Morphologic Evaluation of the Patella: The Impact of Gender and Age.

Introduction: The patellofemoral joint is a complex joint that plays a crucial role in knee joint function and stability. This study aims to describe the MRI characteristics of the patellofemoral joint in Vietnamese adults. Subjects and Methodology: A cross-sectional study was conducted on 280 patients at Hue UMP Hospital from May 2020 to May 2021. All patients underwent knee MRI using Siemens Magnetom Amira 1.5 Tesla. The evaluation parameters included the morphology of the patella and the femoral trochlea. Results: The study found that the morphological parameters of the patellar joint varied significantly between genders and age groups. The mean largest patellar transverse diameter was 4.26 ± 0.37 cm, the average length of the lateral joint facet was 2.5 ± 0.26 cm, and the medial joint facet was 2.0 ± 0.25 cm. The patellar height was 4.07 ± 0.35 cm. The indexes of patellar morphology were higher in men than in women, except for the lateral-medial facet ratio. The most common Wiberg classification was type B (63.9%), followed by type C (25.4%), and type A was the least common (10.7%). There was a statistically significant difference in the patellar measurements between different age groups. There was a weak negative linear correlation between the dimensions of the largest transverse diameter, the length of the articular surface, the patellar articular angle, and the age of the patient. Additionally, there was a moderate inverse linear relationship between patellar height and patient age. Conclusion: This study highlights the significant variations in patellar morphology based on gender and age. The findings emphasize the importance of careful assessment and consideration of these variations in the imaging evaluation of the patellofemoral joint.

Computed Tomography Findings and Classification of Traumatic Lumbosacral Spine Injuries: Insights from the AOSpine Classification System.

Purpose: The main objective of this study was to provide a description and classification of lumbosacral spine injuries based on the new AOSpine classification system. Methods: A cross-sectional study was conducted on 75 patients with lumbosacral spine trauma who were admitted to Hue University of Medicine and Pharmacy Hospital in Hue, Vietnam, between April 2021 and July 2022. All patients underwent lumbosacral computed tomography, and each injured vertebra was classified according to the AOSpine classification system. The frequency and percentage of subtypes of lumbosacral spine trauma were determined. Results: The mean age of the patients was 50.6 ± 16.1 years, and the male-to-female ratio was 1.5:1. Falls and traffic accidents were found to be the main causes of injuries. Among the patients, 78.7% did not exhibit any neurological symptoms, while 1.3% experienced complete hemiplegia and 20% had incomplete hemiplegia. The most common fracture subtype was A3, accounting for 34.6% of cases. Conclusion: This study provides valuable insights into the demographics, associated injuries, and classification of traumatic lumbosacral spine injuries based on the new AOSpine classification system. The study found that falls and motor vehicle accidents were the main causes of these injuries, with a higher proportion of male patients. The majority of injuries were classified as type A fractures, while type C fractures were the least common. Sacral fractures were relatively infrequent and often associated with pelvic ring fractures. These findings contribute to our understanding of lumbosacral spine trauma and can aid in the development of more effective treatment protocols.

Multiple system atrophy-cerebellar: A case report and literature review.

We reported a case of a 48-year-old female patient admitted to the hospital due to balance disorder which progressed rapidly within 1 week. Cerebral magnetic resonance imaging showed significant atrophy and hyperintensities at the middle cerebellar peduncles and the "hot cross bun" sign of the pons. The final diagnosis was probable multiple system atrophy, cerebellar subtype. The clinical and imaging findings will be discussed as well as a brief literature review.

Complicated breast augmentation via self-injection of ultrasound gel and shoe glue: A case report.

Various types of dermal fillers have been developing for soft tissue augmentation. Even though many fillers have been approved and strictly regulated by authorities, homemade products for body contouring procedures are widely available and easily purchased on websites without prescriptions. It is challenging for radiologists to interpret radiological findings of complicated breast augmentation of unknown origin. While ultrasound is the modality of choice for initial work-up, magnetic resonance imaging (MRI) plays a role as the gold standard in evaluating the integrity of prosthetic implants. Using silicone or water-only MRI sequences may also be able to distinguish them. We report a rare case of breast abscess of a young female patient after self-injection of the mixture of ultrasound gel and shoe glue. The clinical and imaging aspect, especially MRI imaging, will be discussed.

Hereditary multiple exostoses: A case report and literature review.

