Radiology Case Reports最新文献

英文中文

Fat embolism syndrome following femoral shaft fracture: A case report and diagnostic considerations 股骨干骨折后脂肪栓塞综合征：病例报告与诊断考虑

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.126

Morteza Gholipour , Mohsen Salimi , Alireza Motamedi , Fatemeh Abbasi

Fat embolism syndrome (FES) is a rare but serious complication that can arise after long bone fractures or orthopedic surgeries. This case report presents a 40-year-old male who developed FES following surgical fixation of a femoral shaft fracture using 2 plates. The day after surgery, the patient exhibited tachycardia, respiratory distress, and a fever of 38.5°C, initially raising concerns for pulmonary embolism. A computed tomography (CT) angiography of the lungs showed no evidence of pulmonary thromboembolism, and methylprednisolone was administered due to the suspicion of fat embolism. On the second postoperative day, petechial and purpuric lesions appeared on the neck, chest, and the surgical limb, strengthening the suspicion for FES. The patient fulfilled 2 major and 3 minor criteria for FES according to the Gurd and Wilson criteria, and scored 8 points on the Schonfeld Fat Embolism Index, indicating a high likelihood of FES. Despite these clinical signs, imaging studies did not reveal any embolic events. The patient was treated with supportive care, including oxygen therapy and anticoagulation, and his condition stabilized over the next 24 hours. He was mobilized and discharged in stable condition. This case highlights the critical need for early recognition of fat embolism syndrome (FES) in postorthopedic surgery patients, as timely diagnosis and intervention are key to preventing serious complications. Although clinical signs may not always align with imaging results, vigilant monitoring and prompt supportive care can significantly improve patient outcomes.

脂肪栓塞综合征（FES）是一种罕见但严重的并发症，可在长骨骨折或骨科手术后出现。本病例报告的患者是一名 40 岁男性，在使用两块钢板进行股骨干骨折手术固定后出现了脂肪栓塞综合征。术后第二天，患者出现心动过速、呼吸窘迫、发热 38.5°C，最初引起了肺栓塞的担忧。肺部计算机断层扫描（CT）血管造影显示没有肺血栓栓塞的迹象，由于怀疑是脂肪栓塞，医生给患者使用了甲基强的松龙。术后第二天，患者的颈部、胸部和手术肢体出现了瘀斑和紫癜性病变，这加强了对脂肪栓塞的怀疑。根据古尔德（Gurd）和威尔逊（Wilson）的标准，该患者符合脂肪栓塞的 2 大标准和 3 小标准，并在 Schonfeld 脂肪栓塞指数上获得了 8 分，表明脂肪栓塞的可能性很高。尽管有这些临床症状，但影像学检查并未发现任何栓塞事件。患者接受了包括氧疗和抗凝在内的支持性治疗，病情在接下来的 24 小时内趋于稳定。他在病情稳定后康复出院。本病例强调了早期识别骨科手术后患者脂肪栓塞综合征（FES）的重要性，因为及时诊断和干预是预防严重并发症的关键。虽然临床症状不一定与影像学结果一致，但警惕的监测和及时的支持性护理可以显著改善患者的预后。

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引用次数: 0

Bone abnormalities in congenital syphilis: A case report 先天性梅毒患者的骨骼异常：病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.137

Andrés Hernando Tascón-Barona , Nathalia Sofia Coral-Rivera

Congenital syphilis, caused by Treponema pallidum, can be transmitted from mother to fetus at any stage of pregnancy, leading to significant neonatal complications. This case report describes a 33-week preterm newborn with a history of untreated gestational syphilis in the mother. At birth, the newborn's serological tests were positive for syphilis, and radiographs of the long bones revealed metaphyseal abnormalities consistent with metaphysitis.

These findings highlight the importance of early radiological evaluation in newborns with suspected congenital syphilis. Despite the absence of clinical symptoms, X-rays can detect bone changes indicative of early complications, enabling timely diagnosis and intervention to improve outcomes. This case emphasizes the crucial role of radiographic imaging in the management of congenital syphilis.

