Iliopsoas impingement syndrome, an infrequent complication of total hip replacement, has been rarely reported in the radiological literature. It follows chronic friction of the posterior aspect of the iliopsoas muscle and tendon against the acetabular cup, a piece of cement, or cup fixation screws. Clinical findings are non-specific and an imaging modality is required to diagnose the condition. Computed tomography (CT) is considered the gold standard imaging modality in evaluating iliopsoas impingement. We report a case of a patient in which the diagnosis was made by ultrasound and later confirmed by CT.

• MRI alone and PET/MR have a similar overall diagnostic performance. • MRI alone has a higher sensitivity than PET/MR for local tumour assessment. • Both MRI and PET/MR have a limited sensitivity for nodal metastases. • Positive lymph nodes on MRI or PET/MR do not require presurgical biopsy.

Percutaneous CT-guided coaxial multisampling large CNB of suspected thoracic lesions, in a mainly cancer-based population, is an accurate procedure for a specific histologic diagnosis and has a low rate of complications.

We evaluated the diagnostic quality of image-guided multisampling core needle biopsy (CNB) in patients investigated for suspected lymphoma in a primary care hospital. A total of 112 patients were consecutively assessed during a 3-year period. There were 80 lymphoid site biopsies and 32 non-lymphoid site biopsies. Eight to nine cores were obtained from different parts of the biopsy site. Two cores were systematically frozen, allowing for further morphological, immunochemistry and molecular studies. The diagnostic yield of CNB for malignancy was 100%. Only 47% (41/87) of patients with initial suspicion of lymphoma were finally diagnosed with Lymphoma. The diagnostic yield of CNB for lymphoma typing was 98% (62/63), according to the WHO classification. The diagnostic yield of CNB for complete lymphoma subtyping/grading was 86% (54/63). The diagnostic yield of CNB for a definite diagnosis of benignity was only 47% (8/17). In a primary care setting, multisampling CNB is a minimally invasive, and very accurate procedure for confirming malignancy in patients with suspected lymphoma, presenting with superficial/deep-seated, lymphoid/non-lymphoid site targets. With a very high diagnostic yield for lymphoma typing and a high diagnostic yield for complete lymphoma subtyping/grading a therapeutic decision can be taken in most patients.

he frequency of fractures of the lateral process of the talus (LPT) has markedly increased because of the expansion of snowboard activity. These lesions are difficult to diagnose, because they have aspecific signs, and standard radiographs do not show the fractures in 50% of cases. Sonography is used more and more in the assessment of ankle trauma, but it is rarely performed for detection of bone fractures. We report a case of a patient in which sonography directly showed an LPT fracture. Case ReportA 32-year-old man was admitted to the Emergency Department for acute right ankle pain that occurred the day before during snowboarding. He had forceful movement of eversion and external rotation of the ankle during a jump landing, followed by inability to bear weight and painful ankle swelling. Clinically, moderate swelling over the lateral malleolar and exquisite inframalleolar local tenderness were evident. Passive inversion and dorsal flexion of the foot were painful. Tests for instability of the ankle joint, including the anterior drawer test, were questionable because of severe pain and reflex muscle activation. Previous routine radiographic findings (anteroposterior [AP] and lateral views) were reported as negative.Because of pain at the external aspect of the ankle, sonography was performed to assess para-articular soft tissues and ligaments. Sonography was performed with commercially available equipment (HDI 5000; Philips Medical Systems, Bothell, WA) working with linear array transducers (frequency band, 5-12 MHz) and no standoff pad. Longitudinal and axial images obtained over the anterior talofibular and calcaneofibular ligaments showed normal aspects of both ligaments and no signs of tears (Fig. 1). A longitudinal image obtained over the