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1.
J Orthop ; 22: 606-611, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33311863

RESUMO

Background/aim: We try to investigate the association between patterns of imaging findings in patients who had a diagnosis of subchondral fracture around the knee, formerly known as SONK and their clinical outcome. Materials and methods: We retrospectively identified 43 knees of 37 patients (28 males, 15 females) who had diagnosis of subchondral fractures around the knee. The mean age is 56-year-old (range 17-83). Musculoskeletal fellowship trained radiologist evaluated all 43 knee MRI in: 1)location of marrow edema 2)peri-osseous edema; 3) subchondral fracture line; 4) subchondral articular surface contour; 5)meniscal tear and extrusion; 6)adjacent soft tissue edema; 7) joint effusion. Independent clinical chart review was performed for clinical outcome with follow up time average of 13.3 months (range 0-88 months). Bad outcome was defined as worsening on imaging, continued complaint with surgical management and knee replacement or another episode of SONK. Chi-square analysis and Student's T tests were conducted to test the statistical significance of association between MR findings and outcomes. Statistical significance was set at p = 0.05 level. Results: Of 43 knees, 6 patients had another episodes of SONK (14%), 11 patients were not improving or needed injection vs arthroscopy (26%), 4 patients required arthroplasty (9%), 22 patients had no negative outcome (51%). Gender, age, diabetic status, and location of the subchondral fracture show no influence on outcome. Worse outcome group had a significantly higher average BMI (31.7 vs. 28.0, P = 0.02). Positive change of subchondral articular surface contour is the only imaging finding with positive association with worse outcome (80% vs. 39.9%, P = 0.02). Presence of positive findings of above 3), 4), 5) and 6) had higher percentage of bad outcome (77.8%) compared to those with less positive findings (47.2%). Conclusion: MR imaging findings may help at identifying SONK patient with potential risk of developing bad outcome.

2.
Medicine (Baltimore) ; 99(14): e19455, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32243364

RESUMO

The aim of this study is to compare the distal femoral cartilage thickness of patients with type II diabetes mellitus with those of healthy subjects using ultrasonography. The study comprised 34 patients and 36 healthy subjects. Demographic characteristics of all the participants were recorded. The thickness of the femoral articular cartilage was measured using a 5-18MHzlinearprobe.Measurements were performed bilaterally from three points (intercondylar area, medial condyle, and lateral condyle). No significant difference could be found between patients and healthy subjects. Two demographic characteristics correlated positively with diabetic patients.


Assuntos
Cartilagem Articular/patologia , Diabetes Mellitus Tipo 2/patologia , Fêmur/patologia , Articulação do Joelho/patologia , Adulto , Idoso , Índice de Massa Corporal , Cartilagem Articular/diagnóstico por imagem , Estudos Transversais , Feminino , Fêmur/diagnóstico por imagem , Humanos , Articulação do Joelho/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Ultrassonografia
3.
J Magn Reson Imaging ; 51(3): 780-790, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31407413

RESUMO

BACKGROUND: Patellar tendon (PT) microstructure integrity and microcirculation status play a crucial role in the progression of tendinopathy and tendon repair. PURPOSE: To assess the feasibility and robustness of stimulated-echo based diffusion-weighted MRI with readout-segmented echo-planar imaging (ste-RS-EPI) for noninvasive assessment of microstructure and microcirculation of human PT. STUDY TYPE: Prospective. SUBJECTS: Fifteen healthy volunteers. FIELD STRENGTH/SEQUENCE: PT diffusion tensor imaging (DTI) and intravoxel incoherent motion (IVIM) were acquired with an ste-RS-EPI protocol on a 3T MRI scanner. ASSESSMENT: Subjects were positioned with their PT at the magic angle. DTI-derived parameters including axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD), and fractional anisotropy (FA) were estimated with b-values of 0 and 800 s/mm2 and 12 diffusion directions. IVIM-derived parameters, f p , D* × f p , V b , and D* × V b were assessed in the central-third and the outer-two thirds of the PT with b-values of 0, 20, 30, 60, 80, 120, 200, 400, and 600 s/mm2 in three orthogonal directions. STATISTICAL TESTS: Paired t-tests were used to evaluate differences in IVIM parameters between the central-third and outer-two thirds regions of the patellar tendon. Paired t-tests and within-subject coefficient of variation were used to assess the intra- and intersession reproducibility of PT DTI and IVIM parameters. RESULTS: DTI parameters for healthy PT were 1.54 ± 0.09 × 10-3 mm2 /s, 1.01 ± 0.05 × 10-3 mm2 /s, 1.18 ± 0.06 × 10-3 mm2 /s, and 0.30 ± 0.04 for AD, RD, MD, and FA, respectively. Significantly higher (P < 0.05) IVIM parameters f p and D* × f p were observed in the outer-two thirds (6.1% ± 2.4% and 95.2 ± 49.6, respectively) compared with the central-third (3.8% ± 2.3% and 48.6 ± 35.2, respectively) of the PT. DATA CONCLUSION: Diffusion MRI of PT with an ste-RS-EPI protocol is clinically feasible. Both DTI- and IVIM-derived parameters of the PT demonstrated good test-retest reproducibility and interrater reliability. LEVEL OF EVIDENCE: 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:780-790.


