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3.
Autops. Case Rep ; 13: e2023454, 2023. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1520271

ABSTRACT

ABSTRACT The gingival cyst of the adult (GCA) is a rare odontogenic cyst, consisting of 0.3% of all odontogenic cysts. This case report, based on CARE guidelines for case reports, aims to present a case of a 52-year-old female patient with a symptomatic translucent nodule in the upper left anterior gingiva, measuring approximately 6mm. Excisional biopsy was performed, and the histological examination revealed multiple cystic cavities lined by the squamous epithelium of varying thickness with focal areas of nodular thickenings. The presence of clusters of cells with clear cytoplasm within epithelial thickenings was observed. PAS staining was negative in clear cells. The diagnosis of the GCA was established. Despite its rarity, GCA should be considered in the differential diagnosis of gingival lesions. Conservative surgical treatment proved to be effective, with no signs of recurrence.

4.
Rev. méd. Paraná ; 79(1): 75-77, 2021.
Article in Portuguese | LILACS | ID: biblio-1282451

ABSTRACT

Os cistos perineurais (Tarlov) referem-se a uma dilatação cística entre o perineuro e o endoneuro das raízes nervosas dorsais, preenchidos com líquido cefalorraquidiano. Foram inicialmente descritos em 1938. Eles são mais frequentemente encontrados na coluna sacral, especialmente nas raízes nervosas de S2- S3, com a prevalência de 4,6% com base em uma revisão retrospectiva das imagens de ressonância magnética (RM) da coluna lombo-sacral. Em ocasiões muito raras, foram observadas acima da coluna lombossacra. Os cistos perineurais são geralmente achados incidentais sem significância clínica. Poucos relatos estão disponíveis sobre cistos sintomáticos na coluna cervical - os casos sintomáticos são raros, constituindo menos de 1% do total


Perineural (Tarlov) cysts refer to a cystic dilatation between the perineurium and endoneurium of the dorsal nerve roots, filled with cerebrospinal fluid, and were the first described in 1938. They are most often found in the sacral spine, especially S2-S3 nerve roots, with a prevalence of 4.6% based on a retrospective review of magnetic resonance images (MRI) of the lumbosacral spine. On very rare occasions, they were observed above the lumbosacral spine. Perineural cysts are usually incidental findings with no clinical significance. Few reports are available on symptomatic cysts in the cervical spine - symptomatic cases are rare, constituting less than 1% of the total


Subject(s)
Humans , Spine , Magnetic Resonance Imaging , Ganglion Cysts
5.
Rev. Salusvita (Online) ; 39(1): 103-110, 2020.
Article in Portuguese | LILACS | ID: biblio-1119728

ABSTRACT

A patela é o maior osso sesamoide do corpo humano, posicionado longitudinalmente na fáscia do músculo quadríceps, entre os tendões quadríceps e patelar. A patela bipartida dolorosa, também conhecida como "sincrondose dolorosa", é uma causa conhecida de dor no joelho anterior, é um diagnóstico de exclusão. Objetivo: Relatar um caso e revisar a literatura acerca desta lesão incomum. Materiais e Métodos: Revisão do prontuário do paciente no Hospital Luxemburgo, registro fotográfico do método diagnóstico e revisão da literatura. Resultados: Homem de 45 anos com dor no joelho direito há 01 ano, principalmente na região anterior, que piora ao agachar. Ao exame físico apresenta edema com dor a palpação da patela. A radiografia demonstra patela bipartida. A ressonância magnética (RM) do joelho direito demonstra patela bipartida com união fibrosa entre o fragmento bipartido superolateral e a patela, associada a lesões condrais e edema subcondrais, compatível com "sincondrose dolorosa" da patela. Conclusão: Este relato demonstra a dificuldade de diagnosticar está lesão, pois seu o exame físico é inespecífico e a radiografia demonstra apenas a variação da normalidade ­ patela bipartida, sem evidenciar as alterações próprias da doença, caracterizada apenas pela RM.


