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May 2019 Issue

 




Other Radiology articles from the Neuroradiology section Neuroradiology

Methadone-induced Toxic Encephalopathy In Pediatric Patients: Two Case Reports by Siew Ching Tiong et al.

Published: 2019 May
Issue: 13(5) :: Pages: 1-9


Free full text article: Methadone-induced Toxic Encephalopathy  In Pediatric Patients: Two Case Reports

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Abstract: Toxic encephalopathy is a wide spectrum of encephalopathy secondary to insult from toxic substances, with variable clinical presentations from minor cognitive impairment to severe neurological dysfunction and death. Methadone-induced toxic encephalopathy is an extremely rare form of toxic encephalopathy which typically demonstrates abnormal imaging findings in the dentate nuclei or cerebellum. This is a report of methadone-induced toxic encephalopathy in two toddlers secondary to accidental ingestion. They were brought in unconscious to the emergency department of a tertiary hospital and were found to be cyanotic and pulseless, requiring cardiopulmonary resuscitation and mechanical ventilation. Magnetic resonance imaging (MRI) of the brain of both patients showed similar findings of symmetrical hyperintense foci in bilateral cerebellar hemispheres on T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences. These areas also demonstrated diffusion restriction on diffusion weighted imaging (DWI). Blood and urine toxicology results confirmed the presence of methadone in both patients. As the exact substance of accidental ingestion may not be known at the time of presentation, early radiological diagnosis of methadone-induced encephalopathy may prompt early initiation of treatment to prevent further life-threatening complications, particularly in vulnerable pediatric population.


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Magnetic Resonance Imaging, Table

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Other Radiology articles from the General Radiology section General Radiology

Leiomyosarcoma of the Inferior Vena Cava with Hepatic and Pulmonary Metastases: Case Report by Andrew Sephien et al.

Published: 2019 May
Issue: 13(5) :: Pages: 30-40


Free full text article: Leiomyosarcoma of the Inferior Vena Cava with Hepatic and Pulmonary Metastases: Case Report

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Abstract: Sarcomas are connective tissue tumors accounting for only 1% of all adult malignancies. Leiomyosarcoma (LMS) is a sarcoma arising from smooth muscle cells, and accounts for 10-20% of all sarcomas. A subtype of LMS are those originating from the smooth muscle of blood vessels. Leiomyosarcoma of the inferior vena cava is a sarcomatous tumor, with less than 350 cases described in the literature. It carries a poor prognosis, with 5- and 10-year survival rates of 31.4% and 7.4%, respectively. We present a case of a 46-year-old female with no significant past medical history presented to the emergency department with mild abdominal pain and distention, early satiety, and weight loss for three weeks, found to have unresectable metastatic leiomyosarcoma of the inferior vena cava.


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Computed Tomography, Microscopic pathology, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Epiploic Appendagitis in a Femoral Hernia by Donald McArthur et al.

Published: 2019 May
Issue: 13(5) :: Pages: 10-14


Free full text article: Epiploic Appendagitis in a Femoral Hernia

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Abstract: Both epiploic appendagitis and femoral herniae are rare diagnoses individually. No radiological cases of a patient having epiploic appendagitis within a femoral hernia have been documented in the literature. We present a case of a 65-year-old patient who underwent clinical work-up for a tender left groin lump. When undergoing a CT scan for investigating possible lymphadenopathy, she was found to have epiploic appendagitis contained within an incarcerated left sided femoral hernia. In this case report, we review the relevant anatomy, aetiology, patient demographics, as well as clinical and imaging findings and management.


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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Klippel-Feil Syndrome with Sprengel Deformity by Georgi P Georgiev et al.

Published: 2019 May
Issue: 13(5) :: Pages: 24-29


Free full text article: Klippel-Feil Syndrome with Sprengel Deformity

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Abstract: Coexistence of Klippel-Feil syndrome with Sprengel deformity and omovertebral bone is a rare complex bone abnormality with unknown incidence and etiology. Herein, we report a case of a 6-year-old girl with coexistence of these congenital abnormalities evaluated by three-dimensional computed tomography. We also make a brief review and discuss in details the role of this imaging modality in the evaluation of such complex cases.


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Computed Tomography, Table

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Other Radiology articles from the Musculoskeletal Imaging section Musculoskeletal Imaging

Intra-prosthetic dislocation of dual mobility hip prosthesis: an original and unusual complication by Nicolas Piette et al.

Published: 2019 May
Issue: 13(5) :: Pages: 15-23


Free full text article: Intra-prosthetic dislocation of dual mobility hip prosthesis: an original and unusual complication

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Abstract: A 78-year-old female presented with dislocation of a dual mobility hip prosthesis. On standard radiographs after closed reduction, the hip prosthesis appeared to be properly reduced, but clinically the hip was unstable. A Computed Tomography showed a round foreign body, that was in fact a dislocation of the intra-prosthetic implant. This was confirmed intra-operatively during revision surgery. Intra-prosthetic dislocation is a specific complication of dual mobility system. Classically, it`s a late complication, linked to the wear of retention area of the polyethylene insert. In this case report we describe an unusual reason of intra-prosthetic dislocation caused by a reduction maneuver of a dislocated dual mobility total hip prosthesis, which to our knowledge has never been documented with Computed Tomography imagery and intra operative pictures. The aim of this article is to analyse the advantages and complications of this implant and to establish recommendations. Dealing with an intra-prosthetic dislocation of a dual mobility hip prosthesis, we recommend attempting a reduction under general anesthesia to avoid mechanical complications. In case of persistent instability after reduction, we recommend performing a Computed Tomography scan.


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Conventional Radiography, Computed Tomography, Clinical image, Other, Table





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