21 research outputs found
Vena Cava Malformations as an Emerging Etiologic Factor for Deep Vein Thrombosis in Young Patients
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Breath-hold spin-echo MR imaging for evaluation of dynamic enhancement of native and treated hepatocellular carcinoma after intravenous Gd-DTPA administration
Predictive value of clinical findings for temporomandibular joint effusion
The aim of this work was to evaluate the predictive value of clinical
symptoms for magnetic resonance imaging (MRI) findings of temporomandibular joint
(TMJ) effusion. STUDY DESIGN: Sixty-one patients with TMJ pain were assessed by
means of a standardized clinical examination and MRI. A calibrated investigator
evaluated the presence of 8 clinical indicators (predictors) of TMJ effusion
(outcome variable). A logistic regression analysis was performed to detect
significant associations between clinical symptoms and MRI findings of TMJ
effusion. The accuracy of the final logit to predict effusion was compared with
that derived from univariate analysis. RESULTS: A clinical examination based upon
the assessment of pain in the TMJ with lateral palpation, with posterior
palpation, during motion, and during maximum assisted opening, and the presence
of click and crepitus sounds has an accuracy of 78.7% to predict TMJ effusion.
Among the single clinical symptoms, the most reliable predictor of TMJ effusion
is the presence of pain with lateral palpation (accuracy 76.2%; K =.525).
CONCLUSION: The use of a multiple regression approach demonstrated that an
extensive clinical assessment which considers 6 main indicators consents to
predict accurately the presence of MRI TMJ effusion. Based on these findings, MRI
assessment should be reserved for patients in which the exact disc-condyle
relationship needs to be evaluated
Temporomandibular joint capsular width as an indirect indicator of effusion. An ultrasonographic study
Temporomandibular joint capsular width as an indirect indicator of effusion. An ultrasonographic study
Ultrasound assessment of an increased capsular width as a predictor of temporomandibular joint effusion
The aim of this study was to evaluate whether an increased capsular
width evidenced by ultrasound (US) could be an indirect marker of
temporomandibular joint (TMJ) effusion. METHODS: 138 TMJs were evaluated by US
and magnetic resonance imaging (MRI) by two blinded calibrated investigators. US
measures of capsular width (in mm) and MRI diagnosis of TMJ effusion
(presence/absence) were used to perform a receiver operating characteristic (ROC)
curve analysis in order to assess the most accurate cut-off value of capsular
width that was able to discriminate between joints with and without MRI effusion.
RESULTS: Diagnostic accuracy of US to detect MRI-depicted TMJ effusion was good
(area under the ROC curve=0.817). US sensitivity was high for values below the
cut-off value of 1.950 mm (true positive rate (TPR)=83.9%; false positive rate
(FPR)=26.3%), while specificity was high for values above the cut-off value of
2.150 mm (TPR=71.0%; FPR=11.8%). CONCLUSIONS: Analysis of ROC curve appears to
reveal that the critical area is around the 2 mm value for TMJ capsular width.
These findings need to be refined by further studies assessing the smallest
detectable difference in capsular width, with attention to reliability of
interobserver observations
Ultrasonographic vs. magnetic resonance imaging findings of temporomandibular joint effusion
The aim of this study was to assess the accuracy of ultrasonography (US) in
the evaluation of temporomandibular joint (TMJ) effusion compared with magnetic
resonance imaging (MRI) findings, assumed as the gold standard. METHODS: The
study group consisted of 44 patients with signs and symptoms of temporomandibular
disorders (TMD). Each joint (N=88) was evaluated using US and magnetic resonance
(MR) to detect the presence of effusion. The 2 examinations were carried out by 2
blinded operators within no more than 2 weeks from each other. During that period
the patients did not receive any kind of treatment. Sensitivity, specificity,
positive predictive values (PPV) and negative predective values (NPV) of US were
calculated. The agreement between the 2 diagnostic techniques was then evaluated
by Cohen's K test. RESULTS: MRI depicted intra-articular effusion in 41 of the 88
TMJs (46.5%) while no effusion was detected in the remaining 47 joints (53.5%).
Ultrasonographic imaging revealed effusion in 42/88 joints (47.8%), while the
remaining 46 joints (52.2%) showed no effusion. US showed a sensitivity of 75.6%
and a specificity of 76.5%. The PPV and NPV were 73.8% and 78.2% respectively. US
vs MRI agreement for the diagnosis of TMJ effusion was fairly good (pct.
agreement 76.1%; K=0.521). CONCLUSION: US is a low-cost, easy-performing,
non-invasive, rapidly-executing imaging technique whose possible employ in the
study of the TMJ is very promising
Progressive Brachial Plexus Palsy after Osteosynthesis of an Inveterate Clavicular Fracture
The thoracic outlet syndrome (TOS) is a rare complication of clavicular fracture, occurring in 0.5-9% of cases. In the literature from 1965 - 2010, 425 cases of TOS complicating a claviclular fracture were described. However, only 5 were observed after a surgical procedure of reduction and fixation. The causes of this complication were due to the presence of an exuberant callus, to technical surgery errors or to vascular lesions. In this paper we describe a case of brachial plexus plasy after osteosynthesis of clavicle fracture
Magnetic Resonance Imaging–Based Three Dimensional Patient-Specific Reconstruction of Uterine Fibromatosis: Impact on Surgery
Acral Dedifferentiated Chondrosarcoma: Report of a Case Arising in the Proximal Phalanx of the Fourth Finger
Dedifferentiated chondrosarcoma is a well-recognized entity, but its occurrence in the distal extremities is exceedingly rare. We present the case of a 49-year-old woman who experienced local recurrence of an “enchondroma” of the proximal phalanx of the fourth finger of the left hand, which had been initially treated with intralesional curettage at another hospital 4 years before, and 1 year before for a local recurrence. The imaging findings indicated an aggressive behavior, and an incisional biopsy showed a highly cellular proliferation of spindle and pleomorphic elements without evidence of matrix production intermixed with few fragments of a well-differentiated cartilaginous neoplasm with bland cellular atypia, focal nuclear hyperchromatism, and binucleation. An isocitrate dehydrogenase 2 R172S mutation was detected. The final diagnosis was dedifferentiated chondrosarcoma. Despite amputation of the fourth finger, the patient developed lung metastases and further local relapse. Recurrent cartilaginous tumors of the extremities should not be underestimated and should be followed in view of the possible acquisition of aggressive clinical behavior