WorldWideScience

Sample records for boy differential diagnosis

  1. Differential diagnosis of tonsillolith

    Directory of Open Access Journals (Sweden)

    Luisa Schertel Cassiano

    2010-07-01

    Full Text Available Introduction:Tonsillolith is a rare type of dystrophic calcification in the palatine tonsils or in the peritonsilar region, which can mimics several intraosseous radiopaque lesions when evaluated by two-dimensional or overlapping images.This may lead to an erroneous diagnosis and to invasive and unnecessary procedures.This study reports a case of tonsillolith that was wrongly diagnosed as an odontoma. Case report: A patient with primary diagnosis of odontoma in the mandibular ramus was referred to surgical treatment of this lesion. Conclusion: Computed tomography (CT scans are fundamentally important to establish differential diagnosis and appropriate treatment for the patient.

  2. Differential diagnosis diphtheria adults

    OpenAIRE

    Yu. I. Liashenko; D. A. Pavlovich; Yu. P. Finogeev; Yu. A. Vinakmen; V. F. Krumgolts

    2010-01-01

    A total of 1,824 human cases of diphtheria, treated at the Clinical Infectious Diseases Hospital SP Botkin (St. Petersburg) during 1993, as well as 19 deaths in 1994. It is known that early diagnosis of infectious diseases, especially diphtheria, contributes to the favorable outcome of the disease. The diagnosis of diphtheria at the prehospital stage is always difficult. Presented in detail the differential diagnosis of the disease, clinically similar to diphtheria: Lacunal angina, angina Sim...

  3. Differential diagnosis diphtheria adults

    Directory of Open Access Journals (Sweden)

    Yu. I. Liashenko

    2010-01-01

    Full Text Available A total of 1,824 human cases of diphtheria, treated at the Clinical Infectious Diseases Hospital SP Botkin (St. Petersburg during 1993, as well as 19 deaths in 1994. It is known that early diagnosis of infectious diseases, especially diphtheria, contributes to the favorable outcome of the disease. The diagnosis of diphtheria at the prehospital stage is always difficult. Presented in detail the differential diagnosis of the disease, clinically similar to diphtheria: Lacunal angina, angina Simanovsky, infectious mononucleosis, angina Ludwig’s angina Dugue, syphilis, non-infectious with clinical «masks» of diphtheria and other. Diphtheria epidemic of 1993–1994 in Russia and, in particular, in St. Petersburg, showed that the late admission of patients with diphtheria infection in hospitals, usually associated with irregular differential diagnosis of this dangerous disease.

  4. Differential diagnosis of hyponatraemia.

    LENUS (Irish Health Repository)

    Thompson, Chris

    2012-03-01

    The appropriate management of hyponatraemia is reliant on the accurate identification of the underlying cause of the hyponatraemia. In the light of evidence which has shown that the use of a clinical algorithm appears to improve accuracy in the differential diagnosis of hyponatraemia, the European Hyponatraemia Network considered the use of two algorithms. One was developed from a nephrologist\\'s view of hyponatraemia, while the other reflected the approach of an endocrinologist. Both of these algorithms concurred on the importance of assessing effective blood volume status and the measurement of urine sodium concentration in the diagnostic process. To demonstrate the importance of accurate diagnosis to the correct treatment of hyponatraemia, special consideration was given to hyponatraemia in neurosurgical patients. The differentiation between the syndrome of inappropriate antidiuretic hormone secretion (SIADH), acute adrenocorticotropic hormone (ACTH) deficiency, fluid overload and cerebral salt-wasting syndrome was discussed. In patients with SIADH, fluid restriction has been the mainstay of treatment despite the absence of an evidence base for its use. An approach to using fluid restriction to raise serum tonicity in patients with SIADH and to identify patients who are likely to be recalcitrant to fluid restriction was also suggested.

  5. Differential Diagnosis of Dystonia

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2003-09-01

    Full Text Available An approach to the early diagnosis of pediatric neurotransmitter diseases (PNTD, and especially dystonia, is outlined in a report from the University Children’s Hospital, Dusseldorf, Germany; and Institute of Child Health, University College, London, UK.

  6. Neurofibromatoses: part 1 ? diagnosis and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Luiz Oswaldo Carneiro Rodrigues

    2014-03-01

    Full Text Available Neurofibromatoses (NF are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1, neurofibromatosis type 2 (NF2 and schwannomatosis (SCH, which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management.

  7. Neurofibromatoses: part 1 - diagnosis and differential diagnosis.

    Science.gov (United States)

    Rodrigues, Luiz Oswaldo Carneiro; Batista, Pollyanna Barros; Goloni-Bertollo, Eny Maria; de Souza-Costa, Danielle; Eliam, Lucas; Eliam, Miguel; Cunha, Karin Soares Gonçalves; Darrigo-Junior, Luiz Guilherme; Ferraz-Filho, José Roberto Lopes; Geller, Mauro; Gianordoli-Nascimento, Ingrid F; Madeira, Luciana Gonçalves; Malloy-Diniz, Leandro Fernandes; Mendes, Hérika Martins; de Miranda, Débora Marques; Pavarino, Erika Cristina; Baptista-Pereira, Luciana; Rezende, Nilton A; Rodrigues, Luíza de Oliveira; da Silva, Carla Menezes; de Souza, Juliana Ferreira; de Souza, Márcio Leandro Ribeiro; Stangherlin, Aline; Valadares, Eugênia Ribeiro; Vidigal, Paula Vieira Teixeira

    2014-03-01

    Neurofibromatoses (NF) are a group of genetic multiple tumor growing predisposition diseases: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis (SCH), which have in common the neural origin of tumors and cutaneous signs. They affect nearly 80 thousand of Brazilians. In recent years, the increased scientific knowledge on NF has allowed better clinical management and reduced complication morbidity, resulting in higher quality of life for NF patients. In most cases, neurology, psychiatry, dermatology, clinical geneticists, oncology and internal medicine specialists are able to make the differential diagnosis between NF and other diseases and to identify major NF complications. Nevertheless, due to its great variability in phenotype expression, progressive course, multiple organs involvement and unpredictable natural evolution, NF often requires the support of neurofibromatoses specialists for proper treatment and genetic counseling. This Part 1 offers step-by-step guidelines for NF differential diagnosis. Part 2 will present the NF clinical management. PMID:24676443

  8. DIFFERENTIAL DIAGNOSIS OF OPTIC NEURITIS

    Directory of Open Access Journals (Sweden)

    Zoric Lepsa

    2013-12-01

    Full Text Available Abstract: Optic neuritis is inflammation of the optic nerve, which in a single or repeated attacks can severely and permanently damage visual function. Errors in diagnostic are daily and usually occur because of incomplete diagnostic procedure performed. This manuscript presents a series of 19 patients reffered with optic neuritis diagnosis. The diagnosis was confirmed in 15, while four had other changes in the optic nerve or macula. We analyzed the diagnostic specificity of the basic parameters of optic neuritis diagnosis and afferent pupillary defect showed the highest sensitivity. The spectrum of differential diagnoses is shown within this finding. Optic neuritis diagnosis should be established carefully, using usual and available diagnostic methods in ophthalmologic and neurological practice, and if necessary, refer patients to neuro-ophthalmologist, as well as to electrophysiological evaluation and other methods that help fifferentiate disease.

