RESUMO
The "diabetic foot" covers the spectrum of neurological, arterial and infectious foot problems that occur as a consequence of diabetes. The wounds, often due to minor injuries, may lead to amputations if not quickly treated. The treatment consists of efficiently alleviating mechanical pressure from the wound (i.e. prevention of repeated trauma by walking on the ulcer) on the one hand, and using adequate local care on the other. In addition, the patient's vascular status needs to be assessed and corrected. If present, infections must be quickly and aggressively treated. The infection may be either superficial or deep and the presence of bone contact at clinical examination is suggestive of osteitis. Optimal care is provided in diabetic foot centers by multidisciplinary teams. These teams include a diabetologist, dermatologist, vascular surgeon, infectiologist, radiologist, podologist, shoemaker and specialized nurses. The main aim is to reduce the number of amputations. The best treatment, however, aims at prevention of foot wounds. It requires knowledge of the physiopathological mechanisms of diabetic foot, the screening for feet at risk, and the education of the patient, family and health care providers.
Assuntos
Pé Diabético/prevenção & controle , Úlcera do Pé/prevenção & controle , Amputação Cirúrgica , Desbridamento , Pé Diabético/cirurgia , Úlcera do Pé/cirurgia , Humanos , Osteíte/etiologia , Osteíte/prevenção & controle , PerfusãoRESUMO
We tried to demonstrate an association between magnetic resonance imaging findings of the Hoffa fat pad and patellar chondropathy. Parallely, we checked the correlation between the diagnosis of patellar chondropathy on magnetic resonance imaging and during arthroscopy. Our study is a retrospective review of the records of 135 patients who underwent an arthroscopy and MRI study at our institution between October 1997 and January 2001. Magnetic resonance images of the Hoffa fat pad were interpreted and typewritten arthroscopy reports were recorded. A patellar chondropathy assessed during arthroscopy was present in 64 of 135 patients. Twenty of them had abnormal signal intensity in Hoffa fat pad with a sensitivity of the magnetic resonance imaging findings of 31% and a specificity of 73%. We didn't find any significant association in the different correlations between signal abnormalities of Hoffa fat pad and patellar chondropathy. On the other hand, there was a significant association between the results of patellar chondropathy on magnetic resonance imaging findings and during arthroscopy. No significant association was shown between the MRI findings of Hoffa fat pad and the patellar chondropathy.
Assuntos
Tecido Adiposo/patologia , Doenças das Cartilagens/diagnóstico , Cartilagem Articular/patologia , Imageamento por Ressonância Magnética , Patela/patologia , Adolescente , Adulto , Idoso , Artroscopia/estatística & dados numéricos , Imagem Ecoplanar/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Aumento da Imagem , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Membrana Sinovial/patologiaAssuntos
Mãos , Herpesvirus Humano 8 , Ferro/efeitos adversos , Metalurgia , Doenças Profissionais/etiologia , Sarcoma de Kaposi/etiologia , Neoplasias Cutâneas/etiologia , Idoso , Comorbidade , Humanos , Imageamento por Ressonância Magnética , Masculino , Exposição Ocupacional , Sarcoma de Kaposi/virologia , Neoplasias Cutâneas/virologiaRESUMO
Technological developments arising from research have affected the whole wide spectrum of medical endeavor and have made a very significant impact on clinical practice and especially on imaging sciences. Ultrasonography brought spectacular advances, but CT and MRI became important landmark techniques. A further important development, which greatly increased the involvement of radiologists in direct patient management, was the growth of interventional and therapeutic techniques, called interventional radiology. Some statistics: approximately 155,000 patients per year including 19,000 CT Scans, 10,000 MRI exams, 21,000 ultrasound examinations and 1,000 therapeutic procedures. Some research activities: CT quantification of pulmonary emphysema, respiratory mechanics, MR and CT angiography, antenatal diagnosis of congenital and genetic diseases of the fetus, quantification of portal haemodynamics, MR imaging of bile and pancreatic ducts, morphologic and functional imaging of the brain, radiology of bone trauma, MR characterization in hepatic lesions.
