstati pojedine tipove prijeloma u frakturne obrasce ISPITANICI I METODE: U istraživanje je uključeno 180 ispitanika sa udruženim prijelomom kostiju lica i lubanjske baze dijagnosticiranog CT-om. Skupinu ispitanika sačinjavalo je 158 muškaraca i 22 žene, srednje životne dobi 41 godina, u rasponu 18 godina do 88 godina. U svrhu usporedbe različitih dijagnostičkih protokola kompjutorizirane tomografije u istraživanje je uključeno 109 ispitanika kojima je CT pregled učinjen na jednoslojnom i 16-slojnom CT uređaju. U svrhu podjele prijeloma u frakturne obrasce u istraživanje je uključeno 180 ispitanika s udruženim prijelomom kostiju lica i baze lubanje kojima je učinjen pregled na 16-slojnom CT uređaju. REZULTATI: Učestalost udruženog prijeloma kostiju lica i lubanjske baze kod ispitanika u istraživanju iznosi 45,2%. Višeslojni CT uređaj u 99,4% ispitanika sa kraniofacijalnim prijelomom adekvatno prikazuje opseg prijeloma. Statističkom obradom podataka izdvojila su se tri frakturna obrasca udruženog prijeloma kostiju lica i lubanjske baze. ZAKLJUČAK: MSCT je kvalitetniji u prikazu opsega i lokalizaciji prijeloma od SSCT, a time i bolji u dijagnostičkom postupku. Analiza prijeloma takvih slikovnih prikaza omogućuje izradu novih frakturnih obrazaca ili podjela. Jasno definiranim MSCT protokolom primjenjenim kod svih pacijenata s tupom ozljedom glave i postavljenom sumnjom na kraniofacijalni prijelom postiže se sustavna standardizacija u dijagnostičkoj obradi pacijenata sa takvom indikacijom.INTRODUCTION: The proposed MSCT protocol allows early detection of associated facial and skull base fractures, while the classification of the fracture patterns can help in the selection of therapeutic treatment. OBJECTIVES: To determine the value of a defined radiological CT protocols and the incidence of radiologically diagnosed cranial base fractures associated with facial fractures, describe the imaging features of the associated fractures and to classify certain types of fractures in the fracture patterns SUBJECTS AND METHODS: The study included 180 patients with associated fractures of the face and skull base diagnosed by CT. The group of respondents consisted of 158 men and 22 women, median age 41 years, range 18 years to 88 years. For the purpose of comparing different diagnostic computed tomography protocols, the study included 109 patients who have had an examination done on SSCT and 16-slice CT device. For the purpose of the classification of fractures in the fracture patterns, the study included 180 patients with associated face and skull base fractures who have had an examination done on 16-slice CT device. RESULTS: The incidence of associated facial fractures and skull base in patients with blunt head injury int he study is 45.2%. Multislice CT, in 99.4% of patients with craniofacial fractures, adequately shows the extent of the fracture. Statistical analysis singled out three fracture patterns of the associated facial and skull base fractures. CONCLUSION: MSCT is better in depiction and localization of the associated face and skull base fracture than SSCT, and thus better for the diagnostic method. The analysis of this type of imaging display enables development oft he new fracture patterns or classifications. Clearly defined MSCT protocol applied in all patients with blunt head injury and a suspicion of craniofacial fracture enables the systematic standardization of the diagnostic treatment of patients with such indication

Comparison of different computed tomography diagnostic protocols in the diagnosis of associated fractures of the face and skull base

