Paraspinal Ganglioneuromain an Adolescent with Painless Scoliosis: Case Report and Literature Review

Adolescent scoliosis secondary to ganglioneuroma is a rare entity with a clinical presentation mimicking adolescent idiopathic scoliosis that can lead to delayed or misdiagnosis. We present this case with a literature review to illustrate the importance of careful evaluation of the clinical and radiological findings in reaching a proper, timely mannered diagnosis. Clinical and radiological evaluation with a keen eye for signs of the atypical curve and radiological abnormalities on plain films and getting more detailed imaging with CT and MRI would lead to earlier diagnosis of secondary causes of scoliosis and direct proper treatment plan.

Non-tuberculous mycobacterial lung disease: a brief review focusing on radiological findings

Abstract The incidence and prevalence of lung disease caused by non-tuberculous mycobacteria (NTM-LD) has increased worldwide and its diagnosis represents a complex challenge. This article aims to review the tomographic findings of NTM-LD in order to facilitate their definitive diagnosis. The search for publications on the subject was performed in PMC and Scielo using the keywords 'non-tuberculous mycobacteria', 'lung disease and computed tomography (CT)' and 'radiological findings'. The radiological findings described by 18 articles on mycobacteriosis were reviewed. In addition, CT images of patients diagnosed with NTM-LD were considered to represent radiological findings. Eighteen publications were used whose main findings were pulmonary cavitation (88.9%), bronchiectasis (77.8%), and pulmonary nodules (55.6%). Despite the overlaps in imaging-related analysis of myocobacterioses with other pulmonary infections, such as tuberculosis, the predominant involvement of the middle lobe and lingula should raise suspicion for NTM-LD.

A study of clinical manifestations of dengue fever with laboratory investigations and outcome in a tertiary care center in Tamil Nadu

Background: Dengue fever it one of the common mosquito born acute febrile illness of major health concern in India due to varying presentations from simple febrile illness to dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). The aim of the study: The present study was done to find out the presence of varying clinical features and severity with outcome during the clinical course in a tertiary care center in Tamil Nadu. Materials and methods: The present study was done as a prospective observational study at government Omandurar Medical College, Chennai/ Kasturba Gandhi Hospital for Women and Children in Tamil Nadu. The study was done during the period of July 2018 to December 2018 for 6 months. Patient included were more than 12 years of age. All patients were hospitalized as in patients under the medicine department. Results: 50 patients diagnosed as dengue positive through dengue IgM Elisa method were taken for the study. The common clinical feature was fever high grade with chills, followed by headache, followed by myalgia, followed by nausea and vomiting followed by rash and GI bleeding. The commonest hematological abnormality was thrombocytopenia with leukopenia when there was a decrease in platelet count less than 50000 there was leukopenia less 3000 which improved with the recovery of rising platelet count. USG showed third space fluid accumulation due to plasma leakage P. Malarvizhi, Gananasambandam Usha. A study of clinical manifestations of dengue fever with laboratory investigations and outcome in a tertiary care center in Tamil Nadu. IAIM, 2019; 6(3): 95-98. Page 96 as evident by GB wall edema (associated with severe dengue) and right pleural effusion, followed by minimal ascites. Elevation of liver enzymes was noted in a few patients in our study. Severe thrombocytopenia was associated with gum bleeding in the younger age group. Melena was present in patients more than 20 years of age group. Menorrhagia was noted in female patients with thrombocytopenia. Few patients with GI bleed and severe thrombocytopenia required platelet transfusion. No mortality was observed and all patients recovered fully. Conclusion: Dengue is a common mosquito-borne viral illness of urban areas. Early hospitalization with appropriate clinical evaluation, relevant investigations, and appropriate management under medical supervision improves the clinical outcome of dengue positive patients hospitalized. Early referral of the patient with hospitalization improves the clinical outcome and reduces mortality.

