Adolescent idiopathic scoliosis is a common disease with an overall prevalence of 0.47-5.2 % in the current literature. The female to male ratio ranges from 1.5:1 to 3:1 and increases substantially with increasing age. In particular, the prevalence of curves with higher Cobb angles is substantially higher in girls than in boys: The female to male ratio rises from 1.4:1 in curves from 10°to 20°up to 7.2:1 in curves [40°. Curve pattern and prevalence of scoliosis is not only influenced by gender, but also by genetic factors and age of onset. These data obtained from school screening programs have to be interpreted with caution, since methods and cohorts of the different studies are not comparable as age groups of the cohorts and diagnostic criteria differ substantially. We do need data from studies with clear standards of diagnostic criteria and study protocols that are comparable to each other.

Although autologous bone grafting represents an effective tool to induce osteogenic regeneration in local bone defects or pseudarthroses, it is associated with significant donor site morbidity and limited by the amount available for grafting. We investigate the potency of bone marrow aspiration concentrate (BMAC) to augment bone grafting and support bone healing. The functional and radiographic outcome of 39 patients with volumetric bone deficiencies treated with BMAC are presented and evaluated in a prospective clinical trial. A collagen sponge (Col) served as scaffold in 12 patients and a bovine hydroxyapatite (HA) was applied in the other 27 individuals. The minimal follow-up was 6 months. Clinical and radiographic findings were completed by in vitro data. All patients showed new bone formation in radiographs during follow-up. However, two patients underwent revision surgery due to a lack in bone healing. In contrast to the Col group, the postoperative bone formation appeared earlier in the HA group (HA group: 6.8 weeks vs. Col group 13.6 weeks). Complete bone healing was achieved in the HA group after 17.3 weeks compared to 22.4 weeks in the Col group. The average concentration factor of BMAC was 5.2 (SD 1.3). Flow cytometry confirmed the mesenchymal nature of the cells. Cells from BMAC created earlier and larger colonies of forming units fibroblasts (CFU-F) compared to cells from bone marrow aspirate. BMAC combined with HA can reduce the time needed for healing of bone defects when compared to BMAC in combination with collagen sponge.

Intramuscular hemangiomas are rare benign tumors, making up 0.8% of all hemangiomas. They are of interest to the surgeon because their location may present considerable therapeutic challenge since radiographic work-up of the soft- tissue mass by magnetic resonance imaging (MRI) may be suspicious for malignancy. The definitive diagnosis is made by histological study of the surgical and/or biopsy specimen. Patients with intramuscular hemangiomas may have soft-tissue complaints, such as pain and swelling, present for years. The gross and microscopic appearance of intramuscular hemangiomas is variable. Grossly, the capillary type is nonvascular and spongy in appearance, whereas the cavernous type is composed of large, thin-walled, dilated vessels lined by flattened endothelial cells. In general, wide excision is the treatment of choice to prevent local recurrence, but every patient with intramuscular hemangioma should be treated individually after evaluating the tumor location, accessibility, and depth of invasion, the patient's age, and cosmetic considerations. From October 1, 1989, to June 30, 1997, 11 patients underwent surgical treatment with the definitive histological diagnosis of intramuscular hemangioma. Pain upon activity but also at rest as well as swelling were the major symptoms. The average duration of symptoms was 13 months (range 1 month to 5 years). After a mean follow- up of 3 years and 4 months (range 12 months to 9 years), one of the patients has developed a recurrence; all remaining patients enjoy pain relief without any recurrence.

With advances in joint preservation surgery that are intended to alter the course of osteoarthritis by early intervention, accurate and reliable assessment of the cartilage status is critical. Biochemically sensitive MRI techniques can add robust biomarkers for disease onset and progression, and therefore, could be meaningful assessment tools for the diagnosis and follow-up of cartilage abnormalities. T2* mapping could be a good alternative because it would combine the benefits of biochemical cartilage evaluation with remarkable features including short imaging time and the ability of high-resolution three-dimensional cartilage evaluation-without the need for contrast media administration or special hardware. Several in vitro and in vivo studies, which have elaborated on the potential of cartilage T2* assessment in various cartilage disease patterns and grades of degeneration, have been reported. However, much remains to be understood and certain unresolved questions have become apparent with these studies that are crucial to the further application of this technique. This review summarizes the principles of the technique and current applications of T2* mapping for articular cartilage assessment. Limitations of recent studies are discussed and the potential implications for patient care are presented.