Background Bone marrow assessment is an important part in the Ann Arbor staging system in lymphoma. It is done routinely through posterior iliac crest bone marrow biopsy (BMB) which is an invasive technique with limited examination of one site. 18F-FDG PET/CT is now used for staging of lymphoma. The purpose of this study was to compare the sensitivity of PET/CT and BMB in detecting bone marrow infiltration (BMI) in lymphoma and determine agreement between both in assessing bone marrow and whether we can evaluate the bone marrow by PET/CT without the need of the routine BMB. Results PET/CT detected 24 (16.5%) cases with positive BMI that were missed by BMB. BMB detected only 2 (1.4%) cases that were missed by PET/CT. The PET/CT showed a higher sensitivity of 95.6% than BMB 46.7% in detecting BMI in lymphoma. We found a moderate agreement between PET/CT and BMB results in the whole cohort using Cohen’s k computation. It was found that 0.47 with p value less than 0.0001. Conclusions PET/CT can detect more bone marrow involvement in lymphoma compared with BMB. It can replace the routine invasive BMB in many cases, especially those showing multifocal uptake in both Hodgkin and non-Hodgkin lymphoma. PET/CT can also help to guide the site of the biopsy in some cases. Iliac crest BMB is still needed in cases showing diffuse FDG uptake to differentiate malignant uptake from reactive hyperplasia, and in those with limited FDG avidity and in some cases with negative uptake to exclude early infiltration if management will differ.

FDG PET-CT appears to be a very efficient tool in post-surgical surveillance of patients with RCC with notable ability to probe even uncommon sites of distant recurrence.

Background: Ankle impingement is a clinical condition of chronic and painful limited range of joint movement. It presents a significant clinical concern athletes and young population. Aim of Study:To study the value of US in the diagnosis of soft tissue and bony ankle impingement, using combined plain radiography and MRI as a reference for diagnosis. Patients and Methods:The study included 20 patients (8 male and 12 female), mean age: 35. 1 years, suspected to have ankle impingement by clinical examination. The included patients underwent US ankle examination. The diagnosis of impingement was classified according to the anatomical compartments and categorized according to the underlying impinging factor as bony or soft tissue impingement. We calculated a p-value to evaluate the role of US in diagnosis of bone and soft tissue impingement.Results: Eight patients had single compartment impingement and 12 patients (60%) had multi-compartments impingement with a total number of 40 compartments impingement. The observed impingements were categorized into 22 soft tissue and 18 bone impingements. Ultrasound could detect 11 out of 18 bone impingements (p-value=0.011) and 21 out of 22 soft tissue impingements (p-value=0.005). Conclusion:Ultrasound is a helpful diagnostic tool in cases of bone and soft tissue ankle impingement.

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