Meniscal Ramp Lesions: What the Radiologist Needs to Know.

Meniscal ramp lesions are a special type of injury that affects the periphery of the posterior horn of the medial meniscus (PHMM) and/or its meniscocapsular attachments. They are strongly associated with acute and chronic anterior cruciate ligament (ACL) tears. These lesions have gained much prominence in recent years, due to a significant increase in their diagnosis and their important biomechanical involvement in the knee. It is known that their presence in ACL-deficient knees is related to instability and if they are not repaired during ACL reconstruction, they can ultimately cause the failure of the graft. Since this type of injury is often underdiagnosed due to its localization at the "blind" point of arthroscopic vision, it is crucial to make an accurate preoperative diagnosis of them with MRI. The objective of this article is to review the recent literature regarding meniscal ramp lesions and to summarize the anatomical, biomechanical and fundamentally diagnostic aspects, emphasizing the radiological findings described until now.

Dolor y masa tras acceso de tos. Papel de la ecografía en su diagnóstico precoz / Pain and mass after coughing. Role of ultrasound in its early diagnosis

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¿Es necesaria la resonancia magnética en la patología musculotendinosa? / Is magnetic resonance imaging absolutely necessary for musculotendinous disease?

La patología del aparato locomotor es muy prevalente en nuestra sociedad, fundamentalmente la referida a músculos y tendones, sobre todo en el ámbito deportivo y laboral. Habitualmente se diagnostica y trata en función de la clínica, pero en muchas ocasiones se necesita un diagnóstico preciso. Las técnicas más utilizadas para ello son la ecografía y la resonancia magnética. En este trabajo proponemos la ecografía como técnica de elección en el diagnóstico de la patología musculotendinosa más prevalente por su precisión diagnóstica, versatilidad, dinamismo y eficiencia (AU)

Disorders of the musculoskeletal system are very prevalent in our society, especially those involving muscles and tendons, above all related to sports and work. These conditions are normally diagnosed and treated according to their clinical symptoms and signs, but a precise diagnosis is often necessary. The most widely used techniques for diagnosing these conditions are ultrasonography and magnetic resonance imaging. In this article, we propose ultrasonography as the technique of choice for diagnosing the most prevalent musculotendinous diseases, because it is accurate, versatile, dynamic, and effective (AU)

[Is magnetic resonance imaging absolutely necessary for musculotendinous disease?]. / ¿Es necesaria la resonancia magnética en la patología musculotendinosa?

Disorders of the musculoskeletal system are very prevalent in our society, especially those involving muscles and tendons, above all related to sports and work. These conditions are normally diagnosed and treated according to their clinical symptoms and signs, but a precise diagnosis is often necessary. The most widely used techniques for diagnosing these conditions are ultrasonography and magnetic resonance imaging. In this article, we propose ultrasonography as the technique of choice for diagnosing the most prevalent musculotendinous diseases, because it is accurate, versatile, dynamic, and effective.

Follow-up of folinic acid supplementation for patients with cerebral folate deficiency and Kearns-Sayre syndrome.

BACKGROUND: Kearns-Sayre syndrome (KSS) is a mitochondrial DNA deletion syndrome that presents with profound cerebral folate deficiency and other features. Preliminary data support the notion that folinic acid therapy might be useful in the treatment of KSS patients. Our aim was to assess the clinical and neuroimaging outcomes of KSS patients receiving folinic acid therapy. PATIENTS: We recruited eight patients with diagnoses of KSS. Four cases were treated at 12 de Octubre Hospital, and the other two cases were treated at Sant Joan de Déu Hospital. Two patients refused to participate in the treatment protocol. METHODS: Clinical, biochemical and neuroimaging data (magnetic resonance imaging or computed tomography scan) were collected in baseline conditions and at different time points after the initiation of therapy. Cerebrospinal fluid 5-methyltetrahydrofolate levels were analysed with HPLC and fluorescence detection. Large-scale mitochondrial DNA deletions were analysed by Southern blot. TREATMENT PROTOCOL: The follow-up periods ranged from one to eight years. Cases 1-4 received oral folinic acid at a dose of 1 mg/kg/day, and cases 6 and 8 received 3 mg/kg/day. RESULTS: No adverse effects of folinic acid treatment were observed. Cerebral 5-methyltetrahydrofolate deficiencies were observed in all cases in the baseline conditions. Moreover, all three patients who accepted lumbar puncture after folinic acid therapy exhibited complete recoveries of their decreased basal cerebrospinal fluid 5-methyltetrahydrofolate levels to normal values. Two cases neurologically improved after folinic therapy. Disease worsened in the other patients. Post-treatment neuroimaging was performed for the 6 cases that received folinic acid therapy. One patient exhibited improvements in white matter abnormalities. The remaining patients displayed progressions in subcortical cerebral white matter, the cerebellum and cerebral atrophy. CONCLUSIONS: Four patients exhibited clinical and radiological progression of the disease following folinic acid treatment. Only one patient who was treated in an early stage of the disease exhibited both neurological and radiological improvements following elevated doses of folinic acid, and an additional patient experienced neurological improvement. Early treatment with high-dose folinic acid therapy seems to be advisable for the treatment of KSS. TRIAL REGISTRATION: Eudrac T2007-00-6748-23.

