Ribbing disease- radiograph to the rescue in an overlooked cause of painful shin

Ribbing disease or multiple diaphyseal sclerosis is a rare clinical entity, which is often confused with many other differential diagnoses when it primarily involves the tibia and fibula. An accurate diagnosis alleviates the need for tissue diagnosis and aids in better clinical management and outcome of the patient. The case report highlights the classical imaging findings, appearance on cross-sectional imaging, and the admirable role of radiographs in diagnosing the entity.

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Evaluation of genitourinary fistulas in pelvic malignancies with etiopathologic correlation: role of cross sectional imaging in detection and management

British Journal of Radiology ◽

10.1259/bjr.20200049 ◽

2020 ◽

Vol 93 (1111) ◽

pp. 20200049 ◽

Cited By ~ 1

Author(s):

Anitha Mandava ◽

Veeraiah Koppula ◽

Gaurav Sharma ◽

Meghana Kandati ◽

K.V.V.N. Raju ◽

...

Keyword(s):

Imaging Findings ◽

Cross Sectional ◽

Pelvic Malignancies ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Cross Sectional Imaging ◽

Sectional Imaging ◽

Ct And Mri

Objective: Genitourinary fistulas in pelvic malignancies are abnormal communications occurring due to either locally advanced tumours invading the surrounding organs or post-therapeutic complications of malignancies. In this article we review and describe the role of cross-sectional imaging findings in the management of genitourinary fistulas in pelvic malignancies. Methods: A retrospective study, for the period January 2012 to December 2018, was undertaken in patients with pelvic malignancies having genitourinary fistulas. The cross-sectional (CT and MRI) imaging findings in various types of fistulas were reviewed and correlated with the primary malignancy and the underlying etiopathology. Results: Genitourinary fistulas were observed in 71 patients (6 males, 65 females). 11 types of fistulas were identified in carcinomas of cervix, rectum, ovary, urinary bladder, sigmoid colon, vault, endometrium and prostate. The commonest were rectovaginal and vesicovaginal fistulas. 13 patients had multiple fistulas. The sensitivity, specificity, positive and negative predictive values of CT and MRI are 98%, 100%, 66%, 98% and 95%, 25%, 88% and 50% respectively. Contrast-enhanced CT with oral and rectal contrast is more sensitive and specific than MRI in the evaluation of genitourinary fistulas. Conclusion: Imaging findings significantly influence the management and outcome of genitourinary fistulas in pelvic malignancies. Contrast-enhanced CT is the imaging modality of choice in the evaluation of pelvic fistulas associated with malignancies and MRI is complimentary to it. Advances in knowledge: To our knowledge, this study is the first of its kind wherein the mean duration of occurrence of fistulas in pelvic malignancies is correlated with the underlying etiopathology.

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Imaging findings of human hepatic fascioliasis: a case report and review of the literature

Journal of Medical Case Reports ◽

10.1186/s13256-021-02945-9 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Faeze Salahshour ◽

Abasin Tajmalzai

Keyword(s):

Case Report ◽

Signal Intensity ◽

Enzyme Linked Immunosorbent Assay ◽

Low Grade ◽

Imaging Findings ◽

Cross Sectional ◽

Weighted Image ◽

Cross Sectional Imaging ◽

Sectional Imaging ◽

Peripheral Enhancement

Abstract Background Fascioliasis is a food-borne hepatobiliary zoonosis caused by Fasciola hepatica and Fasciola gigantica. Human infestations are predominantly seen in developing countries where the disease is endemic, but, due to the increase in international travel rates, hepatic fascioliasis is also appearing in nonendemic areas including Europe and the USA. The clinical and laboratory findings are usually nonspecific. Cross-sectional imaging can be very helpful in the diagnosis of fascioliasis as well as to differentiate it from other liver diseases with a very similar clinical picture. The objectives of this case report are to discuss imaging findings of hepatic fascioliasis and to review the literature. Case presentation We report the case of a 35-year-old Iranian patient who presented with right upper quadrant pain, low-grade fever, fatigue, and anorexia. The patient had a history of recent travel to the Gilan Province of Iran, almost a month before the onset of symptoms, which is an endemic area of fascioliasis in the country. Laboratory examinations revealed eosinophilia, elevated hepatic enzymes, and slightly raised C-reactive protein. Contrast-enhanced computed tomography of the patient shows clusters of focal ill-defined hypodense lesions with mild peripheral enhancement in the right liver lobe and subcapsular regions. Magnetic resonance imaging of the liver revealed multiple ill-defined lesions of low signal intensity on the T1-weighted image and high signal intensity on the T2-weighted image, extending from the liver capsule into deeper parenchyma toward periportal regions, which shows mild peripheral enhancement on post-contrast images. Imaging-based diagnosis of fascioliasis was made depending on the characteristic distribution of subcapsular tracts/lesions on the above-mentioned imaging, which was then confirmed by serologic tests using enzyme-linked immunosorbent assay. The patient was treated with triclabendazole, showing great clinical improvement, and was eventually discharged in good health condition. Conclusion The imaging findings in this case report highlight the importance of cross-sectional imaging for further evaluation of suspected cases of fluke-induced liver disease. The hypothesis of hepatic fascioliasis should be always considered when consistent radiological findings are observed. Clusters of tortuous subcapsular lesions with peripheral contrast enhancement extending into deeper liver parenchyma are characteristic imaging findings that strongly suggest hepatic fascioliasis.