Relación entre hallazgos radiológicos e inmunofenotipos tumorales de pacientes con cáncer de mama / Relationship between radiological findings and immunophenotyped in breast cancer

Resumen OBJETIVO: Evaluar la relación entre los hallazgos radiológicos e inmunofenotipos tumorales de pacientes con cáncer de mama. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y transversal, efectuado en el Hospital ABC de la Ciudad de México, entre 2013 y 2017. Se incluyeron pacientes con diagnóstico de cáncer de mama establecido por biopsia percutánea o escisional, que contaran con estudios de inmunohistoquímica e imagen (mastografía, ultrasonido o ambos). Para evaluar la relación entre las características morfológicas de las lesiones observadas en los estudios radiológicos y el inmunofenotipo se utilizó la prueba de χ2. RESULTADOS: Se registraron 182 pacientes. En cuanto a las características de las lesiones se encontró relación significativa entre las masas de morfología irregular con bordes espiculados y las calcificaciones agrupadas con tumores luminales, y entre las calcificaciones de morfología amorfa con los tumores luminales A y las pleomórficas finas con los tumores luminales B. CONCLUSIÓN: Existe relación entre los hallazgos morfológicos por imagen y el inmunofenotipo de los tumores mamarios. Es importante que el médico radiólogo especialista en imagen mamaria conozca esta relación, con la finalidad de proporcionar información de la inmunohistoquímica al momento del estudio diagnóstico de imagen.

Abstratc OBJECTIVE: Establish if there is a relationship between the radiological findings and the immunophenotype of breast cancer. MATERIALS AND METHODS: An observational, cross-sectional, retrospective study realized at the ABC Medical Center, over a period of 4 years, that included patients diagnosed with breast cancer performed by percutaneous or excisional biopsy, with an immunohistochemical study and images (mammography and/or ultrasound). The relationship between the morphological characteristics of the lesions observed in the radiological studies and the immunophenotyped was studied by means of the χ2 test. RESULTS: We included 182 patients, among the characteristics of the lesions we found a significant relationship between the masses of irregular morphology with spiculate edges and the calcifications grouped with luminal tumors; calcifications of amorphous morphology with luminal A and pleomorphic fine tumors with luminal B. CONCLUSION: The results suggest that there is a relationship between the morphological findings by imaging and the immunophenotype of mammary tumors.

Extent of Lung Involvement and Serum Cryptococcal Antigen Test in Non-Human Immunodeficiency Virus Adult Patients with Pulmonary Cryptococcosis / 中华医学杂志(英文版)

<p><b>Background</b>Serum cryptococcal antigen (CrAg) test is the most used noninvasive method to detect cryptococcal infection. However, false-negative CrAg test is not uncommon in clinical practice. Then, the aim of this study was to investigate the factors associated with false-negative CrAg test among non-human immunodeficiency virus (HIV) adult patients with pulmonary cryptococcosis and its clinical features.</p><p><b>Methods</b>One hundred and fourteen non-HIV adult patients with pulmonary cryptococcosis, proven by biopsy, were retrospectively reviewed. Finally, 85 patients were enrolled; 56 were CrAg positive (CrAg+ group) and 29 were negative (CrAg- group). It was a cross-sectional study. Then, baseline characteristics, underlying diseases, clinical symptoms, laboratory findings, and chest radiological findings were reviewed and analyzed. Chi-square test was used to analyze categorical variable. Odds ratio (OR) was used to measure correlation. Student's t- test was obtained to analyze continuous variable.</p><p><b>Results</b>No difference in baseline characteristics, underlying diseases, clinical symptoms, and laboratory findings were found between two groups (P > 0.05 in all). Nevertheless, diffuse extent lesion was 82.1% in CrAg+ group and 10.3% in CrAg- group (χ = 40.34, P < 0.001; OR = 39.87).</p><p><b>Conclusions</b>Among patients with limited pulmonary involvement, a negative serum CrAg does not preclude the diagnosis of pulmonary cryptococcosis. However, among patients with extensive pulmonary involvement, serum CrAg is a useful diagnostic tool for pulmonary cryptococcosis. Furthermore, we also noticed that the untypical and mild presentations with extensive pulmonary lesion might be the features of pulmonary cryptococcosis, which needs further investigation.</p>

Osteoporosis, hallazgos en radiología convencional. Reporte de un caso / Osteoporosis, findings in conventional radiology. Report of a case

