Asunto(s)
Granulomatosis Orofacial , Humanos , Granulomatosis Orofacial/diagnóstico , Granulomatosis Orofacial/patología , Granulomatosis Orofacial/tratamiento farmacológico , Masculino , Labio/patología , Femenino , Diagnóstico Diferencial , Enfermedades de los Labios/diagnóstico , Enfermedades de los Labios/patología , Edema/etiologíaAsunto(s)
Edema , Extremidad Inferior , Humanos , Edema/etiología , Masculino , Femenino , Persona de Mediana EdadRESUMEN
OBJECTIVE: To review the role of sacro-iliac magnetic resonance imaging (MRI) in the diagnosis of axial spondyloarthritis (AxSpA), with a focus on gender differences. METHODS: The experience of the authors and the results of an informal literature review are reported. RESULTS: Inflammatory changes of the sacro-iliac joint are the hallmark of AxSpA. Early, non-radiographic sacroiliitis may be diagnosed with MRI through the assessment of bone marrow edema (BMO) as well as concomitant structural damage. The MRI protocol should include three necessary sequences, i.e., fat-saturated T2-weighted sequences on two orthogonal planes, T1-weighted semi-coronal sequence, and fat-suppressed T1-weighted semi-coronal sequence. Inflammatory changes comprise required signs (BMO and/or osteitis) and additional signs, including synovitis (better defined as joint space enhancement), enthesitis, and capsulitis. Structural changes consist of erosions, sclerosis, fat metaplasia, and ankylosis. Due to mechanical axial strain, inflammatory changes in the sacro-iliac joint can be found in healthy individuals, runners, and patients with nonspecific low back pain. The prevalence of BMO is higher in women during pregnancy and postpartum, even 12 months after childbirth, but the extent and distribution of MRI findings may help in the differential diagnosis. Other challenges in the MRI diagnosis of sacroiliitis are subchondral T2 hyperintensity during developmental age, periarticular sclerosis in healthy subjects, or osteitis condensans ilii, and several pathological conditions that may mimic AxSpA, some of which are more frequently found in women. CONCLUSIONS: The described diagnostic challenges impose a multidisciplinary approach combining imaging findings with clinical and laboratory data.
Asunto(s)
Espondiloartritis Axial , Imagen por Resonancia Magnética , Articulación Sacroiliaca , Sacroileítis , Humanos , Imagen por Resonancia Magnética/métodos , Articulación Sacroiliaca/diagnóstico por imagen , Femenino , Diagnóstico Diferencial , Sacroileítis/diagnóstico por imagen , Espondiloartritis Axial/diagnóstico por imagen , Factores Sexuales , Masculino , Embarazo , Edema/diagnóstico por imagen , Edema/etiología , Sinovitis/diagnóstico por imagen , Osteítis/diagnóstico por imagen , Bursitis/diagnóstico por imagen , Complicaciones del Embarazo/diagnóstico por imagenRESUMEN
OBJECTIVE: We aimed to evaluate the diagnostic performance of dual-energy computed tomography (DECT) in detecting bone marrow edema (BME) in patients with lower limb joint injuries. METHODS: A thorough literature search was conducted across the PubMed, Embase, and Web of Science databases to identify relevant studies up to April 2024. Studies examining the diagnostic performance of DECT in detecting BME in lower limb joint injuries patients were included. Sensitivity and specificity were evaluated using the inverse variance method and transformed via the Freeman-Tukey double arcsine transformation. Furthermore, the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to evaluate the methodological quality of the included studies. RESULTS: This meta-analysis included 17 articles involving 625 patients. The pooled sensitivity, specificity, and AUC for DECT in detecting BME in lower limb joint injuries patients were 0.82 (95 % CI: 0.76-0.87), 0.95 (95 % CI: 0.92-0.97), and 0.95 (95 % CI: 0.93-0.97), respectively. The pooled sensitivity of DECT for detecting BME in knee, hip, and ankle joint injuries was 0.80, 0.84, and 0.80, with no significant difference among these joints (P = 0.55). The pooled specificity for knee, hip, and ankle injuries was 0.95, 0.97, and 0.89. Specificity differed significantly among the joints (P < 0.01), with the highest specificity in hip injuries. CONCLUSIONS: Our meta-analysis indicates that DECT demonstrates high diagnostic performance in detecting BME in patients with lower limb joint injuries, with the highest specificity observed in hip joint injuries. To validate these findings, further larger prospective studies are necessary.
