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2.
BMJ Case Rep ; 14(2)2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33526520

RESUMO

A 10-year-old child had painful periorbital swelling in the left eye. It was diagnosed as preseptal cellulitis and treated with oral antibiotics. Three days later, the ocular condition worsened so the child was referred for further management. On examination, the child had a temperature of 102 °F. Ocular examination revealed proptosis, restricted ocular movements and a relative afferent pupillary defect in the left eye. Ocular examination of the right eye was normal. There was a history of recurrent episodes of cold in the past. CT scan orbit and sinuses revealed signs of orbital cellulitis with sinusitis on the left side. The child was treated with parenteral antibiotics and endoscopic sinus surgery. A child presenting with unilateral periorbital swelling needs to be thoroughly evaluated. It is important to differentiate orbital cellulitis from preseptal cellulitis. Orbital cellulitis is an emergency and delay in diagnosis can lead to vision and life-threatening intracranial complications.


Assuntos
Antibacterianos/uso terapêutico , Endoscopia , Celulite Orbitária/diagnóstico , Sinusite/diagnóstico , Celulite (Flegmão)/diagnóstico , Criança , Diagnóstico Tardio , Edema/diagnóstico por imagem , Edema/fisiopatologia , Exoftalmia/diagnóstico por imagem , Exoftalmia/fisiopatologia , Humanos , Masculino , Oftalmoplegia/fisiopatologia , Celulite Orbitária/diagnóstico por imagem , Celulite Orbitária/fisiopatologia , Celulite Orbitária/terapia , Distúrbios Pupilares/fisiopatologia , Sinusite/diagnóstico por imagem , Sinusite/terapia , Tomografia Computadorizada por Raios X
3.
Muscle Nerve ; 63(3): 365-370, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33314190

RESUMO

BACKGROUND: Diagnosing cervical radiculopathy (CR) can be difficult because of symptomatic overlap with peripheral neuropathies. In this retrospective observational study, we aimed to determine whether short-tau inversion recovery (STIR) magnetic resonance imaging (MRI) sequences are useful for detecting signs of denervation in the multifidus muscles in patients with CR. METHODS: We analyzed the data of 18 patients with CR who developed arm weakness within 1 year. We also included 10 patients with sensorimotor symptoms involving the upper extremities who did not have intervertebral foraminal stenosis on MRI as controls. For each patient with CR, the signal intensity (SI) of the affected multifidus muscles was measured and compared to that on the contralateral side (signal intensity ratio: SIR). RESULTS: Control patients without CR did not exhibit STIR signal abnormalities in the multifidus muscles. Most of the 18 patients with CR were male (83.3%), and the mean age was 59.4 years. Thirteen of 18 CR patients (72.2%) were determined to have STIR signal abnormalities by a radiologist. The mean SIR in the 13 patients with increased SI was significantly higher than that in the five patients without signal abnormalities (1.23 vs 0.97, P = .004), supporting the radiologist's diagnosis. The distribution of signal abnormalities closely followed those identified via clinical and electrophysiological tests, especially severe weakness (P = .044). CONCLUSIONS: Denervation edema of the multifidus muscles can be detected in CR and correlates with clinical/electrophysiological tests and weakness severity, which may aid in CR diagnostics.


Assuntos
Vértebras Cervicais , Edema/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Músculos Paraespinais/diagnóstico por imagem , Doenças do Sistema Nervoso Periférico/diagnóstico , Radiculopatia/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Diagnóstico Diferencial , Edema/etiologia , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuralgia/diagnóstico , Músculos Paraespinais/inervação , Radiculopatia/complicações , Estudos Retrospectivos
5.
Monaldi Arch Chest Dis ; 90(4)2020 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-33169595

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection continues to be a public health emergency and a pandemic of international concern. As of April 31st,  the reported cases of COVID-19 are three million in 186 countries. Reported case fatality has crossed 200 thousand among which more than fifty thousand has been in the USA. Most patients present with symptoms of fever, cough, and shortness of breath following exposure to other COVID-19 patients. Respiratory manifestations predominate in patients with mild, moderate, severe illness. Imaging of patients with COVID-19 consistently reports various pulmonary parenchymal involvement. In this article we wanted to reinforce and review the various reported imaging patterns of cardiac and mediastinal involvement in COVID-19 patients. Among patients with COVID 19 who underwent various imaging of chest various cardiac findings including pericardial effusion, myocarditis, cardiomegaly has been reported. Most of these findings have been consistently reported in patients with significant acute myocardial injury, and fulminant myocarditis. Acute biventricular dysfunction has also been reported with subsequent improvement of the same following clinical improvement. Details of cardiac MRI is rather limited. In a patient with clinical presentation of acute myocarditis, biventricular myocardial interstitial edema, diffuse biventricular hypokinesia, increased ventricular wall thickness, and severe LV dysfunction has been reported. Among patients with significant clinical improvement in LV structure and function has also been documented. With increasing number of clinical cases, future imaging studies will be instrumental in identifying the various cardiac manifestations, and their relation to clinical outcome.