由苍白螺旋体引起的先天性梅毒可在妊娠的任何阶段由母亲传染给胎儿，导致严重的新生儿并发症。本病例报告描述了一名 33 周早产新生儿，其母亲曾患有未经治疗的妊娠梅毒。出生时，新生儿的梅毒血清学检测呈阳性，长骨X光片显示骺端异常，与梅毒性骺炎一致。尽管没有临床症状，但X光检查可以发现提示早期并发症的骨骼变化，从而及时诊断和干预，改善预后。本病例强调了放射成像在先天性梅毒治疗中的关键作用。

引用次数: 0

Unusual hand tumor: A case report 罕见的手部肿瘤病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.116

H. Msek

Adipose tumors are dominated by lipomas, but other rarer entities may be encountered such as hibernoma which is a benign tumor that develops from brown fat. The thigh is the preferred location for hibernomas, but the tumor can appear in other areas. The upper limb is a rare localization and there is only 1 case of hibernoma on the hand already reported in the English literature. We report the case of a hibernoma of the palmar aspect of the hand. The tumor had no clinical specificities. MRI showed an uncertain appearance mimicking liposarcoma. The diagnosis was only confirmed by histological study. The treatment consisted of complete excision of the tumor. At a follow-up of 8 months, there was no recurrence.

脂肪瘤以脂肪瘤为主，但也可能会出现其他罕见的肿瘤，例如由棕色脂肪形成的良性肿瘤--冬眠瘤。脂肪瘤好发于大腿，但也可能出现在其他部位。上肢是一个罕见的部位，在英文文献中仅有一例手部蜂窝织瘤的报道。我们报告了一例手掌部的冬眠瘤。该肿瘤没有临床特异性。核磁共振成像显示其外观不确定，酷似脂肪肉瘤。组织学研究证实了这一诊断。治疗包括完全切除肿瘤。随访 8 个月后，肿瘤没有复发。

引用次数: 0

When back pain masks a pneumothorax: Atypical presentation in a healthy young nonsmoker male 背痛掩盖了气胸：一名健康非吸烟男性青年的非典型表现

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.108

Mustafa Tareq Qader Hussein , Hashim Talib Hashim , Sabrean Farhan Jawad , Ali kareem Jaheed , Sajjad Ghanim Al-Badri , Mustafa almusawi , Mustafa Najah Al-Obaidi , Ahmed Dheyaa Al-Obaidi

Spontaneous pneumothorax usually presents with sudden chest pain and dyspnea as cardinal symptoms, but its diagnosis may be challenging with atypical presentation. We describe here the case of an unusual presentation of spontaneous pneumothorax in a 20-year-old male nonsmoker with no past medical history, presenting to the emergency department with intense back pain accompanied by vomiting. The diagnosis of spontaneous pneumothorax should be entertained by the clinicians, even in atypical presentations, for timely management.

自发性气胸通常以突发胸痛和呼吸困难为主要症状，但如果表现不典型，其诊断可能具有挑战性。我们在此描述了一例不寻常的自发性气胸病例，患者为 20 岁男性，不吸烟，无既往病史，因剧烈背痛并伴有呕吐而就诊于急诊科。临床医生即使在非典型病例中也应考虑自发性气胸的诊断，以便及时处理。

引用次数: 0

Rare case of intrauterine device rectal migration revealed by lower GI bleeding: A case report and literature review 下消化道出血显示宫内节育器直肠移位的罕见病例：病例报告和文献综述

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.049

Amal Hassini MD , Ghizlane Kharrasse MD , Kaouthar Rais MD , Maissae Rahaoui MD , Fatima Adamou Mainassara MD , Abdelkrim Zazour MD , Hajar Koulali MD , Ouiam Elmqaddem MD , Zahi Ismaili MD

Rectal migration of an intrauterine device (IUD) is a rare but potentially serious complication requiring prompt diagnosis and management. We present a rare case of rectal migration of an intrauterine device (IUD) in a 26-year-old female, highlighting the clinical presentation, diagnostic evaluation, laparoscopic removal, and postoperative outcomes. This case emphasizes the critical importance of vigilant monitoring, early intervention, and close follow-up in managing IUD migration to ensure optimal patient outcomes. Timely recognition and intervention resulted in successful symptom resolution and a favorable long-term prognosis.

宫内节育器（IUD）直肠移位是一种罕见但可能很严重的并发症，需要及时诊断和处理。我们介绍了一例罕见的宫内节育器（IUD）直肠移位病例（26 岁女性），重点介绍了临床表现、诊断评估、腹腔镜取出术和术后结果。该病例强调了在处理宫内节育器移位时警惕监测、早期干预和密切随访的重要性，以确保患者获得最佳治疗效果。及时发现和干预成功地解决了症状，并获得了良好的长期预后。

引用次数: 0

Partial biochemical response of adrenal artery embolization for pheochromocytoma: A case report and review of the literature 肾上腺动脉栓塞治疗嗜铬细胞瘤的部分生化反应：病例报告和文献综述

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.107

Fernando Choque-Chávez MD , Alfredo Páez-Carpio MD, MSc, EDIR, EBIR , Mireia Mora MD, PhD , Silvia Montserrat MD , Alejandro Pascagaza MD, EBIR , Marta Burrel MD, PhD

