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PubMedDate not supplied

Fluid-fluid levels in ovarian teratomas.

BACKGROUND: We evaluated the imaging features of ovarian teratomas containing fluid-fluid levels on ultrasonography (US). METHODS: We retrospectively reviewed US examinations of two groups with 805 masses (370 benign ovarian teratomas and 435 nonteratomatous adnexal masses). RESULTS: In 27 teratomas and eight nonteratomatous adnexal masses, fluid-fluid levels were detected on US. According to the echogenicity of each layer, 27 teratomas were classified as three types: 1, supernatant hypoechoic and dependent hyperechoic layers (n = 16); 2, supernatant hyperechoic and dependent hypoechoic layers (n = 8); and 3, supernatant hypoechoic and dependent hypoechoic layers with bright fluid interface (n = 3). In eight (30%) of 27 teratomas, US showed floating nodules at the interface, five of which had posterior acoustic shadowing. All eight nonteratomatous adnexal masses showed type 1 fluid-fluid levels. CONCLUSION: The fluid-fluid level seen on US is strongly suggestive but not pathognomonic of dermoids. Fluid-fluid levels with supernatant hyperechoic and dependent hypoechoic layers, supernatant hypoechoic and dependent hypoechoic layers with bright interface, and a floating nodule might pathognomonic findings of benign ovarian teratomas.

Adult↗
PubMed2000

How thick is thick? Multicenter study of the rheological and material property characteristics of mealtime fluids and videofluoroscopy fluids.

Objective rheological assessment of fluids given to dysphagic patients at mealtime and during videofluoroscopy was carried out using a multicenter format. Thin, quarter-thick, half-thick and full-thick fluids were examined for the degree of correlation between mealtime fluids and their allegedly matched videofluoroscopy counterparts. The study was carried out to determine whether perceived subjective differences between mealtime fluids and videofluoroscopy fluids could be quantified using the rheological parameters of viscosity, density, and yield stress. The results showed poor correlation between mealtime fluids and videofluoroscopy fluids over all parameters. In general, the videofluoroscopy fluids were more viscous, more dense, and showed higher yield stress values than their mealtime counterparts. Given these results, it is reasonable to assume that the fluids used during videofluoroscopy do not provide an accurate indication of swallowing ability at mealtime. Therefore, it is suggested that clinicians use objective methods to rheologically match videofluoroscopy fluids to mealtime fluids.

Beverages↗
PubMed1993

Intraobserver reliability of amniotic fluid volume estimation by two techniques: amniotic fluid index vs. maximum vertical pocket.

We evaluated the intraobserver agreement of two techniques of amniotic fluid assessment: amniotic fluid index and maximum vertical pocket. The intraobserver variation of the two forms of amniotic fluid assessment was obtained by evaluating amniotic fluid prior to fetal biometry (post-biometry value) and after fetal biometry (pre-biometry value). Between January and June 1990, this amniotic fluid assessment was by the maximum vertical pocket technique, and between July and December 1990, by the amniotic fluid index technique. In the Grace Maternity Hospital, Vancouver, 352 subjects were evaluated by the maximum vertical pocket technique, and 184 subjects by the amniotic fluid index technique.Amniotic fluid volumes were categorized into normal, oligohydramnios, and polyhydramnios, and the pre-biometry and post-biometry categories of amniotic fluid index and maximum vertical pocket techniques were compared by kappa statistics. The maximum vertical pocket technique showed poor intraobserver agreement (kappa = 0.33), but the amniotic fluid index technique showed good agreement (kappa = 0.72). With the poor reproducibility of the maximum vertical pocket technique in assessing extremes of amniotic fluid volume, it is difficult to support its use as a component of fetal assessment.

Journal Article↗
PubMed1985

Isotonic solutions of mannitol, sorbitol and glycine and distilled water as irrigating fluids during transurethral resection of the prostate and calculation of irrigating fluid influx.