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Edema , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Humanos , Tomografía Computarizada por Rayos X/métodos , Edema/diagnóstico por imagen , Edema/etiología , Extremidad Inferior/diagnóstico por imagen , Extremidad Inferior/lesiones , Enfermedades de la Médula Ósea/diagnóstico por imagen , Enfermedades de la Médula Ósea/etiología , Médula Ósea/diagnóstico por imagenAsunto(s)
Amiloidosis , Artritis Reumatoide , Edema , Nefritis Lúpica , Proteinuria , Anciano , Femenino , Humanos , Diagnóstico Diferencial , Edema/diagnóstico , Edema/tratamiento farmacológico , Edema/etiología , Riñón/patología , Riñón/diagnóstico por imagen , Proteinuria/diagnóstico , Proteinuria/tratamiento farmacológico , Proteinuria/etiología , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Fiebre/diagnóstico , Fiebre/etiología , Mano/diagnóstico por imagen , Biopsia con Aguja Gruesa , Nefritis Lúpica/complicaciones , Nefritis Lúpica/diagnóstico , Nefritis Lúpica/patología , Amiloidosis/sangre , Amiloidosis/diagnóstico , Amiloidosis/tratamiento farmacológico , Artritis Reumatoide/sangre , Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico , Artritis Reumatoide/tratamiento farmacológico , Proteína Amiloide A Sérica/análisisRESUMEN
The differential diagnosis of dysphagia and dyspnoea with cervicofacial oedema is wide and includes diseases with variable prognosis that may require an urgent approach. This article presents the case of a middle-aged man who came to the emergency room referring to the symptoms described, with a history of central venous access established approximately 4 years ago. The patient was diagnosed with superior vena cava syndrome and treated with anticoagulants and removal of the catheter. After a week of admission with anticoagulation, the patient clinically improved with a considerable decrease in thrombus and pharyngolaryngeal and subcutaneous mucosal oedema. In the differential diagnosis of dysphagia and dyspnoea, we must also consider systemic diseases, and more specifically, these symptoms such as those described, and think about this entity because of its severity.
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Trastornos de Deglución , Síndrome de la Vena Cava Superior , Humanos , Síndrome de la Vena Cava Superior/etiología , Síndrome de la Vena Cava Superior/diagnóstico , Masculino , Trastornos de Deglución/etiología , Trastornos de Deglución/diagnóstico , Persona de Mediana Edad , Diagnóstico Diferencial , Anticoagulantes/uso terapéutico , Disnea/etiología , Cateterismo Venoso Central/efectos adversos , Edema/etiologíaAsunto(s)
Edema , Estenosis de la Válvula Pulmonar , Escroto , Humanos , Masculino , Escroto/patología , Escroto/diagnóstico por imagen , Estenosis de la Válvula Pulmonar/diagnóstico por imagen , Estenosis de la Válvula Pulmonar/complicaciones , Edema/etiología , Edema/diagnóstico por imagen , Edema/patología , Edema/diagnóstico , Diagnóstico Diferencial , Válvula Pulmonar/diagnóstico por imagen , Válvula Pulmonar/anomalías , Válvula Pulmonar/patologíaRESUMEN
A rare lymphoproliferative disorder involving thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), renal dysfunction (R), and organomegaly (O), called TAFRO syndrome, was first reported in 2010. Considered a variant of idiopathic multicentric Castleman's disease, the recent discovery and rarity of this syndrome pose challenges to diagnosis and management. Herein, we review three pediatric cases, including an infant, that illustrate the heterogeneity of TAFRO syndrome. Despite differences in presentation and treatment responses, all patients experienced excellent outcomes. This multi-institutional case series highlights the need to work toward earlier diagnosis and improved long-term management recommendations for patients with TAFRO syndrome.
