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Öğe Assessment of myocardial changes in athletes with native T1 mapping and cardiac functional evaluation using 3 T MRI(Springer, 2016) Gormeli, Cemile Ayse; Gormeli, Gokay; Yagmur, Julide; Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagar; Colak, Cemil; Ozdemir, RamazanIntensive physical exercise leads to increases in left ventricular muscle mass and wall thickness. Cardiac magnetic resonance imaging allows the assessment of functional and morphological changes in an athlete's heart. In addition, a native T1 mapping technique has been suggested as a non-contrast method to detect myocardial fibrosis. The aim of this study was to show the correlation between athletes' cardiac modifications and myocardial fibrosis with a native T1 mapping technique. A total of 41 healthy non-athletic control subjects and 46 athletes underwent CMR imaging. After the functional and morphological assessments, native T1 mapping was performed in all subjects using 3.0 T magnetic resonance imaging. Most of the CMR findings were significantly higher in athletes who had a parts per thousand yen5 years of sports activity when compared with non-athletic controls and athletes who had < 5 years of sports activity. Significantly higher results were shown in native T1 values in athletes who had < 5 years of sports activity, but there were no significant differences in the left ventricular end-diastolic volume, left ventricular end-diastolic mass, or interventricular septal wall thickness between non-athletic controls and athletes who had < 5 years of sports activity. The native T1 mapping technique has the potential to discriminate myocardial fibrotic changes in athletes when compared to a normal myocardium. The T1 mapping method might be a feasible technique to evaluate athletes because it does not involve contrast, is non-invasive and allows for easy evaluation of myocardial remodeling.Öğe Attritional rupture of the extensor pollicis longus tendon due to calcified extensor carpi radialistendon group: a case report(Turkısh joınt dıseases foundatıon, bugday sokak 6-27, kavaklıdere, ankara 06700, turkey, 2017) Ertem, Kadir; Ozdemir, Zeynep Maras; Gormeli, Gokay; Koroglu, MuhammedIn this article, we report a case with spontaneous rupture of extensor pollicis longus tendon due to calcified extensor carpi radialis tendon group, which has not been published in the literature previously. Successful thumb extension was achieved in a 68-year-old male patient with the transfer of the extensor indicis proprius tendon at two months postoperatively. It appears that calcified extensor carpi radialis tendon group constitutes high risk for a possible attritional rupture of the extensor pollicis longus tendon.Öğe Bilateral thigh abscess due to rectal fistula: A rare case report with silent clinical presentation(2023) Koroglu, Muhammed; Dalda, Yasin; Ozdes, Huseyin Utku; Ozdemir, Zeynep Maras; Aslanturk, OkanA 53-year-old male patient who underwent a rectal cancer operation nine years ago was evaluated with complaints of pain and swelling in the lateral thigh. Radiological imaging revealed abscess foci in the right thigh muscles. Surgical drainage and debridement were performed but developed recurrence. Contrast-enhanced abdominal tomography was performed due to a positive medical history and it was seen that an enterocutaneous fistula was formed from the anastomosis site of previous cancer surgery to both sides of the thigh. Bilateral thigh abscesses were drained and radical debridement was performed in the same session with surgery for the fistula. Pathological examination of the surgical specimens showed no evidence of cancer and the patient was discharged on the 14th postoperative day with complete resolution of the infection. Hip abscesses are rare, delays in the diagnosis and treatment of the underlying cause in cases of abscess secondary to abdominal or pelvic pathologies lead to an increase in mortality. Therefore, it should be kept in mind that thigh abscesses may be another side of the coin besides being seen as an isolated infection.