Henle fibre layer haemorrhage: clinical features and pathogenesis

2020 ◽  
pp. bjophthalmol-2019-315443 ◽  
Author(s):  
Caroline R Baumal ◽  
David Sarraf ◽  
Tara Bryant ◽  
Wei Gui ◽  
Nora Muakkassa ◽  
...  
Keyword(s):  
Clinical Features ◽  
Venous Pressure ◽  
Case Series ◽  
Fundus Photography ◽  
Imaging Features ◽  
Retinal Haemorrhage ◽  
Fiber Layer ◽  
Fibre Layer ◽  
Ruptured Intracranial Aneurysm ◽  
Retinal Haemorrhages

BackgroundTo describe the clinical presentation and characteristic imaging features of deep retinal haemorrhages primarily located in the Henle fibre layer (HFL) of the macula. The spectrum of aetiologies and a comprehensive theory of pathogenesis are presented.MethodsThis is a retrospective, multicentre case series evaluating eyes with retinal haemorrhage in HFL. Clinical features, underlying aetiology, systemic and ocular risk factors, visual acuity, and multimodal imaging including fundus photography and cross-sectional and en face optical coherence tomography (OCT) are presented.ResultsRetinal haemorrhages localised to HFL in 33 eyes from 23 patients were secondary to acute blunt trauma to the head (n=2), eye (n=1) and trunk (n=1), ruptured intracranial aneurysm (Terson’s syndrome, n=3), general anaesthesia (n=1), epidural anaesthesia (n=1), hypertension with anaemia (n=1), decompression retinopathy (n=1), postvitrectomy with intraocular gas (n=1), retinal vein occlusion (n=7), myopic degeneration (n=2), macular telangiectasia type 2 (n=1), and polypoidal choroidal vasculopathy (n=1). Defining clinical features included deep retinal haemorrhage with feathery margin and petaloid pattern radiating from the fovea. OCT demonstrated characteristic hyper-reflectivity from the haemorrhage delineated by obliquely oriented fibres in the Henle layer. Spontaneous resolution of HFL haemorrhage occurred after 3 months in 15 patients with follow-up.ConclusionThe characteristic petaloid-shaped, deep intraretinal haemorrhage with a feathery margin localised to HFL is associated with various disorders. The terminology ‘Henle fiber layer hemorrhage (HH)’ is proposed to describe the clinical and OCT findings, which may result from abnormal retinal venous pressure from systemic or local retinovascular disorders affecting the deep capillary plexus or from choroidal vascular abnormalities.

Imaging Features of Primary Tumors of the Hand

2020 ◽  
Vol 16 ◽  
Author(s):  
Filippo Boriani ◽  
Edoardo Raposio ◽  
Costantino Errani
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Epithelioid Sarcoma ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Therapeutic Decisions ◽  
Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

scholarly journals ARE SPORTS INJURIES THE MOST COMMON CAUSE OF MOREL-LAVALLEE LESIONS IN THE PEDIATRIC POPULATION?

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Indranil Kushare ◽  
Ramesh Babu Ghanta ◽  
Nicole A. Wunderlich
Keyword(s):  
Lower Extremity ◽  
Conservative Management ◽  
Sports Injuries ◽  
Pediatric Population ◽  
Case Series ◽  
Lower Leg ◽  
Functional Score ◽  
Imaging Features ◽  
Associated Injuries ◽  
Common Cause

