Radiographic Appearance Research Articles

Early Femoral Insufficiency Fractures After Primary Total Knee Arthroplasty.

Periprosthetic femur fracture following total knee arthroplasty (TKA) is a devastating complication. Although trauma-related periprosthetic femur fractures have been well studied, early atraumatic insufficiency periprosthetic fractures (IPFs) are gaining attention. We present the largest IPF series to date to better understand and prevent this complication. A retrospective study of all patients who underwent a revision surgery for periprosthetic fracture within 6 months of primary TKA between 2007 and 2020 was performed. Patient demographics, preoperative radiographs, implant details, and fracture radiographs were reviewed. Alignment measurements and fracture characteristics were assessed. Sixteen patients met criteria (rate 0.05%), and 11 had posterior-stabilized TKAs. The mean age was 79 years, mean body mass index was 31 kg/m2, and 94% (15/16) were female. Seven (47%) patients had a confirmed history of osteoporosis. IPF occurred on average 4 weeks (range, 4 days-13 weeks) after the index TKA. Overall, 12 of 16 (73%) had preoperative valgus deformities, and 11 patients (10 valgus, 1 varus) had preoperative deformities >10 degrees. A characteristic radiographic appearance of femoral condylar impaction and collapse was noted in 12 of 16 cases (75%); 11 of these 12 fractures (92%) involved the unloaded compartment based on preoperative varus/valgus deformity. Patients who developed IPFs were most commonly elderly, obese women with osteoporosis and severe preoperative valgus deformities. The apparent mechanism of failure was overloading of previously unloaded osteopenic femoral condyle. In high-risk patients, the use of a cruciate-retaining femoral component or a femoral stem for a posterior-stabilized femur may be considered to help avoid this catastrophic complication.

183 Proposed Classification System of Radiographic Bone Changes After Cervical Disc Replacement

INTRODUCTION: Cervical Disc Replacement (CDR) is an increasingly utilized procedure to address cervical degenerative conditions, as an alternative to discectomy and fusion, for the purpose of preserving natural segmental motion. METHODS: Using serial radiographs from patients, a panel of experts assembled for the purpose of creating a classification system to aid in reproducibly and consistently identifying boney changes and assessing CDR device radiographic appearance. Subdividing the superior and inferior vertebral bodies into 3 equal sections, observed bone loss such as endplate rounding, cystic erosion adjacent to the endplate, and cystic erosion not adjacent to the endplate, is recorded. Determining if bone loss is progressive and estimating severity of bone loss (measured by the percentage of end plate involved) is recorded. Additional relevant boney changes and device observations include radiolucent lines, heterotopic ossification, loss of core implant height, and presence of device migration, subsidence, and olisthesis. RESULTS: Serial radiographs from 26 patients implanted with a variety of CDR products were assessed by 6 investigators including clinicians and scientists experienced in CDR or appendicular skeleton joint replacement. After several iterations, a classification system emerged that had improved concordance among the participating investigators. Next steps include assessing reliability with a broad group of clinicians, using serial radiographs from a significant number of patients, to confirm the proposed classification scheme. CONCLUSIONS: A standardized nomenclature for boney changes following CDR will facilitate accurate and reproducible scientific communications regarding the clinical outcomes of this procedure. The novel system proposed demonstrated good concordance among experienced investigators in this field and represents an important advancement.

The distal metatarsal articular angle in hallux valgus deformities. Comparisons of radiographic and weightbearing CT scan measurements with variations in hindfoot position

BackgroundWhen evaluating hallux valgus (HV) deformity with anteroposterior (AP) foot radiographs, the distal metatarsal articular angle (DMAA) has been the subject of frequent debate. Although a straightforward indicator of structural alignment of the distal first metatarsal articular surface, inter- and intraobserver measurements can vary widely. Alterations in the radiographic appearance of bony “structure” with positional changes of the foot/foot bones in HV deformities in no small part contributes to these inaccuracies. The aim of this study was to determine the effect of hindfoot position on the DMAA. MethodsFour different radiologic images were obtained for 15 subjects with HV: three AP foot radiographs (standard weightbearing, foot supinated, foot pronated) and one weightbearing CT (WBCT) scan. For each image, five investigators measured the DMAA in order to assess reliability. ResultsMean DMAA values measured from the images indicated that the angle was highest with the pronated foot (15.3 (95% CI, 10.3–20.3) degrees) and lowest when measured from the CT image (11.6 (95% CI, 7.3–16.0) degrees). For all image types, the intraclass correlation coefficient was greater than 0.9 and statistically significant (P < 0.0005). ConclusionHindfoot positions affected radiographic DMAA/mean DMAA values, with values highest with feet in pronated attitudes. Unlike radiographic projections, the WBCT appears less likely to overestimate DMAA and is not subject to variations in foot positioning. In the preoperative evaluation of HV deformities, this points to the potential use of WBCT as a reference standard. For markedly severe HV deformities that may present with AP radiographs with marked first metatarsal head “roundness,” the use of WBCT is the intuitive choice.The results indicate excellent reliability in measurements of DMAA between all five investigators. As such, the measurement method used to determine DMAA in this study was dependable and reproducible. Level of evidenceLevel II

