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Kwon S, Noh D, Yamada K, Lee SK, Choi H, Lee Y, Lee K. Magnetic resonance imaging signal changes at the intramuscular injection site in dogs: Comparison of medetomidine and saline. Vet Radiol Ultrasound 2024. [PMID: 39325633 DOI: 10.1111/vru.13438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/15/2024] [Accepted: 09/09/2024] [Indexed: 09/28/2024] Open
Abstract
Intramuscular administration is a commonly used method for delivering sedatives and anesthetics in veterinary medicine. Previous studies have reported inflammation at the intramuscular injection site in laboratory animals and observed signal changes on MRI following intramuscular injections in humans. We hypothesized that following intramuscular injection, the site would exhibit T2 hyperintensity and contrast enhancement on MRI. To investigate this, this prospective study evaluated the pattern of signal changes and grade of T2 signal intensity and contrast enhancement over time after the intramuscular injection of medetomidine at a premedication dosage, comparing it to saline. MRI scans were performed immediately postinjection into the biceps femoris and quadriceps femoris muscles, as well as at 2, 8, 24, and 72 h, and 7 days postinjection. A semiquantitative scale was utilized to grade signal intensity and contrast enhancement. Both medetomidine and saline injections showed T2 hyperintensity immediately after injection and contrast enhancement from 2 h postinjection, manifesting as flame-shaped. These signal changes decreased up to 24 h postinjection (p < .05). The signal changes induced by medetomidine showed higher T2 hyperintense change and stronger contrast enhancement compared with saline at most time points, with the signal changes persisting for a longer duration (p < .05). These findings suggest that intramuscular administration of medetomidine induces a more severe tissue reaction compared with saline, and the results are expected to aid in the differentiation of various muscle diseases that present with similar MRI findings.
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Affiliation(s)
- Sojeong Kwon
- College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
| | - Daji Noh
- College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
- 24 Africa Animal Medical Center, Daejeon, South Korea
| | - Kazutaka Yamada
- Laboratory of Veterinary Radiology, Azabu University, Sagamihara, Japan
| | - Sang-Kwon Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
| | - Hojung Choi
- College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - Youngwon Lee
- College of Veterinary Medicine, Chungnam National University, Daejeon, South Korea
| | - Kija Lee
- College of Veterinary Medicine, Kyungpook National University, Daegu, South Korea
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Alsaggaf K, Aljuhani H, Aljahdali A, Hadrawi M, Almehmadi W. Painless Orbital Bone Infarction in a Child with Sickle Cell Anemia: A Case of Misdiagnosed Periorbital Cellulitis. AMERICAN JOURNAL OF CASE REPORTS 2023; 24:e939595. [PMID: 37917573 PMCID: PMC10626592 DOI: 10.12659/ajcr.939595] [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] [Received: 01/27/2023] [Revised: 09/25/2023] [Accepted: 08/23/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Sickle cell orbitopathy is a rare complication of sickle cell disease that closely mimics other conditions, such as orbital cellulitis and osteomyelitis. We report a case of painless orbital bone infarction masquerading as periorbital cellulitis in a child with sickle cell anemia. CASE REPORT A 4-year-old Saudi girl with sickle cell disease presented to our hospital with vaso-occlusive crisis characterized by bilateral lower limb pain and painless left orbital swelling. On examination, she had swelling of the left upper eyelid with redness and mild ptosis (margin reflex distance 1 was 2 mm) without proptosis. Magnetic resonance imaging with contrast showed bilateral sub-periosteal heterogeneous collections (2×0.8×2.1 cm in the superolateral wall of the left orbit and 1×0.6 cm in the inferolateral wall of the right orbit), with intermediate-to-high T1 signal intensity and high T2 signal, causing a mass effect on the adjacent superior and lateral rectus muscles. The patient was treated with systemic antibiotics and supportive treatment for vaso-occlusive crisis under the care of the pediatric team and was discharged without complications. CONCLUSIONS The diagnosis of sickle cell orbitopathy can be challenging, and an accurate diagnosis is essential to ensure appropriate management. Thus, we report the case of a 4-year-old child with painless sickle cell orbitopathy masquerading as pre-septal cellulitis.