The patella is the largest sesamoid bone in thehuman body, positioned longitudinally in the quadriceps muscle fascia, between the quadriceps and patellar tendons. The painful bipartite patella, also known as "painful synchondrosis", is a known cause of anterior knee pain, is a diagnosis of exclusion.Objective: Report a case and review the literature about this uncommon lesion. Materials and Methods: We carried out a review of medical records at Hospital Luxemburgo, a photographic record of diagnostic methods, and a review from the literature. Results: 45-year-old man with right knee pain for 1 year, mainly in the anterior region, which worsens when crouching. Physical examination shows edema with pain on palpation of the patella. Right knee radiography demonstrates a bipartite patella. Magnetic resonance imaging (MRI) of the right knee demonstrates a bipartite patella with a fibrous union between the superolateral bipartite fragment and the patella, associated with chondral lesions and subchondral edema, compatible with patella "painful synchondrosis". Conclusion: This report demonstrates the difficulty of diagnosing this lesion, since its physical examination is nonspecific and the radiography shows only the normal variation ­ bipartite patella, without evidencing the disease alterations, characterized only by MRI.


Subject(s)
Humans , Male , Adult , Patella/abnormalities , Patella/diagnostic imaging , Bone Diseases/diagnostic imaging , Pain/drug therapy , Pain/diagnostic imaging , Magnetic Resonance Imaging , Pregabalin/therapeutic use , Analgesics/therapeutic use
6.
Rev. chil. endocrinol. diabetes ; 13(1): 14-16, 2020. ilus
Article in English | LILACS | ID: biblio-1048800

ABSTRACT

IINTRODUCCIÓN: el bullosis diabeticorum forma parte del espectro de manifestaciones cutáneas de la diabetes mellitus, descrito por Kramer en 1930 y nombrado como bullosis diabeticorum por Cantwell y Martz. Es una enfermedad conocida, pero bastante rara (0.5 a 2% de la población diabética) siendo dos veces más común en hombres. Es una lesión espontánea y no está relacionada con trauma o causa fisiológica evidente, como infección, 3 que no causa dolor o se asocia a signos flogísticos. Se asocia principalmente a las extremidades, pudiendo ser una lesión única o múltiples lesiones. Puede ocurrir en la diabetes mellitus tipo 1 (DM1) y en el tipo 2. Las lesiones típicamente se curan espontáneamente de 2 a 6 semanas, pero pueden ocurrir en el mismo lugar nuevamente. El pronóstico es bueno, sin tratamiento específico necesario o seguimiento diagnóstico con biopsia. Se relata un caso de esta rara patología con documentación por resonancia magnética.


Bullosis diabeticorum is part of the spectrum of cutaneous manifestations of diabetes mellitus, described by Kramer in 1930 and named bullosis diabeticorum by Cantwell and Martz. It is a known disease, but quite rare (0.5 to 2% of the diabetic population) and is two times more common in men. Bullosis diabeticorum is a spontaneous lesion and not related to trauma or obvious physiological cause, such as infection that does not cause pain or is associated with inflammatory signs. Occurs at the limbs and may be single or multiple. It can occur in diabetes mellitus type 1 (DM1) and type 2, usually in the advanced stages. The lesions heal spontaneously typically in 2 to 6 weeks, but they may happen again on the same site. The prognosis is good with no need of special treatment or further diagnosis with biopsy. We report a case of this rare complication with magnetic resonance imaging.


Subject(s)
Humans , Male , Aged , Blister/diagnostic imaging , Diabetic Foot/diagnostic imaging , Diabetes Mellitus, Type 2/complications , Magnetic Resonance Imaging , Blister/etiology , Blister/pathology
7.
ACM arq. catarin. med ; 48(4): 191-197, out.-set. 2019.
Article in Portuguese | LILACS | ID: biblio-1048289

ABSTRACT

Fraturas por estresse são lesões que ocorrem devido a uma força de baixa intensidade, porém repetida sobre o osso por um longo período de tempo. Esta acomete mais militares e alguns atletas, porém sua incidência vem aumentando na população. Com exceção do calcâneo, estas lesões raramente acometem os ossos do tarso. Cuboide e cuneiforme lateral são dois ossos dessa região do mediopé com poucos relatos na literatura relativos à fratura por estresse. Estes apresentam uma sintomatologia em comum, com dor local, sensibilidade à palpação, possível edema e alterações de pele. Atualmente o melhor método diagnóstico é a ressonância magnética. São fraturas classificadas como de baixo risco e o tratamento é conservador aliado à terapia farmacológica.


Stress fractures are injuries that happen due to a low but repetitive force over the bone during a long period. It is more common in military personnel and in some athletes; however, its incidence has been rising among the population. With exception to the calcaneum, these injuries rarely happen in the tarsal bones. Cuboid and lateral cuneiform are two bones of the midfoot with few literature reports of a stress fracture. These present a common symptomatology with local pain, tenderness to palpation, possible edema and skin changes. Currently, the best diagnostic method is the magnetic resonance imaging. These fractures are classified as low risk and its treatment is conservative, allied to pharmacologic therapy.

