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Closed degloving injuries are uncommon, high-energy injuries that separate the bony structures from the soft tissue and frequently result in amputation. Because the epidermis is often intact, it is difficult to visualize the extent of the soft tissue damage. Although there is no gold standard of treatment for closed degloving injuries at present, previous cases have reported that neurovascular presentation is a key predictor of amputation Herein, we report a closed degloving injury involving the second through fifth phalanges of the left foot following a crushing injury with a forklift. Despite adequate capillary refill upon initial presentation, the patient ultimately underwent transmetatarsal amputation.

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RESUMEN Introducción: Las calcificaciones en tejidos blandos se refieren al depósito de sales de calcio en tejidos que no incluye el hueso; son un conjunto de imágenes radiopacas que se pueden identificar fácilmente en una imagen radiográfica, generalmente la panorámica, siendo esta una de las técnicas más utilizadas en la práctica odontológica; la presencia de estas calcificaciones, de acuerdo con la localización, forma, tamaño y número, presumirá el tipo de tejido blando calcificado. Objetivo: Identificar los tipos de calcificaciones en tejidos blandos, su descripción en una imagen de diagnóstico dental y su probable asociación con una enfermedad sistémica subyacente. Métodos: Estudio de tipo descripción narrativa de la literatura en el que se buscaron publicaciones en las bases de datos PubMed y Google Scholar de artículos relacionados con calcificaciones en tejidos blandos desde enero de 2014 hasta mayo de 2019. Se utilizaron términos como calcificación, radiografía panorámica, tejidos blandos, entre otros. Análisis e integración de la información: La revisión resume de forma detallada varios tipos de calcificaciones, su implicación clínica y aspectos imagenológicos. Conclusiones: Las calcificaciones en tejidos blandos son entidades que se identifican como hallazgos en técnicas de imágenes dentales y que en muchas ocasiones pasan desapercibidas, esta revisión recalca que, es responsabilidad del radiólogo bucal y maxilofacial la identificación e información de estas calcificaciones, sin embargo, los odontólogos generales deben también familiarizarse con este tipo de entidad y de la misma forma informar a los pacientes(AU)

ABSTRACT Introduction: Soft tissue calcifications are the accumulation of calcium salts in tissues other than bones. They are a set of radio-opacities easily identifiable on a radiographic image, generally the panoramic sort, this being one of the most commonly used techniques in dental practice. The presence of these calcifications in terms of their location, shape, size and number, will suggest the type of soft tissue calcified. Objective: Identify the types of soft tissue calcifications, their description on a dental diagnosis image and their probable association with an underlying systemic disease. Methods: A narrative literature review was conducted of papers about soft tissue calcifications published in the databases PubMed and Google Scholar from January 2014 to May 2019. The search terms used included "calcification", "panoramic radiograph" and "soft tissues", among others. Data analysis and integration: The review is a detailed summary of several types of calcifications, their clinical implication and imaging features. Conclusions: Soft tissue calcifications are conditions identified as findings of dental image techniques which often go unnoticed. The revision stresses that it is the responsibility of oral and maxillofacial radiologists to identify and report these calcifications. However, general dental practitioners should also familiarize themselves with this sort of condition and likewise inform the patients(AU)

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Objetivo: Describir las lesiones evaluadas por imágenes de los atletas que participaron en los Juegos Olímpicos de la Juventud Buenos Aires 2018. Materiales y Métodos: Se llevó a cabo un estudio descriptivo con una serie de 38 deportistas que participaron en los Juegos Olímpicos de la Juventud Buenos Aires 2018 y se sometieron a estudios por imágenes. Se analizaron los siguientes datos: distribución por sexo, edad, país, disciplina deportiva y hallazgos patológicos. Resultados: Se atendió a más deportistas mujeres (63,15%), la mayoría (31,57%) era de América del Sur. El atletismo fue la disciplina que más pacientes aportó (7 estudios). Predominaron las lesiones de los tejidos blandos de los miembros inferiores (51,51%). Conclusiones: Las atletas fueron quienes más se realizaron estudios por imágenes, y las lesiones más frecuentes fueron las de los tejidos blandos de los miembros inferiores. Nivel de Evidencia: IV

Objectives: To describe the sports-related injuries observed in young athletes that participated in the 2018 Youth Olympic Games in Buenos Aires. Materials and Methods: This was a descriptive study including 38 athletes that participated in the 2018 Youth Olympic Games in Buenos Aires and who were evaluated using imaging techniques. Athlete's distribution was analyzed by sex, age, sports activity and pathologic findings. Results: There were 4012 athletes that participated in the 2018 Youth Olympic Games in Buenos Aires, and, surprisingly, the number of male and female athletes was exactly the same. Injuries in female athletes were the most common (63.15%), most of them occurring in athletes of South American origin (31.57%). Athletics was the sport practiced by most patients (7 studies). Soft tissue injuries were most common in female athletes and mostly involved the lower limb (51.51%). Conclusions: The number of imaging studies carried out was higher in young female athletes, and the most common injuries were soft tissue injuries of the lower limb. Level of Evidence: IV

