RESUMEN
No official data exist on the status of musculoskeletal (MSK) radiology in Europe. The Committee for National Societies conducted an international survey to understand the status of training, subspecialization, and local practice among the European Society of Musculoskeletal Radiology (ESSR) partner societies. This article reports the results of that survey. An online questionnaire was distributed to all 26 European national associations that act as official partner societies of the ESSR. The 24 questions were subdivided into six sections: society structure, relationship with the national radiological society, subspecialization, present radiology practice, MSK interventional procedures, and MSK ultrasound. The findings of our study show a lack of standardized training and/or accreditation methods in the field of MSK radiology at a national level. The European diploma in musculoskeletal radiology is directed to partly overcome this problem; however, this certification is still underrecognized. Using certification methods, a more homogeneous European landscape could be created in the future with a view to subspecialist training. MSK ultrasound and MSK interventional procedures should be performed by a health professional with a solid knowledge of the relevant imaging modalities and sufficient training in MSK radiology. Recognition of MSK radiology as an official subspecialty would make the field more attractive for younger colleagues as well as attracting the brightest and best, an important key to further development of both clinical and academic radiology. KEY POINTS: · Standardized training and/or accreditation methods in the field of MSK radiology is lacking at a national level.. · With certification methods, such as the European diploma in musculoskeletal radiology, a more homogeneous European landscape could be created in the future with a view to subspecialist training.. · Recognition of MSK radiology as an official subspecialty would make the field more attractive for younger colleagues as well as attracting the brightest and best, an important key to further development of both clinical and academic radiology..
Asunto(s)
Diagnóstico por Imagen/tendencias , Enfermedades Musculoesqueléticas/diagnóstico por imagen , Europa (Continente) , Humanos , Sociedades MédicasRESUMEN
Heterotopic hepatic tissue is a rare development anomaly, exhibiting diverse forms and locations. We present a case report of an asymptomatic woman in her 40s who had an 8 cm mass in the left hypochondrium detected on routine ultrasound, which was initially suspected to be a tumour. Further investigation revealed that the mass had a similar enhancement to the liver on gadoxetate disodium-enhanced MRI and presented a connection with the original liver via vascular pedicle, favouring the diagnosis of accessory liver lobe (ALL). Accurate differentiation of ALL from other abdominal masses poses a diagnostic challenge, potentially leading to misdiagnosis of malignant tumours and unnecessary interventions. Although usually small and asymptomatic, rarely they can present with acute complications, and cross-sectional techniques play an important role in enabling early diagnosis and management. Therefore, radiologists must raise awareness regarding ALL, their imagological findings, and diagnostic pathways, and understand potential associated complications.
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Hígado , Imagen por Resonancia Magnética , Humanos , Femenino , Diagnóstico Diferencial , Hígado/diagnóstico por imagen , Hígado/anomalías , Hígado/patología , Adulto , Ultrasonografía , Coristoma/diagnóstico , Coristoma/diagnóstico por imagen , Medios de Contraste , Gadolinio DTPARESUMEN
Residents experience high pressure to be successful in both their career and in keeping up an optimal work-life balance. With a mentoring program, faculties can alleviate stress and provide help for their residents. It is now well established that mentor-mentee relationships during medical school, have influence in career decisions and professional identity formation. The same can be said for mentor-mentee relationships during radiology residency. In general, universal rules of mentoring are also useful and applicable in the field of radiology. These universal rules for establishing a successful mentoring relationship include creating a relationship of trust and confidentiality, clearly defining roles and responsibilities, establishing short- and long-term goals, using open and supportive communication, and collaboratively solving problems. The institutions and the radiology departments should be well prepared and aware of the responsibility to have trainees, providing time for mentors to dedicate to their academic duties. They have to implement strategies to effective mentor matching and orientation as well as the ability to provide evaluation with qualitative feedback. Periodic assessment should be warranted together with the incorporation of new technology as it plays a critical role in the training of millennial radiologists as they take the profession into a technology-laden future of medical imaging.
