Neglected Scaphocapitate Syndrome

2021 ◽  
Author(s):  
Assaf Kadar ◽  
Sorin D. Iordache
Keyword(s):  
Avascular Necrosis ◽  
Vascular Supply ◽  
Vascular Studies ◽  
Resonance Imaging ◽  
Proximal Pole ◽  
Imaging Studies ◽  
Anatomical Reduction ◽  
Rare Injury ◽  
To Receive

Abstract Background Scaphocapitate syndrome is a rare injury where the proximal pole of the capitate rotates 90 to 180 degrees. The proximal pole of the capitate, thought to receive its vascular supply retrograde, is rendered avascular in such cases. However, recent evidence of low rates of avascular necrosis in displaced capitate fractures, and new vascular studies of the capitate, challenge this paradigm. Case Description We report a case of a missed and neglected scaphocapitate syndrome with more than 30 years follow-up. While the patient experienced midcarpal arthritis, the injury had not resulted in capitate proximal pole avascular necrosis as per T1 magnetic resonance imaging studies. Literature Review Missed and chronic cases of scaphocapitate syndrome were reported previously. Successful outcomes were achieved with anatomical reduction in cases without midcarpal arthritis. Salvage procedures or arthroplasty procedures are recommended with the presence of midcarpal arthritis. However, there are no reports of a neglected case with more than 30 years follow-up with preserved vascularity of the proximal pole of the capitate. Clinical Relevance This case illustrates that vascularity of the proximal pole of the capitate can be preserved even in longstanding displaced fractures.

Intracranial parenchymal schwannoma

1993 ◽  
Vol 79 (2) ◽  
pp. 217-222 ◽  
Author(s):  
Gian Piero Casadei ◽  
Takashi Komori ◽  
Bernd W. Scheithauer ◽  
Gary M. Miller ◽  
Joseph E. Parisi ◽  
...  
Keyword(s):  
Parietal Lobe ◽  
Clinical Course ◽  
Cystic Degeneration ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Imaging Characteristics ◽  
Benign Nature ◽  
Peripheral Enhancement

✓ The clinical, radiological, and pathological features of nine cases of intracranial parenchymal schwannoma are described. The clinical course in four patients 23 years of age or younger mirrored the indolent nature of this neoplasm. Imaging studies included computerized tomography in eight patients and magnetic resonance imaging in three. The lesions were well demarcated with only mild surrounding edema. Five tumors were deep within the temporoparieto-occipital region, three were in the cerebellum, and one lay peripherally in the parietal lobe. Over two-thirds of the nine tumors were either cystic (five) or contained areas of cystic degeneration (two). One lesion was frankly hemorrhagic. A variety of imaging characteristics and contrast enhancement patterns were observed, including those of a cyst with a mural nodule and peripheral enhancement. Of the four solid neoplasms, two enhanced homogeneously while the other two demonstrated heterogeneous enhancement. Six tumors were resected totally. The follow-up period ranging from 2 months to 2 years has shown no recurrences. Microscopically, immunohistochemically, and ultrastructurally, the tumors were indistinguishable from peripheral schwannomas. A possible mechanism underlying the histogenesis of these rare lesions is discussed. The importance of recognizing this tumor is stressed, particularly in younger patients, given its benign nature, radiological resemblance to other tumors such as pilocytic astrocytoma, and favorable response to resection.

scholarly journals Diagnosis and management of secondary lymphedema

2021 ◽  
Vol 3 ◽  
pp. 16-25
Author(s):  
Puravoor Jayasree
Keyword(s):  
Surgical Treatment ◽  
Resonance Imaging ◽  
Limb Volume ◽  
Imaging Studies ◽  
Secondary Lymphedema ◽  
Rehabilitation Programs ◽  
Surgical Options ◽  
Combined Decongestive Therapy ◽  
Late Stages

Secondary lymphedema, more common than its primary variant is essentially a clinical diagnosis. Evaluation should include measurement of limb circumference and volume and appropriate staging protocols to determine the severity of the condition. Imaging studies such as magnetic resonance imaging and lymphoscintigraphy are invaluable in ruling out other causes of extremity swelling and for planning surgical treatment. Conservative measures such as combined decongestive therapy are of prime importance in reducing the limb volume and should be continued to maintain the results of surgical treatment. Pharmacotherapy does not have much role in lymphedema. Surgical options which were initially restricted to debulking procedures in chronic late stages are now gaining more relevance with the advent of physiological techniques to prevent further progression of the condition. Detailed counseling regarding the chronic nature of the disease and the need for regular follow-up along with rehabilitation programs will further improve the management of lymphedema.