9.
J. Bras. Patol. Med. Lab. (Online) ; 55(4): 426-433, July-Aug. 2019. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1019957

ABSTRACT

ABSTRACT A 4-year-old male patient presented with headaches that started 18 months ago and were associated with progressive loss of balance and difficulty walking. Magnetic resonance imaging (MRI) demonstrated an expansile extra-axial mass lesion in the posterior aspect of the posterior fossa on the left, compressing the adjacent brain, as well as the cerebellar hemispheres; it also distorts the fourth ventricle with severe obstructive hydrocephalus upstream. Histological evaluation diagnosed aggressive osteoblastoma with a secondary aneurysmal bone cyst of the skull. We report a case of aggressive osteoblastoma in which the lesion in the MRI was mimicking brain tumor or intracranial primary tumor rather than primary bone tumor.


RESUMEN Paciente masculino, de 4 años de edad, con cefalea de 18 meses asociada a pérdida progresiva de equilibrio y dificultad de deambulación. La resonancia magnética (RM) mostró una lesión espansiva extraaxial en la porción posterior de la fosa posterior a la izquierda, comprimiendo el tejido cerebral adyacente, así como los hemisferios cerebelares; aún deforma el cuarto ventrículo con hidrocefalia obstructiva severa. La evaluación histológica diagnosticó osteoblastoma agresivo con quiste óseo aneurismático secundario del cráneo. Reportamos un caso de osteoblastoma agresivo en lo cual la lesión visualizada con la RM estaba mimetizando tumor cerebral o tumor primario intracraniano y no un tumor óseo primario.


RESUMO Paciente do sexo masculino, 4 anos de idade, com cefaleia há 18 meses associada à perda progressiva do equilíbrio e à dificuldade de deambulação. A ressonância magnética (RM) demonstrou uma lesão expansiva extra-axial na porção posterior da fossa posterior à esquerda, comprimindo o cérebro adjacente, bem como os hemisférios cerebelares; ainda distorce o quarto ventrículo com hidrocefalia obstrutiva grave a montante. A avaliação histológica diagnosticou osteoblastoma agressivo com cisto ósseo aneurismático secundário do crânio. Relatamos um caso de osteoblastoma agressivo em que a lesão na RM estava mimetizando tumor cerebral ou tumor primário intracraniano em vez de tumor ósseo primário.

10.
Rev. méd. Paraná ; 77(1): 65-67, jan.-jun. 2019.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1292288

ABSTRACT

Alguns ossos, em especial, servem como polias para os tendões que passam, resultando em forças de atrito e estresses biomecânicos nesses locais, tais como o maléolo lateral no sulco fibular posterior e o calcâneo no tubérculo fibular, para os tendões fibular longo e curto, e a superfície plantar da cuboide para o tendão fibular longo. O tendão fibular longo é propenso a romper ou a ter tendinopatia em três locais principais: no maléolo lateral, na tróclea fibular do calcâneo e na superfície plantar do cuboide, sendo, este último, o local mais comum para rotura tendínea. Edema ósseo tem sido descrito adjacente aos tendões anormais afetados por rotura, tenossinovite crônica ou por fricção. A tendinopatia é um fator adicional associado com edema da medula óssea que ocorre em um padrão característico subtendinoso. Este edema poderia ser um marcador da RM para a localização dos sintomas em pacientes com dor crônica no tornozelo


Some bones in particular serve as pulleys for tendons passing by, resulting in frictional forces and biomechanical stresses at these locations, including the medial malleolus (from the posterior tibialis and flexor digitorum longus tendons), the sustentaculum tali (from the flexor hallicus longus tendon), the lateral malleolus at the posterior fibular groove and calcaneus at the peroneal tubercle (from the peroneus longus and brevis tendons), and the undersurface of the cuboid (from the peroneus longus tendon). The peroneus longus tendon is leaning to tear or to have tendinopathy in three main locations: the lateral malleolus, the fibular trochlea of the calcaneus and the plantar surface of the cuboid. The plantar surface of the cuboid is the most common site for tendon tear. Bone edema has been described adjacent to abnormal tendons affected by friction, chronic tenosynovitis or tear. Tendinopathy is an additional factor associated with bone marrow edema, which occurs in a characteristic subtendinous pattern. This edema could potentially be an MRI marker for symptom location in patients with chronic ankle pain

