scholarly journals Evaluation of radiologic diagnostic criteria and treatment options in skeletal muscle hydatid cysts

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901988121 ◽  
Author(s):  
Hasan U Oğur ◽  
Rana Kapukaya ◽  
Özgür Külahçı ◽  
Cengiz Yılmaz ◽  
Kemal Yüce ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Diagnostic Criteria ◽  
Diagnosis And Treatment ◽  
Alternative Methods ◽  
Muscular Tissue ◽  
Hydatid Cysts ◽  
Mri Findings ◽  
Cyst Excision ◽  
Soft Tissue Involvement ◽  
The Mean

Aim: To investigate the diagnosis and treatment methods of soft tissue involvement of hydatid cysts (HCs). Materials and Methods: Eleven patients who were diagnosed as having HC with muscular tissue (soft tissue) involvement between 2010 and 2016 were evaluated retrospectively. Seven patients had typical HC magnetic resonance imaging (MRI) and four patients had cysts with an unusual appearance. We evaluated how to diagnose the cysts using imaging methods, their characteristic radiologic images, and treatment alternatives against the disease. The patients were treated with antihelminthic chemotherapy preoperatively and postoperatively. Results: Of the 11 patients who underwent treatment, 7 were diagnosed using MRI and 4 were diagnosed with histopathologic examinations. The mean follow-up period was 16 (range, 6–24) months, and the mean age was 39.4 (range, 24–56) years. In seven patients, multivesicular appearance with specific MRI findings, T2-hypointense rim appearance, double-rim sign, membrane dissociation, and appearance of daughter cysts were identified as diagnostic criteria. Two patients underwent ultrasound assisted percutaneous aspiration–injection–reaspiration (PAIR) treatment. Seven patients underwent total pericystectomy, and two patients underwent subtotal pericystectomy with serum saline injection into the cyst. Two patients showed signs of mild anaphylaxis, one during the diagnosis and one during treatment. Conclusion: There may be difficulties in the diagnosis and treatment of HCs of the musculoskeletal system. It should be known that there are alternative methods in the treatment (cyst excision and PAIR treatment). Clinical, serologic, and radiologic findings should be used in the diagnosis. To avoid complications during the histopathologic diagnosis, MRI should be examined in detail. It is thought that atypical cysts can be diagnosed (double-layer appearance and peripheral rim sign) in addition to typical cysts (detached membrane and multivesicular appearance), and diagnosis and treatment can be planned without anaphylactic complications.

MRI Findings in a Young Boxer with Septic Physitis of the Humerus

2020 ◽  
Vol 56 (3) ◽  
pp. 165-169
Author(s):  
Rachel Kakas ◽  
Stephen Stockdale ◽  
Alaina Carr
Keyword(s):  
Soft Tissue ◽  
Septic Arthritis ◽  
Human Medicine ◽  
Small Animals ◽  
Fine Needle Aspirate ◽  
Ultrasound Guided ◽  
Mri Findings ◽  
Fine Needle ◽  
Soft Tissue Involvement ◽  
Rule Out

ABSTRACT The MRI appearance of appendicular septic physitis has not been reported in small animals. MRI appearance of septic arthritis and osteomyelitis has been described in horses, and the use of MRI has been proposed as a diagnostic alternative to radiographs to allow for earlier diagnosis and treatment. MRI is also routinely used in human medicine for the diagnosis of osteomyelitis owing to increased accuracy of evaluation of the soft tissue involvement. In the case of a 5 mo old male boxer dog described here, radiographs were suggestive of the diagnosis of septic physitis, although an MRI was obtained to rule out neurologic etiologies of lameness based on history and physical exam findings. MRI identified a fluid pocket communicating with the physis. The diagnosis of septic physitis was then confirmed via ultrasound-guided fine-needle aspirate of the fluid pocket communicating with the physis that was seen on the MRI.

