Role of diagnostic imaging in psoriatic arthritis: how, when, and why.

Psoriasis is a common skin disease. Up to 30% of patients with psoriasis develop psoriatic arthritis (PsA) resulting, by far, the most prevalent coexisting condition. Heterogeneity of clinical and radiological presentation is a major challenge to diagnosis of PsA. Initial reports about PsA emphasized a benign course in most patients, but it is now recognized that psoriatic arthritis often leads to impaired function and a reduced quality of life. PsA is a progressive disease characterized by diverse clinical features, often resulting in diagnostic delay and treatment that are associated with poor clinical and structural outcomes. New effective treatments may halt PsA progression, and consequently, treatment goals have evolved from simple reduction of pain to achieving full remission or minimal disease activity. This emerging treat-to-target strategy paradigm emphasize a need for early diagnosis; sensitive imaging techniques may be of value in this process. While radiography and CT depict structural damage, US and MRI have emerged as helpful tools to evaluate magnitude and severity of active inflammatory lesions. This review aims to describe the role of imaging modalities in diagnosis, follow-up and prognosis of PsA.

Idiopathic stenosis of foramina of Monro in an asymptomatic adult patient: a rare entity radiologists should be aware of.

Bilateral Adult Idiopathic Oclussion of Foramen of Monro is a rare entity, with less than 22 cases published in the literature so far, all of them symptomatic.1 When the symptoms require it, the current first-line treatment is endoscopic foraminoplasty, sometimes associated with septum pellucidum fenestration, although some authors consider that a more conservative treatment in paucisymptomatic patients.2 We report the case of an idiopathic biventricular hydrocephalus found incidentally in an asymptomatic 42-year-old female with temporomandibular joint disfunction. The fact that some patients with Monro foraminal stenosis may be asymptomatic increases the possibility of underdiagnosis, so we consider it a condition that radiologists should be aware of, mainly taking into account the fact that the diagnosis of this entity is usually radiologic3 and the potential complications associated with treatment.

[Head and neck paragangliomas: imaging diagnosis and embolization]. / Paragangliomas de cabeza y cuello: diagnóstico por imagen y embolización.

OBJECTIVES: To review imaging features of paragangliomas. To determine the usefulness of pre-operative embolization. MATERIAL AND METHOD: From January 1994 to December 2004, 30 patients at our institution were found to have 33 paragangliomas of the head and neck. They were evaluated with US, CT, MRI, and angiography. RESULTS: Location distribution was: 16 carotid (1 case of bilateral and 2 of multi-centric presentation are reported), 14 in temporal bone, and 3 vagal. Embolization was performed in 22 cases. It was palliative in 2 cases and adjuvant to surgery (18) or to surgery and radiation therapy (2), resulting in a reduction of surgical complications. Eight patients were operated on and 3 rejected any treatment. CONCLUSIONS: Imaging studies are essential in the differential diagnosis of head and neck masses. Pre-operative embolization is a major advance in the surgical management of paragangliomas because it decreases potential intra-operative bleeding.

Paragangliomas de cabeza y cuello: diagnóstico por imagen y embolización / Head and neck paragangliomas: imaging diagnosis and embolization

Objetivos: Revisar los hallazgos de imagen de los paragangliomas. Determinar la utilidad de la embolización preoperatoria. Material y método: De enero de 1994 a diciembre de 2004, en nuestro hospital se diagnosticó a 30 pacientes de 33 paragangliomas de cabeza y cuello. Fueron estudiados mediante ultrasonografía, tomografía computarizada, resonancia magnética y arteriografía. Resultados: Distribución según localización: 16 carotídeos (incluidos 1 caso de bilateralidad y 2 de presentación multicéntrica), 14 en el hueso temporal y 3 vagales. La embolización se realizó en 22 casos. Fue paliativa en 2 y adyuvante a la cirugía (18) o a la cirugía y radioterapia (2), y consiguió la reducción del número de complicaciones quirúrgicas. Se operó a 8 pacientes y 3 rechazaron cualquier tratamiento. Conclusiones: Los estudios de imagen son esenciales en el diagnóstico diferencial de las masas de cabeza y cuello. La embolización preoperatoria es el mayor avance en el manejo quirúrgico de los paragangliomas porque disminuye las potenciales hemorragias intraoperatorias

Objectives: To review imaging features of paragangliomas. To determine the usefulness of pre-operative embolization. Material and method: From January 1994 to December 2004, 30 patients at our institution were found to have 33 paragangliomas of the head and neck. They were evaluated with US, CT, MRI, and angiography. Results: Location distribution was: 16 carotid (1 case of bilateral and 2 of multi-centric presentation are reported), 14 in temporal bone, and 3 vagal. Embolization was performed in 22 cases. It was palliative in 2 cases and adjuvant to surgery (18) or to surgery and radiation therapy (2), resulting in a reduction of surgical complications. Eight patients were operated on and 3 rejected any treatment. Conclusions: Imaging studies are essential in the differential diagnosis of head and neck masses. Pre-operative embolization is a major advance in the surgical management of paragangliomas because it decreases potential intra-operative bleeding