The femoral linea aspera: radiological pattern

1993 ◽  
Vol 3 (4) ◽  
pp. 357-358 ◽  
Author(s):  
C. Hoeffel ◽  
G. Munier ◽  
J. C. Hoeffel
Keyword(s):  
Radiological Pattern ◽  
Linea Aspera

scholarly journals SAT0529 CLINICAL CHARACTERISTICS AND TREATMENT PATTERNS IN A PATIENT GROUP WITH INTERSTITIAL LUNG DISEASE.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1222.2-1222
Author(s):  
R. Ortega Castro ◽  
P. S. Laura ◽  
F. U. Pilar ◽  
J. Calvo Gutierrez ◽  
A. Requejo-Jimenez ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Smoking Habit ◽  
Inflammatory Myopathy ◽  
Usual Interstitial Pneumonia ◽  
Treatment Patterns ◽  
Common Symptom ◽  
Radiological Pattern ◽  
Mechanic’S Hands

Background:Diffuse interstitial lung disease (ILD) is frequently associated with connective tissue diseases (CTD) and is one of the main causes of morbidity and mortality in these patients. Recently, the concept of Interstitial Pneumonia with Autoimmune Features (IPAF) has been defined to characterize ILD associated with systemic manifestations limited to subtle serological and clinical autoimmune abnormalities and not fulfilling the international criteria for the diagnosis of a given CTD.Objectives:The objective of this study is to describe the clinical, serological and radiological characteristics, as well as the treatment patterns of patients with ILD referred to a Rheumatology Service for suspected CTDMethods:Observational, cross-sectional study of 43 patients with ILD referred for evaluation to the medical consultation of CTD of the Rheumatology service at the Reina Sofía Hospital. Patients were classified as patients with defined CTD, patient with IPAF and patients with other types of pneumopathy. We conducted a descriptive study of all patients and compared the clinical-analytical-radiological characteristics and treatment patterns of the first two groups.Results:Of the 43 patients, 67.40% were women with a mean age at diagnosis of 65.65 (10.42) years and 53.50% of smoking patientsOf the total of patients, 16 (37.2%) were included in the CTD group, 17 (39.5%) met criteria for IPAF and 10 (23.3%) had another type of pneumopathy.In the CTD group scleroderma was the most frequent disease (6/16), followed by inflammatory myopathy (4/16), Sjögren’s syndrome (3/16), rheumatoid arthritis (2/16) and polymyalgia rheumatic (1/16). In this group of patients, the most common symptom was Raynaud’s phenomenon (RP) (7/16), followed by arthritis (7/16) and mechanic’s hands (3/16). Regarding the most frequently antibodies were ANA (100%), anti-RO (41.7%), anti-citrullinated protein antibodies (30%) and rheumatoid factor (RF) (28.6%).In patients with IPAF, as in the CTD group, the most observed clinical criterion was RP (5/17), followed by arthritis (1/17) and mechanic’s hands (1/17). Among the serological criteria the most common antibodies were ANA (100%), followed by anti-RO (33.3%), anti-RNA synthetase (28.6%) and RF (22.2%).Regarding the radiological pattern, in both groups the most frequent was nonspecific interstitial pneumonia, followed by the indeterminate pattern and usual interstitial pneumonia (UIP) in third place. There were no significant differences by gender and age, between the group of CTD and IPAF, observing in both groups a predominance of women with a similar mean age, being the upper smoking habit in the IPAF group (70.6% vs 31.5%, p= 0.02). Regarding the treatment used, the use of immunosuppressants (IS) was more frequent in CTD group (56.3% vs 11.8%, p = 0.007).Conclusion:The clinical-serological and radiological characteristics were similar among patients with IPAF and CTD, which supports the notion of a similar pathophysiology in both groups. In our cohort patients with CTD received IS more frequently than IPAF group, however, future work would be necessary to assess whether the response to treatment is similar in these populations and if IS can benefit patients with IPAF to long term. In addition, it could be useful to include the UIP pattern within the IPAF classification criteria, not currently included, since it is the third most frequent radiological pattern.References:[1]Respirology, 21 (2016), pp. 245-258[2]Eur Respir J, 46 (2015), pp. 976-987Disclosure of Interests:Rafaela Ortega Castro: None declared, Pérez Sánchez Laura: None declared, Font Ugalde Pilar: None declared, Jerusalem Calvo Gutierrez: None declared, Antonio Requejo-Jimenez: None declared, Simona Espejo-Pérez: None declared, Teresa Gonzalez-Serrano: None declared, María del Carmen Castro Villegas: None declared, Gómez García Ignacio: None declared, Alejandro Escudero Contreras: None declared, Eduardo Collantes Estevez Grant/research support from: ROCHE and Pfizer, Speakers bureau: ROCHE, Lilly, Bristol and Celgene, Maria A Aguirre: None declared

