The syndrome of pericarditis, arthritis, and camptodactyly: an under-recognized cause of pericardial constriction in children?

1999 ◽  
Vol 9 (5) ◽  
pp. 526-528 ◽  
Author(s):  
Alfonso Buendía ◽  
Fause Attié ◽  
Manuel Martínez-Lavin
Keyword(s):  
Differential Diagnosis ◽  
Pericardial Effusion ◽  
Correct Diagnosis ◽  
Skeletal Abnormalities

AbstractThe syndrome encompassing the combination of pericarditis, arthritis, and camptodactyly is a rarely described cause of pericardial constriction in children. It is likely that this association is being under-recognized. We report a new case in which the skeletal abnormalities were subtle. The syndrome should be included in the differential diagnosis of any child with persistent non-inflammatory pericardial effusion. A careful search at the bedside for the associated skeletal abnormalities should lead to the correct diagnosis. Pericardiectomy is the treatment of choice.

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Errors ◽  
Epileptic Seizures ◽  
Routine Clinical Setting ◽  
Choice Of Treatment ◽  
Transient Loss ◽  
Factual Content ◽  
Patient’S History ◽  
Linguistic Methods

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

scholarly journals Cardiac magnetic resonance imaging in differential diagnosis of cardiac masses

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
EC D"angelo ◽  
P Paolisso ◽  
L Bergamaschi ◽  
A Foa ◽  
I Magnani ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pericardial Effusion ◽  
Tissue Characterization ◽  
Descriptive Analysis ◽  
Gadolinium Enhancement ◽  
Malignant Lesions ◽  
T1 And T2 ◽  
Cardiac Masses

Abstract Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): S. Orsola Hospital Background  Differential diagnosis of cardiac masses represents a challenging issue with important implications for therapeutic management and patient’s prognosis. Cardiac Magnetic Resonance (CMR) is a non-invasive imaging technique used to characterize morphologic and functional features of masses. Integration of these information can lead an accurate diagnosis. Purpose  To evaluate the diagnostic role of CMR in defining the nature of cardiac masses. Methods : Ninety-three patients with cardiac masses evaluated with CMR were enrolled. All masses had histological certainty. CMR sequences allowed a qualitative morphologic description as well as tissue characterization. Evaluation of masses morphology included localization, size and borders assessment, detection of potential multiple lesions and pericardial effusion. Tissue characterization resulted from an estimation of contrast enhancement - early gadolinium enhancement (EGE) and late gadolinium enhancement (LGE) sequences - and tissue homogeneity in T1 and T2 weighted acquisitions. The descriptive analysis was carried out by comparing benign vs malignant lesions as well as dividing patients into 4 subgroups: primitive benign tumours, primitive malignant tumours, metastatic tumours and pseudotumours.  Results  The descriptive analysis of the morphologic features showed that diameter > 50mm, invasion of surrounding planes, irregular margins and presence of pericardial effusion were able to predict malignancy (p < 0.001). As for tissue characteristics, heterogeneous signal intensity - independently from T1 and T2 weighted acquisitions - and EGE were more common in malignant lesions (p <0.001). When analysing the four subgroups, CMR features did not discriminate between primitive malignant masses and metastasis. Conversely, hyperintensity signal and EGE were able to distinguish benign primitive lesions from pseudotumors (p = 0.002).  Furthermore, using classification and regression tree (CART) analysis, we developed an algorithm to differentiate masses: invasion of surrounding planes was a common characteristic of malignancy and identifies itself malignant tumors. In the absence of invasive features, gadolinium enhancement was evaluated: the lack of contrast uptake was able to exclude a pseudotumor diagnosis and reduced the probability of a primary benign tumor.  Conclusions Cardiac magnetic resonance is a very powerful diagnostic tool for differential diagnosis of cardiac masses as it correctly addresses malignancy. Furthermore, an accurate evaluation of the several CMR features, may discriminate primary benign masses and pseudotumours. Abstract Figure. Benign and malignant cardiac masses

scholarly journals Congenital and Developmental Abnormalities of the Hand and Wrist

2021 ◽  
Vol 25 (02) ◽  
pp. 260-271
Author(s):  
Filip M. Vanhoenacker ◽  
Paolo Simoni ◽  
Frederik Bosmans ◽  
Nathalie Boutry
Keyword(s):  
Genetic Counseling ◽  
Correct Diagnosis ◽  
Genetic Tests ◽  
Developmental Abnormalities ◽  
Skeletal Dysplasias ◽  
Skeletal Abnormalities

AbstractIdentification of congenital skeletal abnormalities is complex because of the large variety of individual syndromes and dysplasias that are often difficult to remember. Although a correct diagnosis relies on a combination of clinical, radiologic, and genetic tests, imaging plays an important role in selecting those patients who should be referred for further genetic counseling and expensive genetic tests. In addition to information derived from radiologic analysis of other skeletal elements, radiographs of the hand and wrist may provide particular useful information. In the first part of this article, we provide a guide for a systematic radiologic analysis of the hand and wrist bones that may help characterize congenital and developmental diseases. Special attention is given to the use of correct terminology. In the second part, we discuss typical examples of congenital and developmental diseases involving the hand and wrist, with an emphasis on skeletal dysplasias.