Assuntos
Diagnóstico por Imagem , Serviço Hospitalar de Radiologia , Bélgica , Pesquisa Biomédica , Hospitais Universitários , HumanosRESUMO
A radiological study of osteoarticular changes in Kashin-Beck Disease (KBD) was undertaken on the appendicular skeleton in 105 patients with KBD, in 31 healthy subjects living in an endemic area and in 30 healthy subjects living in a non-endemic area. The bone age was delayed in all three populations with no significant difference between the three studied Tibetan populations. Radiological changes occur in 56% of patients with KBD, and are usually bilateral. An analysis of the distribution of lesions shows a proximo-distal gradient. The changes are more common in the distal aspect of the limb and the lower limb is involved more commonly than the upper limb. The foot and ankle are involved in 89.5% of cases. The radiological changes and their distribution might be explained by the hypothesis of inhibition of angiogenesis by mycotoxins, exacerbated by chemical and physical environmental factors.
Assuntos
Osso e Ossos/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Feminino , Humanos , Masculino , Radiografia , TibetRESUMO
OBJECTIVE: To evaluate the supraspinatus muscle radiodensity on the outlet view as an indication of a tendon tear. DESIGN AND PATIENTS: Plain radiographs and magnetic resonance imaging (MRI) examinations were obtained on both shoulders of 40 subjects aged 23-70 years, including 13 asymptomatic volunteers and 27 patients. Two readers analyzed the superior contour and the heterogeneity of the supraspinatus muscle radiodensity and compared them with the MRI findings. RESULTS AND CONCLUSION: Significant concordances (P < 0.001) were found between the assessments of the superior contour and the heterogeneity of the muscle radiodensity, respectively, on plain radiographs and MR images. For the diagnosis of a full-thickness tear, the analysis of the superior contour and the heterogeneity of the muscle radiodensity reached an accuracy of 85% and 80% respectively. Stepwise discriminant analyses showed low to moderate benefit of considering the contour and the heterogeneity simultaneously. The inter- and intraobserver agreement ranged from moderate to good. We conclude that on the outlet view, modifications in the superior contour and heterogeneity of the supraspinatus muscle radiodensity suggest a full-thickness tear.
Assuntos
Músculo Esquelético/diagnóstico por imagem , Lesões do Manguito Rotador , Ombro/diagnóstico por imagem , Adulto , Idoso , Artroscopia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Variações Dependentes do Observador , Valor Preditivo dos Testes , Radiografia , Manguito Rotador/diagnóstico por imagem , Manguito Rotador/patologia , Sensibilidade e Especificidade , Ombro/patologiaRESUMO
OBJECTIVE: The purpose of this study was to describe on CT scans the presence of a gas collection within a bone fracture reflecting the vacuum phenomenon as a sign of nonunited fracture. CONCLUSION: A gas collection between fractured bone fragments suggests a nonunited fracture.
Assuntos
Fraturas não Consolidadas/diagnóstico por imagem , Gases , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
This work describes the composition, organisation, metabolism, biomechanical and physiologic properties of normal cartilage. The initial involution process, of biochemical nature, preceding by far the morphological changes is described as well as the degenerative, inflammatory and traumatic pathogenesis. The modern cartilage imaging techniques are described with emphasis on MRI.
Assuntos
Doenças das Cartilagens/diagnóstico , Cartilagem Articular/lesões , Diagnóstico por Imagem , Cartilagem Articular/patologia , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios XAssuntos
Doenças Ósseas/diagnóstico por imagem , Mãos/diagnóstico por imagem , Hiperoxalúria Primária/diagnóstico por imagem , Oxalatos/análise , Adulto , Doenças Ósseas/sangue , Reabsorção Óssea/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Dedos/diagnóstico por imagem , Células Gigantes/patologia , Humanos , Hiperoxalúria Primária/sangue , Masculino , Pessoa de Meia-Idade , Osteosclerose/diagnóstico por imagem , Oxalatos/sangue , RadiografiaRESUMO
Dystrophic calcinosis is a more common form of calcinosis cutis; calcium salts are deposited secondary to local inflammation, tissue damage and degeneration. Various conditions can cause dystrophic calcinosis, including connective tissue disease, infection, inflammatory processes, chronic venous stasis, cutaneous neoplasm and trauma. We report a case of ulcerated cutaneous calcinosis associated with a localised linear scleroderma or morphea. Healing of the ulcerations took place after four months of treatment with colchicine 1 mg per day.