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Affiliation(s)
- Khalid Alsaggaf
- Ophthalmology Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Hazem Aljuhani
- Department of Ophthalmology, Jeddah Eye Hospital, Jeddah, Saudi Arabia
| | - Abeer Aljahdali
- Ophthalmology Department, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Manal Hadrawi
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Wasayf Almehmadi
- Department of Ophthalmology, Jeddah Eye Hospital, Jeddah, Saudi Arabia
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Li Y, Gong T, Lin X, Wei X, Cai X, Chen X, Lin L, Wang G. Evaluating changes in the strength of the levator ani muscle after vaginal delivery using T2-parameter mapping. Eur J Radiol 2023; 168:111137. [PMID: 37856940 DOI: 10.1016/j.ejrad.2023.111137] [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] [Received: 03/07/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE To evaluate pelvic floor muscle injury in patients with levator ani muscle (LAM) weakness after vaginal delivery using T2-parameter mapping. MATERIALS AND METHODS 40 parturients (patient group) and 25 nonparturients (healthy control group) were enrolled in the study. The LAM weakness group had a Modified Oxford Grading System (MOGS) grade of less than 3 after vaginal delivery. All participants underwent pelvic magnetic resonance imaging (MRI) scans, including T2 and T2* mapping, on which the main branches of the LAM, the puborectalis and iliococcygeus, were evaluated. The differences in T2 and T2* values in the puborectalis and iliococcygeus between patients with LAM weakness and controls were analyzed using an independent samples t test or a Mann-Whitney U test. RESULTS For both the right and left iliococcygeus, the T2* values of the patient group were lower than those of the control group (P = 0.002 and 0.008, respectively), while no significant difference was observed in the T2 values between the groups (P = 0.45 and 0.69, respectively). For both the right and left puborectalis, no significant differences in the T2* (P = 0.25 and P = 0.25, respectively) or T2 values (P = 0.38 and 0.43, respectively) were observed between the patient and control groups. CONCLUSION T2* mapping as a quantitative measurement is an effective imaging tool to assess LAM injury in women after vaginal delivery. The iliococcygeus was more susceptible to vaginal delivery damage than the puborectalis, and pelvic floor dysfunction may be mainly driven by iliococcygeus injury.
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Affiliation(s)
- Yuchao Li
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China; Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Tao Gong
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xueyan Lin
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xinhong Wei
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xianyun Cai
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Xin Chen
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | | | - Guangbin Wang
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China; Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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Sahr ME, Miller TT. Pain After Hip Arthroplasty. Magn Reson Imaging Clin N Am 2023; 31:215-238. [PMID: 37019547 DOI: 10.1016/j.mric.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
MR imaging and ultrasound (US) have complementary roles for the comprehensive assessment of painful hip arthroplasty. Both modalities demonstrate synovitis, periarticular fluid collections, tendon tears and impingement, and neurovascular impingement, often with features indicating the causative etiology. MR imaging assessment requires technical modifications to reduce metal artifact, such as multispectral imaging, and optimization of image quality, and a high-performance 1.5-T system. US images periarticular structures at high-spatial resolution without interference of metal artifact, permitting real-time dynamic evaluation, and is useful for procedure guidance. Bone complications (periprosthetic fracture, stress reaction, osteolysis, and component loosening) are well depicted on MR imaging.