  9. Differential diagnosis of rheumatic diseases

    International Nuclear Information System (INIS)

    Which imaging modalities are appropriate for the Differential diagnosis of Rheumatic diseases. MRI has far most the highest sensitivity and is unequaled in its brilliant presentation of Anatomy and Pathology. But it is sometimes forgotten, that this is at least in part the result of carefully selected sequences, dedicated to the expected result. In a method totally independent of any result, this should not be the case. In contrary this method should be highly standardised and regardless what will be the findings. This is true for Plain X-ray. It will be shown, that already the outer silhouette of the soft parts with different features of swelling, and differences in density and even more - defects or appositions of the bony silhouette in the majority of cases at least will allow to classify the patient for a group of diseases and in many cases will lead to a definite diagnosis. Differential diagnoses like Rheumatoid Arthritis versus Psoriatic Arthritis or simply but not always simple - inflammatory Arthritis versus degenerative disease - are allowed to be answered definitely, not always so in MRI. The condition of the subchondral bone can give hints, how advanced and how active the disease is at present. Plain X-ray offers high specifity in the differential diagnoses of Rheumatic diseases, it is well standardised and it is a device, to use independent from any suspected findings. So it is the method of choice for questions of differential diagnosis. This is even more true, thinking of the possibility, to investigate all clinically involved regions with not to much extended efforts, whereas MRI and CT are used normally for only one region. (orig.)

  10. Differential diagnosis of sacral lesions

    International Nuclear Information System (INIS)

    The authors reviewed the teaching files of Temple University Hospital and Children's Hospital of Philadelphia and selected the best representative cases of various lesions of the sacrum. They selected the following lesions: metastasis, chondrosarcoma, chrodoma, plasmacytoma, giant cell tumor, osteogenic sarcoma, Ewing sarcoma, neuroblastoma, neurofibrosarcoma, hemangiopericytoma, osteoblastoma, ossifying fibroma, eosinophilic granuloma, aneurysmal bone cyst, sacrococcygeal teratoma, anterior meningocele, endodermal sinus tumor, and stress fracture. The authors illustrate, for each lesion, the likely age range, sights of predilection, likelihood of occurrence in the sacrum, and radiographic findings helpful in limiting the differential diagnosis. They demonstrate the value of bone scintigraphy in detecting, and CT in confirming, stress fractures of the sacrum

  11. Autism: Clinical Features Diagnosis and Differential Diagnosis

    OpenAIRE

    Korkmaz, Barış

    1999-01-01

    Autism is a relatively frequent neurodevelopmental disorder of childhood with behavioral problems categorized in 3 domains These problems are related to social communication and relation verbal and non verbal communication and narrow fields of interest and restricted activity including repetitive behaviors e g stereotypies The diagnosis of autism before 3 years of age pose some difficulties for the clinicians; early indicators may be difficulties in eye contact inability to point and unrespon...

  12. Radiological diagnosis in AIDS - associated diseases: survey and differential diagnosis

    International Nuclear Information System (INIS)

    Acute manifestations of illnesses in patients with HIV-infection or AIDS will benefit from rapid diagnosis. Radiologic examinations provide substantial information to narrow the differential diagnosis. This article reviews clinically important HIV-associated diseases for the radiologist. The braod spectrum of possible manifestations is illustrated by the accompanying case reports that typify the complexity of diagnoses in this growing problem worldwide. (orig.)

  13. Differential diagnosis of disseminated periventricular calcifications

    Energy Technology Data Exchange (ETDEWEB)

    Rieger, P.; Piepgras, U.

    1986-08-01

    Juvenile disseminated periventricular calcifications may occur in tuberous sclerosis, toxoplasmosis, cytomegaly, and in tuberculous meningitis. Cysticercosis, by contrast, does not result in corresponding intracerebral foci until an older age. Differential diagnosis is no problem if clinical findings are typical (tuberous sclerosis) or if serological verification is positive. However, any unclear clinical diagnosis can often be secured by CT.

  14. Differential diagnosis of disseminated periventricular calcifications

    International Nuclear Information System (INIS)

    Juvenile disseminated periventricular calcifications may occur in tuberous sclerosis, toxoplasmosis, cytomegaly, and in tuberculous meningitis. Cysticercosis, by contrast, does not result in corresponding intracerebral foci until an older age. Differential diagnosis is no problem if clinical findings are typical (tuberous sclerosis) or if serological verification is positive. However, any unclear clinical diagnosis can often be secured by CT. (orig.)

  15. Transitional cell carcinoma of the bladder in childhood: radiological findings and differential diagnosis

    International Nuclear Information System (INIS)

    We present a case of transitional cell carcinoma of the bladder in an 11-year-old boy. The rarity of these tumors during childhood is pointed out. The radiological and ultrasonographic findings are described and the differential diagnosis is discussed with respect to other bladder tumors occurring in childhood. (Author) 11 refs

  16. Identification and Differential Diagnosis of Developmental Speech Problems in a Bilingual Child

    Science.gov (United States)

    Tzivinikou, Sotiria

    2005-01-01

    The present, multi-method (methodological triangulation), case study aimed to investigate whether it is possible to obtain a differential diagnosis between the speech problems derived from bilingualism, and the developmental speech problems of an Albanian eight-year-old boy who attended a public primary school in Greece. Although there existed…

  17. Differential Diagnosis of Metabolic Alkalosis

    Directory of Open Access Journals (Sweden)

    M Hafizi

    1995-07-01

    Full Text Available A 9-month old female infant with growth retardation, constipation and restlessness id presented. Laboratory findings revealed hypochloremic metabolic alkalosis with hypokalemia and hyponatremia. Clinical and laboratory findings led us to think of batter syndrome and cystic fibrosis. Serum and urine levels of chloride were low. This led to the estimation of sweat electrolytes, which showed high chloride levels. Taking also into account other laboratory and clinical parameters cystic fibrosis was the final diagnosis.

  18. Differential Diagnosis of Retinal Vasculitis

    Science.gov (United States)

    Abu El-Asrar, Ahmed M.; Herbort, Carl P.; Tabbara, Khalid F.

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings. PMID:20404987

  19. Differential Diagnosis of Retinal Vasculitis

    OpenAIRE

    Abu El-Asrar Ahmed; Herbort Carl; Tabbara Khalid

    2009-01-01

    Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein a...

  20. Differential diagnosis of retinal vasculitis

    Directory of Open Access Journals (Sweden)

    Abu El-Asrar Ahmed

    2009-01-01

    Full Text Available Retinal vaculitis is a sight-threatening inflammatory eye condition that involves the retinal vessels. Detection of retinal vasculitis is made clinically, and confirmed with the help of fundus fluorescein angiography. Active vascular disease is characterized by exudates around retinal vessels resulting in white sheathing or cuffing of the affected vessels. In this review, a practical approach to the diagnosis of retinal vasculitis is discussed based on ophthalmoscopic and fundus fluorescein angiographic findings.

