RESUMEN
UNLABELLED: Even though diagnosis of carpal tunnel syndrome is mainly based on clinical findings, other examinations are often useful for confirmation and management. The most useful of these examinations is EMG. However, EMG may be inconclusive and MRI may then be helpful. The indications for MRI in patients with carpal tunnel syndrome will be reviewed. METHOD: 20 patients with a total of 33 clinically suspected cases of carpal tunnel syndrome (CTS) underwent EMG and MRI evaluation. Clinical and EMG findings identified three groups of patients based on degree of deficit: mild, moderate, and severe. The following structures were evaluated at MRI: median nerve, retinaculum, retrotendinous fat, flexor tendons, thenar space, and muscles and bones of the wrist. Surgery was performed for 19 wrists. RESULTS: Only retinacular bowing and increased T2W signal intensity within the median nerve were significantly related to the diagnosis of CTS (sensitivity of 70% and 57% respectively). Retinacular bowing indicates increased "pressure" within the compartment (mechanical compression of the nerve) and increased T2W signal of the median nerve indicates nerve suffering. These findings correlated well with more severe cases based on clinical and EMG findings. CONCLUSION: In cases where there is discordance between clinical and EMG findings, MRI is helpful to identify patients who would benefit from surgical intervention.
Asunto(s)
Síndrome del Túnel Carpiano/diagnóstico , Electromiografía , Imagen por Resonancia Magnética , Examen Físico , Adulto , Anciano , Anciano de 80 o más Años , Síndrome del Túnel Carpiano/clasificación , Síndrome del Túnel Carpiano/cirugía , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Índice de Severidad de la EnfermedadRESUMEN
Parathyroid adenomas are embedded within thyroid tissue in about 2-5% of cases. Intrathyroid parathyroid adenomas are easily detected at US. As such, US should be performed prior to surgical intervention.
Asunto(s)
Adenoma/diagnóstico , Coristoma/diagnóstico , Glándulas Paratiroides , Neoplasias de las Paratiroides/diagnóstico , Enfermedades de la Tiroides/diagnóstico , Adenoma/diagnóstico por imagen , Adulto , Coristoma/diagnóstico por imagen , Femenino , Humanos , Hiperparatiroidismo/diagnóstico , Imagen por Resonancia Magnética , Glándulas Paratiroides/diagnóstico por imagen , Glándulas Paratiroides/patología , Neoplasias de las Paratiroides/diagnóstico por imagen , Radiofármacos , Tecnecio Tc 99m Sestamibi , Enfermedades de la Tiroides/diagnóstico por imagen , UltrasonografíaRESUMEN
Fractures of the spine in patients with ankylosing spondylitis may be the result of minor trauma. They may lead to severe neurological deficits. They are difficult to detect on plain radiographs and CT or MRI often are required for diagnosis.
Asunto(s)
Vértebras Cervicales/lesiones , Vértebras Lumbares/lesiones , Fracturas de la Columna Vertebral/diagnóstico , Fracturas de la Columna Vertebral/etiología , Espondilitis Anquilosante/complicaciones , Vértebras Torácicas/lesiones , Adulto , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Fracturas de la Columna Vertebral/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
A case of congenital aneurysm of the main pulmonary artery incidentally discovered following blunt chest trauma is reported. This anormaly is rare and the authors will emphasize the plain radiographic and MRI findings. The etiology and evolution of this entity are not well known.