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Walter SS, Fritz J. MRI of Muscular Neoplasms and Tumor-Like Lesions: A 2020 World Health Organization Classification-based Systematic Review. Semin Roentgenol 2022; 57:252-274. [DOI: 10.1053/j.ro.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/03/2022] [Accepted: 01/08/2022] [Indexed: 11/11/2022]
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Tilden W, Saifuddin A. Telangiectatic soft tissue sarcoma and chronic expanding haematoma: a comparative review of MRI features. Skeletal Radiol 2021; 50:2365-2380. [PMID: 34184096 DOI: 10.1007/s00256-021-03853-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 02/02/2023]
Abstract
Soft tissue sarcomas containing a dominant component of haemorrhage are known to be aggressive tumours associated with a poor prognosis. Importantly, the clinical behaviour and imaging characteristics of extensively haemorrhagic soft tissue sarcomas (also termed telangiectatic soft tissue sarcomas) can resemble those of benign haematomas, particularly those that continue to expand over a prolonged period, so-called chronic expanding haematomas (CEH). The following review evaluates the current literature to identify the clinical, imaging and pathological characteristics of telangiectatic soft tissue sarcomas and to determine features that may help distinguish them from CEH. Ultimately, we suggest that lesions with sizeable regions of internal haemorrhage should be regarded with a high degree of suspicion for underlying malignancy and require referral to a tertiary sarcoma centre, where a carefully planned approach to biopsy and follow-up is needed to avoid errors in diagnosis.
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Affiliation(s)
- William Tilden
- Department of Radiology, The Royal National Orthopaedic Hospital, Brockley Hill, HA7 4LP, Stanmore, UK.
| | - Asif Saifuddin
- Department of Radiology, The Royal National Orthopaedic Hospital, Brockley Hill, HA7 4LP, Stanmore, UK
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Carneiro BC, Cruz IAN, Chemin RN, Rizzetto TA, Guimarães JB, Silva FD, Junior CY, Pastore D, Ormond Filho AG, Nico MAC. Multimodality Imaging of Foreign Bodies: New Insights into Old Challenges. Radiographics 2021; 40:1965-1986. [PMID: 33136481 DOI: 10.1148/rg.2020200061] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Traumatic wounds and lacerations are a common reason for patients to present to emergency departments, with retained foreign bodies (FBs) accounting for 7%-15% of cases, particularly those involving the extremities. These retained materials result in a granulomatous tissue response known as an FB reaction, a pathologic attempt to isolate the FB from the host. The most common FB materials are glass, metal, and wood, but other compositions can also be found, such as plastic and animal-derived materials. Clinical history, physical examination, and wound exploration are essential in investigation of retained material but are not sufficient to exclude an FB, and additional investigation is required. Imaging evaluation is a useful tool to help depict and locate an FB, assess possible complications, and guide removal. Conventional radiography, the first-line method in this scenario, is a widely available low-cost depiction method that has good sensitivity for depicting FBs. If the retained material is not depicted at conventional radiography, US can be performed. US is highly sensitive in depicting both radiolucent and radiopaque FBs in superficial locations. For deeper objects, CT may be necessary. MRI is the best imaging modality to delineate local soft-tissue and osseous complications. Retained FBs can result in early and delayed complications, with infection being the most frequent complication. To avoid preventable morbidities related to FBs, radiologists should be familiar with imaging findings and provide essential information to help the attending physician treat each patient. Online supplemental material is available for this article. ©RSNA, 2020.
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Affiliation(s)
- Bruno C Carneiro
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Isabela A N Cruz
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Renan N Chemin
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Thiago A Rizzetto
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Júlio B Guimarães
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Flávio D Silva
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Ciro Yoshida Junior
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Daniel Pastore
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Alípio G Ormond Filho
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
| | - Marcelo A C Nico
- From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, Rua Mato Grosso 306, 1st Floor, Higienópolis, São Paulo, SP, Brazil 01239-040
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Wasserman P, Kurra C, Taylor K, Fields JR, Caldwell M. Intramuscular hemorrhage and fluid extravasation into the anterior compartment secondary to intraosseous resuscitation, the "Nicked-Cortex" sign. Radiol Case Rep 2019; 14:1452-1457. [PMID: 31695835 PMCID: PMC6823788 DOI: 10.1016/j.radcr.2019.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/07/2019] [Accepted: 09/07/2019] [Indexed: 11/24/2022] Open
Abstract
Intraosseous needle access is a reliable method of vascular access used for rapid fluid resuscitation and delivery of medications in certain emergent settings. Fluid extravasation is a possible complication of intraosseous needle access that can lead to compartment syndrome. To our knowledge, imaging findings resulting from this complication have not been described. In this case report, we demonstrate conventional radiograph, computed tomography, and magnetic resonance image findings due to extravasation of resuscitation fluids following the aberrant insertion of an intraosseous needle in an unstable adult trauma patient. We also describe a new radiographic sign associated with this iatrogenic complication, the "Nicked-Cortex" sign.
