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Introduction: Transplantation with fresh cadaveric osteochondral allograft (FOCA) is frequently used in defects of the femoral condyle and tibial plateau to preserve the knee joint. However, the use of FOCA in bipolar lesions remains controversial in cases with bipolar defects and a history of infection. Case Report: We present a 21-year-old male patient with a massive post-traumatic osteochondral defect of the lateral compartment of the knee and a history of infection, treated by a two-stage approach. In stage 1, infection was eradicated, and joint function recovered with aggressive debridement, polymethyl methacrylate beads, bone cement spacers, and Judet's quadricepsplasty. In stage 2, transplantation was performed with a bipolar FOCA. All treatments were planned using 3D-printed models. Conclusion: The two-stage approach and 3D planning can increase the chances of transplant success by preparing the future allograft bed and obtaining an optimal match between the cadaveric allograft and the patient's defect in cases with potential contraindications, such as a bipolar lesion in the femoral condyle and tibial plateau and a history of infection. A combined approach may lead to a more beneficial outcome for the patient to preserve joint function and improve quality of life.

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Background: The intracranial migration of a ventriculoperitoneal shunt (VPS) has been previously described, it is a very rare event, and the mechanisms of this migration have not yet been elucidated. Case Description: Newborn at 38 weeks of gestation by cesarean section, with congenital hydrocephalus due to Dandy-Walker malformation that required right Frazier VPS placement. At 2-month follow-up, computed tomography of the skull showed cranial migration of VPS and dysfunction. At evaluation, there were signs of systemic infection. External ventricular drainage was placed and an intravenous antibiotic scheme for Gram-positive bacteria was started. After 3 months, cerebrospinal fluid cultures were negative and definitive VPS was decided. Conclusion: Different possible mechanisms have been proposed, such as negative intraventricular pressure, positive intra-abdominal pressure, use of valveless catheters, excessive burr hole size, as well as such as occipital ventricular access, thin cortical mantle, incorrect distal and proximal fixation, short distance between the peritoneum and ventricles, and a possible inflammatory reaction to the catheter material (silicone). A combination of these different mechanisms contributes to proximal shunt migration. Although the placement of a VPS is a procedure well taught since the 1st years of neurosurgical residency, it is not exempt from complications. Although, as was previously stated in this paper, the incidence of a complete cranial VPS migration is extremely rare, and only a few cases are documented, it is still important to report this type of cases and to try to elucidate the possible mechanisms involved.

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Parathyroid hormone (PTH) has direct and indirect actions on cardiovascular cells. The effects of chronic hypoparathyroidism on cardiac morphology, function, and conduction are still unclear. Low PTH states are associated with multiple manifestations in the heart, acute or chronic. Acute hypocalcemic cardiomyopathy is a transient dilated cardiomyopathy with reduced ejection fraction and diffuse left ventricular hypokinesia. Chronic hypoparathyroidism-associated cardiomyopathy is a rare disease that may cause reduced myocardial tension, cardiac cavity enlargement, arrhythmias, and congestive heart failure. Here, we describe a 73-year-old woman with chronic hypoparathyroidism and hypocalcemia, who developed a hypertrophic cardiomyopathy, and not a dilated hypocalcemia-associated cardiomyopathy, which would be usually the case.

