RESUMEN
Parkinsonian Syndromes are difficult to accurately diagnose and distinguish from other neurological processes such as essential tremor. Until now, physical exam and clinical presentation have been the gold standard for diagnosis (bradykinesia, tremor, rigidity, and postural instability).1 However, this leads to over- or under diagnosis and improper treatment due to variability in presentation and symptoms.1 A nuclear medicine study using I-123 Ioflupane (DaTSCAN) has been developed, which allows accurate differentiation of Parkinsonian Syndromes from other etiologies.1 This study is now widely performed on the mainland, but has never been done in Hawai'i due to its East Coast sourcing and relatively short physical half-life. Through a highly coordinated logistical effort, Tripler Army Medical Center's Nuclear Medicine Department conducted the first DaTSCAN in Hawai'i in April 2016.
Asunto(s)
Proteínas de Transporte de Dopamina a través de la Membrana Plasmática , Temblor Esencial/diagnóstico , Trastornos Parkinsonianos/diagnóstico , Tomografía Computarizada de Emisión de Fotón Único/métodos , Diagnóstico Diferencial , Temblor Esencial/diagnóstico por imagen , Hawaii , Humanos , Masculino , Nortropanos , Trastornos Parkinsonianos/diagnóstico por imagen , Adulto JovenRESUMEN
Meniscal tears and meniscal instability are rare complications of a discoid lateral meniscus in a very young child. We report a case of a 32-month-old male who presented with a limp and limited extension of his right knee. Magnetic resonance and sonographic images demonstrated a discoid meniscus with a posterior horn tear and unstable anterior horn, confirmed by arthroscopy. The patient was treated with saucerization of the lateral discoid meniscus, debridement of the posterior horn tear, and repair of the unstable anterior horn. This case shows a rare complication of variant anatomy that is not well documented in the pediatric radiologic literature, but nonetheless should be considered in the pediatric population.