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Affiliation(s)
- Paul Wasserman
- Department of Radiology, College of Medicine, University of Florida, 655 West 8th Street C90, Jacksonville, FL 32209, USA
| | - Chandana Kurra
- Department of Radiology, College of Medicine, University of Florida, 655 West 8th Street C90, Jacksonville, FL 32209, USA
| | - Kristin Taylor
- Department of Radiology, College of Medicine, University of Florida, 655 West 8th Street C90, Jacksonville, FL 32209, USA
| | - Jaime R. Fields
- College of Medicine, University of Florida, Gainesville, FL, USA
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9
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Kuwabara H, Yamamoto K, Terada T, Kawata R, Nagao T, Hirose Y. Hemorrhage of MRI and Immunohistochemical Panels Distinguish Secretory Carcinoma From Acinic Cell Carcinoma. Laryngoscope Investig Otolaryngol 2018; 3:268-274. [PMID: 30186957 PMCID: PMC6119803 DOI: 10.1002/lio2.169] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/08/2018] [Accepted: 04/26/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Secretory carcinoma (SC, mammary analogue secretory carcinoma) is a salivary gland tumor with ETV6-NTRK3 gene fusion, and its differential diagnosis includes acinic cell carcinoma (ACC). As hemorrhage is often seen in SC, we hypothesized that magnetic resonance imaging (MRI) and immunohistochemical analyses could distinguish SC from ACC. STUDY DESIGN Retrospective study. METHODS We used ETV6-NTRK3 gene fusion analyses to reclassify 19 parotid gland tumors that had previously been diagnosed as SC or ACC, and then investigated hemorrhage in both hematoxylin-eosin (H&E)-stained sections and MRIs, and immunohistochemical expression of S-100, mammaglobin, DOG1, and α-amylase. RESULTS The 19 tumors were genetically reclassified into 11 (58%) SC and 8 (42%) ACC. Combined S-100 and mammaglobin were specific for SC; whereas DOG1 was specific for ACC, and α-amylase was expressed only in 4 ACC cases (50%). H&E staining showed hemorrhage with hemosiderin deposition in all SC cases, and T2-weighted MRI showed hypointense areas in all investigated SC cases, but not in ACC. CONCLUSION Hemorrhage with hemosiderin deposition is frequently present in SC, and hemorrhage findings in MRI and an immunohistochemical panels for S-100, mammaglobin and DOG1 can distinguish SC from ACC. LEVEL OF EVIDENCE 3b.
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Affiliation(s)
| | | | - Tetsuya Terada
- Department of and OtorhinolaryngologyOsaka Medical CollegeOsakaJapan
| | - Ryo Kawata
- Department of and OtorhinolaryngologyOsaka Medical CollegeOsakaJapan
| | - Toshitaka Nagao
- Department of Anatomic PathologyTokyo Medical UniversityTokyoJapan
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Vidoni A, Gillett M, Botchu R, James S. Lower limb muscle injuries: The good, the bad and the ugly. Eur J Radiol 2018; 104:101-107. [PMID: 29857854 DOI: 10.1016/j.ejrad.2018.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 04/30/2018] [Accepted: 05/07/2018] [Indexed: 11/30/2022]
Abstract
Injuries to the lower limb muscles are a common cause of absence from training and competition in athletes. The different muscular groups of the thigh and leg are involved in various activities with kicking and sprinting being responsible for the largest number of injuries. The muscle acts on bone through the tendon and the fascia. The failure of one or more of these structures results in various degrees of loss of function of the muscle(s) involved. Usually, the point of weakness is the interface between different structures with different elastic properties (myofascial, myotendinous, avulsion). Diagnostic imaging is best performed by MRI that provides valuable information about the severity of the injury and its anatomical extent. In this article, we will review the MRI features of muscle injuries which can be used to guide return to play. We will emphasize the clinical implications of the MRI findings by dividing the muscle injuries into three categories "The Good, The Bad and The Ugly" to help the clinician in the planning of the most appropriate rehabilitation strategy.
