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Said Shavershian and Aziz Shavershian Both brothers were into body building and aesthetics.
Aziz Shavershian A young Aziz Shavershian before he got into body building, self described as an 'ectomorph'. Said Shavershian Said Shavershian was convicted of possession of steroids in August this year and fine $479.
Said Shavershian Said Shavershian is known as 'Chestbrah' because of his large chest muscles.
Aziz Shavershian and friends 'Zyzz' and his gang loved to show off their sculpted or 'shredded' bodies at dance parties.
Aziz Shavershian gets an injection Although there is speculation that Aziz Shavershian took steroids - he claims he was getting a flu shot in this picture. Long-term psychiatric and medical consequences of anabolic-androgenic steroid abuse: a looming public health concern? Treatment of anabolic-androgenic steroid dependence: Emerging evidence and its implications. Extensive right frontoparietal white matter signal abnormality is seen involving the pre and post central gyrus. The lower thoracic cord from T10 to T12 is expanded and demonstrates an ill-defined T2 hyperintensity in two segments.
A: It was thought that this was the case some time ago, but it is increasingly evident that a minority (anything up to 15%) of tumours (especially astrocytomas) do not demonstrate convincing enhancement. Q: Given the relatively short duration of symptoms, what other process (other than neoplasm) should be considered? Q: How can the possibility of this representing transverse myelitis be further investigated?
A: Roughly one third of patients recover with little or no sequelae, one third are left with a moderate degree of permanent disability, and one third are left with severe disabilities. Overall features are fairly typical of transverse myelitis, and the patient has been followed both clinically and with MRI.
He hadn't won competitions and he wasn't a public figure in the usual sense, but he was mourned by tens of thousands of people in Australia and abroad.Although an unremarkable youth, Aziz Sergeyevich Shavershian, or Zyzz, became known for his body image, for his abs and pecs. It is mildly hyperdense on non contrast and arterial phase and appears isodense on portal and delayed phase. Siderotic nodules in the cirrhotic liver at MR imaging with explant correlation: no increased frequency of dysplastic nodules and hepatocellular carcinoma.
Patient proceeded to surgery.Stenosing tumour, which caused the gastric outlet obstruction - gross specimen post partial gastrectomy.
Signal abnormality also extends just into the occipital lobe on the right and is seen on left parietal and occipital lobes. At the level of the upper portion of T10 there is a ventral and then almost complete but mainly right-sided expansion and T2 signal change. Most of these lesions are benign and are related to the collection of fluid in bursae, herniation of synovium from the joint, or ganglia arising from tendons and ligaments. Synovial sarcoma: imaging features of common and uncommon primary sites, metastatic patterns, and treatment response. Extra-articular soft tissue ganglion cyst around the knee: Focus on the associated findings. MR imaging of the medial collateral ligament bursa: Findings in patients and anatomic data derived from cadavers. Mucoid degeneration of the anterior cruciate ligament: Magnetic resonance imaging findings of an underdiagnosed entity. MRI demonstrates the extension of juxta-articular venous malformation of the knee and correlates with joint changes.
Small foci are also identified in the region of the basal ganglia, splenium of corpus callosum, brain stem and cerebellar peduncles. With these features the possibility of siderotic regenerative nodule was suggested which was further confirmed on MRI (images not available)Case DiscussionPatients with cirrhosis can accumulate focal iron within regenerative or dysplastic hepatic nodules, hence they are referred to as 'siderotic nodules'. No evidence of haemorrhage.Case DiscussionProgressive multifocal leukoencephalopathy (PML) is a demyelinating disease which results from the JC virus infecting oligodendrocytes. No contrast enhancement is present.The abnormality involves the intramedullary cord with no abnormality of the extra dural space.
USG can distinguish cysts from solid lesions and assess the degree of vascularity within the lesion.
MRI can help delineate the location of the lesion in relation to anatomic structures and also determine if the lesion is cystic or solid when contrast is administered.
In this article, we systematically review cystic soft-tissue knee lesions, explaining the important characteristics, typical appearances, and potential pitfalls. At times, it may be difficult or even impossible to distinguish them from bursae or ganglia, which lack a true connection to the joint but at times can connect to the joint. At the time of his death, Zyzz was 22 years old and a far cry from the skinny teenager of a few years earlier, unable to attract girls and stand up for himself. His rapid transformation was the stuff of fantasy for thousands of skinny teenagers, and it made him a pin-up boy. This connection can have a "ball-valve" like mechanism, which is typically opened during knee flexion and closed during extension. Every time that I looked at some guy next to me I'd be wondering if his deltoids were bigger than my deltoids.
