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The infrapatellar fat pad of Hoffa is commonly injured but rarely discussed in the radiological literature. Abnormalities within it most commonly are the consequences of trauma and degeneration, but inflammatory and neoplastic diseases of the synovium can be confined to the fat pad. The commonest traumatic lesions follow arthroscopy, but intrinsic signal abnormalities can also be due to posterior and superior impingements syndromes and following patellar dislocation. Infrapatellar plica syndrome may also be traumatic in aetiology. The precise aetiology of ganglion cysts is not understood; the principal differential diagnosis is a meniscal or cruciate cyst. Hoffa's fat pad contains residual synovial tissue, meaning that primary neoplastic conditions of synovium may originate and be confined to the fat pad. Inflammatory changes along the posterior border of the pad may also be used to help differentiate effusion from acute synovitis on unenhanced MR examinations. [References: 52]

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在髌下脂肪垫的霍法是常见的受伤，但很少讨论了放射性文献。异常范围内最常见的是创伤的后果和变性，但炎症和肿瘤疾病的滑膜可限于脂肪垫。最常见的创伤性关节病变的后续，但内在的信号异常也可以是由于后证和优秀impingements及以下髌骨脱位。髌下皱襞综合征也可能是创伤性的病因。确切的病因神经节囊肿不理解;的主要鉴别诊断是一个半月板或十字囊肿。霍法的脂肪垫含有残留滑膜组织，这意味着主要条件滑膜肿瘤可能起源和限于脂肪垫。炎性改变后沿边界的垫也可用于帮助区分积液急性滑膜炎的扫磁共振检查。 [参考文献： 52 ]

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OBJECTIVE: To determine the range of the patellar tendon length to patellar length ratio on magnetic resonance imaging (MRI) of the knee in order to aid in the establishment of MRI criteria for patella alta and baja. PATIENTS: Two hundred and forty-five patients ages 6-85 (mean 44) years who went through 262 consecutive 1.5 MRI studies of the knee performed during November 2000 through February 2001 were evaluated, regardless of their clinical symptoms. DESIGN: Patellar length (PL) and patellar tendon length (TL) were measured by a single musculoskeletal radiologist on sagittal images by a line connecting the superior and inferior patellar poles and the shortest length of the inner margin of the tendon respectively. TL/PL ratio was subsequently calculated. The distribution of ratios was evaluated; the extreme 2.5% at each end of the distribution was defined as patella alta and baja. RESULTS: The TL/PL ratio ranged between 0.56 and 1.71 (mean 1.05). After plotting the ratios, we noted an asymmetric curve skewed to the left. Based upon calculation of the extreme 2.5% of the ratio at each end of the plot, we determined that the MRI definition of patella alta and baja is a ratio of TL/PL of more than 1.50 and less than 0.74 respectively. We found that females had significantly higher TL/PL ratio than males (1.0878 and 1.0032 respectively). Ratios defined for patella alta and baja were 1.52 and 0.79 respectively in females and 1.32 and 0.74 respectively in males ( p<0.0001). CONCLUSION: Patella alta and baja are determined as TL/PL of more than 1.50 and less than 0.74 respectively, somewhat different than traditionally quoted radiographic and previously described MRI criteria.

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目的：测定范围髌腱长度髌骨长度比对磁共振成像（ MRI ）的膝盖，以援助在建立标准的MRI高位髌骨和巴哈。患者：有200名和45例年龄6-85 （平均44岁）经历了262谁连续1.5 MRI研究膝关节期间2000年11月通过2001年2月进行了评估，不论其临床症状。设计：髌骨长度（特等）和髌腱长度（热释光）测定单一肌肉骨骼放射影像上矢状线连接上，下极和髌骨的最短长度的内缘的肌腱分别。热释光/磷脂比值后来计算。分配的比率进行了评估;极端2.5 ％两端分布被界定为高位髌骨和巴哈。结果：热释光/磷脂比值介于0.56和1.71 （平均1.05 ）。经过策划的比例，我们注意到一个不对称曲线偏向左侧。根据计算极端2.5 ％的比率在两端的阴谋，我们确定的MRI定义高位髌骨和下一个比率的TL /特等超过1.50和0.74 ，分别低于。我们发现，女性有较高的TL /磷脂的比例高于男性（分别为1.0878和1.0032 ）。比值定义为高位髌骨和巴哈是1.52和0.79 ，女性分别为1.32和0.74 ，并分别在男性（ p “ 0.0001 ）。结论：高位髌骨和下也决心的TL /特等超过1.50小于0.74分别有所不同传统引述射线和核磁共振先前描述的标准。

