Primary desmoplastic small round cell tumor of the tibia: PET/CT and MRI presentation of a rare case and review of the literature
In this study, we reported a new case of primary DSRCT of the tibia in a 33-year-old man who had intermittent pain in the left tibia. Radiographs showed transparent lesions in the left upper tibial. MRI revealed a lobular, lytic and ill-identified lesion with adjacent soft tissues swelling of the upper left tibia. CT confirmed notable destruction and wormlike osteolysis of the bone cortex. PET/CT showed a mass of high uptakes, indicating the malignance. He accepted surgical resection with followed multi-agent chemotherapy, containing vincristine, doxorubicin, ifosfamide and etoposide. Clinically and radiologically, the patient did not show any evidence of recurrence or metastasis at 30 months after surgical treatment. Primary osteogenic DSRCT was extremely rare and should be considered in differential diagnosis of bone tumors.
Individuals with chronic pain are at an elevated risk of suicide, yet psychosocial factors that might be involved in increasing or decreasing vulnerability for suicidal ideation and behaviour have received little attention. Extant literature on the topic o...
CONCLUSIONS: This study supports the wider application of allografts in managing nerve problems. However, caution must be applied to the use of long grafts with larger diameters. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV. PMID: 31985643 [PubMed - in process]
CONCLUSIONS: The intraoperative anatomy and cause of nerve compression at the frontal trigger site vary greatly among patients. The authors report a supraorbital nerve foramen prevalence of 50.3 percent, which is greater than in previous cadaver studies of the general population. Lastly, the presence of pain at a specific site is associated with macroscopic nerve compression. PMID: 31985652 [PubMed - in process]
Publication date: Available online 27 January 2020Source: Best Practice &Research Clinical RheumatologyAuthor(s): Lykke Midtbøll Ørnbjerg, Mikkel ØstergaardAbstractStructural damage progression in patients with established rheumatoid arthritis (RA) has traditionally been assessed by conventional radiography (CR), which has proven its value in clinical practice and clinical trials over the past decades. The most prominent abnormalities visualized by CR in RA patients are erosions as a consequence of bone destruction and joint space narrowing (JSN) as a consequence of cartilage damage. Several valida...
Publication date: Available online 28 January 2020Source: Respiratory Medicine Case ReportsAuthor(s): Melinda Vasser, Matthew KoroscilAbstractBack pain is a common presenting concern in physician offices and emergency departments alike, with etiologies ranging from minor injuries to severe life-threatening illnesses. This case details the clinical course of a 68-year-old former smoker with no pulmonary symptoms who presented with back pain multiple times before developing cord compression syndrome and being diagnosed with non-small cell lung cancer (NSCLC). It demonstrates the importance of lung cancer screening and the ne...
ConclusionsWomen are less likely to have acute and surgical pathologies on CT ordered for non traumatic abdominal pain. Epigastric tenderness is negatively associated with abnormal and surgical CT results while RLQ tenderness is associated with an abnormal CT that is likely surgical in nature. These findings should help improve diagnostic accuracy of ordering providers and improve resource utilization.
ConclusionIt is preferable to perform CCTA in young patients with cardiac symptoms, especially in Asian and Middle Eastern countries even of the CAC score is zero.
ConclusionBilateral acetabular fractures are very rare due to the unique degree and pattern of force required to fracture both acetabula. They are associated with 4 main fracture patterns and present with Injury Severity Scores that averaged 25 (severe). They are typically observed in young males with road traffic collision being the most common mechanism of injury.
Publication date: Available online 28 January 2020Source: Journal of OrthopaedicsAuthor(s): Bura Sindhupakorn, Darawan Jomkoh, Theeranit NamkunteeAbstractBackgroundCorticosteroid and Ketorolac tromethamine is a pain reducing.ObjectiveThe primary objective was pain intensity scores (VAS) in 10, 30, 60 minutes, 2, 6 hours, 1, and 7 days.Method120 patients were randomized. The placebo group (normal saline) and experimental groups (ketorolac 30 mg, 60 mg, triamcinolone 10 mg, 20 mg., and 40 mg, respectively) were compared.ResultVAS at 60 min, 2, 6 hours, 1 and 7 days was significantly different (P
ConclusionsPRP improves pain and function of osteoarthritis. Heterogeneity and risk-of-bias limit current data, requiring more RCTs to determine any regenerative potential of PRP.Prospero Systematic Review Registration Number: 136582