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Objectives This study aimed to evaluate the frequency and characteristics of specific labral lesions (SLAP and Bankart) and associated tendinous injuries in patients with avulsion fractures of the shoulder using magnetic resonance (MR) arthrography and to investigate their potential clinical implications. Methods A retrospective review was performed on 850 shoulder MR arthrograms retrieved from our institutional PACS database.The study comprised a total of 35 patients with confirmed avulsion fractures and 30 age- and sex-matched controls. . All patients received both conventional MR imaging and 3D volumetric MR arthrography sequences. The evaluation focused on labral lesions (SLAP, Bankart), rotator cuff injuries and biceps tendon pathology which were systematically evaluated by two experienced radiologists. Results The avulsion fracture of the greater tuberosity was the most commonly observed, accounting for 60% of cases. Labral pathology was considerably more prevalent among the patient cohort (51.4%) compared to the control group (23.3%) (p=0.039). Superior labrum anterior to posterior (SLAP) lesions were the most frequently identified labral abnormalities, and were significantly more common than both Bankart lesions (17.1%) and Bankart variant lesions (2.9%) (p=0.015). Patients presenting with fractures of the lesser tuberosity demonstrated a notably higher incidence of combined rotator cuff and biceps tendon pathology (77.8%) in contrast to those with greater tuberosity fractures (14.3%) (p=0.002). Conclusions The research underscores a robust link between avulsion fractures and superior labral injuries, especially SLAP lesions. Moreover, there was a significant correlation between lesser tuberosity fractures and extensive tendinous pathology, indicating a greater degree of biomechanical compromise. These results highlight the critical role of MR arthrography in identifying concurrent labral and tendinous injuries that could affect clinical decision-making.

Introduction Lumbar foraminal inner zone herniations are challenging cases, for which there are variety of approaches. However, there is no information about the distance between these herniations and the edges of the respective lamina. The aim of this study was to measure the distance between the inferomedial aspect of lumbar pedicles and laminar edges. Materials and methods The lumbar CT images of 30 cases were reviewed. The distances between the edges of the lamina and the inferomedial aspects of the respective pedicles were measured. The study was performed on L3, L4, and L5 lumbar vertebrae on both sides. Results The mean distance between the upper edge of the lamina and the inferomedial aspect of the respective pedicle was found to be 10.8 ± 3.5, 11.6 ± 2.4, and 14.1 ± 2.3 mm on the left side, and 11.1 ± 4.4, 12.0 ± 2.5, and 13.8 ± 3.2 mm on the right side of L3, L4, and L5 vertebrae. The mean distance between the inferior edge of the lamina and the inferomedial aspect of the respective pedicle was found to be 23.8 ± 4.2, 19.3 ± 3.5, and 11.6 ± 2.9 mm, on the left side, and 23.9 ± 3.2, 19.1 ± 3.7, and 12.4 ± 2.8 mm on the right side of L3, L4, and L5 vertebrae. There was no statistically significant difference between values of the left and right sides ( p  > 0.05). Conclusion This study revealed that distance between the inferomedial aspect of lumbar pedicles and the superior edge of the same lamina was shorter than the distance between the inferomedial aspect of lumbar pedicles and the inferior edge of the same lamina at L3 and L4 level. It was concluded that this shorter distance could be taken into consideration during surgery on inner zone 1 foraminal herniations.

Introduction: To demonstrate the effect of concha bullosa (CB) on the height of the skull base. Methods: We retrospectively scanned the files of 1022 patients who had undergone paranasal sinus tomography for sinusitis in our hospital. Three hundred thirty patients had bilateral, and 330 had unilateral CB, but 330 patients did not have CB. Patients with inappropriate sections and positions were excluded from the study. A total of 990 patients aged between 18 and 72 years were included in the study. Five hundred sixty-seven of the patients were female, and 423 were male. In each group, the heights of the right and left skull base of male and female patients were compared within themselves and between each other. The height of the skull base was measured in the coronal plane along the lateral lamella between the cribriform plate and the fovea ethmoidalis, and these measurements were classified as Keros classification. (Keros type 1: 1-3 mm, Keros type 2: 4-7 mm, Keros type 3: 8-16 mm). Results: There was no statistically significant difference in the comparison between right and left skull base heights of female and male patients in bilateral CB group. Also, there was no statistically significant difference between the comparison of women and men within themselves. There was a statistically significant difference between CB side and non-CB side skull base heights of female and male patients in unilateral CB group, although there was no statistically significant difference between the comparison of women and men within themselves. Conclusion: In patients with unilateral CB, there is skull base asymmetry between the sides of CB and non-CB, and this should be taken into consideration to prevent complications.