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Aneurisma/congénito , Arteria Pulmonar/anomalías , Adulto , Aneurisma/diagnóstico por imagen , Aneurisma/patología , Angiografía , Femenino , Humanos , Imagen por Resonancia Magnética , Arteria Pulmonar/diagnóstico por imagen , Arteria Pulmonar/patología , Traumatismos Torácicos/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Heridas no Penetrantes/diagnóstico por imagenAsunto(s)
Angiomiolipoma/complicaciones , Neoplasias Renales/complicaciones , Neoplasias Primarias Múltiples/complicaciones , Esclerosis Tuberosa/diagnóstico , Adulto , Angiomiolipoma/diagnóstico , Angiomiolipoma/cirugía , Femenino , Humanos , Neoplasias Renales/diagnóstico por imagen , Neoplasias Renales/cirugía , Imagen por Resonancia Magnética , Neoplasias Primarias Múltiples/diagnóstico , Neoplasias Primarias Múltiples/cirugía , Tomografía Computarizada por Rayos XRESUMEN
Cardiac arrest is a frequent emergency for doctors and resuscitation teams. Patients displaying asystole or pulseless electrical activity are non-shockable. They have extremely poor outcomes. The use of sonographers might contribute to a better understanding of cardiac arrest (CA) etiology and facilitate its treatment. A systematic search in databases (NLM-Gateway, CNRS-INIST/Pascal, Science Direct, Ovid, and Bibliovie) of primary documents and notices allowed us to select clinical trial studies. Editorials, case report and animals studies were excluded from the analysis. The various physiopathological and semiological status revealed by echocardiography are useful to detect the aetiology of cardiac arrest. In the very first minutes following the arrest, a significant increase of right ventricle (RV) volume suggests a pulmonary thromboembolism or a RV infarction. After 4 min of CA, a physiological increase of RV volume is observed, in relation with the pressure balance between high and low arteriovenous pressures. RV and/or left ventricle collapses are straightaway pathological whichever due to pericardic effusion, pneumothorax or shock. A synthesis algorithm dedicated to care of CA, including transthoracic echocardiography for search of curable causes, is proposed. This algorithm fulfills the ILCOR, ERC and AHA recommendations. The echocardiography should be part of ACLS, nevertheless clinical studies are needed to assess its impact on morbimortality.
Asunto(s)
Reanimación Cardiopulmonar , Servicios Médicos de Urgencia/métodos , Paro Cardíaco/diagnóstico por imagen , Hospitalización , Algoritmos , Presión Sanguínea , Taponamiento Cardíaco/complicaciones , Taponamiento Cardíaco/diagnóstico por imagen , Ensayos Clínicos como Asunto/estadística & datos numéricos , Estudios de Cohortes , Cardioversión Eléctrica , Paro Cardíaco/etiología , Paro Cardíaco/fisiopatología , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Pronóstico , Embolia Pulmonar/complicaciones , Embolia Pulmonar/diagnóstico por imagen , Choque/complicaciones , Choque/diagnóstico por imagen , UltrasonografíaRESUMEN
BACKGROUND: Although carpal tunnel syndrome is diagnosed primarily on clinical grounds, a number of investigations can be helpful in confirming the diagnosis and providing therapeutic orientation. Electrodiagnostic testing is the most widely used method in everyday practice but can be inconclusive or inconsistent with the clinical findings. Magnetic resonance imaging is useful in such cases. OBJECTIVES: To compare the diagnostic usefulness of electrodiagnostic testing and magnetic resonance imaging in patients with carpal tunnel syndrome. PATIENTS AND METHODS: Thirty-three cases of clinically-defined carpal tunnel syndrome in 20 patients were investigated by electrodiagnostic testing and magnetic resonance imaging. The nerve entrapment was categorized as mild, moderate, or severe based on clinical and electrodiagnostic findings. Structures evaluated on magnetic resonance imaging scans were the median nerve, the flexor retinaculum, the flexor tendons, the fat lying deep to the tendons, the thenar compartment, and the carpal bones. RESULTS: Bowing of the transverse carpal ligament, high signal from the median nerve on T2 images, and median nerve enlargement were found in 70%, 57%, and 55% of cases, respectively. Bowing of the transverse carpal ligament is a cause of mechanical compression, whereas the other two signs reflect injury to the median nerve. High signal from the median nerve was associated with more severe clinical and/or electrodiagnostic abnormalities. CONCLUSION: When electrodiagnostic abnormalities suggest more severe disease than expected or are otherwise discordant with clinical findings, demonstration by magnetic resonance imaging of high median nerve signal and/or median nerve enlargement may help to select those patients most likely to benefit from surgical treatment.
Asunto(s)
Síndrome del Túnel Carpiano/diagnóstico , Electromiografía , Imagen por Resonancia Magnética , Adulto , Anciano , Anciano de 80 o más Años , Anatomía Transversal , Síndrome del Túnel Carpiano/cirugía , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Muñeca/anatomía & histologíaRESUMEN
The authors present a case of a retroperitoneal lymphocele following prosthetic reconstruction of the abdominal aorta followed by a discussion about the principal differential diagnosis of a retroperitoneal collection following surgery on abdominal aorta. To date, only ten cases have been reported in this post-operative; it is probably a more frequent complication; the radiologist must play a major role both in the detection and the treatment of such collections.