The aim of the study was to evaluate the clinical properties of some irrigating fluids used in transurethral resection of the prostate, to study humoral changes and disposition of the various fluids and solutes on intravenous absorption and, finally, to draw conclusions concerning a suitable composition of irrigation fluid. 60 patients undergoing transurethral resection of the prostate were included in the study. Plasma concentrations of mannitol, sorbitol and glycine were determined (during and after operation) as indicators of intravenous irrigation fluid influx. The serum concentration of prostatic acid phosphatase and, in patients irrigated with distilled water, the postoperative increase in plasma haemoglobin and the serum lactate dehydrogenase increase were used as semiquantitative estimates of fluid influx. A wide-ranging series of biochemical analyses was performed on blood in all cases before, during and after the resection (inter alia, sodium, albumin, haptoglobin in serum). The half-lives in plasma were estimated for mannitol, sorbitol and glycine. Fluid absorption was calculated in several ways. Haemodilution occurred with all iso-osmolar solutions on absorption but not with distilled water. The dilution effect of glycine solution was the most pronounced. Calculation of absorbed fluid volumes gave values up to 3.0 litres. Plasma osmolality was unchanged with all irrigating fluids used. The half-life in plasma for sorbitol was about 30 min, for glycine about 90 min and for mannitol about 120 min. Glycine entered muscle cells and changed the amino acid pattern. There was an increase in the serine and ammonia concentrations in plasma postoperatively. On absorption of distilled water there was an increase in the concentration of plasma haemoglobin and in erythrocyte-derived enzymes. The immediate postoperative concentration of glycine, mannitol and sorbitol in plasma was used to calculate fluid absorption. These concentrations showed good correlation with the immediate postoperative decrease in serum sodium concentration. The serum sodium decrease can be used for calculations of the absorbed fluid volume. On absorption of large volumes of water with haemolysis products, kidney damage is possible. The osmotic diuretic effect of mannitol gives a tendency to low postoperative blood pressure if combined with an intravenous diuretic. Water as an irrigating fluid can be recommended for diagnostic purposes and for general bladder surgery.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed2000

Gamble and Darrow: pathfinders in body fluid physiology and fluid therapy for children, 1914-1964.

The development of body fluid physiology and fluid therapy in pediatrics has special importance in the history of medicine because this development introduced physiology into clinical practice. James Gamble and Dan Darrow were leaders in this enterprise. Gamble was part of the group John Howland attracted to Johns Hopkins to establish the first organized program for clinical investigators in pediatrics. This group initiated fluid therapy as effective treatment for diarrheal dehydration and, led by Gamble, developed the discipline of body fluid physiology. Gamble was the first to describe the nature of extracellular fluid (ECF) to clinicians, using the new terminology for characterizing electrolytes in solution. In doing so, he became the teacher of body fluid physiology to a generation of medical students. Inexplicably, in his later years he failed to adopt yet newer terminology defining cations, anions, and acid-base status. This failure compromised his legacy. Dan Darrow extended our understanding of how body fluids react to hyper- and hyponatremia and to potassium deficiency. He was the first to add potassium to parenteral fluid therapy. In doing so, he broadened clinicians' understanding of body fluids but changed the emphasis of fluid therapy from rapid ECF restoration to replacement of estimated deficits. Unfortunately, this change in concept, taught by his successors as deficit therapy, slowed the adoption of oral rehydration therapy for treating diarrheal dehydration. The lapses noted for each of these men, now seen in hindsight, pale in comparison to their contributions. Pediatrics, medicine, and surgery are all indebted to the research of each, which emphasized the value of basic physiology in clinical practice.

Body Fluids↗
PubMed1992

Microvillar enzyme activity in amniotic fluid, extraembryonic coelomic fluid and maternal serum in the first trimester of pregnancy.

The activities of two microvillar enzymes, gamma-glutamyl transpeptidase and total alkaline phosphatase, have been measured in samples of amniotic fluid and extraembryonic coelomic fluid obtained by high-resolution transvaginal ultrasound-guided amniocentesis from 40 women between 7 and 12 weeks of gestation. There was a highly significant difference between gamma-glutamyl transpeptidase activity in amniotic fluid (median level 31 U/l; range 2-409 U/l) and extraembryonic coelomic fluid (median level 2 U/l; range less than 2-16 U/l) (P less than 0.001; Mann-Whitney U-test). Alkaline phosphatase activity was not detected in 84% of amniotic fluid samples and 97% of extraembryonic coelomic fluid samples. No difference was found between total alkaline phosphatase activity in these fluids (P = 0.14; Mann-Whitney U-test). Enzyme activities in amniotic fluid increased with gestational age. A significant linear correlation was found between amniotic fluid gamma-glutamyl transpeptidase activity and stage of gestation (r = 0.86; P less than 0.001) and total alkaline phosphatase activity in amniotic fluid and stage of gestation (r = 0.66; P less than 0.001).