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Enfermedad de Castleman , Trombocitopenia , Adolescente , Femenino , Humanos , Lactante , Masculino , Enfermedad de Castleman/patología , Enfermedad de Castleman/diagnóstico , Enfermedad de Castleman/terapia , Edema/patología , Edema/etiología , Fiebre/etiología , Síndrome , Trombocitopenia/terapia , Trombocitopenia/diagnóstico , Trombocitopenia/patologíaRESUMEN
INTRODUCTION: Vaginal delivery has several benefits for the parturient; however, during labor, some injuries, such as lacerations and/or episiotomy, can occur. Perineal pain may occur in the puerperium and can be aggravated in cases of perineal injury during childbirth, potentially impacting the physical and emotional aspects of the parturient. For this reason, it is necessary to use techniques that can relieve pain and edema in the immediate postpartum period, directly influencing recovery. OBJECTIVE: To compare the reduction of pain and improvement in healing using two techniques, namely photobiomodulation and cryotherapy, performed in the immediate postpartum period of up to 12 h, in parturients who suffered grade I and II lacerations and/or episiotomy. METHODS: Data collection was carried out through an evaluation questionnaire. Photobiomodulation was applied using the red and infrared laser from the DMC brand. The EVA and McGill scales were used for pain assessment, and the REEDA scale was used for the evaluation of edema and healing. RESULTS: The techniques were evaluated and applied to 56 patients, with 28 in each group (cryotherapy and LBI). Patients who received photobiomodulation showed superior improvement compared to cryotherapy. In the immediate postpartum period, there was a greater reduction in pain in favor of photobiomodulation (p = 0.008); and after 24 h, the difference was even more significant (p < 0.001).
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Crioterapia , Edema , Episiotomía , Laceraciones , Terapia por Luz de Baja Intensidad , Perineo , Periodo Posparto , Humanos , Femenino , Crioterapia/métodos , Perineo/lesiones , Episiotomía/efectos adversos , Adulto , Edema/prevención & control , Edema/terapia , Edema/etiología , Embarazo , Laceraciones/terapia , Terapia por Luz de Baja Intensidad/métodos , Enfermedades de la Vulva/terapia , Vulva , Adulto Joven , Dimensión del Dolor , Parto Obstétrico/efectos adversosAsunto(s)
Edema , Luz Solar , Humanos , Luz Solar/efectos adversos , Edema/etiología , Femenino , Masculino , Dermatosis Facial/etiología , Cara , Persona de Mediana EdadRESUMEN
Background and Objectives: The aim of this study was to investigate the efficacy of a single preoperative dose of deflazacort on pain, swelling, and trismus after impacted lower third molar surgery. Materials and Methods: This randomised, prospective, double-blind, split-mouth clinical study included 26 healthy individuals with bilaterally impacted lower third molars. Group 1 was given a placebo (single-dose vitamin C tablet), and group 2 was given a single 30 mg dose of deflazacort 1 h prior to surgery. Pain was evaluated using the visual analogue scale for 1 week postoperatively. Oedema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. The Mann-Whitney U test was applied for group analyses. p values < 0.05 were considered statistically significant. Results: Postoperative pain scores were significantly lower in the deflazacort group at the 6th and 12th hours after surgery (p < 0.05). There were no significant differences in trismus between the groups at any time point (p > 0.05). There was less oedema in the deflazacort group on postoperative days 2 and 7, without any statistically significant difference (p > 0.05). Conclusions: A single preoperative dose of 30 mg deflazacort was found to be clinically effective in reducing pain and oedema after extraction of impacted lower third molars.
