Limb amputation is one of the oldest known surgical procedures performed for a variety of indications. Little surgical technical improvements have been made since the first procedure, but perioperative and post-operative refinements have occurred over time. Post-amputation pain (PAP) of the stump is a common complication but is an extremely challenging condition to treat. Imaging allows early diagnosis of the underlying cause so that timely intervention is possible to minimize physical disability with its possible psychological and socioeconomic implications. A multidisciplinary approach should be taken involving the rehabilitation medicine team, surgeon, prosthetist, occupational therapist and social workers. Conventional radiographs demonstrate the osseous origin of PAP while high-resolution ultrasound is preferred to assess soft-tissue abnormalities. These are often the first-line investigations. MRI remains as a problemsolving tool when clinical and imaging findings are equivocal. This article aimed to raise a clear understanding of common pathologies expected in the assessment of PAP. A selection of multimodality images from our Specialist Mobility and Rehabilitation Unit are presented so that radiologists are aware of and recognize the spectrum of pathological conditions involving the amputation stump. These include but are not limited to aggressive bone spurs, heterotopic ossification, soft-tissue inflammation (stump bursitis), collection, nervosas, osteomyelitis etc. The role of the radiologist in reaching the diagnosis early is vital so that appropriate treatment can be instituted to limit long-term disability. The panel of authors hopes this article helps readers identify the spectrum of pathological conditions involving the post-amputation stump by recognizing the imaging features of the abnormalities in different imaging modalities.
had not already used a sunbed if they would like to, with 18AE3% of girls replying positively.When questioned about their knowledge of the risks associated with sunbed use, 85AE3% of boys and 89AE9% of girls recognized that using a sunbed could cause skin cancer. However, 23AE5% of boys did not believe that using a sunbed could cause early ageing of the skin, compared with 15AE3% of girls.Regarding tanning, 54AE7% of boys and 70% of girls thought that a tan made them look more attractive, but less than half of all boys and girls thought a tan made them look healthier and sportier. There was no significant difference in response between the two schools.This study confirms a previous study in the U.K. and similar studies elsewhere that sunbed use is commonplace among children, particularly young girls. 3,6 There is also evidence that sunbed use by young people has risen dramatically over the last 20 years. In 1986 Diffey reported that in a survey of sunbed users only six of 1013 users were 15 years or younger. 7 It has been reported that melanoma incidence has recently risen significantly among young women aged 15-39 years in the U.S.A., the age-adjusted annual incidence per 100 000 population rising from 5AE5 in 1973 to 13AE9 in 2004. The authors suggest that one reason for this could be the increasing use of tanning bed usage by young women. 8 This study confirms that that self-regulation of the sunbed industry in England and Wales is not working and therefore the government should bring in legislation to make sunbed use in those under 18 years old illegal. Sunbed use by children is potentially a serious public health issue for the future. Fig 1. Piling of grey to yellow-white rough and thick oyster shell-like horny tissue on the glans penis and scrotum.
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