scholarly journals SAT0535 CLINICAL COURSE IN PATIENTS WITH INTERSTITIAL PNEUMONIA WITH AUTOIMMUNE FEATURES (IPAF) IN A MULTIDISCIPLINARY CONSULTATION.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1225.1-1225
Author(s):  
I. Perez ◽  
C. Vadillo ◽  
M. A. Nieto ◽  
D. Freites ◽  
Z. Rosales ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Classification Criteria ◽  
Therapeutic Management ◽  
European Respiratory Society ◽  
Respiratory Impairment ◽  
Radiological Pattern ◽  
Over Time

Background:A proportion of patients with Interstitial Lung Disease (ILD) show autoimmune characteristics but do not completely meet the classification criteria for a definitive connective tissue disease. In order to unify the nomenclature and criteria to define this condition, the classification of patients with Interstitial Pneumonia with Autoimmune Features (IPAF) has recently been adopted (Fisher, et al).Objectives:To describe the sociodemographic, clinical, functional characteristics and therapeutic management of IPAF patients in clinical practice and to evaluate the incidence rate of functional respiratory impairment over time.Methods:A longitudinal observational study was performed. Patients with IPAF classification criteria (Fischer et al) were included from the time of ILD diagnosis (Feb 2017 to Sept 2018) and followed until loss of follow-up or end of the study (Oct 2019), in a multidisciplinary team, carried by a pneumologist and a rheumatologist in a Tertiary Hospital in Madrid. Main outcome: relative functional respiratory impairment: defined as decline in percent predicted forced vital capacity (FVC%) of ≥ 5% compared to the previous visit. Respiratory function was measured at baseline and every 6 months. Covariates: a) sociodemographic, b) clinical, c) radiological pattern (non-specific interstitial pneumonia [NSIP]; usual interstitial pneumonia [UIP], others); d) FVC%, DLCO%; e) laboratory tests; f) therapy used (glucorticosteroids, disease modifying antirheumatic drugs (DMARDs) and Biologic Agents). Statistical analysis: description of the sociodemographic, clinical, radiological, functional and treatment characteristics of the patients. Survival techniques were used to estimate the incidence rate (IR) of relative functional respiratory impairment, expressed per 100 patient-semester with their respective confidence interval [95 % CI].Results:17 patients were included with a mean follow-up of 3 ± 1.5 years, 70.6% were women with a mean age of 65±10 years. The most frequent IPAF classification criteria were: a) clinical: arthritis (50%), Raynaud`s phenomenon (33%) and mechanical hands (17%); b) serological: 65% had ANA ≥1/360; 31% FR> 40; 30% Anti-Ro positive; c) morphologic: 59% presented NSIP pattern and 29.4% was UIP. The baseline median FVC% and DLCO% were 89 [83-107.7] and 63 [50-79.8] respectively. During the study period, 94% received treatment: 87.5% glucorticosteroids, 68.5% mycophenolate, 56% azathioprine, 18.7% cyclophosphamide iv and 33% antifibrotics. During the follow-up (104.6 patient - semester), 15 patients presented relative functional respiratory impairment, with an IR of 23.8 [16.1-35.3]. After 14 months from IPAF diagnosis 50% of the patients had relative functional respiratory impairment. At the end of the follow-up, 50% showed a worsening of the DLCO%.Conclusion:IPAF patients are mostly women in their sixties. The most frequent clinical criteria are arthritis and Raynaud`s phenomenon and the serological were FR and ANAs. The most frequent radiological pattern was NSIP. The therapeutic management is mainly with glucorticosteroids, mycophenolate and azathioprine. At the beginning, patients have a slightly diminished lung function. These patients have significant functional impairment over time that will impact in their prognosis. Longitudinal and multicenter studies are necessary to advance in the knowledge and management of these patients.References:[1]Fischer A, Antoniou KM, Brown KK, Cadranel J, Corte TJ, du Bois RM, et al. An official European Respiratory Society/American Thoracic Society research statement: interstitial pneumonia with autoimmune features. Eur Respir J [Internet]. 2015 Oct;46(4):976–87. Available from:http://www.ncbi.nlm.nih.gov/pubmed/26160873Disclosure of Interests:None declared