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Affiliation(s)
- Alessandro Vidoni
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, United Kingdom.
| | - Mark Gillett
- West Bromwich Albion Football Club, United Kingdom.
| | - Rajesh Botchu
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, United Kingdom.
| | - Steven James
- Department of Musculoskeletal Radiology, Royal Orthopaedic Hospital NHS Foundation Trust, United Kingdom.
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Malignant Lymphoma in the Psoas Major Muscle. Case Rep Hematol 2017; 2017:3902748. [PMID: 28316847 PMCID: PMC5337863 DOI: 10.1155/2017/3902748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/10/2017] [Accepted: 02/01/2017] [Indexed: 12/30/2022] Open
Abstract
An 84-year-old Japanese man taking warfarin to prevent cerebral infarction secondary to atrial fibrillation was admitted to our hospital for evaluation of a painless right back mass. Magnetic resonance imaging (MRI) showed an oval-shaped mass in the right psoas major muscle. The mass showed high intensity on T1-, T2-, and diffusion-weighted imaging and mimicked an acute-phase hematoma. However, it showed no chronological changes typical of a hematoma, and MRI revealed enlargement of the mass 1 week after admission. Histopathological examination of a biopsy specimen revealed diffuse large B-cell lymphoma (DLBCL). Although skeletal muscle lymphoma is rare, physicians should be familiar with its MRI characteristics. In addition, determination of the lymphoma subtype has important implications for the treatment of skeletal muscle lymphoma because DLCBL may have an especially poor prognosis.
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Wangensteen A, Bahr R, Van Linschoten R, Almusa E, Whiteley R, Witvrouw E, Tol JL. MRI appearance does not change in the first 7 days after acute hamstring injury—a prospective study. Br J Sports Med 2016; 51:1087-1092. [DOI: 10.1136/bjsports-2016-096881] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2016] [Indexed: 11/04/2022]
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Richardson SS, McLawhorn AS, Mintz DN, DiCarlo EF, Weiland AJ. Spontaneous intraneural hematoma of the sural nerve. Skeletal Radiol 2015; 44:605-8. [PMID: 25311865 DOI: 10.1007/s00256-014-2030-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/28/2014] [Accepted: 10/01/2014] [Indexed: 02/02/2023]
Abstract
Symptomatic intraneural hemorrhage occurs rarely. It presents with pain and/or weakness in the distribution following the anatomic innervation pattern of the involved nerve. When a purely sensory nerve is affected, the symptoms can be subtle. We present a previously healthy 36-year-old female who developed an atraumatic, spontaneous intraneural hematoma of her sural nerve. Sural dysfunction was elicited from the patient's history and physical examination. The diagnosis was confirmed with magnetic resonance imaging, and surgical decompression provided successful resolution of her preoperative symptoms. To our knowledge, this entity has not been reported previously. Our case highlights the importance of having a high index of suspicion for nerve injury or compression in patients whose complaints follow a typical peripheral nerve distribution. Prior studies have shown that the formation of intraneural hematoma and associated compression of nerve fibers result in axonal degeneration, and surgical decompression decreases axonal degeneration and aids functional recovery.