Osteochondroma is the most common bone tumor representing 20%-50% of all benign bone tumors and 10%-15% of all bone tumors. Osteochondroma has similar radiological appearance in both solitary and multiple forms; the latter is an autosomal dominant disorder termed hereditary multiple exostoses. Associated complications of osteochondroma include deformity, fracture, neurovascular compromise, bursa formation, and malignant transformation. Measurement of the cartilage cap thickness is an important index suggesting secondary malignancy of osteochondroma. The upper limit of cap thickness after skeletal maturation is 1.5 cm which can be reliably measured on ultrasound or magnetic resonance imaging. Hereditary multiple exostoses are linked to the mutations of different exostoses genes located on chromosome 8, 11, and 19. We reported cases of two siblings presented with multiple osteochondromas managed by surgical excision. We evaluated their clinical and radiological presentation, genetic correlations and compared with the literature.

Quantitative parameters of diffusion tensor imaging in the evaluation of carpal tunnel syndrome.

Background: To explore the value of diffusion tensor imaging (DTI)-derived metrics in quantitative evaluation of carpal tunnel syndrome (CTS). Methods: This prospective cross-sectional study included 39 wrists from 24 symptomatic CTS patients, who underwent clinical, electrophysiological, and magnetic resonance imaging (MRI) evaluations. In addition, 10 wrists of 6 healthy participants were included as controls. Clinical and nerve conduction study (NCS) findings were evaluated and graded according to the Boston Carpal Tunnel Questionnaire (BCTQ) and the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), respectively. We performed MRI using a 1.5 Tesla scanner. Mean diffusivity (MD), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) of the median nerve at the distal radioulnar joint (DRUJ) (d), the inlet of the carpal tunnel (CT) at the pisiform level (i), the middle of the CT (m) and the outlet of the CT at the level of the hook of hamate (o), cross-sectional area at the inlet of the CT (iCSA), and the difference between MD and FA of the DRUJ and the outlet of CT (Delta MD and Delta FA) were measured. Results: The CTS patients had significantly lower FA [for example, oFA: mean difference 0.09, 95% confidence interval (CI): 0.05 to 0.12] and significantly higher MD than healthy participants (for example, iMD: mean difference 0.3, 95% CI: 0.03 to 0.57). There was a negative correlation between iCSA with iFA and between mFA and oFA (-0.5

Diffuse xanthogranulomatous pyelonephritis with complex spontaneous pyeloduodenal fistula: A case report.

Xanthogranulomatous pyelonephritis is a rare and severe form of chronic pyelonephritis. Spontaneous pyeloduodenal fistula is an extremely rare complication of xanthogranulomatous pyelonephritis. We present a rare case of xanthogranulomatous pyelonephritis complicated by a complex pyeloduodenal and ureteromuscular fistulae with a cutaneous opening. A 57-year-old male patient presented with chronic right flank pain and cutaneous discharge at the right lower quadrant. Xanthogranulomatous pyelonephritis was suspected on preoperative computed tomographic urography owing to the presence of fat deposits and complex pyeloduodenal and ureteromuscular fistulae. Open nephrectomy and fistula closure were performed and the patient recovered uneventfully. Xanthogranulomatous pyelonephritis was confirmed pathologically.

The value of sonographic quantitative parameters in the diagnosis of carpal tunnel syndrome in the Vietnamese population.

OBJECTIVE: To examine the value of ultrasound (US) in the diagnosis of carpal tunnel syndrome (CTS) in the Vietnamese population. METHODS: This prospective cross-sectional study involved 42 wrists of 25 patients with idiopathic CTS evaluated by US. In addition, 38 wrists of 22 healthy volunteers were included as the control group. RESULTS: Significant differences in the median nerve cross-sectional area (CSA) at different levels were found between patients with CTS and controls. Using a cut-off value of 9.5 mm2 for the median nerve CSA at the pisiform (p-CSA), US had a sensitivity and specificity of 95.2% and 97.4%, respectively, for the diagnosis of CTS. Area under the curve analysis revealed a sensitivity and specificity of 100% and 95.4%, respectively, for the prediction of severe CTS using a p-CSA of >15.5 mm2. CONCLUSIONS: The median nerve CSA is a highly accurate parameter in the diagnosis of CTS. We recommend using a p-CSA of >9.5 mm2 as a diagnostic criterion for CTS and a p-CSA of >15.5 mm2 as a marker for severe CTS in the Vietnamese population.Research Registry number: 7261.

Isolated arterial pulmonary malinosculation without sequestration in an adult: A case report and literature review.

