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1.
Mult Scler ; 25(1): 122-125, 2019 01.
Article in English | MEDLINE | ID: mdl-30379114

ABSTRACT

A 13-year-old girl presented with a 5-day history of oscillopsia. On examination, ocular flutter and mild cerebellar signs were found. Brain magnetic resonance imaging (MRI) revealed four periventricular and subcortical non-enhancing lesions. Cerebrospinal fluid (CSF) oligoclonal bands were negative. Neuroblastoma or other malignancies were not found. She responded well to a corticosteroid-intravenous immunoglobulin (IVIG) combination and remained symptom-free for 3 years until presenting again with isolated ocular flutter. Brain MRI at this time remained atypical for classic multiple sclerosis (MS) with a predominance of juxtacortical demyelinating lesions. CSF was positive for oligoclonal bands. Serum myelin oligodendrocyte glycoprotein (MOG) antibodies were present. Ocular flutter can be the presenting feature of MOG antibody-associated pediatric demyelination.


Subject(s)
Demyelinating Autoimmune Diseases, CNS/physiopathology , Myelin-Oligodendrocyte Glycoprotein/immunology , Ocular Motility Disorders/physiopathology , Adolescent , Demyelinating Autoimmune Diseases, CNS/complications , Demyelinating Autoimmune Diseases, CNS/diagnosis , Demyelinating Autoimmune Diseases, CNS/immunology , Female , Humans , Ocular Motility Disorders/etiology
2.
Trauma Case Rep ; 43: 100762, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36686411

ABSTRACT

Isolated complete ruptures of the distal biceps femoris tendon are rare injuries. To our knowledge, very few cases have been reported in English literature. We present the case of a young man who complained of pain on the posterolateral corner of the knee after a motor vehicle accident. Clinical examination and MRI findings revealed a complete rupture at the musculotendinous junction of distal biceps femoris tendon. We describe the surgical treatment performed, and the clinical outcome.

3.
J Surg Case Rep ; 2023(6): rjad351, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37337541

ABSTRACT

Quadriceps tendon ruptures are common injuries, however isolated ruptures are rare. Particularly, reports for isolated vastus intermedius ruptures are very scarce. We present a case of a 62-years-old male patient who sustained a complete rupture of vastus intermedius tendon with a partial rupture of vastus medialis while rectus femoris tendon was intact, after a fall from standing height. Due to lag in extension, surgical treatment was performed, consisted of an end-to-end Krakow suture technique accompanied with two anchors placed on osseous attachment to the superior pole of the patella. A hinged knee brace locked in full extension was applied for 4 weeks. Gradual range of flexion was suggested after the 3rd postoperative week. Full range of motion was achieved in the 7th postoperative week.

4.
J Med Case Rep ; 17(1): 188, 2023 May 07.
Article in English | MEDLINE | ID: mdl-37149631

ABSTRACT

INTRODUCTION: Osteomyelitis is a bone inflammation that can be related to various infectious agents. As with any other type of inflammation, the prevailing symptoms and signs may include redness, swelling, pain, and heat. Fungal osteomyelitis is rare and usually found in immune-compromised patients. CASE PRESENTATION: A non-human immunodeficiency virus immunocompromised Greek female patient, 82 years old, visited the emergency department due to a 3 day pain located mainly over the left tibia's anterior surface, accompanied by swelling and redness. There was also a subcutaneous lesion of her left breast. Medical history revealed that the patient had an unmasked close contact with pigeons, a main host of the disease. Initial x-ray imaging showed an osteolytic area in the upper third of the tibial diaphysis. The patient was admitted and underwent a computed tomography-guided biopsy. The specimen revealed a Cryptococcus neoformans infection of the bone and the breast. She was treated with 400 mg fluconazole twice a day for 3 weeks while in hospital and 200 mg twice a day upon discharge for 9 months. After that, she underwent surgical debridement because of lasting local irritation. She was closely monitored in our outpatient office, and in her last visit, 1 year after the initial admission, inflammatory signs had regressed vastly. CONCLUSIONS: To our knowledge, this is the ninth cryptococcal osteomyelitis of the tibia to be recorded since 1974, and the most unusual finding was the bifocal nature of the infection, affecting both the tibia and the breast.


Subject(s)
Cryptococcosis , Cryptococcus neoformans , Osteomyelitis , Female , Humans , Tibia/diagnostic imaging , Cryptococcosis/diagnostic imaging , Cryptococcosis/drug therapy , Fluconazole/therapeutic use , Osteomyelitis/diagnostic imaging , Osteomyelitis/drug therapy , Inflammation/complications
5.
Knee ; 15(3): 233-7, 2008 Jun.
Article in English | MEDLINE | ID: mdl-18281220

ABSTRACT

The proximal tibia metaphysis is a potential alternative donor site for a sufficient amount of cancellous bone, associated with low morbidity and complication rate. We performed an observational computed tomography imaging study to determine the volume of cancellous bone that can be harvested from the proximal tibia compared to the anterior iliac crest, based on an advanced three-dimensional medical imaging model. Results of this study support the findings that a sufficient amount of cancellous bone can be harvested from the proximal tibia compared to the anterior iliac crest. By using a computed tomography imaging technique, the volume of cancellous bone can be precisely determined. However, this study does not show how much bone is safe to remove before increasing the tibial fracture risk.