Objectives The objective of this study is to prospectively assess the effectiveness of shoulder magnetic resonance (MR) arthrograms with positional manoeuvres in detecting posterior synovial folds. Methods Two radiologists independently assessed all axial MR arthrograms in internal rotation, neutral position, and external rotation for the presence of a posterior synovial fold. The diagnostic performances of the MR arthrograms were then compared, with results validated through arthroscopy. Results Arthroscopy was performed on 81 of the 150 patients included in the study. A posterior synovial fold was identified arthroscopically in eleven of these patients. Measurements of the posterior synovial fold obtained in external rotation and the neutral position of the arm showed a significant correlation with arthroscopic results ( p  < 0.05). For detecting the posterior synovial fold with arthroscopic correlation, the sensitivity and specificity values for observer 1 and observer 2 were 100–81.4% and 100–88.6%, respectively, for MR arthrograms in the neutral position; 100–52.9% and 100–62.9% for MR arthrograms in external rotation; and 100–95.7% and 81.8–98.6% for MR arthrograms in internal rotation. There was a fair agreement for MR arthrography in external rotation for detecting posterior synovial folds, while MR arthrograms in internal rotation and neutral position showed near-perfect and significant interobserver agreement. Conclusion The rotational positions of the humeral neck during MR arthrographic examination can influence the diagnostic specificity and sensitivity of axial MR arthrograms in detecting the posterior synovial fold. Clinical relevance statement The posterior synovial fold can mimic a posterior labral detachment. Therefore, its correct identification is crucial in order to avoid unnecessary surgical procedures. Key Points Movement of the shoulder may introduce variability in MR arthrography appearance . Rotation of the humeral neck during MR arthrography can affect diagnoses in posterior synovial fold detection . Given that posterior synovial folds can imitate posterior labral detachment, their correct identification is crucial to avoid unnecessary surgical procedures .

Fahr’s disease is defined as the accumulation of bilateral idiopathic calcification in the basal ganglia, dentate nucleus, and centrum semiovale. The coexistence of Fahr’s disease and intracranial tumors is extremely rare, with only five cases documented in the literature. This study aimed to present a rare case, discussing both similarities and differences with previously reported cases. A 70-year-old female patient presented to our hospital with a progressive headache over the past month. Brain magnetic resonance imaging (MRI) with intravenous contrast was performed for further evaluation. Bilateral basal ganglia, thalamus, and dentate nuclei showed calcifications consistent with Fahr’s disease. After excluding toxic, infectious, and endocrine causes of calcification, the patient was diagnosed with Fahr’s disease. Magnetic resonance imaging also revealed a midline localized, irregularly contoured, and heterogeneously intense mass with contrast enhancement at the centrum semiovale level, accompanied by peripheral edema. Radiologically, the mass resembled a high-grade glioma or metastasis, and the presence of a lipid peak further suggested metastasis. Based on radiological findings, the patient was diagnosed with brain metastasis of breast carcinoma. The patient received chemotherapy for metastasis, which resulted in substantial regression of the mass. In patients with known Fahr’s disease, new-onset headaches and related symptoms should warrant evaluation for possible brain tumors. In these cases, imaging findings should be assessed along with physical examination findings and the patient’s medical history to support the diagnostic process.

The breast MRI parameters such as morphologic features, enhancement kinetics and diffusion restriction can be used for the differential diagnosis. We aimed to compare the Apperant Diffusion Coefficient (ADC) values of masses with other MRI parameters in diagnosis of breast masses. Between March 2014 and September 2017, 49 female patients in whom a breast mass was diagnosed, determined using ultrasound and mammography and who were further examined with MRI, were enrolled to this study. Total 51 lesions were detected. Routine breast MRI protocol was performed and images were evaluated. The ADC cut-off value was taken as 1,1x10-3mm2 /s according to the literature. Fifty-one lesions were diagnosed with biopsy. Of these lesions, 23 (45.1%) were malignant (20 invasive ductal carcinoma and others) and 28 (54.9%) were benign (20 fibroadenomas and others). The accuracy rate of DCE assessment of MRI was 90,9% for benign lesions in with a type 1 curved lesions, and 81,8% for malign lesions in with a type 3 curved lesions. The accuracy rate of ADC values was 93,1% for benign lesions and 95,5% for malign lesions. We believe that the ADC value can provide a higher diagnostic accuracy with the combination of morphological characteristics and contrast kinetics of the lesion and that ADC can be used alone because of its high diagnostic accuracy in some cases.

