Avulsion injuries of the apophysis is a problem in young athletes. A correct diagnosis is necessary for establishing the appropriate treatment and the rehabilitation program. However, it is often difficult to distinguish between a simple muscle strain and an avulsion fracture. The X-ray examination is helpful only when an ossification center of the apophysis exists. Ultrasonography is considered the suitable diagnostic tool for these cases. From June 1988 to June 1993, 243 young athletes were seen with an anamnestic and clinically suspected apophyseal injury of the lower extremity. In all cases X-ray examination and ultrasound examination were performed. In 80 cases the diagnosis was confirmed by X-ray examination and in 97 by ultrasonography. Four criteria were defined for the sonographic examination: (a) a hypoechogenic zone, (b) increased distance to the apophysis, (c) dislocation of the apophysis, and (d) mobility of the apophysis on dynamic examination. These criteria are correlated to (a) edema, (b) lysis, (c) avulsion, and (d) unstable avulsion of the apophysis. Ultrasonography is a proven technique for the detection of apophyseal injuries. In comparison to X-ray examination, it has the advantages of no radiation exposure, early detection even without ossification center, and dynamic examination.

Adverse reaction to titanium-based breast marker clip is a very uncommon complication in medicine. We report a 65-year-old female patient who was referred with left breast lumpiness to the assessment clinic. Breast radiology with interesting sequelae following titanium clip insertion, in combination with literature review, will be discussed. The patient had a history of adverse skin reactions to base metals. However, no allergy specifically to titanium was reported. Imaging findings with regard to the symptomatic breast were nonspecific; thus, multiple core biopsies were taken, and titanium clip was inserted. Subsequent histological examination showed benign changes. However, 7 weeks later, the marked area became very tender and the same patient re-presented to the clinic, requesting removal of the metallic component. Following multidisciplinary meetings and discussions, the person underwent ultrasound-guided vacuum biopsy and the clip was removed. The symptoms completely resolved after the successful procedure, and histological examination revealed lymphocytic infiltration of the tissues. Reactions to titanium-based marker clips are rare and only limited records have been found in the literature. More cases need to be reported in order to establish the full significance of such adverse sequelae. It is recommended that medical history with regard to allergies, prior titanium clip insertions, should be discussed.

Background Artificial intelligence (AI) has significantly impacted numerous medical specialties with high emphasis on radiology. Associated novel diagnostic methods have become a rapidly emerging hot topic, and it is essential to provide insights into quantitative analysis of the growing literature. Purpose The purpose of this study is to highlight future academic trends, identify potential research gaps, and analyze scientific landscape of AI in the field of medicine. The main aim is to explore comprehensive dataset over a 46-year period in terms of publication type, publication citation, country of origin, institution, and medical specialty. Material and Methods The Web of Science database was searched from 1975 to 2020, and publications on AI were explored. Both original research reports and review articles were included in comprehensive bibliometric analysis. Descriptive statistics were calculated, and numerous variables were applied, namely year of publication, institution, type of publication, specialty area, country of origin, and citation numbers, and the Kruskal-Wallis analysis of variance was used. Results A total of 117,974 relevant citations were retrieved, of which 83,979 original research and review articles were retained for analysis. Not surprisingly, the largest proportion of citations were from the United States (23%, n = 19,180) followed by China, Spain, England, and Germany. The number of citations was relatively consistent during the 1970s and emerging gradually during the 1980s. However, ongoing scientific trend positively evolved, and the numbers started to grow significantly in the 1990s and demonstrated continuous increasing wave since then. The most frequently represented key medical specialties were oncology, radiology, neuroradiology, and ophthalmology. Overall, no major statistical difference was found between these four domains (p = 0.753). Conclusions In summary, research on AI-powered technologies in the medical domain was at early stage in the 1970s. However, associated deep learning algorithms significantly attracted and revolutionized the scientific community with subsequent evolution of research and exponential growth of multidisciplinary publications since that time. Work in this field has impacted radiology as an area of predominant interest and has been led by institutions in the United States, Spain, France, China, and England. The bibliometric study reported herein can provide a broad overview and valuable guidance to help medical researchers gain insights into key points and trace the global trends regarding the status of AI research in medicine, particularly in radiology and other relevant multispecialty areas.

A 44-year-old male with no previous medical history or comorbidities presented with significantly increasing shortness of breath, myalgia, nausea, and fatigue. He had no diagnosed medical conditions and enjoyed good health prior to the episode of acute respiratory infection. There was no history of smoking, emphysema, or chronic lung diseases. CT revealed bilateral ground-glass opacities in predominantly peripheral distribution. Based on imaging spectrum and global pandemic of the novel coronavirus, typical SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection was suspected. Viral load was confirmed with biochemical data and laboratory results. Interestingly, despite intensive treatment, the patient developed sudden complications during the second week of his hospitalization. The symptoms started to resolve on pharmacological treatment and supplemental noninvasive oxygen supply over the next weeks. We illustrate and discuss the case of spontaneous pneumomediastinum as an uncommon manifestation of novel SARS-CoV2 chest infection. Even though our patient did not develop acute respiratory distress syndrome or further complications, the presented case highlights the importance of basic radiological monitoring of the disease in order to ensure prompt diagnosis of complications and appropriate subsequent management.

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