Assuntos
Imagem de Tensor de Difusão , Ligamento Patelar , Imagem de Difusão por Ressonância Magnética , Humanos , Processamento de Imagem Assistida por Computador , Microcirculação , Movimento (Física) , Ligamento Patelar/diagnóstico por imagem , Estudos Prospectivos , Reprodutibilidade dos Testes , Tendões
4.
BMC Musculoskelet Disord ; 20(1): 348, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31351447

RESUMO

BACKGROUND: Heterotopic ossification (HO) is a relatively common complication following hip surgery treated with open reduction and internal fixation, total arthroplasty or hemiarthroplasty. Development of HO after hip surgery is an important clinical issue as it can affect functional status. We aimed to determine whether there was association between severity of heterotopic ossification about the hip and the interval between the time of hip fracture and surgery. MATERIALS AND METHODS: Our retrospective study included 151 patients (age range 33-95 years) treated for hip fractures by hemiarthroplasty. Medical records were reviewed for time interval to surgery, laterality, surgical approach, and patient age. Patients who had any post-operative complications were excluded. Radiographs were semiquantitatively assessed for the degree of heterotopic ossification based on Brooker Classification (5-point scale). Statistical analysis was performed utilizing Chi-square, Kruskal-Wallis, and Score tests, and also a proportional odds model (significance level set at 0.05). RESULTS: Thirty eight patients had no heterotopic ossification, 43 had class 1, 55 had class 2, and 15 had class 3 or greater heterotopic ossification. The majority of patients (59.6%) had surgery within 2 days of acute injury. Severe heterotopic ossification (HO 3+) was associated with the longer interval between the time of acute hip fracture and surgery (median 6 days) vs. median 2 days in all other groups (HO classes 0-2) (p = 0.0015). The odds ratio and 95% CI for one level higher HO class was 1.296 (1.152, 1.459), which meant that the odds of having HO class one level higher increased by about 29.6% for every one-day increase in the days to surgery. No significant association was found for other variables. CONCLUSION: Class 3 or greater HO was associated with longer time interval between time of acute hip fracture and surgery compared to all other groups (HO class 0-2).


Assuntos
Artroplastia de Quadril/efeitos adversos , Fixação de Fratura/efeitos adversos , Fraturas do Quadril/cirurgia , Ossificação Heterotópica/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Ossificação Heterotópica/etiologia , Ossificação Heterotópica/patologia , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/patologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/patologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Fatores de Tempo , Tempo para o Tratamento
5.
J Foot Ankle Surg ; 57(6): 1263-1266, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30146337

RESUMO

Pigmented villonodular synovitis mostly affects the knee and other large joints such as the hip. Although the disease is most commonly found in adult patients aged 30 to 40 years, rare cases in children and the elderly have been reported. We present the case of an 11-year-old female who was found to have biopsy-proven pigmented villonodular synovitis in her subtalar joint in 2012. Five years after surgical excision, the patient has continued to be involved in competitive dancing and cheerleading without any pain in her ankle. Moreover, follow-up magnetic resonance imaging studies showed no evidence of recurrence. Our case report emphasizes that the disease should not be solely considered in the middle-age population but should be included in the differential diagnosis of the pediatric patient.