Soft Tissue Profiles of 3-5 Year Old Preschool Children

2011 ◽  
Vol 35 (3) ◽  
pp. 339-344 ◽  
Author(s):  
Kerem Dalci ◽  
Serap Cetiner
Keyword(s):  
Preschool Children ◽  
Soft Tissue ◽  
Significant Relationship ◽  
Primary Dentition ◽  
Diagnosis And Treatment ◽  
Mean Values ◽  
Second Molar ◽  
Dental Patients ◽  
Soft Tissue Profile ◽  
The Mean

Objective: Identifying the characteristics of soft-tissue profiles in 3-5 year old children. Methods: Children that participated in the study were selected from the 6 major districts of Ankara. In the selected schools,3-5 year old 1513 children with primary dentition were examined and profile photographs were obtained. Facial convexity angle (FCA) and Total facial convexity angle (TFCA) were measured from profile photographs.Results: The mean values for the total facial convexity (145.9° ±4.2) and facial convexity(165.3° ±4.5) angles were determined. FCA and TFCA were significantly influenced by primary second molar terminal plane relationship. Conclusion: Finding of this study may be used as clinical references for pediatric dental patients and also, the significant relationship between soft tissue profile and primary occlusion is important for orthodontic diagnosis and treatment of pediatric dental patients.

scholarly journals Weightbearing CT and MRI findings of Stage II Flatfoot Deformity: Can We Predict Patients at High- Risk for Foot Collapse?

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0016
Author(s):  
Cesar de Cesar Netto ◽  
Guilherme Honda Saito ◽  
Andrew Roney ◽  
Lauren Roberts ◽  
Ashraf Fansa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Subtalar Joint ◽  
Stage Ii ◽  
Mr Images ◽  
Mri Findings ◽  
Bone Deformity ◽  
Interosseous Ligament ◽  
Spring Ligament ◽  
Soft Tissue Involvement ◽  
Weightbearing Ct

Category: Hindfoot Introduction/Purpose: Adult acquired flatfoot deformity (AAFD) is characterized by concurrent bony deformities, tendinous and ligamentous insufficiencies. Weightbearing CT (WBCT) allows excellent dynamic evaluation of the relative three-dimensional positioning of the tarsal bones. MRI provides accurate evaluation of soft tissue integrity in the unloaded foot. Study’s objective was to evaluate the correlation between bone deformity and soft tissue insufficiency in patients with stage II AAFD, using WBCT and MR images. We hypothesized that significant correlation would be found between WBCT measurements of increased longitudinal arch collapse, hindfoot valgus, peritalar subluxation and forefoot abduction, with MRI findings demonstrating degree of soft tissue involvement. Methods: This retrospective comparative study included 55 patients (56 feet) with stage II AAFD, 20 men and 35 women, mean age of 52.5 (range, 20 to 78) years. Multiple WBCT and MRI variables related to the severity of the deformity were evaluated by four blinded and independent readers (two radiologists and two foot and ankle surgeons), including: arch collapse (navicular-floor distance and forefoot arch angle), hindfoot alignment angle (HAA), forefoot abduction (talonavicular uncoverage angle), subtalar joint subluxation, sinus tarsi and subfibular impingement, and soft tissue insufficiency (posterior tibial tendon, spring and talocalcaneal ligaments). Tendinous and ligamentous involvement on MRI were graded from zero (normal) to four (complete tear). Intra- and interobserver reliabilities were assessed by Pearson/Spearman’s and intraclass correlation coefficient, respectively. A multiple regression analysis was used to evaluate the relationship between bone alignment (WBCT variables) and soft tissue injury (MRI variables). P-values of less than 0.05 were considered significant. Results: We found overall good to excellent intra (range, 0.83-0.99) and interobserver reliability (range, 0.71-0.97) for WBCT measurements and MRI readings. Spring ligament superomedial component involvement was the only finding to correlate with medial column collapse and decreased navicular-floor distance (p=0.03). Superomedial spring ligament and PTT degeneration were also significantly correlated with increased HAA (p<0.01). Involvement of the talocalcaneal interosseous ligament significantly correlated with increased forefoot abduction as measured by the talonavicular uncoverage angle. Spring ligament degeneration, of both superomedial and inferior components, and talocalcaneal interosseous ligaments significantly correlated to subtalar joint subluxation (p<0.001). Involvement of the talocalcaneal interosseous ligament was the only one to significantly correlate to the presence of subfibular impingement (p=0.02). Degeneration of the PTT was significantly associated with sinus tarsi impingement (p=0.04). Conclusion: This study is the first to evaluate correlation between bone, tendinous and ligamentous involvement in AAFD patients, using WBCT and MR images. Our results demonstrated that progressive bone deformity in WBCT is significantly correlated to MRI involvement of the PTT and other important restraints such as the spring and talocalcaneal ligaments. The implications are that WBCT can predict ligamentous injuries and that MRI can predict dynamic bone deformity in AAFD patients. Furthermore, the correlation of bone and soft tissue involvement could impact surgical planning of flatfoot patients, decreasing thresholds for additional soft tissue procedures such as a spring ligament reconstruction.