Introducción El presente artículo hace una revisión sobre los hallazgos radiológicos mediante radiografía simple, así como también los hallazgos clínicos en el diagnóstico de la osteopetrosis una enfermedad poco común que afecta el desarrollo normal óseo, se trata de un caso clínico reportado en el Hospital Pediátrico Baca Ortiz de la Ciudad de Quito. Reporte de Caso: Nos apoyamos en la presentación de un caso clínico de una paciente que acude por consulta externa con cuadro de fatiga y decaimiento de 2 años de evolución, se realizan exámenes complementarios demostrando presencia de anemia así como los hallazgos característicos de osteopetrosis por imagen posteriormente detallados. Conclusiones: La osteopetrosis es una enfermedad poco común, compleja y por lo menos con cuatro subtipos que difieren en la forma de herencia o de las manifestaciones adicionales asociadas, sin embargo todas se caracterizan por presentarse clínicamente con fatiga debido a anemia crónica, puede presentar o no hepatoesplenomegalia, conjuntamente asociadas siempre a osteoesclerosis difusa con ensanchamiento óseo, fracturas patológicas.

Introduction This article reviews the radiological findings by simple radiography as well as the clinical findings in the diagnosis of osteopetrosis, a rare disease that affects normal bone development. This is a case report reported in the Hospital Pediátrico Baca Ortiz at Quito City. Case Report: We rely on the presentation of a clinical case of a patient who goes by external consultation with fatigue and decay of 2 years of evolution, complementary tests are performed demonstrating the presence of anemia as well as the characteristic findings of osteopetrosis by image later detailed. Conclusions: Osteopetrosis is an uncommon, complex disease and with at least four subtypes that differ in the form of inheritance or associated additional manifestations, however all are characterized by presenting clinically with fatigue due to chronic anemia, may present or not hepatosplenomegaly, Always associated with diffuse osteosclerosis with bone spreading, pathological fractures.

Radiological findings of pulmonary tuberculosis in indigenous patients in Dourados, MS, Brazil / Aspectos radiológicos da tuberculose pulmonar em indígenas de Dourados, MS, Brasil

AbstractObjective:To describe the radiological findings of pulmonary tuberculosis in indigenous patients from the city of Dourados, MS, Brazil, according to age and sex.Materials and Methods:Chest radiographic images of 81 patients with pulmonary tuberculosis, acquired in the period from 2007 to 2010, were retrospectively analyzed by two radiologists in consensus for the presence or absence of changes. The findings in abnormal radiographs were classified according to the changes observed and they were correlated to age and sex. The data were submitted to statistical analysis.Results:The individuals' ages ranged from 1 to 97 years (mean: 36 years). Heterogeneous consolidations, nodules, pleural involvement and cavities were the most frequent imaging findings. Most patients (55/81 or 67.9%) were male, and upper lung and right lung were the most affected regions. Fibrosis, heterogeneous consolidations and involvement of the left lung apex were significantly more frequent in males (p < 0.05). Presence of a single type of finding at radiography was most frequent in children (p < 0.05).Conclusion:Based on the hypothesis that indigenous patients represent a population without genetically determined resistance to tuberculosis, the present study may enhance the knowledge about how the pulmonary form of this disease manifests in susceptible individuals.

ResumoObjetivo:Descrever os aspectos radiológicos da tuberculose pulmonar em pacientes indígenas da cidade de Dourados, MS, Brasil, de acordo com idade e sexo.Materiais e Métodos:Radiografias de tórax de 81 pacientes com tuberculose pulmonar, realizadas de 2007 a 2010, foram analisadas retrospectivamente por dois radiologistas, em consenso quanto à presença ou ausência de alterações. Os achados em radiografias anormais foram classificados de acordo com as alterações observadas e correlacionados com idade e sexo. Os dados foram submetidos a análise estatística.Resultados:A idade dos indivíduos variou de 1 a 97 anos (idade média de 36 anos). Os achados mais frequentes foram consolidações heterogêneas, nódulos, acometimento pleural e escavações. As regiões pulmonares superiores e o pulmão direito foram mais afetados pela tuberculose e a maioria dos pacientes (55/81 ou 67,9%) era do sexo masculino. Fibrose, consolidações heterogêneas e envolvimento do ápice pulmonar esquerdo foram significativamente mais frequentes no sexo masculino (p < 0,05). Presença de apenas um tipo de achado radiográfico foi mais frequente em crianças (p < 0,05).Conclusão:Com base na hipótese de que pacientes indígenas representam pessoas ainda não geneticamente selecionadas para a resistência à tuberculose, esta pesquisa pode ampliar o conhecimento sobre como esta doença, em sua forma pulmonar, manifesta-se em indivíduos suscetíveis.

