Purpose:To assess the joints of the pelvic ring postpartum and to discern normal postpartum findings and pathologic lesions using MRI.
Materials and Methods:MR images were obtained in six women with severe pelvic ring pain after delivery, in 13 women after uncomplicated vaginal delivery, and in 11 healthy, nulliparous non-pregnant volunteers. Distances of the pubic gap, signal intensities of the pubic cartilage, and signal changes of the pelvic ring bones were determined and evaluated.Results: Both postpartum groups had significantly larger distances of the interpubic gap compared to the nulliparous group (P ϭ 0.0002). The mean signal intensity of cartilage of the symphysis pubis was significantly different on the T1-weighted and T2-weighted MR images in postpartum women compared to nulliparous women (P ϭ 0.001), indicating a higher water content of the pubic cartilage. 13 of all 19 postpartum women had bruises of parasymphyseal pubic bones. One pubic symphysis rupture and one sacral stress fracture were detected in two symptomatic women.
Conclusion:MR imaging is a useful adjunct to clinical examination to identify patients with lesions of the pelvic ring postpartum. MRI of the pelvic ring of asymptomatic postpartum women can demonstrate signal changes of the pubic cartilage and small bruises of the pubic bones.
The body stalk anomaly is described as a maldevelopment during embryonic folding in the third week after conception, resulting in a severe defect of the fetal abdominal wall. The extra-embryonic coelom fails to obliterate and parts of the fetal body remain in an exo-coelomic situation. Reports on its occurrence in multiple pregnancies have in the past focused on concordance between monozygotic twins. We report on a case of a twin pregnancy after fertility treatment that was complicated by a Body Stalk Anomaly in one of the fetuses with a positive neonatal outcome of the unaffected twin.
A decrease in iPTH level in hemodialysis patients undergoing an oral calcitriol pulse therapy with an initial dosage of 0.1 microgram/kg bwt. was found in 71% of the patients after one year. Calcitriol improves the histomorphometrical parameters in responders.
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