Isolated torsion of the hydrosalpinx: a rare presentation

Isolated torsion of the Fallopian tube is a rare occurrence, which generally presents in the reproductive age group. It is difficult to diagnose on imaging and the diagnosis is established after laparoscopy. This report describes an unusual presentation of an uncommon condition in a perimenopausal 48-year-old woman who presented with lower abdominal discomfort. The clinical and imaging features led to a suspicion of ovarian neoplasm. Diagnostic laparoscopy revealed torsion of a left sided hydrosalpinx with benign serous cystadenoma of the left ovary. Torsion of the Fallopian tube is a rare event in the perimenopausal age group. It should however be included in the differential diagnosis of lower abdominal pain and recognition of imaging features may allow early surgical intervention.     

Bilateral symmetrical cortical osteolytic lesions in two patients with Gaucher disease

Gaucher disease (GD) is an autosomal recessive lysosomal storage disorder characterized by the reduced or absent activity of glucocerebrosidase. The disease is split into three types. Type 3, or chronic neuronopathic GD, manifests with heterogeneous clinical presentations. Skeletal manifestations of GD can include abnormal bone remodeling resulting in the characteristic Erlenmeyer flask deformities, painful bone crises, osteopenia, and an increased frequency of fractures. Osteolytic lesions can also occur but are rare and tend to be large, expanding intramedullary lesions with cortical thinning. We present two adolescent patients with type 3 GD who developed bilateral symmetrical cortical osteolytic lesions. The lesions in both cases demonstrate predominant cortical scalloping with fairly indolent growth. Neither patient manifests some of the more common bony manifestations of GD—bone crises or osteonecrosis. These atypical and unique skeletal findings in two unrelated probands with type 3 GD further expand the extent of phenotypic variation encountered in this single gene disorder.     

Complete familial Currarino triad in association with Hirschsprung's disease: magnetic resonance imaging features and the spectrum of anorectal malformations

Currarino syndrome, a rare hereditary condition, is defined as a partial sacral agenesis associated with a presacral mass and anorectal malformation. The authors present two siblings with complete Currarino triad and their mother with incomplete triad. The complete Currarino triad in the older sibling was associated with Hirschsprung's disease as the second reported case in the literature. Anorectal malformations, whether suspected of Currarino syndrome or not, should be examined with lumbosacral magnetic resonance imaging.     

Recurrent Lhermitte-Duclos disease: report of two cases and association with Cowden's disease.

Two cases of Lhermitte-Duclos disease (LDD), one associated with Cowden's disease, are reported. Both demonstrated recurrence long after initial surgical resection. There is a propensity for occurrence in the left cerebellar hemisphere. On MR there is hypointensity on T1-weighted images and moderately high signal on T2-weighted images, with parallel linear striations on the surface of the lesion felt to represent dysplastic cerebellar folia. LDD is felt to be a low-grade neoplasm and potential component of Cowden's phakomatosis.     

Bilateral anterior glenohumeral dislocation and coracoid processes fracture after seizure: acute MRI findings of this rare association

We report a rare case of bilateral anterior shoulder dislocation associated with coracoid processes fracture after a seizure episode in a 37-year-old woman. This combination of findings is rare, especially by the presence of bilateral coracoid processes fracture. Possible mechanisms related are direct trauma of humeral heads over the coracoid processes or sudden pull of biceps short head attachment site during uncontrolled contractures. Few reports published similar combination of injuries, and to our knowledge, this is the first to demonstrate its acute features by magnetic resonance imaging. A review of the literature is also presented.     

Associations of body size and composition with physical activity in adolescent girls

PURPOSE: To examine whether components of body composition (size, fat mass, and fat-free mass) were related to physical activity. METHODS: A random sample of 60 eligible sixth grade girls at each of 36 schools (six schools per region and six regions in total sample); complete measurements on 1,553 girls. Physical activity was assessed over 6 d in each girl using an accelerometer, and body composition was assessed using a multiple regression equation using body mass index and triceps skinfold. Minutes of moderate-to-vigorous and vigorous physical activity were estimated from accelerometer counts per 30 s above threshold values determined from a previous study. RESULTS: Significant inverse relationships were found for all measures of body size and composition and all physical activity indices. The combination of fat and fat-free mass expressed as a weight and as an index (divided by height squared) along with race, SES, site, and school were most highly associated with physical activity in multiple regression analysis, accounting for 14-15% of the variance in physical activity. Fat mass was more closely related to moderate-to-vigorous physical activity (MVPA) and vigorous physical activity (VPA) than fat-free mass with higher standardized regression coefficients. CONCLUSION: We conclude that both fat mass or fat mass index as well as fat-free mass or fat-free mass index make independent contributions in association with physical activity levels. These indices are recommended for future studies.     

Bilateral discoid medial menisci: association with bone changes in the tibia

We present here the third case report of bilateral discoid medial menisci with associated bone changes. An 18-year-old man had bilateral medial tibial plateau depression (cupping) accompanying medial discoid menisci documented by magnetic resonance imaging and confirmed by arthroscopy. The patient was treated successfully by excision of the torn central anomalous discoid portion of the menisci using arthroscopic partial resection technique.     

