scholarly journals Renal dysplasia with the ipsilateral ectopic ureter mimicking abscess of the prostate

2014 ◽  
Vol 71 (2) ◽  
pp. 211-213
Author(s):  
Dragan Grbic ◽  
Dimitrije Jeremic ◽  
Sasa Vojinov ◽  
Milan Popov ◽  
Goran Marusic
Keyword(s):  
Clinical Symptoms ◽  
Renal Dysplasia ◽  
Left Lobe ◽  
Definitive Diagnosis ◽  
Urogenital Sinus ◽  
Perineal Pain ◽  
Ectopic Ureter ◽  
Prostatic Abscess ◽  
C 23 ◽  
Magnetic Resonance Imaging Mri

Introduction. In males the ectopic ureter usualy drains into the prostate (50%). During ureteric developement a thin membrane (Chawalla?s membrane) separates the lumen of the ureter and the urogenital sinus at the point where the ureter joins the urogenital sinus. This membrane ruptures allowing urin to drain from the ureter to the urogenital sinus. The authors reported a case of renal dysplasia associated with ipsilateral uretral ectopia mimicking prostatic abscess. Case report. A subfebrile (37.3?C), 23-year-old patient, otherwise healthy, presented with persistent ascending perineal pain non-responsive to antibiotics and analgetics. Digitorectal examination (DRE) showed asymmetric prostate with a soft, tender, buldging left lobe suggestive of prostatic abscess. The diagnosis was suspected using transrectal ultrasonography (TRUS), but the picture of the anechoic tubular structure in the left lobe of the prostate with a proximal undefined extraprostatic extension and a caudal intraprostatic blind end was incoclusive for the definitive diagnosis of prostatic abscess. Magnetic resonance imaging (MRI) was ordered and definitive diagnosis of renal dysplasia associated with the ipsilateral ectopic ureter filled with inflamed content mimicking prostatic abscess was made. Transurethral incision/minimal resection of the distal, blindly closed end of left ectopic ureter was done. Endoscopic surgical treatment was sufficient for relief of clinical symptoms. The patient?s recovery was uneventful. Conclusion. To the best of our knowledge, a case of renal dysplasia with the ipsilateral ectopic ureter mimicking prostate abscess has not been reported so far. Cystic pelvic malformations in males may result from too craniall sprouting of the ureteral bud, with delayed absorption and ectopic opening of the distal end of the ureter.

scholarly journals Cannabinoid Hyperemesis Syndrome: A Case Report of an Underdiagnosed Condition

2020 ◽  
pp. 1-5
Author(s):  
João Machado Nogueira ◽  
Inês Fonseca ◽  
Marco Duarte
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Diagnostic Tests ◽  
Clinical Symptoms ◽  
Definitive Diagnosis ◽  
Hot Water ◽  
Illustrative Case ◽  
Raising Awareness ◽  
Detailed Medical History ◽  
Cannabinoid Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome (CHS) is characterized by episodic bursts of nausea, vomiting and abdominal pain, affecting chronic cannabis users. The clinical picture mimics an acute abdomen, usually leading to multiple assessments in the emergency department. Several complementary diagnostic examinations are performed with non-specific results, making differential diagnosis puzzling. We present a case of a 42-year-old man, who has been admitted multiple times to the emergency department in the last 3 months for abdominal pain, nausea and vomiting, without triggering factors and improving only with hot water baths. He was evaluated by different specialties, the various complementary diagnostic tests performed showed no significant results, and no definitive diagnosis was obtained. Treatment resulted only in a partial and transient resolution of symptoms. A more detailed medical history revealed cannabis use for more than 5 years, with a recent increase in the amount consumed. After psychoeducation, explaining the risks associated with consumption and its relationship with the clinical symptoms, which resulted in complete suspension of cannabis, there have been no new symptomatic episodes since then. We present an illustrative case of a poorly reported clinical entity despite having a probable significant prevalence, raising awareness in order that clinicians identify and properly manage these cases.

Predicting progression in the late onset frontal lobe syndrome

2018 ◽  
Vol 31 (5) ◽  
pp. 743-748 ◽  
Author(s):  
Flora T. Gossink ◽  
Everard Vijverberg ◽  
Welmoed Krudop ◽  
Philip Scheltens ◽  
Max L. Stek ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Clinical Symptoms ◽  
Late Onset ◽  
Clinical Syndrome ◽  
Clinical Markers ◽  
Neuropsychological Profile ◽  
Stereotypical Behavior ◽  
Executive Deficits ◽  
Magnetic Resonance Imaging Mri ◽  
Frontal Lobe Syndrome

