Discovertebral (Andersson) lesions of the spine in ankylosing spondylitis revisited

A well-known complication in patients with ankylosing spondylitis (AS) is the development of localised vertebral or discovertebral lesions of the spine, which was first described by Andersson in 1937. Since then, many different terms are used in literature to refer to these localised lesions of the spine, including the eponym ‘Andersson lesion’ (AL). The use of different terms reflects an ongoing debate on the exact aetiology of the AL. In the current study, we performed an extensive review of the literature in order to align communication on aetiology, diagnosis and management between treating physicians. AL may result from inflammation or (stress-) fractures of the complete ankylosed spine. There is no evidence for an infectious origin. Regardless of the exact aetiology, a final common pathway exists, in which mechanical stresses prevent the lesion from fusion and provoke the development of pseudarthrosis. The diagnosis of AL is established on conventional radiography, but computed tomography and magnetic resonance imaging both provide additional information. There is no indication for a diagnostic biopsy. Surgical instrumentation and fusion is considered the principle management in symptomatic AL that fails to resolve from a conservative treatment. We advise to use the term Andersson lesion for these spinal lesions in patients with AS

Radiologic evaluation of gastrointestinal leiomyosarcomatosis

A 68-year-old woman who had previously undergone small intestinal resection because of leiomyosarcoma was referred to our clinic with epigastric pain. A double-contrast barium study and the subsequent abdominopelvic CT and abdominal MRI examinations demonstrated multiple extraluminal growing tumors arising from the walls of stomach, small bowell, and colon. A CT-guided aspiration biopsy revealed malignant mesenchymal tumor. The presence of disseminated intra-abdominal masses without concomitant ascites and invasion of tissue planes on CT in a patient operated on prior because of a leiomyosarcoma led to the diagnosis of gastrointestinal leiomyosarcomatosis. In this report we discuss the radiological approach to this rare entity

Multiple pulmonary artery aneurysms due to infective endocarditis

Bilateral pulmonary artery aneurysms developed in the course of staphylococcal endocarditis in a 6-year-old girl with ventricular septal defect. Consecutive computed tomography scans revealed the progressive enlargement of one of the aneurysms. She underwent an urgent left upper lobectomy because of the impending rupture and a possible life-threatening hemorrhage. The second ipsilateral aneurysm was plicated in order to exclude the aneurysm sac. In the next operation the ventricular septal defect was closed and vegetations located on the tricuspid valve were removed. On follow-up spontaneous thrombotic resolution occurred in the right-sided aneurysms. (C) 2003 by The Society of Thoracic Surgeons

Lumbar and iliac artery aneurysms in Menkes' disease: endovascular cover stent treatment of the lumbar artery aneurysm

We report lumbar and iliac artery aneurysms in a 3-month-old boy with Menkes' disease. The iliac artery aneurysm thrombosed spontaneously, documented by follow-up colour Doppler sonography. The lumbar artery aneurysm was successfully treated using a cover stent. There was no filling of the lumbar artery aneurysm and no stenosis of the cover stent during the 9-month follow-up

Radiological work-up in Peutz-Jeghers syndrome

Background. The development of modern imaging studies such as high-resolution US and various MR imaging sequences have enabled their application to the examination of the gastrointestinal tract. Objective. To compare radiological contrast studies, US and MRI in patients with Peutz-Jeghers syndrome (PJS). Materials and methods. Ten members of two families were evaluated. The patients were divided into three groups according to the presence of perioral pigmentations and current clinical symptomatology. Patients were examined using US, MRI and radiological contrast studies. Results. In the disease-free family members (n=3), no pathological findings were found. In asymptomatic (n=4) and symptomatic patients (n=3), polyps were demonstrated using contrast studies in all cases. MRI demonstrated all the polyps. Ultrasound revealed the polyps in three out of six patients. In addition to the polyps, intussusceptions were shown. There was no evidence of malignant transformation on any of the studies. Conclusions. Although PJS is a childhood or teenage disease, patients should be closely monitored during adulthood because of the development of gastrointestinal and extragastrointestinal malignancies. Contrast studies remain the gold standard. However, radiological follow-up could be undertaken by US or MRI, which would not impose a radiation burden during life-time follow-up

A combination of small bowel imaging methods: conventional enteroclysis with complementary magnetic resonance enteroclysis

AIM: The aim of this prospective study was to evaluate the overall findings of conventional enteroclysis (CE) with complementary magnetic resonance enteroclysis (MRE) in small bowel disease