Radiographic feature changes in an antral pseudocyst that existed prior to sinus floor augmentation and dental implant placement, 15 years after initial detection - a case report.

INTRODUCTION AND IMPORTANCE: Maxillary sinus floor augmentation is acceptable and safe for bone augmentation prior to insertion of dental implants in atrophied maxillary bones. Anatomical variations and lesions of the maxillary sinus, including antral pseudocysts, are common radiological findings that can affect the outcomes of maxillary sinus augmentation. We show the changes in the radiological features of an antral pseudocyst that existed before maxillary sinus augmentation and 15 years after the insertion of dental implants. CASE PRESENTATION: The patient was a 69-year-old male with an unremarkable medical history. The initial orthopantomogram revealed a very large antral pseudocyst in the left maxillary sinus. After upper left second molar extraction and maxillary sinus augmentation, two dental implants were inserted in regions 26 and 27. The pseudocyst had changed radiologically 15 years later, but a biopsy showed no characteristic changes, and the dental implants showed no functional failures. CLINICAL DISCUSSION: We present a case of an antral pseudocyst that was not removed before or during sinus floor augmentation. A debate is ongoing regarding whether antral pseudocysts affect maxillary sinus augmentation, and various strategies have been applied to prevent intraoperative and postoperative complications, including removal of pseudocysts 3-12 months before maxillary sinus augmentation, removal during maxillary sinus augmentation, and leaving them alone when the floor is raised. CONCLUSION: The present case showed a preexisting antral pseudocyst at maxillary sinus floor augmentation and insertion of the implants, which changed radiologically 15 years later, but did not affect the function of the dental implants.

Clinicopathological study of periapical scars.

BACKGROUND/PURPOSE: Periapical scar (PS) is an alternative healing process with the formation of scar tissue after appropriate endodontic treatments/retreatments with or without periapical surgeries. This retrospective study evaluated the clinical, radiographic, and histopathological features of 7 PSs. MATERIALS AND METHODS: The clinical, radiographic, and histopathological data of 7 PSs were collected and analyzed. RESULTS: The 7 PSs were taken from the maxilla (3 cases) and mandible (4 cases) of 3 men and 4 women. The most frequently involved teeth were maxillary or mandibular incisors (4 cases) and first or second molars (3 cases). Of 7 PS patients, 6 had none of symptoms, 5 had previous nonsurgical endodontic treatments/retreatments, and 2 had previous endodontic treatments/retreatments plus periapical surgery. Radiographically, all 7 PS cases presented as a persistent and well-defined periapical radiolucent lesion for a long period of time. Microscopically, all 7 surgical specimens of PS showed dense fibrous collagenous tissues with one having amalgam particles in the scar tissue. CONCLUSION: PSs do have their common clinical and radiographic features. When the periapical radiolucent lesion is well-defined, persistent without a significant change of its size, and free from symptoms and signs after a long-term follow-up; the involved tooth has no evidence of root fracture and healthy periodontium except the periapical radiolucency; and the previous endodontic treatment/retreatment or periapical surgery is well performed with an adequate root canal or retrograde filling, then the PS may be a possible diagnosis and a close follow-up may be a more conservative treatment strategy for this condition.

Radiographic Features of Metastatic Brain Tumors from ALK-rearranged Non-small Cell Lung Cancer: Implications for Optimal Treatment Modalities.

