RESUMO
Subchondral insufficiency fracture of the femoral head is a recently recognised entity. There are a few cases reported in Japanese and Caucasian patients but none in the Hong Kong population. The condition typically occurs in elderly females with osteoporosis. Acute hip pain is the usual presentation. The patient may have concomitant insufficiency fractures elsewhere. Magnetic resonance imaging is usually required to make the diagnosis. The prognosis of the condition is unknown. Reported complications include rapid collapse of the femoral head and coxopathy. Joint replacement should be considered if conservative management fails.
Assuntos
Cabeça do Fêmur/lesões , Fraturas Espontâneas/diagnóstico , Osteoporose/complicações , Idoso , Diagnóstico Diferencial , Feminino , Necrose da Cabeça do Fêmur/diagnóstico , Humanos , Imageamento por Ressonância MagnéticaRESUMO
Osteolytic lesions are frequently encountered in clinical practice. Radionuclide bone scans with technetium-99m-labeled diphosphonates are often performed in the evaluation of both solitary and multiple osteolytic lesions. In this pictorial review, we critically evaluate the current role of bone scan in common osteolytic tumors including aneurysmal bone cyst, simple bone cyst, fibrous dysplasia, nonossifying fibroma, giant cell tumor, eosinophilic granuloma, enchondroma, chondrosarcoma, osteosarcoma, Ewing sarcoma, myeloma, and metastases. The merits and limitations of bone scanning are emphasized.
Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osteólise/diagnóstico por imagem , Tomografia por Emissão de Pósitrons/métodos , Medronato de Tecnécio Tc 99m , Idoso , Idoso de 80 Anos ou mais , Neoplasias Ósseas/complicações , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteólise/etiologia , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Compostos Radiofarmacêuticos , Estudos RetrospectivosRESUMO
The prone table machine is a mammographic X-ray system specially designed for use in the stereotactic localisation of breast abnormality. In this study, its clinical usefulness was investigated in terms of duration, success rate, complications, and patients' acceptance of the procedure. During a 5-month period, 79 patients attended the Kwong Wah Hospital for stereotactic-guided biopsy on the prone table. Eighty-one lesions were assessed-seven by fine needle aspirations, 67 by large-core needle biopsies, and seven by vacuum-assisted biopsies. Most of the biopsies were done because of clustered microcalcifications (77.8%) and the majority were of mammographically indeterminate nature (58.0%). The mean duration of the procedure was 49 minutes. A high degree of acceptance was experienced by patients. Only one patient had persistent haemorrhage after the biopsy. In conclusion, the prone table machine was considered to be useful and efficient, and had a high degree of acceptance among patients.
Assuntos
Biópsia por Agulha/métodos , Neoplasias da Mama/patologia , Mama/patologia , Adulto , Idoso , Biópsia por Agulha/instrumentação , Neoplasias da Mama/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Feminino , Humanos , Mamografia/instrumentação , Mamografia/métodos , Pessoa de Meia-Idade , Satisfação do Paciente , Decúbito Ventral , Sensibilidade e Especificidade , Fatores de TempoAssuntos
Enfisema/diagnóstico , Dor/etiologia , Pielonefrite/diagnóstico , Pressão Sanguínea , Creatinina/sangue , Diabetes Mellitus , Enfisema/cirurgia , Feminino , Virilha , Humanos , Leucocitose/diagnóstico , Pessoa de Meia-Idade , Nefrectomia , Dor/cirurgia , Pielonefrite/cirurgia , Sepse/diagnósticoRESUMO
PURPOSE: To investigate and compare the sensitivity and specificity of computed tomography and of endoscopy, as diagnostic tests for foreign body ingestion. MATERIALS AND METHODS: Over a two-year period, Asian patients with suspected foreign body ingestion were studied. The clinical findings, computed tomography images, endoscopic results, treatment and outcomes were prospectively analysed. RESULTS: Over the study period, 193 patients were admitted for foreign body ingestion, complaining of a persistent foreign body sensation in the neck. The sensitivity and specificity of computed tomography were 78 and 96 per cent, respectively; the positive predictive value was 75 per cent and the negative predictive value 97 per cent. The diagnostic accuracy of computed tomography was 94 per cent. CONCLUSION: Our study showed that computed tomography had high negative predictive value and accuracy in the diagnosis of foreign body ingestion. It was useful if endoscopy showed negative findings but the patient still had persistent symptoms of foreign body ingestion.