11.
Autops. Case Rep ; 9(1): e2018063, Jan.-Mar. 2019. ilus
Article in English | LILACS | ID: biblio-986756

ABSTRACT

Progressive multifocal leukoencephalopathy (PML) is a feared entity that occurs most frequently in conditions of extreme immunodeficiency. The diagnosis is often made long after the onset of symptoms due to the physicians' unfamiliarity, and the unavailability of diagnostic tests in some medical centers. Although the incidence of PML is decreasing among HIV patients with the advent of highly active antiretroviral therapy (HAART), in Brazil this entity is the fourth highest neurological complication among these patients. The authors present the case of a middle-aged man who tested positive for HIV concomitantly with the presentation of hyposensitivity in the face and the right side of the body, accompanied by mild weakness in the left upper limb. The clinical features worsened rapidly within a couple of weeks. The diagnostic work-up pointed to the working diagnosis of PML after brain magnetic resonance imaging; however, the detection of the John Cunningham virus (JCV) in the cerebral spinal fluid was negative. HAART was started but the patient died after 7 weeks of hospitalization. The autopsy revealed extensive multifocal patchy areas of demyelination in the white matter where the microscopy depicted demyelination, oligodendrocytes alterations, bizarre atypical astrocytes, and perivascular lymphocytic infiltration. The immunohistochemistry was positive for anti-SV40, and the polymerase chain reaction of the brain paraffin-embedded tissue was positive for JCV. The authors highlight the challenges for diagnosing PML, as well as the devastating outcome of PML among HIV patients.


Subject(s)
Humans , Male , Adult , Acquired Immunodeficiency Syndrome/complications , Leukoencephalopathy, Progressive Multifocal/diagnosis , Autopsy , Leukoencephalopathy, Progressive Multifocal/pathology , Fatal Outcome , JC Virus
12.
Semina cienc. biol. saude ; 40(1): 119-122, jan./jul. 2019. Ilus
Article in Portuguese | LILACS | ID: biblio-1223859

ABSTRACT

O osso navicular acessório, do qual foram descritas três variantes, é frequentemente considerado uma variação anatômica normal.É uma anomalia congênita em que a tuberosidade do navicular se desenvolve a partir de um centro de ossificação secundário e tem uma incidência estimada entre 2% e 14% com maior incidência em mulheres sendo bilateral em 50-90% dos casos. Nosso objetivo foi relatar um caso e revisar a literatura acerca desta lesão incomum, utilizando-se da revisão do prontuário, registro fotográfico do método diagnóstico e revisão da literatura. Mulher de 59 anos com dor no lado medial do pé esquerdo há dois anos, com piora ao andar. Exame físico com testes específicos do tornozelo negativos, sem hematoma ou edema. Nega torção, trauma e cirurgias. A ressonância magnética demonstra osso navicular acessório tipo II e osso navicular, ambos com edema. Estes achados com quadro clínico são compatíveis com síndrome do osso navicular acessório. Este relato demonstra a dificuldade de diagnosticar essa lesão, pois seu o exame físico é inespecífico, podendo simular patologias mais complexas, necessitando de exames complementares para seu correto diagnóstico (AU)


The accessory navicular bone, of which three variants have been described, is often considered as a normal anatomic and roentgenographic variant. Is a congenital anomaly in which the tuberosity of the navicular bone develops from a secondary ossification center and it has an incidence estimated between 2% and 14% with higher incidence in women being bilateral in 50-90% of the cases. Our aim was to report a case and review the literature about this uncommon lesion. We carried out a review of medical records, photographic record of diagnostic method, and review from the literature. A 59 years old woman with pain in the medial side of the left foot for two years. Refers worsening with walking. Physical examination with specific ankle negative tests, without bruise or edema. Denies torsion, trauma and surgeries. Magnetic resonance imaging demonstrates type II accessory navicular bone with edema and navicular bone edema. These findings with clinical complaint are compatible with accessory navicular bone syndrome. This report demonstrates the difficulty of diagnosing this lesion, since its physical examination is non-specific, and it can simulate more complex pathologies, requiring complementary tests for its correct diagnosis (AU)


Subject(s)
Humans , Female , Middle Aged , Syndrome , Bone and Bones
13.
Rev. méd. Paraná ; 77(2): 47-50, 2019.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1283826

