Accurate classification of obesity levels is of clinical importance for public health and decision making. Body mass index (BMI) is the most broadly used measure of obesity on a population scale. But, as with other diagnostic indicators, BMI can have potential pitfalls. We attempted to explore the diagnostic performance of BMI for assessing obesity. 330 healthy Caucasian women (native Greeks) (ages, 20 to 85 years) volunteers participated in the study. Dual-energy X-ray absorptiometry (DXA) was used to measure percentage of fat mass (

Abstract Ultrasound (US) equipped with high-frequency linear transducers is a convenient, first-line imaging modality for evaluating a wide spectrum of musculoskeletal abnormalities. In complex cases, the US findings may need to be correlated with findings on the magnetic resonance (MR) imaging studies to generate an accurate diagnosis. Periosteal chondroma is a rare, benign bone surface tumor arising from the periosteum. The lesions are composed of hyaline cartilage and tend to be small, superficial, and slow-growing. Despite an indolent clinical course, this neoplasm may cause scalloping of the outer bone cortex, necessitating detailed imaging investigation to rule out malignancy. Interestingly, the imaging appearances of periosteal chondroma may overlap with those of chondrosarcoma, and in addition, the histological differentiation of these tumors can be difficult. Sporadic cases of MR imaging findings in periosteal chondroma have been published; however, the usefulness of US in diagnosing surface-based bone tumors has not been adequately studied. In this illustrated case, we describe the US features of periosteal chondroma, emphasizing the versatile role of US for diagnosing a tumor of the bone surface, and the correlation with MR imaging findings.

Mazabraud syndrome is a rare condition characterized by the coexistence of fibrous dysplasia (FD) and intramuscular myxomas. A 46-year-old woman, initially diagnosed with polyostotic FD at the age of 23, developed a palpable mass on her left arm 15 years later, which proved to be an intramuscular myxoma. A diagnosis of Mazabraud syndrome was made. Over the following two decades, she developed additional intramuscular myxomas. The patient denied surgical excision of the soft tissue lesions and was managed conservatively for symptomatic FD. Radiologic imaging, including MRI and ultrasound, played a crucial role in the diagnosis and the assessment of disease progression. Although both FD and myxomas are benign musculoskeletal abnormalities, close follow-up of the patients is essential to monitor changes in the number, distribution, and extent of lesions that may occasionally undergo malignant transformation. This case underscores the importance of early detection and long-term follow-up of patients with FD who may present with, or eventually develop, intramuscular myxomas, comprising Mazabraud syndrome.

The "tumbling gallstone sign" is a diagnostic imaging finding described on radiologic examinations of the abdomen, in patients with cholelithiasis associated with intermittent episodes of gallstone obstructive ileus. Best seen on serial radiographs or CT studies of the abdomen, this sign indicates a sudden change in position of the gallstone(s) within the intestinal lumen from the upper segments of the bowel to the lower segments of the bowel, causing transient mechanical bowel obstruction. The tumbling gallstone sign has been likened to that of the classic childrens' tumbling tower balancing game. On repeat CT scans, the dislodged gallstone(s) may be seen proceeding distally and impact in the ileum at a level lower than that seen on the previous CT scans, analogous to the tumbling gallstone sign.

•Caffeine is a vasoactive substance that may have toxic effects in the CNS, if not responsibly consumed.•Energy drinks (EDs) are beverages containing variable doses of caffeine and mixed compounds.•Overconsumption of caffeinated EDs may rapidly induce hemodynamic changes that can be associated with ischemic brain injury.•This association is alarming, especially in young individuals consuming large amounts of popular caffeinated beverages.

We read with great interest the recent article by Umemoto, K. [...]

Foreign bodies (FBs) can pose a diagnostic dilemma because a wide range of objects, comprising items incidentally detected or deliberately retained in the body, can be discovered on imaging investigations. Single or multiple FBs may be retained at different sites including the gastrointestinal tract, the genitourinary system, the respiratory tract, and the soft tissues, all of which warrant medical attention. More importantly, ensuing, serious complications related to harmful positioning of these objects can significantly hamper normal function of any involved organ system. Because various FBs may be detected throughout the body, it is important that radiologists are also familiar with a myriad of life-threatening complications associated with retained items, including impaction, obstruction, perforation, hemorrhage, embolization, chemical dissolution, poisoning, and sepsis. Imaging plays a key role in the detection, localization, and characterization of FBs. Radiologists need to describe in exhaustive detail suspected items with regard to the anatomical location, type, shape, and composition of the object under investigation. Clinicians can then predict whether the foreign object(s) will pass through the body uneventfully or need to be addressed in a surgical procedure.