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OBJECTIVE: To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features. DESIGN AND PATIENTS: MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) were independently reviewed by two radiologists masked to the clinical details. Symptom duration (median 6 months) and clinical side of severity were recorded. Anatomical areas in the pelvis were scored for abnormality (as normal, mildly abnormal or abnormal) and an overall assessment for side distribution of abnormality was recorded, initially without post-gadolinium sequences and then, 3 weeks later (median 29 days), the post-gadolinium sequences only. Correlation between radiological and clinical abnormality was calculated by Spearman's correlation. RESULTS: Abnormal anterior pubis and enthesis enhancement significantly correlated with clinical side for both radiologists (both P=0.008). Abnormal anterior pubis and adductor longus enthesis oedema was significant for one radiologist ( P=0.009). All other features showed no significant correlation ( P>0.05). In the control cases there was no soft tissue abnormality but symphyseal irregularity was present ( n=2). For both radiologists assessment of imaging side severity significantly correlated with clinical side for post-gadolinium ( P=0.048 and P=0.023) but not non-gadolinium sequences ( P>0.05). CONCLUSION: The extent and side of anterior pubis and adductor longus enthesis abnormality on MR imaging significantly and reproducibly correlates with the athletes' current symptoms in chronic adductor-related groin pain.

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目的：评价钆增强MRI运动员慢性腹股沟疼痛和相关的临床特征。设计与患者问：考试对52运动员（ 51男，女1例;平均年龄26岁）慢性腹股沟疼痛和6无症状控制运动员（ 6男，平均年龄29岁）进行了独立审查两个放射蒙面临床细节。症状持续时间（中位数为6个月）和临床方面的严重程度的记录。解剖学领域骨盆得分为异常（正常，轻度异常或异常），并进行全面评估的一侧分布异常记录，最初没有后钆序列，然后， 3周后（中位数29天），后-钆序列只。之间的关系及临床异常放射性计算斯皮尔曼相关。结果：异常前耻骨和显着正相关enthesis加强与临床方面为放射科（均P = 0.008 ）。异常前耻骨和内收肌长enthesis水肿有显着的一个放射（ P值0.009 ）。所有其他的功能没有显着相关（ P “ 0.05 ）。在控制情况下，没有软组织异常，但symphyseal违规在场（ 2例）。对于放射成像方面的评估程度显着相关临床副作用后钆（ P值0.048和P = 0.023 ），但不是非钆序列（ P “ 0.05 ）。结论：一侧的程度和前耻骨和内收肌长enthesis异常的磁共振成像和reproducibly显着相关的运动员目前的症状慢性收相关腹股沟疼痛。

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To evaluate demographic and radiographic features that may differentiate between enchondroma and low-grade chondrosarcoma of the fibula. The radiographs of ninety-three histologically-confirmed cartilaginous tumors of the fibula were retrospectively reviewed along with demographic information as to patient age and gender. Fifty-four enchondromas and thirty-nine low-grade chondrosarcomas were included in the study. Multiple previously-established radiographic features distinguishing enchondroma from chondrosarcoma were evaluated in each fibular tumor in a consensus manner by two experienced, board-certified and fellowship-trained musculoskeletal radiologists. Five radiographic features were shown to statistically favor chondrosarcoma over enchondroma in the fibula. These were soft-tissue mass ( p<0.0001), periosteal reaction ( p=0.008), cortical disruption in the juxta-articular fibula ( p=0.0133), cortical thickening ( p=0.032), and tumor size greater than 4 cm ( p=0.0046). No statistically-significant demographic differences were found between patients with enchondroma and chondrosarcoma of the fibula. When two or more of the identified features of malignancy are identified in the same patient, chondrosarcoma is 2.4 times more likely than in those patients exhibiting none of the features of malignancy. Soft-tissue mass, periosteal reaction, cortical disruption in the juxta-articular fibula, cortical thickening, and tumor size greater than 4 cm indicate chondrosarcoma over enchondroma of the fibula. Radiographs demonstrating more than one of the identified malignant features are more likely to be due to chondrosarcoma than radiographs demonstrating none or only one of the identified features. No unique malignant features of chondrosarcoma in the fibula were observed when compared to previous descriptions of these tumors in the long and short tubular bones of the appendicular skeleton.

