Clinical imaging
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Case Reports
A rare but radiographically recognizable cause of an irreducible hip fracture-dislocation.
Hip dislocations are emergently reduced to decrease the chance of avascular necrosis of the femoral head. However, in some situations, the dislocation may be irreducible by a closed technique. ⋯ This rare type of irreducible fracture-dislocation demonstrates unique physical and associated radiographic findings. These fractures are important to recognize early, as attempts at closed reduction can lead to femoral neck fractures.
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Case Reports
Embolic infarct presented with bilateral thalamic lesions possibly initiated by an emboli to the artery of Percheron.
Bilateral thalamic infarcts are rare and present with varying symptoms. Cardioembolism and small artery disease are the most common etiologic factors. The occlusion of a rare arterial variant called the artery of Percheron results in bilateral thalamic infarcts. Herein, we present the imaging findings of an embolic infarct starting from bilateral thalami, probably due to an emboli to the artery of Percheron first.
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Scedosporium apiospermum is a deadly fungal infection that can infect the central nervous system, particularly in immunocompromised patients. We present two cases of Scedosporium brain abscesses. ⋯ In the second case, the patient recovered and conventional MR findings are followed over several months. In the appropriate clinical setting, conventional MR imaging and MR spectroscopy may facilitate diagnosis, earlier initiation of antifungal pharmacotherapy and surgical intervention in this frequently fatal infection.
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Case Reports
Osteoporotic vertebral compression fractures: a rare complication of radiotherapy in a patient with lung cancer.
The development of bone fractures after radiotherapy is a rare event which mainly concerns the pelvis or the long bones. This complication is unusual in the vertebrae. We describe the case of a 66-year-old male patient with lung cancer who was treated with combined radio-chemotherapy and developed dorsal pain secondary to vertebral compression 4 months after the end of radiotherapy. ⋯ Metastatic bone involvement is common in patients with lung cancer. When images are not typical of secondary progression, however, and there is no change in the general state of the patient, evidence of thoracic progression of the tumour or distal progression other than bone, vertebral osteoporotic complications should be considered. It is important that a wrong diagnosis is not made without histological proof of metastasis which has a poor prognosis.
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Solitary vertebral chordoma presents as an intra- and extraosseous tumour with typical bright signal on T2-weighted images and moderate inhomogeneous enhancement on T1 postcontrast images. The diffusion weighted imaging (DWI) characteristics of this histologically proven third lumbar vertebra chordoma are reported for the first time. The DWI hyperintensity with increased apparent diffusion coefficient (ADC) values strongly supports the preoperative diagnosis of a vertebral chordoma, allows for careful preoperative planning of the surgical procedure, and helps to narrow the differential diagnosis.