Assuntos
Calcinose/etiologia , Úlcera da Perna/etiologia , Perna (Membro)/patologia , Esclerodermia Localizada/complicações , Idoso , Atrofia/etiologia , Feminino , HumanosRESUMO
The diagnosis of reflex sympathetic dystrophy (RSD) relies on clinical evaluation, scintigraphy or MR imaging, and routine radiographs. Because RSD has variable manifestations with a strong psychogenic overlap, it is desirable to have a noninvasive test to determine the presence of RSD to allow for appropriate treatment. MR imaging allows a differential diagnosis between RSD and other bone lesions. It proves to be a reliable technique in showing and characterizing RSD better than radiographic examination and radionuclide study.
Assuntos
Diagnóstico por Imagem/métodos , Distrofia Simpática Reflexa/diagnóstico , Diagnóstico Diferencial , Mãos/diagnóstico por imagem , Quadril/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Radiografia , Cintilografia , Distrofia Simpática Reflexa/diagnóstico por imagemRESUMO
This study compares in normal subjects the variability of wrist x-ray film measurements between the right and left sides with the variability of the distribution of those measurements within the population. Additional purposes were to evaluate possible differences of these measurements according to sex, age, side, and hand dominance. The variability when comparing both sides was found to be statistically less for the carpal height, radiolunate, scapholunate, and capitolunate angles than within the whole group of subjects, and for those measurements, there was a high correlation (r > .88) between the right and left sides. In addition, the carpal height and the carporadial ratios were lower and the capitolunate angle was higher in women than in men. There was also a significant decrease of the scapholunate angle in older individuals. The clinical implication of these findings is that in unilateral wrist diseases, the normal wrist should be used to provide the reference values of the carpal height and of the carpal angles on profile x-ray films. However, for the radial inclination and palmar tilt of the distal radius and for the ulnar variance, the normal side does not provide a better reference than normal values obtained from databases.
Assuntos
Ossos do Carpo/anatomia & histologia , Ossos do Carpo/diagnóstico por imagem , Punho/anatomia & histologia , Punho/diagnóstico por imagem , Adulto , Ossos do Carpo/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Valores de Referência , Punho/fisiopatologiaAssuntos
Imageamento por Ressonância Magnética , Ossos Pélvicos , Sarcoidose/diagnóstico , Doenças da Coluna Vertebral/diagnóstico , Adulto , Doenças Ósseas/diagnóstico , Doenças Ósseas/diagnóstico por imagem , Humanos , Masculino , Osteosclerose/diagnóstico , Osteosclerose/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Radiografia , Sarcoidose/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagemRESUMO
A case is reported of a locked MP joint due to ulceration of the metacarpal head. This was clearly visible on MRI scan.
Assuntos
Artropatias/diagnóstico , Articulação Metacarpofalângica/patologia , Metacarpo/lesões , Adulto , Humanos , Artropatias/etiologia , Artropatias/cirurgia , Imageamento por Ressonância Magnética , Masculino , Articulação Metacarpofalângica/fisiopatologia , Metacarpo/patologia , Metacarpo/cirurgia , Amplitude de Movimento Articular , ÚlceraRESUMO
Plain radiographs obtained in 25 patients with acute anterior cruciate ligament (ACL) tears detected with magnetic resonance imaging were retrospectively evaluated to identify associated bone lesions. Fracture of the posterior part of the lateral tibial plateau (LTP) was seen in 11 patients, impacted fracture of the lateral femoral condyle (LFC) in two, lateral tibial rim fracture (Segond fracture) in three, and avulsion fracture of the tibial attachment of the ACL in two. The latter three fractures have been associated with an ACL tear. Conversely, fractures of the posterior part of the LTP have not been associated with ACL tear and are recognizable on plain radiographs. Impaction of the LFC on the LTP and avulsion of the posterior tibial capsular junction may account for the association of the fracture of the LTP with the acute ACL tear. This type of fracture represents the most frequent indirect sign of ACL tear seen on plain radiographs.