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评价人口和影像功能，可以区分软骨瘤和低度恶性软骨肉瘤的腓骨。在X光片的93病理证实的软骨肿瘤的腓骨进行回顾与人口统计资料，病人年龄和性别。 54个enchondromas和39低品位软骨肉瘤被列入研究。多以前成立的影像学特征鉴别软骨瘤由软骨进行了评价每个腓骨肿瘤在协商一致的方式两名经验丰富，局认证和研究金培训肌肉骨骼放射。 5 X线特征，统计显示，支持多软骨瘤软骨肉瘤的腓骨。这些软组织肿块（ p “ 0.0001 ），骨膜反应（ p值= 0.008 ），皮质中断旁关节腓骨（ p值= 0.0133 ），皮质增厚（ p值= 0.032 ），与肿瘤的大小大于4厘米（ P值0.0046 ）。无统计学显着性差异，人口之间的患者软骨瘤及软骨肉瘤的腓骨。当有两个或两个以上的特点，确定恶性肿瘤被确定在同一病人，软骨肉瘤是2.4倍的可能性比那些没有患者表现出的特点恶性肿瘤。软组织肿块，骨膜反应，骨皮质中断旁关节腓骨，皮质增厚，与肿瘤的大小大于4厘米以上显示软骨肉瘤的腓骨软骨瘤。 X光片显示出一个以上的恶性特征确定更可能是由于软骨肉瘤比X光片显示没有或只有一个确定的功能。没有独特的恶性特征的腓骨软骨肉瘤，观察以往相比，说明这些肿瘤的长期和短期管状骨的四肢骨骼。

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Clinical symptoms of hyperparathyroidism are generally nausea, vomiting, fatigue, constipation, and hypotonicity of the muscles and ligaments; bone pain and tenderness are also seen but are more common in secondary hyperparathyroidism. We report a histologically confirmed case of a 28-year-old man whose sole symptom of primary hyperparathyroidism was lower extremity radicular pain due to a vertebral brown tumor. Magnetic resonance imaging demonstrated brown tumor to be hyperintense on T2-weighted and slightly hypointense on T1-weighted sequences; it showed intense contrast enhancement with gadolinium. Because brown tumors usually contain hemosiderin a short T2 should have been expected, but this was not seen in our case. Healing resulted in decreasing contrast enhancement on T1-weighted sequences and increasingly short T2. To our knowledge, this is the first report of a lumbar vertebral brown tumor associated with primary hyperparathyroidism.

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甲状旁腺功能亢进症临床症状一般都恶心，呕吐，疲劳，便秘， hypotonicity的肌肉及韧带;骨疼痛和压痛，但也被视为是较常见的继发性甲状旁腺功能亢进。我们报告一个病理确诊的28岁男子，其唯一症状是原发性甲状旁腺功能亢进症下肢根性疼痛因椎布朗肿瘤。磁共振成像显示布朗肿瘤是高的T2加权和上略微低T1加权序列;它表现出浓厚的对比度增强与钆。由于布朗肿瘤通常含有含铁血黄素短期时刻应该已经预计，但这是没有看到在我们的案例。愈合导致降低对比度增强的T1加权序列和越来越短的时刻。据我们所知，这是第一次报告的腰椎肿瘤布朗与原发性甲状旁腺功能亢进症。

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The fourth case in the literature is presented of a patient with the rare association of hyperparathyroidism and osteosarcoma. A 56-year-old woman presented with hyperparathyroidism and a lesion in the tibia. Initial diagnosis was brown tumor. Histology, however, revealed osteosarcoma, and the patient was treated accordingly. The experimental induction of osteosarcoma by parathormone in rodent studies makes this finding alarming, considering the increasing use of parathormone in the treatment of osteoporosis. The mechanism by which osteosarcoma is induced in humans cannot be explained based on current knowledge of mechanisms of action of parathyroid hormone.