Assuntos
Cardiomegalia/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Coração/diagnóstico por imagem , Isquemia Miocárdica/diagnóstico por imagem , Miocardite/diagnóstico por imagem , Derrame Pericárdico/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Disfunção Ventricular Esquerda/diagnóstico por imagem , Betacoronavirus , Cardiomegalia/fisiopatologia , Angiografia Coronária , Infecções por Coronavirus/fisiopatologia , Ecocardiografia , Edema/diagnóstico por imagem , Edema/fisiopatologia , Coração/fisiopatologia , Humanos , Imagem por Ressonância Magnética , Isquemia Miocárdica/fisiopatologia , Miocardite/fisiopatologia , Pandemias , Derrame Pericárdico/fisiopatologia , Pneumonia Viral/fisiopatologia , Radiografia Torácica , Recuperação de Função Fisiológica , Tomografia Computadorizada por Raios X , Disfunção Ventricular/diagnóstico por imagem , Disfunção Ventricular/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia
6.
Nat Commun ; 11(1): 5355, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-33097705

RESUMO

Water and lipids are key participants in many biological processes, but there are few non-invasive methods that provide quantification of these components in vivo, and none that can isolate and quantify lipids in the blood. Here we develop a new imaging modality termed shortwave infrared meso-patterned imaging (SWIR-MPI) to provide label-free, non-contact, spatial mapping of water and lipid concentrations in tissue. The method utilizes patterned hyperspectral illumination to target chromophore absorption bands in the 900-1,300 nm wavelength range. We use SWIR-MPI to monitor clinically important physiological processes including edema, inflammation, and tumor lipid heterogeneity in preclinical models. We also show that SWIR-MPI can spatially map blood-lipids in humans, representing an example of non-invasive and contact-free measurements of in vivo blood lipids. Together, these results highlight the potential of SWIR-MPI to enable new capabilities in fundamental studies and clinical monitoring of major conditions including obesity, cancer, and cardiovascular disease.


Assuntos
Raios Infravermelhos , Lipídeos/sangue , Imagem Óptica/métodos , Ondas de Rádio , Espectroscopia de Luz Próxima ao Infravermelho/métodos , Água/análise , Tecido Adiposo Marrom/diagnóstico por imagem , Tecido Adiposo Marrom/patologia , Adulto , Animais , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico por imagem , Edema/diagnóstico por imagem , Edema/patologia , Feminino , Xenoenxertos , Humanos , Inflamação/diagnóstico por imagem , Inflamação/patologia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Neoplasias/diagnóstico por imagem , Neoplasias/patologia , Obesidade/diagnóstico por imagem , Imagem Óptica/instrumentação , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Espectroscopia de Luz Próxima ao Infravermelho/instrumentação
7.
PLoS One ; 15(10): e0238773, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33031459

RESUMO

BACKGROUND: Fractures of the pelvic ring in elderly patients have increased in frequency over time. These injuries are associated with a high morbidity and have a socio-economic impact. The diagnostic procedures and their influence of therapy decisions are still controversial. METHODS: In a retrospective study, we investigate the value of additional MRI examination on therapy decision of fragility fractures of the pelvis. The evaluation of all patients with pelvic fractures without adequate trauma and with performed CT and MRI was conducted at three large German hospitals. The imaging procedure took place within a maximum interval of 4 weeks. After evaluation of the imaging, the resulting therapeutic consequences either based on CT alone or on CT and MRI were reviewed by experienced pelvic surgeons. RESULTS: Of 754 patients with pelvic injuries, 67 (age 80 +/- 9.7 years, f: m 54:13) could be included. The detection of vertical fractures in CT (n = 40 unilateral, n = 11 bilateral) could be increased by the additional MRI (n = 44 unilateral, n = 23 bilateral). A horizontal fracture component was identified in CT in 9.0% (n = 6) vs. MRI in 25.4% (n = 17) of the cases. An anterior pelvic ring injury was detected in 71.6% (n = 44; 4x bilateral) in CT, in 80.6% in MRI (n = 50, 4 bilateral). Additive MRI imaging increased the decision rate for surgical therapy from 20.9% (n = 14) to 31.3% (n = 21). CONCLUSIONS: The results of this study further support the value of bone marrow edema detection by MRI diagnostics (or dual source CT which showed promising initial results) for the detection of pelvic ring fractures. For the first time, the study identifies an additional therapeutic consequence by an increased rate of surgical procedures.