Purpose: To investigate the radiological features on magnetic resonance imaging (MRI) of brain metastases (BM) from ALK-rearranged non-small cell lung cancer (NSCLC). Patients and Methods: We retrospectively evaluated data from 40 eligible patients with ALK-rearranged NSCLC. Radiographic features of metastatic brain tumors, including the number, size, location, and peritumoral brain edema size (PBES), were delineated using MRI. Results: 13 patients had metachronous BM (MBM), having developed BM at least 6 months after diagnosis with NSCLC. The remaining patients were categorized as having synchronous BM (SBM). Compared with patients in the SBM group, patients in the MBM group were found to have more favorable values for radiological features including BM number, BM size, and PBES. Ten (76.9%) of the 13 patients with MBM had ≤3 lesions and were asymptomatic, and none had developed a diffuse BM pattern, supporting the adoption of stereotactic radiosurgery (SRS) in the majority of these patients and against the administration of prophylactic cranial irradiation (PCI). Conversely, among the 27 patients with SBM, 15 (55.6%) patients had >3 lesions and 12 (44.4%) patients were symptomatic, highlighting the necessity of rapidly administrating brain radiotherapy, either as SRS or whole brain radiotherapy (WBRT). Importantly, only two patients (5.0%) had metastases in the hippocampus and peri-hippocampus region, and both were in the SBM group, indicating the feasibility of hippocampal avoidance WBRT in ALK-rearranged NSCLC. Conclusions: Both WBRT and SRS are appropriate for the treatment of BM in patients with ALK-rearranged NSCLC. The incidence of BM in the hippocampus and peri-hippocampus region is low in our radiological data. Nearly 80% of patients with metachronous BM have oligo-metastatic lesions, indicating that SRS is the preferred therapy while PCI is not indicated.

A New radiographic feature of lower lumbar disc herniation in young patients.

PURPOSE: In our study, we assessed the condition of the lumbar laminae defect of L5, other than the defect of spina bifida, in a group of different ages with lower lumbar disc herniation (LDH). We hypothesize that the laminae defect of L5 may be a radiographic feature in young patients with lower LDH. METHODS: We analyzed the features of the laminae of L5 from the anteroposterior X-rays of the lumbosacral spine in 342 patients suffering from lower LDH. The patients were divided into three groups depending on age: age <45 (group A), 45 ≤ age ≤ 59 (group B) and age>59 (group C). The width of the unilateral laminae of L5 was measured by drawing a line named "a" from the upper margin to the lower margin. Then the line "a" was extended downward to the bottom of the laminae interval space to perform a new line named "b". We assessed the condition of the laminae defect of L5 using the ratio "a/b" in each group. RESULTS: The average ratio "a/b" in each group was: 0.47 ± 0.06 in group A, 0.51 ± 0.06 in group B, and 0.52 ± 0.06 in group C. The average ratio "a/b" of group A was significantly smaller than group B and group C (P<0.05). However, there was no statistical difference of the average ratio "a/b" between group B and group C (P>0.05). CONCLUSIONS: Laminae defects of L5 may be a congenitally potential risk factor leading to lower LDH in the young and this radiographic clue could be used for the diagnosis of symptomatic lower LDH patients. For asymptomatic people who encounter this radiographic feature, preventive advice could be provided.

Clinical Analysis of 25 Cases of Cryptogenic Organizing Pneumonia / 沈阳医学院学报

Objective:To analyze clinical features and imaging characteristics of cryptogenic organizing pneumonia (COP) confirmed by pathological examination, and improve clinicians understanding of the disease and reduce the disease misdiagnosis. Methods:General information, clinical manifestations,laboratory examination and radiographic features of 25 patients with COP confirmed by pathological examination of lung biopsy were collected, and a comprehensive analysis of these data was made. Results:There were 15 males and 10 females in 25 patients.The mean age was (61.4±13.1) years.And 6 cases (24??0%) had smoking history. All patients had no obvious allergic and industrial dust related exposure history. The clinical presentations were nonspecific, and the main clinical symptoms were cough with a small amount of sputum. The most common laboratory tests was counting normal white blood cells and faster blood sedimentation.The main features of chest CT were space occupying lesions and patchy consolidation or ground-glass opacification.Conclusion:The clinical manifestation and laboratory examination of COP lack of characteristic, and the chest CT performance is similar to tumor and lung infection, and the diagnosis of COP depends on pathological examination.In order to reduce misdiagnosis,clinical doctors should improve the awareness and vigilance of the disease.

Clinical radiographic features of the wrist without osteoarthritis and its relations to age and sex in Japanese.