ABSTRACTA late onset frontal lobe syndrome (LOF) refers to a clinical syndrome with apathy, disinhibition, or stereotypical behavior arising in middle or late adulthood. Diagnostics are challenging, and both clinicians and patients need reliable predictors of progression to improve clinical guidance. In this longitudinal multicenter and genetically screened prospective study, 137 LOF patients with frontal behavior (FBI score≥11) and/or stereotypical behavior (SRI≥10) were included. Progression was defined as institutionalization, death, or progression of frontal or temporal atrophy at magnetic resonance imaging (MRI) after two years of follow up. Absence of progression at MRI in addition to stable or improved Mini Mental State Examination and Frontal Assessment Battery scores after two years was indicative for non-progression. The presence of stereotypy and a neuropsychological profile with executive deficits at baseline were found to be predictive for progression, while a history and family history with psychiatric disorders were predictors for non-progression. The combination of these clinical markers had a predictive value of 80.4% (p < 0.05). In patients presenting with late onset behavioral symptoms, an appraisal of the rate of deterioration can be made by detailed mapping of clinical symptoms. Distinction of progressive discourses from non-progressive or treatable conditions is to be gained.

Clinical Features and Endolymphatic Hydrops in Patients With MRI Evidence of Hydrops

2018 ◽  
Vol 128 (4) ◽  
pp. 286-292 ◽  
Author(s):  
Suming Shi ◽  
Ping Guo ◽  
Wenquan Li ◽  
Wuqing Wang
Keyword(s):  
Diagnostic Criteria ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Clinical Symptoms ◽  
Endolymphatic Hydrops ◽  
Low Frequency ◽  
Clinical Severity ◽  
Mri Findings ◽  
Vestibular Symptoms ◽  
Magnetic Resonance Imaging Mri

Objectives: The purpose of this study was to investigate the correlation between grades of endolymphatic hydrops (ELH) and clinical characteristics and determine the detailed clinical characteristics of Ménière’s disease (MD) patients with evidence of hydrops based on magnetic resonance imaging (MRI). Methods: One hundred ninety-eight MD patients (396 ears) with MRI evidence of hydrops were included. ELH grades were evaluated using the Nakashima grading standard. Correlations between the extent of ELH and clinical features were evaluated. Detailed clinical characteristics were analyzed to assess the clinical diagnostic criteria. Results: Of 198 patients, ELH was observed in 100% of cases on the clinically affected side and 8.6% of cases on the asymptomatic side. In addition, 98.5% of ELH was classified as moderate or significant grade. Low-frequency hearing loss was significantly correlated with the extent of both vestibular and cochlear hydrops, whereas the vertigo attack frequency showed no significant correlation with ELH grades. The disease duration of MD with bilateral ELH was longer than that with unilateral ELH. The clinical characteristics were variant and did not completely fit the proposed diagnostic criteria. Conclusions: MRI findings have relevance to the clinical severity, to a certain extent, but not vestibular symptoms. The proposed diagnostic criteria based on clinical characteristics may be partially effective; analysis of the detailed clinical characteristics of MD was meaningful. Diagnosis of MD based on both MRI and clinical symptoms could facilitate an early diagnosis.

Computed tomography demonstration of renal dysplasia with a vaginal ectopic ureter

1986 ◽  
Vol 10 (3) ◽  
pp. 273-275 ◽  
Author(s):  
Yukunori Korogi ◽  
Mutsumasa Takahashi ◽  
Noriharu Fujimura ◽  
Hiroshi Terasaki ◽  
Fumimaro Ueno
Keyword(s):  
Computed Tomography ◽  
Renal Dysplasia ◽  
Ectopic Ureter ◽  
Vaginal Ectopic Ureter

Discrepancies in the interpretation of clinical symptoms and signs in the diagnosis of multiple sclerosis. A proposal for standardization

2005 ◽  
Vol 11 (2) ◽  
pp. 227-231 ◽  
Author(s):  
Bernard MJ Uitdehaag ◽  
Ludwig Kappos ◽  
Lars Bauer ◽  
Mark S Freedman ◽  
David Miller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Demyelinating Disease ◽  
Clinical Symptoms ◽  
Clinical Findings ◽  
Large Trial ◽  
Mri Findings ◽  
Mcdonald Criteria ◽  
Magnetic Resonance Imaging Mri ◽  
Eligibility Assessment

The new McDonald diagnostic criteria for multiple sclerosis (MS) incorporate detailed criteria for the interpretation and classification of magnetic resonance imaging (MRI) findings, but, in contrast, provide no instructions for the interpretation of clinical findings. Because MS according to the McDonald criteria is one of the primary endpoints in a large trial enrolling patients after the first manifestation suggestive for a demyelinating disease (BENEFIT study), it was decided to organize a centralized eligibility assessment for this trial. During this eligibility assessment it was observed that there were marked inconsistencies in the decisions of participating neurologists with respect to the classification of clinical symptoms as being caused by one or more lesions provoking discussions in about one in every five patients. This paper describes these inconsistencies and their sources, and recommends a systematic approach that attempts to reduce the variability in interpreting clinical findings.

