Acro-osteólisis, hallazgos de imagen y posibles diagnósticos etiológicos / Acro-osteolysis, imaging findings and possible aetiological diagnoses

La acro-osteólisis es un hallazgo radiológico infrecuente caracterizado por una reabsorción o destrucción ósea que afecta típicamente a las falanges distales de la mano.Sus causas son múltiples. Puede estar asociada a enfermedades sistémicas, tener un origen familiar, ser idiopática o secundaria a agentes externos, por lo que el patrón radiográfico, la edad del paciente y una buena historia clínica serán claves para llegar a su diagnóstico etiológico.Presentamos el caso de una mujer de 40 años que consulta por dolor de aproximadamente 1 año de evolución a nivel de la región interfalángica distal del primer y segundo dedo de la mano derecha. Entre las pruebas complementarias realizadas durante el estudio, destaca la radiografía simple de la mano, donde se observa una reabsorción parcial en banda de la región media de la falange distal del primer y segundo dedo, compatible con acro-osteólisis.(AU)

Acro-osteolysis is a rare radiological finding characterized by bone resorption or destruction that typically affects the distal phalanges of the hand.There are many causes. The condition can be associated with systemic diseases, have a family origin or be idiopathic or secondary to external agents. Therefore, the radiographic pattern, the patient’s age in addition to a good clinical history will be key to diagnosing its aetiology.We report the case of a 40-year-old woman who consulted for pain of approximately one year clinical course at the level of the distal interphalangeal region of the first and second fingers of the right hand. Among the complementary test performed during the study the x-ray revealed a band-like partial resorption in the middle region of the distal phalanx of the first and second fingers, compatible with acro-osteolysis.(AU)

Dígito pélvico como hallazgo incidental y posibles diagnósticos diferenciales / Pelvic digit as an incidental finding and possible differential diagnoses

El dígito pélvico es un tipo de anomalía congénita benigna poco frecuente, que se localiza en la región coxofemoral, en relación con el ilion.A pesar de que suele ser asintomático, es importante conocer su existencia, así como los posibles diagnósticos diferenciales, ya que se puede encontrar como un hallazgo incidental en la radiografía simple.Se presenta el caso de un hombre, de 58 años, que acude a su médico de Atención Primaria (AP) por artralgias generalizadas, quien observa en la radiografía simple de cadera un hallazgo inusual, por lo que interconsulta al servicio de Radiodiagnóstico, donde se realiza el diagnóstico de dígito pélvico.(AU)

The pelvic digit is a rare benign congenital abnormality, located in the hip region, in regard to the ilium.Although usually asymptomatic, it is important to be aware of its existence as well as the possible differential diagnoses since it can be found as an incidental finding on plain x-ray.We report the case of a 58-year-old man who presented to his primary care physician because of generalized arthralgia. He observed an unusual finding on plain x-ray of the hip, whereby he consulted the radiology department, where pelvic digit was diagnosed.(AU)

Pneumatosis intestinalis as an incidental finding in a patient with COVID-19 infection.

In reference to the article by Láinez Ramos-Bossini AJ et al., recently published in your Journal, we would like to provide our experience regarding a probable causal association between pneumoperitoneum and pneumatosis intestinalis in patients affected by COVID-19 (1).

Myocardial fibrosis in arrhythmogenic cardiomyopathy: a genotype-phenotype correlation study.

AIMS: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a life-threatening entity with a highly heterogeneous genetic background. Cardiac magnetic resonance (CMR) imaging can identify fibrofatty scar by late gadolinium enhancement (LGE). Our aim is to investigate genotype-phenotype correlation in ARVC/D mutation carriers, focusing on CMR-LGE and myocardial fibrosis patterns. METHODS AND RESULTS: A cohort of 44 genotyped patients, 33 with definite and 11 with borderline ARVC/D diagnosis, was characterized using CMR and divided into groups according to their genetic condition (desmosomal, non-desmosomal mutation, or negative). We collected information on cardiac volumes and function, as well as LGE pattern and extension. In addition, available ventricular myocardium samples from patients with pathogenic gene mutations were histopathologically analysed. Half of the patients were women, with a mean age of 41.6 ± 17.5 years. Next-generation sequencing identified a potential pathogenic mutation in 71.4% of the probands. The phenotype varied according to genetic status, with non-desmosomal male patients showing lower left ventricular (LV) systolic function. LV fibrosis was similar between groups, but distribution in non-desmosomal patients was frequently located at the posterolateral LV wall; a characteristic LV subepicardial circumferential LGE pattern was significantly associated with ARVC/D caused by desmin mutation. Histological analysis showed increased fibrillar connective tissue and intercellular space in all the samples. CONCLUSION: Desmosomal and non-desmosomal mutation carriers showed different morphofunctional features but similar LV LGE presence. DES mutation carriers can be identified by a specific and extensive LV subepicardial circumferential LGE pattern. Further studies should investigate the specificity of LGE in ARVC/D.

Oclusión venosa pulmonar como complicación del tratamiento ablativo de la fibrilación auricular / Pulmonary Venous Occlusion as a Complication of Ablation Therapy for Atrial Fibrillation

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