Axial rotation of the carpal bones forms an important component of all wrist movements; however, carpal alignment in the axial plane has somehow not attracted attention. The present study comprised computed tomography (CT) imaging of the wrist joint in 53 asymptomatic volunteers lying prone with the shoulder abducted, elbow flexed and the palm facing down. Axial axes of various carpal bones and the distal radius were drawn and measured. The scaphoid axis was found to be in neutral position in 11%, and supinated in 89% of wrists, with mean of 16 degrees (SD 9 degrees ) while the lunate axis was in neutral position in 17% and supinated in 83% of the wrists with mean of 13 degrees (SD 9 degrees ). The axis for the triquetrohamate joint was found to be 9 degrees pronated (SD 13 degrees ) and 6 degrees supinated (SD 7 degrees ) for the capitohamate joint. Mean values for various carpal angles were 24 degrees, 21 degrees, 3 degrees, 22 degrees and 7 degrees for the radioscaphoid, radiolunate, scapholunate, lunotriquetral and lunocapitate angle, respectively. Examination was repeated in ten volunteers and showed statistically similar values for the various measurements, except the lunotriquetral angle. The present study provides a reference database of normal anatomy for carpal axial alignment. Its potential applications include identifying abnormal axial alignment of the carpal bones that may occur in various pathological conditions affecting the wrist joint, and also quantification of normal and abnormal axial motion of the carpal bones.

Lipomas constitute less than 5% of primary brain tumors. Pericallosal lipomas (PCLp) constitute almost half of all intracranial lipomas. Corpus callosal anomalies commonly occur in cases with PCLps. Although PCLp is often described as corpus callosal lipoma, it is most often pericallosal in location. PCLps may have calcification in the periphery and may continue into lateral ventricles, which is a very rare presentation. We observed a case of PCLp with peripheral calcifications associated with PCLp continuing as bilaterally symmetrical lateral ventricular choroid plexus lipomas (CPLp) without any corpus callosal or other central nervous system anomalies, and as this is not been previously reported, we are presenting it. The appearance of PCLp in this case does not correspond to the descriptions of any of the existing morphological types (anterior and posterior) of classification of PCLps; it is rather mixed, where PCLp occupies both anterior and posterior locations around the corpus callosum.

Intrathoracic rib (IR) is a very rare anomaly in which a normal, an accessory, or a bifid rib lies within the chest cavity and may originate from a vertebra or a rib. It is more commonly present on the right side, and sometimes it may be associated with vertebral anomalies. Only 50 cases have been reported to date in the literature. In most cases, the IR is an isolated finding; it is incidentally detected and is asymptomatic. The IR can be easily missed on a chest radiograph and can be mistaken initially for a pleural lesion, lung consolidation, other peripheral lung parenchymal lesions, or a bony lesion. It is, therefore, essential for physicians and radiologists to know about this entity and consider it in the differential diagnosis, to avoid further evaluation and unnecessary investigations. We present a unique case of three intrathoracic ribs, a left second supernumerary rib, left third depressed normonumerary rib, and bifid arm of the left third rib, with block vertebrae and hypoplastic left lung. To our knowledge, this is the first such case presentation in the published literature.

Objective:Thickened fatty filum terminale (FFT) can cause tethered cord syndrome (TCS) and can be easily diagnosed on magnetic resonance (MR) imaging. We aimed to assess a) the incidence, distribution and clinical significance of the incidentally detected FFT in Kuwaiti population and b) the relationship between degenerative disk disease (DDD) and thickness of the FFT.Materials and Methods:A retrospective study was planned at Jaber Al Ahmad Armed Forces Hospital, Kuwait involving 1111 patients. A 1.5T GE machine was used for MR imaging to acquire multiplanar MR sequences. MR images of lumbar spine in 1111 subjects were reviewed and location, size, tightness of FFT, the DDD and clinical details were evaluated.Results:FFT was observed in 43 out of 1111 (3.9%) subjects based on MRI, out of which 11 were females and 32 were males. The mean distance between the tip of conus medullaris and the FFT was 41 mm. The mean diameter of the FFT was 1.74 mm. 40 of 43 patients had DDD of varying severity on MR images and no significant or appreciable slackness of FFT was observed in these cases. There were no clinical symptoms related to FFT associated with degenerated disks.Conclusion:FFT is frequently observed in Kuwaiti male population. No significant slackness of FFT was observed in cases with varying severity of DDD. There were no clinical symptoms related to FFT with or without degenerated disks.

There are very few reported cases of regression of large cervical disc herniation without any intervention—the so-called spontaneous regression, demonstrated using MRI. We report a rare and interesting case of MRI that demonstrated near complete regression of a large herniated cervical intervertebral disc, without any surgical treatment.