ABSTRACT

A neoplasia vulvar representa 5% dos casos de câncer ginecológicos, sendo mais comum o carcinoma de células escamosas. Esse tipo de acometimento totaliza apenas 0,5% de todos os tipos malignos e acomete em sua maioria mulheres com idade superior a 70 anos. Apesar da dissecção cirúrgica ser padrão de tratamento para controle da doença, o índice de metástase é mais prevalente em linfonodos locais em torno de 20,5% enquanto linfonodos à distância 12,9%, seguido de disseminação menos comum para fígado, pulmão e ossos. O presente trabalho tem como objetivo expor o relato de caso de uma paciente de 37 anos com histórico de neoplasia maligna de vulva com disseminação para linfonodos inguinais, que mesmo após tratamento adequado, identificou-se via ressonância magnética disseminação metastática para corpos vertebrais, musculatura paravertebral dorsal e lombar, fato raro e pouco descrito na literatura


Vulvar neoplasm represents 5% of cases of gynecological cancer, and squamous cell carcinoma is more common. This type of involvement represents only 0.5% of all malignant types and affects mainly women over 70 years old. Although surgical dissection is a standard treatment for disease control, the metastasis index is more prevalent in local lymph nodes around 20.5% while distance lymph nodes at 12.9%, followed by less common spread to liver, lung and bone. The objective of this study was to present a case report of a 37-year-old female patient with a history of malignant vulvar neoplasia with dissemination to inguinal lymph nodes, which, even after adequate treatment, was identified by magnetic resonance imaging metastatic dissemination to vertebral bodies, paravertebral musculature dorsal and lumbar, a rare fact and little described in the literature

14.
Rev. méd. Paraná ; 77(2): 55-57, 2019.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1283828

ABSTRACT

Introdução: As fraturas por estresse do colo femoral, comumente relacionada a exercícios de extenuação e corredores de longa distância, têm crescido entre pacientes não ativos fisicamente e em atividades de baixo impacto. Com o avanço dos estudos, notou- se que a parte hormonal, biomecânica e anatômica são realmente os verdadeiros fatores desencadeantes associados. Objetivo: relatar um caso e revisar a literatura acerca desta lesão. Materiais e Métodos: revisão do prontuário, registro fotográfico do método diagnóstico e revisão da literatura. Resultados: mulher de 52 anos com dor no quadril direito há dois meses. A ressonância magnética apresentou traço de fratura na porção interna do colo femoral com importante edema ao redor, compatível com fratura por estresse. Conclusão: na suspeita de fratura de colo femoral, a velocidade do diagnóstico é também prognóstica, de modo que caso a radiografia seja inconclusiva, como comumente é, a RM deve ser realizada


Introduction: Stress fractures of the femoral neck, commonly related to strenuous exercise and long-distance runners, have been growing among non-physically active patients and in low impact activities. Objective: Report a case and review the literature about this uncommon lesion. Materials and Methods: We carried out a review of medical records, photographic record of diagnostic method, and review from the literature. Results: 52-year-old woman with right hip pain for two months. Magnetic resonance imaging showed a fracture trace on the internal portion of the femoral neck with significant surrounding edema, compatible with stress fracture. Conclusion: If a femoral neck fracture is suspected, the speed of diagnosis is also prognostic, so that if radiography is inconclusive, as is commonly the case, magnetic resonance imaging should be performed

15.
Rev. bras. neurol ; 54(4): 34-37, out.-dez. 2018. ilus
Article in English | LILACS | ID: biblio-967838

ABSTRACT

Dyke-Davidoff-Masson Syndrome is a syndrome associated with refractory epilepsy. The Chiari II malformation is a complex congenital malformation of the brain. The authors report a case of a 15 years-old adolescent presenting Dyke-Davidoff-Masson syndrome and Chiari type II malformation association. This case demonstrates an unusual association in neuroimaging tests that indicates the need to evaluate associated diseases, such as myelomeningocele, corpus callosum dysgenesis and syringohydromyelia.


A Síndrome de Dyke-Davidoff-Masson é uma síndrome associada à epilepsia refratária. A malformação de Chiari II é uma malformação congênita complexa do cérebro. Os autores relatam um caso de uma adolescente de 15 anos apresentando a síndrome de Dyke-Davidoff-Masson associada à malformação de Chiari tipo II. Este caso demonstra uma associação incomum nos exames de neuroimagem que indica a necessidade de avaliar doenças associadas, como mielomeningocele, disgenesia do corpo caloso e a siringohidromielia.