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Affiliation(s)
- Shawn S Richardson
- Orthopaedic Surgery Resident, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA,
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Zickri MB. Possible local stem cells activation by microcurrent application in experimentally injured soleus muscle. Int J Stem Cells 2014; 7:79-86. [PMID: 25473445 PMCID: PMC4249907 DOI: 10.15283/ijsc.2014.7.2.79] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Severe injuries in skeletal muscle result in muscle weakness that delays recovery and contribute to progressive decline in muscle function. Microcurrent therapy (MCT) is a novel treatment method used in soft tissue injury and tissue regeneration therapy. The regenerative capacity of skeletal muscle tissue resides in satellite cells, the quiescent adult stem cells. AIM The present work aimed at investigating the relation between microcurrent therapy and local stem cells in regeneration of induced skeletal muscle injury in albino rat. MATERIALS AND METHODS Twenty six adult male albino rats were divided into Sham group, Injury group (I): subjected to soleus muscle injury and subdivided into subgroups I1 & I2 sacrificed 2 and 4 weeks after injury respectively. Microcurrent group (M): subjected to muscle injury and micro-current was applied. The animals were subdivided into subgroups M1 and M2 sacrificed 2 and 4 weeks after injury. Histological, immunohistochemical and morphometric studies were performed. RESULTS Atypical fibers widely separated by infiltrating cells and strong acidophilic sarcoplasm with focal vacuolations were found in injury group. In M1 subgroup few atypical fibers were found. In M2 subgroup multiple typical fibers were detected. A significant decrease in the mean area of atypical fibers, a significant increase in the mean area% of alpha SMA+ve cells and that of CD34+ve cells were found in microcurrent group compared to injury group. CONCLUSION A definite therapeutic effect of the microcurrent was found on induced skeletal muscle injury. This effect was proved to be related to satellite cell activation.
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Affiliation(s)
- Maha Baligh Zickri
- Department of Histology, Faculty of Medicine, Cairo University, Cairo, Egypt
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15
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Zickri MB, Embaby A, Metwally HG. Experimental study on the effect of intravenous stem cell therapy on intestinal ischemia reperfusion induced myocardial injury. Int J Stem Cells 2014; 6:121-8. [PMID: 24386556 DOI: 10.15283/ijsc.2013.6.2.121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2013] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The myocyte death that follows intestinal ischemia reperfusion (I/R) injury is a major factor contributing to high mortality and morbidity in ischemic heart disease. The purpose of stem cell (SC) therapy for myocardial infarction is to improve clinical outcomes. The present study aimed at investigating the possible therapeutic effect of intravenous human cord blood mesenchymal stem cells (HCBMSCs) on intestinal ischemia reperfusion induced cardiac muscle injury in albino rat. METHODS AND RESULTS Thirty male albino rats were divided equally into control (Sham-operated) group, I/R group where rats were exposed to superior mesenteric artery ligation for 1 hour followed by 1 hour reperfusion. In SC therapy group, the rats were injected with HCBMSCs into the tail vein. The rats were sacrificed four weeks following therapy. Cardiac muscle sections were exposed to histological, histochemical, immunohistochemical and morphometric studies. In I/R group, multiple fibers exhibited deeply acidophilic sarcoplasm with lost striations and multiple fibroblasts appeared among the muscle fibers. In SC therapy group, few fibers appeared with deeply acidophilic sarcoplasm and lost striations. Mean area of muscle fibers with deeply acidophilic sarcoplasm and mean area% of fibroblasts were significantly decreased compared to I/R group. Prussion blue and CD105 positive cells were found in SC therapy group among the muscle fibers, inside and near blood vessels. CONCLUSIONS Intestinal I/R induced cardiac muscle degenerative changes. These changes were ameliorated following HCBMSC therapy. A reciprocal relation was recorded between the extent of regeneration and the existence of undifferentiated mesenchymal stem cells.