Visualizing a communicating fluid collection arising between the tendons of the medial head of the gastrocnemius and semimembranosus is the key to making the diagnosis. He's a world authority on steroid use and we'll hear more from him later.A recent Australian survey of high school students, published in the Journal of Science and Medicine in Sport, found steroid use is higher among young people than the general population. Although many popliteal cysts are asymptomatic, large cysts may cause nerve entrapment, compress adjacent vascular structures, or limit knee flexion. And the bare-chested body beautiful trend is visible at dance parties and other public festivals. And, you know, we all know that we're on different trajectories in terms of our physical growth and development.
He claimed his body shape was due to diet and hard work in the gym.A person called Aziz had previously written openly in an online forum about steroid use.
It is hypothesized that increased knee joint pressure in these patients can result in the formation of a synovial cyst in the PTFJ.
These cysts are more common in patients with chronic knee pain and osteoarthritis, but have also been described in high-performance athletes.
Axial T1W MR image (A) demonstrates uniformly hypointense mass (arrow) with small tail (arrowhead), arising from proximal tibiofibular joint. At this year's event, in September, Background Briefing spoke to several patrons about the influence of Zyzz.
Axial proton density (PD) image (A) shows large cyst (arrows) compressing the common peroneal nerve (arrowhead).
If you don't have the, like, the fucking abs and the chest and shit, the arms, chicks don't want a bar of you.
The prepatellar, superficial infrapatellar, and deep infrapatellar bursae are associated with the patella, whereas the pes anserine, iliotibial (IT), and medial (tibial) collateral ligament, fibular collateral, and semimembranosus-tibial collateral ligament bursae [Figure 4] are not. Like, he's not shy about showing his body image off.Brendan King: And when you say 'rig' what do you mean?
Sagittal T2W fat-saturated image demonstrates a tubular bright cystic mass (arrow) just posterior to the semimembranosus tendon (arrowhead) (image courtesy of Dr. Justin Kung, Boston, MA)Click here to view Prepatellar and infrapatellar bursitisThe prepatellar bursa is located anterior to the patella, deep to the subcutaneous soft tissues.
Inflammation of the bursa, popularly referred to as "housemaid's knee," can result from direct trauma to the patella or repetitive injury, producing anterior knee pain which may be associated with a palpable mass [Figure 5].
Infrapatellar bursitis can occur in the superficial (between the tibial tubercle and the overlying skin) or deep (between the posterior aspect of the patellar tendon and the tibia) bursae. Like, you see they guy, you look to your right in the mosh pit and fucking some cunt's massive. Sagittal fat-saturated T2W image shows triangular pocket of fluid (arrow) between distal patellar tendon and anterior tibia. It is common in patients who participate in intense physical activity, such as distance runners, cyclists, and football players.


Pes anserine bursitis affects both genders equally, classically occurring in older overweight women with knee osteoarthritis or in athletes in sports that require running and side-to-side movement. Steroids should be legalised so we can get the correct dosage for each person, so people don't fucking overdo it and go mental. Baker's cysts are often larger, communicate with the joint, and can extend into the thigh, whereas pes anserine bursitis does not. Zyzz claimed he didn't use steroids, but it's clear from this webcam recording he enjoyed party drugs.
For many aspiring bodybuilders and young women, Zyzz had the body.At a gym in Sydney's northern suburbs, Nick the Roman, as he likes to be called, lifts weights nearly every day. On imaging, an oblong fluid collection distends the deep and superficial fibers of the medial collateral ligament.
Medial collateral ligament bursitis can at times be confused with a partial tear of the medial collateral ligament or a parameniscal cyst.
I just felt, you know, very self-conscious and especially of all the guys out there that were juiced up, that were older and were bigger, just the attention they were getting.And, you know, I guess it made me feel smaller in a way.
So, I mean, I am an intelligent guy, but I think especially when you walk into a festival or into an open area, first thing people see isn't intelligence, kind of thing, you know?
Unlike synovial cysts, ganglia do not communicate with the joint space and lack a cellular lining.
Ganglia demonstrate low signal intensity on T1W images, high signal intensity on T2W images, and may show rim enhancement. They classically lack solid internal enhancement, though small multi-septated ganglia can simulate this appearance.
Moreover, long-standing ganglia can cause pressure erosions in the adjacent bone, mimicking an aggressive process.Ganglia around the knee can occur at any tendon insertion, but are most common at the tendon insertion of the medial and lateral gastrocnemius and the popliteus. Ganglia can be painful if large, although a major concern is mistaking one for a soft-tissue tumor. Popliteus tendon ganglia often arise near their insertion onto the lateral femoral condyle and are usually asymptomatic [Figure 11].