Incidence of epilepsy and cognitive impairment following traumatic brain injury: a hospital based cross-sectional study

Background: Traumatic Brain Injury (TBI) is a risk factor for epilepsy. Several studies have been conducted to estimate the incidence of epilepsy after TBI. Similarly cognitive impairment is a common consequence of TBI and a substantial source of disability. Aims: To study the incidence of epilepsy and cognitive impairment following TBI and correlate the findings with radiological abnormalities. Method: The study was conducted on 50 consecutive patients with TBI based on the assessment of clinical history for epilepsy and MMSE for cognitive impairment. Results: The incidence of epilepsy after TBI was found to be 40% in our study. It was increased to 50% among the individuals with radiological abnormality on CT scan brain following TBI. Cognitive impairment was found to be highest in individuals with frontal lobe injury (mean MMSE score – 24.13) followed by temporal lobe injury (mean MMSE score – 25.25) and parietal lobe injury (mean MMSE score 26.28). Individuals with no radiologically detectable injury had least cognitive impairment (mean MMSE score - 27.97) Moreover, cognitive impairment was more in individuals with higher number of days in hospital and greater psychological distress. Conclusion: Severity of TBI and presence of radiological abnormality influence new onset epilepsy after TBI. Similarly, injury to frontal lobe and higher number of days in hospital influence cognitive impairment after TBI.

Hallazgos en radiografías panorámocas de adultos mayores de Talca, Chile / Radiological findings in panoramic radiograhs of elderly people of Talca, Chile

El objetivo del presente estudio fue determinar la prevalencia de hallazgos radiográficos en pacientes mayores de 60 años, atendidos en el Servicio de Radiología del Centro de Clínicas Odontológicas de la Universidad de Talca entre los meses de marzo y octubre del año 2010. Se evaluaron 190 radiografías panorámicas digitales de pacientes mayores de 60 años de edad. Se determinó la presencia de lesiones radiolúcidas (RL), lesiones radiopacas (RO), restos radiculares (RR), lesiones apicales (LA), cuerpos extraños (CE), dientes incluidos (DI), calcificaciones en tejidos blandos (CTB) y calcificaciones del complejo estilohioídeo (CCE). El 58,9 % del total de la muestra tuvo hallazgos. En pacientes edéntulos totales, el 51,4% de las radiografías tuvieron algún hallazgo, mientras que en edéntulos parciales, el porcentaje el 60,6% presentaron hallazgos radiográficos. Estos en el total de la muestra se encontraron en orden decreciente fueron CCE 25,26%; CTB 24,21%; LA 19%; RO 11,05%; RR 7,36%; PI 4,21%; RL 3,68%. No se encontró cuerpos extraños. La mayoría de los hallazgos se encontró de manera única (57%). Nuestros resultados sugieren que sería adecuado solicitar una radiografía panorámica antes de iniciar el tratamiento rehabilitador de un paciente adulto mayor, para obtener información que permita la realización de un tratamiento odontológica de forma segura

The aim of this study was to determine prevalence of radiological findings in digital panoramic radiographs of 60-year-old patients and more, treated in Radiological Service of Universidad de Talca`s Dental Clinical Center during the period between March and October of year 2010. 190 digital panoramic radiographs from elderly patients were observed. Radiolucent lesions (RL), radiopaque lesions (RO), periapical radiolucent lesions (LA), root fragments (RF), foreign bodies (FB), unerupted teeth (UT), soft tissue calcifications (STC) and calcified stylohyoid complex (CSC) were assessed. 58,9 % of full sample showed radiological findings. In edentulous mouths, 51,4% of radiographs had findings, whereas in partially edentulous, percentage of Rx with findings was 60,6%. Radiological findings of full sample in decreasing order were as next: CSC 25,26%; STC 24,21%; LA 19%; RO 11,05%; RF 7,36%; UT 4,21%; RL 3,68%. Foreign bodies were not found. Radiological findings were seen multiple in 43%. Our results suggest that prescribe a panoramic radiograph before starting a rehabilitation treatment to an elderly patient, would be beneficial in order to obtain useful information for safer dental treatments