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Bilateral symmetric striatopallidal calcinosis with or without deposits in dentate nucleus, thalamus, and white matter is reported in patients ranging from asymptomatic, metabolic, toxic, and genetic autosomal dominant, familial or sporadic forms. Of the connective tissue diseases, it has been reported in very few cases in patients with systemic lupus erythematosus, many incorrectly labeled as Fahr syndrome without even having hypoparathyroidism. Here we describe a 30-year-old female patient with neuropsychiatric systemic lupus erythematosus manifested at diagnosis with mood disorders and anxiety, and 1-year later develops Lupus headache; Incidentally, an aneurism of the right middle cerebral artery and bilateral and symmetric calcifications of the caudate and lenticular nuclei were noted; this finding is a rarely reported manifestation of neuropsychiatric systemic lupus erythematosus. A review of the literature based on this case was carried out in electronic databases. There are approximately 29 patients reported in the literature, with calcifications in the basal ganglia associated with systemic lupus erythematosus occurs almost exclusively in young women (96.5%) with a mean age of 33.36 years (2 months-76 years), with a race predilection for Asians (65.5%). Regarding the neuropsychiatric syndromes defined by the American College of Rheumatology, the most frequently associated are movement disorders; followed by cognitive dysfunction, seizure disorders, mood disorders, cerebrovascular disease, psychosis, and acute confusional state, transverse myelitis, and demyelinating syndrome. The mean duration time of the SLE to detection of the basal ganglia calcification is 7.62 years (3 days-31 years).

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BACKGROUND: To date, there is no specific antiviral therapy for severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) that causes Coronavirus disease 2019 (Covid-19). Since there is no specific therapy against SARS-CoV2, current efforts aim to prevent contagion through public health measures and develop a protective vaccine. While waiting for the latter, it is necessary to evaluate the drugs that at least, in initial studies, suggested some degree of utility in the management of Covid-19 or its complications. The main objective of the study was to describe the clinical manifestations and outcomes of patients with severe Covid-19 Pneumonia treated with corticosteroids and colchicine. MATERIALS AND METHODS: A cross sectional study of 301 adult patients with Covid-19 Pneumonia confirmed by Real-Time Polymerase Chain Reaction for SARS-CoV2 (RT-PCR SARS-CoV2), Berlin protocol, who required hospitalization in three hospitals in Antioquia, Colombia. Patients were treated according to the institutional protocol (from March 20, 2020 to June 30, 2020) with corticosteroid if the patient required supplemental oxygen. From July 1, 2020, the management protocol changed with the addition of colchicine to all patients admitted to the institutions. The treatment was supervised and monitored by the same specialist in Infectology of the institutions. We describe the clinical manifestations and outcomes of the patients who received these treatments. The information of the patients was analyzed according to the outcome of interest (alive/dead) with univariate, bivariate, and multivariate measures to adjust the variables that presented statistical association. RESULTS: All patients had pneumonia documented by chest computed tomography with ground glass images and presented an alveolar pressure/inspired oxygen fraction (PaFi) less than 300. Three hundred one patients were included, 240 (79.7%) received corticosteroids, within these 145 (48.2%) received colchicine also, and the remaining 61 (20.3%) patients did not receive corticosterioids or colchicine. Mortality in the group that received colchicine was lower compared to the group that did not receive it (9.6 vs 14.6%, p-value = 0.179). CONCLUSIONS: Treatment with corticosteroids and colchicine for managing patients with severe Covid-19 Pneumonia was associated with low mortality at the hospital level. Randomized, placebo-controlled studies are required to evaluate the effect of corticosteroids and colchicine on complications or death from Covid-19.

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Abstract Introduction: Actinomycosis is a rare infectious disease that affects abdominal organs and simulates oncological disease, hardly ever presents itself as a cause of intestinal obstruction. Symptoms: A 43 years old, male patient with two months of left abdominal pain associated to a growth and an 8 kg weight loss, no fever or bowel habit disruption. Interventions: A colonoscopy and an abdominal scanography. Results: A solid heterogeneous 7 × 3.8 cm mass localized in the splenic flexure of the colon with infiltration of its walls and its surrounding fat. Colon cancer was considered as the first diagnostic possibility. During hospitalization, the patient was taken to an emergency exploratory laparotomy, due to an acute abdominal pain with bowel obstruction symptoms. Histopathological diagnosis: Actinomycetoma. Conjoint continuous monitoring with the infectious disease attending, abdominal US and observation did not show new growths. Weight gain and progressive return to daily life was obtained within 8 weeks. Conclusion: In low income countries, intestinal actinomycosis should be considered in the differential diagnosis of abdominal masses and chronic inflammatory processes, patient prognosis with proper management is excellent.