Perianal Lymphangioma Circumscriptum Mistaken for Genital Warts

PEDIATRICS ◽  
1996 ◽  
Vol 98 (3) ◽  
pp. 461-463
Author(s):  
Gary L. Darmstadt
Keyword(s):  
Sexual Abuse ◽  
Differential Diagnosis ◽  
Case Report ◽  
Correct Diagnosis ◽  
Genital Warts ◽  
Diagnosis And Treatment ◽  
Perianal Region ◽  
Anogenital Region ◽  
Left Buttock ◽  
Lymphangioma Circumscriptum

Genital warts are common relative to other verrucous lesions of the anogenital region. Consideration of the differential diagnosis of verrucous anogenital lesions is necessary, however, to make a correct diagnosis consistently and to avoid futile, painful, and possibly traumatic attempts at treatment. In this report, I describe a child with a history suspicious for sexual abuse who was treated with inappropriate measures because of misdiagnosis of perianal lymphangioma circumscriptum as genital warts. The pathogenesis, differential diagnosis, and treatment of lymphangioma is presented. CASE REPORT A 5-year-old Hispanic boy was referred by his pediatrician to the Dermatology Service with an eruption of red papules on the left buttock and perianal region.

BRAIN TUMORS IN INFANCY

PEDIATRICS ◽  
1948 ◽  
Vol 1 (3) ◽  
pp. 346-363
Author(s):  
I. WALLACE LEIBNER
Keyword(s):  
Nervous System ◽  
Differential Diagnosis ◽  
Brain Tumors ◽  
Correct Diagnosis ◽  
Full Recovery ◽  
The Other ◽  
Congenital Hydrocephalus ◽  
First Case ◽  
Clinical Patterns

Seven cases of brain tumors occurring in infants are presented. Six occurred in males and one was in a female. Three of them arose in the cerebellum while the other four were supratentorial. The tumors included two medulloblastomas, one [See Table II in Source Pdf] spongioblastoma polare, one ependymoma, one astrocytoma and one hemangioblastoma. The seventh case probably was also one of medulloblastoma. One of the proven medulloblastomas was supratentorial, which is unusual so faras location is concerned. The hemangioblastoma arose in the cerebrum. The location of this tumor is also a rare one and to my knowledge, it is the first case of its type reported in an infant in whom full recovery occurred following removal of the tumor. The diagnosis was unsuspected in four cases. Three of these infants were believed to be suffering from congenital hydrocephalus while the fourth was thought to be afflicted with encephalitis. The ways in which the correct diagnosis might have been made are discussed. Since bizarre clinical patterns are sometimes produced by brain tumors in infants and the diagnosis frequently overlooked, the possibility should be kept in mind by the pediatrician in considering the differential diagnosis of conditions producing signs referable to the nervous system.

MEDICAL FILMS

PEDIATRICS ◽  
1962 ◽  
Vol 30 (6) ◽  
pp. 1018-1018
Keyword(s):  
Cystic Fibrosis ◽  
New York ◽  
New York City ◽  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Tools ◽  
Single Test ◽  
Presenting Symptoms ◽  
The Many ◽  
Therapy And Diagnosis

Cystic Fibrosis—NCFRF. 16 mm., color, sound, showing time 32 minutes. Produced in 1961 by Samuel L. Schulman for the National Cystic Fibrosis Research Foundation, medical supervision by Giulio J. Barbero, M.D. Philadelphia. Procurable on purchase from National Cystic Fibrosis Research Foundation, 521 Fifth Avenue, New York City 17. Procurable on loan from American Medical Association, Motion Picture Library, 535 N. Dearborn Street, Chicago 10. This film has been prepared to aid physicians in making a correct diagnosis and to instruct them in the techniques currently being used to prolong life in cases of cystic fibrosis. Following the introductoy remarks there is a good discussion of the presenting symptoms, the differential diagnosis, the multiple system involvement, hereditary aspects, therapy, and prognosis. The film brings out well the panexocrine involvement, the clinical variability, and the fact that the disease is not an all or none phenomenon but rather a disease of all grades of severity and is a disease in which no single test is applicable to the exclusion of others. The diagrams and patient demonstrations are good. Perhaps too much review of older methods of therapy and diagnosis is given, but this serves as a background for the newer recommended procedures. More emphasis could have been given to the tremendous burden, both financial and emotional, this disease is on parents. This is an excellent instructive film and it emphasizes the many problems of cystic fibrosis as related to the diagnostic tools available and to forms of therapy. The photography and sound are satisfactory. It is recommended for pediatricians, general practitioners, house staff, and medical students.