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Internado y Residencia , Tutoría , Radiología , Docentes Médicos , Humanos , Tutoría/métodos , Mentores , Radiología/educaciónRESUMEN
CASE: A 41-year-old right-handed male patient presented to our institution with a chronic distal biceps rupture after failed primary surgery 6 months previously. We performed a reconstruction with semitendinosus autograft fixed proximally with a Pulvertaft weave and distally with a cortical button plus interference screw. The patient showed complete pain resolution and excellent functional results. CONCLUSION: This is the first case described with the use of a cortical button plus interference screw distally for distal biceps reconstruction after chronic distal biceps rupture. The option of doing the Pulvertaft proximally first also allowed us to fine-tune the final graft tension.
Asunto(s)
Traumatismos de los Tendones , Tenodesis , Adulto , Humanos , Masculino , Músculo Esquelético/cirugía , Rotura/cirugía , Traumatismos de los Tendones/cirugía , Tendones/trasplante , Tenodesis/métodosRESUMEN
Inclusion body myositis is a rare acquired muscle disease that predominantly affects individuals older than 45 years of age and that has been classified as an idiopathic inflammatory myopathy. However, it has a distinct course being characterized by a slowly progressive weakness and resistance to immunosuppressive therapy. This diagnosis is usually based on a typical clinical presentation, elevated serum skeletal muscle enzymes, electromyographic findings and muscle biopsy. Magnetic Resonance Imaging (MRI) can aid in the diagnosis by directing muscle biopsy sites through accurate localization of muscle involvement, which avoids the high false-negative rate of blind muscle biopsies. MRI can also depict the nature and extent of muscle abnormalities with high signal intensity seen in the active phase and refractory treated patients on fluid-sensitive images. Recently, there has been important progress in the understanding of IBM. These advances may lead to improved diagnosis and the discovery of effective drug treatments for this debilitating entity with usually poor prognosis and high levels of disability.
Asunto(s)
Imagen por Resonancia Magnética , Miositis por Cuerpos de Inclusión/diagnóstico por imagen , HumanosRESUMEN
Epithelioid sarcoma is a rare mesenchymal neoplasm characterized by aggregates of epithelioid cells. Intra-articular occurrence is exceedingly rare with only few reports described in the literature. A 22 year-old man presented a progressive mechanical knee pain. Initially, the investigation revealed a non-infectious unspecific synovitis. The patient gradually presented increasing knee enlargement and functional impairment. Intra-articular nodular proliferation with bone invasion was later observed on magnetic resonance imaging reevaluation. Pigmented villonodular synovitis hypothesis was considered. The biopsy ultimately revealed nodules of epithelioid cells with an immunoprofile compatible with epithelioid sarcoma diagnosis. The patient underwent neoadjuvant chemotherapy and radiotherapy and an above-knee amputation was performed.
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Artropatías/diagnóstico , Articulación de la Rodilla , Sarcoma/diagnóstico , Adulto , Humanos , Adulto JovenRESUMEN
LEARNING OBJECTIVES: Radiological findings of abdominal tuberculosis can mimic those of many different diseases. A high level of suspicion is required, especially in high-risk population. In this article, we will describe barium studies, ultrasound (US) and computed tomography (CT) findings of abdominal tuberculosis (TB), with emphasis in the latest. We will illustrate CT findings that can help in the diagnosis of abdominal tuberculosis and describe imaging features that differentiate it from other inflammatory and neoplastic diseases, particularly lymphoma and Crohn's disease. As tuberculosis can affect any organ in the abdomen, emphasis is placed to ileocecal involvement, lymphadenopathy, peritonitis and solid organ disease (liver, spleen and pancreas). A positive culture or hystologic analysis of biopsy is still required in many patients for definitive diagnosis.