  1. Pulmonary edema: radiographic differential diagnosis

    International Nuclear Information System (INIS)

    To evaluate the feasibility of using chest radiography to differentiate between three different etiologies of pulmonary edema. Plain chest radiographs of 77 patients, who were clinically confirmed as having pulmonary edema, were retrospectively reviewed. The patients were classified into three groups : group 1 (cardiogenic edema : n = 35), group 2 (renal pulmonary edema : n = 16) and group 3 (permeability edema : n = 26). We analyzed the radiologic findings of air bronchogram, heart size, peribronchial cuffing, septal line, pleural effusion, vascular pedicle width, pulmonary blood flow distribution and distribution of pulmonary edema. In a search for radiologic findings which would help in the differentiation of these three etiologies, each finding was assessed. Cardiogenic and renal pulmonary edema showed overlapping radiologic findings, except for pulmonary blood flow distribution. In cardiogenic pulmonary edema (n=35), cardiomegaly (n=29), peribronchial cuffing (n=29), inverted pulmonary blood flow distribution (n=21) and basal distribution of edema (n=20) were common. In renal pulmonary edema (n=16), cardiomegaly (n=15), balanced blood flow distribution (n=12), and central (n=9) or basal distribution of edema (n=7) were common. Permeability edema (n=26) showed different findings. Air bronchogram (n=25), normal blood flow distribution (n=14) and peripheral distribution of edema (n=21) were frequent findings, while cardiomegaly (n=7), peribronchial cuffing (n=7) and septal line (n=5) were observed in only a few cases. On plain chest radiograph, permeability edema can be differentiated from cardiogenic or renal pulmonary edema. The radiographic findings which most reliably differentiated these two etiologies were air bronchogram, distribution of pulmonary edema, peribronchial cuffing and heart size. Only blood flow distribution was useful for radiographic differentiation of cardiogenic and renal edema

  2. [Hypophysitis : Types and differential diagnosis].

    Science.gov (United States)

    Saeger, W

    2016-05-01

    Inflammatory findings in the pituitary glands account for approximately 1 % of operations in the sellar region. Primary inflammation (e.g. lymphocytic and idiopathic granulomatous hypophysitis) have to be differentiated from secondary types (e.g. concomittant inflammation with Rathke's cleft cysts, craniopharyngiomas and germinomas) and involvement of the pituitary in generalized inflammation (IgG4-related disease, sarcoidosis and septicopyemia). Langerhans cell histiocytosis also has to be considered for the differential diagnostics. Lymphocytic hypophysitis shows lymphocytic infiltrations of varying density, predominantly of the T‑cell type. Granulomatous hypophysitis has the features of sarcoidosis and can only be diagnosed by exclusion of generalized sarcoidosis. Secondary hypophysitis has a mixed cell infiltration, especially by histiocytic infiltration and predominantly originates from ruptures or bleeding from Rathke's cleft cysts. The frequently very sparse remnants of cyst epithelium should be confirmed by pankeratin immunostaining. PMID:27103256

  3. [Differential diagnosis of abdominal pain].

    Science.gov (United States)

    Frei, Pascal

    2015-09-01

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain. PMID:26331201

  4. Diagnosis and differential diagnosis of Graves' orbitopathy in MRI

    International Nuclear Information System (INIS)

    Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.)

  5. [Rare differential diagnosis of urinary incontinence].

    Science.gov (United States)

    Coutty, Nadège; Dubreucq, Sylvie; Delahousse, Guy; Cosson, Michel

    2003-04-01

    The authors report the case of a 55-year-old woman with prolapse presenting a differential diagnosis of urinary incontinence: a peritoneo-vaginal fistula with serous discharge in a patient with ascites and a history of hysterectomy. The only cases of peritoneo-vaginal fistula reported in the literature were discovered during extra-uterine pregnancy after hysterectomy. PMID:12765075

  6. The bronchovalvular mechanism - differential diagnosis in children

    International Nuclear Information System (INIS)

    A differential diagnosis of the bronchovalvular mechanism can usually be made by means of plain radiography of the chest in the inhalation and the exhalation phase. If respiratory distress is due to causes other than foreign body aspiration, there may arise the necessity to apply bronchoradiography or angiography, or to examine the oesophagus. (orig.)

  7. The neuromuscular differential diagnosis of joint hypermobility

    NARCIS (Netherlands)

    Donkervoort, S.; Bonnemann, C.G.; Loeys, B.L.; Jungbluth, H.; Voermans, N.C.

    2015-01-01

    Joint hypermobility is the defining feature of various inherited connective tissue disorders such as Marfan syndrome and various types of Ehlers-Danlos syndrome and these will generally be the first conditions to be considered by geneticists and pediatricians in the differential diagnosis of a patie

  8. Generalized anxiety disorder: Differential diagnosis and treatment

    OpenAIRE

    Tatyana Gratsiyevna Voznesenskaya

    2013-01-01

    Generalized anxiety disorder (GAD) is poorly diagnosed and inadequately treated by general practitioners. The paper considers the major diagnostic signs of GAD, its differential diagnosis, prevalence, etiology, and pathogenesis. Antidepressants from a group of selective serotonin reuptake inhibitors in combination with psychotherapy are the drugs of first choice.

  9. [Differential diagnosis of a narrow QRS tachycardia].

    Science.gov (United States)

    Lewalter, Thorsten

    2015-09-01

    The differential diagnosis of a narrow QRS tachycardia requires on the one hand knowledge about the clinical data of the tachycardia patient but on the other hand a systematic step by step analysis of the electrocardiogram (ECG) is the most successful approach. Apart from the question of regularity or irregularity of the QRS complexes, the presence and detection of P waves is also of importance. The P wave timing in relation to the preceding and the following QRS complexes as well as the numerical relationship of P waves and QRS complexes allow a well-founded suspected diagnosis to be achieved in most cases. Even the differentiation between atrioventricular (AV) nodal reentrant tachycardia (AVNRT) versus orthodromic AV reentrant tachycardia (AVRT), e.g. by accessory leads, is in most cases possible in a surface ECG. Obviously, there are constellations which need an invasive electrophysiological procedure for a definitive diagnosis. PMID:26287273

  10. DIFFERENTIAL DIAGNOSIS OF LONG TERM TONGUE ULCERS

    Directory of Open Access Journals (Sweden)

    Hegde Nidarsh D.

    2012-08-01

    Full Text Available Oral ulcers is a very common disorder of the oral mucosa. Patients with signs or symptoms of oral ulcers are sometimes referred to gastroenterology clinics, however, in most instances the ulcers does not reflect gastrointestinal disease, some with a chronic non- healing ulcer are advised biopsy. Indeed, a spectrum of disorders can give rise to oral mucosal ulcers ranging from minor local trauma to significant local disease such as malignancy or systemic illness. Lesions of the tongue have a broad differential diagnosis ranging from benign idiopathic processes to infections, cancers, and infiltrative disorders. This article will focus on common ulcerative disorders of the tongue in aspects of their clinical features and differential diagnosis, two case reports with the diagnosis and conservative management for long-term chronic ulcers. The two cases which are reported in this article had a differential diagnosis of Squamous cell carcinoma of the tongue. The clinical picture was craterlike lesion, having a velvety-red base and a rolled, indurated border and most important painless in both cases. Removal of the irritant which was the tooth, rehabilitation of the oral mucosa by lubrication with Cocus Nucifera resulted in the healing of the ulcers. Functional components of Cocus Nucifera are Squaline, tocopherol, phytosterols and other sterols which are all plant steroids.

