Prevalence of calcified carotid artery atheromas in panoramic radiographs of HIV-positive patients undergoing antiretroviral treatment: a retrospective study.

OBJECTIVE: This study investigated the prevalence of calcified carotid artery atheromas (CCAAs) in panoramic radiographs of HIV-positive patients. STUDY DESIGN: A retrospective cross-sectional study was performed to evaluate the presence of CCAA in 300 panoramic radiographs. Qualitative variables were compared using the χ(2) test or Fisher exact test, as needed. The Mann-Whitney or Student t test was used for the quantitative variables. RESULTS: In the studied group, 8.2% presented CCAA. Among these patients, most used lopinavir/ritonavir (P = .0459), had a greater mean age (P = .0081), and displayed a lower nadir CD4 (P = .0195). The use of lopinavir/ritonavir increased the chances of CCAA by approximately 2.8-fold compared with those who did not use medication (odds ratio, 2.79; 95% confidence interval, 1.12-6.95; P = .045). CONCLUSIONS: The variables that were associated with the identification of CCAA are compatible with the known atherogenic risk factors in patients with HIV.

Mieloma múltiple: la radiografía panorámica como un primer hallazgo de diagnóstico / Multiple myeloma: ray wide as a first discovery of diagnosis

Mieloma múltiple (MM), también conocido como Mieloma de células plasmáticas, es una proliferación tumoral de plasmocitos que infiltran la médula hematopoyética, de causa desconocida. Recursos de imagen son ampliamente utilizados en clínica estomatológica y los profesionales de esta área puede ser el primero en ser solicitado, por lo tanto, es importante la detección de la afectación que puede tener carácter sistémico en la preservación de la salud del paciente. Bajo estas condiciones, la literatura tiene pruebas de la ocurrencia del mieloma múltiple. En este reporte, una paciente mujer, de raza negra, de 53 años de edad fue remitida al Departamento de Estomatología por un odontólogo, por la presentación de las lesiones radiolúcidas en la mandíbula. Los hallazgos radiográficos panorámicos incluyen múltiples lesiones mal definidas radiolúcidas y la gammagrafía ósea mostró múltiples áreas de captación del radiotrazador en la mandíbula, la pelvis, la columna vertebral, el cráneo, la clavícula y las costillas. La paciente fue remitida a un comité de tumores multidisciplinar, y ha tolerado el tratamiento y su seguimiento desde el año 2009. Debido al comportamiento de esta enfermedad, el cuidado clínico y la evaluación radiológica deben llevarse a cabo, proporcionando información precisa y guías de tratamiento de los pacientes.

Multiple myeloma (MM), also called plasma cell myeloma, is a monoclonal neoplasic proliferation of plasma cells of bone marrow derivation with an unknown cause. Imaging resources are widely used in clinical stomatology and the professionals of this area may be the first to be requested, thus, it is important the detection of involvement that may have systemic character in preserving the patient's health. Under these conditions, the literature has proof the occurrence of the multiple myeloma. In this report the 53-year-old melanoderm woman was referred to the Stomatology Department by a dentist on presentation of radiolucent lesions in the mandible. At the panoramic radiographic findings included multiple ill-defined radiolucent lesions and bone scintigraphy showed multiple areas of radiotracer uptake in the jaw, pelvis, spine, skull, clavicle, and ribs. The patient was referred to a multidisciplinary tumor board, and she has been tolerating her treatment well and following up since 2009. Due to the behavior of this disease, careful clinical and radiological evaluation must be carried out, which provides accurate information and guides treatment of patients.

Correlation among the changes observed in temporomandibular joint internal derangements assessed by magnetic resonance in symptomatic patients.

PURPOSE: The objective was to assess possible correlations among the anatomy and position of the articular disc, the morphology of the articular eminence and of the condyle, and the presence of joint effusion. MATERIALS AND METHODS: Magnetic resonance images of 142 joints of symptomatic patients were assessed. The articular disc was classified as normal, elongated, or folded; displacement was classified as normal, anterior with reduction, anterior without reduction, or posterior, lateral, or medial; the condyle was classified as rounded, convex, flattened, or angulated; and the articular eminence was classified as box, sigmoid, flattened, or deformed. RESULTS: The most frequent forms of the articular disc, articular eminence, and condyle were normal, box, and flattened, respectively. Associations were confirmed between the form of the articular disc and its anterior and lateral positions; between the form of the condyle and an anterior position of the disc; and between the form of the articular eminence and the form of the disc. The form of the articular eminence was the only variant that was not associated to the presence of joint effusion. CONCLUSIONS: Magnetic resonance imaging allowed the clear observation of articular structures, without attributing a cause-and-effect relation. The prevalence of changes observed was associated with the diagnosis of internal derangement and was statistically proved.