Asunto(s)
Peritonitis Tuberculosa/diagnóstico por imagen , Radiografía Abdominal , Tomografía Computarizada por Rayos X , Tuberculosis Gastrointestinal/diagnóstico por imagen , Tuberculosis Hepática/diagnóstico por imagen , Tuberculosis Ganglionar/diagnóstico por imagen , Tuberculosis Esplénica/diagnóstico por imagen , Diagnóstico Diferencial , Humanos , Peritonitis Tuberculosa/fisiopatología , Tuberculosis Gastrointestinal/fisiopatología , Tuberculosis Hepática/fisiopatología , Tuberculosis Ganglionar/fisiopatología , Tuberculosis Esplénica/fisiopatología , UltrasonografíaRESUMEN
Aortic arch anomalies are relatively common, occurring in 0.5-3% of the population. In recent years, they have been recognized as being among the cardiovascular malformations found in chromosome 22q11 deletion. MRI is now an alternative method of diagnosing aortic arch anomalies since it accurately defines aortic anatomy and its relation with the trachea and esophagus, with some advantages in comparison with echocardiography and conventional angiography. The authors present two cases of cervical aortic arch and VSD associated with DiGeorge syndrome (CATCH22+), diagnosed by conventional angiography and magnetic resonance imaging, respectively.
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Aorta Torácica/anomalías , Aorta Torácica/patología , Imagen por Resonancia Magnética , Adolescente , Deleción Cromosómica , Estudios de Seguimiento , Humanos , Recién Nacido , MasculinoRESUMEN
Objetivo: Este trabalho tem o objetivo de avaliar o conhecimento de estudantes de Odontologia sobre os princípios ergonômicos aplicados à prática clínica e de investigar sintomas associados às doenças ocupacionais. Materiais e método: tratou-se de um estudo transversal censitário, no qual foram entrevistados 164 estudantes do 3º ao 9ºperíodo do curso de Odontologia de uma universidade do município de Caruaru-PE. Foram aplicados dois questionários: um, com perguntas relativas às características sociodemográficas, conhecimentos sobre ergonomia, doenças ocupacionais na Odontologia e medidas preventivas; e o outro, o Nordic musculoskeletal questionnaire, para mensuração de sintomas osteomusculares. Para análise estatística foi usado o teste de correlação de Pearson ou o Exato de Fisher (p<0,05). Resultados: a maioria dos pesquisados, 87,2%, soube expressar parcialmente o conceito de ergonomia, exemplificou como principais doenças ocupacionais os distúrbios osteomusculares, 54,3%, bem como destacou realizar medidas preventivas ?às vezes? (45,7%), sendo os alongamentos a principal prática em 53% dos casos. O local mais acometido por sintomas osteomusculares foi a parte superior das costas em 46,3% das ocorrências. Houve diferença estatística entre os períodos dos estudantes (3º, 5º, 70 e 9º) para as variáveis: definição de ergonomia, frequência de uso de medidas preventivas, principais doenças ocupacionais e localização anatômica da dor (p<0,05). Houve tendência de pior desempenho e maiores frequências de distúrbios osteomusculares nos acadêmicos dos períodos finais do curso. Conclusões: o conhecimento dos estudantes foi insatisfatório e as regiões mais acometidas por sintomas associados às doenças ocupacionais foram: a parte superior e a inferior das costas e do pescoço. Procedimentos normativos devem ser adotados com o intuito de prevenir as doenças ocupacionais no ambiente acadêmico.
RESUMEN
Lipoma arborescens is a rare intraarticular lesion of unknown etiology. The disorder usually presents as painless swelling and recurrent joint effusion. It is typically located in the knee (especially the suprapatellar bursa), though it has also been described in other joints. Laboratory test results are normal, as well as aspirated synovial fluid. Synovectomy is curative in most cases. The authors report a review of the literature, highlighting the importance of magnetic resonance imaging in the diagnosis of this pathology. Although it is a rare lesion, synovial lipoma arborescens should be included in the differential diagnosis of patients with a chronic swollen joint or recurrent joint effusions.