Diagnostic validation and development of an algorithm for identification of intussusception in children using electronic health records of Ningbo city in China

ABSTRACTBackgroundMonitoring the risk of intussusception after the introduction of rotavirus vaccines is recommended by the World Health Organization (WHO). Although the validity of intussusception monitoring using electronic health records (EHRs) has been confirmed previously, no similar studies have been conducted in China. We aimed to verify the diagnosis and determine an algorithm with the best performance for identification of intussusception using Chinese EHR databases.Research design and methodsUsing the Regional Health Information Platform in Ningbo, patients aged 0–72 months from 2015 to 2021 with any related visits for intussusception were included. The algorithms were based on diagnostic codes or keywords in different clinical scenarios, and their performance was evaluated with positive predictive value (PPV) and sensitivity in line with the Brighton guidelines.ResultsBrighton level 1 intussusception was confirmed in 2958 patients with 3246 episodes. Fine-tuned algorithms combining the appearance of the relevant ICD-10 codes or the Chinese keyword ‘Chang Tao’ in any diagnostic reports with the results of enema treatments or related surgeries showed the highest sensitivity, while the highest PPV was obtained by further criteria based on typical radiographic appearances.ConclusionIntussusception could be identified and validated internally using EHRs in Ningbo.

Long-Term Outcomes and Return to Work After Isolated Coronal Shear Fractures of the Capitellum

The purpose of this study was to analyze the ability of patients to return to work after ORIF of isolated capitellar shear fractures and assess long-term functional outcomes. We retrospectively reviewed the cases of 18 patients with isolated capitellar shear fractures with or without lateral trochlear extension and investigated demographic data, occupation, worker's compensation status, injury characteristics, surgical details, motion, radiographic appearance at final in-person follow-up, complications, and return to work status via in-person and long-term telemedicine follow-ups. Final follow-up was at an average of 76.6 (7-222.6) months or 6.4 (0.58-18.6) years. Of the 14 patients working at the time of injury, 13 patients had returned to work at final clinical follow-up. The work status of the remaining patient was not documented. Mean elbow motion at final follow-up was 4° (range, 0-30) to 138° (range, 130-145) of flexion, 83° of supination, 83° of pronation. Two patients had complications that required reoperation but had no further complications. For the 13 of 18 patients with long-term telemedicine follow-up, the average Quick Disabilities of the Arm, Shoulder, and Hand score was 6.8 (0-25). In our series, rates of return to work were high after ORIF of coronal shear fractures of the capitellum with or without lateral trochlear extension. This was true across all occupational classes including manual labor, clerical, and professional. With anatomic restoration of articular congruity, stable internal fixation, and postoperative rehabilitation, these patients had excellent ROM and functional scores at an average of 7.9 years of follow-up. After ORIF of isolated capitellar shear fractures with or without lateral trochlear extension, patients can expect a high rate of return to work with excellent ROM and functionality and low long-term disability.

Prevalence and associated factors of delayed sputum smear conversion in patients treated for smear positive pulmonary tuberculosis: A retrospective follow up study in Sabah, Malaysia.

