PurposeThis case-control pilot study examined whether vertebral bone mineral measures were associated with the presence of chronic low back pain (CLBP) and Modic changes (MCs), and to compare psychological wellbeing and inflammation among individuals with CLBP and MCs, compared to individuals with no history of low back pain and without MCs.MethodsEleven individuals with MRI-defined MCs in the lumbar spine and CLBP (cases) and 10 individuals with no history of CLBP or MCs (controls) responded to standard questionnaires regarding pain characteristics and psychological health. Bone mineral density (BMD) was measured with postero-anterior and lateral-projection dual energy X-ray absorptiometry (DXA) to estimate areal BMD (aBMD) and apparent volumetric BMD (ap.vBMD). High sensitivity serum C-reactive protein (hsCRP) was measured as an index of inflammation.ResultsWhile there was no difference between the groups in measures of depression, anxiety and stress, cases reported significantly greater pain catastrophizing attitudes (P < 0.01). hsCRP concentrations did not differ between groups (P = 0.54). Among the 7 cases where MCs were identified between L3–4, significantly higher mean aBMD was observed at the affected vertebral level, compared to the adjacent, unaffected, cephalad level (P = 0.01–0.04), but not when ap.vBMD was calculated (P = 0.36).ConclusionsVertebral BMD is not reduced among individuals with CLBP and MCs compared to a control group, although pain catastrophizing attitudes are increased among individuals with CLBP and MCs.

Veno-arterial extracorporeal membrane oxygenation (VA ECMO) causes changes in the filling and blood flow of the cardiac chambers and pulmonary vessels as well as alterations in the path of intravenous contrast injected during CT. We present a patient with a potentially misleading CT pulmonary angiogram while on full VA ECMO. We demonstrate circulatory changes as well as alterations in contrast flow when ECMO flows are reduced.

Sonographic gallbladder wall thickening is a nonspecific finding with numerous causes. It is uncommon in children and usually associated with disease not localised to the gallbladder. Three paediatric cases of sonographic gallbladder wall thickening in association with acute Hepatitis A are presented. Sonographic resolution, coinciding with clinical improvement, occurred in each case without specific therapy or harmful sequelae.

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13 cases of hepatoblastoma and hepatocellular carcinoma are reviewed with respect to the visibility of the tumour margin, hepatic veins, and portal veins on non-contrast, non-dynamic and dynamic computerised scans. In large tumours the accurate interpretation of venous anatomy can be difficult. We found that dynamic scanning followed by a repeat scan of selected slices after a few minutes was the most useful method. If facilities for dynamic scanning are not available then it is suggested that conventional scanning be performed immediately after the intravenous injection so as to avoid the isodense phase of hepatic enhancement.