  11. Labaratory capacity of differential anemia diagnosis

    Directory of Open Access Journals (Sweden)

    L. M. Meshсheryakova

    2015-06-01

    Full Text Available The paper presents the laboratory values by which modern differential diagnosis of anemias can be performed. This takes into account a widerange of laboratory tests, including: serum ferritin, erythrocyte ferritin, serum iron, total serum iron binding capacity, iron transferrin saturation,transferrin, transferrin receptor, serum vitamin B12, erythrocyte vitamin B12, serum folate, erythrocyte folate, hepsidin, HIF-1 (hypoxiainducible factor-1, immunoglobulins on erythrocytes end others. The combination of these studies helps to accurate diagnosis and appropriate therapy.

  12. CT diagnosis and differential diagnosis of malignant pleural mesothelioma

    International Nuclear Information System (INIS)

    Objective: To study the CT features of malignant pleural mesothelioma and improve diagnostic accuracy. Methods: The CT findings of 14 patients with malignant pleural mesothelioma proven by surgery or histopathology were analyzed retrospectively. CT plain scan was performed in all cases, 9 cases received both CT plain scan and contrast CT scan. Results: All the cases demonstrated various pleural thickening including diffuse pleural thickening (n=10). Among all the cases, there were nodular pleural thickening (n=4), lumpy pleural thickening (n=7), ring-like pleural thickening (n=3). Pleural thickness which was more than 1.0 cm was found in 12 cases. Pleural effusion (n=10), mediastinum immobilization (n=10) and thoracic cavity stricture in the trouble side (n=10) were also revealed. Conclusion: Obvious characteristics in cases with malignant pleural mesothelioma was showed in CT examination, which plays an important role in the diagnosis and differential diagnosis of this disease. (authors)

  13. Cognitive Load Differentially Impacts Response Control in Girls and Boys with ADHD.

    Science.gov (United States)

    Seymour, Karen E; Mostofsky, Stewart H; Rosch, Keri S

    2016-01-01

    Children with attention-deficit hyperactivity disorder (ADHD) consistently show impaired response control, including deficits in response inhibition and increased intrasubject variability (ISV) compared to typically-developing (TD) children. However, significantly less research has examined factors that may influence response control in individuals with ADHD, such as task or participant characteristics. The current study extends the literature by examining the impact of increasing cognitive demands on response control in a large sample of 81children with ADHD (40 girls) and 100 TD children (47 girls), ages 8-12 years. Participants completed a simple Go/No-Go (GNG) task with minimal cognitive demands, and a complex GNG task with increased cognitive load. Results showed that increasing cognitive load differentially impacted response control (commission error rate and tau, an ex-Gaussian measure of ISV) for girls, but not boys, with ADHD compared to same-sex TD children. Specifically, a sexually dimorphic pattern emerged such that boys with ADHD demonstrated higher commission error rate and tau on both the simple and complex GNG tasks as compared to TD boys, whereas girls with ADHD did not differ from TD girls on the simple GNG task, but showed higher commission error rate and tau on the complex GNG task. These findings suggest that task complexity influences response control in children with ADHD in a sexually dimorphic manner. The findings have substantive implications for the pathophysiology of ADHD in boys versus girls with ADHD. PMID:25624066

  14. Mialgias: Approaches to differential diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Nadezhda Aleksandrovna Shostak

    2013-10-01

    Full Text Available Differential diagnosis in muscle pains often presents great difficulties so all existing signs of the disease should be carefully considered to make its diagnosis and to prescribe adequate therapy. The paper considers the causes of muscle pains, laboratory and instrumental studies (immunological tests, determination of the level of specific muscular enzymes, primarily creatine phosphokinase – CPK, etc., and the main reasons for enhanced plasma CPK activity. It also describes acute and chronic mialgias associated with enhanced plasma CPK activity, as well as diseases in which mialgias are related to the normal level of CPK, myofascial syndrome (MFS and fibromyalgia (FM in particular. The characteristic features of MFS are given in its diagnostic criteria. It is stated that a differential diagnosis should be made between MFS and major muscle pain-associated abnormalities, such as polymyalgia rheumatica, FM, etc. Diagnosticcriteria for polymyalgia rheumatica are given. A MFS treatment algorithm is presented. Local exposure methods applied to altered musculoligamentous structures in combination with myorelaxants and non-steroidal anti-inflammatory drugs assume paramount importance in MFS.

  15. Mialgias: Approaches to differential diagnosis, treatment

    Directory of Open Access Journals (Sweden)

    Nadezhda Aleksandrovna Shostak

    2013-01-01

    Full Text Available Differential diagnosis in muscle pains often presents great difficulties so all existing signs of the disease should be carefully considered to make its diagnosis and to prescribe adequate therapy. The paper considers the causes of muscle pains, laboratory and instrumental studies (immunological tests, determination of the level of specific muscular enzymes, primarily creatine phosphokinase – CPK, etc., and the main reasons for enhanced plasma CPK activity. It also describes acute and chronic mialgias associated with enhanced plasma CPK activity, as well as diseases in which mialgias are related to the normal level of CPK, myofascial syndrome (MFS and fibromyalgia (FM in particular. The characteristic features of MFS are given in its diagnostic criteria. It is stated that a differential diagnosis should be made between MFS and major muscle pain-associated abnormalities, such as polymyalgia rheumatica, FM, etc. Diagnosticcriteria for polymyalgia rheumatica are given. A MFS treatment algorithm is presented. Local exposure methods applied to altered musculoligamentous structures in combination with myorelaxants and non-steroidal anti-inflammatory drugs assume paramount importance in MFS.

  16. Intracranial meningioma: an exercise in differential diagnosis.

    Science.gov (United States)

    Flanagan, J G; Kothe, A C

    1990-04-01

    A 48-year-old man presented with a unilateral visual disturbance including reduced visual acuity and decreased sensitivity of the temporal visual field. He was initially diagnosed as having optic neuritis. Four months later the condition not only remained unresolved, but showed signs of progression. This presentation was atypical for optic neuritis and further detailed investigation was warranted. The patient's symptoms, along with multi-channel topographic visual evoked potentials and quantitative visual field analysis, were more indicative of a diagnosis of a space occupying lesion. A CT scan confirmed the presence of an intracranial tumour which was surgically excised. Pre- and post-operative visual function are described. The case report highlights the difficulty of differential diagnosis of optic neuritis and the clinical value of the appropriate and judicious use of multi-channel evoked potentials. PMID:2371068

  17. Differential diagnosis of popliteal masses by CT

    International Nuclear Information System (INIS)

    CT appearances of the 14 cases of popliteal masses were retrospectively evaluated. Baker cysts, ganglions, and neurinomas showed the well-defined homogeneous low density area as same as water. Some neurinomas, aggressive fibromatosis and synovial sarcomas exhibited soft tissue density mass. Two neurinomas were slightly enhanced with intravenous administration of contrast material while a synovial sarcoma and an aggressive fibromatosis showed marked contrast enhancement. We conclude that, in the CT differential diagnosis of the popliteal masses, both pre-and post-contrast studies should be performed. (author)

  18. Differential diagnosis of popliteal masses by CT

    Energy Technology Data Exchange (ETDEWEB)

    Kawashima, Atsuhiro; Takashima, Tsutomu; Suzuki, Masayuki

    1987-09-01

    CT appearances of the 14 cases of popliteal masses were retrospectively evaluated. Baker cysts, ganglions, and neurinomas showed the well-defined homogeneous low density area as same as water. Some neurinomas, aggressive fibromatosis and synovial sarcomas exhibited soft tissue density mass. Two neurinomas were slightly enhanced with intravenous administration of contrast material while a synovial sarcoma and an aggressive fibromatosis showed marked contrast enhancement. We conclude that, in the CT differential diagnosis of the popliteal masses, both pre-and post-contrast studies should be performed.

