“Don’t touch” lesions new version dr ahmed esawy
CALCANEAL PSEUDOCYST
INTRAOSSEOUS LIPOMA
BIPARTITE PATELLA
MYOSITIS OSSIFICANS
AVULSION INJURY
CORTICAL DESMIOD
GEODES
DORSAL DEFECT OF THE PATELLA
PSEUDOCYST OF THE HUMURUS
OS ODONTOIDEUM
NON OSSIFYING FIBROMA
BONE ISLANDS
UNICAMERAL BONY CYST
EARLY BONE INFARCT
MELORHEOSTOSIS
HYPERTROPHIC PULMONARY OSTEOARTHROPATHY
ACHONDROPLASIA
AVASCULAR NECROSIS
HURLER SYNDROME
TRANSIENT OSTEOPOROSIS OF THE HIP
DIAPHYSEAL ACLASIA
MULTIPLE HEREDITARY EXOSTOSIS
OSTEOID OSTEOMA
OSTEPATHIA STRIATA
OSTEOPIKILOSIS
SARCIOD
OS STYLOIDEUM
OS TRIGONUM
Giant osteoid osteoma of tibial shaft: A rare case reportApollo Hospitals
Giant osteoid osteoma of the tibial shaft is a rare entity.
Though this tumor is seen commonly in axial skeleton, so far
no conclusive report has been published on its periosteal
involvement of tibial shaft diaphysis.
Giant osteoid osteoma of tibial shaft: A rare case reportApollo Hospitals
Giant osteoid osteoma of the tibial shaft is a rare entity.
Though this tumor is seen commonly in axial skeleton, so far
no conclusive report has been published on its periosteal
involvement of tibial shaft diaphysis.
Avascular necrosis of the femoral head
introduction
causes
anatomy of femur
blood supply of femur
Clinical Features
Investigations
Differential Diagnosis
treatments
Surgical Treatment
Prognosis
aseptic necrosis
ischemic necrosis.
Legg-Calvé-Perthes syndrome
Causes Of Avascular Necrosis
A classification of bone tumours. Modified after Revised WHO Classification –Schajowicz (1994)
Osteoblastoma
Are larger: > 2 cm.
Periosteal reaction may be more prominent than encountered in osteoid osteomas
Comparison between ct mri in ischemic stroke AHMED ESAWY
Comparison between ct MRI in ischemic stroke .1-Definition
2-Pathology
3-Vascular territory
4-Staging
5-hemorrhagic transformation of the infarct
Difference between simple hemorrhage and hemorrhagic neoplasm
difference between Hemorrhagic infarct and primary intracerebral hemorrhage
6-Comparison between CT/MRI
7-CTA, MRA
8-Fogging
9-Pseudonormalization
10-Protocol
11-Differential diagnosis
12-home message
All thing breast ultrasound breast mammography part 3AHMED ESAWY
All thing breast ultrasound breast mammography part 3
Breast mammogram ultrasound lipoma ,oil cyst ,galactocele intramammary lymph node in UOQ hamartoma Simple cyst (typical) calcification Surgical scar Breast implants, scirrhuc carcinoma lobular carcinoma Skin calcifications vascular calcifications Sutural Dystrophic popcorn Large Rod like rim Round/punctuate Fat necrosis Milk of calcium Fibrocystic FCC fibroadenosis Fat necrosis with oil cyst mastitis with Abscess Haematoma atypical ductal hyperplasia Intracystic papilloma ductal carcinoma in situ ,invasive ductal carcinoma BIRAD
All thing breast ultrasound breast mammography part 1AHMED ESAWY
All thing breast ultrasound breast mammography part 1
Breast mammogram ultrasound lipoma ,oil cyst ,galactocele intramammary lymph node in UOQ hamartoma Simple cyst (typical) calcification Surgical scar Breast implants, scirrhuc carcinoma lobular carcinoma Skin calcifications vascular calcifications Sutural Dystrophic popcorn Large Rod like rim Round/punctuate Fat necrosis Milk of calcium Fibrocystic FCC fibroadenosis Fat necrosis with oil cyst mastitis with Abscess Haematoma atypical ductal hyperplasia Intracystic papilloma ductal carcinoma in situ ,invasive ductal carcinoma BIRAD
Update secrets in plain x ray abdomen gases ,air fluid level .AHMED ESAWY
plain x-ray abdomen gas normal air fluid level in-the-abdomen gasless abdomen small bowel obstruction large intestinal obstruction ileus gastric dilatation extraluminal abdomen gas (pneumonpperitoneum) extraluminal abdomen gas(retropneumonpperitoneum gas in specific organs (hepatobiliary ,genitourinary) gasless abdomen ‘step-ladder apperance stretch/slit sign string of pearls sign coiled spring sign small-bowel feces sign disproportionate dilatation of sb gallstone ileus intussusception caecal volvulus sigmoid volvulus colonic pseudo obstruction ogilvie syndrome acute colitis toxic megacolon ischemic colitis sentinel loops intestinal pseudo-obstruction syndromes gastric volvulus organoaxial gastric volvulus mesenterico-axial right upper quadrant gas crescent sign: air beneath the diaphragm peri hepatic sub hepatic morrison’s pouch fissure for ligament teres doges cap sign rigler’s (double wall sign) ( both the serosal and the related mucosal walls of the bowel are delineated it means free air is at that serosal surface ) ligament visualization falciform ligament sign: air delineating the falciform ligament umbilical inverted ‘v’ sign triangular air cupola sign football sign or air dome (a large air collection beneath that does not confirm to any bowel loop) continous diaphragm sign scrotal air in children decubitus abdomen sign double bubble sign lesser sac sign peritonitis postoperative pelvic and spinal fractures
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
4. “Don’t Touch” Lesions
Auntminnie diagnosis that do not need a biopsy
– more importantly you the radiologist can
prevent any further painful or costly work-up.
