ABSTRACT
The high number of knee imaging exams at radiology clinics, together with the wide variety of knee disorders, calls for expanding the knowledge about the less common lesions seen in routine diagnostic practice. The purpose of this pictorial essay was to illustrate unusual lesions that distend the knee joint, selected by relevance and evaluated with multiple imaging modalities, including X-ray, computed tomography, and magnetic resonance imaging, as well as to perform a brief review of the literature.
A elevada demanda de exames para avaliação do joelho nos serviços de diagnóstico, bem como a extensa variedade de lesões geniculares, estimulam a ampliação do conhecimento sobre alterações menos frequentes na rotina de diagnósticos. O objetivo deste ensaio iconográfico é ilustrar didaticamente lesões não usuais do joelho com efeito expansivo, escolhidas em razão da relevância clínica e avaliadas por meio de diversos métodos de imagem como radiografia simples, tomografia computadorizada e ressonância magnética, bem como fazer uma breve revisão da literatura.
ABSTRACT
Abstract The high number of knee imaging exams at radiology clinics, together with the wide variety of knee disorders, calls for expanding the knowledge about the less common lesions seen in routine diagnostic practice. The purpose of this pictorial essay was to illustrate unusual lesions that distend the knee joint, selected by relevance and evaluated with multiple imaging modalities, including X-ray, computed tomography, and magnetic resonance imaging, as well as to perform a brief review of the literature.
Resumo A elevada demanda de exames para avaliação do joelho nos serviços de diagnóstico, bem como a extensa variedade de lesões geniculares, estimulam a ampliação do conhecimento sobre alterações menos frequentes na rotina de diagnósticos. O objetivo deste ensaio iconográfico é ilustrar didaticamente lesões não usuais do joelho com efeito expansivo, escolhidas em razão da relevância clínica e avaliadas por meio de diversos métodos de imagem como radiografia simples, tomografia computadorizada e ressonância magnética, bem como fazer uma breve revisão da literatura.
ABSTRACT
The study describes the main chest radiographic changes in people living with HIV/AIDS and pulmonary tuberculosis, confirmed by sputum culture. This was a descriptive study involving a total of 42 sputum tests from 42 people living with HIV/AIDS and a clinical suspicion of pulmonary tuberculosis. All patients attended two referral hospitals in Recife-PE, Brazil, between August 2009 and January 2012. The most common isolated radiological change was parenchymal consolidation, encountered in six (14.3%) patients, followed by patterns of interstitial infiltrate, diffuse micronodular (miliary), and an association between interstitial infiltrate and parenchymal consolidation, each being encountered in five (11.9%) patients. No statistically significant difference was observed between the radiological findings and CD4 T-cell counts, p = 0.680.
Subject(s)
AIDS-Related Opportunistic Infections/diagnostic imaging , HIV Infections/complications , Mycobacterium tuberculosis/isolation & purification , Sputum/microbiology , Tuberculosis, Pulmonary/diagnostic imaging , AIDS-Related Opportunistic Infections/complications , Adult , Brazil , CD4 Lymphocyte Count , Enzyme-Linked Immunosorbent Assay , Female , HIV Infections/diagnosis , Humans , Lung/diagnostic imaging , Male , Middle Aged , Prospective Studies , Radiography , Tuberculosis, Pulmonary/complicationsABSTRACT
UNLABELLED: Hepatopulmonary syndrome (HPS) is characterized by the presence of liver disease, arterial hypoxemia and intrapulmonary vascular dilatation (IPVD). IPVD includes diffused or localized dilated pulmonary capillaries and, less commonly, pleural and pulmonary arteriovenous communications. The aim of the present study was to investigate the occurrence of HPS in patients with Schistosoma mansoni periportal fibrosis in treatment at a university hospital in northeastern Brazil. PATIENTS AND METHODS: Eighty-four patients were enrolled in the study between April and July 2007 and underwent arterial blood gas analysis. Patients with an alveolar-arterial oxygen gradient (DA-aO(2)) > or = 15 mmHg were submitted to contrast-enhanced transthoracic echocardiogram (CE-TTE) with saline microbubbles. The diagnostic criterion for HPS was DA-aO(2) > or = 15 mmHg associated to IPVD, as identified through CE-TTE. Patients with HPS underwent contrast-enhanced 16-channel multidetector-row computed tomography (MDCT) of the thorax. RESULTS: Twenty-two patients (26.19%) had DA-aO(2) > or = 15 mmHg (mean value=20.86+/-7.91). CE-TTE was positive for IPVD in five of the 22 patients with DA-aO(2) > or = 15 mmHg and all these patients had hepatosplenic disease, revealing a 6% prevalence of HPS (CI: 1.96-13.35) in the overall population of 84 patients, with a 10.2% prevalence in the group with hepatosplenic disease. The following were the 16-channel MDCT findings in these five patients: dilated peripheral pulmonary vasculature (100%); ratio of segmental arterial diameter to adjacent bronchial diameter equal to or greater than 2:1 (100%); higher number of visible terminal vessel branches in lung dependent regions (40%); and micronodules associated with subpleural surface centrilobular vessels (40%). No patient had evidence of arteriovenous fistula. These findings reveal that HPS occurs (usually in a mild form) in patients with Schistosoma mansoni periportal fibrosis and portal hypertension seems to be an important factor related to the occurrence of HPS in such cases.