Öğe Cerebrospinal Fluid Dynamics in Patients with Multiple Sclerosis: The Role of Phase-Contrast MRI in the Differential Diagnosis of Active and Chronic Disease(Korean Radiological Soc, 2018) Oner, Serkan; Kahraman, Aysegul Sagir; Ozcan, Cemal; Ozdemir, Zeynep Maras; Unlu, Serkan; Kamisli, Ozden; Oner, ZulalObjective: Multiple sclerosis (MS) is an inflammatory disease characterized by demyelinating plaques in the white matter. Chronic cerebrospinal venous insufficiency (CCSVI) has been proposed as a new hypothesis for the etiopathogenesis of MS disease. MS-CCSVI includes a significant decrease of cerebrospinal fluid (CSF) flow through the cerebral aqueduct secondary to an impaired venous outflow from the central nervous system. This study aimed to determine whether CSF flow dynamics are affected in MS patients and the contributions to differential diagnosis in active and chronic disease using phase-contrast magnetic resonance imaging (PC-MRI). Materials and Methods: We studied 16 MS patients with chronic plaques (group 1), 16 MS patients with active plaques-enhanced on MRI (group 2), and 16 healthy controls (group 3). Quantitatively evaluation of the CSF flow was performed from the level of the cerebral aqueduct by PC-MRI. According to heart rates, 14-30 images were obtained in a cardiac cycle. Cardiac triggering was performed prospectively using finger plethysmography. Results: No statistically significant difference was found between the groups regarding average velocity, net forward volume and the average flow (p > 0.05). Compared with the controls, group 1 and group 2, showed a higher peak velocity (5.5 +/- 1.4, 4.9 +/- 1.0, and 4.3 +/- 1.3 cm/sec, respectively; p = 0.040), aqueductal area (5.0 +/- 1.3, 4.1 +/- 1.5, and 3.1 +/- 1.2 mm(2), respectively; p = 0.002), forward volume (0.039 +/- 0.016, 0.031 +/- 0.013, and 0.021 +/- 0.010 mL, respectively; p = 0.002) and reverse volume (0.027 +/- 0.016, 0.018 +/- 0.009, and 0.012 +/- 0.006 mL, respectively; p = 0.000). There were no statistical significance between the MS patients with chronic plaques and active plaques except for reverse volume. The MS patients with chronic plaques showed a significantly higher reverse volume (p = 0.000). Conclusion: This study indicated that CSF flow is affected in MS patients, contrary to the hypothesis that CCSVI-induced CSF flow decreases in MS patients. These findings may be explained by atrophy-dependent ventricular dilatation, which may occur at every stage of MS.Öğe Cerebrotendinous Xanthomatosis patients with late diagnosed in single orthopedic clinic: two novel variants in the CYP27A1 gene(Bmc, 2024) Koroglu, Muhammed; Karakaplan, Mustafa; Gunduz, Enes; Kesriklioglu, Betul; Ergen, Emre; Aslanturk, Okan; Ozdemir, Zeynep MarasBackground Cerebrotendinous Xanthomatosis (CTX) is a rare autosomal recessive lipid storage disorder caused by loss of function variants in the CYP27A1 gene which encodes sterol 27-hydroxylase, on chromosome 2q35. Although the symptoms begin commonly in infancy, CTX diagnosis is often delayed. The aim of this study is to review the orthopedic findings of the disease by providing an overview of the clinical features of the disease. It is to raise awareness of this condition for which early diagnosis and treatment are important. Methods We retrospectively evaluated the clinical, laboratory, radiological, and genetic findings of eight patients from four families who were admitted to our Orthopedics and Traumatology Department between 2017 and 2022 due to bilateral Achilles tendon xanthomas, were found to have high cholestanol and CYP27A1 gene mutations. Results The mean age of patients was 37, and five of them were male. The mean age at the onset of symptoms was 9.25 years. The mean age of initial diagnosis was 33.75 years. Between symptom onset and clinical diagnosis, an average delay of 24.5 years was observed. All patients had bilateral Achilles tendon xanthoma. Notably, a novel variant (c.670_671delAA) in CYP27A1 gene was identified in three patients who also presented with peripheral neuropathy and bilateral pes cavus. One patient had osteoporosis and four patients had osteopenia. Five patients had a history of bilateral cataracts. Furthermore, three of the patients had early-onset chronic diarrhea and three of the patients had ataxia. Two of the patients had epilepsy and seven of the patients had behavior-personality disorder. All patients had low intelligence, but none of them had cardiac disease. Conclusion We present the diagnostic process and clinical features which the largest CTX case series ever reported from single orthopedic clinic. We suggest that patients with normal cholesterol levels presenting with xanthoma being genetically analyzed by testing at their serum cholestanol level, and that all siblings of patients diagnosed with CTX be examined.