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Affiliation(s)
- Maha Baligh Zickri
- Department of Histology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Azza Embaby
- Department of Histology, Faculty of Medicine, Beni-Suef University, Cairo, Egypt
| | - Hala Gabr Metwally
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt, Cairo, Egypt
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Li MTA, Willett NJ, Uhrig BA, Guldberg RE, Warren GL. Functional analysis of limb recovery following autograft treatment of volumetric muscle loss in the quadriceps femoris. J Biomech 2013; 47:2013-21. [PMID: 24280565 DOI: 10.1016/j.jbiomech.2013.10.057] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 10/28/2013] [Accepted: 10/31/2013] [Indexed: 10/26/2022]
Abstract
Severe injuries to the extremities often result in muscle trauma and, in some cases, significant volumetric muscle loss (VML). These injuries continue to be challenging to treat, with few available clinical options, a high rate of complications, and often persistent loss of limb function. To facilitate the testing of regenerative strategies for skeletal muscle, we developed a novel quadriceps VML model in the rat, specifically addressing functional recovery of the limb. Our outcome measures included muscle contractility measurements to assess muscle function and gait analysis for evaluation of overall limb function. We also investigated treatment with muscle autografts, whole or minced, to promote regeneration of the defect area. Our defect model resulted in a loss of muscle function, with injured legs generating less than 55% of muscle strength from the contralateral uninjured control legs, even at 4 weeks post-injury. The autograft treatments did not result in significant recovery of muscle function. Measures of static and dynamic gait were significantly decreased in the untreated, empty defect group, indicating a decrease in limb function. Histological sections of the affected muscles showed extensive fibrosis, suggesting that this scarring of the muscle may be in part the cause of the loss of muscle function in this VML model. Taken together, these data are consistent with clinical findings of reduced muscle function in large VML injuries. This new model with quantitative functional outcome measures offers a platform on which to evaluate treatment strategies designed to regenerate muscle tissue volume and restore limb function.
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Affiliation(s)
- Mon Tzu A Li
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology & Emory University, Atlanta, GA, USA
| | - Nick J Willett
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA; George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Brent A Uhrig
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA; George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Robert E Guldberg
- Parker H. Petit Institute for Bioengineering and Bioscience, Georgia Institute of Technology, Atlanta, GA, USA; George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Gordon L Warren
- Department of Physical Therapy, Georgia State University, Atlanta, GA, USA.
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Zickri MB, Abd El Aziz DH. Relation between microcurrent therapy and satellite cells in the regeneration of induced skeletal muscle injury in rat. THE EGYPTIAN JOURNAL OF HISTOLOGY 2013; 36:409-417. [DOI: 10.1097/01.ehx.0000428366.81246.0a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Quantitative assessment of changes in carotid plaques during cilostazol administration using three-dimensional ultrasonography and non-gated magnetic resonance plaque imaging. Neuroradiology 2012; 54:939-45. [DOI: 10.1007/s00234-012-1011-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 01/11/2012] [Indexed: 11/26/2022]
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Abstract
Magnetic resonance imaging (MRI) is capable of producing images in any anatomical plane, visualizing and analyzing a variety of tissue characteristics, as well as quantifying blood flow and metabolic functions. Although MRI details of compact bone and calcium are poor when compared to those taken with plain radiography or computed tomography, its high soft tissue contrast discrimination and multiplanar imaging capabilities are significant advantages. Musculoskeletal anatomy and neurovascular bundles are well delineated. The advent of MRI has revolutionized the clinician's ability to confirm a proper diagnosis for musculoskeletal problems, which has led to more directed, specific rehabilitative protocols. However, the value of MRI to rehabilitative professionals has been even greater in its ability to identify serious, more uncommon pathologies, such as in those with underlying infection, fracture, or tumor, that require immediate care and are considered to be beyond their scope of practice. Furthermore, MRI, with its precise delineation of fat, muscle, and bone, is an ideal candidate for imaging of muscle disease or injury and has emerged as the method of choice for the detection of early cartilage wear in young patients, such as osteoarthritis. Finally, this imaging modality can avoid radiation exposure in a predominantly younger patient cohort commonly affected by musculoskeletal diseases. The aim of this paper is to consider how physical therapists may take advantage of the diagnostic value of MRI of the upper limb, while avoiding the pitfalls of misinterpretation of images as a result of technical issues, pathological changes, or normal variants.
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