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OBJECTIVES: To describe in detail the anatomic distribution of acute hamstring injuries in football players, and to assess the relationship between location and extent of edema and tears, all based on findings from MRI. DESIGN: Retrospective observational study. METHODS: We included 275 consecutive male football players who had sustained acute hamstring injuries and had positive findings on MRI. For each subject, lesions were recorded at specific locations of the hamstring muscles, which were divided into proximal or distal: free tendon, myotendinous junction, muscle belly, and myofascial junction locations. For each lesion, we assessed the largest cross-sectional area of edema and/or tears. We calculated the prevalence of injuries by location. The relationships between locations and extent of edema and tears were assessed using a one-sample t-test, with significance set at p<0.05. RESULTS: The long head of biceps femoris (LHBF) was most commonly affected (56.5%). Overall, injuries were most common in the myotendinous junction and in proximal locations. The proximal myotendinous junction was associated with a greater extent of edema in the LHBF and semitendinosus (ST) muscles (p<0.05). Proximal locations in the LHBF had larger edema than distal locations (p<0.05). Distal locations in the ST muscle had larger tears than proximal locations (p<0.05). CONCLUSIONS: The proximal myotendinous junction (LHBF and ST muscles) and proximal locations (LHBF muscle) are more commonly affected and are associated with a greater extent of edema in acute hamstring muscle injury. Distal locations (ST muscle), however, seem to be more commonly associated with larger tears.

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PURPOSE: To determine the usefulness of different radiological methods in the diagnoses of wooden foreign bodies (FB). METHODS: Eleven adult chickens were used. Each thigh received a puncture wound and in one of them a wooden splinter was introduced and left in place while in the contralateral it was introduced and removed (control group). After 7 days the animals where killed and the legs removed to be analyzed with conventional radiography (CR), ultrasonography (US), magnetic resonance and computed tomography. The results were viewed by 2 independent senior radiologists. RESULTS: Sensitivity was: CR--13.6%; US--63.6%; MR--59.1%; and CT--72.7%, with specificity of 100%, 100%, 95.5%, and 95.5%, respectively. The positive predictive value for CR and US was 100%, 95% for CT 95% and 93.8% for MR. CT had a negative predictive value of 78.3%, while US, MR, and CR had 73.7%, 70.1%, and 53.7%, respectively. The accuracy for CT was 84.1%, followed by US--81.8%, RM--77.3%, and CR--56.8%. Inflammatory reaction was histologically demonstrated in all thighs containing FB. CONCLUSION: CR showed a poor performance to detect wooden FB in chickens, while US and CT seem to be the best option, followed by RM.

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A 25-year-old active-duty police officer was found to have an intra-articular foreign body on radiographic study of his left knee joint. He had a gunshot wound to the midthigh 54 months prior to the presentation of symptoms. The bullet was lodged in the soft tissue without involving neurovascular structures. The patient complained of limited range of motion of the joint and a "rattle" sensation of the knee. Arthroscopically, a deformed metallic foreign body was found and retrieved. There was no injury inside the joint related to the loose body. These findings were consistent with a migrating bullet from the midthigh to the knee joint. The patient recovered uneventfully and returned to work.

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BACKGROUND: Soft tissue foreign bodies are a frequent cause of consultation in emergency rooms. It is difficult to verify their existence since conventional radiology only detects radio opaque objects. Ultrasound can be a useful diagnostic procedure. AIM: To report our experience in the detection of soft tissue foreign bodies by ultrasound examination. PATIENTS AND METHODS: The ultrasonographic appearance of vegetables, glass and plastic, metal, bone and stones was studied in gelatin preparations. In a second stage, 52 patients (27 male, aged 3 to 88 years old) were studied, in whom the presence of a soft tissue foreign body was confirmed surgically. RESULTS: The mean error of the procedure for the assessment of foreign body size was 0.2 mm in vitro and 0.5 mm in vivo. The deepness and involved planes were correctly diagnosed in 96%, the number of fragments were diagnosed correctly in 94% of cases. The type of foreign body was identified correctly in 77% of cases and complications were detected in 100% of cases. CONCLUSIONS: Ultrasound is a sensitive and accurate method for the detection of soft tissue foreign bodies.

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A case of distal-third reconstruction of a leg with bone exposure is reported. A rectus abdominis muscle free flap, based on the inferior epigastric artery, was anastomosed to the distal stump of the anterior tibial artery with reversed flow. This technique is suggested as an option for microvascular reconstruction in the distal third of the leg. Anatomic and physiologic details are discussed.

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