3-T MRI with thin-slice 3D T1 VIBE is 100 % accurate in diagnosing complete pars fractures and has excellent diagnostic ability in the detection and characterization of incomplete pars stress fractures compared to CT. MRI has the added advantages of detecting bone marrow edema and does not employ ionizing radiation.

Tumor-induced osteomalacia is typically caused by benign mesenchymal tumors of vascular or skeletal origin. Overexpression of fibroblast growth factor 23 (FGF-23) by these tumors is associated with decreased resorption of phosphate in the renal tubules. This phosphate wasting leads to the characteristic findings of hypophosphatemia and hyperphosphaturia. Chronic hypophosphatemia causes abnormal mineralization of bone, increased alkaline phosphatase and, in the longer term, osteomalacia. Localization and resection of the FGF-23-secreting tumor offers the best chance of cure. We report a case of a 74-year-old woman diagnosed with numerous fractures on bone scintigraphy. Bone biopsy confirmed osteomalacia. Biochemical investigations showed hypophosphatemia, hyperphosphaturia, and increased alkaline phosphatase, suggesting the presence of an FGF-23-secreting tumor. Biochemistry also showed hyperparathyroidism and subclinical hyperthyroidism. Thyroid and parathyroid scintigraphy were performed and showed separate areas of focally increased tracer uptake in the neck. The patient underwent octreotide scintigraphy to localize an alternative site of tumor. This showed focally increased tracer uptake in the neck and in the abdomen. The patient underwent a hemithyroidectomy, parathyroidectomy, and adrenalectomy. Histopathology showed a papillary carcinoma of the thyroid, a parathyroid adenoma, and an adrenal adenoma. Postoperatively the patient showed rapid symptomatic and biochemical improvement.

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man, a coroa. That black female sexuality may be desired by whites might be read as 'proof' that Brazilians are not racist and is so offered by many of Glória's friends; but Goldstein demonstrates powerfully how the elevation of the black (especially mulata) female body in the national imagination works as a powerful tool in obscuring, and indeed producing, racial oppression. The book is an excellent illustration of how 'gender, class, sexuality, and race, as well as beauty and age, are all intertwined in one story' (p. 109) and Goldstein tells the story with consummate skill. In some ways this ethnography can be situated within a long tradition of anthropology concerned with the urban poor but it is certainly not part of a 'culture of poverty' school. This work is methodologically innovative and critically self-aware without descending into the hand-wringing solipsistic introspection that has afflicted some recent anthropology. She also constantly unsettles the reader. It would have been doubtless tempting to present Glória as simply an heroic figure but Goldstein offers a woman of far greater complexity: the woman of boundless generosity is quite capable of throwing her children out or making her son eat his own faeces as a punishment. Without excusing these actions Goldstein places them in their own meaningful cultural context and the reader is slowly drawn into a world where people can find rape and murder funny; and understand why. 'What's so funny about rape?' is the title of the final chapter and deals with the recounting of burglary and sexual assault of Glória's two young teenage daughters. That anyone, and especially the victims of the burglary and assault, would find anything to laugh about such an unambiguously terrifying event is, at the very least, perplexing; it is 'laughter out of place'. Goldstein's skill is that she can understand the humour of Glória and her daughters and convey it to her readers without denying or minimizing the awfulness of the experience. In so doing she offers a difficult, and sometimes courageous, exploration of complex and powerful human experiences, refusing to settle for the simplest and most comfortable accounts. Laughter Out of Place will appeal to a broad readership since it so skilfully addresses such a wide range of issues. This is a book which is accessible and challenging and is to be highly recommended: it is a must on any race and gender course but will equally be of interest to those scholars and students of Latin America, anthropology and sexuality.