Automated breast ultrasound is a three-dimensional ultrasonographic technique allowing the evaluation of women with dense glandular breast tissue. In this group of patients, mammography has a low sensitivity because dense breasts can obscure breast cancer on mammogram. On the other hand, women with dense breast tissue, types C and D on the BI-RADS scale, are at an increased risk of developing breast cancer compared to women with fatty breast tissue. Automated breast ultrasound is a standardized and reproducible ultrasound technique which improves breast cancer detection and is promising in the screening and diagnostic settings: it increases the detection of breast cancer, and helps to differentiate benign and malignant lesions. Unfortunately, automated breast ultrasound also has its limitations and disadvantages due to artifacts caused by poor positioning, and lesion and patient characteristics. Many artifacts can be avoided by training and experience of the performing technician. Furthermore, familiarity of the interpreting breast radiologist with these artifacts and pitfalls will decrease false negative diagnosis of true lesions.
The case of a 17-year-old boy with Chronic Recurrent Multifocal Osteomyelitis (CRMO) is presented. Clinical manifestations included a three month history of marked antalgic scoliosis, thoracic and mid-sternal pain, mild fever, elevated erythrocyte sedimentation rate, and skin lesions such as acne and psoriasis. Radiologically, osteolytic lesions were seen in the sternum and the thoracic spine. Histopathological examination of the sternal lesion revealed chronic osteomyelitis. Bone cultures of the resected specimen were negative for known pathogens. The combination of the clinical, radiological, histopathological and microbiological features was the clue to the diagnosis of CRMO.