Assuntos
Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/terapia , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/lesões , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico por imagem , Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Feminino , Alemanha , Humanos , Imagem por Ressonância Magnética , Masculino , Imagem Multimodal , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
9.
Clin Imaging ; 68: 242-248, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32911312

RESUMO

PURPOSE: To investigate the relationship between breast cancer imaging features on magnetic resonance imaging (MRI) and histopathological characteristics. METHODS AND MATERIALS: We prospectively enrolled 46 patients who underwent 1.5-T MRI with 68 breast malignant lesions from 2017 until 2019. Peritumoral edema was determined based on visual assessment on T2 weighted imaging. Lesions were categorized into two groups: A: with edema (48 lesions) and B: without edema (20 lesions). RESULTS: The tumor size was not different among two groups but multifocal-multicentric lesions were more common in the group A (70% vs. 35%). The axillary lymph nodes are most involved in group A. ER and PR positive lesions were more common in group B (90% vs. 56.3%) but in the group A, HER2 positive lesions were found to be more common (31.3% vs. 15%). The mean ADC value in tumors and peritumoral regions were lower (0.97 × 10-3 mm2/s, P = 0.023) and higher (1.85 × 10-3 mm2/s, P < 0.0001) in group A, respectively. Peritumoral ADC value was significantly higher in HER2-positive group. CONCLUSION: Breast carcinomas with peritumoral edema were found to be more multifocal-multicentric, with higher prevalence of axillary lymph node involvement, more HER 2-positive, with lower prevalence of ER/PR-positive, lower tumoral ADC and higher peritumoral ADC values.


Assuntos
Neoplasias da Mama , Biomarcadores , Neoplasias da Mama/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Edema/diagnóstico por imagem , Humanos , Estudos Retrospectivos
10.
Medicine (Baltimore) ; 99(37): e21818, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925718

RESUMO

Lower extremity (LEx) edema is a common complication in gynecologic cancer patients. There are 2 main causes of edema in these patients such as deep vein thrombosis (DVT) and lymphedema. Early diagnosis and treatment of DVT are certainly important, but it is often difficult to evaluate proximal DVT by using ultrasound. The aim of this study is to demonstrate the usefulness of computed tomography venography of the lower extremity (CTV LEx) for the diagnosis of the DVT and investigate predictive factor of DVT in gynecologic cancer patients with LEx edema.The medical records of 415 gynecologic cancer patients who were referred to the department of rehabilitation medicine with LEx edema were retrospectively reviewed in this case-controlled study. We categorized CTV LEx findings as follows: DVT proximal to the inguinal ligament (inferior vena cava or iliac vein thrombosis) and DVT distal to the inguinal ligament (femoral, popliteal, or calf vein thrombosis). We also evaluated patient characteristics including D-dimer level. We analyzed the correlation of each factor with DVT frequency and used receiver operating characteristic curve analysis to determine the appropriate D-dimer threshold.Sixty-six patients were diagnosed with DVT; of them, 35 (53%) had DVT proximal to the inguinal ligament. Twenty-two patients were diagnosed with pulmonary embolism, of whom 15 had proximal DVT. Patients with proximal DVT tended to have pulmonary embolism (P < .001). Distal organ metastasis (odds ratio [OR], 2.88; P = .002) and a high D-dimer level (OR, 1.13; P = .001) were correlated with DVT.CTV LEx is a useful diagnostic tool for gynecologic cancer patients with LEx edema, particularly high-risk patients, that should be performed at the initial evaluation.


