Tunneled Uncuffed Pigtail Drainage Catheter Placement in Patients with Refractory Ascites or Pleural Effusion: A Single-Center Experience

Purpose No evidence exists to support the use of tunneled non-cuffed pigtail drainage catheters in patients with refractory ascites or pleural effusion. The purpose of this study was to determine the feasibility of non-cuffed tunneled pigtail drainage catheters in patients with refractory ascites or pleural effusions. Materials and Methods Between October 5, 2020 and May 25, 2021, 34 pigtail catheters were implanted in 27 patients (17 males, 10 females; average age: 65.66 +/- 12.04 years) under either ultrasound or computed-tomography guidance (19 catheters for ascites, 15 catheters for pleural effusion). Twenty-eight catheters (82.35%) were implanted for malignant etiologies, and 6 catheters (17.65%) were implanted for benign etiologies. The catheters (size: 8-14 French) were implanted through a subcutaneous tunnel. Complication rate and factors related to complications were analyzed. Catheter lifetime was analyzed with Kaplan-Meier method. Results Patency ranged from 3 to 211 days. None of the patients experienced a major complication (e.g., peritonitis and empyema). Meanwhile, 8 minor complications were observed including 3 catheter occlusion, 3 ascites leakage, 1 peri-catheter local skin infection, 1 peri-catheter local skin reaction. None of the etiologies were related to the catheter complications. However, the 8-F catheter was associated with a significantly higher complication rate (odds = 5.5, p = 0.044). The estimated mean [CI] dwelling time of a catheter was 59.18 [32.97, 85.39] days. Conclusions Image-guided insertion of tunneled peritoneal or pleural pigtail external drainage catheters achieved with a 100% technical success rate and resulted in an acceptable complication rate and catheter lifetime for the management of refractory ascites or pleural effusion

Magnetic Resonance Imaging Findings of Primary Synovial Osteochondromatosis

Giriş ve Amaç: Sinoviyal osteokondramatozis sinovial dokunun mezenkimal kalıntılarının kartilajinöz metaplazisi sonucu gelişir. Genellikle eklem aralıklarında ve tenosinoviyumda kalsifiye kartilajinöz oluşumlar ile karakterizedir. Tek eklem tutulumu yapar ve sıklıkla diz, kalça ve el bileği tutulur. Nadir de olsa kondrosarkoma malign dejenerasyon gösterebilmektedir. Patolojik olarak ispatlanmış farklı anatomik lokalizasyonlardaki sinoviyal osteokondromatozisli on olgumuza ait MR bulgularını sunmayı amaçladık. Yöntem ve Gereçler: Sinoviyal osteokondromatozis tanısı almış on olgunun MR incelemeleri retrospektif olarak iki farklı radyolog tarafından birlikte tekrar değerlendirildi. Hastaların demografik ve klinik özellikleri ve lezyonların yerleşimi, şekli, uzanımı ve MR sinyal özellikleri değerlendirildi. Bulgular: Tanı alan 10 olgunun 6'sı erkek,4'ü kadın olup yaş ortalaması 50 bulunmuştur.(14-70 yaş) Hastaların geliş yakınmaları eklem ağrısı (n: 5), şişlik (n: 5) olarak belirtilmiştir. İki lezyon ayak bileğinde, 4 lezyon diz ekleminde, 2 lezyon omuz ekleminde ve 1 lezyon kalça ekleminde ve 1 lezyon dirsek ekleminde tespit edilmiştir. Röntgenografide tüm olguların ilgili eklem aralığında milimetrik noduler kalsikasyonlar izlenmiştir. Sadece 1 olguda kemik tutulumu da izlenmiştir. Omuz eklemi tutulumu olan olgularda ekstraartikülerbursal ve tenosinovial tutulum da izlenmiştir. Kalça eklemi tutulan olguda iliopsoas ve eksternalobturatuar bursalar da tutulmuştur. Tartışma ve Sonuç: Sinoviyal osteokondromatozisin direkt grafi ve MR bulguları genellikle tipiktir. Sinoviyal osteokondromatoziste MR intraartiküler lezyonun bursalara uzanımını ve kemik erozyonlarını göstermekte de oldukça başarılıdır.Introduction: Primary synovial chondromatosis is an uncommon benign monoarticular disorder. It is characterized by proliferation and metaplastic transformation of the synovium. It is generally characterized by calcified cartilagenous structures in the joint space or in the tenosynovium. It involves one joint and knee, hip, wrist are commonly affected joints. Malignant degeneration into chondrosarcoma has been reported but is rare. Here, we aimed to present MR images of 10 patients with primary synovial osteochondromatosis. Material and Methods: We retrospectively reviewed 10 pathologically confirmed cases of synovial chondromatosis. Patients' demographics and clinical presentations were reviewed. Imaging was evaluated by two musculoskeletal radiologists with agreement by consensus. Images were evaluated for lesion location, shape, extent and signal characteristics on MR. Results: Among the ten patients, 6 were male, 4 were female with a mean age of 50. (14-70 years) Lesion locations included knee (n=4), ankle (n = 2), shoulder (n = 2), elbow (n = 1), hip (n = 1). Radiographs commonly showed milimetric nodular calcifications. Only one lesion involved adjacent bone. The two patients with shoulder involvement also involved extraarticular bursa and tenosynovium. The case with the hip involvement also involved iliopsoas and external obturator bursa. Discussion and Conclusion: The radiographic and magnetic resonance imaging findings of synovial osteochondromatosis is typical. MRI is successful in determining the bone erosions and bursal extent of the intraarticular lesion