Asunto(s)
Equimosis/etiología , Hemofilia A/diagnóstico , Tiempo de Tromboplastina Parcial , Anciano de 80 o más Años , Brazo/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Diagnóstico Diferencial , Equimosis/diagnóstico por imagen , Edema/etiología , Factor VIII/antagonistas & inhibidores , Femenino , Hemofilia A/complicaciones , Heparina/sangre , Humanos , Dolor/etiología , Tiempo de Trombina , Tomografía Computarizada por Rayos XRESUMEN
Bruising after dermal filler and neuromodulator injections is a common side effect and can have durations of 1 to 2 weeks. While it ultimately resolves, faster resolution can produce better outcomes for patients and also make patients more likely to return for future treatments. We report the successful reduction in bruising following injections of fillers with an intense pulsed light source. We also documented the onset of action of bruising resolution with serial photographs. Resolution started within the first hour of treatment and continued rapidly over 48 hours. This is the first-time reported study of resolution of bruising from injectables with intense pulsed light. Patient satisfaction is improved when such adverse events are minimized.
Asunto(s)
Técnicas Cosméticas/efectos adversos , Rellenos Dérmicos/efectos adversos , Equimosis/terapia , Tratamiento de Luz Pulsada Intensa/métodos , Rejuvenecimiento , Rellenos Dérmicos/administración & dosificación , Equimosis/diagnóstico por imagen , Equimosis/etiología , Humanos , Inyecciones Subcutáneas/efectos adversos , Tratamiento de Luz Pulsada Intensa/efectos adversos , Tratamiento de Luz Pulsada Intensa/instrumentación , Láseres de Colorantes/efectos adversos , Terapia por Luz de Baja Intensidad/efectos adversos , Terapia por Luz de Baja Intensidad/instrumentación , Terapia por Luz de Baja Intensidad/métodos , Satisfacción del Paciente , Fotograbar , Envejecimiento de la Piel , Resultado del TratamientoAsunto(s)
Equimosis/diagnóstico por imagen , Enfermedades de los Párpados/diagnóstico por imagen , Neuroblastoma/secundario , Neoplasias Orbitales/secundario , Neoplasias Torácicas/patología , Médula Ósea/patología , Preescolar , Exoftalmia/diagnóstico , Humanos , Imagen por Resonancia Magnética , Masculino , Neuroblastoma/diagnóstico por imagen , Neoplasias Orbitales/diagnóstico por imagenRESUMEN
A 72-year-old man presents with left knee pain and swelling over several days. The pain and swelling started after he felt a "pop" when bending to pick up an object off the floor. His past medical history is significant for type 2 diabetes mellitus. Physical exam revealed significant ecchymosis on the anterolateral aspect of the thigh. There was a minimal amount pain upon knee flexion.
Asunto(s)
Hematoma/diagnóstico por imagen , Traumatismos de la Rodilla/diagnóstico por imagen , Imagen por Resonancia Magnética/métodos , Muslo/fisiopatología , Anciano , Artralgia/diagnóstico , Artralgia/etiología , Tratamiento Conservador/métodos , Equimosis/diagnóstico por imagen , Equimosis/fisiopatología , Equimosis/terapia , Estudios de Seguimiento , Hematoma/fisiopatología , Hematoma/terapia , Humanos , Traumatismos de la Rodilla/fisiopatología , Traumatismos de la Rodilla/terapia , Masculino , Dimensión del Dolor , Examen Físico/métodos , Índice de Severidad de la Enfermedad , Muslo/diagnóstico por imagenRESUMEN
Background Besides the known intraarticular femoroacetabular impingement (FAI), recently forms of extra-articular impingement of the hip have been increasingly recognized. Recent studies have described an extra-articular impingement between a distal extension of the anterior inferior iliac spine (AIIS) and the femoral neck (AIIS or subspine impingement). Evidently, an association between this subspine impingement and an intraarticular FAI seems to exist. Little is known about the incidence of this impingement type and the value of its radiological diagnostics. The aim of this study was therefore to evaluate the correlation of a subspine impingement with intraarticular femoroacetabular impingement and radiological criteria of subspine impingement. Material and Methods In 2013 arthroscopic correction of intra-articular femoroacetabular impingement was performed in 80 cases. This collective was evaluated for simultaneous intraoperative findings