scholarly journals Role of Diagnostic Imaging in Chronic Recurrent Multifocal Osteomyelitis (CRMO) in Children: An Observational Study

Children ◽  
2021 ◽  
Vol 8 (9) ◽  
pp. 792
Author(s):  
Michał Kopeć ◽  
Magdalena Brąszewska ◽  
Mariusz Jarosz ◽  
Katarzyna Dylewska ◽  
Andrzej Kurylak
Keyword(s):  
Observational Study ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Conventional Radiography ◽  
Cortical Layer ◽  
Mri Findings ◽  
Multifocal Osteomyelitis ◽  
Magnetic Resonance Imaging Mri

The aim of this single-center observational study was to analyze the applicability of various imaging studies to the diagnosis and further evaluation of patients with chronic recurrent multifocal osteomyelitis (CRMO). The analysis included the data of 10 patients with CRMO treated between 2016 and 2021. The mean ages of the patients at the first manifestation of CRMO and ultimate diagnosis were 10 years and 7 months and 11 years and 10 months, respectively. Conventional radiography demonstrated focal loss of bone density in only 30% of the patients. Computed tomography showed disseminated foci with non-homogeneous osteolytic/osteosclerotic structure, with a massive loss of cortical layer and strong periosteal reaction. On magnetic resonance imaging (MRI), most patients presented with multifocal hypodense areas on T1-weighted images, with the enhancement of signal on T-weighted and STIR sequences. The duration of follow-up varied between 3 months and 3 years. In 40% of the patients, both clinical symptoms and the abnormalities seen on MRI resolved completely, whereas another 50% showed partial regression of clinical and radiological manifestations. MRI findings, co-existing with characteristic clinical manifestations, play a pivotal role in establishing the ultimate diagnosis of CRMO. MRI can also be used to monitor the outcomes of treatment in CRMO patients.

scholarly journals Clinical-radiological dissociation in a patient with nitrous oxide-induced subacute combined degeneration: A case report

2020 ◽  
Author(s):  
Jiwei Jiang ◽  
Xiuli Shang
Keyword(s):  
Nitrous Oxide ◽  
Vitamin B12 ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Serum Vitamin ◽  
Mri Findings ◽  
Subacute Combined Degeneration ◽  
Posterior Aspect ◽  
Magnetic Resonance Imaging Mri ◽  
The One

Abstract Background: Several recent studies have reported subacute combined degeneration (SCD) induced by nitrous oxide (N2O) abuse. However, the association between the evolution of dynamic neuroimaging and clinical manifestations has not been reported in patients with N2O-induced SCD. Case presentation: We described the case of a 24-year-old man who developed SCD with inverted V-sign hyperintensities over the posterior aspect of the spinal cord caused by frequent, excessive N2O inhalation. One month after treatment, his weakness and paresthesia resolved and serum vitamin B12 levels exceeded the normal levels. However, the hyperintensities had extended horizontally and longitudinally on T2-weighted magnetic resonance imaging (MRI), compared to those on the initial scan. Two months after treatment, the patient experienced some residual numbness in the distal limbs, and his serum homocysteine levels were normal, but the abnormal signals seen on cervical T2-weighted MRI had decreased only slightly compared to those seen on the one-month follow-up MRI. The evolution of conventional MRI findings lagged compared to the clinical manifestation, which was suggestive of a clinical-radiological dissociation. Conclusions: Clinical-radiological dissociation might have occurred in this case because T2-weighted imaging was not sensitive enough to reveal cytotoxic edema. Moreover, the serum vitamin B12 level is not a good indicator of cellular vitamin B12. Thus, clinicians should recognize this phenomenon, comprehensively assess the condition of patients with N2O-induced SCD, and avoid terminating treatment based on the resolution of clinical symptoms and serological results.