Three categories :
Posttraumatic
Normal variants
Benign lesions
Dr Ahmed Esawy
12. Myositis Ossificans
Findings: Circumferential calcification with a lucent center.
Best seen on CT
Sometimes associated with periosteal reaction.
Biopsy should be avoided since aggressive histologic appearance can mimic a sarcoma which then
can lead to unfortunate radical surgery! Dr Ahmed Esawy
13. Avusion Injury
Common in characteristic locations at ligament and tendon insertion sites.
Biopsy can be misleading because healing avulsion may mimic malignant histology.
Even further imaging like MRI can lead one towards biopsy.
Rather good clinical correlation and at the most follow up films in several weeks are a better
option. Dr Ahmed Esawy
18. Pseudodislocation of the Humerus
Fracture with hemarthrosis causing distension of the joint and inferior subluxation of the
humerus.
AP view can mimic a posterior dislocation.
Get axillary or scapular Y view to asses for dislocation.Dr Ahmed Esawy
20. Pseudocyst of the Humerus
Normal variant
Hyperemia and disuse caused by rotator cuff problems may increase the lucency in this region.
Very characteristic location for pseudocyst. However, chondroblastoma, infection ,or even
metastasis is still possible in this location Dr Ahmed Esawy
21. Os Odontoideum
Normal variant which demonstrates unfused dens to the body of C2.
Although this still may cause instability especially in the setting of acute trauma, if well corticated
then you can assume that there is no ACUTE fracture.
Additional finding of densely corticated anterior arch of C1 presumably due to compesnatory
hypertrophy.
Dr Ahmed Esawy
24. Non ossifying fibroma
Similar to fibrous cortical defect except for the larger size (greater than 2 cm)
Lytic lesion in the cortex of the metaphysis.
Well-defined with scalloped borders.
Always in younger patients (less than 30 years)
Involute as patient grows
Clinically asymptomatic and never leads to malignant degneration – no biopsy neededDr Ahmed Esawy
25. Healing NOF
Cortically based lytic lesion with sclerotic margins indicating healing and involution.
May have increased radiotracer activity on bone scan.
Again, clinically patient is asymptomatic.
NO BIOPSY !
Dr Ahmed Esawy
26. Bone Islands
Always asymptomatic.
Can it be metastatic disease? (especially when as large as the one we just looked at?)
Two distinguishing characteristic
A. Oblong in shape with long axis is along the axis of stress.
B. Margins show bony trabeculae extending from the lesion into normal bone in a spiculated
fashion.
Dr Ahmed Esawy
28. Unicameral bone cyst
Characteristic location – anteroinferior portion
of the calcaneus
Only differential is psedocyst of the calcaneus.
Dr Ahmed Esawy
31. Early Bone Infarct
Mixed lytic-sclerotic pattern which can resemble a permeative process.
Consider the diagnosis for patients with sickle cell anemia or systemic lupus erythematosus.
MRI can be helpful to avoid biopsy due to the characteristic serpiginous pattern
Dr Ahmed Esawy
36. Miscellaneous
non-touch Bone Lesions
Achondroplasia
Avascular necrosis
Hypertrophic pulmonary osteoarthropathy
Melorheostosis
Mucopolysaccharidoses
Multiple Hereditary Exostosis
Osteoid Osteoma
Osteopathia Striata
Osteopoikilosis
Pachydermoperiostosis
Sarcoidosis
Transient Osteoporosis of the hip
Dr Ahmed Esawy
37. Melorheostosis
Thickened cortical new bone that accumulates near the ends of long bones, usually only on
one side of the bone
“Dripping candle wax”
Can be symptomatic
Dr Ahmed Esawy
38. Hypertrophic pulmonary osteoarthropathy
Manifested by clubbing of the fingers and periostitis
May or may not be associated with bone pain.
Associated with lung cancer, bronchiectasis, GI
disorders, and liver disease.
The actual mechanism of formation of periostitis
secondary to a distant malignancy or other process is
unknown.