Öğe A Comparison of Dual-Energy CT with MRI in the Detection of Traumatic Bone Marrow Edema in Distal Extremity Bones(Erciyes Univ Sch Medicine, 2023) Kaya, Ahmet Turan; Ozdemir, Zeynep Maras; Erbay, Mehmet Fatih; Kahraman, Aysgul Sagir; Karaca, Leyla; Karakaplan, Mustafa; Gurbuz, SukruObjective: Our objective was to evaluate the performance of dual-energy computed tomography (DECT) in detecting post-traumatic bone marrow edema (BME) in distal extremities.Materials and Methods: We prospectively studied 31 consecutive patients (25 males) who presented within the first four weeks following distal extremity traumas (wrist, n=19; ankle, n=14) (protocol number: 2017/74). All patients underwent DECT and magnetic resonance imaging (MRI) within three days of presentation. Two independent radiologists analyzed DECT images for fractures and BME qualitatively. Computed tomography (CT) numbers on Virtual non-calcium (VNCa) images were obtained in both edematous and non-edematous areas for quantitative consensus assessment. We used MRI as a reference standard. Results: MRI identified BME in 56/71 bones (78.9%). The rates of BME detection on CT compared to MRI at the patient level were found to be statistically significantly lower, ex-cept for individuals over 40 years of age, women, those with 7-30 days between trauma and admission, and those with CT-detected fractures (p<0.05). The rates of BME detection on CT at the bone level, compared to MRI, were found to be statistically significantly lower (p<0.01), except for women and those with fractures detected on CT. The interobserver agreement for the qualitative analysis of BME was fair (kappa=0.407 and p<0.001). DECT's diagnostic accuracy rates in predicting BME were significantly higher in patients with fractures (p=0.028). CT numbers in edematous areas were significantly higher than in non-edematous areas (p<0.001).Conclusion: DECT may serve as an alternative for detecting post-traumatic BME in distal extremity bones. However, in our heterogeneous bone sample group, it exhibited low sensitivity and a low negative predictive value.Öğe Comparison of myocardial bridging prevalence using 64-slice versus 256-slice computed tomography scanners: What has changed with recent innovations in CT?(Scientific Publishers India, 2016) Gormeli, Cemile Ayse; Yagmur, Julide; Ozdemir, Ramazan; Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Colak, CemilObjective: To compare the incidence and appearance of myocardial bridging (MB) by computed tomography (CT) angiography using 64-slice versus 256-slice CT. Methods: In total, 775 consecutive patients who underwent coronary CT angiography were evaluated using a 64-slice or a 128x2-slice dual-source scanner. Results: The prevalence of MB was 13.9% using 64-slice-CT and 31.5% using 256-slice-CT. The superficial type of MB segments was detected three times more frequently by 256-slice-CT. Conclusions: A higher prevalence of MB and the superficial type of bridging were revealed with the 256-slice-CT scanner. Advances in CT technology may enable detection and potentially prevent the unwanted effects of MB.Öğe Congenital Agenesis of Right Internal Carotid Artery: A Report of Two Cases(Ubiquity Press Ltd, 2016) Kahraman, Aysegul Sagir; Kahraman, Bayram; Ozdemir, Zeynep Maras; Dogan, Metin; Kaya, Mehmet; Gormeli, Cemile Ayse; Durak, Mehmet AkifCongenital unilateral agenesis of the internal carotid artery (ICA) is a rare anomaly. Due to proper sufficient collateral circulation via the circle of Willis most cases are asymptomatic, but patients can also present with ischemic or hemorrhagic cerebrovascular insults. The absence of the bony carotid canal is essential to differentiate this anomaly from chronic ICA occlusion. Awareness of this situation by clinicians and radiologists is essential because these patients have an increased incidence of various intracranial pathologies. We report two cases of this rare developmental congenital abnormality occurring in two young patients and describe the presentation, diagnosis, determined developmental causes, imaging findings, and complications.