Evaluation of pulmonary and extrapulmonary tuberculosis in immunocompetent adults: a retrospective case series analysis

It was the aim of this study to evaluate the demographic factors and clinical features of extrapulmonary tuberculosis [EPTB] compared to those of pulmonary tuberculosis [PTB] among adult immunocompetent patients. A total of 427 patients with clinically, radiologically and histopathologically confirmed TB were enrolled in the study, in our clinic at a tertiary care hospital in Turkey, during a 5-year period [2007-2012]. Patient data were obtained retrospectively. Among the 427 patients, 55 patients with both PTB and EPTB and who were using steroids or had taken immunosuppressive drugs were excluded from the study. Of the 372 patients, 227 [61%] were males and 168 [45.2%] had EPTB; 204 [54.8%] patients had PTB. The most frequent sites of EPTB were the lymph nodes [n = 45, 12.1%], pleura [n = 40, 10.7%] and brain [n = 7, 1.8%]. The most common symptoms were cough [n = 174, 46.7%], night sweats [n = 127, 34.1%] and fever [n = 123, 33%]. Compared to EPTB patients, PTB patients were less likely to have received Bacillus Calmette-Guerin vaccination [odds ratio 0.41, 95% confidence interval 0.2-0.63; p < 0.001]. Eighty-one [48.2%] of the EPTB and 146 [71.6%] of the PTB patients were males. Pulmonary involvement was more common among men [n = 146, 71.6%] than among women [n = 58, 28.2%; p = 0.000]. There was a high incidence of EPTB in our study. Early diagnosis of EPTB is crucial for treatment, and atypical presentations of TB should be kept in mind for immunocompetent patients living in endemic areas. Females especially should be investigated for EPTB

Evaluation of degenerative diseases of the lumbar spine with reformatted and 3-dimensional computed tomography images

To evaluate the identification of degenerative lesions of the lumbar spine with multiplanar reformatted images and 3-dimensional computed tomography [3DCT]. Fifty-three patients with degenerative spinal disease findings on lumbar CT scanning were reviewed in this retrospective study at the Department of Radiology, Medical Faculty, Sutcu Imam University, Kahramanmaras, Turkey between January 2006 to January 2009. Two-dimensional multiplanar reformatted and 3DCT images were obtained. First, the axial CT images, and then 2-dimensional multiplanar reformatted images [2DMPR] were evaluated. The findings seen on reformatted CT images that were not visualized, or visualized only in retrospect on axial images were recorded. Finally, the 3D images were evaluated by the same team. The results were again recorded in the same manner. When 53 patients were taken into account, the 2DMPR provided better visualization of lateral neural foraminal stenosis in 62%, bulging of the disc in 32%, degenerative retrolisthesis in 15%, and spondylolysis in 15% as compared to axial images. The 3DCT images clearly revealed the presence of lateral neural foraminal stenosis in 41%, degenerative retrolisthesis in 13%, lateral spondylolisthesis in 15% as compared to axial and 2DMPR. The 2DMPR and 3DCT images provide significant anatomic and diagnostic information not readily derived from axial CT. It is useful in detecting degenerative conditions of the spine and associated complications

Hydatid Disease Involving Some Rare Locations in the Body: a Pictorial Essay

Hydatid disease (HD) is an endemic illness in many countries, and it poses an important public health problem that's influenced by peoples' socioeconomic status and migration that spreads this disease. Although rare, it may occur in any organ or tissue. The most common site is the liver (59-75%), followed in frequency by lung (27%), kidney (3%), bone (1-4%) and brain (1-2%). Other sites such as the heart, spleen, pancreas and muscles are very rarely affected. Unusual sites for this disease can cause diagnostic problems. This pictorial essay illustrates various radiological findings of HD in the liver, spleen, kidney, pancreas, peritoneal cavity, omentum, adrenal, ovary, lung, mediastinum and retroperitoneum. Familiarity with the imaging findings of HD may be helpful in making an accurate diagnosis and preventing potential complications.

Diagnostic Importance of 3D CT Images in Klippel-Feil Syndrome with Multiple Skeletal Anomalies: A Case Report

We present here the case of a 12-year-old boy who had Klippel-Feil syndrome with renal, cardiac and multiple skeletal anomalies, and we show the relevent three-dimensional computed tomography images. Our patient had a triple renal pelvis, mitral valve prolapsus, multiple cervical vertebrae fusions, cervical ribs, hypoplasia of the right thumb, spina bifida of L5, lumbalization at the right side of S1 and a sacral curved defect. In this study, we discuss the atypical clinical features and the diagnostic value of three-dimensional CT for evaluating the skeletal anomalies of the Klippel-Feil syndrome cases.