Alkaline Phosphatase↗
PubMed1984

Amniotic fluid activates complement. A role in amniotic fluid embolism syndrome?

A 30-year-old woman died with massive pulmonary microvascular leukostasis immediately after cesarean hysterectomy. We postulated that this might have resulted from amniotic fluid embolization and, therefore, tested amniotic fluids as activators of granulocytes and the plasma complement system. Normal human amniotic fluid failed to aggregate granulocytes, provoke a respiratory burst, or attract the cells chemotactically. However, amniotic fluid activated complement when incubated with normal plasma. The ability to activate complement resided in lipid-rich particulate material in the fluid, and activation proceeded mainly (but probably not exclusively) via the alternative complement pathway. Amniotic fluids varied widely in their ability to activate complement, with the most potent samples derived from women with distressed pregnancies. Plasma samples from donors also varied widely in their ability to be activated by amniotic fluid, and many of the most activatable plasma samples derived from gravid women. We propose that amniotic fluid embolization can, like "shock lung" syndrome, have a leukostatic early phase, and that complement and granulocyte activation on embolization of amniotic fluid can contribute to the pulmonary collapse characteristic of that syndrome, especially when a potently activating fluid is combined with a potently activatable plasma.

Adult↗
PubMed1987

Differing concentrations of human chorionic gonadotropin and prolactin in the cyst fluid of hydatidiform mole and in amniotic fluid.

The concentrations of human chorionic gonadotropin and prolactin in the cyst fluid of molar tissue were compared with that of normal amniotic fluid. Molar fluid was aspirated from the vesicles of molar tissue in eight women (duration of amenorrhea 14.1 +/- 1 week, mean +/- SEM). Amniotic fluid was obtained at amniocentesis in 24 women (mean duration of amenorrhea 15.9 +/- 0.2 week). Hormones were measured by specific radioimmunoassay. The concentrations (mean +/- SEM) of human chorionic gonadotropin in molar fluid and amniotic fluid were 581,829 +/- 112,581 and 3187 +/- 505 mlU/ml (p less than 0.001), respectively. For prolactin the levels in molar fluid and amniotic fluid were 44 +/- 24 and 1962 +/- 313 ng/ml (p less than 0.001), respectively. These data demonstrate that molar fluid contains 182-fold higher levels of human chorionic gonadotropin and 45-fold lower levels of prolactin than amniotic fluid obtained from normal pregnant women with a similar duration of amenorrhea. In addition to altered endocrine function of the trophoblast, there may be altered prolactin secretion from the decidua in molar pregnancy as compared with normal pregnancy. Further research is required to evaluate prolactin production from decidua of molar pregnancy.

Adult↗
PubMed1994

Substance P-, neurokinin A-, calcitonin gene-related peptide- and neuropeptide Y-like immunoreactivity (-LI) in rat knee joint synovial fluid during acute monoarthritis is not correlated with concentrations of neuropeptide-LI in cerebrospinal fluid and plasma.

In a recent study we have shown a bilateral release of substance P (SP)-, neurokinin A (NKA)-, calcitonin gene-related peptide (CGRP)- and neuropeptide Y (NPY)-like immunoreactivity (-LI) in rat synovial fluid during acute monoarthritis. In order to elucidate the mechanisms underlying these phenomena, we examined the correlation between neuropeptide-LI in rat cerebrospinal fluid (CSF) and synovial fluid and between plasma and synovial fluid following the intra-articular injection of equal volumes (0.05 ml) of either Freund's adjuvans, carrageenan 2%, substance P 10(-5) M or human recombinant interleukin-1 alpha. Control rats were given saline intra-articularly. CSF, plasma and synovial fluid from the knee joints were obtained at 2, 6 and 24 h after injection and were analysed by specific radioimmunoassays. The intra-articular injection of pro-inflammatory substances induced changes in neuropeptide-LI in synovial fluid, CSF and plasma. However, there was no correlation between neuropeptide-LI in synovial fluid and plasma or between synovial fluid and CSF. The results of the present study does not support the hypothesis that the bilateral changes in neuropeptide-LI in synovial fluid were due to a release of neuropeptides from the inflamed joint into the systemic circulation. However, in carrageenan induced inflammation there was a tendency towards a correlation in SP-LI between CSF and synovial fluid suggesting that central neurogenic mechanisms should be studied in order to explain the bilateral changes seen.

Acute Disease↗
PubMed2005

A fatigue microcrack alters fluid velocities in a computational model of interstitial fluid flow in cortical bone.