False mass of the thoracic wall in obese adolescent girls

Each of four obese adolescent females were thought to have pre-sternal anterior chest wall "masses" when evaluated by lateral chest radiograph. All had normal physical examinations. The apparent chest wall masses were found to be an artifact created by partial midline contact of both, large breasts, surrounded by a partial midline air space adding contrast to the adjacent soft tissue. Manual abduction of the breasts was followed by disappearance of the apparent radiographic abnormality.     

Maturation of the postural control in adolescent girls: A 3-year follow-up study

BackgroundStable posture is a manifestation of the appropriate functioning of the neuromuscular system that is essential for proper motor development and control. Balance and stability of the erect posture are shaped during the entire childhood to culminate in its full efficiency in adolescent subjects.MethodsIn this 3-year follow-up study, the process of the postural control maturation has been assessed in a group of 18 girls at the transition period between childhood to adolescence. Their balance and postural stability control were assessed using standard static posturography supplemented by two postural stability tests: the rising-on-toes (ROT), and the maximum forward lean (MFL), all performed with (EO) and without vision (EC). Balance control was analyzed with the sway vector (SV) and sway directional indices, whereas the anteroposterior trajectories of the center-of- pressure (COP) during forward-leaning and the raise-on-toes tests were used to determine changes in postural stability control.ResultsThe study documented that stability control in girls aged 11–13 is shaped according to their own pace of development. Their postural sway was characterized by the lower COP velocity but very sensitive to visual input. The directional sway measures remained at the same level for the entire period of observation. MFL and ROT tests provided similar information on postural stability and its dependence on visual input. These tests allow for more thorough assessment of postural stability to compare with quiet stance testing.SignificanceSubtle changes in postural control in adolescents could be assessed based on the results of combined static and dynamic tests. In particular, the ROT test can be recommended for the assessment of postural stability.     

Bilateral orbital lymphangiomas in two patients with generalized lymphangiomatosis

SUMMARY: Generalized lymphangiomatosis is a rare congenital malformation of the lymphatics, characterized by cystic lesions in parenchymal organs and lytic bone lesions. In this report, we describe the radiographic and clinical features of 2 unusual cases of generalized lymphangiomatosis with bilateral orbital involvement.     

Effects of plyometric jump training on bone mass in adolescent girls

PURPOSE: The purpose of this study was to investigate the effects of 9 months of plyometric jump training on bone mineral content (BMC), lower extremity performance, and static balance in adolescent girls (aged 14.6 +/- 0.5 yr; 22.7 +/- 14.0 months past menarche). METHODS: Exercisers (N = 25) trained 30-45 min, three times per week, performing various exercises using weighted vests (squats, lunges, calf raises) and plyometrics (hopping, jumping, bounding, and box depth jumps). The program was designed to load the lower extremities. Controls (N = 28), matched to exercisers for age and months past menarche, maintained their usual activities. The following were assessed at baseline and 9 months: BMC, strength by isokinetic dynamometry, power (Wingate), and static balance. RESULTS: Repeated measures ANOVA revealed no significant differences between groups for BMC, nor were the changes in anthropometric or performance variables, analyzed by MANOVA, significant. In follow-up analyses, t-tests for independent samples revealed that both groups experienced a significant (P < 0.01) increase in percent change in bone mass compared to zero, for the whole body (mean: 3.7% exercisers, 3.6% controls), femoral neck (4.5% vs 2.4%), lumbar spine (L2-4) (6.6% vs 5.3%), and femoral shaft (3.4% vs 2.3%), but only the exercisers improved BMC of the greater trochanter (3.1% vs 1.9%). Furthermore, the exercise group significantly improved knee extensor strength (14.7% vs 7.3%) and medial/lateral balance (38.1% vs 9.5%), whereas the control group demonstrated no changes. The variety of lateral movement activities performed by the exercise group may have contributed to the differences observed between groups for greater trochanter bone mineral density (BMD), leg strength, and medial/lateral balance. CONCLUSION: The trends observed in bone mass between groups suggest that plyometric jump training continued over a longer period of time during adolescent growth may increase peak bone mass.     

Neurocutaneous melanosis with the Dandy-Walker malformation: a possible rare pathoetiologic association

We report a neonate in whom clinical and radiologic studies revealed features of both neurocutaneous melanosis and a Dandy-Walker malformation. We suggest that the association of these two conditions is perhaps not chance.     

MR imaging evaluation of obstructing vaginal malformations with hematocolpos or hematometra in adolescent girls: A cross sectional study

Objective

Vaginal or uterine outlet obstruction leads to hematocolpos or hematometra. Detection of the etiology of this entity is important to guide adequate surgical management and thereby avoid complications and to preserve fertility. The aim of this study was to evaluate obstructing vaginal malformations in adolescent girls presenting with hematocolpos or hematometra with MR imaging.

Bilateral triradiate cartilage injury: an overuse syndrome in an adolescent football player

The triradiate cartilage is not a recognized site for an overuse injury. We present here X-ray and MRI findings of a young athlete with chronic right-sided hip pain that proved to be secondary to triradiate cartilage overuse injury. MRI also revealed similar but milder findings on the left side. Distal radial and proximal humeral epiphyses, iliac bone, tibial tubercle, calcaneal and proximal 5th metatarsal apophyses are common sites of overuse injuries in the skeletally immature athletes. Radiological findings may resemble a Salter-Harris type I injury, but an insidious onset of the symptoms, absence of acute trauma, and bilaterality of MRI findings may help differentiate these entities.