Assuntos
Edema/diagnóstico por imagem , Neoplasias dos Genitais Femininos/complicações , Embolia Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Trombose Venosa/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Edema/etiologia , Feminino , Humanos , Extremidade Inferior/diagnóstico por imagem , Pessoa de Meia-Idade , Flebografia , Embolia Pulmonar/etiologia , Curva ROC , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Trombose Venosa/etiologia
11.
Rev. esp. cir. oral maxilofac ; 42(3): 139-142, jul.-sept. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-196631

RESUMO

Actualmente las sustancias de relleno son la forma más popular para el rejuvenecimiento facial y el aumento de los tejidos. Existen varios problemas añadidos que han condicionado el aumento de las complicaciones con los materiales de relleno, que son el uso de sustancias adulteradas, la inyección de varios materiales en la misma zona o la administración por personal no entrenado/autorizado. Varias investigaciones sugieren que la ecografía de alta frecuencia (EAF) es una herramienta útil, de bajo coste y no invasiva para demostrar el tipo material de relleno e identificar el lugar de inyección y la cantidad de material inyectado. Presentamos en caso de una mujer de 64 años que presentaba edema hemifacial después de 15 años de haberse inyectado silicona líquida (SIL) en los labios, tratada con minociclina, mostrando mejoría clínica significativa


Currently injectable materials are popular for facial rejuvenation and soft tissue augmentation. There are some added problems, which have been conditioned by the increase in complications with fillers, that are the use of adulterated materials, injections of various types of substances in the same area or because administration by inexperienced/untrained professionals. Several studies suggest that high frequency ultrasound (HUS) is an economical, useful and non-invasive diagnostic tool to determine the nature and type of material and to identify the injection site and quantity of injected filler. We report a case of a 64-year-old woman who presented hemifacial swelling after 15 years of being injected with 1 infiltration of liquid injectable silicone (LIS) in the lips, treated with Minocycline, showing a significant clinical improvement


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Edema/diagnóstico por imagem , Silicones/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Assimetria Facial/etiologia , Próteses e Implantes/efeitos adversos , Prednisona/uso terapêutico , Minociclina/uso terapêutico
12.
AJR Am J Roentgenol ; 215(4): 970-977, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32809864

RESUMO

OBJECTIVE. The purpose of this study was to evaluate whether CT features can predict bone marrow edema (BME) on MRI and fracture age in vertebral fragility fractures. MATERIALS AND METHODS. A total of 189 thoracolumbar compression fractures in 103 patients (14 men, 89 women; mean age, 76 years) imaged with both spine CT and MRI were retrospectively included. The presence and extent of BME were assessed on MRI to divide fractures into those with and without BME. The group with BME was then classified for subgroup analysis into fractures with extensive BME (comprising 50% or more of the vertebral body) and those with BME comprising less than 50% of the vertebral body. On CT, five features (presence of cortical or endplate fracture line, presence of trabecular fracture line, presence of condensation band, change in trabecular attenuation, and width of paravertebral soft-tissue change) were analyzed. RESULTS. All five CT findings were predominantly seen in fractures with BME (p < 0.001). Elevated trabecular attenuation, presence of a cortical or endplate fracture line, and paravertebral soft-tissue width showed excellent diagnostic indication for fractures with BME (ROC AUCs: 0.990, 0.976, and 0.950, respectively). In the subgroup with extensive BME, paravertebral soft-tissue width was significantly higher, whereas the change in trabecular attenuation was lower compared with those with BME comprising less than 50% of the vertebral body (p < 0.001). When BME was present, fracture age was not significantly different between the two subgroups, and only greater trabecular attenuation elevation was predictive of older fracture age on linear mixed model analyses (p < 0.001). Interobserver agreement was good for the trabecular fracture line factor and excellent for all other factors. CONCLUSION. CT features accurately correlate with the presence and extent of BME in vertebral fragility fractures. Elevation of trabecular attenuation was the only significant image predictor of fracture age.


Assuntos
Doenças da Medula Óssea/diagnóstico por imagem , Edema/diagnóstico por imagem , Fraturas por Compressão/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Fraturas da Coluna Vertebral/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Doenças da Medula Óssea/etiologia , Edema/etiologia , Feminino , Fraturas por Compressão/complicações , Humanos , Vértebras Lombares/lesões , Imagem por Ressonância Magnética , Masculino , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Fraturas da Coluna Vertebral/complicações , Vértebras Torácicas/lesões
13.
J Am Acad Orthop Surg ; 28(20): e888-e899, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32701688

RESUMO

Bone marrow edema (BME) is a descriptive term used to describe high-signal intensity changes detected on magnetic resonance fluid-sensitive sequences that could be attributed to a number of underlying pathologies. Regardless of the cause, physiologic remodeling of the subchondral bone can be limited because of ongoing joint forces, increased focalization of stress, and reduced healing capacity of the subchondral bone. BME is a known prognostic factor associated with pain, dysfunction, and progressive cartilage damage. This review summarizes the current known causes of BMEs, theories related to histopathological changes, and current treatment options including novel biologic surgical options.