As the global population of older persons increases, age-related medical conditions will have a greater impact on public health. DXA-derived bone and soft tissue metrics are associated with adverse clinical events in aging persons. This study aims to investigate the regional body composition of the appendices by whole-body DXA scans, and the age-related relationships between measures of bone and soft tissue in healthy Caucasian females of a Greek origin residing in the Mediterranean area. Body composition of the legs and the arms was analyzed, and lean mass (LM) and fat mass (FM) metrics were calculated in 330 women aged 20-85 years, using DXA. Peak bone mineral density (BMD) of the legs and arms was achieved between ages 20-30 and 41-50 years, respectively. The overall BMD reduction with age was for the legs 43% and the arms 32.2% (p < 0.001). Peak %LM of the legs and the arms was achieved between ages 20-30. The overall reduction of %LM with age was for the legs 22.5% (p < 0.001) and arms 6.6% (p < 0.05). Peak %FM of the legs and arms was attained between ages 31-40 and 61-70, respectively. The overall %FM reduction with age was for the legs and arms 7.5% and 1.9% (p > 0.05). In appendicular sites, Greek women reach peak values of bone mass in the legs first, in early adulthood. Bone loss predominates in the legs as women age. Also, with advancing age Greek women show preferential significant decreases of %LM and %FM in the legs as opposed to the arms. Although variation in appendicular bone and soft tissue metrics is present, the implications of variable biological crosstalks among the tissue components as women age may ultimately lay the foundation for future clinical trials aimed at healthy aging.

We explored the regional variations in body composition with advancing age in healthy Caucasian females living in the Mediterranean area. The objectives of this study were to establish body composition values for the trunk in healthy women of a Greek origin and to evaluate the effects of aging on the distribution of truncal bone mass, fat mass (FM) and lean mass (LM). Body composition of the trunk and detailed analysis of its anatomical components-the ribs, the thoracic spine, the lumbar spine and the pelvis, and FM and LM ratios--were calculated in 330 women aged 20-85 years, using DXA. Peak bone mineral density (BMD) of the trunk was attained between ages 30 and 33. The overall truncal BMD reduction with age was 20.7% (p < 0.001). Peak %LM of the trunk was achieved at age 20. The overall reduction of %LM with age for the trunk was 9.8% (p < 0.001). Peak %FM of the trunk was attained between ages 68 and 73, and the overall %FM reduction with age was 2.8% (p > 0.05). Multiple comparative analyses showed that the 51-60 years age group was the landmark age for significant changes of truncal bone mass measures across all age groups (p = 0). For truncal LM and FM metrics, multigroup comparative analysis showed the turning point of significant changes in soft tissue was the 41-50 age bracket (p = 0 and p = 0, respectively). In Greek women, truncal %LM exceeded by far %FM across all ages (p = 0). Our results suggest that aging affects body composition of the trunk in ambulatory healthy women of a Greek origin differently, leading to menopausal loss of bone mass, senior adulthood loss of lean mass, and middle-age storage of fat mass. In adult women, these age-related associations between bone and soft tissue metrics on DXA exams carry implications for the attainment of optimal peak values and shifts in body composition overtime, impacting lifelong skeletal health.

Introduction: Filum terminale (FT) is a thin fibrous band connecting the conus medullaris with the coccyx. Tethered spinal cord syndrome (TSCS) is caused by pressure exerted on the spinal cord by a tense inelastic filum terminale. It is subdivided into congenital/primary and acquired/secondary. Congenital TSCS is usually diagnosed at birth and early childhood. In older children, the FT (that was not tethered from birth) is elongated in time by coexisting myelomeningocele, lipomyelomeningocele, split cord malformation, tumor, trauma, surgery or Tarlov cysts (meningeal or perineural cysts around the sacral nerve roots).Case presentation: We present the case of a 14-year-old boy who developed parieto-occipital headache, cervicalgia, dizziness, vomiting, and urinary/fecal incontinence after an injury of the lumbar and sacral spine. The imaging results (MRI and MR myelography) were consistent with lumbar-sacral subarachnoid space distension. Immediate surgery was performed: large Tarlov cysts putting pressure on the FT were identified and surgical untethering of the FT was performed. The postoperative course was smooth: symptoms remitted within 48 hours.Conclusion: The injury of the lumbar and sacral spine in our patient caused an accumulation of cerebral fluid in pre-existing Tarlov cysts, which put pressure and tension on the FT. This caused neurologic symptoms as a first clinical manifestation at the age of 14. Immediate surgical intervention was necessary to prevent permanent damage.

OPINION article Front. Neurol., 05 October 2023Sec. Neuro-Otology Volume 14 - 2023 | https://doi.org/10.3389/fneur.2023.1289357