Clinical and Radiological Spectrum of Posterior Reversible Encephalopathy Syndrome

OBJECTIVE: Symptoms of posterior reversible encephalopathy syndrome (PRES) include headache, altered mental status, visual disturbances, and seizures. Typical radiological features include edema of the parieto-occipital lobes. The purpose of this study is to review the clinical and radiological findings in patients diagnosed with PRES. METHODS: All patients diagnosed with PRES between January 2006 and December 2012 were retrospectively included in this study. We reviewed demographic and clinical characteristics, and radiological findings. RESULTS: We identified 16 patients with PRES. The most common clinical presentation was seizure (n = 12, 75%). Clinical recovery occurred in all patients within days (mean, 5.7 +/- 4.6 days). Comorbid conditions included hypertension (n = 4, 25%), cytotoxic medications (n = 3, 18.8%), sepsis (n = 4, 25%), malignancy (n = 4, 25%), subarachnoid hemorrhage (n = 1, 6.3%), autoimmune disorders (n = 1, 6.3%) and eclampsia (n = 1, 6.3%). The most commonly involved location was the parieto-occipital lobe (n = 13, 81.3%). Atypical radiological findings included significant basal ganglia involvement in 4 episodes; brainstem in 3, cerebellum in 2, and thalamus in 3. Eleven patients (68.8%) underwent diffusion-weighted imaging and apparent diffusion coefficient mapping. Of those, 9 patients (81.8%) had hypo- or isointensity on diffusion-weighted imaging. On the apparent diffusion coefficient map, 10 patients (90.9%) had hyperintensity, and the other had normal values. CONCLUSION: We suggest that PRES may occur in patients with complex systemic conditions. The prognosis of PRES is usually benign. Physicians should be aware of certain atypical radiological findings to avoid a delayed diagnosis of PRES, as delayed diagnosis and treatment can result in permanent neurological sequlae.

Clinical and Radiological Spectrum of Posterior Reversible Encephalopathy Syndrome

OBJECTIVE: Symptoms of posterior reversible encephalopathy syndrome (PRES) include headache, altered mental status, visual disturbances, and seizures. Typical radiological features include edema of the parieto-occipital lobes. The purpose of this study is to review the clinical and radiological findings in patients diagnosed with PRES. METHODS: All patients diagnosed with PRES between January 2006 and December 2012 were retrospectively included in this study. We reviewed demographic and clinical characteristics, and radiological findings. RESULTS: We identified 16 patients with PRES. The most common clinical presentation was seizure (n = 12, 75%). Clinical recovery occurred in all patients within days (mean, 5.7 +/- 4.6 days). Comorbid conditions included hypertension (n = 4, 25%), cytotoxic medications (n = 3, 18.8%), sepsis (n = 4, 25%), malignancy (n = 4, 25%), subarachnoid hemorrhage (n = 1, 6.3%), autoimmune disorders (n = 1, 6.3%) and eclampsia (n = 1, 6.3%). The most commonly involved location was the parieto-occipital lobe (n = 13, 81.3%). Atypical radiological findings included significant basal ganglia involvement in 4 episodes; brainstem in 3, cerebellum in 2, and thalamus in 3. Eleven patients (68.8%) underwent diffusion-weighted imaging and apparent diffusion coefficient mapping. Of those, 9 patients (81.8%) had hypo- or isointensity on diffusion-weighted imaging. On the apparent diffusion coefficient map, 10 patients (90.9%) had hyperintensity, and the other had normal values. CONCLUSION: We suggest that PRES may occur in patients with complex systemic conditions. The prognosis of PRES is usually benign. Physicians should be aware of certain atypical radiological findings to avoid a delayed diagnosis of PRES, as delayed diagnosis and treatment can result in permanent neurological sequlae.

