To the best of our knowledge, this prospective study is the first to investigate the prevalence of acetabular labrum tears in athletes presenting with groin pain. Eighteen athletes who presented to our sports clinic with groin pain, underwent clinical assessment and magnetic resonance arthrography (MRa) to detect presence or absence of acetabular labrum tears. Ethical committee approval and informed consent was obtained from each patient. In four out of these eighteen athletes (22%) the MRa demonstrated the presence of acetabular labrum tear. Three of them underwent arthroscopic debridement of their acetabular labrum tears and returned to their sporting activities within 8 months. Clicking sensation of the hip was a sensitive (100%) and specific (85%) clinical symptom to predict labral tears. The internal rotation-flexion-axial compression manoeuvre was sensitive (75%) but not specific (43%). The Thomas test was neither sensitive nor specific. The conclusion of the study is that acetabular labrum tears can be a common cause of groin pain in athletes. Sports clinicians managing athletes with groin pain have to be well aware of the condition.

No abstract

Thirty eight patients with neurofibromatosis 1 (NFI) had neurological examinations, intellectual assessments and MRI scans. Increased intensity lesions on T2 weighted images were found in 13 patients. These abnormalities were more common in patients aged under 18 years. The lesions occurred predominantly in the basal ganglia, brainstem and cerebellum, and were multiple in 11 patients. They did not produce symptoms or neurological deficit in any patient and did not enhance with gadolinium-meglumine-triamine-pentacetic acid contrast medium (Gd-DTPA). In 2 patients, however, the abnormalities exerted mass effect distorting the brain and in 3 patients they occurred in conjunction with known gliomas.The lesions remained unchanged over a three year follow up period. The nature of the lesions is uncertain but the fact that they may produce mass effect and occur in association with gliomas suggests that they have malignant potential. There was no correlation between the presence of these abnormalities and intellectual impairment. (7 Neurol Neurosurg Psychiatry 1993;56:492-495 The cause of the intellectual difficulties has not been established. However, Rosman and Pearce5 showed in a post mortem study that patients with NF1 and intellectual impairment had heterotopias in the subcortical and deep white matter and disordered cerebral architecture. Patients with NFI and average intelligence had similar less severe changes but these abnormalities were absent in control subjects. They proposed that the intellectual problems were linked to migrational abnormalities in the brain of the developing fetus.MRI is now the investigation of choice for visualising the distinction between grey and white matter in the brain. Increased intensity lesions have been detected on T2 weighted MRI brain scans in children and young adults with NFl. They occur predominantly in the basal ganglia, brainstem and cerebellum.67-9 They do not show mass effect and do not enhance with Gd-DTPA. The nature of the abnormalities is uncertain, but it has been suggested that they may be hamartomas or slow growing gliomas. The lesions are distinguishable from those in multiple sclerosis and vascular disease by their larger size and different location. Another possibility is that these lesions represent grey matter heterotopias. Mirowitz et al observed that 7 of 35 patients with NFl had increased signal intensity lesions in the basal ganglia which were more prominent on TI than on T2 weighted MRI. They suggested that the signal characteristics and morphology were compatible with grey matter heterotopias containing Schwann cells and/or myelin.'0 Sevick et al reported that the lesions increase in frequency in early childhood but tend to resolve with increasing age.9Two recent studies have attempted to correlate the presence of these lesions with learning problems in children with NFl. Duffner et aft found increased intensity T2 weighted lesions in 29 of 47 children and Dunn and Roos" detected these abnormalities in 16 of 31 children. There was, however, no ...

No abstract

We describe a sibship of three males, including monozygous twins, with cerebral and cerebellar malformations and congenital lymphedema. The parents of these children are related, being half second cousins. The clinical, radiologic and histopathologic features do not fit a previously recognized pattern. We feel this sibship represents a syndrome that has not been previously described, though it closely resembles the Walker Warburg syndrome.