BJR Case Reports最新文献

We present an unusual case of Hoffa's fat pad impingement syndrome and chondromalacia patellae in the presence of a rare congenital crossed doubled patellar tendon. The crossed-doubled patellar tendon is exceedingly rare. It's relationship to other conditions involved in anterior knee pain is unclear; however, this case highlights potential pathological associations.

Fetus in fetu (FIF) is an extremely rare pathology in which a malformed fetus is located in the body of its twin. It may occur as a result of an aberration of the twinning process. It is important to distinguish this condition from a teratoma. This article emphasizes the importance of the various modalities in the antenatal diagnosis and post-natal follow-up of FIF. An appropriate early intervention if instituted results in a good prognosis. Only few cases of FIF have been reported in medical literature. We present a case which was antenatally diagnosed and proven on histopathology post-natally. This case report illustrates the importance of multimodality imaging techniques in the diagnosis of this condition.

An otherwise healthy 2-month-old boy was referred to ENT for a congenital right facial palsy, with a birth history of difficult ventouse delivery. Initially, a traumatic cause was suspected, however subsequent MR 3D-FIESTA (T₂ weighted) imaging demonstrated a right facial nerve agenesis with normal appearances of the remainder of the brain parenchyma, cranial nerves and parotid glands. There were no syndromic features or hearing difficulties. Isolated congenital nerve agenesis is a rare condition, with very few case reports available in the literature. Pre-natal 4D ultrasound imaging further supports the diagnosis. To our knowledge, this is the first published pre-natal ultrasound image of congenital facial nerve palsy. The infant has been referred for consideration of nerve reconstruction surgery, and is receiving multi-disciplinary input from ENT, Physiotherapy and Ophthalmology, the latter for prevention of exposure keratitis.

Osteochondromas are the most common primary benign bone tumors which can be either solitary or multiple in the form of hereditary multiple exostosis (HME). Osteochondromas are located frequently in the long bones and rarely involve the spine. Cervical spine remains the most common site for spinal osteochondroma. However, majority of the cases are neurologically asymptomatic as most of them are slow growing with growth directed outside the spinal canal. In this case report, we describe a rare case of solitary osteochondroma arising from C1 vertebra (atlas) resulting in serious neurological complications, ultimately necessitating surgical intervention.

Fetal abdomino-pelvic cystic lesions are uncommon and can have varied etio-pathogenesis. Most commonly they originate from the gastrointestinal or genitourinary tract. These include choledochal cyst, hydronephrosis, renal cyst, mesenteric/omental cyst, ovarian cyst, meconium pseudocyst, and hydrocolpos/hydrometrocolpos among others. Fetal hydrometrocolpos is rare with a reported incidence of 0.006% and its diagnosis requires a high index of suspicion. Antenatal ultrasound and magnetic resonance imaging (MRI) is invaluable in diagnostic evaluation. This case report describes the imaging features of antenatally detected congenital hydrometrocolpos with Mullerian duplication secondary to cloacal malformation using antenatal ultrasound and MRI. Per-operative findings and other possible differential diagnoses are discussed along with a brief review of literature.

Renal affection is common in disseminated non-Hodgkin's lymphoma (NHL) which is known as secondary renal lymphoma (SRL). Primary renal lymphoma (PRL) is an exceedingly uncommon disease, which accounts for less than 1% of all renal masses. Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of NHL in both primary as well as secondary renal lymphomas. PRL is of paramount importance clinically as it is usually managed with neo-adjuvant chemotherapy followed by nephrectomy in contrast to the more frequently seen renal cell carcinoma, which is treated surgically. This outstanding difference in management challenges the longstanding approach that preoperative biopsies are not mandatory prior to nephrectomy for renal masses. Because of its relative rarity, the imaging features of PRL have been described in a few studies, and having an understanding of these typical imaging patterns is crucial for making an accurate diagnosis and differentiation from other renal malignancies. Here, we present a case of a secondary renal lymphoma and discuss its differential imaging features.

Intravenous ferumoxytol infusions are an effective treatment option for iron deficiency anemia. Ferumoxytol contains a superparamagnetic iron oxide core which causes artifacts on multiple MRI brain sequences. However, in our experience, there is not much information on the appearance of intracranial and neck vessels on MR angiography (MRA) after recent therapeutic i.v. administration of ferumoxytol. MRA is an integral part of the work-up for multiple diseases processes including for acute stroke and for detection of aneurysm(s), vasculopathy/vasculitis, vascular malformations, among others and are often performed without the acquisition of MRI brain. Without proper knowledge of the appearance of vessels after administration of i.v. feruomoxytol, radiologists may misinterpret the findings leading to unnecessary further investigation or errant diagnosis. We present the case of a patient who underwent MRI brain and MRA head and neck imaging after recent therapeutic i.v. infusion of ferumoxytol and discuss relevant imaging findings and imaging artifact caused by this medication.

The transradial approach has gained popularity in the neuroendovascular field after several studies proved its low rate of hemorrhagic and vascular-related complications in both diagnostic and therapeutic procedures. This is a case of a patient who presented for flow diversion treatment of an incidental left carotid ophthalmic aneurysm. The procedure was uneventful. Post-operatively, the patient's neurological exam and vital signs were normal, however the patient complained of abdominal and chest pain that worsened when lying down and improved when sitting up. Radiologic diagnosis confirmed the presence of a thyrocervical trunk pseudoaneurysm which was completely obliterated with Onyx 18 embolization. Thyrocervical trunk pseudoaneurysm formation is a rare complication of the transradial approach. Shedding the light on these entities is essential as symptoms vary in severity and presentation and necessitate swift diagnosis and treatment.

A 6-year-old girl presented with a grossly expansive lesion of the left lower jaw. Radiological investigations revealed a large mixed radiolucent/radio-opaque lesion of the left mandible extending into the ramus. Correlation of biopsy and imaging results lead to the diagnosis of an expansile form of focal cemento-osseous dysplasia. Surgical enucleation was performed, and the patient remained free of recurrence after 6 months of follow-up. When dealing with fibro-osseous lesions of the jaw, correlation of radiological and pathological results is mandatory to make a correct diagnosis and avoid unnecessarily extensive surgery.

The combination of disorder of sex development and canal of Nuck hernia, in which the hernial sac contains the internal reproductive organs (gonads) of both genders, is exceedingly rare. We present a unique case of a neonate who presented with ambiguous genitalia and a lump in the left inguinal region. The child underwent various radiographic procedures and hernial repair. Blood work-up, karyotyping, and histopathological analysis from gonads confirmed the diagnosis of Ovotesticular disorder of sex development. Subsequently, the child had a reconstructive vaginoplasty, and the final decision regarding gender assignment will be made after assessing mental and sexual behavior in early childhood.