RESUMO
OBJECTIVE: The purpose of this study was to evaluate the ease, completeness, and clinical utility of double-contrast barium enema (DCBE) performed immediately after incomplete colonoscopy. SUBJECTS AND METHODS: During a 30-month period, a prospective study was performed in 103 patients (79 women, 24 men) to determine the ease and completeness of DCBE immediately after failed colonoscopy and any additional useful information provided by the enema. The ease with which DCBE was performed was graded from 1 (easy) to 10 (difficult). RESULTS: DCBE revealed the entire colon in 97 patients (94%). Incomplete DCBE was a result of obstruction and incontinence in three patients each. The mean score for ease of performing DCBE was 5.0. In 14 patients (14%), significant additional diagnostic information was provided by the immediate DCBE. In eight patients, abnormalities were identified on DCBE that had not been seen at colonoscopy (five malignant neoplasms, one diverticular mass, two extrinsic masses, and multiple strictures). In four patients, a suspected colonoscopic abnormality was excluded with DCBE findings; and in two patients, a colonoscopic abnormality was further characterized with DCBE. CONCLUSION: Immediate DCBE after incomplete colonoscopy allows complete colonic evaluation in most cases, often adds vital diagnostic information, and eliminates repeated bowel preparation and unnecessary delay in diagnosis.
Assuntos
Sulfato de Bário , Doenças do Colo/diagnóstico por imagem , Neoplasias do Colo/diagnóstico por imagem , Colonoscopia , Meios de Contraste , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença de Crohn/diagnóstico por imagem , Doença Diverticular do Colo/diagnóstico por imagem , Enema , Feminino , Humanos , Obstrução Intestinal/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , RadiografiaRESUMO
OBJECTIVE: To determine the ultrasonographic features of dactylitis in psoriatic arthritis (PsA). METHODS: Seventeen patients with PsA presenting with a total of 25 dactylitic fingers and toes underwent ultrasonographic examination of the digits with a 7.5 or 10 MHz transducer. RESULTS: Flexor tenosynovitis was present in 96% (24/25) of dactylitic digits. Articular synovitis was present in 52% (13/25) of dactylitic digits. Subcutaneous soft tissue enlargement was present in all digits. The presence of articular synovitis in a dactylitic finger on ultrasonography correlated with the presence of joint space narrowing and periostitis on plain radiography. CONCLUSION: Dactylitis in PsA is due to both flexor tenosynovitis and articular synovitis. Dactylitis in PsA has an increased incidence of articular synovitis, which was associated with the development of articular damage as assessed by plain radiography.
Assuntos
Artrite Psoriásica/diagnóstico por imagem , Dedos/diagnóstico por imagem , Dedos do Pé/diagnóstico por imagem , Adolescente , Adulto , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/patologia , Feminino , Dedos/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Sinovite/diagnóstico por imagem , Sinovite/etiologia , Dedos do Pé/patologia , UltrassonografiaAssuntos
Adenocarcinoma/terapia , Transtornos de Deglutição/terapia , Obstrução da Saída Gástrica/terapia , Recidiva Local de Neoplasia/terapia , Cuidados Paliativos , Stents , Neoplasias Gástricas/terapia , Adenocarcinoma/diagnóstico por imagem , Sulfato de Bário , Meios de Contraste , Transtornos de Deglutição/diagnóstico por imagem , Feminino , Gastrectomia , Obstrução da Saída Gástrica/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico por imagem , Radiografia , Neoplasias Gástricas/diagnóstico por imagemRESUMO
Amyloid masses of the gastrointestinal tract are very rare. A previously undescribed finding of multiple gastric polyps due to systemic amyloidosis is outlined in a patient with familial amyloid polyneuropathy. The relevant literature pertaining to gastric amyloidosis and mucosal masses is reviewed. Amyloidosis should be included in the differential diagnosis of target lesions in the stomach.
Assuntos
Neuropatias Amiloides/complicações , Pólipos/complicações , Neoplasias Gástricas/complicações , Amiloide/análise , Histocitoquímica , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos/química , Pólipos/diagnóstico por imagem , Pólipos/patologia , Radiografia , Neoplasias Gástricas/química , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologiaRESUMO
OBJECTIVE: To determine the effect of ultrasound guided injection in recalcitrant idiopathic plantar fasciitis. METHODS: Four patients with a clinical diagnosis of idiopathic plantar fasciitis, who were unresponsive to palpation guided injection with triamcinolone acetonide and local anaesthetic, underwent ultrasonographic examination of the heel. RESULTS: The following ultrasonographic features were noted:- (a) increased thickness of plantar fascia in symptomatic heels compared with asymptomatic heels, (b) loss of distinction of the distal plantar fascia borders, (c) reduced echogenicity of the plantar fascia. Ultrasound guided injection of the enlarged, hypoechoic plantar fascia resulted in complete relief in four of five heels (mean duration of follow up = 24 months) in three cases. One patient developed a recurrence of symptoms after six months. CONCLUSION: Ultrasound allows for confirmation of the clinical diagnosis and ultrasound guided injection produces a good clinical response when unguided injection is unsuccessful. The technique is quick, inexpensive, and entails no radiation exposure.