Attention deficit hyperactivity disorder (ADHD)
Misdiagnosis leads to unnecessary biopsy and the correct diagnosis can usually be made on the plain radiograph alone, although scintigraphy, which is characteristically negative-although this does not, of course, exclude myeloma.
Abstract
Salmonella osteoarticular infection without predisposing factors In their case report (July 1999 JRSM, p. 363), Mr Spencer and colleagues show an anteroposterior radiograph of the right shoulder with a lytic lesion in the greater tuberosity of the humerus. This is a normal variant, occurring in 10% of shoulders, and is referred to as a humeral pseudocystl. Misdiagnosis leads to unnecessary biopsy and the correct diagnosis can usually be made on the plain radiograph alone. Comparative views are useful since the lesion is typically bilateral. The investigation of choice in doubtful cases is scintigraphy, which is characteristically negative-although this does not, of course, exclude myeloma. False positives do occur and these are usually due to adjacent disease such as ligamentous avulsion and calcific tendinitis. The septic arthritis referred to cannot be disputed, but the acute osteomyelitis can. John Houghton Department of Diagnostic Radiology, Countess of Chester Hospital, Chester CH2 1UL, UK