Clinical and Imaging Findings of Musculoskeletal Melioidosis in the Right Hip: A Case Report

Melioidosis is an infectious disease caused by a Gram-negative bacterium thought to be caused Burkholderia pseudomallei. This disease is endemic in tropical regions, but is not endemic and is rarely encountered in Korea. Nevertheless, the importance of early diagnosis of melioidosis is drawing substantial attention, due to its proliferation and the high mortality caused by the disease. Melioidosis can attack any organ, and manifests with a variety of symptoms. In particular, musculoskeletal melioidosis is rare and presents with nonspecific musculoskeletal symptoms. The imaging features of musculoskeletal melioidosis manifest a form of osteomyelitis or septic arthritis with soft tissue abscess or can mimic a bone tumor. This study describes the clinical and imaging findings of melioidosis involving the right femur and hip joint in a 64-year-old man.

Long-term Treatment with Anti-platelet Agents for Collagen-induced Arthritis Improves Radiological Findings

OBJECTIVES: The objectives of this study were to evaluate the long-term effect of anti-platelet treatment on the radiological progression of collagen-induced arthritis in rats. METHODS: Female Lewis rats with collagen-induced arthritis were divided into three experimental groups: saline, aspirin monotherapy (n = 12), and aspirin–clopidogrel dual therapy (n = 12). Drugs were administered daily and continued up to 70 days after the induction of arthritis. The clinical arthritis index (weight, morphology score, and paw thickness) and radiological scores were evaluated. RESULTS: The clinical arthritis index peaked on day 20, while the radiological scores peaked on day 35. No intergroup difference was observed in the clinical arthritis index throughout the experiment. The aspirin–clopidogrel dual therapy group had a significantly higher mean radiological score than the other groups (p = 0.045) on day 35. Further treatments resulted in significantly improved radiological findings in the aspirin monotherapy and aspirin–clopidogrel dual therapy groups on day 70 but no significant improvement in the saline group. CONCLUSION: Anti-platelet agent treatment improved radiological findings on day 70. These observations emphasize the importance of a future long-term study of the effects of anti-platelet agent treatment on arthritis.

A Comparison of Conventional Ultrasonography and Arthrosonography in the Assessment of Cuff Integrity after Rotator Cuff Repair

BACKGROUND: This study was designed to perform conventional ultrasonography, magnetic resonance arthrography (MRA) and arthrosonography exams after rotator cuff repair to compare the results of conventional ultrasonography and arthrosonography with those of MRA as the gold standard. METHODS: We prospectively studied 42 consecutive patients (14 males, 28 females; average age, 59.4 years) who received arthroscopic rotator cuff repair due to full-thickness tears of the supraspinatus tendon from 2008 to 2010. The integrity assessment of the repaired rotator cuff was performed 6 months postoperatively using conventional ultrasonography, MRA, and arthrosonography. RESULTS: The diagnostic accuracy of the conventional ultrasonography compared to MRA was 78.6% and the McNemar test results were 0.016 in full-thickness tear and 0.077 in partial-thickness tear. The diagnostic accuracy of arthrosonography compared to MRA was 92.9% and the McNemar test results were 0.998 in full-thickness tear and 0.875 in partial-thickness tear. CONCLUSIONS: It was found that the integrity assessment of the repaired rotator cuff by ultrasonography must be guarded against and that arthrosonography is an effective alternative method in the postoperative integrity assessment. Also, an arthrosonography seems to be a suitable modality to replace the conventional ultrasonography.

The Safety and Feasibility of Transradial Coronary Angiography Over 70-Year-Old Patients

BACKGROUND AND OBJECTIVES: The transradial approach has been suggested as an alternative entry site for coronary angiography. The complication and success rates of the vascular procedure have been associated with age. The aim of this study was to determine the safety, feasibility, and efficacy of transradial coronary angiography for patients greater than age 70 compared with younger patients. SUBJCETS AND METHODS: Clinical and angiographic data were reviewed retrospectively in 894 consecutive patients who underwent transradial coronary angiography from January 2001 through May 2003. Procedure-related results were used to compare 2 groups, patients aged 70 years. RESULTS: In a consecutive series of 894 patients, 638 were 70 years of age. There was no significant difference in the rate of success in patients >70 years compared with patients < 70 (91.1% vs 93.6%). No severe complications, such as death, vascular dissection, rupture, and major cerebrovascular accidents were present in either group. Procedure-related variables, including procedure time, radiographic contrast use, and the number of catheters used per case, were similar between the two groups. CONCLUSION: Transradial access is a safe and feasible approach for coronary angiography in elderly patients, yielding results similar to those achieved with younger patients.

