Vanessa de Albuquerque Dinoá

Aspectos radiográficos e ultra-sonográficos dos pacientes submetidos a alongamento ósseo pelo método de Ilizarov

Ten patients treated with Ilizarov external fixator for limb lengthening were monitored with radiographs and sonography examinations between March, 2001 and March, 2002. Most of the patients were children and adolescents who were submitted to surgery for correction of congenital deformities (six cases). In three patients shortening was secondary to post-traumatic osteomielitis and in one patient due to tumor resection. The femur was affected in 60%, tibia in 30% and fibula in 10% of the cases. The main radiographic findings of bone regeneration during the normal process of limb lengthening were lucent areas, linear ossification, periosteal reaction, soft tissue abnormalities and complete consolidation. Sonographic findings of new bone formation included anechoic areas, sparse echogenic foci within the distraction site, linear longitudinally oriented echogenic foci, amorphous and coarse echogenic foci and complete calcification. There were 15 complications in six patients: fluid collection at the distraction site (five cases), pin site infection (four cases), soft tissue collection (three cases), premature consolidation (two cases) and delayed consolidation (one case).

Synovitis of the knee following a high-pressure injection injury with hydraulic oil

High-pressure injection injuries occur when equipment capable of achieving high pressure injects its contents into the human body. These injuries are largely occupational and may present as small entrance wounds with very few symptoms. However, they represent a surgical emergency, often requiring amputation. They characteristically involve the upper extremities, but other regions of the body may be injured. We present the case of a 26-year-old man who sustained a high-pressure injection injury with hydraulic oil to the knee and a literature review of this type of accident. To our knowledge, this report is the first to describe such an injury to the knee, with magnetic resonance imaging findings.

Congenital lobar emphysema

http://dx.doi.org/10.1590/0100-3984.2016.0144 Kelly Tung1, Ba D. Nguyen1 1. Department of Radiology, Mayo Clinic, Arizona, Scottsdale, AZ, USA. Mailing address: Ba D. Nguyen, MD. Department of Radiology, Mayo Clinic, Arizona. 13400 East Shea Blvd., Scottsdale, AZ, 85259. E-mail: nguyen.ba@mayo.edu. malignancy. Isolated EMPD, without a coexisting internal primary lesion, is usually an indolent, slow-growing cancer that rarely metastasizes. Rare invasive EMPD has a propensity to metastasize to inguinal nodal basins. EMPD involving the external genitalia has a strong association with gastrointestinal and genitourinary adenocarcinomas. A small subset of invasive EMPD cases show signet-ring cell morphology with extracellular mucin. Immunohistochemical analysis establishes the distinction between signet-ring cells intrinsic to EMPD and those originating from coexisting visceral neoplasms. Poor prognostic factors include dermal invasion, nodular skin lesions, lymph node involvement, and distant metastasis. Given the multiple presentations of EMPD and their varying prognoses, there is a need to identify distant metastases and the primary visceral tumor: that effort is facilitated by functional F-FDG PET/CT imaging.

Postictal MRI features with a unilateral pattern

A 14-year-old female presented with focal seizure and secondary generalized convulsive status epilepticus lasting 2 hours. Electroencephalography revealed diffuse slow waves. Magnetic resonance imaging performed 2 days after onset demonstrated cortical swelling, gyri effacement, and restricted diffusion affecting the right temporal and parietal lobes (Figure). The differential diagnosis of these abnormalities included infarction, ischemia, venous thrombosis, vasculitis, infection, neoplasm, and metabolic encephalopathy. Because imaging findings were resolved completely after 38 days without specific treatment aside from supportive seizure therapy, infarction, venous thrombosis, vasculitis, infection, and neoplasm became less likely. Seizure-induced transient cerebral swelling was the most probable diagnosis.