Musculoskeletal pitfalls and pseudotumours in the pelvis: a pictorial review for body imagers

Ghazizadeh, Shabnam; Foss, Erik; Didier, R; Fung, Alice; Panicek, David M.; Coakley, Fergus V.

doi:10.1259/bjr.20140243

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…If the clinical diagnosis is in doubt, magnetic resonance imaging should be used to confirm the diagnosis. Ghazizadeh, Foss et al in their review of CT, MRI and ultrasound imaging of various pseudotumours in the pelvis, raised the awareness of pitfalls to diagnose perineural cyst and thus avoiding a misdiagnosis and any unnecessary surgical intervention [10]. Most Tarlov cysts do not require any treatment as they are usually asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

Lee¹

2015

J Clin Case Rep

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A 41 year old, married for 20 years, presented on 28 th May, 2013 with history of dysmenorrhoea, deep dyspareunia, and pelvic pain for the past 6 months. She was nulliparous and practiced contraception by using condoms. Her menstrual pattern was essentially normal and the pain occurred mainly on the first two days of her period. Initial vaginal ultrasound scanning revealed multiple adnexal cysts on both sides of the pelvis (Figure 1a) with the largest one measured at 5 cm on the left. Bimanual pelvic examination elicited tenderness over the uterosacral ligaments and demonstrated the presence of the cystic adnexal masses. The initial diagnosis was probable ovarian endometrioma and pelvic endometriosis. Laparoscopy was performed with a view to excise any endometriotic lesions and to perform ovarian cystectomy on 1 st June, 2013. Except for a small left ovarian dermoid that was removed at the operation, the uterus, and tubes, right ovary and uteroscral ligaments AbstractTarlov cysts are meningeal dilations of the posterior spinal nerve root. The cysts can grow as a result of an increased inflow of cerebrospinal fluid giving rise to symptoms due to compression or stretching of the adjacent nerve roots. They are usually multiple and asymptomatic, but Tarlov cysts in the sacral neural canal and foramina can be associated with symptoms like radicular pain, low back pain, paresthesia, and urinary or bowel dysfunction. To the best of our knowledge, Tarlov cysts presented with dysmenorrhea has not been reported in the literature. This association, though rare, should not be overlooked, especially when there is enough clinical suspicion while investigating an atypically looking adnexal cyst while managing in the context of dysmenorrhea or pelvic pain. MRI is recommended when the exact diagnosis is in doubt. Laparoscopic excision of the cyst is feasible and in our case it has been shown to be effective and safe. were grossly normal but there was no evidence of any endometriosis. On the contrary, bilateral retroperitoneal cystic swellings were seen lying underneath the uterosacral ligaments and rested against the pelvic floor on both sides (Figure 1b). The cyst on the left side was more prominent and dissection was carried out to completely isolate the cyst after the ureter was lateralized and the rectum deflected to the opposite side using the rectal probe. The cyst was thin walled, smooth, containing clear fluid, and fibrous in nature (Figure 1c). A pedicle was found connecting the cyst to a cystic tubular neurogenic-like structure that lied across the pelvic floor (Figure 1d). The cyst was excised after its rupture with the release of a lightly yellowish clear fluid. The inner wall of the cyst was smooth with no communicating channels identifiable. No further procedure was performed in view of the uncertainty of the pathology involved. The immediate postoperative recovery was uneventful and the patient was discharged home on the first postoperative day. She returned in a week for assessment and reported shooting pain over...

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Section: Discussionmentioning

confidence: 99%

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

Lee¹

2015

J Clin Case Rep

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“…11) and normal variants (e.g., humeral pseudocyst) 22,23 Posttraumatic lesions (►Fig. S6) (e.g., stress fractures and avulsion injuries) 24,25 Infection (►Fig. S7) (e.g., subacute osteomyelitis and tuberculosis) 26,27 Small benign bone tumors (e.g., fibrous cortical defect, bone island, fibrous dysplasia[►Fig.…”

Section: Commandment 8: Do Not Forget Tumor Mimicsmentioning

confidence: 99%

Ten Commandments for the Diagnosis of Bone Tumors

Davies

Lalam

Woertler

et al. 2020

Semin Musculoskelet Radiol

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The diagnosis of tumors and tumorlike lesions of bone is a routine part of both general and specialist radiologic practices. The spectrum of disorders ranges from the small incidental lesion to the potentially life-limiting malignancies whether primary or secondary. In this review, authored by experts from several European orthopaedic oncology centers, we present a collection of pieces of advice in the form of 10 commandments. Adherence in daily practice to this guidance should help minimize adverse patient experiences and outcomes.

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“…Regardless of the secondary precipitating factors, herniation pits remain common in the asymptomatic general population. 1,20,21 Infection Infection has similar causes and morphological changes as other sites in the body. Remember indolent (chronic) infections, like tuberculosis (►Fig.…”

Section: Stress Fracturesmentioning

confidence: 99%

“…13 Aneurysmal bone cysts do not have a specific predilection to the hip and pelvic region (7-9% in the proximal femur, 6% in the ilium, and 2% in the sacrum, pubis, and ischium). 1,4,[13][14][15][16][17][18][19][20][21][22][23][24][25] The imaging presentation is the same as elsewhere in the peripheral skeleton. The best diagnostic clue is the patient's age as well as the presence of an eccentric lytic lesion composed nearly entirely of fluid-fluid levels (notably, fluid-fluid levels are not pathognomic or obligatory; the neocortex can be extremely thin and hardly visible, and progression of this tumor can be very fast) (►Table 6).…”

Section: Aneurysmal Bone Cystmentioning

confidence: 99%

“…MRI appearance varies, from an ill-defined focal defect with surrounding edema early in the postoperative period, to healing and marginal sclerosis of the harvest site. 13,21,28 Caveat: If there is postsurgical backfill of the iliac bone graft donor site, there will be a well-defined area of sclerosis that could be misinterpreted as osteoblastic metastasis. Previous imaging and the clinical history may help clarify this and negate the need for further imaging or biopsies.…”

Section: Langerhans Cell Histiocytosismentioning

confidence: 99%

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Hip and Pelvis Bone Tumors: Can You Make It Simple?

Afonso

Weber

Isaac

et al. 2019

Semin Musculoskelet Radiol

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Although it is possible for any osseous tumor or tumorlike lesion to occur in and around the hip and pelvis, there are preferential lesions. Most tumors share many imaging features with those arising elsewhere in the skeletal system, but some may show specific morphological and imaging features. Furthermore, specific criteria and rules of thumb are related to this anatomical area that radiologists should know, which together with the imaging findings and clinical context will lead to a more confident diagnosis.In this article we review the basic anatomical and imaging principles in the hip and pelvis and their diagnostic criteria, describe the most common regional benign and malignant bone tumors and pseudotumors, and highlight their main imaging features and common differential diagnosis while keep this article as relatively simple and straightforward as possible. Soft tissue tumors are beyond the scope of this article.

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Musculoskeletal pitfalls and pseudotumours in the pelvis: a pictorial review for body imagers

Cited by 8 publications

References 30 publications

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

Dysmenorrhoea and Adnexal Cysts - A Rare Presentation of Tarlov Cysts in the Pelvis

Ten Commandments for the Diagnosis of Bone Tumors

Hip and Pelvis Bone Tumors: Can You Make It Simple?

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