The Safety and Feasibility of Transradial Coronary Angiography Over 70-Year-Old Patients

BACKGROUND AND OBJECTIVES: The transradial approach has been suggested as an alternative entry site for coronary angiography. The complication and success rates of the vascular procedure have been associated with age. The aim of this study was to determine the safety, feasibility, and efficacy of transradial coronary angiography for patients greater than age 70 compared with younger patients. SUBJCETS AND METHODS: Clinical and angiographic data were reviewed retrospectively in 894 consecutive patients who underwent transradial coronary angiography from January 2001 through May 2003. Procedure-related results were used to compare 2 groups, patients aged 70 years. RESULTS: In a consecutive series of 894 patients, 638 were 70 years of age. There was no significant difference in the rate of success in patients >70 years compared with patients < 70 (91.1% vs 93.6%). No severe complications, such as death, vascular dissection, rupture, and major cerebrovascular accidents were present in either group. Procedure-related variables, including procedure time, radiographic contrast use, and the number of catheters used per case, were similar between the two groups. CONCLUSION: Transradial access is a safe and feasible approach for coronary angiography in elderly patients, yielding results similar to those achieved with younger patients.

A Digital Imaging Teaching File by Using the Internet, HTML and Personal Computers

PURPOSE: A film-based teaching file takes up space and the need to search through such a file places limitson the extent to which it is likely to be used. Furthermore it is not easy for doctors in a medium-sized hospitalto experience a variety of cases, and so for these reasons we created an easy-to-use digital imaging teaching filewith HTML(Hypertext Markup Language) and downloaded images via World Wide Web(WWW) services on the Internet. This was suitable for use by computer novices. MATERIALS AND METHODS: We used WWW Internet services as a resource for various images and three different IMB-PC compatible computers(386DX, 486DX-II, and Pentium) in downloading theimages and in developing a digitalized teaching file. These computers were connected with the Internet through ahigh speed dial-up modem(28.8Kbps) and to navigate the Internet. Twinsock and Netscape were used. HWP 3.0, Korean word processing software, was used to create HTML(Hypertext Markup Language) files and the downloaded images were linked to the HTML files. In this way, a digital imaging teaching file program was created. RESULTS: Access to aWeb service via the Internet required a high speed computer(at least 486DX II with 8MB RAM) for comfortabel use ;this also ensured that the quality of downloaded images was not degraded during downloading and that these were good enough to use as a teaching file. The time needed to retrieve the text and related images depends on the sizeof the file, the speed of the network, and the network traffic at the time of connection. For computer novices, adigital image teaching file using HTML is easy to use. CONCLUSION: Our method of creating a digital imaging teaching file by using Internet and HTML would be easy to create and radiologists with little computer experience who want to study various digital radiologic imaging cases would find it easy to use.

Tuberculous Pneumonia: CT Findings in 20 Patients

PURPOSE: To evaluate CT findings of tuberculous pneumonia mainly presenting as parenchymal consolidation. MATERIALS & METHODS: CT scans of twenty patients with tuberculous pneumonia were retrospectively reviewed. Analyses included the location, extent, and homogeneity of consolidation, presence of volume loss of involved lung and air-bronchogram, associated lesions suggesting previous tuberculous infection and evidence of bronchogenic spread. RESULTS: The location of consolidation revealed relatively even distribution without any specific predilection site. The areas of consolidation were irregular in margin (95%), inhomogeneous in attenuation (75%) including focal areas of low attenuation and multiple cavities within it. Volume loss (70%) of the involved lobe was associated. There were lesions suggesting previous tuberculous infection (95%) in the surrounding area and evidences of bronchogenic spread (100%) such as poorly-defined nodules and Iobular consolidations in the remote site from main consolidation. CONCLUSION: In tuberculous pneumonia, the areas of consolidation are irregular in margin and inhomogeneous in attenuation on CT scan. The evidences of bronchogenic spread and lesions suggesting previous tuberculous infection are almost always associated in the surrounding or remote site from main consolidation.