scholarly journals Charcoal granuloma mimicking breast cancer: an emerging diagnosis

2018 ◽  
Vol 7 (12) ◽  
pp. 205846011881572
Author(s):  
Gabriel Lucca de Oliveira Salvador ◽  
Poliana Palma Barbieri ◽  
Laura Maschke ◽  
Anna Luisa Aranha Nunes ◽  
Maria Helena Louveira ◽  
...  
Keyword(s):  
Breast Tissue ◽  
Breast Lesion ◽  
Preoperative Localization ◽  
Histopathological Analysis ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Ultrasound Guided ◽  
Image Guided ◽  
Malignant Lesions

Background Image-guided charcoal injection in suspicious breast lesions for preoperative localization is a procedure that has been increasing over the years because it is safer, faster, and more affordable when compared to needle-wire preoperative localization. To date, no complications have been associated with the method. However, in recent years there have been some reports about charcoal granulomas mimicking malignant lesions in some postoperative patients or in a conservative follow-up. Purpose To report a series of 11 cases which had suspicious imaging findings for malignancy and resulted in charcoal granulomas on histopathological analysis. Material and Methods A database of 1650 patients that attended our center from January 2007 to June 2018 was reviewed and detected 495 patients who had been previously submitted to ultrasound-guided charcoal marking in a breast lesion. Then, patients whose imaging studies were compatible with new suspicious lesions on mammography, breast ultrasound, and/or magnetic resonance imaging and biopsy of this new lesion indicating charcoal granuloma were selected. Results From 495 patients who had undergone charcoal localization injections in previous biopsies, we selected 11 who had new lesions with malignant characteristics on imaging studies but histopathological analysis resulted in charcoal granuloma. Conclusion Charcoal granuloma should be considered in patients with previous preoperative injection localization, since the residual charcoal in the breast tissue may form granulomas and mimic malignant lesions on follow-up imaging studies.

Avascular Necrosis in Untreated Patients with Type 1 Gaucher Disease.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1353-1353
Author(s):  
Pramod K Mistry ◽  
Patrick Deegan ◽  
Ashok Vellodi ◽  
J. Alexander Cole ◽  
Michael Yeh ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Avascular Necrosis ◽  
Gaucher Disease ◽  
Incidence Rates ◽  
Advisory Committees ◽  
Type 1 Gaucher Disease ◽  
Receive Treatment ◽  
To Receive

Abstract Abstract 1353 Poster Board I-375 Objective To determine the incidence of avascular necrosis (AVN) in untreated patients with type 1 Gaucher disease (GD1). Methods All patients with GD1 enrolled in the ICGG Gaucher Registry as of July 2007 were included in this analysis. All GD1 patients who either never received treatment or eventually went on to receive treatment were identified. Follow-up began on each patient's date of earliest reported assessment in the Registry. Among patients who never received treatment, follow-up continued until the last recorded assessment date in the Registry. For patients who eventually went on to receive treatment, follow-up continued until the date of initiation of therapy. Incidence rates (and Poisson exact 95% confidence intervals) of AVN were determined for both groups of patients. AVN was typically ascertained from X-Ray or MRI results. Results As of July 2007, the inclusion criteria were met by 3,497 patients. The incidence rate of AVN among untreated patients was 22.8 per 1,000 person years (95% CI 20.2 to 25.7). Patients with antecedent splenectomy (total or partial) had a higher incidence rate of AVN (46.6 per 1,000 person-years, 95% CI 38.4 to 56.1) compared to patients without a splenectomy (incidence rate 17.0 per 1,000 person-years, 95% CI 14.5 to 19.8). The primary sites where AVN was identified in both groups were the hip and femur. Conclusion This is the first epidemiologic analysis to estimate incidence rates of AVN among untreated patients with GD1. Splenectomy appears to be a risk factor for GD1-associated AVN. Based on the incidence results above and presupposing equal risk distribution, without therapeutic intervention, most patients should theoretically experience at least one episode of AVN at some point in their life. However, because the GD1 population is genotypically and phenotypically heterogeneous, further analyses will attempt to identify characteristics that distinguish untreated patients at high risk of developing AVN from those who are less likely to develop this serious complication. Disclosures Mistry: Genzyme Corporation: Honoraria, Research Funding. Deegan:Genzyme Corporation: Honoraria. Vellodi:Genzyme Corporation: Honoraria, Speakers Bureau. Cole:Genzyme Corporation: Employment. Yeh:Genzyme Corporation: Employment. Weinreb:Genzyme Corporation: Honoraria, Membership on an entity's Board of Directors or advisory committees.

