Introduction: Knee osteoarthritis (OA) develops gradually and causes pain, a decrease in range of motion, muscle mass, and strength and leads to a decrease in physical activity and a poor quality of life for the patient. The aim of this study was to investigate the effects of different physiotherapy programs on pain intensity, range of motion, and quality of life in people with knee OA. Methods: The study was designed as a prospective, experimental, and randomized trial. Sixty subjects of both sexes and all ages with OA of the knee were enrolled in the study. In the studied Group I (n = 30), in addition to the standard protocol, high induction electromagnetic stimulation was applied using a Salus Talent device with a strength of 3 T and a frequency of up to 50 Hz for 10 min. In the test Group II (n = 30), in addition to the standard protocol, high-intensity laser therapy (HILT) with a power of 5 J was applied with the help of the Ilux Yag 1064 device for 7 min. The therapy protocol for both test groups lasted 8 weeks, with subjects treated once a week. Results: Analysis of the mean scores on the VAS scale shows that in both groups, the lowest mean scores were recorded in the III measurement (4.35) and the highest in the I measurement (7.96). In all three measurements, there was a difference in the extent of mobility of internal rotation in the form of a higher average range of motion in the test group II, in which HILT was applied. Analysis of the mean scores on the knee injury and osteoarthritis outcome score quality of life scale showed that in both groups, the lowest mean scores were recorded at the first measurement (14.84), with the mean score increasing at the second (32.95) and third measurements (41.08). Conclusion: Both methods showed significant results in reducing pain intensity, improving knee mobility, activities of daily living, and quality of life in people with knee OA. The obtained data do not give preference to any method but indicate them as adequate physiotherapy protocols to improve the function and quality of life of people with knee OA.

Introduction: Fetal central nervous system (CNS) anomalies are among the most severe and common anomalies, with an incidence of 1: 100 to 1: 500 in newborns. Depending on the type of anomaly, the diagnosis can only be made at specifi c periods of pregnancy. The prenatal ultrasound (US) is an eff ective primary imaging modality for depicting these anomalies, and magnetic resonance imaging (MRI) is a method that provides useful confi rmation and resolves any doubts regarding the diagnosis made on prenatal ultrasound. In situations where ultrasound examination is diffi cult, fetal MRI can provide superior information owing to its many advantages. The aim of this study was to determine the importance of prenatal MRI in making an accurate diagnosis and assessment of fetal CNS anomalies after neurosonographic doubt and in detecting additional anomalies that might have been overlooked on ultrasound, which infl uences clinical decision making and anomaly outcomes. Material and methods: For this research, which was designed as a systematic review of the primary scientifi c research literature, numerous articles were used, i.e.17 scientifi c research papers, published in relevant scientifi c research online databases such as PubMed, Medline, Google Scholar, and the same were published in English in the period from 2015 to 2021. Results: From the assessment of the quality of studies with a cohort design, most studies used in this systematic review are high-quality studies (11 in total) and a smaller number are medium-quality studies (6 in total). Out of 575 cases, MRI confi rmed the ultrasound diagnosis and agreed with it in 59.8% of cases, while in 20.2% of cases, it changed the diagnosis, i.e., in 16.5%, it rejected the ultrasound diagnosis. Additional anomalies detected only on MRI occurred in 236/1225 cases, which totals 19.3% of additional anomalies. Termination of pregnancy was reported in 82/317 cases, accounting for 25.9%, while in 176 cases, the pregnancy continued. A total of 11 cases of neonatal death were reported, and the number of stillbirths or deaths after birth was reported in 8 cases. Conclusion: MRI using T2W SSFSE sequences in 3 planes, T1W and DWI in the axial plane, is a complementary modality to prenatal ultrasound in making an accurate diagnosis and assessment of CNS anomalies and detecting associated anomalies previously overlooked on ultrasound. Keywords: fetal magnetic resonance imaging, fetal neurosonography, fetal central nervous system anomalies, prenatal diagnosis.