scholarly journals MRI Analysis for Clarification of Mechanism of Ankle Osteoarthritis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0035
Author(s):  
Hiroyuki Mitsui ◽  
Takaaki Hirano ◽  
Hisateru Niki
Keyword(s):  
Clinical Symptoms ◽  
Predictive Tool ◽  
Ankle Osteoarthritis ◽  
Talocrural Joint ◽  
Radiographic Findings ◽  
Lateral Process ◽  
Metatarsal Angle ◽  
Magnetic Resonance Imaging Mri ◽  
The Relationship ◽  
Surface Angle

Category: Ankle Arthritis Introduction/Purpose: We have previously studied the relationship between Takakura–Tanaka classification stages and bone-marrow edema (BME) in order to elucidate the pathology of ankle osteoarthritis (ankle OA) on magnetic resonance imaging (MRI). Moreover, we have investigated that BME onset on the talocrural joint can be predicted according to radiographic findings. In the present study, we focused on the changes around the subtalar joint to examine the relationship between talar lateral process impingement (TLPI) and foot and ankle joint alignment, and whether TLPI can be predicted on the basis of X-ray findings. Methods: We assessed 30 feet of 30 patients who had a diagnosis of ankle OA in our hospital and underwent MRI. Alignment was assessed radiographically by measuring the tibial anterior surface angle (TAS), the tibial lateral surface angle (TLS), the lateral talo-first metatarsal angle (LTMT), the lateral talocalcaneal angle (LTC), and the tibial axis–talar ratio (T-T ratio). MRI was obtained with the talocrural, subtalar and Chopart joints into 22 subdivided areas to examine the frequency of BME for each patient. TLPI was considered positive (+) when BME was found in the talar lateral process. The patients were divided into two groups according to TLPI positivity or negativity. Their BME frequency was examined, and significant differences in radiographically measured values were analysed with a t-test. Results: In the TLPI (+) group, BME development occurred at significantly higher frequencies in all areas except those surrounding the lateral process (p = 0.002). In addition, TLS was significantly lower (p = 0.02), and LTMT was significantly higher (p = 0.04). When the cut-off value on the ROC curve was set at TLS of =74° and LTMT of =19°, TLPI onset could be predicted with a sensitivity of 75% and a specificity of 71%. Conclusion: Our results revealed that in the TLPI (+) group, progression of the anteriorly opened talocrural joint and talar dorsiflexion may be causing the talar lateral process to hit the calcaneus. Furthermore, in the TLPI (+) group, BME in other areas also occurred at higher frequencies, and symptoms around the ankle joints may be occurring at multiple locations. The fact that TLPI could be predicted from radiography findings suggests that this may be a potential predictive tool of the severity of clinical symptoms.

scholarly journals A Case of Spontaneous Spinal Subdural Hematoma Complicated by Cranial Subarachnoid Hemorrhage and Spinal Adhesive Arachnoiditis

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Taihei Go ◽  
Toshiyuki Tsutsui ◽  
Yasuaki Iida ◽  
Katsunori Fukutake ◽  
Ryoichi Fukano ◽  
...  
Keyword(s):  
Back Pain ◽  
Subarachnoid Hemorrhage ◽  
Subdural Hematoma ◽  
Subarachnoid Space ◽  
Clinical Symptoms ◽  
Neurological Manifestation ◽  
Subdural Space ◽  
Spinal Subdural Hematoma ◽  
Magnetic Resonance Imaging Mri ◽  
To Come

A 76-year-old woman with a spinal subdural hematoma (SDH) was presented with severe back pain without headache. Magnetic resonance imaging (MRI) performed 4 days after onset showed SDH extending from Th2 to L3. She was diagnosed with spontaneous SDH without neurological manifestation, and conservative treatment was selected. Transient disturbance of orientation appeared 7 days after onset. Small subarachnoid hemorrhage (SAH) was detected on head CT, and strict antihypertensive therapy was started. Symptoms changed for the better. Back pain disappeared 4 weeks after onset. On follow-up MRI at 6 months after onset, the SDH had been resolved spontaneously. Although adhesive arachnoiditis was observed at Th4-6, the recurrence of clinical symptoms was not observed at one year and a half after onset. Spinal subdural space is almost avascular; a hematoma in a subdural space is considered to come from a subarachnoid space when it is a lot. A hemorrhage in subarachnoid space was flushed by cerebral spinal fluid; hematoma or arachnoiditis was not formed in general. In our case, hemorrhage was a lot and expansion of SDH was large enough to cause cranial SAH and arachnoiditis. But longitudinally expanded SDH did not show neurological manifestation and resolved spontaneously in our case.

