Pseudotumour and Metallosis after Revision Total Hip Replacement. Case Study

2018 ◽  
Vol 20 (1) ◽  
pp. 43-50
Author(s):  
Marek Hawranek ◽  
Mateusz Stolarz ◽  
Julian Dutka ◽  
Grzegorz Wrzask ◽  
Jakub Hawranek
Keyword(s):  
Ct Scan ◽  
Pathological Process ◽  
Surgical Removal ◽  
Lower Abdomen ◽  
X Ray ◽  
Total Arthroplasty ◽  
Gastrointestinal Pathology ◽  
Hip Ultrasound ◽  
Revision Total Hip Replacement

Metallosis is a complication of hip arthroplasty. This pathological process contributes to the loosening and dislocation of the prosthesis. This article discusses the case of a 61-year-old patient who reported pressure and pain as well as a palpable subcutaneous lump in the left lower abdomen and groin area. Medical history included total arthroplasty and repeat arthroplasty of the left hip joint, hysterectomy, appendectomy and a laparoscopic fundoplasty. A CT scan and ultrasound showed an unrecognised heterogeneous fluid area raising suspicions of a rumour mass or an old haematoma. After exclusion of gastrointestinal pathology, the patient was referred to the department of trauma and orthopaedic surgery, where a new x-ray of the hip, ultrasound and CT scan were performed and loosening of the prosthesis was ruled out. The pathological tissue was removed surgically through an incision in the groin area. On the basis of intraoperative changes, the pseudotumour was diagnosed as metallosis based. In con­clusion, any suspicion of a pseudotumour requires extensive and accurate evaluation, excluding general surgical causes. Complete surgical removal of the tumour is the only effective method of treatment.

scholarly journals Symptomatic Lumbar Hypertrophy of Flavum Ligament Associated with Neurogenic Claudication

2019 ◽  
Vol 12 (1) ◽  
pp. 473-477
Author(s):  
G.B. Mahadewa Tjokorda
Keyword(s):  
Ct Scan ◽  
Surgical Complication ◽  
Fibrous Tissue ◽  
Pathological Process ◽  
Neurogenic Claudication ◽  
Short Term ◽  
Test Analysis ◽  
X Ray ◽  
Magnetic Resonance Imaging Mri ◽  
Student’S T

To investigate clinical improvements and histologic studies of patients with symptomatic lumbar hypertrophic of flavum ligament (HFL) associated with neurogenic claudication. There were 32 subjects (18 males and 14 females) included in the study with the mean age of 46 years old (range 32 to 64). Patients functionality is measured by Neurogenic Claudication Outcome Score (NCOS). All patients were treated previously in a rehabilitation unit for four weeks and indicated for surgery due to neurogenic claudication (excluding those without neurological deficit). Imaging modalities were taken preoperatively (plain spine x-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI) and postoperatively (plain x-ray at day 3 and two months later, CT scan after eight weeks). Histological studies were also taken, as well as the NCOS for evaluating the claudication. A student’s t-test analysis was carried out on the NCOS pre- and postoperative to evaluate the improvement significance. The improvement of the NCOS score in male was 23.1±2.23 and female was 24.85±2.68 (p=0.023). Histologically, the flavum ligament was hardening, stiffening, and calcifying resulting in a decrease in the ratio of elastin to fibrous tissue, leading to the hypertrophic process. In the short term, surgical results improved in all patients with no surgical complication. Surgical decompression can yield a better outcome in the short term for treating symptomatic lumbar HFL associated with neurogenic claudication. This early pathological process in the flavum ligament results in an overall tissue thickening leading to narrowing of the lumbar canal.

scholarly journals Foreign Body in the Anterior Chamber Presenting as Inflammatory Mass on the Iris

2021 ◽  
pp. 19-25
Author(s):  
Rajgopal Arvinth ◽  
Mimiwati Zahari ◽  
Sagili Chandrasekhara Reddy
Keyword(s):  
Foreign Body ◽  
Ct Scan ◽  
Anterior Chamber ◽  
Anterior Segment ◽  
Intraocular Foreign Body ◽  
Surgical Removal ◽  
Eye Drops ◽  
Metallic Foreign Body ◽  
Inflammatory Mass ◽  
X Ray

A 40-year- old male factory worker presented to our eye clinic with left eye pain, redness and blurring of vision, associated with history of an injury sustained while hammering a nail into the wall               three days ago.  He had mild symptoms at the onset of the injury.  Slit lamp examination of left eye showed a small, self-sealed laceration corneal wound at the temporal limbus and a smooth, well      defined, oval mass on the iris in the anterior chamber in the lower temporal quadrant. Rest of the anterior segment and fundus were normal. X-ray orbits showed no intraocular foreign body in the             left eye.  In view of clinical suspicion, we proceeded with a CT scan of orbits which showed the presence of a small metallic foreign body in the anterior chamber of left eye. After giving topical antibiotic, cycloplegic, and corticosteroid eye drops along with systemic antibiotics for three days, we planned surgical removal of the mass in the anterior chamber. After the mass was removed, we noted a small metallic foreign body embedded within the fibrin mass. The same treatment was continued postoperatively. The left eye became white and quiet, and vision improved to 6/6 with above treatment. The key learning point presented is that when the history is suggestive of intraocular foreign body, even though the X-ray orbits does not show the foreign body one has to get CT scan of orbits done to rule out its presence, especially when there is inflammatory mass in the anterior chamber as seen in our case.