Abnormal connections between systemic and pulmonary vascular systems are rare conditions and have been mostly documented in the pediatric population. We report a case of type B isolated arterial pulmonary malinosculation in an adult. The patient's chief complaint was intermittent hemoptysis during physical exertion. He had a dual arterial supply from the anomalous systemic artery and the pulmonary artery to the left lower lobe and the venous drainage was through the pulmonary vein. The bronchial connection appeared normal. The fistula was identified on chest computed tomography and was treated endovascularly. The patient remains asymptomatic at 1-year follow-up.

Herlyn-Werner-Wunderlich syndrome: A report of three cases in adolescents and adult woman.

We report three cases with Herlyn-Werner-Wunderlich syndrome in adolescents and young female. The objective of this report was to describe the clinical presentation, ultrasound (US) and magnetic resonance imaging (MRI) findings of Herlyn-Werner-Wunderlich syndrome. The three patients were 12, 13 and 34 years old, respectively. The reason for admission and clinical symptoms varied between the 3 patients, including menstrual cramps, vaginal bleeding, and dull pain in the hypogastric region. Nevertheless, the sonographic and MRI findings of all three cases were typical for HWWS, including didelphys uterus, obstructed hemivagina, and ipsilateral renal agenesis.

Systemic sclerosis-associated interstitial lung disease in a Vietnamese adult female: Case report and literature review.

Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is a rare disease in the Asian population and might be overlooked in clinical practice. Early diagnosis is crucial to initiate treatment and to prevent disease progression. Chest high-resolution computed tomography (HRCT) is the modality of choice for diagnosing and assessing this disorder. SSc-ILD should be included in the list of differential diagnoses of ILD. Familiarity with HRCT findings and thorough clinical examination are crucial for diagnosis and treatment.

Giant lumbar spinal schwannoma: a case report and literature review.

We report a case of a 40-year-old female patient admitted to the hospital due to lumbar pain that spread to both legs and was associated with weakness of the lower extremities. Magnetic resonance imaging revealed an intradural - extramedullary tumor at the level of the T12 - L2 vertebra. The lesion was over 7 cm in greatest diameter and compressed the conus medullaris. The patient underwent surgery to remove the entire tumor. Postoperative pathology confirmed the diagnosis of schwannoma. The symptoms resolved almost completely without significant complications.

Synchronous Renal Cell Carcinoma and Hepatocellular Carcinoma.

The coexistence of multiple synchronous primary malignancies is uncommon. The coexistence of hepatocellular carcinoma (HCC) and renal cell carcinoma (RCC) is even rarer. We present a case of a 44-year-old male patient with a history of chronic hepatitis B and a right renal mass treated by radical nephrectomy. At the 2-month follow-up, a new lesion was detected in the left lobe of the liver. Postsurgery histologic evaluation with immunohistochemical study of both lesions confirmed the renal and hepatic lesions to be RCC and HCC, respectively.

Evaluation of the Insall-Salvati Ratio Among the Vietnamese Population: Application for Diagnosis of Patellar Malalignment.

INTRODUCTION AND PURPOSE: An abnormal patellar position has been proven to be associated with anterior knee pain and several other conditions that affect the patellofemoral joint. The purpose of this study was to determine the incidence of patella alta and patella baja and the applicability of the normal range of the Insall-Salvati ratio in the Vietnamese population. METHODOLOGY: Magnetic resonance imaging (MRI) was used to examine 455 Vietnamese subjects' knees. The Insall-Salvati ratio-the ratio of patellar ligament length (LL) and patellar length (PL)-was measured using sagittal T1-weighted images. RESULTS: The overall mean LL/PL ratio was 1.02 (standard deviation 0.15). No significant differences in the LL/PL ratio were observed between sexes. The frequencies of patella alta (Insall-Salvati ratio >1.32) and patella baja (Insall-Salvati ratio <0.72) were 0.9% and 2.4%, respectively. CONCLUSION: The Insall-Salvati ratio is applicable to Vietnamese populations in which high flexion activities such as kneeling and sitting cross-legged are customary. According to our measurement, the normal range of the ratio among Vietnamese subjects was 0.72 to 1.32.

The focal hepatic hot spot sign with lung cancer in computed tomography.

The focal hepatic hot spot sign appears as an area of intense focal wedge-shaped enhancement of the quadrate lobe (segment IVa) of the liver in the arterial and venous phase. If this sign appears on enhanced computed tomography of the abdomen, obstruction of thoracic central venous must be considered, especially when clinical symptoms are unclear.

Extragastrointestinal stromal tumor presenting as an exophytic prostatic mass.

Extragastrointestinal stromal tumors (EGISTs) are uncommon manifestation of gastrointestinal stromal tumors originating from cells outside the gastrointestinal tract. Documented sites of EGISTs include the omentum, mesentery, retroperitoneum, and prostate gland. Prostatic EGISTs are rare entities, which have been sporadically observed, yet all of them were found to be confined within enlarged prostates. We herein report a rare case of EGIST in a 66-year-old man, presenting as a large exophytic prostatic mass.