scholarly journals Orbital Schwannoma: Case Report and Review

2019 ◽  
Vol 38 (03) ◽  
pp. 199-202 ◽  
Author(s):  
Ricardo Lourenço Caramanti ◽  
Mário José Goes ◽  
Feres Chaddad ◽  
Lucas Crociati Meguins ◽  
Dionei Freitas de Moraes ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Previous History ◽  
Mass Effect ◽  
Complete Resection ◽  
High Signal ◽  
Resonance Imaging ◽  
History Of Disease ◽  
Orbital Pain ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

AbstractOrbital schwannomas are rare, presenting a rate of incidence between 1 and 5% of all orbital lesions. Their most common clinical symptoms are promoted by mass effect, such as orbital pain and proptosis. The best complementary exam is the magnetic resonance imaging (MRI), which shows low signal in T1, high signal in T2, and heterogeneous contrast enhancement. The treatment of choice is surgical, with adjuvant radiotherapy if complete resection is not possible. We report the case of a 24-year-old male patient with orbital pain and proptosis, without previous history of disease. The MRI showed a superior orbital lesion compatible with schwannoma, which was confirmed by biopsy after complete resection using a fronto-orbital approach.

scholarly journals Effect of extensive tenosynovectomy on diffuse flexor hallucis longus tenosynovitis combined with effusion

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986335 ◽  
Author(s):  
Wenqing Qu ◽  
Tong Liu ◽  
Wentao Chen ◽  
Zhenzhong Sun ◽  
Shengjie Dong ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Final Analysis ◽  
Flexor Hallucis Longus ◽  
Foot And Ankle ◽  
Aofas Score ◽  
Pain Scores ◽  
The Difference ◽  
Magnetic Resonance Imaging Mri ◽  
American Orthopaedic

Objective: The objective of this study was to examine the clinical and magnetic resonance imaging (MRI) outcomes of extensive tenosynovectomy on patients with diffuse flexor hallucis longus tenosynovitis combined with effusion (DFHLT-E). Methods: Consecutive patients undergoing extensive tenosynovectomy for DFHLT-E in the same foot and ankle center from January 2013 to December 2016 were selected; a total of 14 patients were included in the final analysis. Patients with a minimum 1-year follow-up were evaluated with physical examination, MRI, American Orthopaedic Foot and Ankle Society (AOFAS) clinical midfoot scale, and visual analog scale (VAS) pain scores. Results: The 14 patients were followed up for an average of 15.0 ± 2.3 months (12–18 months). There were no recurrences in all clinical examinations at the final follow-up. The AOFAS score was improved from 61.57 ± 10.70 before surgery to 90.28 ± 9.41 at the final follow-up. The difference was statistically significant ( p = 0.001). The VAS score was improved from 4.00 ± 0.82 before surgery to 0.43 ± 0.53 at the final follow-up ( p < 0.001). MRI examination revealed two patients with small residual and limited effusion with no clinical symptoms. Superficial pin infection was observed in one patient, and two patients had transient neurostimulation. Conclusions: Extensive tenosynovectomy is an effective alternative for the treatment of DFHLT-E with less complications or recurrence.

The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: A literature review

2020 ◽  
pp. 197140092097515
Author(s):  
Irene Grazzini ◽  
Duccio Venezia ◽  
Gian Luca Cuneo
Keyword(s):  
Diffusion Tensor Imaging ◽  
Normal Pressure Hydrocephalus ◽  
Clinical Symptoms ◽  
Diffusion Tensor ◽  
Clinical History ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Csf Shunt ◽  
Magnetic Resonance Imaging Mri

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome that comprises a triad of gait disturbance, dementia and urinary incontinence, associated with ventriculomegaly in the absence of elevated intraventricular cerebrospinal fluid (CSF) pressure. It is important to identify patients with iNPH because some of its clinical features may be reversed by the insertion of a CSF shunt. The diagnosis is based on clinical history, physical examination and brain imaging, especially magnetic resonance imaging (MRI). Recently, some papers have investigated the role of diffusion tensor imaging (DTI) in evaluating white matter alterations in patients with iNPH. DTI analysis in specific anatomical regions seems to be a promising MR biomarker of iNPH and could also be used in the differential diagnosis from other dementias. However, there is a substantial lack of structured reviews on this topic. Thus, we performed a literature search and analyzed the most recent and pivotal articles that investigated the role of DTI in iNPH in order to provide an up-to-date overview of the application of DTI in this setting. We reviewed studies published between January 2000 and June 2020. Thirty-eight studies and four reviews were included. Despite heterogeneity in analysis approaches, the majority of studies reported significant correlations between DTI and clinical symptoms in iNPH patients, as well as different DTI patterns in patients with iNPH compared to those with Alzheimer or Parkinson diseases. It remains to be determined whether DTI could predict the success after CSF shunting.

Sign in / Sign up

Export Citation Format

Share Document