Ossyfying periarticular lipoma is a very rare entity. Lipomas undergo involutional changes like chondrification, calcification and very rarely ossification. These changes result in altered clinical, radiological and histopathological features leading to diagnostic challenge in differentiation from the soft tissue tumor like synovial sarcoma, liposarcoma and rhabdomyosarcoma. We present a series of three cases of ossifying lipomas presenting as soft tissue tumor around the knee, shoulder and hip joints. All the tumors revealed calcification and ossification on plain X-rays and on MRI/CT Scans. Clinico-radiological evaluation lead to a similar diagnostic dilemma in our series and a confirmed diagnosis of ossifying lipoma became possible only after histopathology. All the three tumors were excised completely without any recurrence during last 3 1/2 years of follow-up. We recommend the early imaging by MRI/CT scan with closed core biopsy to exclude the malignant pathology and complete excision of the tumor with early mobilization of the adjacent joint.
We found no significant difference between the groups in the EMG intensity of vastus lateralis relative to biceps femoris, or vastus medialis relative to vastus lateralis, during the balance test or during the step up task (Mann Whitney U test all p>
0.05). We did not find any difference in the proprioceptive abilities of the two groups
The foot pressures were measured in Kilopascals(Kpa). Independent T-tests was used to compare mean pressure distributions in the six anatomical divisions. We found the mean pressures through the 5th metatarsal head – 217(t=−2.32,p<
0.05) and midfoot 94(t=−3.17, p<
0.05), were significantly higher when compared to pressures in normal subjects (table 1).
The change in management that the CT scan brought about was also assessed for each of the observers using the McNemars test. The CT scan did not make any significant difference to the decision made based on the plain radiographs, on whether to operate or not. A Cochran Q test used to assess the variability of the decisions, showed that there was more inter-observer variability in decision making, using the CT based assessment (Q=9.50, p=0.009) as compared to plain radiographs (Q=3.84, p=0.14).
CT- scan as an management tool is being used extensively in managing calcaneal fractures. We set out to see if a CT-scan makes any difference to the management plan as obtained by looking at the plain radiograph. We also looked at the correlation with the actual management.
The sensitivity of clinical diagnosis for medial and lateral meniscus and ACL lesions was found to be less than 90%. Clinical impression was found to be significantly specific for lesions of ACL and the articular cartilage. The negative predictive value of the MRI scan was found to be significantly high (>
95%), for lesions of the medial and lateral meniscus and the ACL.
Schistosomiasis is a common parasitic infestation in Egypt. We describe the case of a 24-year-old Egyptian man who presented with the signs of acute septic arthritis of the hip and in whom biopsy subsequently revealed schistosome ova in the synovium.