Öğe A critical overview of the imaging arm of the ASAS criteria for diagnosing axial spondyloarthritis: what the radiologist should know(Turkish Soc Radiology, 2012) Aydingoz, Ustun; Yildiz, Adalet Elcin; Ozdemir, Zeynep Maras; Yildirim, Seray Akcalar; Erkus, Figen; Ergen, Fatma BilgeThe Assessment in SpondyloArthritis international Society (ASAS) defined new criteria in 2009 for the classification of axial spondyloaithritis (SpA) in patients with >= 3 months of back pain who were aged <45 years at the onset of back pain. This represents a culmination of a number of efforts in the last 30 years starting with the 1984 modified New York criteria for ankylosing spondylitis, followed by the 1990 Amor criteria and the 1991 European Spondyloarthropathy Study Group criteria for SpA. The importance of new ASAS criteria for radiologists is that magnetic resonance imaging (MRI) takes center stage and is one of the major criteria for the diagnosis of axial SpA when active (or acute) inflammation is present on MRI that is highly suggestive of sacroiliitis associated with SpA. According to the new criteria, sacroiliitis on imaging plus >= 1 SpA features (such as inflammatory back pain, arthritis, heel enthesitis, uveitis, dactylitis, psoriasis, Crohn's disease/colitis, good response to non-steroidal anti-inflammatory drugs, family history for SpA, HLA-B27 positivity, or elevated C-reactive protein) is sufficient to make the diagnosis of axial SpA. A number of rules and pitfalls, however, are present in the diagnosis of active sacroiliitis on MRI. These points are highlighted in this review, and a potential shortcoming of the imaging arm of the ASAS criteria is addressed.Öğe Demystifying ABER (ABduction and External Rotation) sequence in shoulder MR arthrography(Aves, 2014) Aydingoz, Ustun; Ozdemir, Zeynep Maras; Ergen, Fatma BilgeABduction and External Rotation (ABER) sequence in magnetic resonance (MR) arthrography of the shoulder is particularly important to better depict abnormal conditions of some glenohumeral joint structures and surrounding tissues by making imaging possible under a stress position relevant to pathologic conditions. Among the structures and tissues better depicted in this position are articular surface of the supraspinatus tendon, anteroinferior portion of the glenoid labrum, and anterior band of the inferior glenohumeral band. Despite these benefits of the ABER sequence, it is either not being used extensively as part of shoulder MR arthrograms or, when utilized, not properly assessed, mostly due to some practical difficulties in setting up the sequence and unfamiliarity with the alignment of structures displayed on MR images. In this technical note, we aimed to explain the ABER sequence planning in a step-by-step manner with emphasis on scout series set-up, and also present an outline of anatomic landmarks seen on ABER images.Öğe Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values(Springer, 2016) Kahraman, Aysegul Sagir; Kahraman, Bayram; Ozdemir, Zeynep Maras; Gormeli, Cemile Ayse; Ozdemir, Fatih; Dogan, MetinPurpose: The aim of this study was to determine the correlation between the liver and spleen apparent diffusion coefficient (ADC) values of patients with chronic liver disease and the presence and the degree of ascites. Materials and method: In this retrospective study, we assessed 107 patients with chronic liver disease and 39 control subjects who underwent upper abdominal MR imaging including echo-planar diffusion-weighted imaging (DWI). Among the 107 cirrhotic patients, 56 were classified as group 1, 25 as group 2, and 26 as group 3 according to the absence, the presence of minimal, and the presence of massive ascites, respectively. The scores of model for end-stage liver disease (MELD) were matched between groups as the standard reference. The liver ADC, spleen ADC, and normalized liver ADC values were compared between the control group and patients' groups. Results: Patients with massive ascites had significantly higher MELD score compared with the other groups. The MELD score was also significantly higher in patient groups than in control group. The liver and normalized liver ADCs of patients' groups were significantly lower than that of the control group. With some overlap among groups, the measured ADC values decreased as the amount of the ascites increased, and these relationships were statistically significant. Furthermore, compared to control group, patients with massive ascites had significantly higher spleen ADCs. Conclusion: Our results indicate that the ADC value of the liver and spleen correlates with the presence and the degree of ascites in patients with chronic liver disease, and merits further study.