Aneurysmal bone cysts is a benign, slow growing expansile lesion usually found in long bones or vertebrae. Only 5 cases of ABC of the ethmoid bone have been reported in the literature. Plain radiographs are not specific. CT and MRI are very useful to depict the extent of the lesion and demonstrate the presence of blood-fluid levels, which is a characteristic finding of ABC. We present one atypical case of ABC of the ethmoid bone in a 15-year-old female characterised by its extensive involvement and its rare location.

OBJECTIVE:We report 4 patients with sickle cell anemia presenting with intra-splenic benign nodules corresponding to islands of preserved tissue within splenic ferro-calcinosis.MATERIAL AND METHODS:Ultrasound, CT and MRI findings were evaluated and compared to a follow-up study by ultrasound and CT done after 6 to 12 months.RESULTS:Ultrasound showed multiple well-defined rounded nodules appearing hypoechoic compared to the rest of the spleen that was hyperechoic. On CT, the nodules were homogenous, hypodense relative to the spleen, isodense to the liver in 3 cases and hypodense to the liver in 1 case. On MRI, the nodules appeared relatively hyperintense within low-signal-intensity spleens. The ultrasound and CT follow-up study demonstrated no remarkable change.CONCLUSION:In sickle cell patients, intra-splenic benign nodules corresponding to normal splenic tissue may be identified on imaging studies. The differential diagnosis is discussed.

Septic thrombosis of the cavernous sinuses most commonly follows staphylococcal infections of the middle third of the face. Orbital symptoms are constant. We report six cases diagnosed only by CT. At present, MR imaging is the diagnostic procedure of choice. Its findings are thought to reflect the septic nature of the thrombosis.

Splenic abscesses are rare and account for only 2 to 5.4% of all intra-abdominal suppurations. Hematogenous dissemination during septicemia or endocarditis, infection of an infarct or post-traumatic hematoma, and spread of a neighboring infection are the mechanisms that can lead to development of a splenic abscess. Hemoglobinopathies, diabetes mellitus, and immune depression are the main risk factors. Clinical symptoms are often inconspicuous and nonspecific, and until recently the diagnosis was often established only upon autopsy. Painful enlargement of the spleen in a febrile patient should suggest a splenic abscess. The most common causative agents are Staphylococcus aureus, streptococci, and Gramnegative rods. Ultrasonography and computed tomography readily demonstrate the abscess. and can be used to guide percutaneous aspiration and/or drainage and to monitor the course. Percutaneous aspiration or drainage with appropriate antimicrobial therapy usually ensures recovery. Splenectomy is indicated if percutaneous drainage fails.

Septic thrombosis of the cavernous sinuses most commonly follows staphylococcal infections of the middle third of the face. Orbital symptoms are constant. We report six cases diagnosed only by CT. At present, MR imaging is the diagnostic procedure of choice. Its findings are thought to reflect the septic nature of the thrombosis.

Thirteen cases of pyogenic abscess of the psoas muscle were reviewed retrospectively. The abscess was primary in five cases (38.5 %) and secondary in eight (61.5 %). Fever (n = 12), low back pain (n = 7), and hip flexion with a psoas sign (n = 8) were the main clinical manifestations. Ultrasonography was done in all 12 patients and computed tomography in ten. Cultures of pus specimens were performed in 11 patients and yielded Staphylococcus aureus in eight, Escherichia coli in two, and Proteus mirabilis in one. All patients were given antimicrobials. The abscess was drained surgically in seven patients and percutaneously in six. The short-term outcome was favorable in every case. An unusual characteristic of our series was the large proportion of patients with abscesses secondary to renal or osteoarticular infections. Nonsurgical treatment was effective in five of six patients.