They want to know that if they do take anabolic steroids, I guess they want to make the most of their time, you know? You're only going to be 18 to 24 once and I guess the girls that you would get in that era won't come when you're 40 and 50.
Anterior cruciate ligament (ACL) ganglia are more common than posterior cruciate ligament (PCL) ganglia and can have a "drumstick" appearance with enlargement and increased T2 signal in the proximal ACL fibers [12] [Figure 12]. This increased T2 signal can be seen as a discrete focus of fluid or a more diffuse abnormality of "mucoid degeneration." It is important to distinguish ACL ganglia from a ligament tear because patients with ACL ganglia do not have instability and are usually asymptomatic. Although the ACL becomes enlarged due to the ganglion, one should still be able to see continuous intact ligament fibers, which distinguishes this process from an ACL tear.
Note the presence of continuous intact ACL fibersClick here to viewFigure 13: PCL ganglion. Meniscal cysts are believed to form as a result of tears in the meniscal fibrocartilage, with extrusion of synovial fluid through the meniscal tear. Do you think that's true?Sarah: Well, personally I love tattoosa€”like, that's an attractive thing for mea€”but muscles, it just really depends on the volume of their muscles. Like, you know, a nice ab, a nice 'V', is all right, but when it's, like, too full ona€”like, it looks like their body's about to explodea€”that's disgusting to me.Brendan King: And what about steroids? Parameniscal cysts are the most common subtype and occur at the joint line as a focal mass emanating from a meniscal tear [Figure 14]. It is important to remember that medial parameniscal cysts may dissect through the soft tissues of the joint capsule or medial collateral ligament (MCL), thus appearing far from the tear origin.
If you go online, you can see how easy it is to order all types of steroids and growth hormones.
Companies offer safe and discreet shipping.In a written statement to Background Briefing, customs said the increase in seizures can be attributed to the easy availability of these substances in countries which do not have the same controls as Australia. Loculations or septations are common and show peripheral contrast enhancement, unlike the solid areas of enhancement seen with a neoplasm.
On arthrography, a meniscal cyst may fill with contrast, but a lack of filling should not exclude the diagnosis. In the subacute phase (1-4 weeks following initial injury), a hematoma can contain fluid with free methemoglobin, resulting in high signal intensity on both T1W and T2W images . So people will plan trips and go there for that amount of time.There's lots of gyms in Thailand. Axial pre (B) and post (C) T1W fat-saturated, and subtracted post-contrast images (D) confirm lack of enhancement. They'll take a good cycle of the geara€”prescription strength, rather than buying the sort of underground, homemade things that you get in Australia most often.
And they'll go through a full cycle and training up there and then come back to Australia for their off-cycle.I was living in the south of Thailand, on one of the islands in the Gulf of Thailand.
And there was a couple of good gyms on the island and there was just the amount of people living there that you see coming and going on holidays just for that purpose alone. MRI reveals a simple, thin-walled cystic mass that has high T2 intensity and is isointense or hypointense to muscle on T1W images. I mean, obviously to enjoy the beautiful tropical surrounds, the weather, et cetera; to relax, have a cheap holiday, save thousands of dollars on their gear and just try and get big and eat a lot. Went over and went to the chemist that he suggested and I walked straight in and spoke to the guy, and he said to mention his name, so I did.
You go there for a holiday, you live like a king, and you get massive, and you come back looking fantastic.
A characteristic finding is a thickened rim that enhances after contrast administration [Figure 17]. Moreover, the presence of perilesional edema and enhancement often can help distinguish this "cystic" lesion from a seroma or hematoma.
And again, some people might find some of the language here offensive.Testosterone was first isolated by Nazi chemists in the 1930s.
A potential pitfall in distinguishing an abscess from a solid tumor is a phlegmon, which is a precursor to an abscess and can have solid enhancement mimicking a neoplasm.
Soon afterwards, synthetic variations of testosterone were developed, creating the family of drugs now known as anabolic steroids. It wasn't until the 1950s that the elite athletic community discovered how well the drugs actually worked. The first documented case was the Russians using testosterone injections at the Vienna weightlifting championships in 1954. In contrast to the entities described previously, these vascular lesions can have internal solid enhancement that mimics a tumor and may be confused with malignancy.
Identifying a connection between the lesion and the vessel of origin can help make the proper diagnosis and avoid a potentially disastrous biopsy.Aneurysms of the popliteal artery [Figure 18] account for up to 80% of peripheral arterial aneurysms and are bilateral in half of the cases. In that hypothetical scenario, we would have a few anecdotal cases of people with lung cancer or some small case series of people with emphysema, or whatever, but we would have little idea of the full magnitude of what was about to hit us.