Avaliação por meio da ressonância magnética do sinal do tecido retrodiscal associado à anatomia de eminência articular do osso temporal na presença de derrame articular e deslocamento do disco com e sem redução em pacientes sintomáticos / Evaluation of MRI signal intensity of retrodiscal tissue associated with morphology of the articular eminence of the temporal bone,TMJ effusion status, and disc disc displacement with and without reduction in symptomatic patients

Este estudo avaliou por meio da Ressonância Magnética a intensidade de sinal do tecido retrodiscal associando a anatomia da eminência articular, derrame articular e deslocamento do disco com e sem redução. Para isto, foram analisadas imagens por RM de 48 ATM de 24 indivíduos sintomáticos, sendo 19 (79,2%) do gênero feminino e 5 (20,8%) do gênero masculino. Considerando o posicionamento sagital, cerca de 5 (10,4%) das articulações eram normais, 23 (47,9%) das articulações eram DDCR e 20 (41,7%) eram DDSR. Para a forma da eminência articular, cerca de 15 (31,3%) das articulações foram classificadas como tendo formato de caixa, 12 (25,0%) foram classificadas como sigmoide, 10 (20,8%) como aplainada e 11 (22,9%) das articulações foram classificadas como deformada. A maioria das articulações apresentaram derrame cerca de 32 (66,7%). Das articulações com DDSR, 16 (51,6%) apresentaram derrame e as com DDCR 15 (48,4%). As articulações com DDCR apresentaram 9 (39,15) em forma de caixa, 6 (26,1%) como sigmóide, 3 (13,0%) estavam aplainada e 5 (21,7%) deformadas; as ATM com DDSR apresentaram 5 (25,5%) como caixa, 4 (20,0%) como sigmóide, 6 (30,0%) aplainadas e 5 (25,5%) deformadas. A forma da eminência articular não está relacionada ao posicionamento sagital (p=0,520).

O posicionamento sagital do disco não está relacionado à presença de derrame (p=0,281). A intensidade de sinal do TR foi estatisticamente menor no posicionamento sagital DDCR, quando comparado ao posicionamento sagital DDSR (p=0,016). Houve uma tendência da intensidade do sinal do tecido retrodiscal ser maior nas articulações com derrame quando comparado às sem derrame (p=0,065). Não houve relação entre posicionamento sagital do disco e derrame. E por fim, o presente estudo não conseguiu estabelecer uma relação entre o sinal do tecido retrodiscal e eminência articular (p=0,159).

This study evaluated MR signal intensity of retrodiscal tissue associated with articular eminence morphology, joint effusion status, and disc displacement with and without reduction (DDwR and DDwoR, respectively). Forty-eight TMJ MR images of 24 symptomatic subjects (19 females and 5 males) were analyzed. For the sagittal position, 5 (10.4%) joints were normal, 23 (47.9%) showed DDwR and 20 (41.7%) DDwoR. Regarding articular eminence morphology, 15 (31.3%) joints were classified as box-shaped, 12 (25.0%) as sigmoid, 10 (20.8%) flattened and 11 (22.9%) deformed. The majority of TMJs (32 or 66.7%) showed effusion. Sixteen (51.6%) of the TMJs with DDwoR had effusion versus 15 (48.4%) of those with DDDwR. Of TMJs with DDwR, 9 (39.1%) were box-shaped, 6 (26.1%) sigmoid, 3 (13.0%) flattened and 5 (21.7%) deformed. Among joints with DDwoR, 5 (25.5%) were boxshaped, 4 (20.0%) sigmoid, 6 (30.0%) flattened and 5 (25.5%) deformed. As a conclusion, articular eminence shape was not related to sagittal position of the disk (p = 0.520). Sagittal position of the disk was not related to presence of effusion (p = 0.281). Signal intensity of retrodiscal tissue (RT) was statistically lower in the DDwR sagittal position than in DDwoR cases (p = 0.016). There was a tendency for higher RT signal intensity in joints with effusion versus those without effusion (p = 0.065). No relationship between sagittal position of the disc and effusion was observed. No relationship between signal intensity of retrodiscal tissue and shape of articular eminence was identified (p = 0.159).