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Edema , Tercer Molar , Dolor Postoperatorio , Pregnenodionas , Diente Impactado , Trismo , Humanos , Trismo/prevención & control , Trismo/etiología , Tercer Molar/cirugía , Dolor Postoperatorio/tratamiento farmacológico , Femenino , Masculino , Edema/prevención & control , Edema/etiología , Adulto , Método Doble Ciego , Diente Impactado/cirugía , Estudios Prospectivos , Pregnenodionas/uso terapéutico , Pregnenodionas/administración & dosificación , Extracción Dental/efectos adversos , Extracción Dental/métodos , Adulto Joven , Dimensión del Dolor/métodosAsunto(s)
Enfermedades de la Médula Ósea , Errores Diagnósticos , Edema , Osteomielitis , Humanos , Osteomielitis/diagnóstico , Edema/diagnóstico , Edema/etiología , Enfermedades de la Médula Ósea/diagnóstico , Síndrome , Valor Predictivo de las Pruebas , Resultado del Tratamiento , Enfermedad Crónica , Masculino , Femenino , Imagen por Resonancia MagnéticaRESUMEN
RATIONALE: TAFRO syndrome is a systemic inflammatory disorder, manifesting as thrombocytopenia (t), anasarca (a), fever (f), reticulin myelofibrosis/renal insufficiency (r), and organomegaly (o), and considered as a unique clinical subtype of idiopathic multicentric Castleman disease (iMCD). Such syndrome gave rise to a clinical picture similar to that of either a connective tissue disease or an autoimmune disease. PATIENT CONCERNS: A Chinese young female initially presenting with arthralgia, Raynaud phenomenon, generalized edema, and a positive anti-small nuclear ribonucleoprotein particle antibody was diagnosed as mixed connective tissue disease. The kidney biopsy showed thrombotic microangiopathy. Bone marrow smear showed bone marrow hyperplasia and biopsy revealed suspected light chain restricted expression, megakaryocyte proliferation, and moderate to severe bone marrow fibrosis. A lymph node biopsy was conducted and the histopathological findings were consistent with the subtype of mixed Castleman disease. The clinical symptoms were relieved after regular chemotherapy. DIAGNOSES: After above examination results and clinical manifestations, the final diagnoses was TAFRO syndrome. INTERVENTION: The she was started on chemotherapy with bortezomib, cyclophosphamide, and dexamethasone. OUTCOME: After chemotherapy, symptoms such as thrombocytopenia, hematuria and proteinuria disappeared, lymphadenopathy and VEGF level decreased, and bone marrow fibrosis relieved. LESSONS: Our case illustrated the first cases of shared characteristics of mixed connective tissue disease and iMCD-TAFRO syndrome. Cytokines may play a role in the shared pathogenicity of the iMCD-TAFRO syndrome and systemic autoimmune diseases. Therapy directly against inflammatory factors such as corticosteroids or chemotherapy have an important therapeutic implication.
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Enfermedad de Castleman , Diagnóstico Tardío , Trombocitopenia , Humanos , Femenino , Enfermedad de Castleman/diagnóstico , Enfermedad de Castleman/tratamiento farmacológico , Enfermedad de Castleman/patología , Trombocitopenia/diagnóstico , Síndrome , Ciclofosfamida/uso terapéutico , Fiebre/etiología , Edema/diagnóstico , Edema/etiología , Bortezomib/uso terapéutico , Adulto , Dexametasona/uso terapéuticoRESUMEN
BACKGROUND: Immunoglobulin A vasculitis, historically known as Henoch-Schönlein purpura, is a rare form of autoimmune-induced vasculitis most common in children. This disease is characterized by a purpuric rash, arthritis, digestive tract complication, and renal inflammation (Hopkins). CASE REPORT: We present the case of a 78-year-old man in the emergency department with findings of weakness, abdominal pain, and bloody diarrhea for 3 days and a new-onset bilateral lower extremity rash. Diagnostic imaging and labs diagnosed this patient with immunoglobulin A vasculitis (IgAV) with associated acute kidney injury and abdominal mesenteric edema. Why Should an Emergency Physician be Aware of This? Recognition of IgAV by emergency physicians and assessment of multiple organ involvement is critical to expedite treatment and minimize complications. Particularly, physicians should consider and recognize the increased severity and different presentation of IgAV in adults in comparison with the more widely known manifestation in children.