Assuntos
Articulação do Tornozelo , Sinovite Pigmentada Vilonodular/diagnóstico , Sinovite Pigmentada Vilonodular/cirurgia , Criança , Feminino , Humanos
6.
J Magn Reson Imaging ; 48(6): 1690-1699, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29741808

RESUMO

BACKGROUND: Limited microcirculation has been implicated in Achilles tendinopathy and may affect healing and disease progression. Existing invasive and noninvasive approaches to evaluate tendon microcirculation lack sensitivity and spatial coverage. PURPOSE: To develop a novel Achilles tendon intravoxel incoherent motion (IVIM) MRI protocol to overcome the limitations from low tendon T2 /T2 * value and low intratendinous blood volume and blood velocity to evaluate tendon microcirculation. STUDY TYPE: Prospective. SUBJECTS: Sixteen healthy male participants (age 31.0 ± 2.1) were recruited. FIELD STRENGTH/SEQUENCE: A stimulated echo readout-segmented echo planar imaging (ste-RS-EPI) IVIM sequence at 3.0T. ASSESSMENT: The feasibility of the proposed ste-RS-EPI IVIM protocol combined with Achilles tendon magic angle effect was evaluated. The sensitivity of the protocol was assessed by an exercise-induced intratendinous hemodynamic response in healthy participants. The vascular origin of the observed IVIM signal was validated by varying the diffusion mixing time and echo time. STATISTICAL TESTS: Two-tailed t-tests were used to evaluate differences (P < 0.05 was considered significant). RESULTS: Consistent with known tendon hypovascularity, the midportion Achilles tendon at baseline showed significantly lower IVIM-derived perfusion fraction (fp ) (3.1 ± 0.9%) compared to the proximal and distal Achilles tendon (6.0 ± 1.8% and 6.1 ± 2.0%, respectively; P < 0.01). Similarly, the midportion Achilles tendon exhibited significantly lower baseline blood flow index (D*×fp ) (40.9 ± 19.2, 18.3 ± 5.3, and 32.0 ± 9.4 in proximal, midportion, and distal Achilles tendon, respectively; P < 0.01). Eccentric heel-raise exercise led to ∼2 times increase of Achilles tendon blood flow in healthy participants. Consistent with its vascular origin, the estimated fp demonstrated a high dependency to IVIM protocol parameters, while the T1 /T2 -corrected absolute intratendinous microvascular blood volume fraction (Vb ) did not vary. DATA CONCLUSION: Achilles tendon ste-RS-EPI IVIM noninvasively assessed baseline values and exercise-induced changes to tendon microcirculation in healthy tendon. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;48:1690-1699.


Assuntos
Tendão do Calcâneo/irrigação sanguínea , Tendão do Calcâneo/diagnóstico por imagem , Processamento de Imagem Assistida por Computador/métodos , Adulto , Exercício Físico , Voluntários Saudáveis , Humanos , Masculino , Microcirculação , Movimento (Física) , Reconhecimento Automatizado de Padrão , Estudos Prospectivos , Reprodutibilidade dos Testes
7.
AJR Am J Roentgenol ; 207(4): 820-825, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27533135

RESUMO

OBJECTIVE: Although some research and publication practices are clearly unethical, including fraud and plagiarism, other areas of research and publication, such as informed consent and conflicts of interest, fall into grayer areas. CONCLUSION: The purposes of this article are, therefore, to review a variety of relevant ethical issues in radiology-related journalism, peer review, and research; to review the radiology literature to date that has addressed these issues; and to present position statements and potential solutions to these problems.

