RESUMO
Cervical spine trauma encompasses a wide of injuries, ranging from stable, minor lesions to unstable, complex lesions that can lead to neurologic sequelae or vascular involvement. The Canadian C-Spine Rule and the NEXUS criteria aim to identify individuals with a low risk of cervical spine trauma who can safely forgo imaging tests. In high-risk patients, an imaging test is indicated. In adult patients the imaging test of choice is multidetector computed tomography. Complementary imaging tests such as CT angiography of the supra-aortic vessels and/or magnetic resonance imaging are occasionally necessary. It can be challenging for radiologists to diagnose and classify these lesions, because some of them can be subtle and difficult to detect. This paper aims to describe the most important imaging findings and the most widely used classification systems.
Assuntos
Traumatismos da Coluna Vertebral , Adulto , Humanos , Canadá , Traumatismos da Coluna Vertebral/diagnóstico por imagem , Traumatismos da Coluna Vertebral/etiologia , Imageamento por Ressonância Magnética , Vértebras Cervicais/diagnóstico por imagem , Tomografia Computadorizada MultidetectoresRESUMO
Peliosis hepatis is a rare histopathological entity of unknown etiology. We present a case of peliosis hepatis in a 44-year-old man with disseminated tuberculosis and acquired immunodeficiency syndrome. The diagnosis of peliosis hepatis was based on liver biopsy results which were suggestive of tuberculous etiology. Diagnosis of tuberculosis was confirmed by auramine stain, rRNA amplification and culture of Mycobacterium tuberculosis from synovial fluid of the elbow joint. The patient responded favourably to tuberculostatic treatment with four drugs and the early initiation of highly active antiretroviral therapy. Histopathological evidence of peliosis hepatis, without an obvious cause, makes it necessary to rule out tuberculosis, especially in the context of immunodeficiency diseases and immigrants from endemic areas.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Mycobacterium tuberculosis/isolamento & purificação , Peliose Hepática/diagnóstico , Peliose Hepática/etiologia , Tuberculose/complicações , Tuberculose/diagnóstico , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Adulto , Antirretrovirais/uso terapêutico , Antituberculosos/uso terapêutico , Biópsia , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/microbiologia , Articulação do Cotovelo/patologia , Histocitoquímica , Humanos , Fígado/patologia , Masculino , Peliose Hepática/patologia , Radiografia Abdominal , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose/tratamento farmacológico , Tuberculose/patologiaRESUMO
Invasive vascular procedures have good efficacy and safety profiles and are now widely used for the diagnosis and treatment of many cardiovascular disorders. However, they do have potential complications that can occasionally be life-threatening. We present a new case of infectious pseudoaneurysm following percutaneous transluminal coronary angioplasty and complicated by septic emboli to the skin. It is a rare condition characterized by persistent bacteremia, sepsis of unknown origin, and regional septic emboli. Histopathology of the skin lesions typically reveals gram-positive coccobacilli and septic vasculitis. The condition carries a significant morbidity and mortality, making early diagnosis essential. Both cholesterol and septic emboli should be considered in the differential diagnosis of skin lesions after invasive vascular procedures.