Targeted remodeling is activated by fatigue microcracks and plays an important role in maintaining bone integrity. It is widely believed that fluid flow-induced shear stress plays a major role in modulating the mechanotransduction process. Therefore, it is likely that fluid flow-induced shear stress plays a major role in the initiation of the repair of fatigue damage. Since no in vivo measurements of fluid flow within bone exist, computational and mathematical models must be employed to investigate the fluid flow field and the shear stress occurring within cortical bone. We developed a computational fluid dynamic model of cortical bone to examine the effect of a fatigue microcrack on the fluid flow field. Our results indicate that there are alterations in the fluid flow field as far as 150 microm away from the crack, and that at distances farther than this, the fluid flow field is similar to the fluid flow field of intact bone. Through the crack and immediately above and below it, the fluid velocity is higher, while at the lateral edges it is lower than that calculated for the intact model, with a maximum change of 29%. Our results suggest that the presence of a fatigue microcrack can alter the shear stress in regions near the crack. These alterations in shear stress have the potential to significantly alter mechanotransduction and may play a role in the initiation of the repair of fatigue microcracks.

Biomechanical Phenomena↗
PubMed1997

The accuracy of the summated amniotic fluid index in evaluating amniotic fluid volume in twin pregnancies.

OBJECTIVE: Our purpose was to determine the accuracy of the summated amniotic fluid index designed to estimate the total amniotic fluid volume in twin pregnancies. STUDY DESIGN: The summated amniotic fluid index was measured in 62 normal diamniotic twin pregnancies by adding the deepest vertical pockets in the four quadrants. Actual amniotic fluid volume was then determined in all 124 amniotic sacs by amniocentesis and a dye-dilution technique. For data analysis, amniotic fluid volumes were classified by percentile with use of previously reported norms. RESULTS: There were significant differences in the percentile distribution of amniotic fluid volume as estimated by the summated amniotic fluid index and the actual volume as determined by dye dilution (p < 0.001). The summated amniotic fluid index has a sensitivity of only 13% in predicting amniotic sac volume. CONCLUSION: The summated amniotic fluid index is a poor predictor of intertwin differences in amniotic fluid volume and cannot identify twin pairs at risk for oligohydramnios and hydramnios.

Adult↗
PubMed1998

Evaluating rapid diagnostic tests of intra-amniotic infection: Gram stain, amniotic fluid glucose level, and amniotic fluid to serum glucose level ratio.

OBJECTIVE: The aim of the study was to compare the diagnostic utility of the Gram stain, the amniotic fluid glucose level, and the ratio of amniotic fluid glucose level to serum glucose level in detecting intra-amniotic infection. STUDY DESIGN: We conducted a prospective study of 127 patients with preterm labor and 26 patients with preterm premature rupture of the membranes (153 total). All patients underwent amniocentesis to diagnose intra-amniotic infection. The diagnostic criterion for intra-amniotic infection was a positive amniotic fluid culture result. RESULTS: The Gram stain is 80% sensitive and 91% specific when a positive is considered the presence of white blood cells or bacteria. Amniotic fluid glucose level and the ratio of amniotic fluid glucose level to serum glucose level are significantly lower when amniotic fluid culture results are positive, but as diagnostic tests they are inferior to the Gram stain. Logistic regression models that combine predictors yield superior accuracy with respect to individual tests. The most accurate combination was amniotic fluid glucose level and Gram stain with white blood cells or bacteria. Although the number of patients with preterm premature rupture of the membranes was small in this study (n = 26), analysis of our data suggests that the diagnostic performance levels of these tests were similar when used in patients with preterm labor and intact membranes and in patients with premature rupture of the membranes. CONCLUSIONS: The amniotic fluid glucose level and the ratio of amniotic fluid to serum glucose level have equivalent diagnostic utility and are inferior to the Gram stain. The combination of Gram stain with amniotic fluid glucose level is superior to any individual test.

Adult↗
PubMed1991

Early amniocentesis: alphafetoprotein levels in amniotic fluid, extraembryonic coelomic fluid and maternal serum between 8 and 13 weeks.