Estudo clínico-radiológico de crianças e adolescentes indígenas Suruí, Região Amazônica / Clinical and radiological study of Suruí indigenous children and adolescents, Amazon Region, Brazil

INTRODUÇÃO: Entre os Suruí de Rondônia foram registradas incidências médias de TB > 2.500/100.000 habitantes, entre 1991-2002. Aproximadamente 50 por cento desses casos foram notificados em < 15 anos. MÉTODOS: Trata-se de um estudo clínico-epidemiológico que teve como objetivo descrever as características clínico-radiológicas em crianças e adolescentes identificados como contatos de doentes de TB. Além disto, aplicar o sistema de pontuação para o diagnóstico de TB na infância e verificar se as condutas adotadas no nível local foram concordantes com as diretrizes nacionais. RESULTADOS: Foram analisados 52 Rx de 37 indígenas. Deste conjunto, 48,1 por cento foram normais e 51,9 por cento anormais. Alguns dos Rx apresentaram duas ou mais alterações, totalizando 36 eventos independentes. Observou-se infiltrados (38,9 por cento), calcificações (38,9 por cento), cavitações (11,1 por cento) e atelectasias/derrame pleural (11,1 por cento). Nas imagens anormais, 22,2 por cento eram TB provavelmente ativa e 33,3 por cento sequelas. A confrontação com as diretrizes constatou 52,6 por cento de condutas discordantes. CONCLUSÕES: A presença da infecção tuberculosa latente (ITBL) e TB ativa, entre crianças e adolescentes, são indicadores de transmissão ativa e continuada do Mycobacterium tuberculosis. Os Rx mostrando alta frequência de infiltrados e calcificações é compatível com primo-infecção em idade precoce. Entretanto, essas alterações não são diferentes daquelas observadas entre outros grupos, não sugerindo comprometimento imunológico. As discordâncias apontadas indicam que o momento ideal para o tratamento da ITBL passou despercebido. Conclui-se que é fundamental a utilização do sistema de pontuação para o correto diagnóstico de TB na infância, assim como a realização de baciloscopia e cultura de escarro em adolescentes capazes de expectorar.

INTRODUCTION: The average incidence coefficient of tuberculosis in Suruí Indians from Rondônia was 2.500/100.000 inhabitants in 1991-2002. About 50 percent of these cases were reported in children < 15 years-old. METHODS: This study aimed to describe the clinical and radiological characteristics of children and adolescents identified as TB case contacts. A score system for the diagnosis of childhood TB was used and the procedures adopted by local health services were in accordance with national guidelines. RESULTS: 52 chest X-rays of 37 indigenous subjects were analyzed; of these, 51.9 percent were abnormal. Some X-rays showed more than two lesions, making a total of 36 independent events. Infiltrates (38.9 percent), calcifications (38.9 percent), cavitations (11.1 percent) and atelectasis/pleural effusion (11.1 percent) were observed. Among the abnormal images, 22.2 percent were probably indicated active TB and 33.3 percent showed sequelae. Confrontation with the guidelines revealed 52.6 percent of divergent procedures. CONCLUSIONS: The presence of latent tuberculosis infection (LTBI) and active TB between children and adolescents are indicators of active and progressive transmission of Mycobacterium tuberculosis. The X-rays showed high frequencies of infiltrates and calcifications, which are compatible with primary infection in early childhood. However, these lesions are not different from those observed among other groups and do not suggest immune deficiencies. The divergences presented show that the best moment for the treatment of LTBI went unnoticed by local personnel. In conclusion, the use of a score system is fundamental for the correct diagnosis of TB in childhood, as is conducting bacilloscopy and sputum culture in adolescents able to expectorate.

Carcinoma medular da mama: correlação anátomo-radiológica / Medullary breast carcinoma: anatomo-radiological correlation", "_i": "en