Background: Traumatic internal degloving injury i.e. Morel-Lavallée lesion (MLL) develops as a result of blunt trauma with tangential shear forces. In the pediatric population, these have been described only as small case reports till date. Purpose: To describe the largest case series of lower extremity Morel-Lavallée lesion (MLL) in the pediatric population, to determine its etiology (especially its relationship to sports), treatment and outcomes. Methods: Retrospective study of patients <18 years presenting to a tertiary children’s hospital with MLL between 2013-2019. Demographics, clinical data, imaging features, treatment and outcomes data was collected. Descriptive statistical analysis was conducted. Results: 38 patients (21 males, 17 females) having MLL with mean age 14.6 years were classified into 2 groups- hip/thigh MLL (9 patients) and lower leg MLL (29) (Table 1.1). Most common cause of lower leg MLL was sports injury (79%). Most commonly implicated sports in MLL were football and baseball(24% each). Associated injuries were seen in 9 (23%) patients. Radiographs done in 58% of patients showed no bony abnormalities. Imaging modality of choice was MRI for lower leg MLLs (72%) and US for hip/thigh MLL (67%)(Fig.1.2). MLL size was larger for hip/thigh MLL (168 cm3) as compared to leg MLL (38.6 cm3). 25 (65.8%) of MLLs were treated with conservative management,12 (31.5%) with minimally invasive methods and 1(2.6%) needed surgical management. 2/9 (22.2%) of the associated injuries required operative management. 2/38 (5%) patients were given prophylactic antibiotics. 72.4% Lower leg MLLs were treated with conservative management while intervention was needed more in hip/thigh MLLs (55.6%). Patients returned to activities at 14.3 weeks for hip/thigh MLL;9.1 weeks for lower leg MLL. 24 patients with adequate documentation demonstrated lower extremity functional score (LEFS) and pain level of 74/80 (92.5%) and 0.7/10 respectively at mean 12.5 months follow-up. Leg cellulitis was seen as a complication in one patient. Conclusion: The largest case series on MLL exclusively in the pediatric population suggests that they are more common in knee/leg region region and usually caused by sports injuries which is notably different as compared to adult population. Most pediatric injuries are treated conservatively, especially sports related MLLs. Although return to activities takes longer for hip/thigh injuries, majority of patients regain satisfactory functionality post-injury. [Table: see text][Figure: see text]

Imaging Features of Hepatic Small Vessel Neoplasm: case series

Hepatology ◽  
2021 ◽  
Author(s):  
Anita Paisant ◽  
Sarah Bellal ◽  
Jérôme Lebigot ◽  
Clémence M Canivet ◽  
Sophie Michalak ◽  
...  
Keyword(s):  
Case Series ◽  
Small Vessel ◽  
Imaging Features

scholarly journals Clinical features and predictors of severity in COVID-19 patients with critical illness in Singapore

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ser Hon Puah ◽  
◽  
Barnaby Edward Young ◽  
Po Ying Chia ◽  
Vui Kian Ho ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Clinical Features ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Series ◽  
Plateau Pressure ◽  
Apache Ii Score ◽  
Multivariable Logistic Regression Model ◽  
Reactive Protein ◽  
Ventilatory Management

AbstractWe aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19 patients and ten who required mechanical ventilation were collected. We compared clinical features between the groups, assessed predictors of intubation, and described ventilatory management in ICU patients. Ventilated patients were significantly older, reported more dyspnea, had elevated C-reactive protein and lactate dehydrogenase. A multivariable logistic regression model identified respiratory rate (aOR 2.83, 95% CI 1.24–6.47) and neutrophil count (aOR 2.39, 95% CI 1.34–4.26) on admission as independent predictors of intubation with area under receiver operating characteristic curve of 0.928 (95% CI 0.828–0.979). Median APACHE II score was 19 (IQR 17–22) and PaO2/FiO2 ratio before intubation was 104 (IQR 89–129). Median peak FiO2 was 0.75 (IQR 0.6–1.0), positive end-expiratory pressure 12 (IQR 10–14) and plateau pressure 22 (IQR 18–26) in the first 24 h of ventilation. Median duration of ventilation was 6.5 days (IQR 5.5–13). There were no fatalities. Most COVID-19 patients in Singapore who required mechanical ventilation because of ARDS were extubated with no mortality.

scholarly journals Challenging Presentations of Seven Cases of Gastrointestinal Basidiobolomycosis in Sudan: Clinical Features, Histology, Imaging, and Recommendations

2020 ◽  
Vol 12 (04) ◽  
pp. 281-284
Author(s):  
Sawsan A. Mohammed ◽  
Azza A. Abdelsatir ◽  
Mohamed Abdellatif ◽  
Suliman Hussein Suliman ◽  
Omer Mohammed Ibrahim Elbasheer ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Fungal Infection ◽  
Clinical Features ◽  
Subcutaneous Tissue ◽  
Case Series ◽  
First Case

AbstractsBasidiobolomycosis is a fungal infection caused by Basidiobolus ranarum which affects the skin and subcutaneous tissue and rarely the gastrointestinal tract. We report seven cases of gastrointestinal basidiobolomycosis with interesting clinical, radiological, and histological presentations. To our knowledge, this is the first case series of abdominal basidiobolomycosis to be reported from Sudan.

