ABSTRACT
Encephalopathy is an uncommon complication of childhood influenza infection, typically recognized during influenza epidemics. Imaging hallmarks include characteristic thalamic lesions, thalamic necrosis and hemispheric edema. We describe a child with acute influenza A associated necrotizing encephalopathy with MR angiographic evidence of significant cerebral vasculopathy and a hemispheric edema pattern consistent with PRES. This case reinforces that significant cerebral vasculopathy can accompany influenza infection and that influenza is a likely trigger for PRES.
Subject(s)
Encephalitis, Viral/pathology , Influenza A virus , Influenza, Human/complications , Magnetic Resonance Imaging , Posterior Leukoencephalopathy Syndrome/pathology , Cerebrovascular Disorders/pathology , Cerebrovascular Disorders/virology , Child, Preschool , Encephalitis, Viral/virology , Female , Humans , Influenza, Human/pathology , Magnetic Resonance Angiography , Necrosis , Posterior Leukoencephalopathy Syndrome/virologyABSTRACT
Patella fractures following anterior cruciate ligament (ACL) reconstruction are a recognized but rarely reported complication. To our knowledge, 24 reports of patella fractures after ACL reconstruction using the central-third patella-tendon autograft have been reported in the literature. Patellar fractures associated with the use of the medial-third bone-patellar tendon-bone autograft have not been reported. This article describes four cases of patellar fractures in 478 ACL reconstructions between 1992 and 1999, using the medial third of the patellar tendon graft. All of them were transverse fractures of the patella but only one was displaced. All patients suffered local injury to the donor knee between 2 and 4 months postoperatively. No significant differences in the final outcome were noticed between the cases complicated with patellar fracture and those with uncomplicated ACL reconstructions.
Subject(s)
Anterior Cruciate Ligament/surgery , Fractures, Bone/etiology , Patella/injuries , Patellar Ligament/transplantation , Plastic Surgery Procedures/adverse effects , Adolescent , Adult , Anterior Cruciate Ligament Injuries , Female , Humans , Male , Patella/surgery , Retrospective Studies , Transplantation, AutologousABSTRACT
PURPOSE: To determine whether a filling defect seen at radiocarpal arthrography represents the volar radioscaphocapitate ligament and to establish how frequently this finding is seen in patients referred for wrist arthrography. MATERIALS AND METHODS: Radiopaque markers were surgically placed along the borders of the radioscaphocapitate ligament in three cadaveric wrist specimens. Each cadaveric wrist was examined at arthrography. Seventy contrast material-enhanced wrist arthrograms were retrospectively reviewed for visualization of the radioscaphocapitate ligament. The arthrographic appearance of the ligament was compared with its reported appearance at dissection, radiography, and magnetic resonance arthrography. RESULTS: The cadaveric study, together with an analysis of the appearance of the ligament, confirmed that the radioscaphocapitate ligament can be seen as a filling defect at radiocarpal arthrography. Fifty-five (78%) of the 70 clinical arthrograms unequivocally demonstrated the radioscaphocapitate ligament. The ligament was most conspicuous early during the injection, especially with the wrist in ulnar deviation. CONCLUSION: The radioscaphocapitate ligament of the wrist can be visualized during routine radiocarpal arthrography. Future studies will need to determine whether abnormalities of the radioscaphocapitate ligament can be diagnosed at arthrography.
