A study on MRI of internal derangements of knee

Background: The various imaging modalities used to evaluate pathological conditions of the knee include conventional fluoroscopy, arthrography, radiography, sonography, computed tomography, nuclear medicine, and magnetic resonance imaging. However, magnetic resonance imaging (MRI) has been recognized as an efficient, non-invasive test for identifying meniscal tears and other knee diseases. The Aim of the study: To evaluate the internal derangements of ligaments of the knee in an acute traumatic knee setting and to identify their patterns in MRI. Materials and methods: A cross-sectional study of fifty cases where MRI was used as the diagnostic modality evaluating the internal derangement of the knee. The study period was May 2017 to November 2018. The study included patients with traumatic knee injuries. The studies were carried out with a 1.5 Tesla Philips MRI machine. Results: Majority of the participants having IDK had anterior cruciate ligament tear followed by medial menisci tear and lateral menisci tear while posterior cruciate ligament tear and lateral collateral ligament tear are not so much common. Conclusion: MRI is a beneficial and non-invasive modality which possesses higher diagnostic accuracy and better sensitivity. It might be advantageous in the clinical conditions where the arthroscopy may not useful for the inferior surface and peripheral meniscus tears. The results of this present study support that MRI can be very helpful in diagnosing the cruciate and meniscal ligament injuries. It can accurately detect, localize and distinguish various internal derangements of the knee joint with excellent soft tissue delineation and help in arriving at an accurate anatomical diagnosis thereby helping further management of the patients.

Intracranial ruptured dermoid cyst presenting as dysarthria: A case report

Intracranial dermoid cysts are tumors which are rare and are derived from ectopic epithelial cells. These dermoid cysts are slow-growing and are benign; they can cause morbidity by compressing the neurovascular structures. They also do rupture rarely into the subarachnoid space. Dermoid cystic tumors arise from the inclusion of ectodermal committed cells at the time of neural tube closure during the third to fifth week of embryogenesis. These lesions are slow growing due to the active production of hair and oils from the internal dermal elements. This is a case of a ruptured intracranial dermoid presenting as slurring of speech caused by the fat droplets.

Radio-diagnosis of Herlyn Werner Wunderlich Syndrome a rare case of urogenital abnormality

Herlyn-Werner-Wunderlich syndrome (HWWS) is a very rare urogenital abnormality, which is characterized by Mullerian duct anomaly with associated mesonephric duct anomaly. This syndrome is also known as OHVIRA (Obstructed hemivagina with Ipsilateral Renal Anomaly). The incidence of Mullerian Duct Anomaly is 2-3%, and incidence of OHVIRA is 0.16 to 10% of that. The three important components of Herlyn-Werner-Wunderlich (HWW) syndrome are didelphys uterus, obstructed hemivagina and renal agenesis on the same side. Typically presents with pelvic pain in young females after menarche. Presentation in the reproductive age group is unusual. The most common renal anomaly associated with this condition is renal agenesis. Other renal anomalies include renal dysplasia, duplication of kidneys and ureters, crossed fused ectopia and ectopic ureter. Ultrasound and Magnetic resonance imaging are considered as the vital modalities for detection. MRI is the gold standard modality for assessing the anatomical characteristics of the uterus, cervix, and vagina. Early diagnosis helps to prevent complications such as endometriosis, pyocolpos, adhesions, infertility. The unique feature of our case is a presentation in the reproductive age group. Only very few case reports of OHVIRA with a presentation in the reproductive age group are available in the literature. Whenever there is a renal anomaly or renal agenesis, screening of pelvic organs is important in a female child for early detection of Mullerian duct anomalies and prevention of further complications.

Radiological interpretation of a small cell neuroendocrine cancer of the lung

Neuroendocrine tumors may develop throughout the human body with the majority being found in the gastrointestinal tract and bronchopulmonary system. Neuroendocrine tumors are classified according to the grade of biological aggressiveness (G1–G3) and the extent of differentiation (welldifferentiated/ poorly-differentiated). The well-differentiated neoplasms comprise typical (G1) and atypical (G2) carcinoids. Large cell neuroendocrine carcinomas, as well as small cell carcinomas (G3), are poorly-differentiated. The identification and differentiation of atypical from typical carcinoids or large cell neuroendocrine carcinomas and small cell carcinomas are essential for treatment options and prognosis. Pulmonary neuroendocrine tumors are characterized according to the proportion of necrosis, the mitotic activity, palisading, rosette-like structure, trabecular pattern, and organoid nesting. These neuroendocrine tumors of the lung arise from Kulchitzky cells of the bronchial mucosa and comprise typical carcinoid, atypical carcinoid, large cell neuroendocrine carcinoma (LCNEC), and small cell lung cancer (SCLC). Here is a case report of the 75-year-old male patient presented with complaints of a cough and sudden onset of breathlessness and weight. On Computed Tomography (CT) a large heterogeneous lesion noted in the left anterior mediastinum which was subjected to CT guided biopsy. On histopathology and immunohistochemistry, the tumor was confirmed as small cell neuroendocrine tumor.

Histopathological and radiological findings of desmoid tumor of abdominal cavity

Desmoid tumors are rare slow growing, monoclonal, fibroblastic proliferation characterized by variable and often unpredictable clinical outcome, sometimes with aggressive infiltration of adjacent tissue but with no metastatic potential. Desmoids are histologically benign. On a molecular study level, they have been characterized by mutations in the β-catenin gene, APC (Adenomatous Polyposis Coli) gene or the CTNNB1. Gene studies are useful when the pathological diagnosis is difficult. Application of various multidisciplinary assessments along with multimodality treatment forms the basis of management for these patients. In selected asymptomatic patients, watchful waiting might be the most appropriate management. But for patients with desmoid located in other sites like the mesentery or at the head and neck region which might present with serious complications, thus requiring a more aggressive approach of treatment. In this article, we reported a 28-year-old female with a desmoid tumor of the anterior abdominal wall who underwent surgical resection. Preoperative evaluation was done using abdominal ultrasound, computed tomography, and magnetic resonance imaging. The histopathological examination of the resected specimen revealed a desmoid tumor. Because of the heterogeneity of the desmoid tumors, treatment needs to be individualized. However, complete surgical resection with negative margins seems to be the treatment of choice for this tumor entity and postoperative radiotherapy can help reduces the local recurrence rate.