9.
J Radiol Case Rep ; 9(1): 26-35, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25926918

RESUMO

Soft tissue aneurysmal bone cyst is a rare entity, with about 20 cases reported in literature, only 3 of which are in patients over 40 years of age. We present a case of a 41 year old Latin American female who presented for evaluation of atraumatic chest pain with radiation to the left shoulder. Her initial workup was negative, including radiographic imaging of the chest and left shoulder. 4 months later, she presented to her orthopedic surgeon with a palpable mass and mild left shoulder pain. Radiographs acquired at that time demonstrated a 7.0 × 5.5 × 6.7 cm mass with rim calcification in the region of the upper triceps muscle. Subsequent CT imaging showed central areas of hypodensity and thin septations, a few of which were calcified. MR evaluation showed hemorrhagic cystic spaces with multiple fluid-fluid levels and enhancing septations. Surgical biopsy was performed and pathology was preliminarily interpreted as cystic myositis ossificans, however on final review the diagnosis of soft tissue aneurysmal bone cyst was made. The lesion was then surgically excised and no evidence of recurrence was seen on a 3 year post-op radiograph. Following description of our case, we conduct a literature review of the imaging characteristics, diagnosis, and treatment of soft tissue aneurysmal bone cyst.


Assuntos
Cistos Ósseos Aneurismáticos/diagnóstico , Doenças Musculares/diagnóstico , Ombro/diagnóstico por imagem , Ombro/patologia , Adulto , Cistos Ósseos Aneurismáticos/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Doenças Musculares/cirurgia , Miosite Ossificante/diagnóstico , Ombro/cirurgia , Tomografia Computadorizada por Raios X
10.
AJR Am J Roentgenol ; 204(1): 128-39, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25539248

RESUMO

OBJECTIVE: The purpose of this article is to review the imaging features of necrotizing fasciitis and its potential mimics. Key imaging features are emphasized to enable accurate and efficient interpretation of variables that are essential in appropriate management. CONCLUSION: Necrotizing fasciitis is a medical emergency with potential lethal outcome. Dissecting gas along fascial planes in the absence of penetrating trauma (including iatrogenic) is essentially pathognomonic. However, the lack of soft-tissue emphysema does not exclude the diagnosis. Mimics of necrotizing fasciitis include nonnecrotizing fasciitis (eosinophilic, paraneoplastic, inflammatory (lupus myofasciitis, Churg-Strauss, nodular, or proliferative), myositis, neoplasm, myonecrosis, inflammatory myopathy, and compartment syndrome. Necrotizing fasciitis is a clinical diagnosis, and imaging can reveal nonspecific or negative findings (particularly during the early course of disease). One should be familiar with salient clinical and imaging findings of necrotizing fasciitis to facilitate a more rapid and accurate diagnosis and be aware that its diagnosis necessitates immediate discussion with the referring physician.


Assuntos
Fasciite Necrosante/diagnóstico , Inflamação/diagnóstico , Doenças Musculares/diagnóstico , Neoplasias/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Adulto Jovem
11.
Skeletal Radiol ; 43(12): 1743-8, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25001874

RESUMO

It is well established that irregular bursae can form adjacent to an osteochondroma (bursa exostotica) as a result of mechanical irritation and that these bursae can be complicated by inflammation, hemorrhage, or infection. Bursal chondromatosis is a rare complication, with only seven published cases in the literature according to our searches. We present the case of a 53-year-old female who presented with slowly progressive left hip/thigh pain and was found to have an osteochondroma arising from the lesser trochanter with numerous ossified bodies in the adjacent soft tissues. MRI demonstrated osteochondral bodies in a fluid-filled bursa adjacent to the osteochondroma, with several of the bodies noted to be fairly displaced from the osteochondroma cartilaginous cap. At surgery, the osteochondroma was removed and numerous bodies of varying sizes were excised, some of which were noted to be adherent to the bursal lining and others that were separated/distant from the cartilage cap. The question arises as to whether this process represents bursal chondromatosis resulting from benign neoplasia of cells lining the abnormal bursa, "cartilage shedding" from the osteochondromatous cap, or both. The purpose in presenting this case is to introduce a rare complication of an osteochondroma, demonstrate that soft tissue calcification and osteochondral densities displaced from an underlying osteochondroma are not always the result of sarcomatous degeneration, and provide support for the theory that cells lining a bursa in a nonphysiologic location can undergo benign neoplasia with subsequent formation of osteochondral bodies.