Resumo Introdução: A actinomicose é uma doença infecciosa rara que acomete órgãos abdominais, simula doença oncológica e dificilmente causa de obstrução intestinal. Sintomas: Paciente do sexo masculino, 43 anos, com quadro de dor abdominal esquerda por dois meses, associado ao surgimento de massa e perda de peso de 8 kg, sem febre ou alterações dos hábitos intestinais. Intervenções: Colonoscopia e uma tomografia computadorizada abdominal. Resultados: Observou-se massa sólida heterogênea de 7 × 3,8 cm localizada na flexão esplênica do cólon, com infiltração de suas paredes e gordura adjacente. Câncer de cólon foi a primeira possibilidade diagnóstica considerada. Durante a internação, o paciente foi submetido a uma laparotomia exploradora de emergência, devido a uma dor abdominal aguda com sintomas de obstrução intestinal. Diagnóstico histopatológico: Actinomicetoma. Monitoramento contínuo em conjunto com o tratamento da infecção, ultrassom abdominal e observação; não foram observados novos crescimentos. Ganho de peso e retorno progressivo à vida diária foram observados por oito semanas. Conclusão: Em países de baixa renda, a actinomicose intestinal deve ser considerada no diagnóstico diferencial de massas abdominais e processos inflamatórios crônicos; com manejo adequado, o prognóstico é excelente.

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INTRODUCCIÓN: La artritis reumatoide es una enfermedad multifactorial, sistémica, crónica, autoinmune e inflamatoria, que afecta fundamentalmente las articulaciones. La ultrasonografía/ecografía ha demostrado utilidad en la detección de sinovitis subclínica; sin embargo, la mayoría de la evidencia disponible es en pacientes en remisión y la evidencia para la correlación con el índice de actividad clínica (DAS-28), en Colombia, es limitada. OBJETIVOS: Establecer la correlación entre la actividad clínica medida por DAS-28 y la ecografía, en pacientes con artritis reumatoide. MATERIALES Y MÉTODOS: Cuarenta pacientes con diagnóstico de artritis reumatoide que iniciaron terapia biológica o leflunomida, fueron incluidos en el estudio descriptivo, longitudinal, prospectivo para evaluar la correlación entre el DAS-28 y la ecografía, en la consulta basal y a los 4 meses.RESULTADOS: Se encontró; correlación entre el índice de actividad clínico de la enfermedad (DAS-28) y el índice de actividad ecográfico (DAS ecográfico), tanto por escala de grises (r=0,943,p<0,01) como por Power Doppler(r =0,946, p <0,01); también se encontró; correlación entre el DAS ecográfico por escala de grises y el DAS ecográfico por Power Doppler (r= 0,953 ,p <0,01). CONCLUSIONES: La ecografía es de utilidad en la detección de inflamación subclínica y los resultados son concluyentes cuando se compara el número de articulaciones inflamadas en la evaluación clínica, con el conteo obtenido en la evaluación ecográfica. La evaluación ecográfica sugiere que las manos son las articulaciones con mejor rendimiento para la medición del grado de sinovitis en la artritis reumatoide

NTRODUCTION: Rheumatoid arthritis is a multifactorial, systemic, chronic, autoimmune, and inflammatory disease that mainly affects the joints. Ultrasound has shown to be useful in detecting subclinical synovitis; however, most of the available evidence is in patients on remission, and the evidence on a correlation with the clinical activity measured by DAS-28, in our midst, is limited. OBJECTIVE: To establish the correlation between clinical activity measured by DAS-28 and ultrasound in patients with rheumatoid arthritis. MATERIALS AND METHODS: A total of 40 patients diagnosed with rheumatoid arthritis who were started on biological therapy or leflunomide were included in the descriptive, longitudinal, prospective study to evaluate the correlation between DAS-28 and ultrasound at baseline visit and 4 months later. RESULTS: A correlation was found between DAS-28 and ultrasound, both by using the grayscale (r = 0.943, p <.01) and the power Doppler (r = 0.946, p <.01). There was also a correlation between the ultrasound DAS by grayscale and ultrasound DAS by power Doppler (r = 0.953, p<.01). CONCLUSIONS: Ultrasound is a useful tool for detecting sub-clinical inflammation and the results are conclusive when comparing the number of swollen joints in the clinical evaluation with the count obtained in the ultrasound assessment. Ultrasound evaluation suggests that the hands are the joints with better performance for measuring the grade of synovitis in rheumatoid arthritis

