The goal of this study was to assess the safety and efficacy of hyaluronan (HA) with/without corticosteroid in patients with knee osteoarthritis (OA). In a 1-year, randomized, single-blind trial, 24 patients were treated with HA weekly for 3 weeks, then three injections on the 6th month for a total of six injections. Sixteen patients were treated the same but with the addition of 1 ml triamcinolone acetonide prior to the first and fourth HA injection. The treatment was repeated at the sixth month. The patients were evaluated with the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the visual analog pain scale (VAS). After 1 year, progression of OA was evaluated with magnetic resonance imaging (MRI). During the study, pain relief was marked in patients who received combined treatment with respect to WOMAC pain and VAS (p<0.05). At the first year, no progression was observed in either treatment group. Although all patients had improvement for both pain and function, HA together with corticosteroid was superior to HA alone for early pain relief. The MRI findings showed that neither treatment showed a progression on the damage of the cartilage.

Hydatid disease is an infectious disease caused by the larval stage of the parasitic tapeworm Echinococcosis granulosus. Its distribution is worldwide. Although hydatid disease can develop in almost any part of the body, it is most commonly found in the liver and lung. Musculoskeletal involvement is rare. The radiological appearance of the hydatid disease of musculoskeletal system mimics tumors and other inflammatory conditions. Therefore preoperative diagnosis of musculoskeletal hydatid disease is sometimes difficult clinically and radiologically. On radiography, different radiographic changes may occur. In cases of osteolytic and inflammatory changes, it may mimic any variant of nonspecific or specific osteomyelitis. Bone erosion and destruction may lead to almost complete osteolysis, bone may distort, and on occasion, its radiologic appearances may be confused with those of a malignant bone tumor. Computed tomography (CT) is more accurate in delineating the area of destruction. The primary role of CT and magnetic resonance imaging is in the recognition of extraosseous spread of the hydatid disease within the soft tissues. This article reviews the pathological basis and the clinical and imaging features of musculoskeletal hydatid disease.

All tumors showed well-defined and mostly lobulated margins. The well-differentiated liposarcomas were composed mainly of fat with septations or nodules, were hyperintense on T2-weighted images, and demonstrated faint enhancement or no enhancement following intravenous contrast. Myxoid liposarcomas were homogeneous or mildly heterogeneous and a pseudocapsule was present in one case. Pleomorphic types showed a markedly heterogeneous internal structure. Both myxoid and pleomorphic lesions-showed moderate or marked heterogeneous enhancement after contrast administration. Well-differentiated liposarcomas may be differentiated from other types of the tumor by their largely lipomatous appearance. The malignancy grade increases in parallel with tumor heterogeneity and contrast enhancement.

Hydatid disease of the soft tissues forms a rare mass lesion of the extremities. Two cases of primary hydatid disease in soft tissues are presented with MR imaging findings. A cystic mass with multiloculated or multicystic appearance was identified on MR images in both cases. The lesions were surrounded by a rim with two layers representing a collageneous and a vascularized pericyst. The contrast-enhanced images demonstrated the vascularized component of the wall clearly in the first case. In diagnosis of hydatid disease and in its differentiation from other cystic lesions of the extremities, we think that the described MR appearances can be used confidently.

).Spinal tumors consist of a large spectrum of various histologic entities. Primary spinal tumors may arise from the spinal cord (intraaxial or intramedullary space), the surrounding leptomeninges (intradural extramedullary space), or the extradural soft tissues and bony structures (extradural space). Almost 60% of the spinal tumors are located in the extradural space, whereas 40% are located within the dural sac. Primary tumors of the spine are uncommon and represent < 5% of all bone neoplasms as compared with secondary metastatic disease, multiple myeloma, and lymphoma.