Objectives: Breast manifestations in patients with systemic lupus erythematosus (SLE) include primary lupus of the breast (i.e., lupus mastitis) and secondary manifestations of lupus such as lymphadenopathy or vascular calcifications. To clarify the spectrum of breast manifestations in patients with SLE, we reviewed the clinical, imaging, and pathological manifestations of breast diseases in SLE patients. Methods: We retrospectively reviewed cases of SLE patients with breast imaging performed in five centres from January 2010 to April 2020. Patient demographics, breast symptoms, imaging, and pathological findings, and their subsequent management, were reviewed. Results: A total of 16 cases were included. The mean follow-up period was 61 months. A palpable breast mass was the most frequent clinical presentation, followed by mastalgia and axillary swelling. A wide range of imaging findings was encountered on ultrasonography and/or mammography, including extensive calcifications in both breasts, breast masses with features suspicious for malignancy, fat necrosis, oedema, arterial calcifications, architectural distortion, and axillary lymphadenopathy. Two cases of lupus mastitis and a case of invasive ductal carcinoma were identified. Conclusion:No definite distinguishing features between lupus mastitis and breast malignancy were observed on imaging. Pathological correlation is recommended when imaging features suspicious for malignancy are demonstrated.

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Objectives:We sought to examine the frequency and patterns of monosodium urate (MSU) crystal deposition in the hand/wrist in non-acute gout patients using dual-energy computed tomography (DECT). Methods: All hand/wrist DECT imaging data of patients with chronic tophaceous gout undergoing their first examination before dissolution therapy from March 2015 to March 2019 were identified. Cases without positive MSU crystal deposition were excluded. The reports and images of the positive cases were retrospectively analysed, and the anatomical locations of all urate crystal depositions were recorded. Results: A total of 48 cases were identified with positive findings. Thirty of the cases had undergone DECT of both hands, and 18 had undergone DECT of a single hand. In total, 60 hands/wrists had flexor tendon involvement. The carpal joints were the most commonly involved site (78.2%). The carpal tunnel was the most commonly involved soft tissue site in the hand and wrist (71.8%), followed by the fourth (55.1%) and fifth (53.8%) extensor compartments. The second digit extensor digitorum (47.4%) was the most commonly involved soft tissue site in the hand while the fourth digit flexor digitorum was the most commonly (46.2%) involved flexor tendon in the hand. In the hand and wrist soft tissue sites, extensor pollicis brevis (11.5%), flexor carpi ulnaris (11.5%) and extensor compartment I (11.5%) were involved least commonly. We found Zones II (75%) and IV (78.3%) to be the most commonly involved flexor tendon zones in the hand. Conclusion:In this observational study, we have provided a detailed analysis of hand and wrist urate distribution in gout.

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Objectives: To compare the procedural outcomes of magnetic seed localisation and hookwire localisation (HWL) of nonpalpable breast lesions in an Asian population. Methods: We performed a retrospective review of 91 nonrandomised female patients who underwent breast surgery after image-guided magnetic seed localisation or HWL from July 2019 to June 2021. Rates of placement success (defined as marker-lesion distance <10 mm), lesion detection, marker retrieval, and complications, were compared. Results: A total of 48 patients received magnetic seeds, and 43 patients received hookwires for preoperative localisation; a total of 100 lesions (50/100, 50.0% Magseed vs. 50/100, 50.0% hookwire) were marked and excised. Magnetic seeds were placed 0 to 126 days before surgery (median=14); of the 50 lesions marked, 22 were removed on the same day and 28 on a later day. Placement success was identical between the two groups, 98.0% magnetic seeds versus 98.0% hookwire. All lesions were detected at the first operation and successfully excised; all markers were removed intact without complications. Conclusion: Magnetic seed localisation demonstrated comparable procedural success and safety to conventional HWL in Asian patients with thinner and denser breasts. It could be an effective alternative to HWL, with the additional advantage of decoupling localisation and surgery dates.