RESUMO
We report 3 cases of snapping medial meniscus due to hypermobility confirmed on extension and flexion MR imaging. The anterior horn of the medial meniscus was anteriorly subluxed during extension with reduction during flexion. Analysis of our imaging data and a review of the literature confirm that this relates to hypermobile medial meniscus, an anatomical variant.
Assuntos
Luxações Articulares/diagnóstico , Instabilidade Articular/diagnóstico , Articulação do Joelho/patologia , Imageamento por Ressonância Magnética/métodos , Meniscos Tibiais/patologia , Adolescente , Adulto , Artroscopia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular/fisiologia , Sinovite/diagnósticoRESUMO
PURPOSE: The purpose of our study was to determine evolutive patterns and signs of active tuberculosis on high resolution CT (HRCT) scans. METHOD: We followed up over 15 months 27 patients with postprimary pulmonary tuberculosis that was proven bacteriologically. CT scans were performed before, during, and after 6 months of anti-tuberculosis treatment. Both 10-mm-thick sections and 1.5-mm-thick HRCT scans were performed. RESULTS: Ground-glass pattern was noticed 26 times, 9 times after 2 month treatment and only 2 times after 6 month treatment. Among these two patients, one did not undergo his treatment properly and the other one had an additional bacterial infection. Centrilobular nodules (n = 17) and poorly marginated nodules (n = 21) were present only before treatment. Reticular pattern (intralobular and septal thickening), interstitial nodules, and fibrosis were seen both before and after treatment. Ground-glass pattern, poorly marginated nodules, and infiltrates as well as centrilobular nodules were related to an active infection. CONCLUSION: This HRCT may be helpful to demonstrate activity in patients suspected of having tuberculosis and to assess antituberculous treatment efficiency.
Assuntos
Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos , Tuberculose Pulmonar/diagnóstico por imagem , Adolescente , Adulto , Idoso , Antituberculosos/uso terapêutico , Progressão da Doença , Feminino , Seguimentos , Humanos , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tuberculose Pulmonar/tratamento farmacológicoRESUMO
A 37 year-old man had headaches for 10 days, then a single tonic-clonic seizure and coma due to an extensive cerebral venous thrombosis. In spite of full-dose heparin treatment for 7 days, the clinical picture worsened along with increasing edema on CT-Scan. Direct thrombolytic treatment was then performed using transvenous catheterization and instillation of Urokinase (2.6 MU over 4 days). A near complete repermeabilization of the sinuses was obtained and the patient improved dramatically in a few days. The only adverse effect of Urokinase was hematuria. Based on our experience and review of the literature which includes 26 previous cases, direct thrombolytic therapy appears to be a relatively safe procedure. This treatment should be considered in a patient with extensive dural sinus thrombosis which fails to respond to heparin treatment.
Assuntos
Embolia e Trombose Intracraniana/tratamento farmacológico , Ativadores de Plasminogênio/administração & dosagem , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagem , Adulto , Cateterismo Periférico , Resistência a Medicamentos , Heparina , Humanos , Injeções , Masculino , Terapia TrombolíticaRESUMO
UNLABELLED: The aim of this study was to evaluate chest radiographs and computed tomography (CT) in patients with thoracic actinomycosis. MATERIAL AND METHOD: Chest radiographs and CT scans of 9 patients with proved thoracic actinomycosis were reviewed. CT scans were performed after intravenous contrast administration. RESULTS: Airspace consolidation was present in the upper lobes in 6 patients and in the lower lobes in 3. Cavitations not apparent on the radiographs were seen on CT s in 2 cases. Mediastinal lymphadenopathies were seen on CT s in 2 cases, in one the infection extended through the mediastinal pleura into the mediastinum. Pleural thickening adjacent to the airspace consolidation was identified in 6 cases. Chest wall invasion occurred in 4 cases with a wavy periostal reaction involving ribs adjacent to the site of parenchymal involvement in 3 cases. Extension into the abdomen through the diaphragm was seen in one case. DISCUSSION: In humans, actinomycosis involves the thorax in 15% of the cases. Thoracic and pulmonary parenchymal involvement is usually secondary to aspiration of colonized material from the oropharynx in patients with poor oral hygiene. There is a basilar predominance of the disease, but some studies have reported apical predominance. The pulmonary infection leads to an airspace consolidation mainly in the lung periphery. The infection may extend across fissures and through the pleura. Chest wall and bone invasion are not uncommon. A wavy periosteal reaction involving ribs is said to be highly suggestive of pulmonary actinomycosis. CONCLUSION: Thoracic actinomycosis is characterized by airspace consolidation with adjacent pleural thickening. Chest wall invasion with a wavy periosteal reaction is highly suggestive.
Assuntos
Actinomicose/diagnóstico por imagem , Radiografia Torácica , Doenças Torácicas/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Feminino , Humanos , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico por imagemRESUMO
We described on computed tomography, two cases of pleural tuberculosis with parietal pleural enhancement and thickening associated with another external high density line. We called this parietal pleural and extra pleural change, the "double band sign". After study of the regional anatomy, we think that this external line is the endothoracic fascia.