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Dolor Abdominal , Vasculitis por IgA , Humanos , Masculino , Anciano , Dolor Abdominal/etiología , Vasculitis por IgA/complicaciones , Vasculitis por IgA/diagnóstico , Vasculitis por IgA/fisiopatología , Lesión Renal Aguda/etiología , Servicio de Urgencia en Hospital/organización & administración , Edema/etiologíaRESUMEN
BACKGROUND: Data in the literature on the results of Kinesio taping (KT) application after cast removal in patients with distal radius fracture (DRF) are quite limited. PURPOSE: It was aimed to evaluate the effectiveness of KT applied immediately after cast removal in addition to the exercise program on edema, functionality, range of motion, and muscle strength in patients with conservatively followed DRF. STUDY DESIGN: Randomized controlled single-blinded clinical study. METHODS: This study was conducted with 64 patients with a diagnosis of DRF. The patients were randomized as Kinesio taping group (KTG) and control group. Both groups received a conventional home exercise program. KT was applied to patients in KTG for 10 days. Circumference and volume measurements were taken at baseline and day 10. Arm, Shoulder, and Hand Questionnaire for Disability, Visual Analog Scale, grip strength, and wrist joint range of motion measurements were taken at baseline, day 5, and day 10. RESULTS: The circumference difference between the affected extremity and the healthy extremity was statistically greater in the control group on the fifth day at the wrist level (<0.001) and 6 cm proximal to the wrist (p = 0.001). The circumference difference between the affected extremity and the healthy extremity was statistically greater in the control group on the 10th day at the wrist level (p < 0.05) and 6 cm proximal to the wrist (p = 0.01). Wrist extension angle (<0.001), wrist flexion angle (p = 0.001), and supination angle (p = 0.001) were higher in KTG on the 10th day. On the 10th day, the grip strength (p < 0.05) was higher in the KTG, while the Visual Analog Scale value (p < 0.01), Arm, Shoulder, and Hand Questionnaire for Disability score (p < 0.01), and the percentage of strength loss in the healthy arm (p < 0.01) were lower in the KTG. CONCLUSIONS: In patients with DRF who were treated conservatively with a cast, the inclusion of Kinesio taping (KT) in the rehabilitation program was found to be effective in reducing edema and pain, as well as improving functionality, strength, and range of motion.
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Cinta Atlética , Moldes Quirúrgicos , Edema , Fracturas del Radio , Rango del Movimiento Articular , Humanos , Método Simple Ciego , Masculino , Fracturas del Radio/terapia , Fracturas del Radio/rehabilitación , Femenino , Rango del Movimiento Articular/fisiología , Edema/etiología , Persona de Mediana Edad , Fuerza de la Mano/fisiología , Adulto , Articulación de la Muñeca/fisiopatología , Fuerza Muscular/fisiología , Anciano , Terapia por Ejercicio/métodos , Tratamiento Conservador , Fracturas de la MuñecaRESUMEN
This case report describes a man in his mid 40s, with a history of chronic smoking, who presented with dysphonia. He underwent microlaryngoscopy and biopsy for a suspicious lesion on the anterior right vocal cord. Mask ventilation proved difficult on induction of general anaesthesia due to a solid lesion acting as a ball valve into the glottis. This mass was LASER debulked and sent for histopathology. This demonstrated a haematoma, likely traumatic in origin, with some polypoidal features, consistent with advanced Reinke's oedema. Reinke's oedema is a benign condition where chronic inflammation causes fluid accumulation within the vocal cords. Long-standing inflammation leads to disarrangement of the vocal cord lamina propria, causing fluid accumulation and thereby resulting oedema of the vocal cords. This process can subsequently lead to polyp formation and can cause gravelly voice. This case report describes the potential airway sequelae of this benign condition.
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Disfonía , Laringoscopía , Pliegues Vocales , Humanos , Masculino , Pliegues Vocales/patología , Disfonía/etiología , Edema Laríngeo/etiología , Edema Laríngeo/diagnóstico , Edema/etiología , Adulto , Enfermedades de la Laringe/cirugía , Enfermedades de la Laringe/diagnóstico , Hematoma/cirugíaRESUMEN
BACKGROUND: Mirror syndrome is a rare disease characterized by "triple edema", while Hemolytic Uremic Syndrome (PHUS) is a serious disease that occurs within a short period of time after the end of pregnancy, with a low prevalence and poor prognosis, and it is even rarer for both to occur in the same patient. METHODS: We report a case of mirror syndrome combined with PHUS and analyze the clinical data to improve the understanding of the disease. RESULTS: The patient presented clinically with "triple edema" and was diagnosed with mirror image syndrome. After cesarean section, the patient developed cardiac insufficiency, renal insufficiency, hemolysis, and other symptoms and was diagnosed as PHUS. After active treatment, the maternal prognosis was good. CONCLUSIONS: Mirror syndrome and PHUS are both clinically rare diseases with poor long-term prognosis if not diagnosed and treated in a timely manner; therefore, awareness of the diseases, early and accurate diagnosis and timely and correct treatment should be improved.