For patients with chronic Achilles tendon rupture with a rupture gap of at least 5 cm, surgical repair using a single turndown fascial flap covered with Hyalonect achieved excellent outcomes.

Objective: To evaluate the functional and radiological outcomes of anterograde headless cannulated screw fixation for medial malleolar fractures. Subjects and Methods: This study included 12 patients (8 males, 4 females; age 27-55 years) with medial malleolar type B fractures according to the Herscovici fracture classification who had undergone anterograde headless cannulated screw fixation surgery between 2012 and 2014. Seven had an isolated medial malleolar fracture and 5 a bimalleolar fracture. All of the bimalleolar fractures were classified as 44-B2 based on the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification. Postoperatively, bone union was evaluated on direct radiographs at the final follow-up examination. The American Orthopaedic Foot and Ankle Society (AOFAS) scoring system was used for clinical evaluation. Results: The mean follow-up period was 17.2 ± 5.3 months (range 12-23). Full union was achieved in all fractures. The mean time to union was 3.4 ± 1.5 months (range 2-5). No instability, loss of reduction, non-union or infection was observed in any patient. The mean AOFAS score was 95.0 ± 5.4 (range 87-99). Based on the AOFAS score, 4 patients showed good results and 8 excellent results. The mean time to return to the previous level of activity was 4.0 ± 2.5 months (range 2-5). Conclusion: In this study, anterograde headless cannulated screw fixation yielded good clinical outcome in the surgical treatment of Herscovici type B fractures.

For successful outcomes in lateral plateau fractures, it is essential to determine whether there is a meniscus tear. In cases with meniscus tears, meniscus repair can be easily performed and should be considered because it has a positive impact on the treatment outcome.

Purpose To identify the correlation of nonalcoholic pancreatic steatosis (NAPS) with nonalcoholic fatty liver disease (NAFLD) in an outpatient group. Based on its metabolic and imaging properties, NAPS has been increasingly recognized in recent years; however, its interaction with NAFLD is still not clear. Patients and Methods In this cross-sectional observational study, 345 consecutive patients without any chronic illness who were referred to the senior radiologist for abdominal ultrasound (US) were included. The US report showed hepatic and pancreatic echogenicity. The patients’ demographic, anthropometric, and laboratory data were collected from medical records. Results Overall, NAPS and NAFLD were seen in 227 (65.8%) and 219 (63.5%) patients, respectively. Normal echogenicity was noted in 74 (21.4%) patients. Forty-four patients (12.8%) had steatotic liver without NAPS, 52 (15.1%) had steatotic pancreas without NAFLD, and 175 (50.7%) had steatosis in both organs. The discordance in steatosis grading between NAPS and NAFLD was 55.1%. Insulin resistance was present in 8.7, 26.7, 19, and 61.3% of patients with no steatosis, only NAFLD, only NAPS, and steatosis in both organs, respectively. Evident NAFLD and NAPS having grade 2 and 3 steatosis were present in 15.3% and 29.0% of the study group, respectively. Cholecystolithiasis was present in 6.8, 13.6, and 28.8% of patients with normal echogenic pancreas, only NAFLD, and only NAPS, respectively (p=0.01). Conclusion Based on the ultrasonographic, clinical, demographic, and anthropometric features of the included patients, we found that NAPS did not fully accompany nonalcoholic fatty liver. Despite severe pancreatic steatosis, more than a quarter of cases had normal liver echogenicity. Insulin resistance frequency was insignificantly higher in NAFLD than NAPS (p=0.694). The significantly higher frequency of cholecystolithiasis in NAPS needs further large-scale studies. The inconsistency of steatosis degree in NAPS and NAFLD in >50% cases may reflect differences in the pathophysiology of these two clinical entities.

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Purpose:The aim of the study is to evaluate the prevalence of extrapulmonary findings in low-dose computed tomography (LDCT) of the thorax.Methods: Patients who were referred to the radiology department by the department of pulmonary medicine between June 2016 and January 2018 for LDCT examination to assess either a certain or a potential pulmonary disease were identified. Images were retrospectively re-evaluated and findings were categorized according to organ system (Total of 8 groups including cardiac, vascular, mediastinal, abdominal, skeletal, thyroidal, breast and muscular-soft tissue). The LDCT was performed by using a 64-detector CT scanner with scanning parameters standardized as 120 kVp and 20 mAs with 3 mm slice thickness.Results: 102 patients (41 female, 61 male) aged between 25 and 90 years (mean age: 54.5±14.3 years) were included in the final assessment. 87 (85.3%) out of 102 patients had total 245 incidental extrapulmonary findings. Abdominal pathologies were the most common findings (62 patients (60.8%)). Overall, 26 extrapulmonary findings led to further work-up or consultation. Conclusion:Incidental extrapulmonary findings can be detected commonly in LDCT of the thorax. Radiologists should be aware of evaluating all the structures in the scanning area by following a systematic approach in the reading of such studies in order to identify possible pathologies and guide the clinician for the accurate management of patients.

Objective: The purpose of this study is to evaluate the misty mesentery sign on computed tomography in patients with ureterolithiasis. Methods: This retrospective study enrolled all consecutive patients with ureteral stone diagnosed in abdominal computed tomography in the 3-year study period. Computed tomography scans were reviewed to assess the presence and interrelations between misty mesentery, ureteral diameter, volume and location of stones, presence of periureteral and perinephric stranding, thickening of the perirenal fascia, nephromegaly, and grade of hydronephrosis. Results: Four hundred thirty-four patients were included in the analysis. Misty mesentery was identified in 62 (14.2%) patients. Patients with misty mesentery were significantly older (mean age=45.2±12.2) than those without (mean age=37.3±10.9) (p=0.022). Perirenal fascial thickening was identified in 101 (23.2%) patients and found to be significantly associated with misty mesentery (c 2 =7.74, p=0.005). Two hundred patients (46%) were noted to exhibit periureteral stranding which was noted to be significantly related with misty mesentery (c 2 =13.6, p=0.000). The relationship between misty mesentery and pelvicalyceal ectasia, perinephric stranding, ureteral location of the stone, and nephromegaly were not found statistically significant. Conclusions: Ureterolithiasis can be accompanied by misty mesentery at computed tomography examination. There may be a potential association between ureterolithiasis and misty mesentery.

Objective: To investigate the properties of paraspinal muscle structures in osteoporotic patients, lumbar computed tomography (CT) and their relationship with lumbar and femoral neck bone mineral density (BMD).