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Dermatofibrosarcoma protuberans (DFSP) is a rare soft tumor which originally represents a cutaneous sarcoma. It grows slowly and presents usually as nodular superficial lesion on the trunk or the extremities. Although these tumors are locally aggressive with high rate of recurrence following surgery; the prognosis is considered excellent when it is effectively treated. The radiological appearance of this tumor has rarely been studied and findings infrequently discussed in the literature probably because many lesions underwent resection before imaging. Although imaging is infrequently performed for this lesion; it can show characteristic features and demonstrate the full extent. Imaging may also play a role in the differentiation of this tumor from more serious soft tissue lesions such as more aggressive sarcomas and hemangioma. In this article, we discuss the imaging findings of DFSP that can aid in its diagnosis and its variable appearances. In addition; the clinical presentation and treatment options are also described with review of the previous literature.

Aneurysms of the gluteal arteries are very rare with the majority being post-trauma pseudoaneurysms. Generally, management of these aneurysms could be surgical or through endovascular techniques. We present a case of a superior gluteal artery pseudoaneurysm complicating a pelvic fracture that presented as a gluteal mass. It was successfully treated by transcatheter coil embolization. We review the presentation, imaging, and treatment options. Aneurysms have to be considered in the differential diagnosis of soft tissue masses, therefore lesion intervention by aspiration or needle biopsy should not be tried before ruling out a possible vascular nature which will easily be revealed by ultrasound Doppler or computed tomography scans.

Necrotising fasciitis is a rapidly progressive soft tissue infection that leads to diffuse tissue necrosis. It is associated with systemic toxicity and rapid deterioration resulting in high mortality. Rapid diagnosis and prompt treatment are essential to improve the outcome. We report the case of a 26-year-old woman who presented with severe thigh pain and swelling associated with irritability of a few hours' duration following 2 days history of right abdominal pain. Urgent MRI and CT scan showed features of necrotising fasciitis in the thigh spreading from an inflamed appendix. Emergency surgery was performed which revealed perforated appendix with disseminated infection in the intraperitoneal and retroperitoneal spaces as well as the right thigh. The patient rapidly deteriorated with evidence of sepsis, shock and renal impairment. In spite of surgery and all supportive measures, she succumbed shortly postoperatively. Blood culture revealed Staphylococcus aureus and Streptococci, while tissue culture showed growth of Escherichia coli and proteus.

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Objective: To identify the flexion type of hangman's fracture on imaging studies. Methods: 38 cases of hangman's fracture were retrospectively studied and categorized into flexion and nonflexion groups. Plain radiograph, CT and MRI of these patients were evaluated; 13 radiological parameters that might define flexion injuries were measured. The data were statistically analyzed to identify good criteria and to rank them according to their importance in predicting flexion.Results: Seven radiological criteria that have the highest correlation with flexion injury were identified. These are C2-3 lower end-plate angle, C2-3 posterior body angle, interspinous angle, disc disruption (MRI), widening of interspinous distance, disruption of the posterior ligamentous complex (MRI) and angle at the fracture site. Scoring 1 point for each positive criterion, a total score of 4 predicts flexion injury with 100% sensitivity and 96.9% specificity. Score of 5 has 83.3% sensitivity and 100% specificity. Conclusion: Flexion hangman's injury can be diagnosed by the presence of four out of seven radiological criteria in the newly introduced scoring system. The authors believe that this method may help spinal surgeons in their selection of therapeutic strategy. Advances in knowledge: This study introduces fast, simple and more objective imaging criteria for the diagnosis of flexion hangman's injury and separates it from the non-flexion pattern.

Study Design Case report. Objective To report and discuss a rare complication after a patient was treated conservatively with a halo vest. Methods A 51-year-old man sustained a hangman's injury of the C2 vertebra following a motor vehicle collision. He was treated conservatively in a halo vest appliance and following mobilization was discharged from the hospital. Two weeks after discharge, the patient presented to the emergency department complaining of proptosis, ptosis, diplopia, and pin loosening. He was readmitted to the hospital, the halo vest was removed, and urgent imaging studies including computed tomography scan and magnetic resonance imaging were performed. They revealed that one of the halo pins had penetrated the orbital roof with active infection of the extraocular soft tissues. In consultation with the ophthalmologist, he was treated conservatively with antibiotics for 10 days. Results His ophthalmologic complaints resolved gradually and his eye returned to normal appearance and function. In the meantime, he was immobilized in a sterno-occipital mandibular immobilizer brace. Conclusion Though rare, penetrating injuries after cranial pin insertion can occur. Halo devices must be applied by, or under close supervision of, experienced personnel to avoid such complications, and halo vests should be reviewed frequently to detect such incidents early.

Pseudoaneurysms of the iliac arteries are extremely rare and can complicate trauma, surgical or interventional procedures. We report a case of pseudoaneurysm arising from the common iliac artery in a 37-year-old man which presented as a paravertebral collection. As the MRI appearance mimicked spondylodiscitis, a CT guided biopsy was requested. However, the presence of a signal void centre guided the radiologist to the correct diagnosis, which was later confirmed on contrast-enhanced CT. Following unsuccessful treatment by percutaneous thrombin injection, open surgery was performed which revealed a leaking aneurysm associated with a huge retroperitoneal haematoma. We present this case to highlight the importance of considering vascular lesions as a differential diagnosis in patients presenting with a mass or pressure symptoms in different parts of the body. Misdiagnosing such lesions as soft tissue tumours or abscesses may result in serious consequences.