And that would suggest that these guys may be having aging of their arteries that is going several times as fast as an ordinary person.
They are typically soft, compressible, non-pulsatile masses that give a bluish discoloration to the involved skin and subcutaneous tissues. And all the claims about heart disease, cancer, and stroke, there's really not much data to show that that happens either.
These masses typically have low-to-intermediate signal intensity on T1W images, high signal intensity on fluid-sensitive sequences, and contain foci of low signal on all sequences from phleboliths. If you challenge one of these people and say, 'Name a famous athlete who's died of a heart attack or a stroke,' it's hard to come up with even one. So there are many mild or reversible effectsa€”like hair loss or deepening of the voice for women or temporary infertilitya€”but the claims that they kill you or shorten your life is not supported by any data.Brendan King: But is that because they've only been used widely, I suppose, in the greater community, since the 1980s?
Is that because we just don't have the data yet?Norman Fost: Well, they've been in use for 30 or 40 years, so there's been time to find out if there's some major mortality. But one of the problems is that we really don't have any numbers and we probably never will as long as we criminalise these drugs.
MRI demonstrates a similar appearance to that of venous malformations; they may be macrocystic or microcystic, with the latter form predominating in the extremities [Figure 20].
We ended up seeing a 35-year-old with severe heart failure, or a sudden heart death at 35 where the coronary arteries looked good.


These are the deaths that are probably anabolic steroid use, but because that's never documented anywhere because the drugs are acquired illegally, we don't know the actual figures. And it's the testicles that make testosterone, so usually during this time they've had shrinkage of the testicles, sometimes to such a degree that the scrotal sack is empty.
And the problem is there's such an individual sensitivity to these drugs that some people might say, 'Oh, I've been on them for 12 months, I've never had any trouble and I haven't become infertile, and my blood pressure's fine, ' but equally we have documented cases of people that have been on a very brief course of thema€”and very brief is four weeks to six weeksa€”who have developed significant side effects, with high cholesterols and subsequently risk of coronary artery disease, including deaths in 20-year-olds. The main diagnostic considerations are peripheral nerve sheath tumor (PNST), synovial sarcoma, and myxomatous tumor, all of which can appear uniformly isointense and hyperintense when compared to skeletal muscle on T1W and T2W MR images, respectively.
The more common schwannomas arise from schwann cells, which produce myelin and are located on the periphery of the nerve; neurofibromas arise from the nerve itself, making surgical resection more difficult. Axial (A) T1W and (B) T2W fat-suppressed images show T2-hyperintense lesion (arrows) in the lateral soft tissue of the knee. So I used to go to the doctor, the doctor kept the steroids and he injected me once a week, because it was a prescription. Other times it was like, no, take x amount of mls every third day and then increase the dosage over a few weeks and then decrease the dosage maybe as you were coming off them. Initial investigators mistook the tumor cells for synovial cells, leading to this misnomer.
Synovial sarcomas occur most commonly in young adults, often around knee, ankle, and foot joints. How did you convince someone that you were the right person to be able to use steroids and what are the rules around that?Jamie Close: Ah, I suppose really there's no rules around that depending on who you go and see. They often appear as well-defined, non-infiltrative masses that are T1 hypointense and T2 hyperintense [Figure 24].
My training partner at the time, he knew of a doctor, a sports doctor, so I went to see this sports doctor and had a chat to him. They may demonstrate a "triple signal" pattern on T2W MRI images, which is characterized by hypointense, isointense, and hyperintense regions within the mass relative to fat. And I just let him know that I wasn't just a young kid wanting to get huge, I actually wanted to be a professional bodybuilder back then.And I told him I'd had a sperm count done and I showed him the results and they were healthy. And I said, 'I'm serious about this, so I don't want some rubbish that I'm going to take orally, I want something that's going to get me the result.'And so I suppose because I came across in that light, he decided then that he'd work with me. And he wrote the prescription and I went to the doctor and next thing you know, my strength went through the roof and I felt like I could snap a steel pole in half. The tumor is characterized by its lack of nuclear pleomorphism and a mitotic rate that is lower than expected for such a cellular tumor, consistent with a synovial sarcomaClick here to view Myxomatous neoplasms, which may be benign or malignant, are associated with an overproduction of mucopolysaccharide substances. I remove myself from it, having given them advice as to why and having explained to them my position.
On USG, myxomatous lesions appear as well-defined, hypovascular, and hypoechoic masses with minimal internal echoes, and they can demonstrate enhanced through transmission similar to cysts.