Subject(s)
Humans , Male , Adult , Arnold-Chiari Malformation/complications , Arnold-Chiari Malformation/diagnosis , Brain Diseases/congenital , Brain Diseases/diagnosis , Epilepsy , Paresis , Arnold-Chiari Malformation/diagnostic imaging , Seizures , Magnetic Resonance Imaging/methods , Diagnosis, Differential
16.
Semina cienc. biol. saude ; 39(2): 181-184, jul 2018. Ilus
Article in Portuguese | LILACS | ID: biblio-994949

ABSTRACT

Cistos no ligamento cruzado anterior são difíceis de diagnosticar devido à falta de sintomas e sinais específicos. A incidência deste transtorno é mais alta entre 20 e 40 anos de idade, ocorrendo predominantemente em homens. Nosso objetivo foi relatar um caso e revisar a literatura acerca desta lesão incomum, através de revisão do prontuário, registro fotográfico do método diagnóstico e revisão da literatura. Homem de 18 anos com dor no joelho direito há 04 meses. Refere jogar duas horas de futebol todos os dias por alguns anos. Exame físico com testes específicos do joelho negativos, sem hematoma ou edema. Nega torção, trauma e cirurgias. A ressonância magnética demonstra cisto lobulado intrasubstancial no ligamento cruzado anterior. Este relato demonstra a dificuldade de diagnosticar essa lesão, pois o exame físico é inespecífico, podendo simular patologias mais graves, necessitando de exames complementares para seu correto diagnóstico.


Cysts in the anterior cruciate ligament is difficult to diagnose due to the lack of specific symptoms and signs. Incidence of this disorder was the highest for 20­40 years of age group. Occurs predominantly in males. Our aim was to report a case and review the literature about this uncommon lesion. We carried out a review of medical records, photographic record of diagnostic method, and review from the literature. 18 years-old man with pain in the right knee for 04 months. He plays two hours of soccer everyday for a few years. Physical examination with specific knee negative tests, without bruise or edema. Denies torsion, trauma and surgeries. Magnetic resonance imaging demonstrates intrasubstantial lobulated cyst in the anterior cruciate ligament. This report demonstrates the difficulty of diagnosing this lesion, since its physical examination is non-specific, and it can simulate more serious pathologies, requiring complementary tests for its correct diagnosis.


Subject(s)
Humans , Male , Adolescent , Magnetic Resonance Imaging , Anterior Cruciate Ligament , Cysts , Arthroscopy
18.
Rev. Salusvita (Online) ; 37(2): 371-376, 2018.
Article in Portuguese | LILACS | ID: biblio-1050522

ABSTRACT

Introdução: o processo anterior do calcâneo (PAC) é uma projeção óssea em forma de sela que se articula com o osso cuboide anteriormente para formar a articulação do calcâneo-cuboide e forma a articulação subtalar Anterosuperiormente. Liga-se aos ossos cuboide e navicular pelo ligamento bifurcado e ao osso cuboide por um ligamento interósseo. Objetivo: relatar um caso raro de uma fratura do processo anterior do osso do calcâneo. Materiais e Métodos: estudo descritivo analítico por meio de revisão do prontuário, registro fotográfico dos métodos diagnósticos e revisão da literatura. Resultados: mulher de 56 anos que refere dor intensa no tornozelo direito durante três meses após uma entorse. O exame físico mostra o edema do tornozelo e dificuldade ao andar. Radiografia normal do tornozelo. A ressonância magnética (RM) demonstra edema no processo anterior do calcâneo com uma fratura, sem deslocamento ou diástase significativas. Conclusão: esse relato demonstra a dificuldade de diagnosticar essa fratura, pois seu mecanismo de trauma é o mesmo de uma entorse, apresentando sintomatologia similar. Com dor prolongada ­ ou a alta intensidade de dor ­ indica a complementação diagnóstica com tomografia computadorizada ou RM.