Differential diagnosis for periostitis in a long bone
without an underlying bony abnormality would
include :
venous stasis
thyroid acropachy
Pachydermoperiostosis
trauma
Dr Ahmed Esawy
39. Achondroplasia
The most common cause of dwarfism is achondroplasia
Congenital, hereditary disease of failure of endochondral bone formation.
Characteristic finding is that the spine typically has narrowing of the interpedicular
distances in a caudal direction
Achondroplasia causes rhizomelic dwarfism
Dr Ahmed Esawy
41. Patient on steroids AVN
Lack of blood supply with subsequent bone death
and ensuing bony collapse in an articular surface
Etiology of AVN most commonly includes trauma,
steroids, aspirin, collagen vascular diseases,
alcoholism, and idiopathic causes
Dr Ahmed Esawy
52. Osteopathia Striata
Also known as Voorhoeve disease
This disorder is manifested by multiple 2- to 3-mm-thick linear bands of sclerotic bone aligned
parallel to the long axis of a bone
It usually affects multiple long bones and is asymptomatic; hence, it is usually an incidental finding.Dr Ahmed Esawy
53. Osteopoikilosis
Clue: Patient is asymptomatic
Osteopoikilosis is an hereditary, asymptomatic disorder that is usually an incidental finding of
multiple small (3 to 10 mm) sclerotic bony densities affecting primarily the ends of long bones and
the pelvis
It has no clinical significance other than that it can be confused for diffuse osteoblastic metastases.
Dr Ahmed Esawy
54. Sarcoid
When sarcoid affects the musculoskeletal system is involved, the hands are most often affected,
with the spine and long bones only infrequently involved.
Sarcoid causes a characteristic lacelike pattern of bony destruction in the hands.
Multiple phalanges are typically affected in either one or both hands.
Auntminnie diagnosis. Dr Ahmed Esawy
55. Hyoid bone:
The hyoid bone is considered a lingual bone
The hyoid bone consists of a central body and paired lateral
greater and lesser horns
The line of fusion of the body and greater horns of the hyoid
bone should not be mistaken for a fracture
Dr Ahmed Esawy
56. Normal lucency (white arrowhead) between the
body and greater cornus of the hyoid bone is
seen. Large arrow, omohyoid muscle; small arrow
platysma muscle. Dr Ahmed Esawy
58. Accessory bones of the foot
21 accessory bones of the foot have been discovered (includes the sesamoid
bones)
25% of the feet of adults and 22% of the feet of children under 16 years of
age have roentgenographic evidence of one or more accessory bones.
Os trigonum – lokal pain (simptomatic treatment, excission)
Accessory Navicular bone – local tenderness from pressure of the shoe (
excision of bone and fixation of the posterior tibial tendon)
os tibiale
externum
os
peroneum
Accessory
Navicular
Os
Trigonum
Os
vesalinum
Dr Ahmed Esawy
63. type II accessory navicular (arrow) articulating with the medial aspect
of the navicular bone, with irregular articulating surfaces and
osteophytes
Dr Ahmed Esawy
64. lateral radiographs show fragmentation/fracture of an os peroneum (arrows)
and a transverse fracture of the fifth metatarsal base (arrowheads).
The os peroneum is an oval or round ossicle located within the substance of
the distal peroneus longus tendon near the cuboid.
Dr Ahmed Esawy
65. Os Intermetatarseum
os intermetatarseum situated between the first and second
metatarsal bases (arrow). Dr Ahmed Esawy
66. Hallux Sesamoids
transverse fracture through the central portion of the tibial hallux
sesamoid bone, with mild distraction of the 2 fragments (arrows).Dr Ahmed Esawy
71. Os Subfibulare: Case report of a
painful fibular accessory ossicle
The AP and Oblique radiograph showing a large accessory ossicle or os subfibulare to the
tip of the lateral malleolus. The accessory ossicle is at the anterior medial portion of the
malleolus giving it a bifid appearance.
Dr Ahmed Esawy
72. CT images show a fibular ossicle or os subfibulare at the
distal end of the fibular with pseudo-arthrosis.
Dr Ahmed Esawy
73. 3-dimensional CT reveals a large accessory ossicle or
os subfibulare to the tip of the lateral malleolus with
pseudo-arthrosis of the fragment
Dr Ahmed Esawy
74. Illustration of lateral foot shows os peroneum (white
arrow) and peroneus longus tendon (black arrows.)
Dr Ahmed Esawy
75. fracture of os peroneum and full-thickness tear of peroneus longus tendon .Dr Ahmed Esawy
76. os peroneum fracture and full-thickness peroneus longus tendon tear .(
Dr Ahmed Esawy
77. fracture of os peroneum and full-thickness peroneus longus tendon tear .(
Dr Ahmed Esawy
80. We have reviewed a spectrum of pathology
involving accessory ossicles and sesamoid bones.
These normal anatomic variations may, in fact,
represent the source of patient symptomatology.
The identification of key imaging characteristics
can help determine whether or not to attribute
clinical symptoms to these structures
Dr Ahmed Esawy