Öğe The evaluation of non-ischemic dilated cardiomyopathy with T1 mapping and ECV methods using 3T cardiac MRI(Springer-Verlag Italia Srl, 2017) Gormeli, Cemile Ayse; Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Yagmur, Julide; Ozdemir, Ramazan; Colak, CemilThe aim of this study was to examine the correlation between ventricular function and the extracellular volume fraction (ECV) in patients with non-ischemic dilated cardiomyopathy (NIDCM) using 3.0 T magnetic resonance imaging (MRI). We also hypothesized that native T1 and ECV values would be increased in patients with NIDCM, independent of the left ventricular ejection fraction (LVEF). The findings of our study could lead to further studies of the follow-up protocols. In total, 53 consecutive dilated cardiomyopathy patients who had undergone cardiac MRI were functionally evaluated and underwent tissue characterization. The mean native T1 value was 1235 +/- 10 ms, and the mean ECV value was 35.4 +/- 2.7% in the myocardia. The LVEF values ranged from 29 to 44%. No significant correlations were observed between functional analysis measurements and native T1 or ECV values. Our results showed that myocardial fibrosis is unrelated to cardiac functional findings in NIDCM patients. Therefore, we propose that these patients should be evaluated using MRI and tissue characterization techniques, in addition to cardiac functional analysis.Öğe Image-Guided Percutaneous Bone Biopsy with a Simulated Van Sonnenberg Removable Hub System(Aves, 2015) Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Baysal, Tamer; Kutlu, Ramazan; Ozturk, Mehmet Halil; Hekimoglu, Baki; Guvercinci, MeltemObjective: To retrospectively examine the success and complication rates associated with image-guided percutaneous bone biopsy with a simulated Van Sonnenberg removable hub system. Materials and Methods: During a 3.5-year period, 27 bone lesions at different anatomic locations with an indication for biopsy based on plain film, computed tomography (CT) and/or magnetic resonance imaging (MRI) findings were determined, and a total of 28 image-guided (fluoroscopy or CT) percutaneous biopsies were performed using a simulated Van Sonnenberg -removable hub system. This technique entailed the use of a cut-out Chiba needle hub that performed as a guide for the insertion of a larger needle. Either core and aspiration biopsy or core biopsy alone was utilized. Results: The procedure yielded diagnostic material 89% of the cases (48% infection, 22% benign lesions, and 19% malignant lesions). Combined use of core and aspiration biopsy resulted in a higher diagnostic accuracy as compared to core biopsy alone. No false positive or false negative diagnoses were observed. No serious complications such as neurological deficits, bleeding, or organ injury were observed. Conclusion: The simulated Van Sonnenberg removable hub system provides a useful technique for percutaneous bone biopsies and is particulary suitable for deep seated (such as vertebral) lesions with its ability to facilitate the accessibility of the lesion with its built-in guidance needle. The procedure is safe in light of the literature data.Öğe Ischiofemoral Space on MRI in an Asymptomatic Population: Normative Width Measurements and Soft Tissue Signal Variations(Springer, 2015) Ozdemir, Zeynep Maras; Aydingoz, Ustun; Gormeli, Cemile Ayse; Kahraman, Aysegul SagirTo make normative width measurements of the ischiofemoral (IF) space in an asymptomatic population and to record soft tissue MRI signal variations within the IF space in order to determine whether such variations are associated with IF space dimensions. Normative width measurements of the IF space were prospectively made in 418 hips on 1.5 T MR images of 209 asymptomatic volunteers. Quantitative and qualitative assessments of the IF soft tissues including the quadratus femoris (QF) muscle were also made. The mean IF space width was 2.56 +/- 0.75 cm (right, 2.60 +/- 0.75 cm; left, 2.53 +/- 0.75 cm). Soft tissue MRI signal abnormalities were present within the IF space in 19 (9.1 %) of 209 volunteers. Soft tissue abnormalities within the IF space included oedema (3/209, 1.4 %) of the QF and/or surrounding soft tissue, and only fatty infiltration (16/209, 7.7 %) of the QF. Bilateral IF spaces are asymmetrical in asymptomatic persons. There is a parts per thousand yen10 % of width difference between right and left IF spaces in approximately half of asymptomatic individuals. Fatty infiltration and oedema can be present at the IF space in a small portion of the asymptomatic population, who also have narrower IF spaces than those without soft tissue MRI signal abnormalities. aEuro cent Bilateral IF spaces are commonly asymmetrical in asymptomatic individuals. aEuro cent MRI signal abnormalities can be observed within IF space in asymptomatic people. aEuro cent Abnormal quantitative/qualitative MRI findings are not necessarily related to IF impingement.