Primary hyperparathyroidism presenting with bilateral slipped capital femur epiphysiolysis. A pictorial essay.

It has become rare to find the typical radiological manifestations of primary hyperparathyroidism like generalized osteoporosis, brown tumors and advanced bone resorption because of the generalized usage of biochemical screening techniques. We present a 17-year-old patient with a parathyroid adenoma resulting in these typical skeletal manifestation throughout the skeleton combined with secondary bilateral slipped capital femur epiphysiolysis.

Takotsubo cardiomyopathy or apical ballooning: a case report and a short literature study.

Takotsubo cardiomyopathy is an important differential diagnosis in patients with an acute coronary syndrome. This syndrome is typically characterized by a reversible contractile dysfunction of the left ventricular myocardium without any obstructive etiological coronary disease. This is not a rare entity in acute settings and a better knowledge of the syndrome could result in a heightened alertness and a higher detection. We present a case of takotsubo showing the importance of cardiac MRI in the differential diagnosis and reviewed the present literature concerning this syndrome and the usefulness of MRI in the detection.

MDCT imaging before transcutanous aortic valve implantation: rationale and measurements.

Since its introduction in 2002, transcatheter aortic valve implantation (TAVI) has assumed growing importance in the treatment of patients with severe aortic stenosis (AS), because it offers a much less invasive alternative for those in high risk for surgery. Good early results and advances in percutaneous valve technology have led to a substantial increase in procedural success rate and number of patients undergoing this less invasive treatment. Pre-procedural screening of several anatomic factors to assess the feasibility of this technique is important. Multidetector row computed tomography (MDCT) is the technique of choice in assessing these factors.This technical note aims to describe and illustrate the key elements that need to be evaluated before the procedure.

Ectopic gastric pancreatitis: unusual cause of epigastric pain.

Ectopic pancreatic tissue has the same characteristics than normal pancreatic tissue.Therefore it may be affected by the same diseases. We report a rare cause of epigastric pain due to gastric heterotopic pancreatitis.The rare diagnosis was suspected by ultrasound and CT and definitively confirmed by echo-endoscopic guided biopsies.

Cost effectiveness of multi detector CT angiography of the coronary arteries for the diagnosis of suspected non-ST elevation acute coronary syndrome (NSTE-ACS) in the emergency department. Mathematical analysis with a decision model.

The purpose of our study is to model cost-effectiveness of MDCTA for the diagnosis of NSTE-ACS with initially negative enzymes, in the emergency department. In Belgium, the use of multi-detector computed tomography (MDCTA) is probably cost-effective in the diagnosis of NSTE-ACS in the acute setting A decision tree model was developed and a mathematical study was performed that included two hypothetical strategies: MDCTA and admission with classic clinical follow-up and treatment. Cost-effectiveness for the Belgian situation was simulated with sensitivity analysis using known values for diagnostic performance and known costs for the different strategies or components of strategies.