scholarly journals POS1288 TUBERCULOUS SPONDYLODISCITIS IN ELDERLY: EPIDEMIOLOGY, CLINICAL, FEATURES, TREATMENT AND OUTCOMES

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 926.1-926
Author(s):  
M. Mrabet ◽  
S. Boussaid ◽  
S. Jemmali ◽  
H. Sahli ◽  
H. Ajlani ◽  
...  
Keyword(s):  
Clinical Features ◽  
The Elderly ◽  
Lumbar Pain ◽  
Elderly Subjects ◽  
Normocytic Anemia ◽  
Imaging Features ◽  
X Rays ◽  
Significant Difference ◽  
Young Subjects ◽  
Tuberculous Spondylodiscitis

Background:Tuberculosis is still endemic all over the world. The incidence of tuberculous spondylodiscitis (TS) is steadily increasing. Clinical features and outcomes of this affection are various and depending on various parameters, including age.Objectives:Our objective was to explore the differences in presentation and the results of further investigations and the prognosis of TS between young and elderly subjects.Methods:We conduct a retrospective and descriptive study in a single rheumatology department. Data were collected from files of patients hospitalized in the past 20 years (2000-2020) who have been diagnosed with TS. We carried out a comparative study concerning the clinical biological, imaging features and outcomes between young subjects and subjects aged over 65 years.Results:Fifty-two cases of TS were collected (37F/15M). The mean age of the population was 55.21 years ± 17.79 [19-91]. Thirty-three patients (69.2%) were classified as young versus 16 elderly patients (30.8%), with female predominance in both groups (69.4% and 75% respectively, p = 0.57). Young subjects was more frequently vaccinated (88.9%) by Bacillus Calmette–Guérin (BCG) (p < 0.001). A delayed diagnosis was noted in both groups (p = 0.24). Lumbar spine involvement was the most common (57.7%). In the two age ranges, the onset of the disease was progressive (p = 0.22), characterized by segmental spine stiffness (p = 0.57) and lumbar pain with general signs (p = 0.27), such as: impaired general condition, fever, night sweats and weight loss. Biological inflammatory syndrome and normochrome normocytic anemia were encountered in both cases (p = 0.08 and p = 0.2, respectively). Standard X-rays and Computed tomography were more performed in young subjects (94.4% and 69.4%, respectively; p < 0.001), unlike magnetic resonance imaging which was more common in elderly subjects but with no statistically significant difference (p = 0.22). Disc pinch, erosion of vertebral plateaus and vertebral collapse were the major signs (82.7%, 65.4% and 67.3%, respectively). Clinical, biological and imaging arguments contributed to positive diagnosis in both groups (p = 0.24). Common medical treatment was anti-tuberculosis: Isoniazid (H), Rifampicin (R), Pyrazinamide (Z), Ethambutol (E) and physical treatment such as immobilization witch was more common in the eldery (56.3%, p = 0.16). The evolution of the disease was characterized by a clear improvement of young subjects during the second week of treatment (p < 0.001). A more frequent clinical improvement in older subjects was during the fourth week but with no statistically significant difference (p = 0.13). The occurrence of immediate complications was more frequent in the elderly (p = 0.23) with a predominance for drug complications (56.3%) such as: hepatic cytolysis (12.5%), hyperuricemia (18.8%) and major intolerance to anti-tuberculosis (18.8%).Conclusion:TS is a frequent condition that needs to be treated rapidly. the clinical presentation of TS in the elderly is less noisy which leads to more frequent complications and mortality.Disclosure of Interests:None declared

Imaging and clinical features of neurocutaneous melanosis in the pediatric population.