We present the case of a 22-year-old male with a left adrenal pheochromocytoma, initially diagnosed during a workup for thoracic pain. The patient's tumor was refractory to medical management, and surgical resection was ruled out due to high cardiovascular risk, stemming from cyanotic congenital heart disease, aortic aneurysm, and factor VII deficiency. The patient underwent adrenal artery embolization (AAE) as a salvage treatment. Following the procedure, there was an initial reduction in hypertensive crises and biochemical markers, with plasma normetanephrine levels decreasing from 1490 pg/mL to 313 pg/mL. However, over subsequent months, the patient experienced symptom recurrence, and biochemical relapse occurred, with normetanephrine levels rising to 742 pg/mL by 3 months postprocedure. This case highlights the potential for AAE to provide short-term symptom relief and biochemical response; nevertheless, it may not be an effective long-term curative option. More collaborative and prospective studies are needed to assess its success and efficacy.

我们介绍了一例 22 岁男性左肾上腺嗜铬细胞瘤患者的病例，该患者最初是在胸痛检查中被确诊的。患者的肿瘤对药物治疗无效，由于发绀型先天性心脏病、主动脉瘤和因子 VII 缺乏症导致的高心血管风险，手术切除被排除在外。患者接受了肾上腺动脉栓塞术（AAE）作为挽救治疗。术后，患者的高血压危象和生化指标最初有所缓解，血浆正常肾上腺素水平从 1490 pg/mL 降至 313 pg/mL。然而，在随后的几个月中，患者症状复发，生化指标也复发，正常肾上腺素水平在术后 3 个月升至 742 pg/mL。该病例突出表明，AAE 有可能在短期内缓解症状并产生生化反应；然而，它可能不是一种有效的长期治疗方案。需要更多的合作性和前瞻性研究来评估其成功率和疗效。

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引用次数: 0

Polycythemia vera with acute coronary syndrome and bleeding as initial presentation: A case report and literature review 以急性冠状动脉综合征和出血为首发症状的多血症：病例报告和文献综述

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.109

Rabia Iqbal MBBS , Aemen Shafqat Bazaz MBBS , Ahmad Taimoor Bajwa MBBS , Hnin Nadi Linn MD , Nyan Linn Htet MD , Sabrin Marowa MD , Asmat Ullah MD

Polycythemia vera (PV) is a chronic myeloproliferative disorder characterized by increased red blood cell mass, leading to a heightened risk for thrombosis and hemorrhage. While thrombotic complications such as stroke, deep vein thrombosis, and pulmonary embolism are commonly associated with PV, coronary artery syndromes, as the initial presentation, are rare. Here, we present the case of a 73-year-old male who presented with severe chest pain and was diagnosed with non-ST–elevation myocardial infarction (NSTEMI). During his hospitalization, the patient experienced spontaneous psoas muscle hemorrhage, which prompted further investigation. Laboratory workup revealed elevated hemoglobin levels and a positive JAK2 V617F mutation, confirming a diagnosis of polycythemia vera. This case highlights the importance of considering myeloproliferative disorders in patients with atypical thrombotic and hemorrhagic events. It emphasizes the need for early diagnosis and appropriate treatment to optimize patient outcomes.

多发性红细胞增多症（PV）是一种慢性骨髓增生性疾病，其特点是红细胞增多，导致血栓形成和出血的风险增加。虽然中风、深静脉血栓和肺栓塞等血栓并发症通常与红细胞增多症有关，但以冠状动脉综合征为首发症状的病例却很少见。在此，我们介绍了一例 73 岁男性患者的病例，他因剧烈胸痛就诊，被诊断为非 ST 段抬高型心肌梗死（NSTEMI）。住院期间，患者出现自发性腰肌出血，这促使他接受进一步检查。实验室检查发现血红蛋白水平升高，JAK2 V617F 突变阳性，确诊为多发性红细胞症。本病例强调了在非典型血栓和出血事件患者中考虑骨髓增生性疾病的重要性。它强调了早期诊断和适当治疗的必要性，以优化患者的预后。

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引用次数: 0

Significance of ultrasonography in diagnosing transverse testicular ectopia: A case report 超声波检查在诊断横向睾丸异位症中的意义：病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.106

Govindarajan B. Rajendran , Sharmeela Sukumar , Raam Ratish Gobinathan

An uncommon congenital abnormality known as crossed testicular ectopia (CTE) or transverse testicular ectopia (TTE) occurs when both testes migrate into the same hemiscrotum. Inguinal hernia and persistent Müllerian duct syndrome are frequently associated with it. We present a case of “TTE” in a 1-year-old boy with an empty right hemiscrotum and left inguinal hernia. TTE, first described by Von Lenhossek, can be diagnosed via ultrasound, with over 100 cases reported. Theories of its origin include developmental anomalies of the genital ridge and Wolffian duct fusion. Accurate diagnosis is crucial due to increased malignancy risks and complications in management.

