Agreement on the assessment of metastatic spine instability is moderate. The SINS can help improve communication among clinicians in oncology care.

MRI is an effective tool in the assessment of osteonecrosis of the jaw. The significance of focal lesions detectable on radiologic examination but without clinical correlation and their progression over time remains to be determined.

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Materials and methods: Clinical data and imaging from 90 patients with biopsy-proven spinal metastases, were provided to 83 specialists from 44 hospitals. Spinal levels involved and the Tomita and modified Bauer scores for each case were determined twice by each clinician, with a minimum of 6-week interval. Clinicians were blinded to every evaluation. Kappa statistic was used to assess intra and inter-observer agreement. Subgroup analyses were performed according to clinicians' specialty (medical oncology, neurosurgery, radiology, orthopedic surgery and radiation oncology), years of experience (67, 8-13, P14), and type of hospital (four levels).Results: For metastases identification, intra-observer agreement was ''substantial'' (0.60 < k < 0.80) at sacrum, and ''almost perfect'' (k > 0.80) at the other levels. Inter-observer agreement was ''almost perfect'' at lumbar spine, and ''substantial'' at the other levels. Intra-observer agreement for the Tomita and Bauer scores was almost perfect. Inter-observer agreement was almost perfect for the Tomita score and substantial for the Bauer one. Results were similar across specialties, years of experience and type of hospital. Conclusion: Agreement in the assessment of metastatic spine disease is high. These scoring systems can improve communication among clinicians involved in oncology care.

Cardiovascular complications of brucellosis are rare, but account for most deaths of this disease. Only a few case reports describe infected aortic aneurysms caused by Brucella melitensis. In this report we present a patient with rupture of a non-dilated abdominal aorta due to Brucella melitensis infection.