Assuntos
Doenças da Medula Óssea/etiologia , Doenças da Medula Óssea/terapia , Fosfatos de Cálcio/economia , Edema/etiologia , Edema/terapia , Adulto , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/patologia , Substitutos Ósseos/administração & dosagem , Fosfatos de Cálcio/administração & dosagem , Cartilagem Articular/patologia , Tratamento Conservador , Imagem de Difusão por Ressonância Magnética , Edema/diagnóstico por imagem , Edema/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Procedimentos Ortopédicos , Dor/etiologia , Prognóstico
16.
Ann Rheum Dis ; 79(8): 1063-1069, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32522743

RESUMO

OBJECTIVES: To determine the prevalence of bone marrow oedema (BME) at the sacroiliac joint (SIJ) in early postpartum (EPP), nulliparous (NP) and late postpartum (LPP) women, and to identify factors associated with BME presence at the SIJ. METHODS: Three groups were obtained: NP (never given birth), EPP (given birth within 12 months) and LPP (given birth more than 24 months). The primary outcome was the presence of BME and/or structural lesions (erosions, osteophytes, ankylosis and sclerosis) at the SIJ MRI. RESULTS: BME prevalence was greater among EPP (33%) than NP (14%, p=0.001), but was not different to LPP (21%, p=0.071). The Assessment of SpondyloArthritis international Society (ASAS) MRI criteria for sacroiliitis were positive in 75%, 71% and 80%, respectively, of EPP, NP and LPP women with BME. EPP (38%) had similar prevalence of sclerosis than LPP (28%, p=0.135), but greater than NP (18%, p=0.001). Lastly, EPP (28%) had similar prevalence of osteophytes than LPP (42%) and NP (27%), although there was a difference between LPP and NP (p=0.006). CONCLUSIONS: EPP have higher BME prevalence at the SIJ than NP, EPP tend to have higher BME prevalence compared with LPP and BME presence decreases with time from delivery. Three-quarters of women with BME at the SIJ had a positive ASAS MRI criteria for sacroiliitis, indicating that BME presence as the main criterion for a positive diagnosis can lead to false-positive results. SIJ MRIs should not be interpreted in isolation, since age, time from delivery and other factors may outweigh the pertinence of MRI findings. Trial registration number NCT02956824.


Assuntos
Período Pós-Parto , Sacroileíte/diagnóstico por imagem , Espondilartrite/diagnóstico por imagem , Dor nas Costas/etiologia , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Edema/diagnóstico por imagem , Edema/patologia , Feminino , Humanos , Inflamação/diagnóstico por imagem , Inflamação/etiologia , Inflamação/patologia , Imagem por Ressonância Magnética , Paridade , Gravidez , Prevalência , Articulação Sacroilíaca/patologia , Sacroileíte/etiologia , Sacroileíte/patologia , Espondilartrite/patologia
17.
AJR Am J Roentgenol ; 215(3): 545-558, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32507017

RESUMO

OBJECTIVE. The purpose of this study is to clarify which imaging parameters of patellofemoral maltracking are associated with superolateral Hoffa fat pad (SHFP) edema. MATERIALS AND METHODS. A systematic search of the MEDLINE, Embase, and Cochrane Library databases was performed to identify studies evaluating the relationship between SHFP edema and patellofemoral maltracking. Parameters for assessing patellofemoral maltracking on MRI were reviewed for each study. Two reviewers performed study selection, methodologic quality assessment, and data extraction. RESULTS. Nine studies were eligible for inclusion in the present study. From the included studies, nine parameters assessing patellofemoral maltracking were analyzed: lateral patellofemoral angle, patellar tilt, patellar lateralization, trochlear depth, sulcus depth, sulcus angle, lateral trochlear inclination, distance between the tibial tuberosity and trochlear groove, and the Insall-Salvati ratio. Patients with SHFP edema had greater patellar tilt (standardized mean difference, 0.89°; 95% CI, 0.38-1.40°; p = 0.0006), greater patellar lateralization (standardized mean difference, 0.78 mm; 95% CI, 0.21-1.36 mm; p = 0.008), greater distance between the tibial tuberosity and trochlear groove (standardized mean difference, 0.96 mm; 95% CI, 0.48-1.44 mm; p < 0.0001), and higher Insall-Salvati ratio (standardized mean difference, 1.94; 95% CI, 1.29-2.60; p < 0.00001) than patients without SHFP edema. CONCLUSION. Patellofemoral maltracking imaging parameters, such as a more laterally displaced patella, greater TTTG distance, and patella alta, are correlated with SHFP edema.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Doenças do Tecido Conjuntivo/diagnóstico por imagem , Edema/diagnóstico por imagem , Artropatias/diagnóstico por imagem , Imagem por Ressonância Magnética , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/fisiopatologia , Tecido Adiposo/fisiopatologia , Doenças do Tecido Conjuntivo/fisiopatologia , Edema/fisiopatologia , Humanos , Artropatias/fisiopatologia
19.
BMJ Case Rep ; 13(4)2020 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-32317364

