Imaging of sports injuries in adolescents.

Musculoskeletal injuries in adolescents tend to occur in particular locations and have distinct characteristics, as they affect an immature skeleton. Increased engagement in sports, extended training and competition periods, and early specialization in specific sports, among other factors, have contributed significantly to the rise in musculoskeletal sports injuries in adolescents. Furthermore, females show a particularly pronounced increase in sports participation, where anatomical and hormonal factors play crucial roles in the development and increased frequency of sports-related injuries. Consequently, there is a growing demand for diagnostic imaging techniques. Musculoskeletal and pediatric radiologists require a comprehensive understanding of intrinsic and extrinsic risk factors and the successive stages of skeletal development that can influence the specific characteristics of sports injuries in adolescents. These aspects are crucial for the diagnostic, prognostic, and therapeutic management of these injuries and for mitigating chronic conditions that could compromise future sports participation. This review analyzes the primary musculoskeletal injuries in adolescent athletes and highlights the pivotal role of different imaging methods in their diagnosis and management.

Endovascular Treatment of Carotid Blowout Syndrome.

INTRODUCTION: Carotid blowout syndrome (CBS) is a life threatening complication associated with head and neck cancers (HNC) and its treatment. The mortality rate was reported to range from 3% to over 50% in the literature. Direct surgical repair of the ruptured internal carotid artery is often not technically possible due to the difficult anatomy and underlying poor co-morbid status. Endovascular techniques such as coil embolization and stent grafting offer an alternative to surgical ligation with better patient outcomes. METHODS: We describe the successful use of an endovascular approach in a case of emergent rupture of the common carotid artery (CCA) with massive bleeding in a patient submitted to radiotheraphy for the treatment of a neck malignancy. RESULTS: A 75-year-old man with a squamous cell carcinoma of the esophagus having undergone chemotherapy and radiotherapy, was admitted to the emergency room with haematemesis with approximately 1 hour of evolution. An angiogram revealed, in the right common carotid artery, contrast extravasation with a possible fistula communicating to the esophagus. A self-expandable covered stent was deployed in the right common carotid artery. Successful repair of the vessel was confirmed in the control angiogram. The patient was discharged 10 days later without neurological deficit or recurrent bleeding. Carotid blowout syndrome is one of the most complex bleeding complications that may occur in HNC patients. It is usually a life-threatening event and is accompanied with unexpectedly massive bleeding and high mortality/morbidity rates. Short and long term effects of radiation over arteries have been reported. Radiation can induce damage to the vasa vasorum of large arteries and it might lead to the rupture of arteries. In the HNC population with previous surgery or radiotherapy, a high index of suspicion must be maintained for CBS in patients presenting with any recent history of oral bleeding or haemorrhaging from an exposed neck wound. CONCLUSION: Current evidence shows that there was no significant difference in technical and hemostatic outcomes between the reconstructive and deconstructive endovascular methods. Permanent vessel occlusion resulted in higher immediately cerebral ischemia and stent grafting induced the more potentially delayed complications, such as infection, rebleeding, and stent thrombosis. In the present case, the endovascular management of CBS of the common carotid artery had high technical success and allowed immediate haemostasis. It has been suggested that self-expanding stent-grafts are useful for the initial control of carotid bleeding but are associated with more delayed complications.

Bilateral transient osteoporosis of the hip: a neglected cause of hip pain during pregnancy.

Transient osteoporosis of the hip (TOH) is an important but often neglected cause of hip pain, which can gradually lead to debilitating mobility and carries risks such as fracture or avascular necrosis. A 39-year-old woman presented to the Rheumatology department two weeks post-cesarean delivery, reporting the onset of left mechanical hip pain since the 33rd week of pregnancy. After delivery, similar complaints emerged on the right side. Hip X-ray showed a decrease in bone density in the left hip. Later, Magnetic Resonance Imaging revealed bilateral bone marrow edema in both proximal femurs. The diagnosis of TOH was established, and the patient was treated with conservative measures. Seven months later, she was asymptomatic. Pregnancy is a recognized risk factor for TOH, especially in the last trimester. It is an important differential diagnosis to consider in cases of hip pain in pregnant or newly breastfeeding women.

Schwannoma of the tongue-A common tumour in a rare location: A case report.

Schwannoma is a benign tumour that arises from Schwann cells of the peripheral nerve sheath, and is a common tumour of the head and neck. However, intraoral location is very uncommon (only 1% of all head and neck schwannomas). We report a rare case of lingual schwannoma in a 20-year-old male patient who presented with a small, slow-growing mass over the right lateral border of the tongue with 1 year of evolution and that became recently ulcerated. The patient underwent MRI examination and complete surgical excision. Histopathological and immunohistochemical examination confirmed the diagnosis.

Diffuse pulmonary ossification: A case report.

Diffuse pulmonary ossification (DPO) is a rarely diagnosed entity that may present with characteristic imaging features. It is listed in the differential diagnosis of lung parenchymal calcifications and should be considered by the radiologist if the appropriate findings are identified. We report a case of DPO secondary to mitral stenosis in a patient whose severe cardiac pathology lead to death few weeks after a chest CT was done. To date, there are no specific treatments with proved benefit in this pathology.

An unusual case of extensive peritoneal calcification: A case report.

The peritoneum is the largest serous membrane of the body and can be exposed to several injuries that may cause abnormal findings on imaging exams. Linear peritoneal calcification is remarkably rare, usually secondary to long duration peritoneal dialysis. We report an uncommon case of extensive peritoneal calcification in a 39-year-old female without long exposure to peritoneal dialysis solutions, in which peritoneal calcification could be linked to Alport syndrome and previous adverse reaction to intraperitoneal iodinated contrast. Radiologist should be aware of this and related imaging findings, know when to search for them as well as understand their clinical value.