Recurrence of retroperitoneal mature cystic teratoma in an adult: A case report.

Mature cystic teratoma is one of the most common tumors of the ovaries, testis, mediastinum, and retroperitoneum; however, secondary retroperitoneum lesions are rare entities in adults. We report a case of a 22-year-old female who was previously diagnosed with a mature teratoma of left ovarian was hospitalized due to dull abdominal pain in right hypochondria. Radiological evaluation revealed a mass in the right upper abdominal and flank region with an extension from the posterior aspect of the duodenum, composed of greasy and cystic elements. A tumor was resected through the Kocher's laparotomy and the pathology report confirmed the diagnosis of a mature cystic teratoma with no evidence of malignancy or immature components.

Iatrogenic Iliofemoral Vein Dissection: A Rare Complication of Femoral Artery Puncture.

Iatrogenic iliac vein dissection secondary to femoral artery puncture is a rare complication that has not yet been documented. A 55-year-old woman presented to our institution with acute right iliofemoral thrombosis 2 weeks after transfemoral cerebral angiography. She was previously healthy and was not taking any medication. Right iliofemoral vein dissection was diagnosed by computed tomography angiography and confirmed by conventional venography. The patient was treated endovascularly with stent insertion, and the venous outflow was patent on the 6-month follow-up computed tomography angiogram.

Contralateral Deep Vein Thrombosis after Iliac Vein Stent Placement in Patients with May-Thurner Syndrome.

PURPOSE: To investigate the incidence and potential causes of contralateral deep vein thrombosis (DVT) after common iliac vein (CIV) stent placement in patients with May-Thurner syndrome (MTS). MATERIALS AND METHODS: Data of 111 patients (women: 73%) who had CIV stent implantation for symptomatic MTS at a single center were retrospectively analyzed. Mean patient age was 63.1 ± 15.2 years. Median follow-up was 36 months (range, 1-142 months). Stent location was determined by venogram and classified as extended to the inferior vena cava (IVC), covered the confluence, or confined to the iliac vein. Potential causes of contralateral DVT were presumed based on venographic findings. The relationship between stent location and contralateral DVT was analyzed. RESULTS: Ten patients (9%, men/women: 4/6) exhibited contralateral DVT at a median timing of 40 months (range, 6-98 months). Median age was 69 years (range, 42-85 years). Median follow-up was 73.5 months (range, 20-134 months). Potential causes were venous intimal hyperplasia (VIH) (n = 7), "jailing" (n = 2), and indeterminate (n = 1). All patients with VIH had previous CIV stents overextended to the IVC. Overextension of CIV stent was associated with contralateral DVT (P < .001). The primary patency rate of the contralateral CIV stent was 70% at 20 months. CONCLUSIONS: Contralateral DVT after CIV stent implantation has a relatively high incidence and often occurs late during follow-up. Overextension of the CIV stent to the IVC is associated with development of contralateral DVT, and VIH should be considered a potential cause.

Evaluation of Delayed Endoleak Compared with Early Endoleak after Endovascular Aneurysm Repair.

PURPOSE: To identify prevalence and evaluate outcomes of delayed endoleak (DEL) compared with early endoleak (EEL) after endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: Data of 164 patients who underwent elective EVAR at a single center were retrospectively analyzed. DEL was defined as any type of endoleak that was first detected ≥ 12 months after EVAR. Patients who had < 1 year of follow-up were excluded. Endoleak was classified into a more aggressive category if a patient had > 1 type of endoleak. Analysis included 81 patients (82.7% male). Mean age was 73.1 years ± 9.3. Median follow-up duration was 43 months (range, 12-135 months). RESULTS: Endoleak was present in 32 patients (39.5%), including 21 EEL (25.9%) and 11 DEL (13.6%). DEL consisted of 2 type I, 5 type II, 1 type III, and 3 type V (endotension). Median time to detection was 45 months (range, 15-60 months), and median follow-up duration was 62 months (range, 37-104 months). Compared with EEL, DEL had larger aneurysm diameters and higher rates of non-type II endoleak and reintervention. Type II DEL also required more reintervention procedures than type II EEL. CONCLUSIONS: DEL had a noteworthy incidence and occurred late after EVAR. It predominantly consisted of non-type II endoleak and appeared to have more reinterventions than EEL. Meticulous long-term imaging surveillance to identify and manage DEL is critical.