ABSTRACT
A 39-year-old woman developed severe arterial hypertension associated with brainstem hyperintensity in T2-weighted images and hyperintense lesion in the left basal ganglia. Clinical findings were a sudden loss of consciousness, confusion, nausea, vomiting and headache. Rapid treatment of hypertension resulted in clinical and radiological improvement. Rapid identification and appropriate diagnostics are essential, as prompt treatment usually results in reversal of symptoms; permanent neurologic injury or death can occur with treatment delay.
Subject(s)
Brain Ischemia/pathology , Brain Stem Infarctions/pathology , Hypertensive Encephalopathy/pathology , Pons/pathology , Adult , Arterioles/pathology , Arterioles/physiopathology , Basal Ganglia/diagnostic imaging , Basal Ganglia/pathology , Basal Ganglia/physiopathology , Brain Edema/etiology , Brain Edema/pathology , Brain Edema/physiopathology , Brain Ischemia/etiology , Brain Ischemia/physiopathology , Brain Stem Infarctions/etiology , Brain Stem Infarctions/physiopathology , Confusion/etiology , Disease Progression , Female , Homeostasis/physiology , Humans , Hypertensive Encephalopathy/physiopathology , Magnetic Resonance Imaging , Nausea/etiology , Pons/diagnostic imaging , Pons/physiopathology , Radiography , Unconsciousness/etiologyABSTRACT
The Authors describe their own experience of functioning and nonfunctioning tumors of the adrenal gland. In two cases the neoplasm was an adrenal adenoma, one causing a Cushing syndrome, the other clinically asymptomatic and associated with renal tuberculosis. In two patients the neoplasm was a clinically unsuspected pheochromocytoma and in one case it proved to be a malignant tumor.
Subject(s)
Adenoma , Adrenal Gland Neoplasms , Cushing Syndrome/etiology , Paraneoplastic Syndromes/etiology , Pheochromocytoma , Adenoma/complications , Adenoma/diagnosis , Adenoma/metabolism , Adrenal Gland Neoplasms/complications , Adrenal Gland Neoplasms/diagnosis , Adrenal Gland Neoplasms/metabolism , Adrenal Gland Neoplasms/pathology , Adult , Female , Humans , Male , Middle Aged , Pheochromocytoma/diagnosis , Pheochromocytoma/metabolism , Pheochromocytoma/pathology , Tuberculosis, Renal/complicationsABSTRACT
Five cases of chronic perirenal hematoma are reported. Preoperative tests were performed to assess the malignant or benign nature of the lesions which were observed some time after the dramatic episode which marked their onset. The varying characteristics of the disease showed by different imaging techniques (urography, arteriography, US, CAT) are such that only surgery can remove all doubts in the majority of cases.
Subject(s)
Hematoma/diagnosis , Kidney Diseases/diagnosis , Kidney/injuries , Aged , Chronic Disease , Diagnosis, Differential , Diagnostic Imaging , Female , Hematoma/etiology , Hematoma/surgery , Humans , Kidney Neoplasms/diagnosis , Male , Middle AgedABSTRACT
Partial-thickness articular tears of the supraspinatus represent a not uncommon event in shoulder pathology, but their treatment remains controversial. We believe that these lesions must be treated with surgical repair: we hereby describe our technique of transtendon arthroscopic repair. We have treated 33 patients with an average age of 53.3 years (range 34-69). The average follow-up was 33 months (range 26-45). The post-operative Constant score values have shown a total increase of 48.2 points (from preoperative 44.4 points to post-operative 91.6 points). In the MRI follow-up assessment no cases of retears have occurred. The use of this technique enables the reconstitution of the tendon with complete reconstruction of its footprint without damaging its intact part. We believe that this can allow a better recovery.
Subject(s)
Arthroscopy/methods , Plastic Surgery Procedures/methods , Rotator Cuff/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Rotator Cuff Injuries , Severity of Illness Index , Suture Anchors , Treatment OutcomeABSTRACT
To evaluate the ability of ultrasonography with high frequency transducer (13-MHz) in detecting metacarpophalangeal (MCP) joint abnormalities, 20 patients with rheumatoid arthritis (RA) and a symptomatic involvement of MCP joints were studied. Twenty healthy subjects served as controls. In all RA patients, ultrasonography clearly demonstrated one or more soft tissue and/or bone abnormalities. Sixteen patients (80%) had joint cavity widening because of effusion (1 case), synovial thickening (7 cases), and joint effusion with synovial thickening (8 cases). Loss of definition of the metacarpal articular cartilage was observed in 17 cases (85%). Sixteen (80%) had bone erosions and 9 (45%) showed a definite widening of the flexor tendons sheath. Margin irregularities of the extensor and flexor tendons were respectively visualized in 7 (35%) and in 8 (40%) cases. An extensor tendon rupture was observed in 2 cases (10%). Ultrasound examination by 13-MHz transducer appears to increase the accuracy of MCP joints evaluation in RA with respect to conventional radiography. It can be recommended as the first investigation in the assessment of soft tissue involvement in RA patients.
Subject(s)
Arthritis, Rheumatoid/diagnostic imaging , Bone and Bones/ultrastructure , Metacarpophalangeal Joint/diagnostic imaging , Tendons/ultrastructure , Adult , Aged , Female , Humans , Male , Middle Aged , UltrasonographyABSTRACT
OBJECTIVE: To characterize finger tendon involvement in patients with rheumatoid arthritis (RA). METHODS: The finger tendons of 20 RA patients were studied by ultrasonography using a high-frequency (13-MHz) transducer. RESULTS: Eighteen patients (90%) showed finger tendon abnormalities: widening of the flexor tendon sheath (80%), loss of the normal fibrillar echotexture (60%), irregularity of the extensor (30%) and flexor (50%) tendon margins, tendon tear (10%), synovial cyst (20%). CONCLUSION: High-frequency sonography is helpful in assessing even minimal finger tendon lesions in RA patients.