Primary giant cell tumor of soft tissue: fluid-fluid levels at MRI (2010:3b).

PURPOSE: Giant cell tumor of soft tissue (GCT-ST) is an extremely rare lesion with an unpredictable behavior. The histological appearance closely resembles that of giant cell tumor of bone and, as such, has been characterized as the soft-tissue equivalent. MATERIALS AND METHODS: We describe the clinical, histological and radiological features of an unusual magnetic resonance imaging (MRI) and deep intramuscular location of GCT-ST with fluid-fluid levels (FFLs) simulating other soft tissue tumors or a hydatid cyst in a 52-year-old man. The lesion was resected. RESULTS: Neither metastasis nor recurrence has occurred in the 6-month period since resection. A review of the literature did not reveal any similar description of intramuscular GCT-ST. CONCLUSION: GCT-ST should be included in the differential diagnosis of soft tissue tumors with FFLs.

Oclusión intestinal mecánica por DIU intrabdominal: presentación de un caso / Mechanical intestinal occlusion due to intraabdominal intrauterine device: a case report

Se presenta el caso de una paciente de 43 años de edad, atendida en el Hospital Clinicoquirúrgico "Celia Sánchez Manduley" de Manzanillo, por presentar una rara complicación de los dispositivos intrauterinos. La paciente fue operada por un cuadro de obstrucción intestinal mecánica, a causa del paso de un segmento del intestino delgado a través del orificio de un anillo de Zipper, alojado en la cavidad abdominal. La evolución posoperatoria fue satisfactoria(AU)

Oclusión intestinal mecánica por DIU intrabdominal: presentación de un caso / Mechanical intestinal occlusion due to intraabdominal intrauterine device: a case report

Se presenta el caso de una paciente de 43 años de edad, atendida en el Hospital Clinicoquirúrgico "Celia Sánchez Manduley" de Manzanillo, por presentar una rara complicación de los dispositivos intrauterinos. La paciente fue operada por un cuadro de obstrucción intestinal mecánica, a causa del paso de un segmento del intestino delgado a través del orificio de un anillo de Zipper, alojado en la cavidad abdominal. La evolución posoperatoria fue satisfactoria(AU)

The case of a 43-year-old patient who received attention at "Celia Sánchez Manduley" Clinical and Surgical Hospital, in Manzanillo, for presenting a rare complication of the IUD is presented. The patient was operated on due to a mechanical intestinal obstruction resulting from the passage of a segment of the small intestine through the orifice of a Zipper's ring located in the abdominal cavity. The postoperative evolution was satisfactory(AU)

Poliposis intestinal asociada con pigmentaciones melánicas mucocutáneas: síndrome de Peutz-Jeghers / Intestinal polyposis associated with ucocutaneous melanin pigmentations: Peutz-Jeghers

Se revisan y estudian las historias clínicas de 14 pacientes: 5 adultos (2 del sexo femenino y 3 del masculino) y 9 niños (6 del sexo femenino y 3 del sexo masculino), todos pertenecientes a una misma familia y que padecen de una enfermedad congénita que se hereda con carácter autosómico, el llamado síndrome de Peutz-Jeghers. Los pacientes fueron estudiados desde el punto de vista clínico, radiológico, endoscópico, quirúrgico e histológico para llegar al diagnóstico certero. Las tumoraciones poliposas del tracto gastrointestinal se encontraron en orden de frecuencia en los segmentos siguientes: yeyuno-íleon, estómago, colon, sigmoide y recto. En algunos pacientes concomitaron pólipos en 2 segmentos del tracto gastrointestinal. El estudio hístico resultó en 12 adenomas y 1 hamartoma. En 1 de los pacientes no se demostró pólipos en ningún segmento de los explorados, solamente tenían presente las pigmentaciones mucocutáneas

Poliposis intestinal asociada con pigmentaciones melánicas mucocutáneas: síndrome de Peutz-Jeghers / Intestinal polyposis associated with mucocutaneous melanin pigmentations: Peutz-Jeghers

Se revisan y estudian las historias clínicas de 14 pacientes: 5 adultos (2 del sexo femenino y 3 del masculino) y 9 niños (6 del sexo femenino y 3 del sexo masculino), todos pertenecientes a una misma familia y que padecen de una enfermedad congénita que se hereda con carácter autosómico, el llamado síndrome de Peutz-Jeghers. Los pacientes fueron estudiados desde el punto de vista clínico, radiológico, endoscópico, quirúrgico e histológico para llegar al diagnóstico certero. Las tumoraciones poliposas del tracto gastrointestinal se encontraron en orden de frecuencia en los segmentos siguientes: yeyuno-íleon, estómago, colon, sigmoide y recto. En algunos pacientes concomitaron pólipos en 2 segmentos del tracto gastrointestinal. El estudio hístico resultó en 12 adenomas y 1 hamartoma. En 1 de los pacientes no se demostró pólipos en ningún segmento de los explorados, solamente tenían presente las pigmentaciones mucocutáneas