  19. Pre-operative diagnosis of symptomatic meckel's diverticulum in a 20-months old boy using radioisotopes scanning

    International Nuclear Information System (INIS)

    A 20-month-old boy presented to our department with painless rectal bleeding for three days was diagnosed to have a bleeding Meckel's diverticulum on radioisotopes scan. This scintigraphic finding was later confirmed on surgery and histopathology. Radioisotope scanning with Perechnetate is a simple, non-invasive and valuable test for pre-operative diagnosis of Meckel's diverticulum. (author)

  20. Psoriasis: epidemiology, natural history, and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Basko-Plluska JL

    2012-09-01

    Full Text Available Juliana L Basko-Plluska, Vesna Petronic-RosicDepartment of Medicine, Section of Dermatology, University of Chicago, Chicago, IL, USAAbstract: Psoriasis is a chronic, immune-mediated, inflammatory disease which affects primarily the skin and joints. It occurs worldwide, but its prevalence varies considerably between different regions of the world. Genetic susceptibility as well as environmental factors play an important role in determining the development and prognosis of psoriasis. Genome-wide association studies have identified many genetic loci as potential psoriasis susceptibility regions, including PSORS1 through PSORS7. Histocompatibility antigen (HLA studies have also identified several HLA antigens, with HLA-Cw6 being the most frequently associated antigen. Epidemiological studies identified several modifiable risk factors that may predispose individuals to developing psoriasis or exacerbate pre-existing disease. These include smoking, obesity, alcohol consumption, diet, infections, medications and stressful life events. The exact mechanism by which they trigger psoriasis remains to be elucidated; however, existing data suggest that they are linked through Th1-mediated immunological pathways. The natural history of psoriasis varies depending on the clinical subtype as well as special circumstances, including pregnancy and HIV infection. In general, psoriasis is a chronic disease with intermittent remissions and exacerbations. The differential diagnosis is vast and includes many other immune-mediated, inflammatory disorders.Keywords: psoriasis, epidemiology, natural history, differential diagnosis

  1. Differential diagnosis of infratentorial tumors in children

    International Nuclear Information System (INIS)

    With the exception of the first year of life, infratentorial brain tumors are more frequent in the first decade than tumors in the supratentorial compartment. In particular these are cerebellar low-grade astrocytomas, medulloblastomas, brainstem gliomas and ependymomas of the fourth ventricle. The morphology on MRI and CT and the mode of dissemination permit differential diagnosis in many cases. To allow correct stratification into different treatments in possibly disseminating malignant brain tumors, knowledge of the status of dissemination is essential, and therefore not only cranial but also spinal MRI is indispensable for staging. If the spinal MRI is performed in the immediate postoperative period, knowledge of the normal non-specific purely postoperative changes, often seen as enhancement in the subdural spinal spaces, is necessary in order to avoid misinterpretation as meningial seeding. The differential diagnosis of pediatric infratentorial brain tumors and the morphology of subdural enhancement are illustrated with typical images. The natural history of the most frequent tumors and its importance for treatment decisions is discussed in light of the literature. (orig.)

  2. Lymphangioleiomyomatosis: differential diagnosis and optimal management

    Directory of Open Access Journals (Sweden)

    Xu KF

    2014-08-01

    Full Text Available Kai-Feng Xu,1 Bee Hong Lo2 1Department of Respiratory Medicine, Peking Union Medical College Hospital, Beijing, People's Republic of China; 2Developmental Pediatrician, PECAT, Children's Hospital Westmead, Sydney, NSW, Australia Abstract: Lymphangioleiomyomatosis (LAM is an uncommon disease presented as diffuse thin-walled cystic changes in the lung. The main differential diagnoses include pulmonary Langerhans' histiocytosis (PLCH, Birt-Hogg-Dubé syndrome (BHD, lymphoid interstitial pneumonia (LIP, and amyloidosis. A combination of clinical, radiological, and pathological approaches as well as genetic testing will clarify the diagnosis in most cases. LAM is a disease almost exclusively in women. Dyspnea, pneumothorax, and hemoptysis are common presentations in LAM patients. LAM is also a lymphatic disorder affecting lymphatic vessels and lymph nodes. Chylothorax, chylous ascites, and lymphangiomyomas are frequently seen. LAM can present sporadically as a single entity or as part of tuberous sclerosis complex (TSC. Angiomyolipoma (AML is a characteristic extra-pulmonary lesion, either found in association with sporadic or TSC-related LAM. High-risk populations should be screened for LAM, including adult women with TSC and female patients with spontaneous pneumothorax, AMLs in the kidney, and diffuse cystic lung diseases. Definitive diagnosis of LAM is based on a high level of clinical suspicion on presentation supported by pathological findings or by a distinct feature, such as a history of TSC, AMLs in the kidney, chylothorax, or chylous ascites. Vascular endothelial growth factor-D (VEGF-D in serum is a noninvasive and reliable diagnostic biomarker. In experienced centers, trans-bronchial lung biopsy (TBLB provides a convenient and safe way to obtain lung specimens for diagnostic purposes. An effective treatment for LAM is now available, namely using a mechanistic target of rapamycin (mTOR inhibitor such as sirolimus. Efficacy of sirolimus has

  3. Angiographic diagnosis and differentiation of pancreatic tumours

    International Nuclear Information System (INIS)

    In an 8-year period (1971-1978) 92 patients were examined because of suspected pancreatic tumour and the following symptoms were found: in 13 cases (14.1%) inoperable pancreatic carcinoma, in 2 cases insuloma, in 5 patients pancreatic cyst, in 5 cases pancreatitis, in one patient pancreatic abscess and in 12 cases alterations in the environing organs. The observed angiographic symptoms are described in detail. Except the richly vascularized tumour grown together with the stomach all pancreatic carcinomas were poor in vessels and they caused tumourous invasions in the greater arteries. The obliteration of the lienal vein, as well as the development of mesenteric venous collateral circulation signify an inoperable stage. The signs of the differential diagnosis of the pancreatitis and the carcinoma are dealt with in detail. In case of secondary pancreatic tumours - not even detectable by post-mortem examination - the angiographic signs are to be taken into consideration. (author)

  4. [Differential diagnosis and management of balanitis].