UVOD: Predloženi MSCT protokol omogućuje pravovremeno prepoznavanje udruženog prijeloma kostiju lica i baze lubanje, dok podjela u frakturne obrasce može pomoći u odabiru terapijskog postupka. CILJEVI: utvrditi vrijednost definiranog radiološkog CT protokola i pojavnost radiološki dijagnosticiranih prijeloma baze lubanje udruženih sa prijelomom kostiju lica, opisati slikovne karakteristike udruženog prijeloma i razvrstati pojedine tipove prijeloma u frakturne obrasce ISPITANICI I METODE: U istraživanje je uključeno 180 ispitanika sa udruženim prijelomom kostiju lica i lubanjske baze dijagnosticiranog CT-om. Skupinu ispitanika sačinjavalo je 158 muškaraca i 22 žene, srednje životne dobi 41 godina, u rasponu 18 godina do 88 godina. U svrhu usporedbe različitih dijagnostičkih protokola kompjutorizirane tomografije u istraživanje je uključeno 109 ispitanika kojima je CT pregled učinjen na jednoslojnom i 16-slojnom CT uređaju. U svrhu podjele prijeloma u frakturne obrasce u istraživanje je uključeno 180 ispitanika s udruženim prijelomom kostiju lica i baze lubanje kojima je učinjen pregled na 16-slojnom CT uređaju. REZULTATI: Učestalost udruženog prijeloma kostiju lica i lubanjske baze kod ispitanika u istraživanju iznosi 45,2%. Višeslojni CT uređaj u 99,4% ispitanika sa kraniofacijalnim prijelomom adekvatno prikazuje opseg prijeloma. Statističkom obradom podataka izdvojila su se tri frakturna obrasca udruženog prijeloma kostiju lica i lubanjske baze. ZAKLJUČAK: MSCT je kvalitetniji u prikazu opsega i lokalizaciji prijeloma od SSCT, a time i bolji u dijagnostičkom postupku. Analiza prijeloma takvih slikovnih prikaza omogućuje izradu novih frakturnih obrazaca ili podjela. Jasno definiranim MSCT protokolom primjenjenim kod svih pacijenata s tupom ozljedom glave i postavljenom sumnjom na kraniofacijalni prijelom postiže se sustavna standardizacija u dijagnostičkoj obradi pacijenata sa takvom indikacijom.INTRODUCTION: The proposed MSCT protocol allows early detection of associated facial and skull base fractures, while the classification of the fracture patterns can help in the selection of therapeutic treatment. OBJECTIVES: To determine the value of a defined radiological CT protocols and the incidence of radiologically diagnosed cranial base fractures associated with facial fractures, describe the imaging features of the associated fractures and to classify certain types of fractures in the fracture patterns SUBJECTS AND METHODS: The study included 180 patients with associated fractures of the face and skull base diagnosed by CT. The group of respondents consisted of 158 men and 22 women, median age 41 years, range 18 years to 88 years. For the purpose of comparing different diagnostic computed tomography protocols, the study included 109 patients who have had an examination done on SSCT and 16-slice CT device. For the purpose of the classification of fractures in the fracture patterns, the study included 180 patients with associated face and skull base fractures who have had an examination done on 16-slice CT device. RESULTS: The incidence of associated facial fractures and skull base in patients with blunt head injury int he study is 45.2%. Multislice CT, in 99.4% of patients with craniofacial fractures, adequately shows the extent of the fracture. Statistical analysis singled out three fracture patterns of the associated facial and skull base fractures. CONCLUSION: MSCT is better in depiction and localization of the associated face and skull base fracture than SSCT, and thus better for the diagnostic method. The analysis of this type of imaging display enables development oft he new fracture patterns or classifications. Clearly defined MSCT protocol applied in all patients with blunt head injury and a suspicion of craniofacial fracture enables the systematic standardization of the diagnostic treatment of patients with such indication

Comparison of different computed tomography diagnostic protocols in the diagnosis of associated fractures of the face and skull base

UVOD: Predloženi MSCT protokol omogućuje pravovremeno prepoznavanje udruženog prijeloma kostiju lica i baze lubanje, dok podjela u frakturne obrasce može pomoći u odabiru terapijskog postupka. CILJEVI: utvrditi vrijednost definiranog radiološkog CT protokola i pojavnost radiološki dijagnosticiranih prijeloma baze lubanje udruženih sa prijelomom kostiju lica, opisati slikovne karakteristike udruženog prijeloma i razvrstati pojedine tipove prijeloma u frakturne obrasce ISPITANICI I METODE: U istraživanje je uključeno 180 ispitanika sa udruženim prijelomom kostiju lica i lubanjske baze dijagnosticiranog CT-om. Skupinu ispitanika sačinjavalo je 158 muškaraca i 22 žene, srednje životne dobi 41 godina, u rasponu 18 godina do 88 godina. U svrhu usporedbe različitih dijagnostičkih protokola kompjutorizirane tomografije u istraživanje je uključeno 109 ispitanika kojima je CT pregled učinjen na jednoslojnom i 16-slojnom CT uređaju. U svrhu podjele prijeloma u frakturne obrasce u istraživanje je uključeno 180 ispitanika s udruženim prijelomom kostiju lica i baze lubanje kojima je učinjen pregled na 16-slojnom CT uređaju. REZULTATI: Učestalost udruženog prijeloma kostiju lica i lubanjske baze kod ispitanika u istraživanju iznosi 45,2%. Višeslojni CT uređaj u 99,4% ispitanika sa kraniofacijalnim prijelomom adekvatno prikazuje opseg prijeloma. Statističkom obradom podataka izdvojila su se tri frakturna obrasca udruženog prijeloma kostiju lica i lubanjske baze. ZAKLJUČAK: MSCT je kvalitetniji u prikazu opsega i lokalizaciji prijeloma od SSCT, a time i bolji u dijagnostičkom postupku. Analiza prijeloma takvih slikovnih prikaza omogućuje izradu novih frakturnih obrazaca ili podjela. Jasno definiranim MSCT protokolom primjenjenim kod svih pacijenata s tupom ozljedom glave i postavljenom sumnjom na kraniofacijalni prijelom postiže se sustavna standardizacija u dijagnostičkoj obradi pacijenata sa takvom indikacijom.INTRODUCTION: The proposed MSCT protocol allows early detection of associated facial and skull base fractures, while the classification of the fracture patterns can help in the selection of therapeutic treatment. OBJECTIVES: To determine the value of a defined radiological CT protocols and the incidence of radiologically diagnosed cranial base fractures associated with facial fractures, describe the imaging features of the associated fractures and to classify certain types of fractures in the fracture patterns SUBJECTS AND METHODS: The study included 180 patients with associated fractures of the face and skull base diagnosed by CT. The group of respondents consisted of 158 men and 22 women, median age 41 years, range 18 years to 88 years. For the purpose of comparing different diagnostic computed tomography protocols, the study included 109 patients who have had an examination done on SSCT and 16-slice CT device. For the purpose of the classification of fractures in the fracture patterns, the study included 180 patients with associated face and skull base fractures who have had an examination done on 16-slice CT device. RESULTS: The incidence of associated facial fractures and skull base in patients with blunt head injury int he study is 45.2%. Multislice CT, in 99.4% of patients with craniofacial fractures, adequately shows the extent of the fracture. Statistical analysis singled out three fracture patterns of the associated facial and skull base fractures. CONCLUSION: MSCT is better in depiction and localization of the associated face and skull base fracture than SSCT, and thus better for the diagnostic method. The analysis of this type of imaging display enables development oft he new fracture patterns or classifications. Clearly defined MSCT protocol applied in all patients with blunt head injury and a suspicion of craniofacial fracture enables the systematic standardization of the diagnostic treatment of patients with such indication