Assuntos
Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico , Condromatose Sinovial/complicações , Condromatose Sinovial/diagnóstico , Osteocondroma/complicações , Osteocondroma/diagnóstico , Neoplasias Ósseas/cirurgia , Bolsa Sinovial/diagnóstico por imagem , Bolsa Sinovial/patologia , Bolsa Sinovial/cirurgia , Condromatose Sinovial/cirurgia , Meios de Contraste , Feminino , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/patologia , Articulação do Quadril/cirurgia , Humanos , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Osteocondroma/cirurgia , Compostos Radiofarmacêuticos , Medronato de Tecnécio Tc 99m , Tomografia Computadorizada por Raios X/métodos , Imagem Corporal Total/métodos
12.
Emerg Radiol ; 19(6): 505-12, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22699854

RESUMO

This study was conducted to evaluate the impact of different patient presentations/characteristics on medical imaging and radiation exposure. We collected data on the estimated effective radiation dose (EED) of patients admitted through our University Hospital ER, and analyzed the relationships of patient gender, age, admitting diagnosis, and admission duration on EED. All (592) patients admitted through our ER (with imaging) during 1-week periods in May/November 2009 were included. To compare EEDs according to admission diagnosis, seven categories were created: Cardiopulmonary, Gastrointestinal, Genitourinary, Neurologic, Trauma, Infectious, and Other. EEDs of patients with various admission durations were also evaluated. Units for all EEDs are mSv. Median EED (MEED) for all patients was 4.5. Males (7.8, females = 2.5) and adults (6.1, pediatrics = 1.8) experienced higher MEEDs, but significance was lost after controlling for other variables. MEED increased with admission duration (0.1 for <24 h, 1.8 for 1-3 days and 92.0 for >2 months). Trauma patients experienced the highest MEED (18.3), while patients with gastrointestinal/genitourinary diagnoses experienced the second highest MEED (13.0 mSv for both). Pediatric/male patients experienced heightened radiation exposure, but these relationships were largely due to other variables (higher male frequency/severity of trauma, pediatric patients had shorter admissions and diagnoses requiring less radiologic workup). Patients admitted following trauma and for prolonged durations showed elevated radiation exposure even after adjustment for all other variables. The identification of these relationships may aid in the development and focusing of future radiation awareness/reduction efforts to persons involved in the evaluation and care of patients with these presentations and characteristics.


Assuntos
Diagnóstico por Imagem , Serviço Hospitalar de Emergência , Doses de Radiação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Hospitais Universitários , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estatísticas não Paramétricas
13.
J Radiol Case Rep ; 6(6): 1-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23378876

RESUMO

Extra-adrenal myelolipoma is a relatively rare entity, with fewer than 50 cases reported in literature. We present a case of a 79 year-old female who presented for evaluation of hip fracture following trauma, where a lobulated presacral mass with mixed fat/soft tissue attenuation was incidentally seen on initial bone algorithm pelvic CT. Subsequent MRI showed signal characteristics of a lesion with mixed fat and soft tissue composition. The lesion demonstrated stability on follow-up imaging. An elective surgical resection was performed which yielded a grossly fatty mass. The diagnosis of presacral myelolipoma was confirmed on microscopic examination. Following description of our case, we conduct a literature review of the imaging characteristics, diagnosis, and treatment of presacral myelolipoma.


Assuntos
Mielolipoma/diagnóstico , Mielolipoma/cirurgia , Neoplasias Pélvicas/diagnóstico , Neoplasias Pélvicas/cirurgia , Pelve/diagnóstico por imagem , Pelve/patologia , Diagnóstico Diferencial , Feminino , Humanos , Pelve/cirurgia , Radiografia , Resultado do Tratamento
14.
Skeletal Radiol ; 39(11): 1073-9, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20593175

RESUMO

Magnetic resonance diffusion tensor imaging (DTI) allows the directional dependence of water diffusion to be studied. Analysis of the resulting image data allows for the determination of fractional anisotropy (FA), apparent diffusion coefficient (ADC), as well as allowing three-dimensional visualization of the fiber tract (tractography). We visualized the ulnar nerve of ten healthy volunteers with DTI. We found FA to be 0.752 ± 0.067 and the ADC to be 0.96 ± 0.13 × 10(-3) mm(2)/s. A nuts-and-bolts description of the physical aspects of DTI is provided as an educational process for readers.