    Science.gov (United States)

    Borelli, S; Lautenschlager, S

    2015-01-01

    Balanitis is a descriptive diagnosis for a heterogeneous group of infectious or inflammatory dermatoses which have to be differentiated from malignant conditions. Balanitis is caused not only by Candida spp. and bacterial infections, including anaerobic bacteria: viral infections, parasites and other sexually transmitted infections (STI) also have to be considered. Lichen planus, psoriasis and contact dermatitis can characteristically lead to inflammatory conditions of the glans penis. In addition to a complete skin examination, a thorough patient history with respect to topically applied products and sexual behavior is essential. Infections must be treated and the glans penis should be kept dry. It is important to ensure a balanced genital hygiene in patients. As a last resort therapeutic circumcision can be considered for most forms of chronic balanitis. PMID:25475625

  5. Current differential diagnosis of hypereosinophilic syndrome

    Directory of Open Access Journals (Sweden)

    Dinić-Uzurov Vera

    2007-01-01

    syndrome is a subcategory of idiopathic eosinophilia. If the differential diagnosis of hypereosinophilia fails to resolve the etiology succesfully, the diagnosis of idiopathic HES remains.

  6. Pyomyositis - a differential diagnosis of malignant soft tissue tumours

    International Nuclear Information System (INIS)

    The case of a seven-year-old boy with an enlarging woody-hard mass in the upper thigh is described and the related literature is reviewed. In absence of conclusive sings of inflammatory on both clinical and radiological findings a malignant soft tissue tumour was initially suspected. On operation the mass was found to contain multiple loculated abscesses, and turned out to be a subacute staphylococcal myositis (pyomyositis). Such lesions are quite common in subtropical and tropical climates, and a review of the literature indicates that the incidence of this formerly rare entity is increasing in temperature climates. A variety of factors play a role in pathogenesis, and a history of previous aspectic trauma can be found in about 50% of all cases. The most frequent location is the proximal lower limb or buttock. The clinical history and physical findings are often non-specific. Plain radiographs are non-diagnostic; ultrasound, CT and/or MRI may in some cases be equivocal and angiography sometimes is even misleading. It is important to keep this differential diagnosis in mind, especially in children. (orig.)

  7. Gender-Differentiated Parenting Revisited: Meta-Analysis Reveals Very Few Differences in Parental Control of Boys and Girls

    Science.gov (United States)

    Endendijk, Joyce J.; Groeneveld, Marleen G.; Bakermans-Kranenburg, Marian J.; Mesman, Judi

    2016-01-01

    Although various theories describe mechanisms leading to differential parenting of boys and girls, there is no consensus about the extent to which parents do treat their sons and daughters differently. The last meta-analyses on the subject were conducted more than fifteen years ago, and changes in gender-specific child rearing in the past decade are quite plausible. In the current set of meta-analyses, based on 126 observational studies (15,034 families), we examined mothers’ and fathers’ differential use of autonomy-supportive and controlling strategies with boys and girls, and the role of moderators related to the decade in which the study was conducted, the observational context, and sample characteristics. Databases of Web of Science, ERIC, PsychInfo, Online Contents, Picarta, and Proquest were searched for studies examining differences in observed parental control of boys and girls between the ages of 0 and 18 years. Few differences were found in parents’ use of control with boys and girls. Parents were slightly more controlling with boys than with girls, but the effect size was negligible (d = 0.08). The effect was larger, but still small, in normative groups and in samples with younger children. No overall effect for gender-differentiated autonomy-supportive strategies was found (d = 0.03). A significant effect of time emerged: studies published in the 1970s and 1980s reported more autonomy-supportive strategies with boys than toward girls, but from 1990 onwards parents showed somewhat more autonomy-supportive strategies with girls than toward boys. Taking into account parents’ gender stereotypes might uncover subgroups of families where gender-differentiated control is salient, but based on our systematic review of the currently available large data base we conclude that in general the differences between parenting of boys versus girls are minimal. PMID:27416099

  8. [Ductal adenocarcinoma and unusual differential diagnosis].

    Science.gov (United States)

    Haage, P; Schwartz, C A; Scharwächter, C

    2016-04-01

    Ductal pancreatic adenocarcinoma is by far the most common solid tumor of the pancreas. It has a very poor prognosis, especially in the more advanced stages which are no longer locally confined. Due to mostly unspecific symptoms, imaging is key in the diagnostic process. Because of the widespread use of imaging techniques, incidental findings are to a greater extent discovered in the pancreas, which subsequently entail further work-up. Ductal pancreatic adenocarcinoma can be mimicked by a large number of different lesions, such as anatomical variants, peripancreatic structures and tumors, rarer primary solid pancreatic tumors, cystic tumors, metastases or different variants of pancreatitis. Additionally, a number of precursor lesions can be differentiated. The correct classification is thus important as an early diagnosis of ductal pancreatic adenocarcinoma is relevant for the prognosis and because the possibly avoidable treatment is very invasive. All major imaging techniques are principally suitable for pancreatic imaging. In addition to sonography of the abdomen, usually the baseline diagnostic tool, computed tomography (CT) with its superior spatial resolution, magnetic resonance imaging (MRI) with its good soft tissue differentiation capabilities, possibly in combination with MR cholangiopancreatography (MRCP), endosonography with its extraordinary spatial resolution, conceivably with additional endoscopic retrograde CP or the option of direct biopsy and finally positron emission tomography CT (PET-CT) as a molecular imaging tool are all particularly useful modalities. The various techniques all have its advantages and disadvantages; depending on the individual situation they may need to be combined. PMID:27000276

  9. Differential diagnosis of pelvic cavities containing gas and fluids

    International Nuclear Information System (INIS)

    Since untreated intra-abdominal abscesses are associated with a high mortality rate, early diagnosis is important. In abscesses involving gas formation, plain radiographs of the abdomen in various projections are sufficient for diagnosis. In this article, differential diagnosis of cavities containing gas and fluids is discussed. (orig.)

  10. DIFFERENTIAL DIAGNOSIS OF ORGANIC ACIDEMIA: CLINICAL AND NEUROIMAGING FINDINGS

    OpenAIRE

    Mahmoud Reza ASHRAFI; Alireza TAVASOLI

    2012-01-01

    Clinical differential DiagnosisThe organic acidemias are important in the differential diagnosis of metabolic and neurologic derangement in the neonate and of new-onset neurologic signs in the older child.A-Organic aciduriaSeveral disorders, not classified as primary disorders of organic acid metabolism, have a characteristic urinary organic acid profile that suggests the appropriate diagnosis.• Mevalonicaciduria, a disorder of cholesterol biosynthesis, shows mevalonic acid in the urine.• Glu...

  11. Bullying victimization among underweight and overweight U.S. youth: differential associations for boys and girls.

    Science.gov (United States)

    Wang, Jing; Iannotti, Ronald J; Luk, Jeremy W

    2010-07-01

    To examine the associations between body weight and physical, verbal, relational, and cyber victimization among U.S. boys and girls in grade 6 through 10. Underweight boys and girls were more likely to be physical and relational victims, respectively. Overweight boys and obese girls were more likely to be verbal victims. PMID:20547298

  12. Bullying Victimization among Underweight and Overweight U.S. Youth: Differential Associations for Boys and Girls

    OpenAIRE

    Wang, Jing; Iannotti, Ronald J; Luk, Jeremy W.

