Caput medusae in a patient with non-cirrhotic portal fibrosis: Clinical images

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.

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Faculty Opinions recommendation of Classification of the clinical images for benign and malignant cutaneous tumors using a deep learning algorithm.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.732648119.793554280 ◽

2018 ◽

Author(s):

Christine Ko

Keyword(s):

Deep Learning ◽

Learning Algorithm ◽

Clinical Images ◽

Deep Learning Algorithm

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AI-Provided Instant Differential Diagnosis of Pemphigus Vulgaris and Bullous Pemphigoid: Qualitative Study (Preprint)

10.2196/preprints.24845 ◽

2020 ◽

Author(s):

Xiaoyu He ◽

Juan Su ◽

Guangyu Wang ◽

Kang Zhang ◽

Navarini Alexander ◽

...

Keyword(s):

Artificial Intelligence ◽

Early Diagnosis ◽

Image Classification ◽

Bullous Pemphigoid ◽

Skin Diseases ◽

Pemphigus Vulgaris ◽

Classification Model ◽

Clinical Image ◽

Clinical Images ◽

Multimodal Classification

BACKGROUND Pemphigus vulgaris (PV) and bullous pemphigoid (BP) are two rare but severe inflammatory dermatoses. Due to the regional lack of trained dermatologists, many patients with these two diseases are misdiagnosed and therefore incorrectly treated. An artificial intelligence diagnosis framework would be highly adaptable for the early diagnosis of these two diseases. OBJECTIVE Design and evaluate an artificial intelligence diagnosis framework for PV and BP. METHODS The work was conducted on a dermatological dataset consisting of 17,735 clinical images and 346 patient metadata of bullous dermatoses. A two-stage diagnosis framework was designed, where the first stage trained a clinical image classification model to classify bullous dermatoses from five common skin diseases and normal skin and the second stage developed a multimodal classification model of clinical images and patient metadata to further differentiate PV and BP. RESULTS The clinical image classification model and the multimodal classification model achieved an area under the receiver operating characteristic curve (AUROC) of 0.998 and 0.942, respectively. On the independent test set of 20 PV and 20 BP cases, our multimodal classification model (sensitivity: 0.85, specificity: 0.95) performed better than the average of 27 junior dermatologists (sensitivity: 0.68, specificity: 0.78) and comparable to the average of 69 senior dermatologists (sensitivity: 0.80, specificity: 0.87). CONCLUSIONS Our diagnosis framework based on clinical images and patient metadata achieved expert-level identification of PV and BP, and is potential to be an effective tool for dermatologists in remote areas in the early diagnosis of these two diseases.

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Thromboelastographic evaluation of coagulation in patients with extrahepatic portal vein thrombosis and non-cirrhotic portal fibrosis: A pilot study

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.2008.05761.x ◽

2009 ◽

Vol 24 (6) ◽

pp. 992-997 ◽

Cited By ~ 13

Author(s):

Sorabh Kapoor ◽

Sujoy Pal ◽

Peush Sahni ◽

Tushar K Chattopadhyay

Keyword(s):

Pilot Study ◽

Portal Vein ◽

Portal Vein Thrombosis ◽

Portal Fibrosis ◽

Vein Thrombosis

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Evaluation of image quality at the detector’s edge of dedicated breast positron emission tomography

EJNMMI Physics ◽

10.1186/s40658-020-00351-6 ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Yoko Satoh ◽

Utaroh Motosugi ◽

Masamichi Imai ◽

Yoshie Omiya ◽

Hiroshi Onishi

Keyword(s):