Öğe Isolated Tuberculosis of Capitate and Triquetrum(Thieme Medical Publ Inc, 2017) Karakaplan, Mustafa; Koroglu, Muhammed; Ergen, Emre; Aslanturk, Okan; Ozdemir, Zeynep Maras; Ertem, KadirMusculoskeletal system is involved in about 20% of the patients diagnosed with tuberculosis. Although musculoskeletal tuberculosis generally affects spine and large joints (hip and knee), hand involvement of the tuberculosis is seen in 10% of the patients with musculoskeletal involvement and also isolated tuberculosis of hand or wrist is much rarer. In the following report, we discuss the case of a 23-year-old male patient who was diagnosed with isolated tuberculosis of the capitate and triquetrum bone. The patient presented with a nonhealing sinus on the left wrist joint. Imaging revealed lytic lesions of the capitate and triquetrum. The diagnosis of tuberculosis was confirmed by histopathological examination on the bone specimen obtained from the debridement and curettage. Antituberculosis therapy was started postoperatively and 1month later, healing of the sinus was observed. There was no sign of reactivation seen at follow-up 22 months after treatment.Öğe Langerhans Cell Histiocytosis with Atypical Intervertebral Disc and Sacroiliac Joint Involvement Mimicking Osteoarticular Tuberculosis in an Adult(Aves, buyukdere cad 105-9, mecıdıyekoy, sıslı, ıstanbul 34394, turkey, 2016) Ozdemir, Zeynep Maras; Kahraman, Aysegul Sagir; Gormeli, Cemile Ayse; Sevimli, Resit; Akpolat, NusretBackground: Langerhans cell histiocytosis (LCH), typically found in children, is a rare single or multisystem disorder with a wide range of clinical and radiological manifestations. Unusual presentations of LCH are occasionally encountered and it may be difficult to distinguish LCH from an infection or a benign or malignant tumor. Results: A 35-year-old female presented with pain in her back and left buttock, malaise, and weight loss, with a duration of several months. Her laboratory test results were within the normal ranges except for the levels of acute phase reactants, which were elevated. Magnetic resonance imaging and computed tomography revealed a unilateral destructive sacroiliac lesion, and multiple vertebral lesions with adjacent discal involvement and extensive soft tissue extensions. She was initially misdiagnosed with multifocal osteoarticular tuberculosis. An open biopsy and joint curettage was performed. Histopathological examination showed that she had LCH. Conclusion: To the best of our knowledge, this is the first case of LCH associated with a destructive unilateral sacroiliac lesion, discal involvement, and involvement of the adjacent vertebrae, in an adult patient; the LCH mimicked osteoarticular tuberculosis. Disease onset in adulthood is rare, and this can potentially delay diagnosis. Familiarity with the imaging features of unusual LCH manifestations is necessary to ensure accurate diagnosis and appropriate treatment.Öğe MRI of lower extremity impingement and friction syndromes in children(Aves, buyukdere cad 105-9, mecıdıyekoy, sıslı, ıstanbul 34394, turkey, 2016) Aydingoz, Ustun; Ozdemir, Zeynep Maras; Gunes, Altan; Ergen, Fatma BilgeAlthough generally more common in adults, lower extremity impingement and friction syndromes are also observed in the pediatric age group. Encompassing femoroacetabular impingement, iliopsoas impingement, subspine impingement, and ischiofemoral impingement around the hip; patellar tendon-lateral femoral condyle friction syndrome; iliotibial band friction syndrome; and medial synovial plica syndrome in the knee as well as talocalcaneal impingement on the hindfoot, these syndromes frequently cause pain and may mimic other, and occasionally more ominous, conditions in children. Magnetic resonance imaging (MRI) plays a key role in the diagnosis of musculoskeletal impingement and friction syndromes. Iliopsoas, subspine, and ischiofemoral impingements have been recently described, while some features of femoroacetabular and talocalcaneal impingements have recently gained increased relevance in the pediatric population. Fellowship-trained pediatric radiologists and radiologists with imaging workloads of exclusively or overwhelmingly pediatric patients (particularly those without a structured musculoskeletal imaging program as part of their imaging training) specifically need to be aware of these rare syndromes that mostly have quite characteristic imaging findings. This review highlights MRI features of lower extremity impingement and friction syndromes in children and provides updated pertinent pathophysiologic and clinical data.