The purpose of this study was to identify a clinical radiographic features containing the measurements of carpal alignment, configuration, and joint space width of the wrist without osteoarthritis (OA) in Japanese. We also aimed to analyse age-related correlations in these parameters with reference to the difference between men and women. A total of 184 cases were analysed to establish the following relations: (1) Sex-related differences in the morphology and joint space width of the wrist without OA; (2) correlation coefficient between these parameters and age according to sex. This study suggests that carpal height ratio (CHR) was higher in men than in women. Also the ulnar variance (UV) increased and the radial inclination (RI) decreased with age in both men and women, and the volar tilt (VT) decreased with age in women.

Displaced acetabular fractures in the elderly: results after open reduction and internal fixation.

BACKGROUND: The optimal management of elderly patients with displaced acetabular fractures remains controversial. This paper aims to summarize the clinical results of open reduction and internal fixation (ORIF) and the possible factors influencing them. METHODS: Radiographic and clinical data on 52 elderly patients with displaced acetabular fractures that were treated by ORIF between May 2000 and May 2008 were retrospectively analysed. Data, such as fracture type (Letournel's classification system), quality of reduction, clinical outcomes (Harris hip score and modified Merle d'Aubigne-Postel score), and radiological outcomes (Matta score), were evaluated. RESULTS: Good to excellent clinical and radiological outcomes were recorded in 43 (82.7%) and 37 patients (71.2%), respectively. Acetabular fractures without radiographic features, such as quadrilateral plate fracture, Gull sign, posterior dislocation of hip, posterior wall marginal impaction, comminuted posterior wall fracture, and femoral head injury, can still achieve good to excellent outcomes. However, patients with the abovementioned radiographic features tend to achieve fair or poor outcomes. When an acetabular fracture with the aforementioned features, except for femoral head injury, can achieve and maintain anatomic reduction until complete fracture healing, the difference between fractures with and without the radiographic features is no longer significant. The results indicate that the outcomes are more affected by reduction rather than radiographic features. CONCLUSION: ORIF may be suggested for displaced acetabular fractures in the elderly. Good to excellent outcomes and a high degree of patient satisfaction can be achieved in majority of the patients. We recommend ORIF as the preferred treatment for displaced acetabular fractures without the abovementioned radiographic features. LEVEL OF EVIDENCE: Therapeutic level IV.

Clinical and radiographic manifestations and treatment outcome of pulmonary tuberculosis in the elderly in khuzestan, southwest iran.

BACKGROUND: Presentation of pulmonary tuberculosis (PTB) in the elderly is expected to be different from that in younger patients because of the debilitating factors and comorbidities. This issue should be considered in the national tuberculosis programs of countries. The purpose of this study was to evaluate the differences in the clinical and radiographic manifestations and treatment outcomes of PTB between the elderly and young patients. MATERIALS AND METHODS: This study was conducted as part of a mega project on tuberculosis by the Infectious and Tropical Diseases Research Centre affiliated to Ahvaz Jundishapur University of Medical Sciences. We retrospectively analyzed the medical records of 2,080 relatively young (18-64 years old at the time of diagnosis) and 346 elderly (≥65 years) PTB patients, who had been recently diagnosed and treated in the TB unit of Khuzestan Health Center from 2005 to 2010. RESULTS: Dyspnea and hemoptysis were the most common symptoms and the frequency of positive sputum smear -AFB was lower in the elderly PTB patients. On chest X-ray, elderly patients were less likely to have cavitation in comparison with younger patients. The frequency of favourable treatment outcome in the elderly was significantly lower than that in younger patients (64% vs. 77%, P = 0.003). CONCLUSION: Dyspnea, weight loss and hemoptysis were more common in the elderly PTB patients. Chest X-ray showed less frequent typical findings of active PTB such as cavitation; and microscopic examination showed fewer sputum smear AFB positive cases in the elderly. The treatment outcome was less favorable in the elderly compared to younger TB patients.