[LANGUAGE= \"English\"] OBJECTIVE: Computed tomography of the thorax (Thorax CT) is frequently used to diagnose viral pneumonia in moderate to severe COVID-19 patients, but its diagnostic performance in mildly symptomatic COVID-19 patients is still unclear. Assessing the diagnostic performance of thorax CT in mildly symptomatic COVID-19 patients was the purpose of our study.METHODS: Mildly symptomatic and clinically stable, suspected COVID-19 patients scanned with Thorax CTs between March 11, 2020, and April 13, 2020, were included in this study. The sensitivity, specificity, positive and negative likelihood ratios, positive and negative predictive values, and the respective accuracies were calculated for diagnostic purposes.RESULTS: Among the 1119 patients enrolled in our study, abnormal thorax CT scans were 527 out of which 363/527 (68.9%) had typical CT features for COVID-19. According to analysis of typical COVID findings, sensitivity, specificity, positive predictive values, negative predictive value, and the accuracy of Thorax CTs with were 51.45%, 86.07%, 78.24%, 64.55%, and 68.99%, respectively. When typical CT findings and atypical CT findings were combined for the statistical analysis, the sensitivity, specificity, and accuracy observed 68.84%, 74%, and 71.49%.CONCLUSION: Diagnosing pneumonia can be challenging in mildly symptomatic COVID-19 patients since the Reverse Transcription Polymerase Chain Reaction test results, when compared with symptoms are not always evident. According to our study, thorax CT sensitivity was higher when atypical COVID-19 CT findings were included compared to those with typical COVID-19 CT findings alone. Our study which included the largest number of patients among all other similar studies indicates that not only typical but also atypical CT findings should be considered for an accured diagnosis of COVID-19 pneumonia.[LANGUAGE= \"Turkish\"] Amaç: Toraks bilgisayarlı tomografi (BT), orta ila şiddetli Covid19 hastalarında viral pnömoniyi teşhis etmek için sıklıkla kullanılır, ancak hafif semptomlu Covid19 hastalarındaki tanısal performansı halen net değildir. Hafif semptomlu Covid19 hastalarında Toraks BT tanısal performansını değerlendirmek, çalışmamızın amacı idi.Yöntemler: 11 Mart 2020 ile 13 Nisan 2020 tarihleri arasında toraks BT ile taranan, hafif semptomlu ve klinik olarak stabil, şüpheli Covid19 hastaları bu çalışmaya dahil edildi. Tanı amaçlı sensitivite, spesifite, pozitif ve negatif olabilirlik oranları, pozitif ve negatif prediktif değerleri ve ilgili doğruluklar hesaplandı.Bulgular: Çalışmamıza katılan 1119 hasta arasında, anormal Toraks BT taramaları 527 idi ve bunların 363 / 527'sinde (%68,9) Covid19 için tipik BT özellikleri vardı. Tipik Covid19 bulgularınınanalizine göre; Toraks BT’lerin sensitivite, spesifite, pozitif prediktif değer, negatif prediktif değer ve doğruluğu sırasıyla %51.45, %86.07, %78.24, %64.55 ve %68.99 idi. Tipik BT bulguları ve atipik BT bulguları istatistiksel analiz için birleştirildiğinde, sensitivite, spesifite ve doğruluk % 68,84, %74 ve %71,49 olarak gözlendi.Sonuç: Hafif semptomlu Covid19 hastalarında pnömoni tanısı koymak zor olabilir çünkü Revers-Transkriptaz Polimeraz Zincir Reaksiyonu (RT-PCR) test sonuçları, semptomlarla karşılaştırıldığında her zaman net değildir. Çalışmamıza göre atipik Covid19 BT bulguları dahil edildiğinde toraks BT duyarlılığı, tek başına tipik Covid19 BT bulgularına göre daha yüksekti. Diğer tüm benzer çalışmalar arasında en fazla sayıda hastayı içeren çalışmamız, Covid19 pnömonisinin doğru tanısı için yalnızca tipik değil, aynı zamanda atipik BT bulgularının da dikkate alınması gerektiğini göstermektedir.

[...]he did not have a family history of vascular disease and stroke. At the emergency room, his blood pressure was 160/90 mmHg, and he suffered from a throbbing, persistent headache at the front of his head. The high blood glucose level and mildly elevated blood pressure decreased to normal levels with the medication. According to his cerebral angiography findings, there was no evidence of cerebral vasculitis or fibromuscular dysplasia. [...]the patient died while eating his lunch on the fifth day in the intensive care unit due to acute cardiac arrest. Since triggering conditions such as sexual intercourse, mechanical stress, and trauma were absent and the dissection was occurred between the peak plasma concentration time and the half-life of sildenafil, sildenafil was considered The etiology of spontaneous artery dissections includes collagen tissue diseases, hypertension, systemic infections, migraine, high homocysteine levels, alcohol consumption, and oral contraceptive use. In a study on the relationship between aortic dissection and sildenafil use, the pathological mechanism was proposed to be an increase in the risk of intimal rupture because the vasodilatory property of sildenafil causes a decrease in arterial wall stiffness (5). Tantini B, Manes A, Fiumana E, Pignatti C, Guarnieri C, Zannoli R, Branzi A,...