Objective To estimate the prevalence of acetabular rim ossifications in the adult population with asymptomatic, morphologically normal hips at CT and to determine whether the presence of these ossifications is associated with patient- or hip-related parameters. Methods We prospectively included all patients undergoing thoracoabdominal CT over a 3-month period. After exclusion of patients with a clinical history of hip pathology and/or with signs of osteoarthritis on CT, we included a total of 150 hips from 75 patients. We analyzed the presence and the size of ossifications around the acetabular rim. The relationships between the size of acetabular rim ossifications and patient-related (sex, age, BMI) or hip-related parameters (joint space width, and cam- and pincer-type femoroacetabular impingement morphology) were tested using multiple regression analysis. Results The prevalence of acetabular rim ossifications in this population of asymptomatic, non-osteoarthritic hips was 96% (95% CI = [80.1; 100.0]). The presence of ossifications and their size were correlated between the right and left hips (Spearman coefficient = 0.64 (95% CI = [0.46;0.79]), p < 0.05)). The size of acetabular rim ossifications was significantly associated with age (p < 0.0001) but not with BMI (p = 0.35), gender (p = 0.05), joint space width (p ≥ 0.53 for all locations), or any of the qualitative or quantitative parameters associated with femoroacetabular morphology (p ≥ 0.34). Conclusion Acetabular rim ossifications are highly prevalent in asymptomatic, non-osteoarthritic adult hips at all ages. Their size is not correlated with any patient- or hip-related parameters except for age. These findings suggest that ossifications at the acetabular rim, when present in isolation, should not be considered a sign of osteoarthritis or femoroacetabular impingement morphology. Key Points • Acetabular rim ossifications are extremely common in asymptomatic, non-osteoarthritic adult hips. • Acetabular rim ossifications are present independently from other signs of osteoarthritis in adult hips at all ages and should not be interpreted as a pathological finding. • The diagnosis of osteoarthritis or femoroacetabular impingement morphology should not be made based on the sole presence of ossifications at the acetabular rim.
Oligometastatic disease (OMD) is an emerging state of disease with limited metastatic tumor burden. It should be distinguished from polymetastatic disease due the potential curative therapeutic options of OMD. Imaging plays a pivotal role in the diagnosis and follow-up of patients with OMD. The imaging tools needed in the case of OMD will differ according to different parameters, which include primary tumor type, timing between measurement and treatment, potential metastatic location and the patient’s individual risk for metastasis. In this article, OMD is defined and the use of different imaging modalities in several oncologic situations are described in order to better understand OMD and its specific implication for radiologists.
Background:In clinical practice, ossifications adjoining the acetabular rim are frequently seen in healthy-appearing hip joints, at all ages. The origin of these acetabular rim ossifications (ARO) is unclear. While ARO have been described by some authors as variants that may mimic marginal acetabular osteophytes, others have hypothesized that ARO may be the cause or the consequence of femoroacetabular impingement. Overall, the literature on ARO is limited, in particular in the healthy population, and their characteristics and origin not fully understood.Objectives:To estimate the prevalence of acetabular rim ossifications in the adult population with asymptomatic, morphologically normal hips at CT and to determine whether the presence of these ossifications is associated with patient-, or hip-related parameters.Methods:We prospectively included all patients undergoing thoracoabdominal CT over a 3-month period. After exclusion of patients with a clinical history of hip pathology and/or with signs of osteoarthritis on CT, we included a total of 150 hips from 75 patients. We analyzed the presence and the size of ossifications around the acetabular rim. The relationships between the size of acetabular rim ossifications and patient-related (sex, age, BMI), or hip-related parameters (joint space width, and cam- and pincer-type femoroacetabular impingement morphology) were tested using multiple regression analysis.Results:The prevalence of acetabular rim ossifications in this population of asymptomatic, non-osteoarthritic hips was 96% (95%CI=[80.1;100.0]). The presence of ossifications and their size were correlated between right and left hips (Spearman coefficient=0.64 (95%CI=[0.46;0.79]),p<0.05)).The size of acetabular rim ossifications was significantly associated with age (p<0.0001) but not with BMI (p=0.35), gender (p=0.05), joint space width (p≥0.53 for all locations) or any of the qualitative or quantitative parameters associated with femoroacetabular morphology (p≥0.34).Conclusion:Acetabular rim ossifications are highly prevalent in asymptomatic, non-osteoarthritic adult hips at all ages. Their size is not correlated with any patient-, or hip-related parameters except for the age. These findings suggest that ossifications at the acetabular rim, when present in isolation, should not be considered as signs of osteoarthritis or femoroacetabular impingement morphology.References:[1]J. W. T. Byrd, K. S. Jones, C. R. Freema. Surgical Outcome of Pincer Femoroacetabular Impingement With and Without Labral Ossification. Arthroscopy 2016; 32: 1022–1029.[2]P. D. Byers, C. A. Contepomi, and T. A. Farkas. A post mortem study of the hip joint. Including the prevalence of the features of the right side. Annals of Rheumatic Diseases 1970; 29: 15–31.[3]S. Ninomiya, A. Shimabukuro, T. Tanabe, Y. T. Kim, Y. Tachibana. Ossification of the acetabular labrum. Journal of Orthopaedics Science 2001; 5: 511–514.Table 1.Association between the average severity size of ossifications and patient-related, and hip-related parametersRegression coefficientp- valuePatient-related parametersBMI0.020.35Age0.04<0.001Gender-0.430.05Joint space widthApical0.170.53Supero-medial0.170.65Supero-lateral0.060.82Cam morphotype parametersAngle alpha 450.000.81Offset0.090.34Pincer morphotype parametersAcetabular version angle-0.010.83Lateral center-edge angle0.020.56Acetabular index0.030.53Crossover sign0.260.41Posterior wall sign-0.250.47Figure 1.Coronal reformats of CT examinations showing different sizes of labral ossifications in the posterosuperior quadrant (arrows). (a) No labral ossification, (b-c-d-e) Increasingly large labral ossification from left to right. Two lines are visible at the location of the ossification, formed by the contour of the acetabular rim and of the ossification (double line-sign).Disclosure of Interests:None declared
Most breast cancers are diagnosed by conventional breast imaging which includes mammography, ultrasound and MRI. However, CT is an often overlooked modality in the detection and diagnosis of breast cancer. Incidental findings of breast cancer by CT are not so rare. This article aims to aware radiologists and gynaecologists to the potential of breast cancer detection with CT. In this brief review of the literature, we will discuss the morphological characteristics of breast tumours on CT and the imaging mangement of suspicious lesions discovered on CT.
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