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BACKGROUND: Magnetic resonance imaging is an essential tool in the pre-surgical evaluation of patients with drug-resistant epilepsy. OBJECTIVE: Our aim was to assess the value of re-imaging patients with focal drug-resistant epilepsy. METHODS: Thirty patients with negative or non-conclusive 1.5 Tesla magnetic resonance imaging were rescanned with 1.5T and 3T. All of them had previous 1.5 scans with no seizure protocol in a non-specialized center. Two neuroradiologists who were blinded to prior imaging results randomly reviewed the magnetic resonance images. Kappa score was used to assess the reliability. RESULTS: Mean age of patients was 30 (SD ± 11) years. The intra-observer agreement for the first radiologist was 0.74 for 1.5T and 0.71 for 3T. In the second radiologist it was 0.82 and 0.66, respectively. Three lesions (10%) were identified by general radiologists in non-specialized centers using a 1.5T standard protocol. In our center a consensus between two neuroradiologists using epilepsy protocol identified seven lesions (23%) using 1.5T and 10 (33%) using 3T (p < 0.01). In 28% of patients this additional information resulted in a change in clinical management. CONCLUSIONS: 3T magnetic resonance imaging rescanning improves the diagnostic yield in patients with focal epilepsy and previous negative 1.5T magnetic resonance imaging. Use of 3T magnetic resonance imaging, epilepsy protocols, and interpretation by experienced neuroradiologists is highly recommended.

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This is a case report of a successful right ventricle stab wound suture through a video-assisted pericardial thoracoscopic window, avoiding the need of a thoracotomy diminishing its associated risks, morbidity and costs. A 22-year-old patient was admitted to the emergency room with a stab wound on the left side of his chest, the patient showed symptoms of dyspnea and signs of pulmonary hypoventilation on his left lung, a chest tube were placed on the affected side with an improvement on his symptoms. A video-assisted thoracoscopic pericardial window (VATPW) was performed within the next 24 hours to rule out underlying heart wound. A VATPW shows a 1 cm right ventricle wound which was treated through the same portals avoiding a thoracotomy. The left chest tube was removed 48 hours after de procedure and the patient underwent a control echocardiogram, with no abnormalities reported and no symptoms of dyspnea, respiratory distress or palpitation the patient was subsequently discharged. The VATPW is a feasible and safe procedure to rule out underlying heart injury in individualized cases and it provides a minimally invasive treatment option in selected patients avoiding major surgery like thoracotomy or sternotomy and the added morbidity that carry with them.

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Objetivo: Hacer una revisión del abordaje diagnóstico por imágenes de los tumores óseos y resaltar la importancia de la radiografía convencional y sus debilidades. Métodos: Se realizó una búsqueda de artículos en PubMed con términos MeSH de tumores óseos relacionados con radiografía simple y resonancia magnética, seleccionando los de mayor relevancia para este trabajo. Conclusiones: A pesar de las limitaciones que tiene la radiografía convencional y todas las ventajas que tiene la resonancia magnética, sigue siendo la "placa simple", junto con la edad del paciente, el estudio de elección para una adecuada aproximación diagnóstica en tumores óseos.

Objective: A review of the radiologic diagnostic approach and the importance and limitations of conventional radiography are discussed in this paper. Methods: An article search was performed in PubMed with MeSH terms including bone neoplasms, conventional radiography and magnetic resonance. The most relevant articles were selected for this paper. Conclusions: Despite the limitations of conventional radiography and the advantages of magnetic resonance imaging, conventional radiography along with the age of the patient are still the initial approach to diagnosis of bone tumors.