    2010-01-01

    To examine the associations between body weight and physical, verbal, relational and cyber victimization among U.S. boys and girls in grade 6 through 10. Underweight boys and girls were more likely to be physical and relational victims respectively. Overweight boys and obese girls were more likely to be verbal victims.

  13. Familial Case of Cherubism from South India: Differential Diagnosis and Report of 2 Cases

    Directory of Open Access Journals (Sweden)

    Varun Muthuraman

    2014-01-01

    Full Text Available Cherubism is a rare familial multilocular cystic lesion of the jaws. The condition clinically appears as a bilateral symmetric swelling of the cheeks in children and is the primary reason for referral. It is a rare lesion of the jaws that has a dominant pattern of inheritance. We report two cases of cherubism, that of a boy and his mother suggestive of a strong familial incidence. A variety of lesions of the jaw mimic this condition and hence the differential diagnosis has been emphasised.

  14. The Wolf Boy: Reactive Attachment Disorder in an Adolescent Boy

    OpenAIRE

    Swain, James E.; Leckman, James F.; Volkmar, Fred R.

    2005-01-01

    An adolescent boy presented with episodic wolf-like aggressive behaviors, for which his rural community planned an exorcism. Admission to a tertiary care hospital revealed an adolescent suffering an array of severe psychiatric symptoms, which best fit the diagnosis of reactive attachment disorder (RAD). The differential diagnosis included delusional disorder, mood problems, anxiety, schizophrenia, and “feral child” syndrome. Nosology and pathophysiology as well as pharmacological and psychoso...

  15. Differential diagnosis of ambiguous genitalia in Chines e patients

    Institute of Scientific and Technical Information of China (English)

    田秦杰; 葛秦生

    2002-01-01

    Objective: To study the etiology and differential diagnos is of ambiguous genitalia.Methods: One hundred and five cases of ambiguous genitalia with disorders of sexual differentiation were analyzed based on clinical characterist ics and basic research. Results: Ambiguous genitalia are closely related to the functio n of androgen. It could be classified into 3 groups: androgen excess, androgen d eficiency and failure of gonadal differentiation. Differential diagnosis depends on clinical manifestations, chromosome examination, serum hormone determination s, final gonadal pathology, receptor study etc.Conclusion: Ambiguous genitalia are related to abnormal androgen ic effect and early correct etiological diagnosis is the key to its management.

  16. Differential Diagnosis in Idiopathic Granulomatous Mastitis and Tuberculous Mastitis

    OpenAIRE

    Seo, Hee Ri Na; Na, Kuk Young; Yim, Hyun Ee; Kim, Tae Hee; Kang, Doo Kyoung; Oh, Ki Keun; Kang, Seok Yun; An, Young-Sil; Chun, Mison; Kim, Woojae; Park, Rae Woong; Jung, Yong Sik; Kim, Ku Sang

    2012-01-01

    Purpose Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of unknown etiology. The diagnosis of IGM requires that other granulomatous lesions in the breast be excluded. Tuberculous mastitis (TM) is also an uncommon disease that is often difficult to differentiate from IGM. The purpose of this study is to develop a new algorithm for the differential diagnosis and treatment of IGM and TM. Methods Medical records of 68 patients (58 with IGM and 10 with TM) between Ju...

  17. Multiple intracranial calcifications caused by parasites and their differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kuckein, D.

    1980-08-01

    In connection with a case of cysticercosis the CT differential diagnosis of multiple intracranial calcifications is discussed. In addition to CT, conventional X-ray diagnosis, angiography and clinical data are needed in order to clarify the origin of intracranial calcifications.

  18. Tuberculous and brucellosis meningitis differential diagnosis

    DEFF Research Database (Denmark)

    Erdem, Hakan; Senbayrak, Seniha; Gencer, Serap;

    2015-01-01

    BACKGROUND: The Thwaites and Lancet scoring systems have been used in the rapid diagnosis of tuberculous meningitis (TBM). However, brucellar meningoencephalitis (BME) has similar characteristics with TBM. The ultimate aim of this study is to infer data to see if BME should be included in the dif...

  19. [Diagnosis of mild hemophilia A made by massive intraabdominal bleeding in a 13-year-old boy].

    Science.gov (United States)

    Terao, Yoko; Akiyama, Masaharu; Yokoi, Kentaro; Yamaoka, Masayoshi; Shimizu, Mika; Kato, Yoko; Tanaka, Keiichiro; Baba, Yuji; Kuwashima, Naruo; Ashizuka, Shuichi; Yoshizawa, Jyoji; Motoki, Takanori; Saito, Yoshihiro; Ida, Hiroyuki

    2012-08-01

    We report a 13-year-old boy who had massive intra-abdominal bleeding without a history of bleeding episodes or traumatic cause of bleeding. The patient underwent surgical treatment because bleeding was not controlled after treatment with tranexamic acid and transfusions including fresh-frozen plasma. Bleeding was traced to the lower left lobe of the liver. The mother's side of the family had a history of bleeding episodes in the boy's grandfather, great uncle, and son of a great aunt. A low level of plasma factor VIII coagulant activity (22%) led to a diagnosis of mild hemophilia A. Compared with severe hemophilia, mild hemophilia is more difficult to diagnose because bleeding episodes are less frequent. Most cases are found after incidental trauma or uncontrolled surgery-related bleeding, there is rarely a family history of hemophilia and activated partial thromboplastin time is normal or slightly prolonged. However, bleeding episodes in mild hemophilia may result in excessive, sometimes life-threatening hemorrhage and require early diagnosis and replacement treatment with adequate amounts of factor VIII, as in severe hemophilia. PMID:22975817

  20. Developing a semantic web model for medical differential diagnosis recommendation.

    Science.gov (United States)

    Mohammed, Osama; Benlamri, Rachid

    2014-10-01

    In this paper we describe a novel model for differential diagnosis designed to make recommendations by utilizing semantic web technologies. The model is a response to a number of requirements, ranging from incorporating essential clinical diagnostic semantics to the integration of data mining for the process of identifying candidate diseases that best explain a set of clinical features. We introduce two major components, which we find essential to the construction of an integral differential diagnosis recommendation model: the evidence-based recommender component and the proximity-based recommender component. Both approaches are driven by disease diagnosis ontologies designed specifically to enable the process of generating diagnostic recommendations. These ontologies are the disease symptom ontology and the patient ontology. The evidence-based diagnosis process develops dynamic rules based on standardized clinical pathways. The proximity-based component employs data mining to provide clinicians with diagnosis predictions, as well as generates new diagnosis rules from provided training datasets. This article describes the integration between these two components along with the developed diagnosis ontologies to form a novel medical differential diagnosis recommendation model. This article also provides test cases from the implementation of the overall model, which shows quite promising diagnostic recommendation results. PMID:25178271

  1. Nuclear magnetic tomography in the differential diagnosis of liver disease

    Energy Technology Data Exchange (ETDEWEB)

    Roedl, W.