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Cross-sectional imaging of head trauma: a retrospective analysis of the incidence, and imaging findings of traumatic brain injury in King Fahad Hospital, Al-Ahsa, Saudi Arabia

International Journal of Medicine in Developing Countries ◽

10.24911/ijmdc.51-1546788085 ◽

2019 ◽

pp. 663-668

Author(s):

Qasem Alalwan ◽

Hisham Dossary ◽

Hassan Alsayegh ◽

Maram Alothman

Keyword(s):

Traumatic Brain Injury ◽

Saudi Arabia ◽

Brain Injury ◽

Retrospective Analysis ◽

Head Trauma ◽

Imaging Findings ◽

Cross Sectional ◽

Cross Sectional Imaging ◽

Sectional Imaging

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P264. Meta-analytic Bayesian model for differentiating intestinal tuberculosis from Crohn’s disease utilising clinical, endoscopic, and cross-sectional imaging findings, and the interferon-gamma releasing assay

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjw019.383 ◽

2016 ◽

Vol 10 (suppl 1) ◽

pp. S225-S226

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Interferon Gamma ◽

Bayesian Model ◽

Intestinal Tuberculosis ◽

Imaging Findings ◽

Cross Sectional ◽

Cross Sectional Imaging ◽

Sectional Imaging

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Cross-Sectional Imaging of Small Bowel Malignancies

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2010.10.001 ◽

2012 ◽

Vol 63 (3) ◽

pp. 215-221 ◽

Cited By ~ 8

Author(s):

Dellano D. Fernandes ◽

Ram Prakash Galwa ◽

Najla Fasih ◽

Margaret Fraser-Hill

Keyword(s):

Small Bowel ◽

Accurate Diagnosis ◽

Imaging Features ◽

Cross Sectional ◽

Conventional Endoscopy ◽

Cross Sectional Imaging ◽

Pretreatment Staging ◽

Sectional Imaging ◽

Histologic Subtypes

Small bowel malignancies are rare neoplasms, usually inaccessible to conventional endoscopy but detectable in many cases by cross-sectional imaging. Modern multidetector computed tomographies permit accurate diagnosis, complete pretreatment staging, and follow-up of these lesions. In this review, we describe the cross-sectional imaging features of the most frequent histologic subtypes of the small bowel malignancies.

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Unusual cross-sectional imaging findings in hepatic peliosis

European Radiology ◽

10.1007/s00330-002-1675-9 ◽

2003 ◽

Vol 13 (8) ◽

pp. 1916-1919 ◽

Cited By ~ 25

Author(s):

K. Steinke ◽

L. Terraciano ◽

W. Wiesner

Keyword(s):

Imaging Findings ◽

Cross Sectional ◽

Cross Sectional Imaging ◽

Hepatic Peliosis ◽

Sectional Imaging

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Routine surveillance of patients post Fontan palliation: lessons learnt from cardiac catheterisation

Journal of Congenital Cardiology ◽

10.1186/s40949-021-00057-z ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Maria Victoria Ordonez ◽

Giovanni Biglino ◽

Radwa Bedair

Keyword(s):

Clinical Management ◽

Liver Stiffness ◽

Adult Patients ◽

Cardiac Catheterisation ◽

Cross Sectional ◽

Lateral Tunnel ◽

Cross Sectional Imaging ◽

Sectional Imaging ◽

Diagnostic Catheter ◽

Fontan Palliation

Abstract Background There is no consensus on the clinical utility of ‘routine’ diagnostic cardiac catheterisation in patients with Fontan palliation in the absence of symptoms or haemodynamic lesions. Objective We sought to evaluate whether diagnostic cardiac catheterisation for a variety of indications led to a change in the clinical management of patients with a Fontan circulation. Methods All adult patients (≥16 years) with Fontan palliation undergoing diagnostic cardiac catheterisation at our institution from 2016 to 2019 were included retrospectively. Patients undergoing electrophysiological studies were excluded as haemodynamic measurements were not taken. Routine cardiac catheterisation at our institution is considered in adult patients who have not had a diagnostic cardiac catheter for more than 5 years. Results Thirty-eight patients, mean age 27 ± 7 years, 60% NYHA I, 31% NYHA II, 8% NYHA III, at mean duration post Fontan of 20 ± 6 years, lateral tunnel (LT) n = 20, extracardiac (EC) n = 14 and atriopulmonary (AP) n = 4, underwent 41 diagnostic cardiac catheterisation procedures. Indication for cardiac catheterisation was as follows: haemodynamic lesion identified on cross-sectional imaging in 12; routine catheterisation in 9; cyanosis in 8; dyspnoea in 8; significant liver stiffness on ultrasound hepatic elastography in 2; and arrhythmia in 2. Of the 9 patients undergoing routine diagnostic catheterisation, 3 had not had any diagnostic catheterisation since their Fontan completion and, in the remaining six, the mean time lapsed since the last diagnostic catheter was 8 ± 3 years. The diagnostic catheterisation led to a recommended change in clinical management on 24 occasions (59%): catheter intervention in 17 (40%); surgery in 4 (10%); medication change in 3 (17%); and transplant referral in 2 (5%). The clinical indications that led to changes in clinical management were: cyanosis (8/8), dyspnoea (7/8), haemodynamic lesions on cross-sectional imaging (8/11) and arrhythmia (1/2). None of the 9 patients listed for routine diagnostic catheterisation or as a result of findings on ultrasound hepatic elastography had a recommended change in clinical management. Conclusion Diagnostic cardiac catheterisation frequently leads to changes in the clinical management of patients with Fontan palliation presenting with dyspnoea, cyanosis, and for further evaluation of potential haemodynamic lesions identified on cross-sectional imaging. Routine cardiac catheterisation in the absence of the above indications had limited impact on clinical management in our cohort.

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