Requesting physicians’ knowledge of X-radiation exposure from computed tomography scan examinations: A case study of two Nigerian tertiary hospitals

2020 ◽  
Vol 3 ◽  
pp. 36-39
Author(s):  
Samson O. Paulinus ◽  
Benjamin E. Udoh ◽  
Bassey E. Archibong ◽  
Akpama E. Egong ◽  
Akwa E. Erim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ionizing Radiation ◽  
Ct Scan ◽  
Radiation Exposure ◽  
Work Experience ◽  
Radiation Risk ◽  
Radiological Protection ◽  
X Ray ◽  
Tertiary Hospitals ◽  
Medical Exposure

Objective: Physicians who often request for computed tomography (CT) scan examinations are expected to have sound knowledge of radiation exposure (risks) to patients in line with the basic radiation protection principles according to the International Commission on Radiological Protection (ICRP), the Protection of Persons Undergoing Medical Exposure or Treatment (POPUMET), and the Ionizing Radiation (Medical Exposure) Regulations (IR(ME)R). The aim is to assess the level of requesting physicians’ knowledge of ionizing radiation from CT scan examinations in two Nigerian tertiary hospitals. Materials and Methods: An 18-item-based questionnaire was distributed to 141 practicing medical doctors, excluding radiologists with work experience from 0 to >16 years in two major teaching hospitals in Nigeria with a return rate of 69%, using a voluntary sampling technique. Results: The results showed that 25% of the respondents identified CT thorax, abdomen, and pelvis examination as having the highest radiation risk, while 22% said that it was a conventional chest X-ray. Furthermore, 14% concluded that CT head had the highest risk while 9% gave their answer to be conventional abdominal X-ray. In addition, 17% inferred that magnetic resonance imaging had the highest radiation risk while 11% had no idea. Furthermore, 25.5% of the respondents have had training on ionizing radiation from CT scan examinations while 74.5% had no training. Majority (90%) of the respondents were not aware of the ICRP guidelines for requesting investigations with very little (<3%) or no knowledge (0%) on the POPUMET and the IR(ME)R respectively. Conclusion: There is low level of knowledge of ionizing radiation from CT scan examinations among requesting physicians in the study locations.

scholarly journals Characterization and mapping of hematite ore mineral classes using hyperspectral remote sensing technique: a case study from Bailadila iron ore mining region

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Ibrahim Shaik ◽  
S. K. Begum ◽  
P. V. Nagamani ◽  
Narayan Kayet
Keyword(s):  
Infrared Absorption ◽  
Near Infrared ◽  
Spectral Feature ◽  
Absorption Feature ◽  
X Ray ◽  
Remote Sensing Technique ◽  
Ore Minerals ◽  
Feature Fitting ◽  
Hematite Ore

AbstractThe study demonstrates a methodology for mapping various hematite ore classes based on their reflectance and absorption spectra, using Hyperion satellite imagery. Substantial validation is carried out, using the spectral feature fitting technique, with the field spectra measured over the Bailadila hill range in Chhattisgarh State in India. The results of the study showed a good correlation between the concentration of iron oxide with the depth of the near-infrared absorption feature (R2 = 0.843) and the width of the near-infrared absorption feature (R2 = 0.812) through different empirical models, with a root-mean-square error (RMSE) between < 0.317 and < 0.409. The overall accuracy of the study is 88.2% with a Kappa coefficient value of 0.81. Geochemical analysis and X-ray fluorescence (XRF) of field ore samples are performed to ensure different classes of hematite ore minerals. Results showed a high content of Fe > 60 wt% in most of the hematite ore samples, except banded hematite quartzite (BHQ) (< 47 wt%).

Evaluating drilling fluid infiltration in porous media – Comparing NMR, gravimetric, and X-ray CT scan methods

2021 ◽  
Vol 198 ◽  
pp. 108242
Author(s):  
Badr S. Bageri ◽  
Abdulrauf R. Adebayo ◽  
Jaber Al Jaberi ◽  
Shirish Patil ◽  
Rahul B. Salin
Keyword(s):  
Porous Media ◽  
Ct Scan ◽  
Drilling Fluid ◽  
X Ray ◽  
Fluid Infiltration

scholarly journals ctDNA Clearance and Radiographic Resolution of Disease in Response to Dual Checkpoint Inhibition in Metastatic Microsatellite Stable Colorectal Cancer with a High Tumor Mutation Burden

2021 ◽  
pp. 849-853
Author(s):  
Charles J. Schneider ◽  
Michael Krainock ◽  
Allyson Koyen Malashevich ◽  
Meenakshi Malhotra ◽  
Perry Olshan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Ct Scan ◽  
Circulating Tumor Dna ◽  
Therapeutic Benefit ◽  
Tumor Mutation Burden ◽  
Early Treatment Response ◽  
Mutation Burden ◽  
Disease Present

Immunotherapy (IO) has increasingly been demonstrated to provide therapeutic benefit to patients with metastatic colorectal cancer (mCRC). However, only a subset of mCRC tumors respond to IO. Monitoring response with tumor biomarkers like carcinoembryonic antigen (CEA) has been challenging in patients with microsatellite stable (MSS) mCRC due to low expression of CEA (CEA/lo). Noninvasive blood-based biomarkers such as circulating tumor DNA (ctDNA) can inform early treatment response and augment radiographic monitoring. We describe a case study of a patient with chemotherapy-refractory CEA/lo MSS mCRC, with metastatic disease present in a cardiophrenic lymph node. The patient was given 2 cycles of combination IO (ipilimumab/nivolumab). Response was monitored by ctDNA using a multiplex PCR next-generation sequencing assay, CEA, and CT scan. After IO administration, ctDNA levels rapidly declined, becoming undetectable. This was concurrent with radiographic resolution of the lymph node metastasis. Serial monitoring of CEA during this same period was uninformative, with no significant changes observed. Significant decline in ctDNA identified metastatic response to IO in a patient with CEA/lo, MSS mCRC and was concurrently validated by CT scan. This case study provides evidence that ctDNA can be used as a prospective surrogate for radiographic tumor response.

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