Subject(s)
Computed Tomography Angiography , Coronary Angiography , Coronary Stenosis/diagnosis , Electrocardiography , Multidetector Computed Tomography , Pneumothorax/diagnosis , Chest Tubes , Coronary Stenosis/etiology , Coronary Stenosis/physiopathology , Decompression, Surgical/instrumentation , Diagnosis, Differential , Humans , Male , Needles , Pneumothorax/complications , Pneumothorax/physiopathology , Pneumothorax/surgery , Predictive Value of Tests , Treatment Outcome , Young AdultABSTRACT
BACKGROUND The complications of fine-needle aspiration cytology (FNAC) are rare but can be challenging for performing physicians to diagnose and manage. This type of procedure is perceived as routine and devoid of substantial risks, but uncommon complications can occur and need to be addressed with careful workup. CASE REPORT A FNAC procedure for a young female patient with multiple thyroid nodules was requested by her general practitioner. After the FNAC thyroid procedure, a carotid wall hematoma was suspected and could not be excluded with ultrasound (US) alone. Thus, the patient underwent a computed tomography angiogram (CTA) that excluded blood extravasation from the carotid, confirming the suspicion of perivascular blood accumulation. As a precaution, the patient was hospitalized, with US follow-up; she was dismissed the day after her hospital admission with a diagnosis of a benign thyroid nodule in multinodular goiter according to SIAPEC-IAP classification. CONCLUSIONS This case highlights how a routine-perceived procedure such as FNAC could present a challenge to the performing physicians, pathologist, and radiologist, raising the suspicion of a severe complication that needs to be addressed with a readily available emergency service that may be accessible only within a central hospital-level organization. This case reinforces the point that more careful adherence to clinic-radiological guidelines is needed to avoid potentially inappropriate and harmful procedures. A review of the literature concerning guidelines for FNAC procedure, diagnostic classifications, and reported complications is provided as part of this case report.
Subject(s)
Biopsy, Fine-Needle/adverse effects , Carotid Artery Injuries/etiology , Goiter/diagnosis , Hematoma/etiology , Thyroid Nodule/diagnosis , Adult , Carotid Artery Injuries/diagnostic imaging , Female , Guideline Adherence , Hematoma/diagnostic imaging , Humans , UltrasonographyABSTRACT
PURPOSE: The aim of this retrospective study was to report the clinical and radiographic results of the biodegradable subacromial spacer (InSpace Balloon®) implantation in patients with massive irreparable rotator cuff tears. MATERIALS AND METHODS: From February 2014 to October 2015, 30 patients affected by massive irreparable rotator cuff tears were treated with the implantation of InSpace Balloon®. Clinical evaluation (Constant Score and VAS), X-rays and MR imaging were performed preoperatively in all patients and 3, 6, 12 and 24 months after surgery, dividing patients in different groups according to the time elapsed from surgery. RESULTS: Constant Score increased from 39.89 to 62.33 points (p 0.0002) in the 6 months group and from 41.66 to 65.38 points (p< 0.0001) in the 12 months group. ROM (Range of Movement) and ADL (Activity of Daily Living) significantly improved with the contemporary reduction of VAS and pain at 12 months and, furthermore, an increase of functional performance with reduction of pain was registered at 24 months. CONCLUSIONS: Our results supported the surgical procedure of the arthroscopic implantation of biodegradable subacromial InSpace Balloon® for irreparable massive cuff tears in worker patients and with recreational activities' demands in order to recover the shoulder function with a reduction of the pain.