Malignant myxoid tumors are often difficult to distinguish from each other, but all are typically larger, with less-defined margins and heterogeneous signal on all sequences when compared to benign myxomatous lesions. And I don't lecture people; I actually give them advice about my concerns about what these products can do.
But the other thing is that even if they were harmful, it's quite paternalistic to tell a competent adult that he or she can't take risks in exchange for benefits of wealth, fame, and whatever else comes from being an elite athlete.
You know, we allow people to become fire fighters and police and to join the military and to drive race cars and do things that are far more dangerous than even the worst claims about steroids. So wouldn't legalising something like that when we're not sure yet be extremely problematic?Norman Fost: Well, you have to realise that other drugs that get approved by the FDA, and comparable agencies in other countries, there aren't long term data on most any drug that gets approved.
The drug gets approved based on a clinical trial in which it's given to people for a period of weeks or months or maybe a year or two, but concerns about what might happen over 20 or 30 years is unknown. And you could say, 'Who's going to exploit it?' Well, there would be numerous levels of gain, commercial gain, from this kind of thinking.And so I'm extremely reluctant.
I kind of feel that we were naturally built a certain way and it's been generations and generations and generations of evolution. I'd prefer that we look at our sedentary lifestyles and say, 'Well, you know, we were all meant to be hauling rocks and working in the fields,' and if you do that, well of course you're going to be more muscular.
Why on earth should you think that you can sit at a desk for ten hours and then also have the physique of somebody who rowed boats in the Roman ages, for example, or was a Viking, or was a mountain man who spent 15 hours working out of doors every day?So I think we need to be really sensible about this. One of the most talked about side effects is what's known as 'roid rage', or steroid fuelled aggression.
It's been really difficult to try and tease out that relationship between steroid use and aggression and violence. The studies that we've done haven't been the best, and I don't think we'll ever get a 100 per cent definitive answer.
What is really interesting, though, is that when we do studies with steroid users, there is a proportion that do admit that they get more aggressive, or they do see mood changes.
While violence is obviously of concern to the police, roid rage is not something they're particularly focussed on.
Steroid users aren't usually involved in criminal activity, but the New South Wales police are looking at the possibility of amending some laws as steroids turn up more often when police are searching for other drugs. And most of our steroid seizures come from out of other search warrants, vehicle stops, or other proactive operations where we may be targeting other drugs.
When we are seeing an increase in the detection of steroids, and I'm speaking with our legal area and some of my fellow squad commanders to possibly look at amending some legislation in relation to increasing penalties, for supply of steroids in particular. And it's like, if anyone came up to me you felt like you'd be able to defend yourself quite easily.
So going from where I was at at 16 to where I was at 28, 29 in that position, yeah, it was quite addictive, because it appealed to that 16-year-old in me that used to get bashed.Brendan King: And how effective was it? I mean, what was the jump that you made when you were using the steroids?Jamie Close: Well, I suppose the jump was on every level. You know, my strength went through the roof, the weights I was lifting in the gym incredibly grew in size, and I looked awesome (laughs). You know, to finally have a six-pack and to have a decent chest and back and to look in the mirror and just go, 'Fuck,' you know, 'that's an amazing body.' I was so proud of my achievements. And especially when they get to the age of 22, most of the guys are on the gear at the comps. Yeah, so that's why I've decided to now start on my first cycle.Brendan King: And what does that mean?
That's a very important factor as well, and oral steroids have a big effect on your liver, as well as injectables have a big effect on your testicles and the testosterone production stops. And there's a lot of factors that you do have to consider.Brendan King: And were you worried about those things? You've obviously given them some thought, but have you experienced any of the side effects so far?Sam: I have experienced some side effects.
I can feel a stabbing sensation just in the liver and that's probably about four to five hours after taking it. And I think it's also, you know, maybe part of the primate (laughs)a€”always being the bigger animal.
Do you feel like you're competing with other people when you're walking through a shopping centre, or you go to dance parties?Sam: You do tend to feel that, you do tend to feel that. But then even looking at guys who are bigger than you still gives you more motivation in the end, you know. You may as well stick a prosthesis on your nose and pretend you're somebody else.As a woman over the last 20 years, one of the things that I've often lamented is the negative self-image that women have about themselves. It's not what we mean by equality of the sexes to have men now suffering from low self-image, but it certainly is one of the things that the media and other things that are prevalent in the community have been promoting. It had like these big steroid guys, and it said, 'Supplements that work.'And I said, 'They're not! They might be taking the supplements, but they're on the gear and human growth hormone!' And I thought, what sort of image is that projecting to say the young 16-year-old kids like I was, that are skinny, maybe getting bullied or picked on, that want to get huge.



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