DIAGNOSIS OF OVARIAN CANCER AND ACUTE ENDOMETRITIS BY NETWORK MODELING OF CHANGES IN BLOOD FLOW IN THE PELVIC ARTERIES

2021 ◽  
pp. 88-93
Author(s):  
Виталий Вячеславович Аксёнов ◽  
Николай Михайлович Агарков ◽  
Александра Игоревна Сурнина
Keyword(s):  
Ovarian Cancer ◽  
Blood Flow ◽  
Differential Diagnosis ◽  
Network Modeling ◽  
Correct Diagnosis ◽  
Arterial Blood Flow ◽  
Diagnostic Significance ◽  
The Past ◽  
Arterial Blood ◽  
High Level

Заболеваемость раком яичников в России в последнее время остается на высоком уровне. В мире более ста тысяч женщин умирают вследствие протекания данного заболевания. За последнее десятилетие заболеваемость острым эндометритом также неуклонно возрастает. Острый эндометрит обладает полиморфизмом симптомов, лабораторных и ультразвуковых изменений и вследствие этого тяжело поддается диагностике и дифференциальной диагностике. В условиях стационара обследованы 100 пациенток с раком яичников II-III стадии и 90 пациенток с диагнозом острого эндометрита. Им выполнялось ультразвуковое исследование. Полученные результаты подвергались обработке и математико-статистическому анализу, включающему расчёт показателей дезинтеграции, сетевое моделирование, математическое ранжирование. Изучение ультразвуковых изменений кровотока в маточных и яичниковых сосудах и венах у 100 заболевших раком яичников и 90 заболевших острым эндометритом дал возможность выделить ведущие дифференциально-диагностические аспекты. Характеристики дезинтеграции, в одном ряду со средними значениями локального кровотока, объективизируют дифференциацию рака яичников и острого эндометрита. В согласовании с дифференциально-диагностической значимостью ультразвуковых характеристик артериального кровотока в маточных и яичниковых сосудах построена сетевая модель дифференциальной диагностики рака яичников и острого эндометрита по более приоритетным переменам, собственно, что разрешает уменьшить размер и время обследования пациента и постановки верного диагноза The incidence of ovarian cancer in Russia has recently remained at a high level. In the world, more than a hundred thousand women die as a result of the course of this disease. The incidence of acute endometritis has also been steadily increasing over the past decade. Acute endometritis has a polymorphism of symptoms, laboratory and ultrasound changes and, as a result, is difficult to diagnose and differential diagnosis. 100 patients with stage II-III ovarian cancer and 90 patients with acute endometritis were examined in the hospital. They performed an ultrasound examination. The obtained results were processed and subjected to mathematical and statistical analysis, including the calculation of disintegration indicators, network modeling, and mathematical ranking. The study of ultrasound changes in blood flow in the uterine and ovarian vessels and veins in 100 patients with ovarian cancer and 90 patients with acute endometritis made it possible to identify the leading differential diagnostic aspects. The characteristics of disintegration, along with the average values of local blood flow, objectify the differentiation of ovarian cancer and acute endometritis. In accordance with the differential diagnostic significance of the ultrasound characteristics of arterial blood flow in the uterine and ovarian vessels, a network model for the differential diagnosis of ovarian cancer and acute endometritis is constructed according to higher priority changes, which actually allows reducing the size and time of the patient's examination and making the correct diagnosis

Rectovaginal extragastrointestinal stromal tumour (EGIST): an additional entity to be considered in the differential diagnosis of tumours of the rectovaginal septum

2021 ◽  
Vol 14 (3) ◽  
pp. e237669
Author(s):  
Susan Addley ◽  
Moiad Alazzam ◽  
Catherine Johnson ◽  
Hooman Soleymani majd
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
High Risk ◽  
Kinase Inhibitor ◽  
Correct Diagnosis ◽  
Rectovaginal Septum ◽  
Gastrointestinal Stromal Tumours ◽  
Diagnostic Challenge ◽  
High Quality ◽  
Primary Surgery

Gastrointestinal stromal tumours (GISTs) are rare - and rectovaginal extragastrointestinal stromal tumours (RV-EGISTs) even rarer. We share a case of RV-EGIST, complemented by high-quality radiological and surgical images. A review of current literature pertaining to RV-EGIST is also included. Our case report highlights the diagnostic challenge presented by extragastrointestinal stromal tumours. Differentiated from overlapping pathologies only by targeted application of immunohistopathology and cytogenetics, the inclusion of RV-EGIST in the differential diagnosis of a rectovaginal tumour is essential to making this correct diagnosis. Primary surgery is the treatment of choice for RV-EGIST if complete cytoreduction can be achieved, combined with adjuvant tyrosine kinase inhibitor (TKI) therapy for those with high-risk features to further reduce rates of future recurrence.