Tuberculosis remains a major health problem globally and in Malaysia, particularly in the state of Sabah. Delayed sputum conversion is associated with treatment failure, drug-resistant tuberculosis and mortality. We aimed to determine the prevalence of delayed sputum conversion among smear positive pulmonary tuberculosis (PTB) patients and its associated factors in Sabah, Malaysia. A retrospective follow up study on all patients newly diagnosed with smear positive pulmonary tuberculosis from 2017 to 2019 was conducted at three government health clinics in Sabah, utilizing data from a national electronic tuberculosis database and medical records. Descriptive statistics and binary logistic regression were applied for data analysis. The outcome of the study was the sputum conversion status at the end of the two-month intensive treatment phase with either successful conversion to smear negative or non-conversion. 374 patients were included in the analysis. Our patients were generally younger than 60 years old with no medical illness and varying proportions of tuberculosis severity as judged by radiographic appearance and sputum bacillary load upon diagnosis. Foreigners constituted 27.8% of our sample. 8.8% (confidence interval: 6.2-12.2) did not convert to smear negative at the end of the intensive phase. Binary logistic regression showed that older patients ≥60 years old (adjusted odds ratio, AOR = 4.303), foreigners (AOR = 3.184) and patients with higher sputum bacillary load at diagnosis [2+ (AOR = 5.061) and 3+ (AOR = 4.992)] were more likely to have delayed sputum smear conversion. The prevalence of delayed sputum conversion in our study was considerably low at 8.8% with age ≥60 years old, foreigners and higher pre-treatment sputum bacillary load associated with delayed conversion. Healthcare providers should take note of these factors and ensure the patients receive proper follow up treatment.

Incidentally Discovered Right Atrial Mass: A Rare and Unexpected Etiology

Primary cardiac sarcoma is a rare type of intracardiac mass. This report describes a patient with atrial flutter who had a new right atrial mass incidentally discovered on transesophageal echocardiography. A thrombus was suspected based on radiographic appearance, but there was minimal change with anticoagulation. The mass was resected and found to be an undifferentiated pleomorphic cardiac sarcoma, an uncommon sub-type within the already rare category of primary cardiac neoplasms. This report highlights the importance of considering primary malignancy and thoroughly correlating radiographic and clinical evidence during the diagnostic workup of patients with intracardiac masses.

Radiographic Appearance and Root Resorption Caused by Ameloblastoma in pts attending Teaching Institute of Dentistry

Background: Odontogenic tumors represent the heterogeneous organization of lesions with numerous histopathological characteristics and medical manifestations. Ameloblastoma is real neoplasm of odontogenic epithelium, constitute one percentage of oral complete ectodermal tumors &amp;9percentage of an odontogenic tumors4. This tumor is benign, which suggests the insidious slowly increase, regionally aggressive having excessive recurrence rate5 Aim: To evaluate radiographical features and root resorption among patients of Ameloblastoma reporting to Dept. of OMFS Study Design: Descriptive Cross-Sectional Study Place and duration of study: Department of Oral and Maxillofacial surgery, Multan Dental College Multan. Duration of this study was 2 years from 1st Jan 2021 to 31th Dec 2022. Methodology: A descriptive audit including all patient records with a histo-pathologically confirmed report of ameloblastoma based on the routine Hematoxylin and Eosin stain. Consecutive non-probability sampling technique was used. Results: One hundred and forty people with an ameloblastoma were contained within ours study amongst whom 45(32.1%) were female and 95(67.9%) were men. 123(87.9%) lesions were found in the mandible. Swelling was mostly told symptoms in 137(97.8%) of all cases. 76(54.3%) showed root resorption. Radiographically, the multilocular appearance accounted for 97(69.3%) while uni-loculancy was present in 43(30.7%) of the lesions. Practical implication: This study help in diagnosis of amelolastoma. This also guides the clinician to differentiate different forms of aelolastoma and differentially diagnose from other radiolucent lesions. Conclusion: This study pointed that ameloblastoma was seen more in men when compared with females Most cases showed root resorption. Mostly ameloblastomas were of multi-locular form/pattern with posterior are of lower jaw as most frequent site involved. Keywords: Ameloblastoma, features, radiolucency &amp; Multi-locular

CASE REPORT OF A RARE DISEASE : MELORHEOSTOSIS

Introduction: Melorheostosis is a rare, non-genetic, non-developmental, sclerosing developmental dysplasia of bone and adjacent soft tissue. The characteristic radiographic appearance is that of candle wax dripping. Diagnosis is usually based on classical radiographic appearance rather than clinical picture. A 26 year old female with Case report: dull aching pain over upper third left leg and knee with limitation in movements and associated swelling. On examination tenderness and limitation of movements were present. Plain radiograph showed extensive, dense, undulating or irregular cortical hyperostosis, resembling candle wax dripping along length of left tibia suggestive of Melorheostosis and MRI showed features of Osteopathica striata of left femur and Osteopoikilosis of left hip joint. Inj. Zolindronic acid given. Physiotherapy was started to avoid contractures. Lab investigations in Melorheostosis is usua Conclusion: lly normal. Exact pathophysiology of the disease remains uncertain. No curative treatment options are available. Bisphosphonates, Denosumab and physiotherapy are the available options for treatment.