Clinical and Radiographic Features of Short Stature Combined with Skeletal Deformity in Children / 实用儿科临床杂志

Objective To analyze the clinical and radiographic features of short stature combined with skeletal deformity in children,and to diagnose exactly and cure promptly in children.Methods One hundred and twenty children were collected,included 69 males and 51 females.All of the children were collected detail medical history including history of birth,feeding,growth and development and family history and taken both physical and X ray examination that bone age could be evaluate by Gruelich-Pyle method.The children were taken a laboratory examination including calcium,phosphours,alkaline phosphatase,chromosome karyotype,and so on.Results Among 120 children,there were 36 cases(30.0%) of achondroplasia,20 cases(17.0%)of Turner syndrome,10 cases(8.0%)of multiple epiphyseal dysplasia,1 case(0.8%)of spondyloepiphseal dysplasia congenital,7 cases(5.8%) of spondyloepiphyseal dysplasia tarda,2 cases(1.6%) of osteogenesis imperfecta,1 case(0.8%) of cleidocranial dysplasia,5 cases(4.2%)of mucopolysaccharide Ⅳ,5 cases(4.2%) of pseudoachondroplasia,9 cases(7.5%)of hypophosphatemic ricket,24 cases(20%)of short limb dwarf.Among 120 cases,27 were regularity dwarfism(22.5%),93 cases were irregularity dwarfism(77.5%);Among 93 cases of irregularity dwarfism,80 cases were short limb dwarfism including 36 cases of short upper limb(short upper arm 35 cases,shortforearm 1 case),20 cases of short lower limb,24 cases of proportional short stature,13 cases of short trunk.X ray bone age lag 46 cases,ahead of schedule 15 cases(12.5%),normal 59 cases.Conclusions The main causes of short stature combined with skeletal deformity are genetic bone disease.To analyze the feature of clinical and radiographic is a valuble instrument for the children diagnosis of short stature combined with skeletal deformity.Part of them skeletal age were lagged.

Joint Contracture and Radiologic Features in Mucopolysaccharidosis / 대한정형외과학회잡지

PURPOSE: To evaluate the clinical manifestations of contracted joints and the radiological features in mucopolysaccharidosis(MPS). MATERIALS AND METHODS: From January 1996 to March 2002, 15 children from a pool of children diagnosed with MPS through a fibroblast culture and an enzyme assay, who could tolerate a large umber of examinations, underwent orthopedic physical and radiological examinations. RESULTS: There were limitations in the abduction and internal rotation of the shoulder, extension limitation of the wrist, and internal rotation of the hip joint and flexion contractures of the elbow and DIP joints. Scoliotic deformities were all within the physiological curve. There were only three cases of a dorsolumbar kyphotic change and there were no neurological deficits due to the spinal deformities. The mean bone age was delayed compared with the mean chronological age. As the chronological age increased, the gap between the chronological age and the bone age increased. CONCLUSION: Joint contracture, which is the most severe symptom in orthopedic aspect, was more severe in the upper extremities than in the lower extremities. The spinal deformity was relatively mild and there were no neurological problems. The bone age tended to be delayed as the chronological age increased.

Radiographic feature of central salivary gland type malignant tumors of the jaws(CSMTJ) and meta-analyses of literature:10 cases report / 实用口腔医学杂志

Objective:To classify the types of radiographic feature of central salivary gland type malignant tumors of the jaws(CSMTJ) with studying the clinical data,radiographic characteristics and pathological classifications,and to help the diagnose CSMTJ correctly and effectively in future. Methods:The clinical,radiological and pathological features of 62 cases of CSMTJ were studied and summarized. Among these cases,52 cases were collected from the medical records of patients of the internal databank according to the World Health Organization (WHO) Histological Classification of Salivary Gland Tumors standard and 10 cases of CSMTJ were from Guangdong Provincial Stomatological Hospital. Results:The maxilla to mandible ratio was 1∶1.7,Among CSMTJ cases,central mucoepidermoid carcinoma of the jaws (CMCJ) was the most common pathological type and the second was central adenoid cystic carcinoma of the jaws(CACCJ). 62 cases of CSMTJ could be classified into four types:Unicystic type,Multicystic type,"Flame shape" type and Osteolytic type. Conclusion:The radiographic presentation of CSMTJ was very complicated and its classification was connected with tumor malignant degree. The classification was very helpful to determine the treatment methods and the prognosis of the CSMTJ.