Three cases of cauda equina syndrome in long-standing ankylosing spondylitis are reported. In all, vertebral scalloping and dural ectasia were confirmed by magnetic resonance imaging and computed tomography. MRI showed widening of the dural sac with signal intensity corresponding to cerebrospinal fluid. CT demonstrated asymmetrical lesions of the posterior elements of the lumbar spine. Myelography was not felt necessary to confirm the findings.
We studied the clinical, scintigraphic, and histopathologic characteristics of 26 intravenous drug abusers with costochondral involvement secondary to systemic infection with Cundida ulbicuns. The clinical findings were of a mass appearing in the anterior region of the thorax. In general, signs of inflammation were absent. Histopathologic study of this costochondral mass in 12 patients showed perichondritis in 100% and myositis in 87%, with secondary involvement of cartilage in 43% and of bone in 75%. Results of bone scintigrams using 99mTc-methylene diphosphonate were positive in only 7 of 15 patients (47%), with a correlation between positive uptake and osteitis. Gallium scintigraphy findings were positive in 9 of 10 patients (90%). The greater sensitivity of 67Ga was probably because the invariably present pericartilaginous inflammatory mass was not always accompanied by secondary cartilage and bone involvement.Systemic candidiasis in heroin addicts is a new syndrome produced by Candida albicans; it is characterized by cutaneous, ocular, or osteoarticular involvement, alone or in combination (1).
A case is presented of a scapular chondrosarcoma which showed intense uptake of Tc99m MDP in the primary tumour and in pleural and osseous metastases. Additionally, there was intense visualization of the malignant pleural effusion. The bone scintigraphy correctly diagnosed the extent of the involvement. This finding is unusual because chondrosarcomas in such a disseminated state are relatively rare.
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