2021 ◽  
Vol 17 ◽  
Author(s):  
Mormina Enricomaria ◽  
Granata Francesca ◽  
Vinci Sergio Lucio ◽  
Coglitore Alessandra ◽  
Caragliano Antonio Armando ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Clinical Features ◽  
Pediatric Population ◽  
Cord Compression ◽  
Imaging Method ◽  
Imaging Features ◽  
Multisystem Disease ◽  
Neurocutaneous Melanosis ◽  
Pubmed Database

Background: Neurocutaneous melanosis (NCM) is a rare nonfamilial phakomatosis characterized by the presence of congenital melanocytic nevi and abnormal melanocytes infiltration of the leptomeninges. Objective & Methods: This paper shows the importance of early diagnosis and the most important imaging features of the disease on CT and MR scans. PubMed database was searched from January 1972 to September 2020. Papers including imaging findings of NCM, clinical, follow-up, and treatment features were collected, selecting only 89 studies. Discussion: NCM is a term used for the first time by van Bogaert in 1948. It refers to a condition caused by an error during morphogenesis and migration leading to leptomeningeal melanocytic accumulation. Although histological findings are the gold standard for diagnosis confirmation, neuroimaging and clinical features strongly support the suspect of NCM. Localization and extension of the lesions are predictive of neurological manifestations related to increased intracranial pressure, mass lesions, or spinal cord compression. CT demonstrates sites of increased density in the anterior temporal lobe - mainly the amygdala - thalami, cerebellum, and frontal lobes base. However, MRI is the best imaging method to diagnose central nervous system lesions, often appearing as T1-short signal areas of the cerebral parenchyma, indicative of central nervous system melanosis. MRI can also reveal associated intracranial and intraspinal abnormalities. Conclusion: Early imaging, when available, is helpful if NCM suspect is raised and may be of guidance in comparing later studies. NCM requires a multidisciplinary approach since it is a multisystem disease with a genetic component.

scholarly journals Clinical features of cats with aqueous tear deficiency: a retrospective case series of 10 patients (17 eyes)

2018 ◽  
Vol 21 (10) ◽  
pp. 944-950 ◽  
Author(s):  
Lisa K Uhl ◽  
Akihiko Saito ◽  
Hiroko Iwashita ◽  
David J Maggs ◽  
Jonathan P Mochel ◽  
...  
Keyword(s):  
Clinical Features ◽  
Ocular Surface ◽  
Clinical Signs ◽  
Case Series ◽  
Reference Interval ◽  
Clinical Findings ◽  
Response To Therapy ◽  
Ocular Surface Disease ◽  
Retrospective Case ◽  
Schirmer Tear Test

Objectives The aim of this study was to describe the clinical findings, diagnostic test results and response to therapy of cats with Schirmer tear test 1 (STT-1) values below the reference interval. Methods The medical records of three institutions were searched for cats with ocular surface disease and STT-1 values <9 mm/min, confirmed at two or more separate visits. Results Ten cats (17 eyes) were included. The mean ± SD (range) age and STT-1 values in affected eye(s) were 6.1 ± 5.7 (0.2–16) years and 2.4 ± 3.1 (0–8) mm/min, respectively. Concurrent ocular surface disease was bilateral in 5/10 cats. Clinical signs included conjunctivitis (14/17 eyes), corneal ulceration (6/17 eyes), non-ulcerative keratitis (4/17 eyes), symblepharon (4/17 eyes), eosinophilic keratitis (3/17 eyes), corneal sequestrum (3/17 eyes), corneal fibrosis (2/17 eyes) and meibomitis (2/17 eyes). Management included: topically applied lacrimomimetics, antiviral drugs, corticosteroids or immunomodulatory drugs; orally administered famciclovir; or surgical procedures, in various combinations. Response to therapy (defined as an increase in STT-1 value of ⩾5 mm/min) was transient (seen at a single reassessment) in 65% of eyes and sustained (seen at ⩾2 consecutive reassessments) in 18% of eyes. Conclusions and relevance Clinical features seen in cats with low STT-1 values are described, although the association between aqueous deficiency and the reported ocular changes is unknown at this time. We encourage clinicians to assess the tear film in cats with ocular surface disease, and initiate therapy with lacrimomimetics if STT-1 values are repeatedly below normal. Such information will further define aqueous tear deficiency in cats, providing a better understanding of disease prevalence, pathogenesis and treatment.

scholarly journals Tratamento cirúrgico do ceratocisto odontogênico por meio de enucleação e osteotomia periférica: relato de caso

2020 ◽  
Vol 9 (6) ◽  
pp. 531-534
Author(s):  
Diogo Henrique Marques ◽  
Maylson Alves Nogueira Barros ◽  
Vitor Bruno Teslenco ◽  
Cláudio Marcio Santana Junior ◽  
Lucas Marques Meurer ◽  
...  
Keyword(s):  
Case Report ◽  
Meta Analysis ◽  
Benign Lesion ◽  
Dentigerous Cyst ◽  
Case Series ◽  
Odontogenic Keratocyst ◽  
Imaging Features ◽  
Retrospective Case ◽  
Odontogenic Keratocysts