OBJECTIVE: The aim was to establish a normal range of alphafetoprotein (AFP) concentrations in amniotic fluid from 8 to 12 weeks gestation, and to determine any difference between AFP levels in amniotic fluid and extraembryonic coelomic fluid. DESIGN AND SUBJECTS: 150 women had a transvaginal ultrasound guided amniocentesis before termination of an apparently normal first trimester pregnancy. Separately identified samples of amniotic fluid and extraembryonic coelomic fluid were obtained and assayed by radioimmunoassay for AFP. RESULTS: In amniotic fluid, very high levels of AFP were present at 8 weeks, levels falling rapidly up to 10 weeks after which there was a slight rise. Thus over the period 8 to 10 weeks, there was a significant inverse correlation between amniotic fluid AFP and gestational age (r = 0.67; P less than 0.001). In extraembryonic coelomic fluid, by contrast there was no trend in AFP relative to gestational age. CONCLUSIONS: The rapidly changing levels of AFP from 8 to 10 weeks as well as the small volume of the amniotic cavity makes the use of amniocentesis impracticable before 11 weeks gestation. The lack of any relation between AFP levels in amniotic fluid and extraembryonic coelomic fluid emphasises the importance of identifying the site of amniocentesis in the first trimester.

Amniotic Fluid↗
PubMed1992

Erythropoietin levels in amniotic fluid and extraembryonic coelomic fluid in the first trimester of pregnancy.

OBJECTIVE: The aim was to measure erythropoietin levels in amniotic fluid and extraembryonic coelomic fluid from 7-12 weeks' gestation. SUBJECTS: Twenty healthy women with ultrasonographically normal first trimester pregnancies prior to surgical termination. METHODS: Paired samples of amniotic fluid and extraembryonic coelomic fluid were collected by transvaginal ultrasound guided needling. Erythropoietin was measured in both pregnancy fluids using a radioimmunoassay. RESULTS: There was a highly significant difference between erythropoietin levels in extraembryonic coelomic fluid (median level 15.45 mU/ml; range 6.8-32.1 mU/ml) and those in amniotic fluid (median 5.0 mU/ml; range < 5.0-5.8 mU/ml) (P < 0.0001; Mann-Whitney U-test). The levels of erythropoietin in maternal serum (median 15.4 mU/ml; range 5.6-29.4 mU/ml) were similar to those in the extra-embryonic coelom (P = 0.81; Mann-Whitney U-test). No relation was demonstrated between erythropoietin levels in amniotic fluid or coelomic fluid and stage of gestation. CONCLUSION: High levels of erythropoietin in coelomic fluid suggests that the hormone is involved in the process of human extraembryonic erythropoiesis. The exact regulatory role remains unknown.

Amniotic Fluid↗
PubMedDate not supplied

Fibronectin in rheumatoid and non-rheumatoid arthritic synovial fluids and in synovial fluid cryoproteins.

Concentrations of fibronectin, immunoglobulins G, M, and A, and C3 and C4 components of complement, and other plasma proteins were determined in synovial fluids from patients with rheumatoid arthritis (RA) and other diseases (non-RA). Fibronectin concentrations were two to three times greater in all synovial fluids than in plasma, and RA synovial fluids had a significantly higher mean concentration than non-RA fluids (883 microgram per ml vs. 588 microgram per ml, respectively, p less than 0.01). The mean concentrations of other synovial fluid constituents were less than their mean plasma concentrations. These results suggest that unlike other plasma constituents, either plasma fibronectin is concentrated in synovial fluids or that a substantial portion of synovial fluid fibronectin may be derived from synovial tissue cells. Both the C3 and C4 complement components were present in lower concentrations in RA than in non-RA synovial fluids. The C3 contents showed a statistically significant negative correlation with the fibronectin contents. Fibronectin was also found in all synovial fluid cryoprotein fractions tested, although its content varied greatly as a percent of the total cryoprotein protein (0.01 to 43 percent). The data show that fibronectin is a consistent constituent of synovial fluid cryoproteins in agreement with our previously reported finding that fibronectin is found in all serum cryoglobulin fraction tested.

Arthritis↗
PubMed2003

Occupational exposure to metalworking fluid mist and sump fluid contaminants.