Abstract Introduction: Pulmonary embolism is still a challenge in diagnosis due to its variable and nonspecific symptoms. Computed tomography and ventilation/perfusion scanning are the modalities most commonly used in the diagnosis of pulmonary embolism, and both modalities have their advantages and disadvantages. One of the most important factors in the assessment and localization of pulmonary embolism is the diagnostic accuracy of these modalities, which serves to model different diagnostic strategies in the diagnosis of pulmonary embolism. Material and methods: The research was conducted as a review of professional literature available in scientific research databases. A selection of 20 professional papers was made, based on which an analysis was conducted and a database was formed. Criteria for inclusion in the research were scientific research papers that report on the sensitivity and specificity of diagnostic modalities of CT and V/P scanning as well as the results of diagnostic tests based on which the comparison of data from two modalities determined a diagnostically more accurate modality. Results: Sensitivity of 91.89% and specificity of 98.86% and diagnostic accuracy of 94.83% were determined in the case of computed tomography. Sensitivity of 90.58% and specificity of 98.33% and diagnostic accuracy of 96.43% were determined for the ventilation perfusion scanning method. We can conclude that the application of ventilation/perfusion scanning in the diagnosis of pulmonary embolism is a little more accurate compared to computed tomography. Conclusion: Ventilation/perfusion lung scanning will more accurately identify healthy individuals while on the other hand we can conclude that computed tomography is more accurate in diagnosing embolism in sick individuals. . Given that this difference between the two modalities is very small, the question is whether it is statistically significant at all. We can conclude that both diagnostic procedures have a high level of accuracy.

Objective: Determination of the importance of computed tomography in the diagnosis of pulmonary infection caused by COVID-19 infection, to compare computed tomography and computed tomography in detecting pathological changes caused by COVID-19 infection, and to prove the sensitivity and specificity of computed tomography. Method: The results of prospective and retrospective studies were used to write this review article, by systematic selection on Internet scientific databases: PubMed, Google Scholar, Crossref. Results: Based on a systematic review of the literature, it was established that chest CR is the first diagnostic method of choice, due to its wide availability. Conclusion: CT is a highly sensitive diagnostic method, and is recommended for more severe stages of the disease and accelerated exacerbation of the disease, in patients with slow regression of radiographic findings and in patients recovering from COVID-19 with impaired lung function.

A 65-year-old woman with a negative family history of breast cancer presented with a palpable mass in the left breast’s central portion. Mammography revealed an oval heteroechogenic, partly solid, partly cystic, sharply demarcated mass, measuring 100×90 mm in greatest diameter, classified as BI-RADS 4c, according to ACR BI-RADS Atlas Fifth Edition (Figure 1A-B). Breast MRI showed a lobulated mass with smooth margins appearing hypointense on T1WI and high signal intensity on T2WI (Figure 1C-D). A core needle biopsy revealed a cellular neoplasm, composed of small, closely packed tubules with spindle cell intervening stroma without prominent atypia and mitotic activity, classified as B3 category according to the UK National Coordinating Committee for Breast Screening Pathology (Figure 2A). The multidisciplinary tumor board discussed the case and recommended a wide surgical excision. With the patient’s approval, a left mastectomy was recommended and performed. The axillary clearance was not performed. The 100×90 mm tumor was grossly well-circumscribed, grayish-white, and predominantly solid, with a smaller cystic component, without necrosis and hemorrhage (Figure 2B). Histopathologic examination revealed a well-circumscribed tumor with two distinct components (tubular adenoma and phyllodes tumor) with the transition to one another (Figure 2C). The larger portion of the tumor was composed of closely packed small round to oval tubules with little intervening spindle cell stroma consistent with tubular adenoma. The smaller component showed a biphasic fibroepithelial tumor with leaf-like projections with moderately cellular stroma (Figure 2D-E). The stromal cells exhibited mild to moderate atypia, and their mitotic activity was up to six mitoses/10 hpf (Figure 2F). Stromal overgrowth was absent, while the malignant heterologous elements were not observed despite the exhaustive tumor sampling (25 paraffin blocks). The final diagnosis was a complex fibroepithelial tumor composed of borderline phyllodes and tubular adenoma. Clinical Science