Accuracy of MRI in the Differential Diagnosis of Wilms Tumor

2021 ◽  
Vol 15 (8) ◽  
pp. 2057-2059
Author(s):  
Maham Ashraf ◽  
Aysha Anjum ◽  
Eisha Tahir ◽  
Amber Goraya ◽  
Rabia Aqeel
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Wilms Tumor ◽  
Correct Diagnosis ◽  
Renal Tumors ◽  
Common Finding ◽  
Predictive Values ◽  
Female Ratio ◽  
Male Predominance

Background & Objective: Renal tumors are a common finding in diagnostic imaging; these lesions usually are solid or cystic, benign or malignant, and the correct diagnosis may be difficult. The current study aims at to determine the diagnostic accuracy of magnetic resonance imaging for the diagnosis of Wilms tumor taking histopathology as gold standard. Methodology: This cross-sectional study was carried at the Department of Radiology, The Children’s Hospital & Institute of Child Health Lahore over 6 months from March 2019 to September 2019. The study involved 125 children of both genders aged between 2 years to 14 years presenting with a neoplastic mass in the retroperitoneum on ultrasound abdomen during initial workup. These children were assessed on MRI for the diagnosis of Wilms tumor. Later the diagnosis was confirmed on histopathology which was taken as gold standard and the diagnosis of MRI was judged accordingly as true/false and positive/negative. A written informed consent was obtained from every patient. Results: The mean age of the children was 5.8±3.9 years having a male predominance with male to female ratio of 1.8:1. Wilms tumor was suspected in 13 (10.4%) children on MRI. The diagnosis of Wilms tumor was confirmed in 13 (10.4%) children on histopathology. MRI was found to be 76.9% sensitive, 97.3% specific and 95.2% accurate with positive and negative predictive values of 76.9% and 97.3% respectively. Conclusion: In the present study, MRI was found to be 95.2% accurate in the differential diagnosis of Wilms tumor in children presenting with retroperitoneal mass which along with its non-invasive and radiation free nature advocates the preferred use of MRI in the diagnostic evaluation of such children in future oncologic practice. Keywords: Retroperitoneal Tumor, Wilms Tumor, MRI, Diagnostic Accuracy

scholarly journals Heparin-induced thrombocytopenia occurring after surgical treatment of atrial myxoma: A case report

2009 ◽  
Vol 137 (9-10) ◽  
pp. 540-544 ◽  
Author(s):  
Irena Djunic ◽  
Dragica Tomin ◽  
Nebojsa Antonijevic ◽  
Sinisa Gradinac ◽  
Mirjana Kovac ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Platelet Count ◽  
Correct Diagnosis ◽  
Corticosteroid Treatment ◽  
Clinical Score ◽  
Atrial Myxoma ◽  
Platelet Factor ◽  
Heparin Induced Thrombocytopenia ◽  
Unfractioned Heparin ◽  
Left Atrial Myxoma

Introduction Heparin-induced thrombocytopenia (HIT) is an acquired, prothrombotic disorder, caused by antibodies to a complex of heparin and platelet factor 4 (PF4) that activates platelets, resulting in the release of procoagulant microparticles, thrombocytopenia occurrence, generation of thrombin, and frequent thromboses. Case Outline We present a case of severe HIT in a 68-year-old female, which occurred after cardiosurgery of the left atrial myxoma with the aim to point out the importance of differential diagnosis of thrombocytopenia in patients recently exposed to heparin. Platelet count dropped on the eleventh postoperative day, six days after unfractioned heparin and enoxaparine treatment, to 4?109/l. The correct diagnosis failed to be made at first. Since thrombocytopenia remained refractory to a corticosteroid treatment and platelet transfusion, the patient was hospitalized on the 13th postoperative day at the Institute of Hematology. The diagnosis of HIT was confirmed with the high-probability clinical score (4T's) and strongly positive antiheparin-PF4 (PaGIA) test as well as positive platelet aggregation test. The treatment started with a smaller therapeutic doses of danaparoid than recommended of 750 U intravenous bolus and was followed by continuous infusions of 100 U per 1 h and intravenous gammaglobulins in full dosage for four days. The platelet count started to rise on the third day and it was completely normalized on the 5th day of the therapy. Conclusion Treatment of severe HIT with small doses of danaparoid supplemented by intravenous gamma globulin was successful. Additional awareness of heparin-induced thrombocytopenia is needed, especially of HIT in differential diagnosis of thrombocytopenia in patients recently exposed to heparin.

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