A Case of Unrelenting Facial Swelling

Melkersson-Rosenthal syndrome (MRS) is an uncommon disorder with presenting symptoms that typically involve the face and orofacial structures. It is a difficult diagnosis to make, as it may present with a protracted course of seemingly unrelated dermatological, ocular, and neurological findings. This case report reviews the presentation, workup, and diagnosis of a 75-year-old woman who presented with orofacial swelling, facial palsy, and tongue fissuring that had intermittently recurred over 10 years without a unifying diagnosis. Extensive medical history, photography, laboratory workup, and radiographic imaging were performed to identify the diagnosis of MRS in this patient. Our case highlights the challenge and importance of critically evaluating and consolidating a patient’s history of their present illness, physical examination, and ancillary testing to successfully establish a unifying diagnosis, especially when the diagnosis is relatively rare and diverse in its range of affected populations and symptomatology.

Multilocular Thymic Cyst in a Patient with Untreated HIV/AIDS: Case Report and Review of the Literature

Background: Multilocular thymic cysts (MTCs) in adults with human immunodeficiency virus (HIV) are rarely reported. Case Presentation: We describe a case of symptomatic MTC in a male with untreated HIV. A presumptive diagnosis was established based on radiographic imaging and biopsy. Pathologic diagnosis and exclusion of malignancy were ultimately confirmed the following thymectomy. In conjunction with starting antiretroviral therapy, the patient recovered well post-operatively with a resolution of his presenting symptoms. Conclusion: Our case report and review of the literature serve to highlight MTCs as an important clinical entity occurring in persons with HIV.

Radiographic Landmarks for Ideal Port Placement in Wrist Arthroscopy

Background The placement of wrist arthroscopy portals is traditionally performed using distances from anatomic landmarks. We sought to evaluate the safety of traditional portal placement and determine if radiographic landmarks could provide an additional method of identifying tendon intervals. Methods Six cadaveric specimens were used to evaluate the accuracy of portal placement based on anatomic and radiographic landmarks. Fluoroscopic images were used to document the location of previously described surface landmarks. Soft tissue was dissected away to identify the relationship between the transcutaneously placed portals and the extensor tendons. With soft tissue removed, tendon intervals were identified in relationship to anatomic carpal bone landmarks, and interval distances measured. Portals were then placed under radiographic imaging on the final three specimens and accuracy was examined by the removal of overlying soft tissue to confirm accurate interval placement Results The 3,4 portal was safely placed using only surface anatomic landmarks, however the 4,5 and midcarpal ulnar (MCU) portal sites were not consistently placed in the intended tendon interval, especially in larger wrists. Radiographic interval targets for the 3,4 portal were identified at the ulnar aspect of the scaphoid and the 4,5 portal at the ulnar one-third of the lunate. The radiographic site for the MCR was located at the inferior radial one-third of the capitate and the MCU portal was located at the radial aspect of the hamate. The 6R portal radiographic landmark is at the radial aspect of the triquetrum and 6U at the ulnar aspect of the triquetrum. Conclusion Portal placement in wrist arthroscopy based on anatomic landmarks alone can be unreliable in larger wrists. Radiographic imaging based on carpal bone landmarks provides an additional tool for consistent placement of portals in wrist arthroscopy and may limit unintended injury to extensor tendons. Level of Evidence This is a Level VI study.

Breathy Dysphonia, Not Just a Pain in the Neck

We describe a rare occurrence of unilateral vocal fold paralysis associated with a cervical osteophyte abutting the course of the recurrent laryngeal nerve. Trans-nasal laryngoscopy is vital in diagnosing vocal fold paralysis, but often does not provide insight into etiology. This case highlights the importance of radiographic imaging in newly diagnosed vocal fold paralysis, and underscores the principle that a diagnosis is not idiopathic until all sources have been ruled out.

Bilateral Mcl Avulsion Following Total Knee Arthroplasty: A Case Report and Review of Literature

this article describes a traumatic bilateral MCL avulsion in previously well-functioning total knee arthroplasty. A thorough physical examination with appropriate radiographic imaging study is required for proper evaluation and treatment of this injury, as it is associated with debilitating instability of the knee and accelerated wear and failure of the TKA.