Introduction: Among the female population, breast cancer is the most commonly diagnosed cancer in the world, and nearly half of women population with breast cancer develop metastatic disease during their lifetime. Breast cancer most often metastazises to the lungs, liver, bones, brain and lymph nodes. 18F-FDG PET/CT can detect metastases that are not visible in other imaging modalities, and with the newly discovered lesions, decision about adequate treatment option can be evaluated. Material and methods: The examination was conducted as a retrospective descriptive study in May and June of 2019 at the Clinic for Nuclear Medicine and Endocrinology of the University Clinical Center in Sarajevo. It included 100 female patients with the age structure of 33-79 years. The patient's reference diagnosis is breast cancer, with a suspected finding of metastatic activity. A comparison of the sensitivity and specificity of the breast imaging between PET/CT, CT and bone scintigraphy was performed. Results: PET/CT revealed significantly more positive findings on metastatic activity than other diagnostic imaging modalities, with Mann-Whitney test value of p = 0.01014. In the diagnosis of lungs and liver lesions, PET/CT sensitivity and specificity are 92.59% and 85.37%, respectively, while the statistical parameters for CT are 77.78% for sensitivity and 90.24% for specificity. The PET/CT sensitivity and specificity for bone lesions are 93.55% and 88.89%, respectively, compared to 78.57% and 100% for bone scintigraphy. Conclusion: Hybrid imaging technique, which integrates PET and CT imaging methods, has considerable advantages over other diagnostic methods in the detection of distant metastases, and based on obtained results, PET/CT may be method of choice in evaluation of metastatic activity in breast cancer.

The clinical appliance of perfusion is being continuously developed and it is closely related to technology development. The role of perfusion neuroimaging in the management of acute stroke has been to prove reduced regional blood flow and to give the contribution in the identification of ischemic areas, respectively the regions of hypoperfusion that can be treated by thrombolytic and/or endovascular recanalization therapy. There are two main approaches to the measurement of cerebral perfusion by magnetic resonance. The aim of this article is to compare different measuring approaches of MR perfusion neuroimaging.

To the Editor A 65-year-old woman with a positive family history for breast cancer presented with the palpable mass in the upper outer quadrant of the left breast. Ultrasonography and mammography revealed an oval, hypoechogenic, sharply demarcated mass, measuring 23 9 14 mm, classified as Bi-RADS 4 (Fig. 1A). A core needle biopsy revealed a cellular spindle cell lesion (AE1/AE3 negative) without prominent atypia and mitotic activity (B3 category, Fig. 1B). The multidisciplinary breast meeting discussed the case and recommended a wide local excision of the mass. Grossly, the 20-mm tumor was well-circumscribed, grayish-white on cut section, without necrosis and hemorrhage (Fig. 1C). Histopathologic examination revealed a well circumscribed, spindle cell neoplasm composed of the cells with mild to moderate atypia and sporadic mitotic activity (up to 5/10 hpf mitotic figures, Fig. 1D,E). An extensive immunohistochemical (IHC) examination revealed only convincing S-100 positivity in about 20% of neoplastic cells (Fig. 1F). All other markers were negative (AE1/AE3, Cam5.2, p63, GFAP, SMA, desmin, CD34, HMB-45, SOX-10) while beta-catenin retained cytoplasmic/membranous expression without nuclear positivity. Morphologic and immunohistochemical findings were consistent with a low-grade malignant peripheral nerve sheath tumor (MPNST). Due to the tumor size, clean margins, and the tumor grade, a close follow-up without further treatment of the patient was recommended (1–3). Additional clinical