Les abces de la rate sont rares. Ils representent 2 a 5,4 % des suppurations intra-abdominales. Ils sont secondaires a une dissemination par voie sanguine au cours d'une septicemie ou endocardite, a une surinfection d'un infarctus ou hematome post-traumatique ou a la propagation d'un processus infectieux de voisinage. Les hemoglobinopathies, le diabete et les etats d'immuno-depression constituent les principaux facteurs favorisants. Par le passe, les abces de la rate etaient souvent de decouverte autopsique en raison de leur symptomatologie clinique souvent discrete et non specifique. Le diagnostic doit etre evoque devant une splenomegalie douloureuse et febrile. Staphylococcus aureus, les streptocoques et les bacilles Gram negatif sont les germes les plus frequemment en cause. Le diagnostic des abces de la rate est devenu facile grâce a l'echographie et la tomodensitometrie. Ces examens confirment rapidement le diagnostic, permettent de guider une ponction et/ou un drainage percutanes et de suivre l'evolution. La ponction et le drainage percutanes associes a une antibiotherapie adaptee permettent souvent la guerison. La splenectomie est indiquee en cas d'echec du drainage percutane.

Nous avons analyse de facon retrospective 13 observations de malades atteints d'un abces du psoas a pyogenes. L'abces etait primitif dans 5 cas (38,5 %) et secondaire dans 8 cas (61,5 %). Une fievre (n = 12), une douleur lombaire (n = 7) et un psoitis (n = 8) etaient les principaux signes cliniques. Tous les malades ont ete explores par echographie et 10 par tomodensitometrie. La culture du pus de l'abces preleve chez 11 malades a permis d'isoler 8 Staphylococcus aurens, 2 Escherichia coli et 1 Proteus mirabilis. Dans tous les cas, une antibiotherapie a ete prescrite associee a un traitement chirurgical dans 7 cas et a une ponction ou un drainage percutane dans 6 cas. L'evolution immediate a ete favorable dans tous les cas. Notre etude est particuliere par la frequence des abces du psoas secondaires a une infection renale ou osteo-articulaire. L'efficacite du traitement non chirurgical a ete confirmee chez 5 malades sur 6

The authors report a case of a thoraco-abdominal duplication of the foregut, observed in a 10-year old boy. Thoraco-abdominal duplication is an expression of notochordodysraphia, as it is frequently associated with vertebral malformations. Barium meal, ultrasonography and CT-Scan should provide a preoperative diagnosis. One-stage total excision in a single stage is mandatory in order to treat the symptoms and avoid the risks of further progression.

Intrathoracic extra-medullary hematopoiesis is a compensatory mechanism usually seen in thalassemia. The authors report a case with multiple mediastinal localisations fortuitously discovered. CT has allowed diagnosis and led percutaneous biopsy.

A case of tuberculosis of the greater trochanter was discovered upon investigations for a cold abscess in the thigh. Plain roent-genograms and computed tomography showed lysis of the greater trochanter and a fluid-filled mass in the soft tissues. Histologic examination of a bone specimen harvested during surgery confirmed the diagnosis of tuberculosis. Outcome was favorable under antituberculous therapy.

Mondini's malformation is a rare internal ear malformation. It's often discovered in childhood in the course of perception deafness check up, or repetitive meningitis in some other cases. The authors report a case of complex Mondini's malformation with fistulas of cerebro-spinal-fluid in oval and round windows, and stress the interest of high resolution computed tomography.

Histiocytosis X is an uncommon disease. Temporal bone involvement is a frequent head and neck manifestation. Most patients are under fifteen years of age. The authors report a case of a bilateral extensive temporal involvement complicated with vertigo and peripheric facial palsy. CT plays a dominant role in the diagnosis because of the ability to identify bone destruction, soft tissue involvement and intra-cranial histiocytosis more accurately.

Mondini's malformation is a rare internal ear malformation. It's often discovered in childhood in the course of perception deafness check up, or repetitive meningitis in some other cases. The authors report a case of complex Mondini's malformation with fistulas of cerebro-spinal-fluid in oval and round windows, and stress the interest of high resolution computed tomography.