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La enfermedad de moyamoya es una rara afección cerebrovascular, caracterizada por estenosis bilateral de la carótida interna en su porción terminal y por el desarrollo de vasculatura colateral anormal en la base del cerebro, secundario a un proceso isquémico. Su etiología es desconocida, pero se cree que es un trastorno genético. En el presente artículo, a propósito de un caso clínico de un paciente masculino de 24 años de edad con diagnóstico de esta enfermedad luego de un trauma craneano, se presenta una revisión corta de la bibliografía actual en cuanto al diagnóstico por imágenes de la enfermedad de moyamoya.

Moyamoya disease is a rare cerebrovascular disease characterized by bilateral internal carotid artery stenosis in its terminal portion and by the development of abnormal collateral vasculature in the base of the brain, secondary to an ischemic process. Its etiology is unknown, but it is believed to be a genetic disorder. The purpose of this article is a short review of the current literature of diagnostic imaging of moyamoya disease regarding the case of a 24 year old male patient with this condition, diagnosed after head trauma.

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Determinar la prevalencia de restricción del crecimiento intrauterino (RCIU) en el Hospital Universitario San José (HUSJ), describir sus características y hacer una exploración de los factores de riesgo asociados a RCIU. Materiales y métodos: estudio de corte transversal en el que se incluyeron los recién nacidos vivos en un hospital universitario de referencia ubicado en la región suroccidental de Colombia en el año 2013, se excluyeron aquellos con información inconsistente. Se definió recién nacido con restricción del crecimiento intrauterino (RCIU) como el neonato vivo con índice ponderal (Rohrer) menor al percentil 10, IP = [peso (en gramos) x 100] ÷ [longitud (en cm)]3. Para el tamaño de muestra se tuvo en cuenta una prevalencia esperada de RCIU del 4 %, un error tolerado del 2 %, corrección por población finita y por no respuesta del 20 %, obteniendo así un tamaño muestral de 400 sujetos. Se realizó un muestreo aleatorio sistemático. Se utilizó un cuestionario semi-estructurado, que incluyó variables biológicas, sociales y demográficas. Se estimó la prevalencia de periodo de RCIU y se realizó exploración de los factores asociados a RCIU por medio de análisis bi y mutivariado. Se utilizó la prueba t de Student para variables continuas y chi cuadrado para categóricas.Resultados: el análisis se realizó con 392 neonatos; se excluyeron 8, por inconsistencia en la información suministrada; se encontraron 79 neonatos con RCIU para una prevalencia del 20,15 %. En la exploración de los factores de riesgo se encontró una asociación positiva con RCIU y ganancia inadecuada de peso (OR = 2,35; IC 95 %: 1,15-4,82), antecedente de RCIU (OR = 3,26; IC 95 %: 1,08-9,78), amenaza de parto pretérmino (OR = 3,58; IC 95 %: 1,15-11,1), antecedente de cesárea (OR = 2,64; IC 95 %: 1,24- 5,60), y una asociación negativa entre etnia mestiza y raza blanca (OR = 0,25; IC 95 %: 0,07-0,91). Conclusión: la prevalencia encontrada fue del 20,15%, la cual es mayor que la reportada en otras instituciones de este mismo nivel de complejidad...