Early Detection of Occult Fractures around the Hip with Magnetic Resonance Imaging

2003 ◽  
Vol 13 (2) ◽  
pp. 80-85
Author(s):  
A. González Della Valle ◽  
U. Macea Ibáñez ◽  
M. Buttaro ◽  
A. Rolón ◽  
F. Piccaluga
Keyword(s):  
Medical Records ◽  
Weight Bearing ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Partial Weight Bearing ◽  
Neck Fracture ◽  
Occult Fractures ◽  
Displaced Fracture ◽  
Partial Weight

Hip fractures may not be evident on initial radiographs but can be demonstrated with special imaging studies. These “occult fractures” can displace if not promptly treated. In a four-year period, 34 occult fractures around the hip in 33 patients were diagnosed in one general hospital. There were 6 men and 27 women, with a mean age of 74 years (22/92). The medical records and imaging studies were retrospectively reviewed. Two patients presented with a displaced femoral neck fracture one month and 10 days respectively after a fall and initial radiographs resulting normal. In the remaining 31 patients with normal radiographs, 30 fractures were detected with MRI obtained at an average of 6.8 days (0/35) from the onset of symptoms, and one with bone scan. Treatment consisted in partial weight-bearing or surgery, depending on the location and displacement of the fracture. Fractures united in all patients treated non-operatively and in those treated with internal fixation. One patient with a displaced fracture underwent a hip arthroplasty. At an average follow-up of 16.7 months (6/46) all patients remained ambulatory. In a selected group of patients with high suspicion of hip fracture, full-sequence MRI proved to be useful for early diagnosis and localization of an occult fracture around the hip.

scholarly journals Proximal Scaphoid Pole Reconstruction Utilizing Ipsilateral Proximal Hamate Autograft

Hand ◽  
2016 ◽  
Vol 11 (4) ◽  
pp. 495-499 ◽  
Author(s):  
Bassem Elhassan ◽  
Mohamed Noureldin ◽  
Sanjeev Kakar
Keyword(s):  
Avascular Necrosis ◽  
Vascular Supply ◽  
Surgical Reconstruction ◽  
Scaphoid Nonunion ◽  
Proximal Pole ◽  
Secondary Fragmentation ◽  
Scapholunate Instability ◽  
Scaphoid Reconstruction

Background: Fractures of the proximal pole of the scaphoid can be difficult to heal because of its limited vascular supply. Furthermore, nonunion with avascular necrosis and secondary fragmentation makes surgical reconstruction a challenging procedure. Method: We describe a technique and report the outcome of a proximal hamate autograft to treat a proximal pole scaphoid nonunion with avascular necrosis. Results: At 3.5 years post reconstruction, the patient remains asymptomatic with union of his scaphoid reconstruction without any evidence of scapholunate instability. Conclusion: Proximal hamate autograft is a useful technique for addressing proximal pole scaphoid nonunions with avascular necrosis.

scholarly journals Avascular necrosis with non-union of the scaphoid managed with a dorsal pedicled vascularised bone graft of the distal radius – a case report

2021 ◽  
Vol 8 (10) ◽  
pp. 3189
Author(s):  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy ◽  
Anand P. Jayachandiran ◽  
Suresh Rajendran
Keyword(s):  
Bone Graft ◽  
Avascular Necrosis ◽  
Bone Remodelling ◽  
Bone Grafts ◽  
Vascular Supply ◽  
Favourable Outcome ◽  
Proximal Pole ◽  
Non Union ◽  
Hand Surgeon ◽  
Vascularised Bone Graft

Avascular necrosis (AVN) of the scaphoid is common following proximal pole fractures due to an arduous retrograde arterial vascular supply and it is a challenge to the hand surgeon. The treatment for scaphoid non-union with avascular necrosis is vascularized or non-vascularized bone grafts. Non vascularised bone grafts (NVBGs) can be categorized as autograft or allograft and cancellous or cortical bone grafts. Vascularised bone grafts promote biological healing and revascularizes ischaemic bone and they are free or pedicled grafts. Pedicled vascularised bone grafts maintain the vascular supply of the donor bone graft and this leads to better bone remodelling, less osteopenia, faster incorporation and better maintenance of bone mass compared to the non-vascularised graft with good clinical and radiological outcomes. In this paper, we have treated avascular necrosis of scaphoid with a pedicled vascularised bone graft based on the 1, 2 intercompartmental supraretinacular artery (1, 2-ICSRA) that resulted in a favourable outcome.

