Forty-five patients with 46 scaphoid fractures were studied more than 6 months after union by clinical examination and trispiral tomography. Twenty had normal scaphoid alignment with lateral intrascaphoid angles less than 35 degrees; the rest had varying degrees of increased flexion angulation of the scaphoid, ranging from 36 degrees to 60 degrees. Increasing lateral scaphoid angulation, eventually resulting in a "humpback" deformity, was associated with progressively poor clinical and radiographic results. There were satisfactory clinical outcomes in 83% and posttraumatic arthritis in only 22% of those with normal scaphoid anatomy. Those with greater than 45 degrees of lateral intrascaphoid angulation present at the time of union had a satisfactory clinical outcome in 27% and posttraumatic arthritis in 54%. Union alone is an insufficient criterion for success in treating scaphoid fractures.

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Despite tremendous technical advances in spine surgery in recent decades, patients may experience residual or recurrent pain and other symptoms after such surgery. The standard history and physical examination have only limited utility for assessing the postoperative anatomy, and radiologists can play an important role in diagnosing complications and guiding postoperative care. To do so effectively, they must be familiar with the imaging features of successful and unsuccessful fusion, instrumentation fracture and loosening, complications due to faulty hardware placement, and postoperative infection. A basic knowledge of spinal biomechanics and common approaches to surgical instrumentation also may help radiologists anticipate and identify complications.

Thirteen cases of congenital seminal vesicle cysts with pathologic correlation were diagnosed between 1970 and 1988. Twelve of the 13 patients had ipsilateral renal anomalies. Intravenous urography, performed in 11 of the 13 patients, demonstrated associated renal anomalies. Computed tomography, performed in nine of the 13 patients, demonstrated associated renal anomalies and displayed the cystic seminal vesicles. Transabdominal or endorectal ultrasonography, performed in eight patients, allowed characterization of the seminal vesicle masses as cystic. Magnetic resonance imaging, performed in three of the 13 patients, accurately demonstrated dilated ejaculatory ducts into which ectopic ureters inserted. The fluid in the seminal vesicle cysts had an increased signal intensity on T1- and T2-weighted sequences. Seminal vesiculographic study demonstrated anomalous communications with the seminal tract. Cystic disease of the seminal vesicles can be either congenital or acquired; congenital cysts are associated with anomalies of the ipsilateral mesonephric duct.

Diffuse neurofibroma frequently grows as a plaquelike or infiltrative lesion involving the skin and subcutaneous tissues. Prominent internal vascularity is common. There is a much wider soft-tissue and age distribution and association with neurofibromatosis than previously reported.