We recommend routine use of MRI in male patients, younger than 11 years old, and abnormal superficial abdominal reflexes. Even if a patient has no specific indications for MRI, we recommend its routine use in preoperative planning.

We report a case of pigmented villonodular synovitis (PVNS) in an adolescent with monarticular involvement of the ankle and without congenital anomalies or sibling involvement.Résumé Les auteurs rapportent un cas de synovite villonodulaire pigmentée de la cheville, chez une adolescente de 14 ans, ne présentant aucun facteur d'anomalie congenitale ni de facteur familial.

This article recognized 3 distinctive types of the retrodental mass in RA; type 1 (pannus), type 2 (pseudotumor), type 3 (mixed). It further concludes in all types of the retrodental mass associated with atlantoaxial subluxation secondary to RA, posterior fusion without decompression can achieve improvement of the myelopathy. In type 2 associated with vertical subluxation, on balance between calculable benefits and high risks of anterior transoral decompression, the authors prefer to opt for occipitocervical fusion with decompressive laminectomy of the atlas.

Primary synovial sarcoma originating from the cauda equina is extremely rare. Only one case, involving an 11-year-old girl, has been reported. The authors describe the case of a 23-year-old woman with a primary synovial sarcoma of the cauda equina. The patient visited a local hospital and described a 2-month history of low-back pain. She was referred to the authors' hospital for further evaluation. On physical examination, she had a straight–leg raising result of 70° bilaterally. Motor examination revealed Grade 4/5 strength in the bilateral extensor hallux longus muscles. There was normal sensation to light touch and vibration in the lower extremities. Sagittal Gd-enhanced T1-weighted MR imaging demonstrated an intradural, extramedullary, and uniformly enhancing mass that extended from L-3 to L-4. The mass was totally resected and adjuvant local radiation therapy was administered. Reverse transcriptase polymerase chain reaction (RT-PCR) of a paraffin-embedded tissue sample revealed SYT-SSX fusion transcripts, and the diagnosis of synovial sarcoma was confirmed. Five and a half years after surgery, the patient is free of local recurrence and metastatic disease. The RT-PCR detection of SYT-SSX fusion transcripts played a key role in establishing the diagnosis of synovial sarcoma of the cauda equina. Complete resection of the mass with adjuvant local radiation therapy proved to be effective.

Purpose：Identifying prospective predictors of a poor treatment outcome in acute to subacute sciatica would be of great importance for clinical practice. This study aimed to determine what baseline factors are associated with short-to medium-term outcomes on acute to subacute sciatica caused by lumbar disk herniation （LDH） after epidural injections.Methods：Variables including demographic data, neurological and radiological examination, the visual analog scale（VAS）, the Roland-Morris Disability Questionnaire （RMDQ） , and the Spielberger State-Trait Anxiety Inventory from 48 LDH patients （25 males and 23 females between 20 and 60 years old） with acute to subacute sciatica before and 1, 3, and 6 months following epidural injections were measured. A poor outcome was defined as a VAS reduction of less than 50％ or a RMDQ reduction of less than an important change. Results：In multiple logistic regression analysis, the presence of a high trait anxiety（OR=0. 133, 95％ CI；0. 027─0. 651） and motor disturbances（OR=3. 517, 95％ CI；1. 098─11. 267） were significantly associated with an increasing risk of poor outcome at the 1-month assessment. At the 3-month assessment, the presence of a high trait anxiety（OR=0. 115, 95％ CI；0. 022─0. 611） was the only prognostic factor. At the 6-month assessment, the presence of a high trait anxiety（OR=0. 065, 95％ CI；0. 007─ 0. 570） was the only significant prognostic factor.