Image-guided percutaneous procedures have increasingly been established as safe and effective interventional tools in the diagnosis and management of masses and collections in several body segments. However, lesions in deep pelvic sites still pose a challenge for radiologists because of overlying anatomic structures. The success of a percutaneous biopsy depends on a safe access route planning based on a deep understanding of cross sectional anatomy of the pelvis. Anterior and lateral transabdominal, anterolateral extraperitoneal, transvaginal, transrectal and transgluteal approaches are described. The present study was aimed at reviewing the normal pelvic cross-sectional anatomy, demonstrating the different access routes for ultrasonography and computed tomography guided pelvic biopsies and drainages as well as discussing the main advantages and complications associated with these approaches.

Keywords: Biopsies, Percutaneous drainage, Interventional procedures, Pelvic anatomy, Pelvic abscesses

Verrucous carcinoma is a variant of squamous cell carcinoma seen in mucous membranes and skin, and rarely found in the hand. The present report describes a case of two lesions on the dorsum of the hand, with no contact to each other, which underwent en-block resection and were confirmed as verrucous carcinoma.

Keywords: Verrucous; Carcinoma; Spiculated; Sea-urchin; Squamous; Hand.

Focal bone lesions are not uncommon findings in the daily practice of radiology. Therefore, it is essential to differentiate between lesions with aggressive, malignant potential that require action and those that have no clinical significance, many of which are variants or benign lesions, sometimes self-limited and related to reactive processes. In some cases, a diagnostic error can have catastrophic results. For example, a biopsy performed in a patient with myositis ossificans can lead to an incorrect diagnosis of sarcomatous lesions and consequently to mutilating surgical procedures. The present study reviews the main radiological aspects of the lesions that are most commonly seen in daily practice and have the potential to be confused with aggressive, malignant bone processes. We also illustrate these entities by presenting cases seen at our institution.

Keywords: Bone diseases; Muscular diseases; Diagnostic imaging; Myositis ossificans; Bone neoplasms.

The term avascular necrosis describes any one of a number of bone diseases that have a common mechanism: the death of bone components due to lack of blood supply. Avascular necrosis can occur in diverse parts of the skeleton, each location-specific form not only receiving a distinct designation but also presenting unique epidemiologic characteristics. However, the imaging findings are similar in all of the forms, which pass through well-described radiological phases, regardless of the site of involvement. Because avascular necrosis can cause considerable morbidity if not properly detected and managed, the radiologist plays a fundamental role. The present study provides a brief review of the main radiological aspects of the various forms of avascular necrosis, illustrated on the basis of a collection of cases from our institution.

Keywords: Osteonecrosis/diagnostic imaging; Radiography; Tomography, X-ray computed; Magnetic resonance imaging.

Snapping scapula syndrome manifests as an audible or palpable crackling during the sliding movements of the scapula over the rib cage, often perceived during physical or professional activities. It can be caused by morphological alteration of the scapula and rib cage, by an imbalance in periscapular musculature forces (dyskinesia), or by neoplasia (bone tumors or soft tissue tumors). In this pictorial essay, we review the main causes of snapping scapula syndrome, exemplified by a collection of didactic cases.

Keywords: Scapula; Joint diseases/diagnostic imaging; Shoulder.

Hip arthroplasty is a widely used and successful orthopedic procedure for the treatment of degenerative, inflammatory, or traumatic joint disease. The procedure promotes significant pain relief, as well as recovery of limb function, reduction of disability, and better quality of life. However, there are related complications, which have characteristic imaging aspects. In the present study, we review the literature and exemplify such complications using images obtained at our facility, illustrating the main radiological aspects of complications such as heterotopic ossification, periprosthetic fractures, osteolysis, infection, wear, and dislocation.

Keywords: Hip joint/physiopathology; Hip joint/diagnostic imaging; Arthroplasty, replacement, hip/diagnostic imaging; Arthroplasty, replacement, hip/adverse effects.