Spondyloarthritides are a group of inflammatory rheumatological diseases that cause arthritis with a predilection for spinal or sacroiliac involvement in addition to a high association with HLA-B27. Juvenile spondyloarthritis is distinct from adult spondyloarthritis and manifests more frequently as peripheral arthritis and enthesitis. Consequently juvenile spondyloarthritis is often referred to as enthesitis-related arthritis (ERA) subtype under the juvenile idiopathic arthritis (JIA) classification criteria. The American College of Rheumatology Treatment Recommendations for JIA, including ERA, are based on the following clinical parameters: current treatment, disease activity and the presence of poor prognostic features. The MRI features of juvenile spondyloarthritis include marrow edema, peri-enthesal soft-tissue swelling and edema, synovitis and joint or bursal fluid. Marrow edema is nonspecific and can be seen with other pathologies as well as in healthy subjects, and this is an important pitfall to consider. With further longitudinal study and validation, however, whole-body MRI with dedicated images of the more commonly affected areas such as the spine, sacroiliac joints, hips, knees, ankles and feet can serve as a more objective tool compared to clinical exam for early detection and monitoring of disease activity and ultimately direct therapeutic management.

We investigated personal protective behaviors against West Nile virus infection. Barriers to adopting these behaviors were identified, including the perception that DEET (N,N-diethyl-m-toluamide and related compounds) is a health and environmental hazard. Televised public health messages and knowing that family or friends practiced protective behaviors were important cues to action.

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egmental testicular infarction is a localized infarct of the testis. Case reports have described it in relation to epididymoorchitis, trauma, sickle cell disease, polycythemia, hypersensitivity angitis, intimal fibroplasia of the testicular artery, and as a complication of recent surgery. [1][2][3][4][5] Most cases, however, have no clear etiology and are considered idiopathic. 6 Scrotal pain is the predominant presenting symptom. Consequently, sonography with color Doppler is the initial imaging modality of choice. Wedge-shaped or round hypoechoic intratesticular lesions with absent or low flow on color Doppler sonography have been most often described in the literature. 6-9 Perilesional hyperemia has also been described. Contrast-enhanced magnetic resonance imaging and sonography can increase confidence in the diagnosis of segmental testicular infarction by showing perilesional rim enhancement. 10 In many cases, however, a definitive diagnosis is made histologically only after orchiectomy.A few case series and case reports have been published, but there is a paucity of radiologic-pathologic correlation in the literature. To our knowledge, this is the most extensive clinical-pathologic and radiologic-pathologic series to date. The purpose of this series is to describe the sonographic features of pathologically proven cases of segmental testicular infarction and present the associated histologic findings. CASE SERIESSegmental testicular infarction can mimic testicular carcinoma on sonography and can lead to unnecessary orchiectomy. This case series describes and correlates sonographic and histologic findings of 7 pathologically proven segmental testicular infarction cases. Segmental testicular infarction should be suspected on sonography when a geographic lesion with low or mixed echogenicity has absent or near-absent flow in a patient with scrotal pain. A hyperechoic rim and peripheral hyperemia correspond to interstitial hemorrhage and inflammatory changes. As an infarct evolves, it becomes more discrete and hypoechoic as ghost outlines replace seminiferous tubules. Follow-up or contrastenhanced magnetic resonance imaging or sonography can increase diagnostic confidence in suspected cases and prevent unnecessary orchiectomy.