Introdução: Os ceratocistos odontogênicos (CCA) são considerados raros cistos de desenvolvimento, derivados dos remanescentes da lâmina dentária, com atividade intraóssea benigna, porém localmente invasivo e agressivo. O tratamento para o ceratocisto odongênico é variado, podendo-se encontrar modalidades tais como:enucleação, isolada ou associada a curetagem, com osteotomia periférica, aplicação da solução de Carnoy ou crioterapia, descompressão, marsupialização e ressecções. Objetivo: O presente trabalho tem como objetivo relatar um caso de ceratocisto odontogênico, onde foi escolhida abordagem conservadora por curetagem e osteotomia periférica. Relato de caso: Paciente de 68 anos, leucoderma, referiu ao exame clínico dor espontânea em região retromolar esquerda e parestesia em lábio inferior. A paciente foi submetida a biopsia por aspiração e excisional, após confirmação histopatológica foi proposto uma enucleação associada a osteotomia periférica sob anestesia geral. A paciente permanece em acompanhamento clínico e radiográfico, sem sinais de recidiva da lesão. Conclusão: Embora apresentem um comportamento agressivo, os ceratocistos odontogêncios podem ser tratados com segurança, de forma conservadora, por meio de enucleação seguida de osteotomia periférica com mínimo de morbidade. Descritores: Osteotomia; Curetagem; Cistos Odontogênicos. Referências Borghesi A, Nardi C, Giannitto C, Tironi A, Maroldi R, Di Bartolomeo F, Preda L. Odontogenic keratocyst: imaging features of a benign lesion with an aggressive behaviour. Insights Imaging. 2018 Oct;9(5):883-897. Park JH, Kwak EJ, You KS, Jung YS, Jung HD. Volume change pattern of decompression of mandibular odontogenic keratocyst. Maxillofac Plast Reconstr Surg. 2019 Jan 7;41(1):2.  Karaca C, Dere KA, Er N, Aktas A, Tosun E, Koseoglu OT, Usubutun A. Recurrence rate of odontogenic keratocyst treated by enucleation and peripheral ostectomy: Retrospective case series with up to 12 years of follow-up. Med Oral Patol Oral Cir Bucal. 2018 Jul 1;23(4):e443-e448.  Guerra LAP, Silva PS, Dos Santos RLO, Silva AMF, Albuquerque DP. Tratamento conservador de múltiplos tumores odontogênicos ceratocístico em paciente não sindrômico. Rev cir traumatol. buco-maxilo-fac. 2013; 13(2):43-50. Sundaragiri KS, Saxena S, Sankhla B, Bhargava A. Non syndromic synchronous multiple odontogenic keratocysts in a western Indian population: A series of four cases. J Clin Exp Dent. 2018;10(8):e831-6. Freitas AD, Veloso DA, Santos ALF, Freitas VA. Maxillary odontogenic keratocyst: a clinical case report. RGO Rev Gaúch Odontol. 2015; 63(4):484-88. Madhireddy MR, Prakash AJ, Mahanthi V, Chalapathi KV. Large Follicular Odontogenic Keratocyst affecting Maxillary Sinus mimicking Dentigerous Cyst in an 8-year-old Boy: A Case Report and Review. Int J Clin Pediatr Dent. 2018 Jul-Aug;11(4):349-351.  Moura BS, Cavalcante MA, Hespanhol W. Tumor odontogênico ceratocistico. Rev Col Bras Cir., 2016;43(6):466-71. Valori FP, Costa E, Buscatti MY, Oliveira JX, Costa C. Tumor odontogênico queratocístico: características intrínsecas e elucidação da nova nomenclatura do queratocisto odontogênico. J Health Sci Inst. 2010;28(1):80-3. Slusarenko da Silva Y, Stoelinga PJW, Naclério-Homem MDG. The presentation of odontogenic keratocysts in the jaws with an emphasis on the tooth-bearing area: a systematic review and meta-analysis. Oral Maxillofac Surg. 2019;23(2):133-47.

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