The ankylosed spine is prone to fracture even after minor trauma due to its changed biomechanical properties. The two central features of ankylosing spondylitis (AS) that promote the pathological remodeling of the spine are inflammation and new bone formation. AS is also associated with osteoporosis that is attributed to an uncoupling of the bone formation and bone resorption processes. Therefore, bone resorption occurs and promotes weakening of the spine as well as increased risk of vertebral fractures which can be hugely different in terms of clinical relevance. Even in the presence of symptomatic clinical vertebral fractures, the diagnosis can be overruled by attributing the pain to disease activity. Furthermore, given the highly abnormal structure of the spine, vertebral fracture diagnosis can be difficult on the basis of radiography alone. CT can show the fractures in detail. Magnetic resonance imaging is considered the method of choice for the imaging of spinal cord injuries, and a reasonable option for exclusion of occult fractures undetected by CT. Since it is equally important for radiologists and clinicians to have a common knowledge base rather than a compartmentalized view, the aim of this review article was to provide the required clinical knowledge that radiologists need to know and the relevant radiological semiotics that clinicians require in diagnosing clinically significant injury to the ankylosed spine.

Deep infiltrating endometriosis is an important gynecologic disease that may develop during the reproductive years and is responsible for severe pelvic pain. Deep pelvic endometriosis can affect the retrocervical region, uterosacral ligament, rectum, rectovaginal septum, vagina, urinary tract, and other extraperitoneal pelvic sites. Surgery remains the best therapeutic treatment for affected patients and an accurate preoperative evaluation of the extension of endometriotic lesions is essential for a successful outcome. However, many atypical locations for deep pelvic endometriosis exist although still lesser known to both gynecologists and radiologists such as endometriosis of the round ligaments of the uterus (RLUs). In this article, we review embryology and anatomy of the RLUs as well clinical characteristics associated with these endometriotic locations. In addition, we describe magnetic resonance (MR) imaging protocol, normal MR imaging appearances of the RLUs and the most common abnormal findings of endometriotic involvement of these ligaments at MR imaging. Radiologists should always keep in mind the RLUs as a possible site of deep pelvic endometriosis localization and should not forget to carefully look for them on MR images.

Our findings highlight the existence of episodes of discrimination by some hygienists towards HIV-infected individuals. From clinical point of view, this discriminatory behaviour may expose the dental health care workers and their patients to a greater risk of cross-infection.

T here are two main treatment options in patients with cervical cancer: radical surgery, including trachelectomy or radical hysterectomy, which is usually performed in early stage disease as suggested by the International Federation of Gynecology and Obstetrics (FIGO stages IA, IB1, and IIA), or primary radiotherapy with concurrent administration of platinum-based chemotherapy (CRT) for patients with bulky FIGO stage IB2/ IIA2 tumors (> 4 cm) or locally advanced disease (FIGO stage IIB or greater). Some authors suggested the use of CRT followed by surgery for bulky tumors or locally advanced disease (1). Others proposed resection of the Müllerian compartment (fallopian tubes, uterus, proximal and middle vagina, enveloped by peritoneal and subperitoneal mesotissue known as mesometrium) and pelvic lymph node dissection by total mesometrial resection, without adjuvant radiation in FIGO stages IB, IIA, and selected IIB (2), following their ontogenetic theory of locoregional cancer spread (3-6). In all cases, pretreatment assessment of tumor extension and presence of parametrial invasion are of paramount importance to help define an appropriate management strategy. Staging of cervical cancer is still based on FIGO criteria, which are based on clinical findings. Its accuracy is limited in the advanced stages (7). Magnetic resonance imaging (MRI) has been shown to be the most reliable imaging technique in local staging, treatment planning, and follow-up of cervical cancer (8, 9), with staging accuracy ranging from 75% to 96% (10). In 2010, National Comprehensive Cancer Network (NCCN-2010) included MRI in the basic work-up of patients suffering from cervical cancer for stages greater than IB1.The aim of this paper is to show MRI anatomy of the parametrium, paying special attention to the pelvic landmarks, using a series of T2-weighted and diffusion-weighted imaging (DWI) findings that are useful to identify its complete extension (i.e., anterior and posterior extensions, in addition to the lateral extension). Technical suggestionsThe MRI protocol for cervical cancer usually includes anatomical and morphologic sequences of the pelvis, such as T1-weighted imaging in the axial plane and T2-weighted imaging in the axial and sagittal planes, and high spatial resolution axial oblique (short axis of cervix) and coronal oblique (long axis of cervix) T2-weighted imaging with small fieldof-view, which improve identification of parametrial invasion (12). Large field-of-view axial T1-and/or T2-weighted imaging of the abdomen is applied to identify enlarged lymph nodes and hydronephrosis. Dynamic multiphase contrast-enhanced three-dimensional T1-weighted imaging sequence is not routinely used for staging cervical carcinoma, unless the tumor is small and the patient is considered for fertility-sparing surgery or to distinguish ABSTRACTThis paper highlights an updated anatomy of parametrial extension with emphasis on magnetic resonance imaging (MRI) assessment of disease spread in the parametrium in patients with locally advanced cer...