of subspine impingement. In addition, the patients were evaluated for radiological signs of subspine impingement in conventional X-ray. A projection of the AIIS either below the acetabular sourcil or the anterior acetabular rim in an AP pelvis X-ray was considered as a radiological sign of low AIIS formation. These radiological findings were compared with the presence of intraoperative signs for subspine impingement, which are defined as a combination of focal capsule synovitis, labral ecchymosis close to the AIIS and a decreased offset between the acetabular rim and the AIIS. The specificity and sensitivity of the pre-operative radiological signs were calculated. Results A subspine impingement was found in 17 cases (21â%, 3 female, 14 male, mean age 28 years). A projection of the AIIS caudal to the acetabular sourcil in the AP pelvis X-ray was represented in 15 of the 17 cases detected (sensitivity 0.90, specificity 0.88). A projection below the anterior glenoid rim was detectable in 2 cases with symptomatic AIIS impingement (sensitivity 0.12, specificity 1). Conclusion A relevant proportion of patients with intraarticular FAI showed intraoperative signs for an additive extraarticular AIIS impingement. Preoperative pelvic X-rays are helpful with a sensitivity of 90â% in detecting the presence of a distal extension of the AIIS in FAI patients. Evaluation of the preoperative AP pelvis x-ray should include the projection of the AIIS. We recommend evaluation for subspine impingement during routine arthroscopy.
Asunto(s)
Pinzamiento Femoroacetabular/diagnóstico por imagen , Cuello Femoral/diagnóstico por imagen , Luxación de la Cadera/diagnóstico por imagen , Ilion/diagnóstico por imagen , Adolescente , Adulto , Artroscopía , Diagnóstico Diferencial , Equimosis/diagnóstico por imagen , Equimosis/cirugía , Femenino , Pinzamiento Femoroacetabular/cirugía , Cuello Femoral/cirugía , Estudios de Seguimiento , Luxación de la Cadera/cirugía , Humanos , Ilion/cirugía , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Estadística como Asunto , Sinovitis/diagnóstico por imagen , Sinovitis/cirugía , Adulto JovenRESUMEN
Paranasal sinus mucoceles are benign lesions that commonly present with orbital signs due to their anatomic proximity. We are reporting a case of bilateral frontal sinus mucocele presenting with spontaneous eyelid ecchymosis. To our knowledge this is the first case report of eyelid ecchymosis as the initial sign of this condition. In addition, our patient lacked commonly described symptoms such as diplopia or pain. This report highlights the importance of including frontal sinus mucocele in the differential diagnosis of spontaneous periorbital ecchymosis.
Asunto(s)
Equimosis/diagnóstico por imagen , Enfermedades de los Párpados/diagnóstico por imagen , Seno Frontal/diagnóstico por imagen , Mucocele/diagnóstico por imagen , Enfermedades de los Senos Paranasales/diagnóstico por imagen , Adulto , Equimosis/cirugía , Enfermedades de los Párpados/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Mucocele/cirugía , Enfermedades de los Senos Paranasales/cirugía , Tomografía Computarizada por Rayos X , Agudeza Visual/fisiologíaAsunto(s)
Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/secundario , Equimosis/diagnóstico por imagen , Equimosis/etiología , Neoplasias Renales/patología , Neuroblastoma/diagnóstico por imagen , Neuroblastoma/patología , Neoplasias Orbitales/secundario , Femenino , Hueso Frontal/diagnóstico por imagen , Humanos , Lactante , Neoplasias Orbitales/diagnóstico por imagen , Cintigrafía , Neoplasias Craneales/diagnóstico por imagen , Neoplasias Craneales/secundarioRESUMEN
Throat pain is a common presenting complaint in the pediatric emergency department and often occurs secondary to non-life-threatening conditions. Certain etiologies may initially appear benign, but if not recognized and treated, may result in airway compromise. Patients with blunt trauma to the neck may present with throat pain. This is an uncommon pediatric injury usually due to a sharp blow to the anterior neck. This injury is rarely seen in isolation. We present a case of laryngeal injury due to blunt trauma to the neck. This case illustrates the potentially serious consequence after an apparently minor traumatic injury.
