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Augustin D, Augustin DH, Pharol A, Deverson V, Khawly CGP. Intramuscular Dissecting Baker's Cysts: A Case Series Highlighting Ultrasound Diagnosis and Differential Considerations. Cureus 2024; 16:e53658. [PMID: 38322098 PMCID: PMC10846661 DOI: 10.7759/cureus.53658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 02/08/2024] Open
Abstract
Baker's cysts, commonly incidental findings, can occasionally present as intramuscular dissecting cysts within the medial gastrocnemius muscle. This case report highlights the ultrasound features and differential diagnoses of intramuscular dissecting Baker's cysts through the examination of three distinct cases: a 64-year-old woman with severe osteoarthritis, an 80-year-old man with a palpable mass in the popliteal fossa, and a 37-year-old man with early degenerative arthropathy. Each case was investigated using ultrasound, revealing fusiform hypoechoic fluid collections with heterogeneous echostructure parallel to the medial gastrocnemius muscle bundle and lacking posterior reinforcement. The clinical context and ultrasound findings were critical in differentiating these cases from other conditions, such as superficial thrombophlebitis, intramuscular seroma, and intramuscular myxoma. These cases emphasize the role of ultrasound in diagnosing intramuscular dissecting Baker's cysts. Accurate diagnosis requires careful consideration of ultrasound features in conjunction with clinical findings.
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Affiliation(s)
- Delange Augustin
- Radiology, Hôpital de l'Université d'Etat d'Haïti, Port-au-Prince, HTI
| | | | - Almenord Pharol
- Orthopaedics and Traumatology, Hôpital Universitaire la Paix, Port-au-Prince, HTI
| | - Valerie Deverson
- Radiology, Hôpital de l'Université d'Etat d'Haiti, Port-au-Prince, HTI
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Yao J, Han M, Shi J, Wang W, Zhang J, Zhang Y. Prognosis and Factors 4 to 10 Years After Deep Vein Thrombosis: A Long-Term Follow-up Cohort Study. Clin Appl Thromb Hemost 2024; 30:10760296241266820. [PMID: 39140994 PMCID: PMC11375659 DOI: 10.1177/10760296241266820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024] Open
Abstract
Post-thrombotic syndrome (PTS) is one of the most common long-term complications of lower extremity deep vein thrombosis (DVT). In order to study the long-term adverse prognosis of patients with DVT, explore the influencing factors for the prognosis of DVT, and provide a reliable reference for future research in the field of venous thrombosis, we collected and summarized information about the incidence of PTS, the PTS score and grading, the associated symptoms and drug-related adverse reactions in 501 patients with DVT. In our study, 54.1% of patients with DVT (271 of 501) experienced indications and manifestations of PTS, the male to female ratio was approximately 1:1. During the long-term follow up, the most common symptoms of PTS were anterior tibial edema and pain. By statistical analysis, we found that the outcome of thrombosis was the influencing factor of PTS score (1-4 points, P<.05). The grading of PTS was primarily influenced by the history of varicose veins and DVT in the lower extremities. The duration of taking antithrombotic drugs affected the outcome of thrombosis (P<.05), especially among the female patients. In addition, varied factors, such as lower extremity DVT complicated with pulmonary embolism and the duration of antithrombotic drug use were found to increase the chances of experiencing drug-related adverse reactions (odds ratio [OR]=2.798, 95% confidence interval [CI]: 1.413-5.541 / OR=2.778, 95% CI: 1.231-6.269). The above 2 factors were significant only among female patients with DVT (OR=4.03, 95% CI: 1.608-10.103 / OR=3.918, 95% CI: 1.123-13.669).
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Affiliation(s)
- Jinhan Yao
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
- Medical College, Nantong University, Nantong, China
| | - Mengru Han
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
- Medical College, Nantong University, Nantong, China
| | - Jin Shi
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
- Medical College, Nantong University, Nantong, China
| | - Weina Wang
- Department of Obstetrics and Gynecology, Shanghai Tenth People's Hospital, Shanghai, China
| | - Jiayi Zhang
- Department of Obstetrics and Gynecology, The Ninth People's Hospital of Suzhou, Suzhou, China
| | - Yuquan Zhang
- Department of Obstetrics and Gynecology, Affliated Hospital of Nantong University, Nantong, China
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Popovych YM, Kostiunin VS. Ultrasound assessment of the risk of venous thromboembolic complications in thrombosis of varicose transformed tributaries of the great saphenous vein. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:1004-1010. [PMID: 39008590 DOI: 10.36740/wlek202405120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/17/2024]
Abstract
OBJECTIVE Aim: To evaluate the ultrasound criteria for venous thromboembolic complications in patients with thrombosis of varicose veins of the tributaries of the great saphenous vein (GSV). PATIENTS AND METHODS Materials and Methods: The results of ultrasound examination of 52 patients with thrombosis of varicose veins of the tributaries of GSV were analyzed. The indicators of venous hemodynamics were compared with the control group (CG) (n=32). RESULTS Results: Varicose transformation of GSV and failure of its valvular apparatus were detected in 44 (84.6%) patients, in 8 (15.4%) patients the superficial venous highway was intact. Vertical reflux was diagnosed in varicose ectasia of GSV: local reflux in 14 (31.8%), widespread reflux in 14 (31.8%), and total reflux in 16 (36.4%) patients. The diameter of GSV in tributary varicothrombophlebitis was 8.9±0.27 mm (p<0.05 vs. CG) and 11.2±0.25 mm (p<0.05 vs. CG) in the horizontal and vertical positions, respectively. The proximal and distal borders of thrombosis exceeded the clinical ones by 15.26±1.21 cm (p<0.05) and 7.94±1.32 cm (p<0.05), respectively. The spread of tributary thrombophlebitis to the superficial venous highway was detected in 14 (26.9%) patients, among whom 12 (85.7%) patients had unfixed apices of thrombotic masses. CONCLUSION Conclusions: The results obtained convincingly demonstrate the need for early ultrasound examination of patients with tributary thrombophlebitis, which allows to identify the real limits of the thrombotic process, timely diagnose the transition of the thrombotic process to superficial and deep venous lines, effectively predict the risk of venous thromboembolic complications and choose the optimal surgical tactics.