Introduction: the anterior process of the calcaneus (APC) is a saddle-shaped osseous projection that articulates with the cuboid anteriorly to form the calcaneocuboid joint and forms the anterior subtalar joint superiorly. It is attached to the cuboid and navicular bones by the bifurcate ligament and attached to the cuboid by an interosseous ligament. Objective: report a rare case of a fracture of the anterior process of the calcaneus bone. Materials and Methods: we carried out a review of medical records, photographic record of diagnostic methods, and review from the literature. Results: 56 years-old woman referring intense pain in the right ankle for three months after a torsion. Physical examination shows ankle swelling and difficulty walking. Normal ankle radiograph. Magnetic resonance imaging (MRI) demonstrates edema on the anterior process of the calcaneus with a fracture, without significant displacement or diastasis. Conclusion: this report demonstrates the difficulty of diagnosing this fracture, since its mechanism of trauma is the same of a torsion, presenting similar symptomatology. With prolonged pain ­ or the high intensity of pain ­ indicates the diagnostic complementation with computed tomography or MRI


Subject(s)
Humans , Magnetic Resonance Imaging , Bone and Bones , Fractures, Bone
19.
Rev. méd. Paraná ; 76(2): 125-127, 2018.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1343258

ABSTRACT

Introdução: A fabela é um pequeno osso sesamoide localizado no aspecto póstero-lateral do joelho, na porção proximal do tendão gastrocnêmio lateral, articulando-se com o côndilo femoral lateral. Objetivo: Relatar um caso e revisar a literatura acerca desta lesão. Materiais e Métodos: Revisão do prontuário, registro fotográfico do método diagnóstico e revisão da literatura. Resultados: Mulher com 63 anos, referindo dores crônicas nos dois joelhos de longa data. A ressonância magnética demonstrou lesões condrais com edema ósseo subcondrais na região posterolateral do côndilo femoral lateral, adjacente à fabela ­ síndrome da fabela ­ nos dois joelhos. Conclusão: Relatamos um caso de síndrome da Fabela bilateral, entidade pouco relatada na literatura médica, muitas vezes insuspeitada na avaliação clínica inicial sendo que, na falha do tratamento conservador, a cirurgia se torna necessária


Introduction: Fabella is a small sesamoid bone located in the posterolateral aspect of the knee, the proximal portion of the lateral gastrocnemius tendon, articulating with the lateral femoral condyle. Objective: Report a case and review the literature about this uncommon lesion. Materials and Methods: We carried out a review of medical records, photographic record of diagnostic method, and review from the literature. Results: A 63-year-old woman reported chronic pain in both knees. Magnetic resonance imaging showed chondral lesions with subchondral bone edema in the posterolateral region of the lateral femoral condyle, adjacent to the fabela - Fabela syndrome - in both knees. Conclusion: We report a case of bilateral fabela syndrome, an entity rarely reported in the medical literature, often unsuspected in the initial clinical evaluation, and in the failure of conservative treatment, surgery becomes necessary

20.
Clinics ; 73(supl.1): e558s, 2018. tab, graf
Article in English | LILACS | ID: biblio-974945

ABSTRACT

The name of the family Polyomaviridae, derives from the early observation that cells infected with murine polyomavirus induced multiple (poly) tumors (omas) in immunocompromised mice. Subsequent studies showed that many members of this family exhibit the capacity of mediating cell transformation and tumorigenesis in different experimental models. The transformation process mediated by these viruses is driven by viral pleiotropic regulatory proteins called T (tumor) antigens. Similar to other viral oncoproteins T antigens target cellular regulatory factors to favor cell proliferation, immune evasion and downregulation of apoptosis. The first two human polyomaviruses were isolated over 45 years ago. However, recent advances in the DNA sequencing technologies led to the rapid identification of additional twelve new polyomaviruses in different human samples. Many of these viruses establish chronic infections and have been associated with conditions in immunosuppressed individuals, particularly in organ transplant recipients. This has been associated to viral reactivation due to the immunosuppressant therapy applied to these patients. Four polyomaviruses namely, Merkel cell polyomavirus (MCPyV), Trichodysplasia spinulosa polyomavirus (TSPyV), John Cunningham Polyomavirus (JCPyV) and BK polyomavirus (BKPyV) have been associated with the development of specific malignant tumors. However, present evidence only supports the role of MCPyV as a carcinogen to humans. In the present review we present a summarized discussion on the current knowledge concerning the role of MCPyV, TSPyV, JCPyV and BKPyV in human cancers.


Subject(s)
Humans , Tumor Virus Infections/virology , Polyomavirus/pathogenicity , Polyomavirus Infections/virology , Neoplasms/virology , Virus Activation , Cell Transformation, Viral , Polyomavirus/classification , Polyomavirus/physiology
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