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in part by the British Columbia Cot. lege ofChiropractors and the Council on Chiropractic Roentgenology, British Columbia Division. Address reprint sequests to DIR. RSNA, 1993 817 , .:. bones are numerous. Differentiating trau-a. matic, arthritic, infectious, ischemic, and congenital abnormalities can be difficult but is important in instituting appropriate management for each condition. Once the sesamoid bones have been identified as the probable source of pain, an understanding of the anatomy, pathophysiology, and clinical and radiographic manifestations of each condition will help the clinician make a precise diagnosis. 818 U RadioGraphics U Tayloreta! Volume 13 Number 4 row). (Courtesy ot v .

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Xanthoma is a lesion containing abundant foamy histiocytes most commonly occurring in superficial soft tissues such as skin, subcutis, or tendon sheaths. The involvement of deep skeletal structures, however, is rare and has only been infrequently reported in the English literature. Most xanthomas occur in patients with hyperlipidemic disorders. We report a case of a xanthoma in the sacrum and ilium of a patient with hyperlipidemia type IIa, who had chronic lower back pain for more than 20 years. On radiographs the lesion appeared multiloculated and osteolytic with a thin sclerotic border and containing multiple nodular calcifications within its matrix. Computed tomographic images revealed a presacral soft-tissue mass that also infiltrated the adjacent sacroiliac joint and iliac fossa. On histologic examination, abundant areas of xanthoma cells and cholesterol clefts, typical of xanthoma, were present. The patient received simple curettage of the lesion, and his symptoms were markedly relieved.

MR imaging can offer useful information in detection and diagnosis of patients with chronic knee pain due to ganglion cysts of the cruciate ligaments. The size and location of the ganglion cysts can attribute to the clinical manifestations.