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.

scholarly journals Role of magnetic resonance imaging in prediction of outcome in traumatic diffuse axonal injury: A single-centre observational study

2021 ◽  
Vol 18 (3) ◽  
pp. 39-43
Author(s):  
Suraj Thulung ◽  
Nikunj Yogi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Observational Study ◽  
Axonal Injury ◽  
Diffuse Axonal Injury ◽  
Resonance Imaging ◽  
Unfavourable Outcome ◽  
Neurological Assessment ◽  
Mri Findings

Introduction: Incidence of diffuse axonal injury has been estimated at 40-50% of hospitalizations. Recently, much interest has been directed towards the potential of newer imaging sequences of magnetic resonance imaging to investigate diffuse axonal injury (DAI) and to prognosticate the outcome. In this study, we correlated the magnetic resonance imaging grades of diffuse axonal injury with clinical outcome in terms of Glasgow Outcome Scale (GOS). Methods and Materials: A hospital based observational study was carried out at Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Kathmandu in 69 patients of diffuse axonal injury between November 2017 to November 2018. Data was collected on patient and trauma characteristics, as well as neurological assessment and MRI findings. Outcome was assessed as favourable and unfavourable GOS for various MRI grades of diffuse axonal injury. Results: There were 21.74%, 42.03% and 36.23% of cases with grade I, II and III diffuse axonal injury respectively. There were 0 (0%), 2 (11.8%) and 15 (88.2%) cases of MRI grade I, II and III diffuse axonal injury in favourable GOS group and 15 (28.8%), 27 (51.9%) and 10 (19.2%) cases of MRI grade I, II and III diffuse axonal injury in unfavourable GOS group (p=0.00). Conclusion: This study showed that there was a significantly higher chance of unfavourable outcome with increasing MRI grades of diffuse axonal injury.

scholarly journals The role of nicotinamide in the correction of renal function in diabetic nephropathy

2019 ◽  
Vol 23 (2) ◽  
pp. 218-221
Author(s):  
L. V. Yanitskaya ◽  
L. F. Osinskaya ◽  
A. V. Redko
Keyword(s):  
Diabetes Mellitus ◽  
Body Weight ◽  
Diabetic Nephropathy ◽  
Statistical Analysis ◽  
Rat Kidney ◽  
Clinical Manifestations ◽  
Diabetic Rats ◽  
Cortical Layer ◽  
The Difference

Hyperglycemia of diabetes mellitus leads to the activation of the polyol way of oxidation of glucose with the activation of the enzymes of aldose reductase and sorbitol dehydrogenase and of their coenzymes NADPH and NAD, which triggers the mechanism of formation of sorbitol. The consequences of these changes lead to microangiopathy of the tissues of the kidneys, which may be one of the pathogenetic mechanisms of diabetic nephropathy. In an accessible literature, the role of coenzymes of sorbitol pathway in the development of diabetic nephropathy is not sufficiently defined. The purpose of the study was to study the content of NAD and NADPH coenzymes, their correlation, and their role in the mechanism of kidney damage in diabetes mellitus and to predict the possible correction of these changes with the NAD-nicotinamide derivative. The study was conducted on a model of streptotrozectinic diabetes mellitus (single administration of streptozotocin in a dose of 60 mg per 1 kg of body weight). Four weeks after induction of diabetes, nicotinamide (100 mg per 1 kg body weight) was injected. The level of glucose was determined by the Accu-chek (Roshe Diagnostics, Switzerland) glucose meter. The content of NAD and NADH was determined in the non-protein extracts. The statistical analysis was carried out using the Microsoft Excel statistical analysis program. The difference between the indicators was considered statistically significant (p<0.05). The NAD level was reduced by 31%, the NAD/NADN ratio was 32%. The dependence of the ratio of NADP/NADPN in conditions of hyperglycemia of diabetes mellitus with clinical manifestations of diabetic nephropathy is determined. A decrease in the ratio of NADP/NADPN to 38% in the rat kidney in the cortical layer was detected. The introduction of nicotinamide normalized the reduced content of NAD diabetic rats. These results provide perspectives for further research in which nicotinamide can be used as a renal protector.

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.

Diverse MRI findings and clinical outcomes of acute Marchiafava-Bignami disease

2020 ◽  
pp. 028418512094304
Author(s):  
Wei Li ◽  
Chao Ran ◽  
Jun Ma
Keyword(s):  
Clinical Outcomes ◽  
Clinical Manifestations ◽  
Acute Onset ◽  
Restricted Diffusion ◽  
Type I ◽  
Type Ii ◽  
Mri Findings ◽  
Type Iii ◽  
Mri Features ◽  
Magnetic Resonance Imaging Mri