Assuntos
Lesões do Ligamento Cruzado Anterior , Ligamento Cruzado Anterior/diagnóstico por imagem , Fraturas da Tíbia/diagnóstico por imagem , Adolescente , Adulto , Feminino , Humanos , Traumatismos do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Fraturas da Tíbia/complicaçõesAssuntos
Aneurisma da Aorta Torácica/diagnóstico por imagem , Síndrome da Veia Cava Superior/diagnóstico por imagem , Dissecção Aórtica/complicações , Dissecção Aórtica/diagnóstico por imagem , Aneurisma da Aorta Torácica/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome da Veia Cava Superior/etiologia , Tomografia Computadorizada por Raios XRESUMO
The aims of the study were to determine the frequency of visualization of the normal transverse geniculate ligament (TGL) of the knee on lateral plain radiographs with magnetic resonance imaging (MRI) as a reference, and to determine features that make this ligament apparent on plain radiographs. 50 consecutive lateral plain radiographs and sagittal T1-weighted images of corresponding knees were evaluated prospectively. A TGL was considered visualized on plain radiographs when an opacity of soft-tissue density was apparent in the posterior part of the Hoffa's fat pad. The TGL was identified in 29 of the 50 (58%) sagittal MR images; a TGL was observed on the lateral plain radiographs of six patients (12%). Correlation with the MR images showed that, when visualized on plain radiographs, the ligament is at least 3 mm thick and completely surrounded by fat. Our study shows that the TGL is a normal variant that can be recognized frequently on lateral plain radiographs of the knee.
Assuntos
Articulação do Joelho/diagnóstico por imagem , Ligamentos Articulares/diagnóstico por imagem , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Articulação do Joelho/anatomia & histologia , Ligamentos Articulares/anatomia & histologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , RadiografiaRESUMO
Fourteen patients with prostatic carcinoma, benign prostatic hyperplasia, or chronic granulomatous prostatitis underwent gadolinium-DOTA enhanced magnetic resonance imaging of the prostate. Gadolinium-DOTA was administered intravenously in a dosage of 0.1 mmol/kg body weight. All studies were performed on a superconductive 1.5-T system. As compared to noncontrast T1- and T2-weighted images, Gd-DOTA enhanced T1-weighted images were useful in distinguishing malignant tumor from granulomatous prostatitis in one case, but were uncontributive to the differentiation between carcinoma and benign prostatic hyperplasia.
Assuntos
Meios de Contraste , Gadolínio , Compostos Heterocíclicos , Imageamento por Ressonância Magnética/métodos , Compostos Organometálicos , Doenças Prostáticas/diagnóstico , Humanos , Masculino , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/diagnóstico , Prostatite/diagnósticoRESUMO
Perinatal urology is a rapidly expanding field in pediatric urology bringing significant changes in the diagnosis and management of congenital uropathies. Renal duplication was detected by antenatal and perinatal ultrasound in 19 cases (22 duplicated systems). In most cases, no precise diagnosis could be established in utero (4 of 13), but this lack of accuracy is of little clinical significance since all newborns with suspected uropathies undergo complete urological investigations in the perinatal period. Voiding cystogram demonstrated reflux in 11 of 22 cases. On postnatal urography a functioning upper pole was demonstrated in 11 of 22 kidneys. There were 12 ureteroceles: in 8 a nonfunctioning upper pole was removed, while 3 were endoscopically incised with good functional improvement and 1 was reimplanted. Early recognition of congenital uropathies in association with duplication by prenatal ultrasound significantly improves patient care allowing early postnatal relief of obstruction by less invasive methods and before infection or persistent obstruction worsens the prognosis.