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Affiliation(s)
- Yaroslav M Popovych
- STATE HIGHER EDUCATIONAL ESTABLISHMENT ≪UZHHOROD NATIONAL UNIVERSITY≫, UZHHOROD, UKRAINE
| | - Volodymyr S Kostiunin
- STATE HIGHER EDUCATIONAL ESTABLISHMENT ≪UZHHOROD NATIONAL UNIVERSITY≫, UZHHOROD, UKRAINE
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Bortolotto C, Draghi F, Bianchi S. Ultrasound findings in subcutaneous plantar vein thrombosis: retrospective analysis of seven patients. Acta Radiol 2021; 63:1522-1527. [PMID: 34842472 DOI: 10.1177/02841851211046500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Several disorders may result in forefoot pain. An uncommon cause of forefoot pain is subcutaneous plantar veins thrombosis (SCPVT) involving veins superficial to the plantar fascia. PURPOSE To describe the ultrasound (US) appearance of SCPVT, which has been described only once in the radiological literature. MATERIAL AND METHODS We performed a retrospective search of our PACS system from 2016 to 2020 to collect all cases of US-diagnosed SCPVT. We collected data on seven patients. Two radiologists analyzed the US images retrieved. All US examinations were performed with a multifrequency linear probe (frequencies in the range of 5-17 MHz). RESULTS A localized plantar nodule was palpable in 86% of patients. The subcutaneous thrombosed vein appeared in all patients as a round or ovoid nodule located in the subcutaneous tissues that corresponded in four patients (4/5, 80%) to the painful palpable nodule. The size was in the range of 4-7 mm (mean = 5.4 mm). The thrombosed vein presented a connection with adjacent patent veins, appeared enlarged, and almost filled with hypo-isoechoic material, and in two patients (2/7, 29%), a thin peripheral fluid component surrounding the thrombus was detectable. Continuous scanning demonstrated slow blood movements inside the peripheral component due to blood circulation. Failure to compress the lumen of the thrombosed vein during the real-time US was evident in all patients. CONCLUSION SCPVT is a rare or underreported condition. Sonologists must know the US appearance of SCPVT to exclude other conditions and avoid unnecessary invasive studies.
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Affiliation(s)
- Chandra Bortolotto
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Ferdinando Draghi
- Radiology Institute, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Diagnostic Imaging Department, Centro Medico Clastmed, Codevilla, Italy
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Ierardi AM, Coppola A, Fusco S, Stellato E, Aliberti S, Andrisani MC, Vespro V, Arrichiello A, Panigada M, Monzani V, Grasselli G, Venturini M, Rehani B, Peyvandi F, Pesenti A, Blasi F, Carrafiello G. Early detection of deep vein thrombosis in patients with coronavirus disease 2019: who to screen and who not to with Doppler ultrasound? J Ultrasound 2020; 24:165-173. [PMID: 32809207 PMCID: PMC7431752 DOI: 10.1007/s40477-020-00515-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023] Open
Abstract
PURPOSE Aim of the study is to evaluate the incidence of DVT in COVID-19 patients and its correlation with the severity of the disease and with clinical and laboratory findings. METHODS 234 symptomatic patients with COVID-19, diagnosed according to the World Health Organization guidelines, were included in the study. The severity of the disease was classified as moderate, severe and critical. Doppler ultrasound (DUS) was performed in all patients. DUS findings, clinical, laboratory's and therapeutic variables were investigated by contingency tables, Pearson chi square test and by Student t test and Fisher's exact test. ROC curve analysis was applied to study significant continuous variables. RESULTS Overall incidence of DVT was 10.7% (25/234): 1.6% (1/60) among moderate cases, 13.8% (24/174) in severely and critically ill patients. Prolonged bedrest and intensive care unit admission were significantly associated with the presence of DVT (19.7%). Fraction of inspired oxygen, P/F ratio, respiratory rate, heparin administration, D-dimer, IL-6, ferritin and CRP showed correlation with DVT. CONCLUSION DUS may be considered a useful and valid tool for early identification of DVT. In less severely affected patients, DUS as screening of DVT might be unnecessary. High rate of DVT found in severe patients and its correlation with respiratory parameters and some significant laboratory findings suggests that these can be used as a screening tool for patients who should be getting DUS.
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Affiliation(s)
- Anna Maria Ierardi
- Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
| | - Andrea Coppola
- Radiology Unit, Ospedale di Circolo e Fondazione Macchi, Insubria University, Varese, Italy
| | - Stefano Fusco
- Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Elvira Stellato
- Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Stefano Aliberti
- UOC Pneumologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Maria Carmela Andrisani
- Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Valentina Vespro
- Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Antonio Arrichiello
- Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Mauro Panigada
- Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Milan, Italy
| | - Valter Monzani
- Department of Internal Medicine, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Giacomo Grasselli
- Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Massimo Venturini
- Radiology Unit, Ospedale di Circolo e Fondazione Macchi, Insubria University, Varese, Italy
| | - Bhavya Rehani
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Flora Peyvandi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione Luigi Villa, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Antonio Pesenti
- Department of Anesthesia and Critical Care, Fondazione IRCCS Ca' Granda, Ospedale Maggiore, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Francesco Blasi
- UOC Pneumologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy
| | - Gianpaolo Carrafiello
- Radiology Department, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
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