Emphysematous gastritis in a patient with neutropenic sepsis: A case report and literature review with comment on management.

Emphysematous gastritis is a severe form of gastritis caused by gas-forming infectious organisms and is most frequently encountered in critically unwell patients. Diagnosis rests on the radiographic appearances of air within the gastric wall, which may extend into the portal venous system. Not previously described in the context of neutropenic sepsis, our case involves a 77-year-old patient with emphysematous gastritis who was admitted to the intensive care unit with a neutrophil count of 0.1 × 109/L and managed successfully with conservative treatment. Presenting complaints usually include abdominal pain, nausea, vomiting and occasionally haematemesis, in the context of systemic upset. Predisposing factors may include diabetes and immunosuppression, ingestion of corrosive substances, alcohol abuse, and abdominal surgery. The historical approach to management which previously involved urgent exploratory laparotomy with gastrectomy, has largely been replaced with conservative therapy, including broad-spectrum antimicrobials, gut rest and parenteral nutrition, with improved outcomes. Previously considered a commonly terminal diagnosis with mortality rates as high as 60%, this recent shift in approach to management has contributed to mortality rates being halved. The role of oesophago-gastro-duodenoscopy has not been established and is unlikely to be indicated in every case. Longterm complications may be of concern and include fibrosis and gastric contractures.

Calcium pyrophosphate deposition disease mimicking spinal neuroarthropathy.

A 75-year-old male with degenerative joint disease status-post T12-L5 fusion five years ago presented with new-onset left lower extremity weakness. He denied any sensory abnormalities, saddle anaesthesia, or dysfunction of the bladder or bowels. Physical examination was notable for 2/5 left quadriceps and gastrocnemius strength, compared with 5/5 on the right side. CT scan shows erosion and sclerosis of the T10 and T11 end plates with gas within the disk space, consistent with Charcot spinal neuroarthropathy (Fig. 1A). Due to the persistent neurological deficits, the epidural mass was resected and a dural patch graft was placed. Histopathology revealed fibrocartilaginous tissue fragments with degenerative changes and deposition of positively birefringent crystals consistent with calcium pyrophosphate deposition disease (CPPD) (Fig. 1B). One month after resection, the patient’s lower extremity weakness had fully resolved. CPPD can mimic many joint pathologies, including gout and osteoarthritis, in atypical locations. In this case, the radiographic appearance of destruction, debris, distention, disorganization, and density changes resembled Charcot neuroarthropathy but in an unexpected location without the typical antecedent sensory neuropathy [1]. This case illustrates that, when radiographic evidence seems to contradict clinical signs and symptoms of joint disease, clinicians should reserve a high index of suspicion for CPPD [2]. Informed consent has been obtained.

The True History of Cementoblastoma.

Cementoblastoma (CB) is unique among odontogenic tumors because its gross pathological anatomy is pathognomonic in most cases, i.e., a rounded calcified growth that is fused to the root of a tooth and completely encapsulated by fibrous tissue. The resulting radiographic appearance is a well-defined, globular mixed radiopaque/lucent or completely radiopaque mass obliterating some details of the root, with a thin radiolucent zone surrounding the central opacity. Although hundreds of publications have covered the clinicopathologic features of CB, almost nothing is known about its true history. Also it seems there is little understanding about how the term "CB" was originally introduced as a pathologic entity. This report covers some overlooked papers on CB dating back to the 19th century, including the first complete description in 1888 and the first radiographic presentation in 1906.

Lesser Tuberosity Osteotomy Healing in Stemmed and Stemless Anatomic Shoulder Arthroplasty Is Higher with a Tensionable Construct and Affected by Body Mass Index and Tobacco Use.