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Cartílago Cricoides/lesiones , Trastornos de Deglución/etiología , Fútbol Americano/lesiones , Fracturas del Cartílago/diagnóstico , Traumatismos del Cuello/complicaciones , Dolor de Cuello/etiología , Heridas no Penetrantes/complicaciones , Adolescente , Equimosis/diagnóstico por imagen , Equimosis/etiología , Urgencias Médicas , Fracturas del Cartílago/diagnóstico por imagen , Fracturas del Cartílago/etiología , Ronquera/etiología , Humanos , Edema Laríngeo/diagnóstico por imagen , Edema Laríngeo/etiología , Masculino , Tomografía Computarizada por Rayos X , Pliegues Vocales/lesionesRESUMEN
Ovarian hyperstimulation is a recognised complication of longstanding hypothyroidism. A 12 year old girl with atrophic thyroiditis who presented with abdominal pain and distension is reported. She was noted to have bruising in the vicinity of the umbilicus (Cullen's sign). She had pronounced ovarian enlargement on ultrasonography and it was hypothesised that this profound phenotype might reflect an abnormal FSH receptor. However sequencing of the FSH receptor was normal. The ovarian enlargement resolved with thyroxine replacement. Physicians and surgeons should consider longstanding hypothyroidism in patients presenting with Cullen's sign.
Asunto(s)
Equimosis/etiología , Hipotiroidismo/complicaciones , Síndrome de Hiperestimulación Ovárica/etiología , Pubertad Precoz/complicaciones , Receptores de HFE/genética , Adolescente , Diagnóstico Diferencial , Equimosis/diagnóstico por imagen , Equimosis/metabolismo , Femenino , Hormona Folículo Estimulante/metabolismo , Humanos , Hipotiroidismo/diagnóstico por imagen , Síndrome de Hiperestimulación Ovárica/diagnóstico por imagen , Síndrome de Hiperestimulación Ovárica/metabolismo , Ovario/diagnóstico por imagen , Pubertad Precoz/diagnóstico por imagen , Pubertad Precoz/metabolismo , Receptores de HFE/metabolismo , Análisis de Secuencia de ADN , Factores de Tiempo , Ultrasonografía , OmbligoRESUMEN
Shockwave lithotripsy (SWL) is the treatment of choice for most renal calculi because it is highly effective and relatively noninvasive. Although complications of SWL are relatively few, one that occurs more frequently is perirenal hematoma, usually diagnosed by radiologic procedures. We present an interesting case of scrotal ecchymosis as an unusual presentation of perirenal hematoma causing ipsilateral spermatic-vein thrombosis after SWL for a left renal stone. To our knowledge, this condition has not been reported previously.
Asunto(s)
Equimosis/patología , Equimosis/terapia , Enfermedades de los Genitales Masculinos/patología , Enfermedades de los Genitales Masculinos/terapia , Litotricia , Escroto/patología , Anciano , Equimosis/diagnóstico por imagen , Enfermedades de los Genitales Masculinos/diagnóstico por imagen , Humanos , Masculino , Tomografía Computarizada por Rayos X , UltrasonografíaAsunto(s)
Equimosis/diagnóstico por imagen , Tratamiento de Urgencia/métodos , Fracturas Orbitales/diagnóstico por imagen , Adolescente , Antibacterianos/uso terapéutico , Diagnóstico Diferencial , Equimosis/tratamiento farmacológico , Equimosis/etiología , Humanos , Masculino , Fracturas Orbitales/tratamiento farmacológico , Fracturas Orbitales/etiología , Tomografía Computarizada por Rayos X , ViolenciaRESUMEN
Bite wounds are relatively frequent, the order of frequency being, dogs, cats and humans. The clinical importance of other types of bites depends on the severity of the injury or any subsequent infection. We report on the case of a woman bitten on her thigh by a horse, producing severe haematoma, fat necrosis and muscle rupture, without an external wound. We emphasize the importance of the ultrasound examination in the evaluation of the extent of the crush injury.