Assuntos
Imagem de Tensor de Difusão/métodos , Aumento da Imagem/métodos , Nervos Periféricos/patologia , Doenças do Sistema Nervoso Periférico/patologia , Humanos
15.
Skeletal Radiol ; 39(8): 821-5, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20596812

RESUMO

Salmonella osteomyelitis is seen most commonly in patients with sickle cell disease and in those with compromised immune systems. We report on the clinical, histological and imaging findings of salmonella osteomyelitis with intraosseous abscess formation occurring in a non-sickle cell patient receiving anti-tumor necrosis factor (TNF) alpha therapy.


Assuntos
Fêmur/diagnóstico por imagem , Fêmur/patologia , Doença Granulomatosa Crônica/induzido quimicamente , Doença Granulomatosa Crônica/complicações , Osteomielite/induzido quimicamente , Infecções por Salmonella/complicações , Fator de Necrose Tumoral alfa/efeitos adversos , Anemia Falciforme , Doença Granulomatosa Crônica/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Infecções por Salmonella/tratamento farmacológico , Infecções por Salmonella/etiologia , Fator de Necrose Tumoral alfa/uso terapêutico
16.
Radiol Case Rep ; 5(1): 381, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-27307853

RESUMO

We present a rare case of multisite xanthomatosis occurring in a 38-year-old normocholesterolemic man without a familial history. More commonly, these conditions are associated with familial hypercholesterolemia and cerebrotendinous xanthomatosis. Tendon xanthomas should prompt clinicians to perform a thorough investigation of the patient's metabolic panel and family history. Rarely, these conditions occur in patients without demonstrable dysmetabolic state. The characteristic MR imaging findings are presented in conjunction with review of the literature.

17.
Radiol Case Rep ; 4(2): 286, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-27307809

RESUMO

We present the case of a 20-year-old man with the chief complaint of right foot pain for the past three years presenting with focal bony prominence at dorsomedial aspect of right mid foot with interdigital pain. MRI demonstrated a metatarsal coalition with interdigital neuroma.

18.
J Foot Ankle Surg ; 46(5): 398-402, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17761326

RESUMO

We present a rare case of an unusually large schwannoma of the posterior tibial nerve that extended through the tarsal tunnel into the forefoot. Radiographic, computerized tomographic and magnetic resonance images supported the diagnosis, and the diagnosis was confirmed by pathological analysis. We found this schwannoma to be unique because of the combination of its location and extensive involvement of the foot.


Assuntos
Doenças do Pé/patologia , Pé/patologia , Neurilemoma/patologia , Adulto , Pé/cirurgia , Doenças do Pé/cirurgia , Humanos , Masculino , Recidiva Local de Neoplasia , Neurilemoma/cirurgia
19.
Hand Surg ; 11(1-2): 51-3, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17080529

RESUMO

Digital papillary adenocarcinoma (DPAc) is a relatively rare neoplasm arising from the sweat glands with a predilection for the hand. A case of DPAc in the third finger at the level of the proximal phalanx in a 55-year-old male is presented. Our paper recommends specific consideration of DPAc in evaluating digital soft tissue masses, particularly those that present with an aggressive nature.


Assuntos
Adenocarcinoma Papilar/patologia , Dedos , Neoplasias das Glândulas Sudoríparas/patologia , Humanos , Masculino , Pessoa de Meia-Idade
20.
J Hand Surg Am ; 30(6): 1318-21, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16344196

RESUMO

Enchondroma protuberans is a rare benign tumor. We present a case of late recurrence of a previously reported enchondroma protuberans in the hand. This was treated successfully with curettage and calcium carbonate grafting.


Assuntos
Neoplasias Ósseas/patologia , Condroma/patologia , Recidiva Local de Neoplasia/patologia , Adolescente , Neoplasias Ósseas/cirurgia , Condroma/cirurgia , Fraturas Ósseas/etiologia , Fraturas Ósseas/patologia , Fraturas Ósseas/cirurgia , Humanos , Masculino , Ossos Metacarpais/lesões , Ossos Metacarpais/patologia , Ossos Metacarpais/cirurgia , Recidiva Local de Neoplasia/complicações , Recidiva Local de Neoplasia/cirurgia
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