This study compared the healing rates of lesser tuberosity osteotomy (LTO) for anatomic total shoulder arthroplasty (TSA), repaired with either standard knot tying or a tensionable construct. Second, we evaluated LTO healing in stemmed and stemless prostheses and identified the patient characteristics associated with healing. An analysis of consecutive primary TSAs approached with an LTO performed by a single surgeon between 2016 and 2020 was conducted. In the first two years of the study period, the LTOs were repaired with four #2 polyblend sutures passed through drill tunnels and around a short press-fit stem, followed by manual knot tying. Subsequently, a tensionable construct with suture tapes (TCB) was universally adopted. The radiographic appearance of the LTO was evaluated at a minimum of six months postoperatively. A total of 340 patients met the study criteria, including 168 with manual knot tying, 84 TCB repairs with a stemmed implant, and 88 TCB repairs with a stemless implant. There was no difference in the baseline demographics between the groups. The LTO healing rate of the manual knot tying group (85%) was lower than that of the stemmed (95%) and stemless (98%) TCB groups (p < 0.001). When directly comparing the LTO healing between the stemmed and stemless TCB groups, the differences were not significant (p = 0.44). Across all constructs, the body mass index (BMI) was higher in the displaced nonunion group (p = 0.04), with a failure rate of 9.4% for a BMI between 30 and 40, 12.5% for a BMI between 40 and 50, and 28.6% for a BMI > 50. The rate of tobacco use was higher in the displaced nonunion group (p = 0.037). A tensionable construct improves LTO healing compared to manual knot tying, irrespective of the implant type. In addition to the surgical technique, the patient factors that influence tuberosity healing include a greater BMI and tobacco use. Level III, retrospective comparative study.

Evolution of Radiographic Changes of a Vascularized Pedicled Nasoseptal Flap after Endonasal Endoscopic Skull Base Surgery.

There is active research involving the radiographic appearance of the skull base following reconstruction. The purpose of this study was to describe the radiographic appearance of the vascularized pedicle nasoseptal flap after endoscopic skull base surgery across time. We performed chart and imaging review of all patients with intraoperative nasoseptal flap placement during endoscopic skull base surgery at a tertiary academic skull base surgery program between July 2018 and March 2021. All patients underwent immediate and delayed (>3 months) postoperative MR imaging. Primary outcome variables included flap and pedicle enhancement, flap thickness, and flap adherence to the skull base. Sixty-eight patients were included. Flap (P = .003) enhancement significantly increased with time. Mean nasoseptal flap thickness on immediate and delayed postoperative scans was 3.8 and 3.9 mm, respectively (P = .181). The nasoseptal flap adhered entirely to the skull base in 37 (54.4%) and 67 (98.5%) patients on immediate and delayed imaging, respectively (P < .001). Our findings demonstrate heterogeneity of the nasoseptal flap appearance after skull base reconstruction. While it is important for surgeons and radiologists to evaluate variations in flap appearance, the absence of enhancement and lack of adherence to the skull base on immediate postoperative imaging do not appear to predict reconstructive success and healing, with many flaps "self-adjusting" with time.

Characteristic yet unusual presentation of an odontogenic myxoma in the anterior mandible

Odontogenic myxoma (OM) is a rare benign odontogenic tumor characterized by stellate and spindle-shaped cells dispersed in an abundant myxoid extracellular matrix. The bony invasion by the tumor imparts a characteristic ‘soap bubble’, ‘honeycomb’, or ‘tennis racquet’ radiographic appearance to the lesion. The decision of adopting a conservative or radical approach also depends on various factors such as location, size, and duration of the lesion, and age, gender, and expectations of the patient. Therefore, adequate treatment planning is crucial for the management of cases of OM and varies on an individual basis. The present case report described the management of a case of unusually large OM occurring in a 31-year-old Indian female in the mandibular anterior region crossing the midline.

An In vitro, Nonexperimental, Exploratory Research for the Development of a Guidance System to Identify Dental Implant System Used in India Based on Their Radiographic Appearance

Introduction: Identifying an osseointegrated dental implant could become vitally important in case some other clinician tries to restore it and plays a vital role in forensic odontology. However, existing ways to identify them are very crude and nonspecific. In addition, they are not focusing on implants used frequently in India. Aims: The aim of this study was to design a guidance system to identify different implant systems and their subtypes used in India and to evaluate the efficiency of this guidance system to identify an unknown dental implant. Materials and Methods: Radiographs of the 15 most common dental implant systems used in India were analyzed and categorized based on their morphological appearance under the headings. Nontapered or tapered/threaded or not, neck design, thread length, shape, etc., were observed on intraoral periapical radiographs, and a guidance system in the form of a flow chart was made. Based on the flow chart, 15 randomized assessor-blinded radiographs were tested for the accuracy of the guidance system that was developed. The Chi-square test was used at a 95% confidence interval to determine the accuracy of the guidance system used for the identification of assessor-blinded radiographs. Results: The newly designed dental implant identification guidance system effectively identified 14 out of 15 unknown implant radiographs among implant systems and subtypes used in this study. Nonparametric Chi-square test was applied and the results were highly significant (P &lt; 0.05). Conclusions: The guidance system developed has the potential to identify the implant system mentioned in this study based on its radiographic appearance.

