Desmoplastic fibroma (DF) is a benign, rare fibroblastic intraosseous neoplasm histologically resembling a desmoid soft tissue tumor. Although classified as benign, DF frequently exhibits an aggressive behavior, has a moderate-to-high recurrence rate, and often causes pathological fractures and extensive bone destruction. This case report presents an incidentally detected DF of the tibia, which was diagnosed using a minimally invasive approach. A 36-year-old African female patient was referred to the Department of Diagnostic Imaging of Arcispedale Santa Maria Nuova-IRCCS (Reggio Emilia, Italy), to be examined by a computed tomography scan on an outpatient basis, after an x-ray examination of the tibia, which was performed after an injury to exclude the presence of a fracture, revealed a hyperlucency of unknown origin. The aim of this study was to discuss the clinical, histological, immunohistochemical and radiographic characteristics of this rare neoplasm, with a focus on image-guided bone biopsy.

AVM is as accurate as MDM but faster. Both methods are more accurate for size assessment of breast lesions compared with US and mammography.

Architectural and dynamic features are important in the interpretation of breast MRI findings. ILC may be detected on MRI as solitary or multiple lesions that correspond to tumour morphology on pathologic examination. False-negative MRI findings do occur in a small percentage of ILC.

BackgroundMRI is often used to assess muscle inflammation in myositis. Muscle edema on short tau inversion recovery (STIR) sequences is thought to represent active inflammation. Dermatomyositis (DM) and polymyositis (PM) affect very frequently thigh muscles. However, it is unknown whether DM and PM differ in the respective involvement of the various thigh muscle groups.ObjectivesTo assess which thigh muscle groups are preferentially affected by DM and PM, respectivelyMethodsWe analysed 72 patients from 2 Rheumatology centers, 31 with DM and 41 with PM diagnosed according to Bohan and Peter criteria. MRI edema (1= present, 0= absent) was assessed bilaterally on STIR sequences in 17 thigh/pelvic floor muscles. An MRI composite edema score (0-17) was calculated by adding the separate scores bilaterally and dividing them by two as described elsewhere (1). The (single measures) intraclass correlation coefficient (ICC) between the Radiologists involved was 0.78. Fisher's exact test was used for comparison of binomial data.ResultsAge (years, mean ± SD) was similar in patients with DM (53±16) and PM (56±16). The F:M ratio was similar in DM (23/8) and PM (32/9). Disease duration (months, mean ± SD) was longer (20±31) in DM than in PM (52±68) (p=0.02). The frequency of the thigh muscle groups involved in DM and PM is shown in the Table below.Table 1.Prevalence of involvement of thigh muscle groups in DM and PMCompartmentDM (n=31)PM (n=41)p valueGluteus maximusaxial17 (55%)13 (32%)0.06Quadratus femorisaxial9 (29%)1 (2%)0.002Vastus lateralisanterior15 (48%)11 (27%)0.08Ileopsoasaxial8 (26%)3 (7%)0.046Vastus medialisanterior14 (45%)10 (24%)0.08Tensor fasciae lataeanterior12 (39%)4 (10%)0.005Rectus femorisanterior16 (52%)10 (24%)0.03Sartoriusanterior13 (42%)11 (27%)0.2Gracilismedial15 (48%)8 (20%)0.01Pectineusmedial8 (26%)2 (5%)0.02Adductor longusmedial9 (29%)6 (15%)0.16Adductor brevismedial12 (39%)5 (12%)0.01Adductor magnusmedial10 (32%)10 (24%)0.6Short head biceps femorisposterior10 (32%)6 (15%)0.09Long head biceps femorisposterior12 (39%)12 (29%)0.5Semimembranousposterior10 (32%)8 (20%)0.3Semitendineousposterior14 (45%)10 (24%)0.08 ConclusionsCompared with PM, DM affects more frequently some muscle groups. Posterior muscle groups appear to discriminate poorly between DM and PM. These findings may be useful for differential diagnostic purposes in patients with histological features of DM without the typical skin rash as well as to target physiotherapy on more frequently affected muscles. Larger studies are needed to confirm our preliminary findings.The last 2 authors share senior authorship.ReferencesClin Exp Rheumatol 2012; 30:570-3.Disclosure of InterestNone declared

In our experience, we have observed that conscious sedation can be safely administered by neuroradiologists during spinal procedures, provided that some basic rules are respected regarding patient selection and monitoring, personnel training and angiography equipment.