Isolated traumatic proximal tiobiofibular joint dislocation: clinical-radiological correlation and literature review

Disrupcija proksimalnog tibiofibularnog zgloba je rijetka i neuobičajena ozljeda uz do sada nekolicinu slučajeva opisanih u literaturi. Četiri tipa instabiliteta ili disrupcije proksimalnog tibiofibularnog zgloba klasificirana su u literaturi kao subluksacija, anterolateralna dislokacija, posteromedijalna dislokacija i proksimalna dislokacija. Ovo je prikaz slučaja 26-godišnjeg nogometaša ozlijeđenog tijekom nogometne utakmice. Dijagnoza anterolateralne dislokacije proksimalnog tibiofibularnog zgloba postavljena je tijekom kliničkog pregleda i potvrđena radiološkom obradom. Cilj ovoga rada je opisati mehanizam ozljede, konzervativno liječenje, kirurške tehnike, plan rehablitacije i povratak sportu nakon dislokacije proksimalnog tibiofibularnog zgloba.A disruption of the proximal tibiofibular joint has been considered a rare and uncommon condition with only few cases reported in literature. Four types of instability or disruption of the proximal tibiofibular joint are classified in literature as subluxation, anterolateral dislocation, posteromedial dislocation, and superior dislocation. We report a case of a 26-year-old soccer player injured during a match. The diagnosis of the anterolateral proximal tibiofibular joint dislocation was established after clinical examination and was also confirmed radiologically. The objective of this paper is to elaborate the mechanism of injury, nonoperative protocols, surgical techniques, rehabilitation schedules and sports guidelines after proximal tibiofibular joint dislocation

Implementation of Copy Number Variations-Based Diagnostics in Morphologically Challenging EWSR1/FUS::NFATC2 Neoplasms of the Bone and Soft Tissue

In the last decade, new tumor entities have been described, including EWSR1/FUS::NFATC2-rearranged neoplasms of different biologic behavior. To gain further insights into the behavior of these tumors, we analyzed a spectrum of EWSR1/FUS::NFATC2-rearranged neoplasms and discuss their key diagnostic and molecular features in relation to their prognosis. We report five patients with EWSR1/FUS::NFATC2-rearranged neoplasms, including one simple bone cyst (SBC), two complex cystic bone lesions lacking morphological characteristics of SBC, and two sarcomas. In three cases, fluorescence in situ hybridization (FISH) and in all cases copy number variation (CNV) profiling and fusion analyses were performed. All patients were male, three cystic lesions occurred in children (aged 10, 14, and 17 years), and two sarcomas in adults (69 and 39 years). Fusion analysis revealed two FUS::NFATC2 rearrangements in two cystic lesions and three EWSR1::NFATC2 rearrangements in one complex cystic lesion and two sarcomas. EWSR1 FISH revealed tumor cells with break-apart signal without amplification in one complex cystic lesion and EWSR1 amplification in both sarcomas was documented. CNV analysis showed simple karyotypes in all cystic lesions, while more complex karyotypes were found in NFATC2-rearranged sarcomas. Our study supports and expands previously reported molecular findings of EWSR1/FUS::NFATC2-rearranged neoplasms. The study highlights the importance of combining radiology and morphologic features with molecular aberrations. The use of additional molecular methods, such as CNV and FISH in the routine diagnostic workup, can be crucial in providing a correct diagnosis and avoiding overtreatment