Image Quality ◽

Chest Wall ◽

Clinical Studies ◽

Breast Imaging ◽

Phantom Study ◽

Breast Lesions ◽

Clinical Images ◽

Dedicated Breast Pet ◽

Pet Ct ◽

Significant Difference

Abstract Background Using phantoms and clinical studies in prone hanging breast imaging, we assessed the image quality of a commercially available dedicated breast PET (dbPET) at the detector’s edge, where mammary glands near the chest wall are located. These are compared to supine PET/CT breast images of the same clinical subjects. Methods A breast phantom with four spheres (16-, 10-, 7.5-, and 5-mm diameter) was filled with 18F-fluorodeoxyglucose solution (sphere-to-background activity concentration ratio, 8:1). The spheres occupied five different positions from the top edge to the centre of the detector and were scanned for 5 min in each position. Reconstructed images were visually evaluated, and the contrast-to-noise ratio (CNR), contrast recovery coefficient (CRC) for all spheres, and coefficient of variation of the background (CVB) were calculated. Subsequently, clinical images obtained with standard supine PET/CT and prone dbPET were retrospectively analysed. Tumour-to-background ratios (TBRs) between breast cancer near the chest wall (close to the detector’s edge; peripheral group) and at other locations (non-peripheral group) were compared. The TBR of each lesion was compared between dbPET and PET/CT. Results Closer to the detector’s edge, the CNR and CRC of all spheres decreased while the CVB increased in the phantom study. The disadvantages of this placement were visually confirmed. Regarding clinical images, TBR of dbPET was significantly higher than that of PET/CT in both the peripheral (12.38 ± 6.41 vs 6.73 ± 3.5, p = 0.0006) and non-peripheral (12.44 ± 5.94 vs 7.71 ± 7.1, p = 0.0183) groups. There was no significant difference in TBR of dbPET between the peripheral and non-peripheral groups. Conclusion The phantom study revealed poorer image quality at < 2-cm distance from the detector’s edge than at other more central parts. In clinical studies, however, the visibility of breast lesions with dbPET was the same regardless of the lesion position, and it was higher than that in PET/CT. dbPET has a great potential for detecting breast lesions near the chest wall if they are at least 2 cm from the edge of the FOV, even in young women with small breasts.

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Clinical Images: Pseudogout of the temporomandibular joint

ACR Open Rheumatology ◽

10.1002/acr2.11268 ◽

2021 ◽

Author(s):

Mithu Maheswaranathan ◽

Jessica L. Houk ◽

Danielle Elliott Range ◽

Jennifer Rogers

Keyword(s):

Temporomandibular Joint ◽

Clinical Images

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Clinical Images: Hydroxychloroquine‐associated mucous labial pigmentation in a patient with systemic lupus erythematosus improving under topical treatment with tacrolimus

ACR Open Rheumatology ◽

10.1002/acr2.11209 ◽

2021 ◽

Author(s):

Ian Pirker ◽

Ieva Saulite ◽

Johannes Kempis

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Topical Treatment ◽

Systemic Lupus ◽

Clinical Images

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Combination of Novel c.3484G> T/p.Glu162Ter Variant in ABCB11 and c.208G> A/p.Asp70Asn Variant in ATP8B1 Are Associated with Severe Symptoms in Progressive Family Intrahepatic Cholestasis

Journal of Pediatric Genetics ◽

10.1055/s-0039-1700971 ◽

2020 ◽

Vol 09 (04) ◽

pp. 285-288

Author(s):

Mervan Bekdas ◽

Guray Can ◽

Recep Eroz ◽

Selma Erdogan Duzcu

Keyword(s):

Intrahepatic Cholestasis ◽

Autosomal Recessive ◽

Autosomal Recessive Disease ◽

Bile Secretion ◽

Peripheral Blood Sample ◽

Portal Fibrosis ◽

Traditional Treatment ◽

Pathogenic Variants ◽

Chronic Cholestasis ◽

Whole Exome

AbstractProgressive family intrahepatic cholestasis (PFIC) is an autosomal recessive disease that causes chronic cholestasis. It is associated with pathogenic variants in genes that encode proteins involved in bile secretion to canaliculus from hepatocytes. In this study, we present a 16-year-old boy who presented with severe pruritus and cholestatic jaundice. All possible infectious etiologies were negative. A liver biopsy was consistent with intrahepatic cholestasis and portal fibrosis. DNA was isolated from a peripheral blood sample, and whole exome sequencing was performed. A novel c.3484G > T/p.Glu162Ter variant in the ABCB11 gene and a c.208G> A/p.Asp70Asn variant in the ATP8B1 gene were detected. Despite traditional treatment, the patient's recurrent severe symptoms did not improve. The patient was referred for a liver transplantation. This novel c.3484G > T/p.Glu162Ter variant is associated with a severe and recurrent presentation, and the two compound variants could explain the severity of PFIC.

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