To determine the prevalence of Intra-uterine Growth Restriction (IUGR) at San Jose University Hospital (HUSJ), describe its characteristics, and explore risk factors associated with IUGR.Materials and methods: Cross-sectional study of live neonates delivered in a referral university hospital located in Southwestern Colombia in 2013. Cases with inconsistent information were excluded. Neonates with intra-uterine growth restriction (IUGR) were defined as live neonates with a ponderal index (Rohrer) below the 10th percentile, PI = [weight (in grams) x 100] ÷ [length (in cm)]3. For the sample size, the following was taken into consideration: expected IUGR prevalence of 4%, 2% tolerated error, finite population correction and 20% non response, resulting in a final sample size of 400 subjects. A systematic random sampling was performed. A semi-structured questionnaire including biological, social and demographic variables was used. The prevalence of the IUGR period was estimated. Factors associated with IUGR were explored using bivariate and multivariate analyses. The Student t test was used for continuous variables and the Chi square test was used for categorical variables.Results: Overall, 392 neonates were included in the analysis, and 8 were excluded because of inconsistent information. There were 79 neonates with IUGR, for a prevalence of 20.15%. When the risk factors were explored, a positive association was found between IUGR and inadequate weight gain (OR = 2.35; 95% CI: 1.15-4.82), history of IUGR (OR = 3.26; 95% CI: 1.08-9.78), threat of preterm delivery (OR = 3.58; 95% CI: 1.15-11.1), and prior C-section (OR = 2.64; 95% CI: 1.24-5.60), and a negative association was found with mestizo ethnic background and white race (OR = 0.25; 95% CI: 0.07-0.91).Conclusion: The prevalence was found to be 20.15%, which is higher than that reported in other institutions of similar complexity level...

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Economic evaluation of pharmacological cancer treatment is a critical clinical problem currently under consideration worldwide. We have analysed their main characteristics in Spain between 1990 and 2010 following a systematic review of the 29 complete economic analyses published. The pathology most frequently evaluated was non-small cell lung cancer (31 %). Cost-effectiveness analyses (69 %) were the most frequent analyses. A wide range of incremental cost-effectiveness values (295-160,667 € /QALY) has been reported, and mostly are developed from the perspective of the National Health System (65.5 %). However, none of the studies estimated the indirect costs. The major conclusion is that the absence of regulations concerning the application of the efficiency criterion in decision-making on the subject of price and financing and, most importantly, the fact that these are not included in Spanish hospitals forms make it difficult to analyse the real impact of economic evaluations of cancer treatments on such decisions.

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La cadera en resorte interno es un síndrome que se produce por un resalto anormal del tendón del iliopsoas sobre la cabeza femoral. Este fenómeno se presenta asintomático en el 5 % a 10 % de la población, pero en algunos casos puede haber limitación funcional por dolor. El diagnóstico es clínico, aunque las imágenes radiológicas ayudan a descartar otras causas de dolor. El tratamiento inicial es conservador, pero ante la persistencia de los síntomas debe considerarse la cirugía. La tenotomía artroscópica ha demostrado buenos resultados clínicos sin diferencias significativas con respecto al nivel del corte del tendón, presentando un menor riesgo de complicaciones que la vía abierta, por lo que actualmente se considera una buena alternativa. En este artículo se describe la técnica artroscópica de la tenotomía transcapsular del iliopsoas con radiofrecuencia.

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Introducción. Para la obtención de imágenes con calidad diagnóstica en la población pediátrica por medio de la resonancia magnética es necesario usar la sedación profunda asistida por un anestesiólogo, dado que ésta garantiza la inmovilidad completa del paciente para el adecuado desarrollo del examen. Objetivo. Describir el uso de sedación profunda asistida por un anestesiólogo en los estudios de resonancia magnética para población pediátrica. Métodos. Estudio observacional de serie de casos; se eligieron aleatoriamente 113 exámenes de resonancia magnética asistida por anestesiólogo en pacientes menores de 15 años de edad, atendidos en la Fundación Instituto de Alta Tecnología Médica de Antioquia en el 2009; y para la concordancia entre observadores se evaluaron 84 exámenes con sus respectivas series de imágenes. Resultados. Los tiempos promedio de sedación de las resonancias magnéticas más comunes fueron: cráneo simple, 45,2 ± 12,4 minutos; cráneo contrastado, 46,3 ± 16,7 minutos; cardiaca, 96 ± 24,1 minutos; angio de cráneo, 60 ± 16,8 minutos, y cráneo-columna total, 76,3 ± 32 minutos. Al ajustar por sexo no se hallaron diferencias significativas (p > 0,05). Los medicamentos sedantes empleados para estos exámenes fueron: midazolam, ketamina, propofol, hidrato de cloral y fentanyl. Respecto a la fiabilidad de las series de imágenes de los pacientes con sedación profunda, se halló una excelente concordancia entre observadores (Kappa > 0,9). Conclusión. Se considera la sedación asistida por un anestesiólogo un procedimiento con baja tasa de complicaciones, el cual puede ser usado con mayor frecuencia en la población pediátrica para la obtención de imágenes con calidad diagnóstica en pacientes con comorbilidades y en procedimientos de resonancia magnética complejos.