scholarly journals A new type of Hypersensitivity Pneumonitis: salami brusher’s disease

2015 ◽  
Vol 77 (1) ◽  
Author(s):  
M. Marvisi ◽  
L. Balzarini ◽  
C. Mancini ◽  
P. Mouzakiti
Keyword(s):  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis ◽  
Community Acquired Pneumonia ◽  
Prick Test ◽  
White Mould ◽  
Clinical Onset ◽  
Oral Steroids ◽  
Radiological Pattern ◽  
New Type ◽  
Penicillium Spp

We observed five consecutive cases of Hypersensitivity Pneumonitis in subjects working in a salami factory. The workers had to clean the white mould growing on salami surface using a manual wire brush. The five patients (four female) had a mean age of 39±15 years; two were smokers. Three patients had an acute clinical presentation with fever, dyspnoea, dry cough, oxygen desaturation, and presented at the emergency department with suspected diagnosis of community acquired pneumonia. The mean latency for developing respiratory symptoms was 11.6 days. Pulmonary function test demonstrated a reduction in diffusing capacity (DLCO) in all 5 patients (60±15% of predicted value). Skin prick test was positive for Penicillium spp in 3 cases and for Cladosporium and Aspergillus spp in 2 others. Specific IgG antibodies against Penicillium spp were positive in 3 subjects; 2 were positive for Aspergillus Fumigatus. The prevailing radiological pattern was a ground glass appearance in the three patients with acute clinical onset and a centrilobular one in patients with subacute onset. All patients were advised to avoid exposure to the antigens. Follow-up visits including pulmonary function testing, and DLCO measurement were conducted at one, three and six months. HRCT was performed at six month. Four subjects had a complete radiological and clinical resolution after changing work. Only one patient was treated with oral steroids for severe dyspnoea and progressive reduction of DLCO, gaining a complete radiological and clinical stability at six months.

scholarly journals RADIOLOGICAL PATTERN OF PULMONARY TUBERCULOSIS IN DIABETICS VISITING A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 6 (85) ◽  
pp. 5920-5923
Author(s):  
Sindhura Goganti ◽  
Lithya Kumari S ◽  
Ashly Thomas ◽  
Hari Prasad B ◽  
Rajagopalan B ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Radiological Pattern

Bioarchaeological Analysis of Remains

2017 ◽  
Author(s):  
Grace Turner
Keyword(s):  
Infectious Disease ◽  
Social Status ◽  
Nutritional Deficiency ◽  
Small Sample ◽  
Enamel Hypoplasia ◽  
Men And Women ◽  
Moist Sand ◽  
Limited Food ◽  
Linea Aspera ◽  
Physically Demanding Work

Presumably in constructing the sidewalk, the bones from these shallow burials were disposed of elsewhere. Remains of five adults and one child were excavated. Seven subadult teeth were surface-collected around a hole at the western edge of the site. Being buried in moist sand meant that most bones excavated were fragmented. Bones and teeth were examined for evidence of pathologies. This small sample is not representative of the community, but the pathologies provide insight on these persons’ lives. The linea aspera on the only femur excavated is fairly robust. The individual’s sex was indeterminate, but this ambiguity reinforced the point that both men and women in this community engaged in physically demanding work. Cranial fragments from two individuals were thickened, an indicator of anemia resulting from nutritional deficiency or disease. Cribra orbitalia was noted in the eye socket of one individual, another indicator of nutritional deficiency. Two of the child’s incisors have transverse lines, evidence of enamel hypoplasia, an indicator of infectious disease and nutritional stress. Individuals buried in this cemetery were likely of low social status, living in congested and unsanitary conditions with limited food. These pathologies raise questions about the extent these conditions existed among African-Bahamian communities. Economic opportunities for free and enslaved workers would have been limited.