Asunto(s)
Bolsa Sinovial , Lipoma/diagnóstico , Diagnóstico Diferencial , HumanosRESUMEN
A ausência de uma boa aptidão física relacionada à saúde está fortemente associada à predisposição a doençashipocinéticas, as quais muitas vezes resultam em óbito. Considerando-se que quanto antes esses problemasforem diagnosticados, maiores serão as possibilidades de prevenção e intervenção. Este estudo teve por objetivoanalisar o nível da aptidão física relacionada à saúde (AFRS) de crianças de 7 a 10 anos e as diferenças entreos sexos. A amostra foi composta por 280 escolares, sendo 157 meninas e 123 meninos. A AFRS foi avaliadaatravés das medidas de índice de massa corporal (IMC), força/resistência abdominal e flexibilidade,classificando-se os resultados em abaixo, na e acima da zona saudável de massa corporal (ZSMC) e dazona saudável de aptidão física (ZSAF). Embora a maioria das crianças se encontre na ZSMC e ZSAF, altospercentuais de escolares com excesso de massa corporal - sobrepeso e obesidade (33,24%) e abaixo da ZSAFna força/resistência abdominal (23,83%) foram encontrados em ambos os sexos. Conclui-se que, com exceçãoda flexibilidade, os resultados não foram satisfatórios, devendo estratégias ser pensadas a fim de possibilitar oalcance da zona saudável e amenizar os riscos à saúde.
The lack of physical ability is strongly associated to the hypokinetic diseases predisposition, which often results indeaths. Considering that, as soon as these problems are diagnosed, greater are the possibilities of preventionand intervention. The aim of this study was to analyze the level of health related to physical ability (HRPA) onchildren aged from 7 to 10 and the differences between the sexes. The sample was a group of 280 scholars, 157girls and 123 boys. The health related physical ability (HRPA) was evaluated through the measures of BodyMass Index (BMI), abdominal strength/resistance and flexibility, classifying the results as low, on and overthe Body Mass Health Zone (BMHZ) and the Physical Ability Health Zone (PAHZ). Although most of the childrenanalyzed were on BMHZ and PAHZ, a large group of scholars were on the over zone showing an excess ofbody mass - overweight and obese (33.24%) and low on abdominal strength/resistance PAHZ (23.83%) in bothsexes. It could be concluded that, except for the flexibility, the results were not satisfactory, and strategies shouldbe developed in order to reach the health zone and reduce the health risks.
La ausencia de una buena aptitud física a la salud está fuertemente asociada a la predisposición a enfermedadeshipocinéticas, muchas veces resultando en óbitos. Considerando que, cuanto antes esos problemas seandiagnosticados, mayores serán las posibilidades de prevención e intervención, este estudio tuvo por objetivoanalizar el nivel de la aptitud física relacionada a la salud (AFRS) de niños de 7 a 10 años y las diferencias entrelos sexos. La muestra fue compuesta por 280 escolares, siendo 157 niñas y 123 niños. La AFRS fue evaluada através de las medidas de Índice de Masa Corporal (IMC), fuerza/resistencia abdominal y flexibilidad, clasificandolos resultados en abajo, en la y superior de la Zona Saludable de Masa Corporal (ZSMC) y de la ZonaSaludable de Aptitud Física (ZSAF). Sin embargo la mayoría de los niños se encuentra en la ZSMC y ZSAF, altosporcentuales de escolares con exceso de masa corporal - sobrepeso y obesidad (33,24%) y abajo de la ZSAF enla fuerza/resistencia abdominal (23,83%) fueron encontrados en ambos los sexos. Se concluye, que exceptuandola flexibilidad, los resultados no fueron satisfactorios, habiendo la necesidad de pensar estrategias a fin deposibilitar el alcance de la zona saludable y amenizar los riesgos a la salud.