Initial experience with gamma knife surgery for endocrine ophthalmopathy

2005 ◽  
Vol 102 ◽  
pp. 272-275
Author(s):  
Julio C. Antico ◽  
Luis Crovetto ◽  
Eduardo Tenca ◽  
Carlos Artes
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Soft Tissue Involvement ◽  
Endocrine Ophthalmopathy ◽  
A Prospective Study ◽  
Fine Print

Object. The aim of this study was to evaluate both the effectiveness and safety of the treatment of endocrine ophthalmopathy with gamma knife surgery (GKS). Methods. Five patients were included in a prospective study designed to assess the results of GKS of endocrine ophthalmopathy secondary to Graves disease. All the patients completed a 2-year follow-up period. During this period, the patients were evaluated both clinically and by means of additional methods, including computerized tomography and magnetic resonance imaging studies. The minimum dose delivered to the 50% isodose line was 6.5 Gy in all the patients. In all cases, a clinical improvement was observed. The best effect was seen in symptom regression related to soft-tissue involvement. No treatment-related side effects were detected. Conclusions. In light of the results obtained the authors consider that GKS may be a safe and effective way to treat endocrine ophthalmopathy.

Treatment and prevention of tethered and retethered spinal cord using a Gore-Tex surgical membrane

1994 ◽  
Vol 80 (4) ◽  
pp. 689-693 ◽  
Author(s):  
Hiroshi K. Inoue ◽  
Satoshi Kobayashi ◽  
Katsumi Ohbayashi ◽  
Hideaki Kohga ◽  
Masaru Nakamura
Keyword(s):  
Spinal Cord ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
New Method ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Follow Up Study ◽  
Treatment And Prevention

✓ The incidence of the tethered cord syndrome after repair of spinal dysraphism is not insignificant. A retethered spinal cord may also develop after an untethering operation. In order to treat and/or prevent the tethered and retethered spinal cord, the authors developed and successfully used a new method in 12 cases. After complete release and reconstruction of the spinal cord, a Gore-Tex surgical membrane was placed over the cord and fixed to the lateral dural surface with stay sutures. During a postoperative follow-up period ranging from 23 months to 7 years, no further neurological deterioration was observed in the 12 patients and magnetic resonance imaging studies showed no adhesion of the spinal cord to the operative site. It is concluded that this simple new method is effective for the treatment and prevention of tethering and/or retethering of the spinal cord, although a longer follow-up study is required.

Initial experience with gamma knife surgery for endocrine ophthalmopathy

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 272-275
Author(s):  
Julio C. Antico ◽  
Luis Crovetto ◽  
Eduardo Tenca ◽  
Carlos Artes
Keyword(s):  
Gamma Knife ◽  
Gamma Knife Surgery ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Content Type ◽  
Soft Tissue Involvement ◽  
Endocrine Ophthalmopathy ◽  
A Prospective Study ◽  
Fine Print

Object. The aim of this study was to evaluate both the effectiveness and safety of the treatment of endocrine ophthalmopathy with gamma knife surgery (GKS). Methods. Five patients were included in a prospective study designed to assess the results of GKS of endocrine ophthalmopathy secondary to Graves disease. All the patients completed a 2-year follow-up period. During this period, the patients were evaluated both clinically and by means of additional methods, including computerized tomography and magnetic resonance imaging studies. The minimum dose delivered to the 50% isodose line was 6.5 Gy in all the patients. In all cases, a clinical improvement was observed. The best effect was seen in symptom regression related to soft-tissue involvement. No treatment-related side effects were detected. Conclusions. In light of the results obtained the authors consider that GKS may be a safe and effective way to treat endocrine ophthalmopathy.

Sign in / Sign up

Export Citation Format

Share Document