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第四起案件是在文献中提出了一个罕见的患者甲状旁腺功能亢进症协会和骨肉瘤。一位56岁的女子提出性甲状旁腺功能亢进和病变的胫骨。初步诊断是布朗肿瘤。组织学，但是，发现骨肉瘤，病人是相应处理。实验诱导的骨肉瘤的甲状旁腺在啮齿动物的研究使这一发现令人震惊，考虑到越来越多地使用甲状旁腺在治疗骨质疏松症。这一机制的诱导成骨肉瘤是人类无法解释目前的知识基础上的机制的行动甲状旁腺激素。

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Soft tissue aneurysmal bone cyst.

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A soft tissue aneurysmal bone cyst located in the right gluteus medius of a 21-year-old man is reported. On conventional radiography, the lesion demonstrated a spherically trabeculated mass with a calcific rim. On CT scan, it showed a well-organized peripheral calcification resembling a myositis ossificans. On MRI, it presented as a multilocular, cystic lesion with fluid-fluid levels. The lesion had no solid components except for intralesional septa. Although findings on imaging and histology were identical to those described in classical aneurysmal bone cyst, diagnosis was delayed because of lack of knowledge of this entity and its resemblance to the more familiar post-traumatic heterotopic ossification (myositis ossificans).

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软组织动脉瘤样骨囊肿位于右臀medius的一名21岁男子报道。常规X线，表现出病灶球trabeculated大规模的钙化环。 CT扫描，但它表明一个组织良好的周边钙化类似骨化性肌炎。 MRI上，它作为一个多，囊性病变与流体流体水平。病灶没有坚实的组成部分除了注射间隔。虽然调查结果成像和组织学相同所描述的那些经典的动脉瘤样骨囊肿，诊断被推迟，因为缺乏知识的实体和其相似的更熟悉创伤后异位骨化（骨化性肌炎）。

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Epidermoid cyst in a long bone is an extremely rare condition. The authors describe such a tumor located in the cortex of the tibia in a 21-year-old woman. She was successfully treated with curettage and autogenous bone grafting.

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表皮样囊肿在长骨是一种极为罕见的疾病。作者描述这种肿瘤位于胫骨皮质的21岁女子。她成功地治疗术和自体骨移植术。

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Osseous hemangiopericytoma is rare. We present a case of a 30-year-old woman with low-back pain with radiation to the left buttock for 1 month. Magnetic resonance imaging (MRI) showed a tumor mass with areas of serpentine signal void pattern in the sacrum suggestive of a vascular tumor. Neither calcifications nor layered blood serum were noted. Histological diagnosis was compatible with osseous hemangiopericytoma.

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骨血管外皮细胞瘤是罕见的。我们报告的病例是一名30岁女子下腰痛与辐射左侧臀部1个月。磁共振成像（ MRI ）显示肿瘤领域的蛇纹石信号无效格局暗示骶骨肿瘤的血管。既不钙化或分层血清指出。病理诊断符合骨血管外皮细胞瘤。

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A benign- appearing osteolytic lesion surrounded by a sclerotic rim was found in the upper fibula of a 25-year-old man. Based on histological features the definitive diagnosis of osteofibrous dysplasia-differentiated adamantinoma was made. The correct histological diagnosis of differentiated adamantinoma depends on factors such as the uniform predominance of an osteofibrous dysplasia-like pattern, and scattered epithelial elements positive for cytokeratin and vimentin. In this case the scattered epithelial cells had abundant eosinophilic cytoplasm and resembled rhabdoid elements, but immunohistochemistry proved their epithelial origin.

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阿良性出现溶骨性病灶周围有硬化环被发现在上腓骨的25岁男子。根据组织学特征的明确诊断骨发育不良分化造釉了。正确的病理诊断有区别的造釉取决于一些因素，如统一的占主导地位的一个骨发育不良样的模式，分散元素阳性上皮细胞角蛋白和波形。在这种情况下，分散的上皮细胞有丰富的嗜酸性细胞和横纹肌样的内容相似，但免疫组化证明了他们的上皮来源。

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