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Mordeduras y Picaduras/diagnóstico por imagen , Equimosis/diagnóstico por imagen , Caballos , Heridas no Penetrantes/diagnóstico por imagen , Adulto , Animales , Antibacterianos , Mordeduras y Picaduras/terapia , Drenaje , Quimioterapia Combinada/uso terapéutico , Equimosis/terapia , Femenino , Estudios de Seguimiento , Humanos , Muslo , Ultrasonografía , Cicatrización de Heridas/fisiologíaRESUMEN
Fracture of the penis is a rare surgical emergency. A case is presented where a 7.5 mHz ultrasonography probe was used to demonstrate the tear in the corpus cavernosum. Ultrasonography was able to identify the site and extent of the injury. Preoperative ultrasonography shows the best place for surgical incision and can be used to avoid negative surgical exploration.
Asunto(s)
Pene/lesiones , Adulto , Equimosis/diagnóstico por imagen , Estudios de Seguimiento , Hematoma/diagnóstico por imagen , Hematoma/cirugía , Humanos , Masculino , Pene/diagnóstico por imagen , Pene/cirugía , Rotura , Trasplante de Piel/métodos , UltrasonografíaRESUMEN
The authors report on an infant suspected of having been abused, who presented with periorbital edema and ecchymoses (clinical "raccoon eyes"). The pattern of the nuclear medicine bone scan suggested neuroblastoma rather than trauma. Both the bone scan and the subsequent MIBG scan revealed multiple abnormalities, including markedly increased activity around the orbits, that we termed the scintigraphic raccoon eyes sign. In addition, the grossly abnormal MIBG scan demonstrated avid uptake of MIBG throughout the entire skeleton with essentially complete absence of visualization of the liver and heart (the MIBG super scan ). These signs have not previously been described in an infant or a child with neuroblastoma.
Asunto(s)
Maltrato a los Niños/diagnóstico , Radioisótopos de Yodo , Yodobencenos , Neuroblastoma/diagnóstico por imagen , Neuroblastoma/secundario , Neoplasias Orbitales/diagnóstico por imagen , Neoplasias Orbitales/secundario , 3-Yodobencilguanidina , Neoplasias de las Glándulas Suprarrenales/patología , Medios de Contraste , Diagnóstico Diferencial , Equimosis/diagnóstico por imagen , Edema/diagnóstico por imagen , Humanos , Lactante , Masculino , Enfermedades Orbitales/diagnóstico por imagen , CintigrafíaRESUMEN
The cornerstone for radiographic evaluation of genitourinary trauma is intravenous pyelography (IVP). Despite its widespread use, however, the indications for emergency IVP in trauma remain controversial. Some authors recommend the use of an IVP for all patients with hematuria, while others are selective, basing their decision on the degree of hematuria or such other factors as the mechanism of injury, physical examination, or the presence of associated injuries. Based on the data reviewed for blunt and penetrating trauma, we recommend that an IVP be performed in: all patients with gross hematuria; all patients who present with pain or tenderness that could be referrable to the genitourinary tract, even in the absence of hematuria; all patients with flank hematoma or ecchymosis; and all patients with penetrating trauma that could reasonably be expected to injure the genitourinary tract. Recently computed tomography (CT) has been proposed for the evaluation of renal trauma. The CT proponents cite superior definition of the extent of renal injury and superior detection of injuries not clinically suspected. Some have proposed the following algorithm, incorporating computed tomography. If an isolated renal injury is suspected clinically, an emergency IVP is performed. If the IVP is normal, expectant conservative treatment follows. If the IVP is abnormal or if the patient has persistent symptoms, an emergency CT scan is performed. Furthermore computed tomography is performed initially in the stable patient with multiple trauma and in the patient with suspected severe renal injury. While this algorithm has not been universally accepted, future studies confirming the theoretical advantages of this approach are anticipated.