Background The acute onset of Marchiafava-Bignami disease (MBD) is difficult to capture, and its clinical manifestations are overlapped. Magnetic resonance imaging (MRI) is very useful in the diagnosis of acute MBD. Purpose To investigate the MRI features and clinical outcomes of acute MBD. Materials and Methods Sagittal T2-weighted (T2W) or T1-weighted (T1W) imaging, axial T1W and T2W imaging, and axial FLAIR and diffusion-weighted imaging (DWI) sequences were performed in 17 patients with acute MBD on 1.5-T MR. According to the different ranges of callosal restricted diffusion, MBD was divided into Type I (n = 7, the completely involved), Type II (n = 5, the mostly involved), and Type III (n = 5, the partly involved). The MRI findings and outcomes of each type were retrospectively analyzed. Results With the reduced range of the callosal restricted diffusion, the callosal atrophy or cavitation was more common: no case of Type I; 1 (20%) case of Type II; and 3 (60%) cases of Type III. With the increased range of callosal restricted diffusion, the extracallosal involvement was more common: 6 (86%) cases of Type I; 3 (60%) cases of Type II; and 1 (20%) case of Type III. During the follow-up, five cases had neuropsychiatric sequelae: 1 (14%) case of type I; 1 (20%) case of Type II; 3 (60%) cases of Type III. Conclusion The MRI findings and clinical outcomes of acute MBD are regular. The extensive restricted diffusion of acute MBD may present the curable condition. Callosal heterogeneity may affect the outcome of acute MBD.

Chronic Recurrent Multifocal Osteomyelitis in Children

1988 ◽  
Vol 29 (5) ◽  
pp. 565-570 ◽  
Author(s):  
W. Mortensson ◽  
G. Edeburn ◽  
M. Fries ◽  
R. Nilsson
Keyword(s):  
Bone Scintigraphy ◽  
Bone Biopsy ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Conventional Radiography ◽  
Radiographic Appearance ◽  
Radiologic Evaluation ◽  
Biopsy Specimens ◽  
Multifocal Osteomyelitis ◽  
Vertebral Bodies ◽  
Bacteria And Fungi

Thirty cases of chronic recurrent multifocal osteomyelitis have been reported in the literature. A radiologic evaluation of thirty-one additional cases, 25 of whom also underwent bone scintigraphy, is presented. Bone biopsy specimens were obtained in 16 patients. Most lesions were located in the metaphyses of the long bones adjacent to the physis and had a characteristic, probably pathognomonic appearance. Extension into the epiphyses was rare. Lesions in the vertebral bodies, clavicle and pelvis had possibly a less specific radiographic appearance. Lesions in short tubular bones were non-specific. Bone scintigraphy had a pratical value in evaluating the global distribution of lesions including asymptomatic lesions and lesions in the spine or pelvis, the latter being somewhat hard to detect with conventional radiography. All biopsies showed acute, subacute or chronic unspecific osteomyelitis, sometimes mixed in the same lesion. Staining for bacteria and fungi was negative.

The role of CT in the diagnosis of sacro-iliitis

1998 ◽  
Vol 39 (3) ◽  
pp. 265-268 ◽  
Author(s):  
M. Geijer ◽  
H. Sihlbom ◽  
J. H. Göthlin ◽  
E. Nordborg
Keyword(s):  
Clinical Symptoms ◽  
Conventional Radiography ◽  
Symptom Duration ◽  
Radiological Findings ◽  
Early Start ◽  
Early Course ◽  
Low Sensitivity ◽  
Higher Sensitivity ◽  
Made In

Objective: Ankylosing spondylitis is a progressive, debilitating disease in which early diagnosis and early treatment can improve the prognosis. Radiographic confirmation is essential for diagnosis but conventional radiography has not proved useful, particularly in the early course of the disease. The aims of this study were to correlate the findings at conventional radiography with those at CT, and to correlate the duration of clinical symptoms with the radiological findings Material and Methods: Forty patients with clinical sacro-iliitis and 13 controls were evaluated by means of conventional radiography and CT Results: Conventional radiography was positive in 10/40 patients and CT in 30/40 patients. Conventional radiography was positive in only 2/14 patients with a symptom duration of less than 2 years while CT was positive in 10/14 such patients Conclusion: The study demonstrated a considerably higher sensitivity in CT than in conventional radiography in detecting the subtle changes necessary for the radiological diagnosis of sacro-iliitis, particularly in cases of short duration. CT allows an early start to be made in treatment with a consequently improved prognosis. The use of conventional radiography cannot be recommended because its low sensitivity delays diagnosis in many instances

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.

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