Valoración ecográfica del neuroma de Morton / Ultrasound examination of morton´s neurona

Objetivo: Se ha realizado un estudio para evaluar la utilidad diagnóstica de la ecografía en el neuroma de Morton. Material y Metódos: Se evaluaron mediante estudio ecográfico del antepie a veinticinco pacientes con sintomatología clínica sugestiva de neuroma de Morton. Todos los pacientes fueron sometidos a tratamiento quirúrgico. Resultados: Diecinueve pacientes mostraron evidencia ecográfica de neuroma, confirmándose mediante cirugía y estudio histológico. Un paciente con sospecha ecográfica no obtuvo confirmación quirúrgica. Los cinco pacientes restantes no mostraron evidencia ecográfica no quirúrgica, a pesar de presentar sintomatología clínica. No se observaron neuromas múltiples. La fiabilidad diagnóstica de la ecografía para la localización de los neuromas fue del 96,7 porciento. La ultrasonografía demostró una sensibilidad del 100 porciento y una especificidad del 83,3 porciento para la identificación de los neuromas. Conclusiones: La ecografía es una técnica con un alto rendimiento para la identificación y localización de los neuromas de Morton (AU)

[Echography evaluation of Morton's neuroma]. / Valoración ecográfica del neuroma de Morton.

OBJECTIVE: We have carried out a study to evaluate diagnostic usefulness of ultrasound in Morton's neuroma. METHODS: Twenty five patients with symptoms suggestive of Morton's neuroma underwent ultrasound examination of the forefoot. All patients subsequently had surgical treatment. RESULTS: Nineteen patients had sonographic evidence of neuroma which were confirmed surgically and later by histological exams. One patient had sonographic evidence of a neuroma that was not confirmed surgically. The remaining five patients did not have sonographic or surgical evidence of neuroma in spite of clinical signs and symptoms. No adjacent neuromas were appreciated. Ultrasound accurately predicted the location of the neuroma in 96.7%. Ultrasound demonstrated a sensitivity of 100% and a specificity of 83.3%. CONCLUSION: We conclude that ultrasound is a highly accurate technique in the diagnosis of the presence and location of Morton's neuromas.

Osteopoiquilosis: a propósito de un caso / Osteopoikilosis: a case report

La ostepoiquilosis es una alteración esquelética infrecuente que se engloba dentro de las distrofias óseas, cuya herencia es autosómica dominante con penetrancia incompleta que se manifiesta por áreas opacacificadas en las regiones metafiso-epifisarias de los huesos largos y ausencia de manifestaciones clínicas. Se presenta un caso de un varón de 21 años, asintomático con afectación ósea múltiple en las radiografías practicadas, sin otras alteraciones asociadas y que fue detectado en un "Examen preventivo de salud", no padeciendo la enfermedad ni sus progenitores, ni la hermana del paciente (AU)

[The diagnostic performance of echography and CT in pancreatic diseases producing extrahepatic cholestasis]. / Rendimiento diagnóstico de la ecografía y TC en las enfermedades del páncreas productoras de colestasis extrahepática.

A hundred and fifty patients with jaundice and analytical suspicion of extrahepatic cholestasis were studied prospectively; history, laboratory investigation and ultrasound examination were realized. Computerized tomography was performed in 146 patients. Ultrasonography and computerized tomography findings were confirmed by CPRE o CPTH and surgery. Ultrasonography has a sensitivity of 92.6% while that of computerized tomography was 87.2% for the identification of dilated biliary ducts. The accuracy of ultrasonography was higher than the one obtained in computerized tomography in cholangiocarcinoma (sensitivity: 77.7%) and gallbladder carcinoma (sensitivity: 100%). Computerized tomography recognized choledocholithiasis (sensitivity: 83.3%) and ampullary carcinoma (sensitivity: 88.8%) with better accuracy. However for pancreatic carcinoma (sensitivity: 88.8%) and pancreatitis (sensitivity: 83.3%) both examinations had the same accuracy.

[Extrahepatic cholestasis: the echographic and CT findings]. / Colestasis extrahepática: hallazgos mediante ecografía y TC.

One hundred and fifty patients with jaundice and analytical suspicion of extrahepatic cholestasis were studied prospectively; history laboratory investigation and ultrasound examination were done in all. Computerized tomography was performed in 46 patients. Ultrasonography has a sensitivity of 92.6% while that of computerized tomography was 87.2% for the identification of dilated biliary ducts. Computerized tomography demonstrated the level of obstruction with a sensitivity of 89.1%, being most useful at the suprapancreatic and ampullary levels, while ultrasound examination had a sensitivity of 80%. The accuracy of ultrasonography was higher than the one obtained in computerized tomography in cholangiocarcinoma (sensitivity: 77%) and gallbladder carcinoma (sensitivity: 100%). Computerized tomography recognized choledocholithiasis (sensitivity: 83%) and ampullary carcinoma (sensitivity: 75%) with better accuracy. However for pancreatic carcinoma (sensitivity: 87%) and pancreatitis (sensitivity: 88%) both examinations had the same accuracy.