当两个睾丸移位到同一个半阴囊时，会出现一种不常见的先天性异常，称为交叉性睾丸异位（CTE）或横向睾丸异位（TTE）。腹股沟疝和持续性穆勒氏管综合征经常与之相关。我们报告了一例 "TTE "病例，患者是一名一岁男孩，右侧半阴囊空虚，左侧腹股沟疝。TTE 由 Von Lenhossek 首次描述，可通过超声波诊断，已有 100 多例报道。其起源理论包括生殖器脊发育异常和沃尔夫导管融合。由于恶性肿瘤风险和并发症的增加，准确诊断至关重要。

引用次数: 0

Mesenteric desmoid tumor in its cystic form: Case report of a very rare variant 囊性肠系膜脱模瘤：非常罕见的变异病例报告

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.101

Nourrelhouda Bahlouli , Kaouthar Imrani , Esseti Sara , Fatima Chait , Faraj Chaimae , Moatassimbillah Nabil , Ittimad Nassar , Sassi Samia , Derqaoui Sabrine , Bernoussi Zakia , Babana Alaoui Amina , Touhami Ouazzani Youssef , Lahjomri Ismail , Hadj Omar El Malki , Ifrine Lahcen , Belkouchi Abdelkader , Belkouchi Omar

Desmoid tumors, also known as deep fibromatosis or desmoid-type fibromatosis, represent a rare subset of deep fibromatoses. It is a locally aggressive tumor, with no specific symptoms, and no metastatic potential. We report a case of a 38-year-old male patient with an abdominal mass. Radiological findings showed 2 tumors, the first was a solid inguinal mass of the left lateral iliac pedicle, and the second was a giant cystic mass in the abdominal cavity. An elective explorative laparotomy was performed to remove the 2 masses. Histopathological examination confirmed the desmoid tumor diagnosis of both lesions.

蝶形细胞瘤又称深部纤维瘤病或蝶形细胞型纤维瘤病，是深部纤维瘤病的一个罕见分支。它是一种局部侵袭性肿瘤，没有特殊症状，也没有转移潜力。我们报告了一例腹部肿块的 38 岁男性患者。放射学检查结果显示有两个肿瘤，第一个是左侧髂外侧腹股沟实性肿块，第二个是腹腔内巨大囊性肿块。为切除这两个肿块，患者接受了择期开腹探查手术。组织病理学检查证实了这两个病灶均为类苔藓样肿瘤。

引用次数: 0

Isolated unilateral proximal focal femoral deficiency: A case report and literature review 孤立性单侧股骨近端局灶性缺损：病例报告和文献综述

Q4 Medicine

Radiology Case Reports

Pub Date : 2024-11-22 DOI: 10.1016/j.radcr.2024.10.122

Mariam Thalji MD , Hakam Shrouf MD , Fadi Dana MD

Proximal focal femoral deficiency (PFFD) is a rare congenital anomaly resulting in distinct degrees of femoral hypoplasia and limb shortening. .We present a case of 20-month-old female child, presented with a history of right lower limb shortening from birth and a progressive deformity over time. Physical examination revealed a shortened, externally rotated, and flexed right lower limb. The right and left lower limbs measured 27 cm and 40 cm, respectively. A diagnosis of PFFD was established. Due to limited resources and a shortage of specialized orthopedics doctors 2QA, the patient was referred to a medical mission organization that could help in such cases. Though PFFD is a rare limb anomaly, it significantly impacts a patient's life, if left untreated. Timely diagnosis and early intervention in these cases would have significantly improved prognosis and health outcomes.

股骨近端局灶性缺损（PFFD）是一种罕见的先天性畸形，会导致不同程度的股骨发育不良和肢体短缩。.我们报告了一例 20 个月大的女婴，她从出生起就有右下肢短缩的病史，并随着时间的推移逐渐出现畸形。体格检查显示患儿右下肢缩短、外旋和弯曲。左右下肢的长度分别为 27 厘米和 40 厘米。诊断结果为 PFFD。由于 2QA 资源有限，骨科专科医生短缺，患者被转诊到一个可以帮助处理此类病例的医疗任务组织。虽然 PFFD 是一种罕见的肢体异常，但如果不及时治疗，会严重影响患者的生活。对这些病例的及时诊断和早期干预将大大改善预后和健康状况。

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