Rare case of Mycobacterium marinum in a patient presenting with tenosynovitis

2021 ◽  
Vol 14 (5) ◽  
pp. e234417
Author(s):  
Henrik Zachar Langkilde ◽  
Kim Nesten ◽  
Melanie Birger Morillon
Keyword(s):  
Soft Tissue ◽  
Medical History ◽  
Rare Case ◽  
Correct Diagnosis ◽  
Mycobacterium Marinum ◽  
Local Injection ◽  
Diagnosis And Treatment ◽  
Extensor Tendons ◽  
Soft Tissue Involvement

A 72-year-old man presented with tenosynovitis of the left hand’s extensor tendons that had been present for several months. He was initially treated with corticosteroids, first by local injection then systemically, but with no effect. When re-evaluated, the patient had developed a rash, and the symptoms had spread locally to surrounding structures. At this point, the patient added to the medical history that he had been stung by a sculpin a month before the debut of symptoms. Based on this, the patient’s involved area was biopsied, and subsequent microbiology findings proved consistent with Mycobacterium marinum infection. By the time of diagnosis, the patient had soft tissue involvement, arthritis and osteomyelitis with an overlying rash. This case emphasises the need for reassessment when treatment is not effective and for further investigations of the medical history to establish the correct diagnosis and treatment.

Percutaneous removal of a soft tissue cement leakage complicating a percutaneous vertebroplasty by the mean of a supple biopsy forceps

2013 ◽  
Vol 40 (2) ◽  
pp. 140-142 ◽  
Author(s):  
Jérémie Durrleman ◽  
Frédéric Clarençon ◽  
Evelyne Cormier ◽  
Lise Le Jean ◽  
Jacques Chiras
Keyword(s):  
Soft Tissue ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Biopsy Forceps ◽  
Percutaneous Removal ◽  
The Mean

Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

2021 ◽  
pp. 107110072110130
Author(s):  
Kyeong-Hyeon Park ◽  
Chang-Wug Oh ◽  
Joon-Woo Kim ◽  
Hee-June Kim ◽  
Dong-Hyun Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Kirschner Wire ◽  
Wound Complications ◽  
Calcaneal Fractures ◽  
Simple Method ◽  
Wire Fixation ◽  
The Mean ◽  
Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

Delayed post-hypoxic leukoencephalopathy: Case report

2017 ◽  
Vol 41 (S1) ◽  
pp. s839-s839 ◽  
Author(s):  
M. Solerdelcoll Arimany ◽  
M. Garriga ◽  
E. Parellada
Keyword(s):  
Neuropsychiatric Symptoms ◽  
Brain Mri ◽  
Clinical History ◽  
Good Prognosis ◽  
Mri Findings ◽  
The Mean ◽  
Competing Interest ◽  
Weighted Sequences ◽  
Direct Toxicity ◽  
Progressive Cognitive Impairment

IntroductionDelayed post-hypoxic leukoencephalopathy (DPHL) is an underrecognized syndrome of delayed demyelination, where patients manifest neuropsychiatric symptoms after a period of 2–40 days of apparent recovery from a cerebral hypo-oxygenation episode.ObjectivesWe report a case of a patient who successfully recovered from an overdose of heroin, but then suffered a delayed abrupt neurological deterioration.AimsTo improve assessment and recognition of DPHL.MethodsAn adequate retrospective collection of clinical data and nonsystematic review of the literature was performed.ResultsA 43-year-old male with schizoaffective disorder who attempted suicide with an overdose of heroin, was successfully revived and return to his previously mental status, but 3 weeks after, he abruptly developed progressive cognitive impairment with akinetic mutism and ataxia. He was admitted to our acute psychiatric unit after brain CT and chemistry analyses were unremarkable. Brain MRI showed diffusely symmetric hyperintensity in the white matter (WM), pronominally the periventricular WM, on FLAIR and T2 weighted sequences. At 16 weeks postoverdose, he presented improvement both cognitive and motor symptoms, lasting deficits in frontal-executive functions.DiscussionDPHL is characterized by similar clinical and neuroimaging features regardless of the initial insult. The mean lucid interval coincides with the replacement half-life for myelin related lipids and proteins. Prolonged mild-to-moderate hypo-oxygenation of WM is thought to disrupt myelin turnover. It appears probable that these were responsible for DPHL in our patient rather than a direct toxicity.ConclusionDPHL can be diagnosed when clinical history, laboratory assessments and MRI findings are concordant. DPHL requires extensive support care and carries a relatively good prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Accuracy of total knee arthroplasty using the modified gap technique based on the bone gap: an evaluation of the bone gap with a distal femoral trial component