OBJETIVO: Avaliar as características radiológicas do câncer de mama medular em pacientes submetidas atratamento cirúrgico no Instituto Nacional de Câncer (INCA) û Ministério da Saúde, Rio de Janeiro, RJ, correlacionando os achados com estudo histopatológico. MATERIAIS E MÉTODOS: Foi realizado estudo descritivo retrospectivo de mulheres submetidas a tratamento cirúrgico no INCA, no período de janeiro de 1997 adezembro de 2006, para identificação das pacientes com carcinoma medular e análise dos achados radiológicos.RESULTADOS: Foram identificadas 21.287 pacientes com diagnóstico de carcinoma neste período, sendo 76 pacientes com diagnóstico de carcinoma medular típico (0,357%). Nessas pacientes selecionadas, a idade média foi de 51,9 anos (32 a 81 anos). Dezenove pacientes apresentavam lesão na mamografia, sendo 17 (89,5%) nódulos e 2 assimetrias focais (10,5%). Entre as pacientes com nódulo, 15 (88,1%) apresentavam alta densidade e 2 eram isodensos (11,9%). Doze pacientes apresentavam achados ultra-sonográficos e, destas, 11 (91,6%) apresentavam nódulos hipoecóicos. Foi observada uma paciente com nóduloanecóico com áreas de degeneração cística. CONCLUSÃO: O nódulo foi o achado radiológico dominante (89,5%), dos quais 88,1% apresentaram nódulos com alta densidade e margens circunscritas. Apesar das características radiológicas de benignidade, um nódulo com alta densidade, sólido, margens circunscritas e crescimento rápido deve ser investigado para confirmar o diagnóstico.

OBJECTIVE: To evaluate radiological findings in patients submitted to surgical treatment for medullary breast cancer at Instituto Nacional de Câncer (INCA), Rio de Janeiro, RJ, Brazil, correlating them with histological results. MATERIALS AND METHODS: A retrospective descriptive study was developed with patients submitted to surgery at INCA, in the period from January 1997 to December 2006, for identifying the presence of medullary breast carcinoma and analyzing radiological findings. RESULTS: Among 21,287 patients diagnosed with carcinoma, 76 (0.357%) had typical medullary breast carcinoma. The age range of these patients was 32û81 years (mean = 59.1 years). Mammography demonstrated lesions in 19 of these patients, 17 (89.5%) of them with masses, and 2 with focal asymmetry. Among the patients with masses, 15 (88.1%) presented with high density and 2 (11.9%) with isodensity. Twelve patients presented sonographic findings, 11 (91.6%) of them with hypoechoic masses, and one with an anechoic mass with areas of cystic degeneration. CONCLUSION: Nodular mass was the predominant radiological finding (89.5%), 88.1% of them corresponding to masses with high density and circumscribed margins. Despite the radiological characteristics of benignity, a solid, fastgrowing, highly dense mass with circumscribed margins should be further investigated to confirm the diagnosis.

Sacralization of L5 in Radiological Studies of Degenerative Spondylolisthesis at L4-L5

STUDY DESIGN: Radiological analysis. PURPOSE: To investigate sacralization of L5 on radiological studies of degenerative spondylolisthesis at L4-L5. OVERVIEW OF LITERATURE: Degenerative spondylolisthesis commonly develops at L4-L5. Sacralization of L5 is thought to cause stress concentration at this level, which accentuates degenerative changes and promotes development of degenerative spondylolisthesis. However, there has been no study dedicated to determining whether the presence of sacralization at L5 influences the radiological findings in degenerative spondylolisthesis at L4-L5. METHODS: Seventy-eight patients with degenerative spondylolisthesis at L4-L5 were classified into two groups according to the presence of L5 sacralization: with (n=54) and without (n=24). Four radiographic parameters were measured and compared between the two groups: anterior slippage of L4 on L5 (% slip), facet orientation of L4-L5 (degrees), facet osteoarthritis of L4-L5 by Fujiwara's criteria (1~4 grades), and disc degeneration of L4-L5 by Frymoyer's criteria (grades 1~5). RESULTS: There was no significant difference in the degree of anterior slippage of L4 on L5 (17.02+/-6.21 versus 16.65+/-4.87, p=0.809), facet orientation (54.99+/-12.18 versus 56.23+/-4.35, p=0.642), facet osteoarthritis (3.43+/-0.59 versus 3.53+/-0.37, p=0.527), or disc degeneration (4.50+/-0.51 versus 4.35+/-0.61, p=0.340) between the two groups. CONCLUSIONS: Our study shows that the influence of sacralization of L5 on radiological findings in degenerative spondylolisthesis at L4-L5 may be less significant than previously expected. Further studies in large patient groups are needed to clarify the role of L5 sacralization on the development of degenerative spondylolisthesis at L4-L5.