This paper summarizes the analytical and occupational hygiene findings from a recent survey of occupational exposure to metalworking fluids (MWFs) in the engineering industry. The aim of the survey was to link MWF mist exposure measurements with particular engineering processes and controls, and utilize the data obtained to develop exposure standards. At the same time the opportunity was taken to assess fluid management and control, including bacterial and fines contamination in the machine sumps. In general, occupational exposure to mineral oil MWF mist was controlled to <3 mg/m(3) (8 h time-weighted average) and to <1 mg/m(3) for water-mix MWF mist (in terms of the concentrate). These exposure values do not necessarily represent best practice, but are believed to be achievable and representative of industry as a whole. Gravimetric analysis of the total inhalable particulate was found to be a good predictor of mineral oil MWF mist but not for water-mix MWF mist. Grinding and drilling operations produced higher exposures than turning and milling for water-mix fluids. There were insufficient data to compare machining operations for mineral oil MWFs. On the whole, fluid management was found to be poor, with most sites failing to meet industry good practice or Health & Safety Executive (HSE) standards. Some of the operating procedures utilized were deficient or unsatisfactory. Poor standards of fluid management were found at all sizes of company. High levels of bacteria, endotoxin and fines were found in sumps, and control of other factors, such as water-mix fluid concentration, was often poor. Mineral oils had higher levels of fines than water-mix fluids (medians of 395 and 18 mg/l, respectively), and grinding produced high levels of fines in both types of MWF. Many water-mix sumps contained bacterial levels of >1 x 10(6) CFU/ml, and endotoxin levels of >100 000 EU/ml were not uncommon. The median values were 109 000 CFU/ml and 8039 EU/ml, respectively. Mists could potentially contain extensive contamination from bacteria and endotoxin. Analysis of the data suggests that sumps operating under typical conditions for machining (a temperature of 20 degrees C, a pH of 9 and a fluid strength below 10%), also appear to provide optimum conditions for the proliferation of bacteria. Low levels of benzo[a]pyrene (median 0.03 micro g/g) were found in the mineral oils, and low levels of N-nitrosodiethanolamine (median 0.4 micro g/ml) were found in the water-mix MWFs. The results of this work will contribute to guidance from the HSE, setting out accepted industry good practice, including guide values for MWF mist and sump fluid contaminants, with significant emphasis on sump fluid management (maintenance and monitoring), as well as control issues.

Aerosols↗
PubMed1978

A study of the composition of pericardial fluid, with special reference to the probable mechanism of fluid formation.

The composition of pericardial fluid and simultaneously withdrawn plasma have been measured in rabbits and greyhounds. 1. Sodium and chloride distributions were found to be not markedly different from the ratio predicted for a passive distribution. The small deviation found in greyhounds could be largely corrected by the in vitro dialysis of plasma against pericardial fluid. 2. Calcium and magnesium were distributed in a manner expected from a passive ultrafiltrate of plasma. 3. Pericardial fluid was found to contain between one quarter and one third of the protein of plasma. 4. Separation of the protein constituents demonstrated a far higher proportion of albumin to other proteins in the pericardial fluid. 5. The osmolality of plasma was slightly higher than that of pericardial fluid, as would be expected from a plasma ultrafiltrate. 6. The potassium concentration of pericardial fluid was higher than the plasma concentration in all animals studied. This difference could be abolished, and an expected distribution obtained in the samples from greyhounds, by the in vitro dialysis of plasma against pericardial fluid. This observation for potassium cannot be attributed to haemolysis of blood in pericardial fluid samples or to the use of any inappropriate references. It is suggested that the elevated potassium concentration of pericardial fluid may reflect the lability of the cardiac intracellular potassium during cardiac contraction. 7. The results obtained in this study do not support the concept of an active secretion of pericardial fluid as has been claimed by others. The distribution of ions would appear to be passive and to follow the values predicted by the Gibbs-Donnan relationship.

Animals↗
PubMed1990

Fluid-fluid level: a nonspecific finding in tumors of bone and soft tissue.

Fluid-fluid levels have commonly been reported to occur in aneurysmal bone cysts but have also been seen in telangiectatic osteosarcoma, chondroblastoma, and giant cell tumor of bone. The authors reviewed their experience with nine bone and three soft-tissue tumors that showed fluid-fluid levels on computed tomographic or magnetic resonance images. The bone tumors included fibrous dysplasia, simple bone cyst, recurrent malignant fibrous histiocytoma of bone, two classical osteosarcomas, and four aneurysmal bone cysts. The soft-tissue tumors included soft-tissue hemangioma and two synovial sarcomas. Except for aneurysmal bone cysts, these types of tumors have not been reported to be associated with fluid-fluid levels. Radiologic-pathologic correlation was available in seven patients; in all seven, the fluid-fluid levels indicated prior hemorrhage. The authors conclude that the presence of fluid-fluid levels in bone or soft-tissue tumors cannot be considered diagnostic of any particular tumor.

Adolescent↗