Caso clínico radiologico / Radiological clinical case

La osteoporosis transitoria de la cadera es una entidad poco frecuente de causa desconocida que se presenta como coxalgia cuyo diagnóstico se realiza con el estudio por imágenes, especialmente con resonancia magnética. Presentamos el caso de una paciente que presentó este cuadro con su estudio imagenológico. Se discuten aspectos clínicos, diagnósticos y terapéuticos de esta entidad. La osteoporosis es una osteopatía metabólica de alta prevalencia. Es la principal causa de fracturas óseas en mujeres después de la menopausia y ancianos en general. Es asintomática y por lo general su primer signo visible es una fractura de cadera, muñeca o de los cuerpos vertebrales que originan dolor o deformidad. Presentamos el caso de una paciente portadora de osteoporosis que presenta fracturas vertebrales. Se discuten aspectos del diagnóstico por imágenes.

Transient Osteoporosis of the hip is an uncommon clinical condition. The etiology is unknown. It could be confused with other diagnosis that causes hip pain. We present a case report of a woman with transient osteoporosis. We discuss clinical, diagnostic and therapeutic aspects of this entity Osteoporosis is a metabolic condition with high prevalence. It is the principal cause of fracture in women after menopause and elderly population in general. Usually the first sign is a hip, wrist or vertebral fracture that causes pain and deformity. We present a case report of a woman with osteoporosis and vertebral fractures. We discuss the radiologic diagnostic.

Tumores neurogénicos de nervios periféricos: estudio por imágenes / Neurogenic tumors of peripheral nerves: study by images

Se revisa la manifestación en imágenes de los tumores benignos y malignos que afectan los nervios periféricos. Se destacan sus características en diferentes modalidades en especial ultrasonografía y resonancia magnética.

Valor pronóstico del índice de Sharp en la respuesta clínica y de laboratorio a un pulso intravenoso de metilprednisolona en pacientes con artritis reumatoídea / Prognostic value of Sharp index in the clinical and laboratory response to an iv methylprednisolone pulse in patients with rheumatoid arthritis

Background: No reliable variables to predict clinical or laboratory response to treatment in patients with rheumatoid arthritis were available until recently. Aim: To asses the potential predictive value of the Sharp's modified radiographic joint damage index for the assessment of clinical and laboratory response to a methylprednisolone i.v. pulse. Patients and Methods: Twenty-two patients suffering from rheumatoid arthritis received a single i.v. pulse of 1 g of methylprednisolone. Hand X-rays were taken at baseline and blindly scored by two trained radiologists. Clinical and laboratory variables were assessed at baseline and at weekly intervals up to 30 days plus a 60 days final evaluation. Improvement was defined as a 50 percent amelioration in 4 variables. Results: Assessment of radiographic scores had a high correlation between and within observers (intraclass correlation= 0.998). Sharp score did not reach statistical significance as global predictor for the inflammatory variable response to methylprednisolone. However, when the number of swollen joints was taken into account, patients with a low erosive score (Sharp ² 50) had a more prolonged clinical response, than patients with higher erosive score (Sharp >50) (Fisher test p= 0.023). It is of clinical importance to point out that among patients with high Sharp score there were also responders who reached a high level of improvement. A statistically significant correlation between the basal PCR serum titers and the radiographic score (p< 0.02) was observed. Conclusions: The number of swollen joints and other variables that consider joint structural changes should be considered for the assessment of rheumatoid arthritis patients