Biokinetic Evaluation of Contrast Media Loaded Carbon Nanotubes Using a Radiographic Device

Considerable progress has been made in various fields of applied research on the use of carbon nanotubes (CNTs). Because CNTs are fibrous nanomaterials, biosafety of CNTs has been discussed. The biokinetic data of CNTs, such as using the radioisotope of carbon and surface labeling of CNTs, have been reported. However, the use of radioisotopes requires a special facility. In addition, there are problems in the surface labeling of CNTs, including changes in surface properties and labels eliminating over time. In order to solve these problems and properly evaluate the biokinetics of CNTs, the authors synthesize peapods with platinum (Pt) encapsulated within the hollow region of Double-Walled CNTs (DWCNTs) and develop a new system to evaluate biokinetics using widely available imaging equipment. In the cell assay, no significant difference is observed with and without Pt in CNTs. In animal studies, radiography of the lungs of rats that inhaled Pt-peapods show the detectability of Pt inside the CNTs. This new method using Pt-peapods enables image evaluation with a standard radiographic imaging device without changing the surface property of the CNTs and is effective for biokinetics evaluation of CNTs.

Principles and Perspectives of Radiographic Imaging with Muons

Radiographic imaging with muons, also called Muography, is based on the measurement of the absorption of muons, generated by the interaction of cosmic rays with the earth’s atmosphere, in matter. Muons are elementary particles with high penetrating power, a characteristic that makes them capable of crossing bodies of dimensions of the order of hundreds of meters. The interior of bodies the size of a pyramid or a volcano can be seen directly with the use of this technique, which can rely on highly segmented muon trackers. Since the muon flux is distributed in energy over a wide spectrum that depends on the direction of incidence, the main difference with radiography made with X-rays is in the source. The source of muons is not tunable, neither in energy nor in direction; to improve the signal-to-noise ratio, muography requires large instrumentation, long time data acquisition and high background rejection capacity. Here, we present the principles of the Muography, illustrating how radiographic images can be obtained, starting from the measurement of the attenuation of the muon flux through an object. It will then be discussed how recent technologies regarding artificial intelligence can give an impulse to this methodology in order to improve its results.

Diagnosis and conservative treatment of adolescent idiopathic scoliosis

Background: Adolescent idiopathic scoliosis (AIS) has a diagnosis rate of 3% to 5% per year, but the number of cases requiring surgical treatments is very small, accounting for only 0.17% to 1.75% of all AIS patients. Most patients with AIS are diagnosed, treated, and managed in outpatient clinics.Current Concepts: AIS is a disease that occurs more frequently, and progresses faster, in females than in males. Scoliosis deformity can occur due to various causes. To differentially diagnose AIS, it is necessary to perform careful physical examinations, investigate family history, and check for neurological, growth, and developmental abnormalities. Definitive diagnosis of AIS can be performed through radiographic imaging. In the case of atypical curvature and symptoms, examinations such as magnetic resonance imaging could be required in addition to radiographic imaging. Treatment of AIS patients in outpatient clinics can be performed through observation, exercise, and orthosis. The selection and application of treatment methods and the termination period of the treatments are complexly affected by the age at the time of diagnosis; pattern, location and size of the curve; and growth potential.Discussion and Conclusion: AIS is a disease in which good results can be obtained with conservative treatments such as exercise and orthosis, which is generally applied in an outpatient setting. To properly treat AIS, it is necessary to have an in-depth understanding of the characteristics of AIS, timing of treatment, and factors influencing treatment.

The deceptive histomorphology of DGCT – A case report

Dentinogenic ghost cell tumors (DGCTs) are uncommon neoplasms classified as a solid variant of the calcifying odontogenic cyst and defined as a locally invasive neoplasm, characterized histologically by an ameloblastomatous epithelium with an area of ghost cell formation and a varying amount of dentinoid. Herein, we present the case of a 22-year old man who was referred to us due to recurrent swelling of right posterior mandibular region. The diagnosis of a DGCT was made by the use of advanced radiographic imaging and detailed histopathological examination.

The deceptive histomorphology of DGCT – A case report

Dentinogenic ghost cell tumors (DGCTs) are uncommon neoplasms classified as a solid variant of the calcifying odontogenic cyst and defined as a locally invasive neoplasm, characterized histologically by an ameloblastomatous epithelium with an area of ghost cell formation and a varying amount of dentinoid. Herein, we present the case of a 22-year old man who was referred to us due to recurrent swelling of right posterior mandibular region. The diagnosis of a DGCT was made by the use of advanced radiographic imaging and detailed histopathological examination.