Radiological Feature and Significance of Hand X-Rayin Early Rheumatoid Arthritis / 대한내과학회지

OBJECTIVES: To evaluate the disease status in relation to the radiological findings of hands using some short term indices of disease activity and laboratory tests in early rheumatoid arthritis. METHOD: 136 patients with symptoms of rheumatoid arthritis for less than 2 years were studied by means of measuring erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, and anti-nuclear antibody. Of these, 71patients were performed the radiographies of hands at mean 1.3months after diagnosis. Also, 30 radiological films of hands were studied for measurement of intra- & inter-observer variations by well-trained rheumatologist and radiologist. All films were scored by the modified Sharps method. RESULTS: The radiological features of hands showed that the carpal bone was involved more common in the bony erosion (5.7%) and the joint space narrowing (8.8%), and the radiological progression in the interval of 24 months was positively correlated with the disease duration (p<0.05). Also, the radiological lesions and progressions appeared more severe in high disease activity, C-reactive protein (r : 0.334, p : 0.004) and Ritchie index (r : 0.249, p : 0.01) at diagnosis. On the other hand, they were correlated negatively with the age of disease onset (r : -0.357, p : 0.002). The Spearman correlations of inter- & intra-observer variations were significant by 0.716 and 0.775. CONCLUSION: The development of radiological lesions in early rheumatoid arthritis is closely correlated with the duration of disease. The patients with early rheumatoid arthritis who had active arthritis at the time of diagnosis showed more severe radiological progressions.

Intradural Extramedullary Enterogenous Cyst in Cervical Spine: Case Report

A 4-year-old boy presented with a cervical enterogenous cyst manifesting as right arm pain. Neurological examination revealed weakness of his right upper extremities and increased deep tendon reflexes. This isolated, cervical intraspinal enterogenous cyst was treated successfully by posterior laminectomy, intradural exploration, and subtotal resection. He made a good recovery without additional neurological deficits. A brief overview is given of this rare cyst, together with their clinical, pathological, radiological features and associated findings.

Congenital Midgut Malrotation : Radiological Findings / 영남의대학술지

An accurate early diagnosis of congenital midgut malrotation is essential to prevention of catastrophic effects of volvulus. To evaluate the usefulness of radiologic examinations in diagnosing intestinal malrotation, we retrospectively analyzed radiologic findings and operation records of 17 intestinal malrotation patients, who were radiologically diagnosed. The age range of the patients studied were from 1day to 12years. The presenting symptoms were vomiting, vomiting with abdominal pain, abdominal distention, diarrhea and failure to thrive. The viewpoints of this analysis were the location of duodeno-jejunal flexure on barium meal and cecal location on barium enema. Sixteen of 17 patients, who were radiologically diagnosed, were surgically proven, but one patient with annular pancreas was false positive. In the case of 3 surgically proved patients, malrotation was suspected on barium meal prior to the barium enema, but final diagnosis was determined on barium enema examination. We concluded that a barium enema should be performed on all children with suspected malrotation where the initial upper gastro-intestinal study was normal or suspicious on account of the small incidence of false positive and false negative barium meals.

Radiological Findings of Low Back Pain Complainers in Some Part of Kyungin area workers / 대한산업의학회지

Preliminary survey of low back pain(LBP) was conducted from 7,668 workers of some part of Kyungin area. Among them, 1,183 workers complained LBP. If we do not mind X-ray findings, the prevalence rate of LBP was 15.4%. Lumbar series(anterior-posterior view, lateral view, both oblique view) were take from 973 workers who complained LBP. Three radiological findings which are not related with congenital anomaly or definite trauma-degenerative spondylitis, flattening of the lumbar spine, decreased intervertebral disc space were selected. In the group of degenerative spondylitis, the prevalence rate was relatively high after thirties in both sex. In female, prevalence rate was more higher in 5th and 6th decades than other decades. In the case of flattening of lumbar spine, the prevalence rate was relatively high in 2nd, 3rd and 4th decades in both sex. In case of decreased intervertebral disc space, there was no specific prevalent age group in both sex.