RESUMO

We describe a case of paediatric orbital cellulitis with subperiosteal abscess following blunt facial trauma. Clinical features of orbital cellulitis developed on day 1 post-trauma. A subperiosteal collection subsequently formed lateral to the globe, causing significant ocular compromise. Surgical drainage and sinus washout were performed via external incisions, with satisfactory outcome. This case highlights how trauma may represent a non-sinogenic aggravating factor in orbital cellulitis. We describe how a subperiosteal abscess may vary depending on its aetiology, and how the surgical approach can be modified to locate and drain a laterally sited subperiosteal abscess.


Assuntos
Abscesso/diagnóstico por imagem , Edema/diagnóstico por imagem , Traumatismos Faciais/complicações , Celulite Orbitária/etiologia , Ferimentos não Penetrantes/complicações , Adolescente , Antibacterianos/uso terapêutico , Drenagem/métodos , Feminino , Humanos , Celulite Orbitária/terapia , Resultado do Tratamento
20.
Ann Rheum Dis ; 79(7): 929-934, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32299794

RESUMO

OBJECTIVES: Bone marrow oedema (BMO) on MRI of sacroiliac joints (SIJs) represents a hallmark of axial spondyloarthritis (SpA), yet such lesions may also occur under augmented mechanical stress in healthy subjects. We therefore sought to delineate the relationship between pregnancy/delivery and pelvic stress through a prospective study with repeated MRI. Results were matched with maternal, child and birth characteristics. METHODS: Thirty-five women underwent a baseline MRI-SIJ within the first 10 days after giving birth. MRI was repeated after 6 months and, if positive for sacroiliitis according to the Assessment of SpondyloArthritis International Society (ASAS) definition, after 12 months. BMO and structural lesions were scored by three trained readers using the Spondyloarthritis Research Consortium of Canada (SPARCC) method. RESULTS: Seventy-seven per cent of the subjects (27/35) displayed sacroiliac BMO immediately postpartum, 60% fulfilled the ASAS definition of a positive MRI. After 6 months, 46% of the subjects (15/33) still showed BMO, representing 15% (5/33) with a positive MRI. After 12 months, MRI was still positive in 12% of the subjects (4/33). Few structural lesions were detected. Intriguingly, in this study, the presence of BMO was related to a shorter duration of labour and lack of epidural anaesthesia. CONCLUSION: A surprisingly high prevalence of sacroiliac BMO occurs in women immediately postpartum. Our data reveal a need for a waiting period of at least 6 months to perform an MRI-SIJ in postpartum women with back pain. This study also underscores the importance of interpreting MRI-SIJ findings in the appropriate clinical context.


Assuntos
Parto Obstétrico/efeitos adversos , Imagem por Ressonância Magnética/métodos , Transtornos Puerperais/epidemiologia , Sacroileíte/epidemiologia , Adulto , Dor nas Costas/diagnóstico por imagem , Dor nas Costas/etiologia , Doenças da Medula Óssea/diagnóstico por imagem , Doenças da Medula Óssea/epidemiologia , Doenças da Medula Óssea/etiologia , Canadá/epidemiologia , Diagnóstico Diferencial , Edema/diagnóstico por imagem , Edema/epidemiologia , Edema/etiologia , Feminino , Humanos , Parto/fisiologia , Ossos Pélvicos/diagnóstico por imagem , Ossos Pélvicos/fisiopatologia , Período Pós-Parto , Gravidez , Prevalência , Estudos Prospectivos , Transtornos Puerperais/diagnóstico por imagem , Transtornos Puerperais/etiologia , Sacroileíte/diagnóstico por imagem , Sacroileíte/etiologia , Estresse Fisiológico
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