Subject(s)
Computer Simulation , Ilium/transplantation , Imaging, Three-Dimensional , Radiographic Image Interpretation, Computer-Assisted , Tibia/transplantation , Adult , Aged , Aged, 80 and over , Bone Transplantation/methods , Female , Humans , Ilium/diagnostic imaging , Male , Middle Aged , Prospective Studies , Software , Tibia/diagnostic imaging , Tomography, X-Ray Computed
6.
Int Urol Nephrol ; 40(4): 1107-10, 2008.
Article in English | MEDLINE | ID: mdl-18709439

ABSTRACT

Central venous catheterization is widely used for hemodialysis for patients with renal failure. A number of short and long-term complications have been reported in literature. We describe a rare case of a lethal iatrogenic injury of the brachiocephalic artery (BA) in a 65-year-old woman following subclavian venous catheterization with a Hickman catheter. Contrast-enhanced CT-scan and reconstruction images demonstrated a pseudoaneurysm of the BA. Due to clinical deterioration, the patient underwent urgent sternotomy. Aspects concerning prevention and diagnosis of the above complication are analyzed.


Subject(s)
Aneurysm, False/etiology , Brachiocephalic Trunk/surgery , Catheterization, Central Venous/adverse effects , Iatrogenic Disease , Aged , Aneurysm, False/diagnosis , Contrast Media , Diagnosis, Differential , Fatal Outcome , Female , Humans , Tomography, X-Ray Computed
8.
Int J Endocrinol ; 2016: 6169721, 2016.
Article in English | MEDLINE | ID: mdl-27087809

ABSTRACT

The purpose of this study is to identify the prevalence of osteoporosis in male patients with chronic obstructive pulmonary disease (COPD) by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) and to compare the diagnostic abilities of the above methods. Thirty-seven male patients with established COPD were examined with DXA and standard QCT in lumbar spine, including L1, L2, and L3 vertebrae. T-scores and bone mineral density values were calculated by DXA and QCT method, respectively. Comparative assessment of the findings was performed and statistical analysis was applied. QCT measurements found more COPD patients with impaired bone mineral density compared to DXA, namely, 13 (35.1%) versus 12 (32.4%) patients with osteopenia and 16 (43.2%) versus 9 (16.2%) patients with osteoporosis (p = 0.04). More vertebrae were found with osteoporosis by QCT compared to DXA (p = 0.03). The prevalence of osteoporosis among male patients with COPD is increased and DXA may underestimate this risk. QCT measurements have an improved discriminating ability to identify low BMD compared to DXA measurements because QCT is able to overcome diagnostic pitfalls including aortic calcifications and degenerative spinal osteophytes.

9.
Vascular ; 18(4): 242-5, 2010.
Article in English | MEDLINE | ID: mdl-20643035

ABSTRACT

Injury to the inferior thyroid artery (ITA) is an extremely rare complication of blunt neck trauma. The subtle initial clinical presentation and the potential life-threatening sequelae make it a diagnostic and therapeutic challenge. We report a case of an ITA pseudoaneurysm caused by seat-belt injury. Imaging findings and successful treatment with coil embolization are described. The role of noninvasive imaging techniques in establishing the diagnosis is emphasized.


Subject(s)
Accidents, Traffic , Aneurysm, False/etiology , Thyroid Gland/blood supply , Wounds, Nonpenetrating/etiology , Aged , Aneurysm, False/diagnostic imaging , Aneurysm, False/therapy , Arteries/injuries , Echocardiography, Doppler, Color , Embolization, Therapeutic , Humans , Male , Tomography, X-Ray Computed , Treatment Outcome , Wounds, Nonpenetrating/diagnostic imaging , Wounds, Nonpenetrating/therapy
10.
Angiology ; 59(4): 503-6, 2008.
Article in English | MEDLINE | ID: mdl-18388086

ABSTRACT

Splenic artery aneurysms represent approximately 60% of visceral arterial aneurysms. Their incidence at autopsy is 0.02 - 2 % in all age groups and rises to 10.4% above the age of 60. Although splenic artery aneurysms are the most common visceral aneurysms, giant splenic artery aneurysms >10 cm in diameter have rarely been reported. A recent review of the literature came up with 12 true giant splenic artery aneurysms >10 cm. A case of 12-cm splenic artery aneurysms is presented in this study and the imaging findings are described.


Subject(s)
Aneurysm/pathology , Splenic Artery/pathology , Aged, 80 and over , Aneurysm/therapy , Angiography, Digital Subtraction , Humans , Male , Tomography, X-Ray Computed , Ultrasonography, Doppler, Color
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