Öğe A Novel Physical Examination Test for Ischiofemoral Impingement: Validation With Magnetic Resonance Imaging Correlation(Lippincott Williams & Wilkins, 2021) Ozdemir, Zeynep Maras; Yildirim, Tulay; Karaca, Leyla; Kahraman, Aysegul Sagir; Aydingoz, UstunObjective The purpose of this study was to propose and validate a novel physical examination test for ischiofemoral impingement with magnetic resonance imaging (MRI) correlation. Methods We prospectively studied 24 women with buttock (deep gluteal) pain and 27 asymptomatic women. Each group underwent a 2-stage physical examination test that featured hip adduction-external rotation-extension and knee flexion. Visual analog scale pain scores were noted just before and during test stages on both sides. The MRI findings of the ischiofemoral impingement were evaluated quantitatively and qualitatively. Results Mean ages were 56.0 and 55.2 years (P = 0.797), and mean body mass indexes were 29.1 and 28.8 kg/m(2) (P = 0.817) in symptomatic and asymptomatic groups, respectively. Ischiofemoral spaces were significantly narrower (P < 0.001), ischial angles were wider (P < 0.001, right; P = 0.002, left), and soft tissue edema at the ischiofemoral space was more common (P < 0.001) in the symptomatic group, which also had higher pretest visual analog scale scores (P < 0.001) that increased significantly during both upright standing (P = 0.003, right; P < 0.001, left) and recumbent (P < 0.001 for both sides) stages of the physical examination test. Conclusions A novel physical examination test significantly increases symptoms of ischiofemoral impingement with positive MRI correlation.Öğe A patellar giant-cell tumor with soft tissue involvement: an alternative treatment method and review of the literature(Turkish Joint Diseases Foundation, 2015) Gormeli, Gokay; Gormeli, Cemile Ayse; Ozdemir, Zeynep Maras; Sevimli, Resit; Akpolat, NusretIn this article, we report a case of a giant-cell tumor of the patella which occurred in an atypical location with soft tissue involvement, which makes our case clinically and radiologically unique. A 24-year-old patient was admitted to our clinic with a complaint of anterior knee pain. Radiological examination and percutaneous fine needle biopsy showed a diagnosis of giant-cell tumor of the patella. The patient underwent patellectomy with en-bloc resection of the lesion with totally involved soft tissue components and the extensor mechanism was reconstructed with two Achilles allografts. After surgery, the diagnosis was confirmed by histopathological examination. At 12 months, the patient had no recurrence with 110 degrees flexion and 30 degrees extension of the range of motion of the knee. Lysholm knee score was 72. At 90 degrees/sec isokinetic muscle strength test, the muscle strength loss was found to be 51.1% in the extensor and 21.1% in the flexor, compared to non-involved knee. In conclusion, giant cell tumors are difficult to treat, as they are destructive lesions with high recurrence rates. Despite reduced range of motion and muscle strength, based on our study results, we believe that our surgical treatment modality may be an alternative for the treatment of patellar giant cell tumors.Öğe Radiological Findings of the Primary Female Urethral Malignant Melanoma: A Rare Case Report(Aves, 2019) Oner, Serkan; Erdem, Gulnur; Ozdemir, Zeynep Maras; Gunes, Ali; Unlu, SerkanPrimary malignant melanomas of the female urethra are rare tumors with poor prognosis. Biopsy of the detected urethral mass was performed in a 71-year-old woman who presented with hematuria and voiding dysfunction. No other localized lesions were detected. The patient was diagnosed with primary malignant melanoma of the urethra according to the histopathologic and immunohistochemical findings. Immunohistochemical staining revealed that the tumor cells were immunoreactive for vimentin, HMB-45, S-100, and Melan-A. The present study aimed to present radiological findings of very rare primary urethral malign melanoma with histopathologic correlation and to review the relevant literature.