Objetive. Obtaining diagnostic quality images in the pediatric population using magnetic resonance imaging, requires the use of deep sedation assisted by the anesthesiologist to ensure the totalimmobility of the patient for an adequate examination. Objective. To describe the use of deep sedation assisted by an anesthesiologist in magnetic resonance studies for the pediatric population. Methodos. Observational study of a series ofcases. 113 randomly selected MRI scans, with assisted sedation by an anesthesiologist in pediatric patients aged less than 15, treated at the Fundación Instituto de Alta Tecnología Médica de neAntioquia in 2009. The inter-observer consistency was evaluated in 84 examinations with their corresponding series of images.Results. Average sedation time for the most common MRIs were are follows: cerebral MRI, 45.2 ± 12.4 minutes; cerebral with contrast, 46.3 ± 16.7 minutes; cardiac, 96 ± 24.1 minutes; cerebral angiography, 60 ± 16.8 minutes and cerebral-total spine, 76.3 ± 32 minutes. No significant gender-adjusted differences were found (p > 0.05). The sedatives used for these examinations were: midazolam, ketamine, propofol, chloral hydrate and fentanyl. Excellent inter-observer consistency was found in terms of the reliability of the series of images of deep sedation patients (Kappa > 0.9).Conclusions. Sedation assisted by an anesthesiologist is considered a procedure with a low rate of complications that can be used more often in the pediatric population for obtaining diagnostic quality images in patients with co-morbidities and in complex MRI procedures.

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La tendinitis alrededor del tobillo es bastante común en deportistas de alto y mediano rendimiento, y muy frecuente en bailarines de ballet, comprometiendo especialmente el tendόn del flexor largo del hallux en la regiόn retromaleolar interna, con engrosamiento tendinoso, crepitaciόn y dificultad para el desempeño en las actividades que exigen posiciones forzadas del pie y del hallux. Esta patología puede ser subdiagnosticada ya que usualmente mejora con el reposo. En algunos casos requiere del manejo quirúrgico para liberar el tendόn del flexor largo del hallux en el túnel fibro-όseo por donde transcurre normalmente. Se reporta aquí el caso de una paciente de 52 años, quien no practica ningún tipo de actividad deportiva, y que requiriό el manejo quirúrgico luego de un manejo conservador fallido por un año.

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Se realizó un estudio retrospectivo durante un año, desde junio de 2006 a junio de 2007. Se examinaron un total de diez tipos de lesiones focales hepáticas en 60 pacientes, con descripción de sus características por resonancia magnética (RM) utilizando secuencias de T1, T2 y T1 posgadolinio dinámica con supresión grasa y sin esta. Las lesiones se clasificaron en tumores benignos o malignos y se propuso un diagnóstico. Se hicieron diagnósticos específicos como quiste simple, absceso, hemangioma, hiperplasia nodular focal, carcinoma hepatocelular y colangiocarcinoma.

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Las lesiones, tanto agudas como crónicas, de rodilla son una causa frecuente de consulta en la población general y en los deportistas. Además de las lesiones de ligamentos y meniscos, existe un gran número de patologías que produce rodilla dolorosa o limitación funcional, que tienen un tratamiento diferente o pueden modificar el tratamiento inicial. De ahí que la resonancia magnética sea un método eficaz para el estudio y diagnóstico de estas patologías. En este artículo se describen algunas de estas patologías, cuyos estudios fueron realizados en el Instituto de Alta Tecnología Médica de Antioquia (IATM).

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