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Goki Kamei ◽  
Shigeki Ishibashi ◽  
Koki Yoshioka ◽  
Satoru Sakurai ◽  
Hiroyuki Inoue ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Distal Femur ◽  
Gap Size ◽  
Flexion Gap ◽  
Gap Technique ◽  
Joint Gap ◽  
Total Knee ◽  
The Mean

Abstract Background In total knee arthroplasty (TKA) using the modified gap technique, the soft-tissue balance is measured after osteotomy of the distal femur and proximal tibia (conventional bone gap). However, after osteotomy, the flexion gap size during 90° knee flexion may be larger than that observed after implantation. The tension of the lateral compartment during 90° flexion may also be reduced after osteotomy of the distal femur. We manufactured a distal femoral trial component to reproduce the condition after implantation and prior to posterior condyle osteotomy. This study aimed to evaluate the effect of the trial component on the flexion gap. Methods This prospective study included 21 consecutive patients aged 78 years with medial osteoarthritis who underwent cruciate-retaining TKA between February 2017 and March 2018. The postoperative flexion gap size and inclination during 90° flexion were compared between cases with and without the trial component. Results The mean joint gap size with the trial component (13.4 ± 0.80 mm) was significantly smaller than that without the trial component (14.7 ± 0.84 mm). The mean gap inclination angle with the trial component (3.7° ± 0.62°) was significantly smaller than that without the trial component (5.5° ± 0.78°). Conclusions In the present study, the joint gap size and medial tension were significantly reduced after the trial component had been set. Accurate measurement of the soft-tissue balance is an important factor in the modified gap technique, and this method using a distal femoral trial component can offer better outcomes than those achieved with conventional methods.

scholarly journals Skin stretch suturing with Nice knots in the treatment of small- or medium-sized wounds

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jianmin Xu ◽  
Rui Chang ◽  
Wei Zhang ◽  
Chengcheng Zhang ◽  
Dezhi Zhu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hair Growth ◽  
Wound Closure ◽  
Skin Wound ◽  
Soft Tissue Defects ◽  
Cutaneous Sensation ◽  
The Mean ◽  
Skin Stretch ◽  
Mean Time ◽  
Tissue Defects

Abstract Background To investigate the clinical efficacy and outcomes of skin stretch suturing with self-locking sliding Nice knots in the treatment of small- or medium-sized wounds. Methods From June 2015 to May 2018, 26 patients with small- or medium-sized wounds were included in the present study. Skin stretch suturing with self-locking slide Nice knots was performed to gradually close the soft-tissue defects in these patients. The time of wound closure and healing was recorded. The color and blood supply of the skin, cutaneous sensation, the stretch of skin, and the hair growth situation of the skin wound were observed and recorded. Results There were 17 males and 9 females with an average age of 30.65 years (range, 15–48 years). The areas of the soft-tissue defects were between 3.2 × 7.1 cm and 8.0 × 15.2 cm. All patients underwent stretch suturing with self-locking slide Nice knots to close the soft-tissue defects. All wounds were successfully closed and healed. The mean time of wound closure was 10.69 days (range, 5–20 days), and the mean time of wound healing was 16.85 days (range, 10–24 days). The cutaneous sensation of skin wound recovered normally, and the color of the skin wounds was the same as that of normal skin at the last follow-up. The hair growth situation of the skin wounds also returned to normal. Conclusions This study revealed that Nice knots yielded an accepted clinical result as a new method to close small- or medium-sized wounds that was simple and less minimally invasive, resulted in progressive tension, did not return to previous results, and partially replace flaps or free skin grafts.

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