scholarly journals Topography of diaphyseal nutrient foramina of femora and their implications in bone grafting

2016 ◽  
Vol 05 (03) ◽  
pp. 127-132
Author(s):  
Venkatesh Kamath ◽  
Shivarama Bhat ◽  
Muhammed Asif ◽  
Ramakrishna Avadhani
Keyword(s):  
Bone Grafting ◽  
Success Rates ◽  
Orthopedic Surgeon ◽  
Nutrient Artery ◽  
Nutrient Foramina ◽  
Vascular Compromise ◽  
Rapid Healing ◽  
The Mean ◽  
Linea Aspera ◽  
Upper Third

Abstract Background : Long bones derive their nutrition through a nutrient artery that enters the bone through a foramen in its diaphysis. An orthopedic surgeon must be familiar with the topography of the nutrient foramina to avoid vascular compromise during surgery. Aim :This study attempts to analyze the topography of primary nutrient foramina of femora. Materials and method : One hundred dry adult femora were used for this study. The primary diaphyseal nutrient foramina were identified macroscopically using hand lens. The number of foramina and their position were noted and the foramina! index was calculated. Results : It was observed that 79% of femora had single primary nutrient foramen, 20% had double foramina and I% had three foramina. All the foramina were located between 30.8%-89.6% of total length of femur. 11.47 % of foramina were in the upper third, 1.64% in the lower third and the majority 86.88% of foramina were in the middle third of femur. The mean foramina!index was 46.01. 82.78% of foramina were located on the linea aspera, 14.75% on the medial surface and2.46% on the lateral surface. Conclusion : An orthopedic surgeon operating on femur must be careful in the middle 1/3rd, especially over the linea aspera as majority of primary diaphyseal foramina were observed in this region. A cogent knowledge of vascular topography ensures preservation of vasculature of the bone during surgeries. This enables rapid healing of surgical wound increasing the success rates of fracture fixation, bone grafting, vascularized microscopic surgeries and hip and knee replacement procedures.

scholarly journals Rituximab in the Treatment of Interstitial Lung Disease Associated with Autoimmune Diseases: Experience from a Single Referral Center and Literature Review

2020 ◽  
Vol 9 (10) ◽  
pp. 3070
Author(s):  
Belén Atienza-Mateo ◽  
Sara Remuzgo-Martínez ◽  
Diana Prieto-Peña ◽  
Víctor Manuel Mora Cuesta ◽  
David Iturbe-Fernández ◽  
...  
Keyword(s):  
Literature Review ◽  
Interstitial Pneumonia ◽  
Therapeutic Option ◽  
Pulmonary Function Tests ◽  
Usual Interstitial Pneumonia ◽  
Inflammatory Myositis ◽  
Idiopathic Inflammatory Myositis ◽  
Referral Center ◽  
Radiological Pattern ◽  
One Year

In the present study, we aimed to report our experience with rituximab (RTX) in the treatment of patients with ILD associated with AD (AD-ILD) at a single center. For this purpose, clinical characteristics, radiological findings, and pulmonary function tests (PFTs) of RTX-treated AD-ILD-patients seen from May 2016 until March 2020 at a referral center for individuals with ILD were retrospectively reviewed. Additionally, an updated literature review was conducted. A total of 26 patients (mean age 58.3 ± 11.1 years at ILD diagnosis) was included. The most common ADs related to ILD were systemic sclerosis, idiopathic inflammatory myositis (including anti-synthetase syndrome) and rheumatoid arthritis. Non-specific interstitial pneumonia (n = 12) and usual interstitial pneumonia (n = 11) were the predominant radiological patterns. The sustained improvement in PFTs was observed from the start of RTX, with a statistically significant increase in DLCO from basal to one year after RTX (mean + 4.2%, p = 0.024). Overall, there were no differences when comparing PFT outcome according to the radiological pattern or the specific type of AD. In conclusion, RTX constitutes a good therapeutic option to preserve lung function in patients with AD-ILD, regardless of the radiological pattern or the underlying AD.

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