TREATMENT OF RECURRENT ANTERIOR SHOULDER DISLOCATION USING THE LATARJET TECHNIQUE.

To describe the functional results, recurrence rate, postoperative radiographic appearance, and complications of patients undergoing the Latarjet procedure over 24 months. Retrospective case series, including adult patients with recurrent traumatic anterior glenohumeral dislocation undergoing the Latarjet procedure. We clinically evaluated patients preoperatively by the Rowe score and at six, 12, and 24 months after the procedure. The positioning, consolidation, and resorption of the graft were analyzed by plain radiography. The recurrence rates and other complications were also described. We analyzed 40 patients (41 shoulders). The Rowe score median increased from 25 before surgery to 95 at 24 months after surgery (p < 0.001). We observed graft resorption in three cases (7.3%) and consolidation in 39 (95.1%). Most grafts presented adequate placement. We observed two recurrences (4.8%), one case of dislocation and one of subluxation. Seven patients (17.1%) had a positive apprehension test. The study had no cases of infection, neuropraxia, or graft breakage. Latarjet surgery is a safe and effective procedure in the treatment of recurrent anterior dislocation of the shoulder. This surgery enables a statistically significant improvement according to the Rowe score, with a low number of recurrences. Level of Evidence IV, Case Series.

Two cases of pneumomediastinum in full-term newborns after uncomplicated vaginal deliveries: Various etiologies and radiographic appearances

Pnemomediastinum is defined as the presence of aberrant air in the mediastinum, also known as mediastinal emphysema. Significant pneumomediastinum is rare, particularly in term neonates. It is usually related to the different predisposing factors such as birth injury, meconium aspiration, assisted ventilation or infectious diseases although it may occur idiopathically. Pneumomediastinum is one of the important causes of respiratory distress syndrome that should not be overlook in term neonates. The elevation of thymic lobes off the heart on plain view and the presence of retrosternal air collection on lateral view are crucial signs on chest x-rays that need to be assessed cautiously by radiologists and neonatologists. We report two cases of pneumomediastinum in term infants who presented with respiratory distress. One case was diagnosed as pneumomediastinum and assisted ventilation was supposed as a predisposing factor, the other case was diagnosed as spontaneous pneumomediastinum without underlying lung disease or predisposing factors. The definitive diagnosis was made by combination plain and lateral chest x-rays without further imaging method was required. Both patients received conservative treatment with close observation clinically and radiologically and were discharged after several days in good condition.

Radiographic Distribution as a Diagnostic Clue in Pulmonary Disease.

Because some disease processes produce radiographic abnormalities that occur in characteristic distributions in the chest, classifying the position and appearance of these suggestive features and the underlying diseases provides a tool by which diagnostic accuracy might be improved. The goal of this review is to offer to the chest clinician a taxonomy of these disease entities that can produce characteristic chest radiographic distributions. These radiographic distributions often reflect anatomic or physiologic conditions that drive the radiographic appearance; for example, foramen of Morgagni diaphragmatic hernias most commonly present in the right ventral chest, consistent with the anatomic location of the diaphragmatic foramen. This taxonomy includes 3 distributional categories: (1) upper versus lower lung zone-predominant processes, (2) central versus peripheral processes, and (3) processes with distinctive focal locations, eg, "photonegative appearance" as in chronic eosinophilic pneumonia. It is hoped that this taxonomy aids the chest clinician in generating and streamlining a differential diagnosis and in ascertaining the specific cause of diseases with radiographic abnormalities.

A rare case of Central Giant Cell Granuloma mimicking Solitary Bone Cyst

Background- Central giant cell granuloma is an uncommon benign tumor of jaws, most prevelant in anterior region of mandible. It has both aggressive and non aggressive nature and occurs in young adults.&#x0D; Case presentation - We present a case of a central giant cell granuloma in a 21 year old boy who presented with all the features of solitary bone cyst. Lesion was present in right body of mandible and diagnosis was made histopathologically followed by surgical enucleation.&#x0D; Conclusion - Our case demonstrates a rare clinical and radiographic appearance of central giant cell granuloma which was also an accidental finding. Prompt diagnosis and treatment plan can prevent further damage and improve outcome.&#x0D;