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Purpose:To determine the association between osseous injuries and short-term clinical outcome in patients with anterior cruciate ligament (ACL) tear. Materials and Methods:The retrospective study was performed with institutional review board approval, and the requirement to obtain informed consent was waived. The study group consisted of 114 patients (57 male and 57 female patients with a mean age of 26.1 and 25.1 years, respectively) with ACL tear who underwent magnetic resonance (MR) imaging and ACL reconstruction surgery and who filled out International Knee Documentation Committee (IKDC) knee evaluation questionnaires before and 1 year after surgery. All MR images were independently reviewed by two radiologists to determine the presence of a cortical depression fracture on each surface of the knee joint. Bone marrow edema volume was quantified by using segmentation software. Correlation coefficients were used to determine the association between bone marrow edema volume and IKDC score. A multivariate analysis model was used to compare IKDC scores in patients without fracture, patients with a single fracture, and patients with multiple fractures. Results:There was no significant association between total bone marrow edema volume and preoperative or postoperative IKDC score (P = .32 and P = .91, respectively). The mean preoperative and postoperative IKDC scores were 53.4 6 18.6 and 93.0 6 5.0, respectively, for patients without fracture, 54.8 6 13.6 and 87.3 6 10.8 for patients with a single fracture, and 53.1 6 17.2 and 83.4 6 12.7 for patients with multiple fractures. Patients with single and multiple fractures had similar (P = .91) preoperative IKDC scores but significantly lower (P , .001) postoperative IKDC scores compared to patients without fracture. Conclusion:Cortical depression fractures in patients with ACL tear are associated with decreased clinical outcome scores 1 year after ACL reconstruction surgery.q RSNA, 2012Supplemental material: http://radiology.rsna.org/lookup /suppl

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Lymphangiography as a diagnostic procedure dates back to the 1950s and was widely performed for several decades until being supplanted by other advanced imaging techniques. With the advent of thoracic duct embolization to treat chylothorax, Constantin Cope ushered in a transition from lymphangiography as a diagnostic procedure to a precursor for lymphatic intervention. Subsequently, technical modifications and applications of lymphatic embolization to other medical conditions have greatly expanded the scope and application of lymphangiography and lymphatic intervention. Although there is increasing familiarity with lymphatic interventions, few interventionalists have performed a high enough volume to be aware of potential complications and their management. Potential complications of lymphangiography and those encountered while performing lymphatic interventions are discussed along with approaches to minimize their risk and management strategies should they occur.

Cystic duct stump leak remains a difficult clinical problem despite advancements in endoscopic techniques. When these minimally invasive strategies fail, patients are often subject to high morbidity and mortality associated with open surgical exploration. We report the successful treatment of persistent biliary leak from the cystic duct stump following cholecystectomy using percutaneous transabdominal access of the cystic duct and coil embolization.

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BackgroundHyperimmunoglobulin E syndrome (HIES) is a rare primary immunodeficiency disorder defined by high serum immunoglobulin E titers that is associated with recurrent respiratory infections, formation of pneumoatoceles, recurrent skin abscesses, and characteristic dental and skeletal abnormalities.Case presentationWe report a case of a 56-year-old male with a history of HIES, cavitary mycetomas, and allergic bronchopulmonary aspergillosis who presented with recurrent massive hemoptysis. Bronchial artery angiography and bronchoscopy failed to identify active hemorrhage, and two embolizations of the bronchial artery did not resolve the bleeding. Subsequently, selective pulmonary artery angiography was conducted that demonstrated a subsegmental pulmonary artery branch pseudoaneurysm with extravasation into an adjacent lung cavity. This was treated successfully with transcatheter embolization.ConclusionsTo our knowledge, this is the first case reported of pulmonary artery pseudoaneurysm in HIES in the medical literature. Pulmonary artery pseudoaneurysm should be considered in the differential diagnosis in patients with HIES and massive hemoptysis.

In our study, immediate removal of T-fasteners was not associated with a higher complication rate.