    1985-05-01

    In evaluating nuclear magnetic tomography for the diagnosis of liver disease, one must differentiate between circumscribed and diffuse lesions. Nuclear magnetic tomography provides additional information for lesions which are echogenic on ultrasound and can differentiate between metastases, haemangiomas and hamartomas. In diffuse parenchymal disease measurement of relaxation time can differentiate between fatty liver, cirrhosis (alcoholic, primary biliary), haemochromatosis (cirrhotic transformation) and hepatoma. NMR spectroscopy is a method for the future.

  2. [Borderline leprosy as a rare differential diagnosis].

    Science.gov (United States)

    Trawinski, Henning; Brüning, Jan-Hinnerk; Baum, Petra; Ziemer, Mirjana; Schubert, Stefan; Lübbert, Christoph

    2016-06-01

    History and clinical findings | A 42-year-old migrant from Brazil presented with persistent sensory disturbances, skin discolorations and local alopecia in the upper limbs. Decisive for the presentation in our Tropical Medicine Clinic were new occurrences of severe pain and redness and swelling in the area of the lesions that had already been assessed by a number of medical specialists without a clear diagnosis could be made. Investigations and diagnosis | The histological analysis of skin biopsies showed perivascular, perineural, periadnexial lymphocytic and granulomatous dermatitis. In a direct microbiological preparation individual acid fast bacilli could be detected (Ziehl-Neelsen stain). The electroneurographical examination demonstrated a sensitive peripheral-neurogenic damage with emphasis on the right median nerve and the left ulnar and radial nerves. Thermography revealed an increased heating or cooling threshold. The serological investigation by ELISA for IgM antibodies against the phenolic glycolipid (PGL-1) was positive (titer 1 : 1200). In summary, the diagnosis of borderline leprosy (infection with Mycobacterium leprae) with transition to multibacillary leprosy (according to WHO) and leprosy reaction type 1 was made. Treatment and course | We initiated an oral antimycobacterial therapy (multidrug therapy, MDT) with rifampin, clofazimine and dapsone for 12 months (WHO regimen for multibacillary leprosy). Leprosy reaction type 1 was treated with prednisolone and by increasing the dose of clofazimine. Analgesic therapy on demand was carried out with nonsteroidal anti-inflammatory drugs (ibuprofen). MDT and successful management of leprosy reaction lead to a rapid improvement of symptoms. Conclusions | Leprosy is an infectious disease occurring only rarely in Germany (average incidence of 1-2 cases per year) that is diagnosed almost exclusively among migrants. Main symptoms comprise non-itchy, reddish, touch insensitive skin lesions or nerve deficits. The

  3. Differential diagnosis of small bowel occlusions

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2009-06-01

    Full Text Available Hereditary nonpolyposis colorectal cancer (HNPCC, also known as Lynch syndrome, is a common autosomal dominant syndrome characterized by early age at onset, and microsatellite instability (MSI. Patients with Lynch syndrome have a markedly increased risk of colorectal cancer. We report a case of a 28-year-old male with Lynch syndrome; the case allows to describe clinical manifestations and diagnostic criteria of this syndrome, and to underline the importance of genetics in the diagnosis of this disease.

  4. MSCT diagnosis and differential diagnosis of hepatic focal nodular hyperplasia

    International Nuclear Information System (INIS)

    Objective: To evaluate the MSCT findings of focal nodular hyperplasia (FNH) of the liver, and to improve the diagnostic standard. Methods: The MSCT findings were analyzed retrospectively in 25 patients pathologically approved with FNH. All patients underwent 16 detector row spiral CT scanning with and without contrast enhancement. Results: 28 lesions were discovered by CT, with single lesion showed in 22 cases, 2 lesions showed in 3 cases. All lesions showed a solitary nodules or lobulated mass in the liver. On plain CT, FNH showed equal or slightly low density. In the arterial phase, 27 lesions were vigorously and homogeneously enhanced, except the central scars with CT value of 99∼149HU and the mean CT-number of 124 HU. 1 lesion ws enhanced inter-homogeneously. Tortuous and enlarged arteries were seen at the center or periphery in 8 of the 28 lesions. In the portal venous phase, 16 lesions remained slightly hyperdense, 8 lesions turned to isodense, and 1 lesion turned to slightly hypodense. The typical central scar was showed in 8 lesions and 2 lesions showed delayed enhancement. 21 cases were correctly diagnosed by MSCT, with the diagnostic accuracy of 84.0%. Conclusion: MSCT scanning can fully show the pathologic and the blood supplying characteristics of FNH. The typical FNH can be easily diagnosed by CT, while the atypical cases should be differentiated from hepatocellular carcinoma, hemangioma of liver, liver cell adenoma and fibrolamellar hepatocarcinoma. (authors)

  5. Diagnosis and differential diagnosis value of magnetic resonance imaging in autoimmune pancreatitis

    Institute of Scientific and Technical Information of China (English)

    汪建华

    2014-01-01

    Objective To investigate the diagnosis and differential diagnosis value of multi-sequences magnetic resonance imaging(MRI)in autoimmune pancreatitis(AIP).Methods The MRI data of twelve AIP patients were retrospectively analyzed.The sequences of MRI included T1-weighted imaging,T2-weighted imaging,magnetic resonance cholangiopancreatography(MRCP),diffusionweighted imaging(DWI)and dynamic enhancement ima-

  6. Radiological differential diagnosis in chronic aspiration pneumonia

    International Nuclear Information System (INIS)

    6% of all patients suffering from a cerebro-vascular injury die from aspiration pneumonia within the first year. The high temporal resolution of high-speed cineradiography (HFK) (50 frames/sec.) allows the recording of the 0.7 sec. process of pharyngeal swallow. Five case-examples are presented (total number of cases: 95) illustrating the possibility of differentiation between three types of aspiration by means of cineradiography. These types are the so-called pre-, intra- and postdeglutitive aspiration, that is aspiration before or after triggering of the swallowing reflex. This differentiation is of great therapeutic importance. The analysis of disturbances of pharyngo-laryngeal motility and the temporal coordination allows setting up individual surgical and/or conservative programme for rehabilitation. (orig.)

  7. Differential diagnosis and treatment of vestibular vertigo

    Directory of Open Access Journals (Sweden)

    Vladimir Anatolyevich Parfenov

    2010-06-01

    Full Text Available Vertigo is a common complaint that leads patients to visit physicians of various specialties. Diseases resulting in vestibular vertigo are very diverse and may be caused by lesion of both the central parts of the vestibular system and the peripheral vestibular apparatus. In many cases, its diagnosis can be made from complaints and a history of disease and special bedside tests requiring no sophisticated equipment. Management of vestibular vertigo should aim at treating the underlying disease; vestibular dilators as symptomatic therapy can be effective for several days. Vestibular exercises the efficiency of which can be enhanced by betahistine and other drugs accelerating vestibular compensation should be further needed. Data on the efficacy of betaver (betahistine in patients with vestibular vertigo are given.

  8. Positron Emission Tomography in the Differential Diagnosis of Parkinsonism

    Directory of Open Access Journals (Sweden)

    Juha O Rinne

    2009-10-01

    Full Text Available Positron emission tomography (PET studies on presynaptic dopaminergic function can reveal hypofunction in early Parkinson’s disease (PD which may help in the early diagnosis especially in patients with mild symptoms. This hypofunction can be detected with fluorodopa (reflecting mainly aromatic amino acid decarboxylase activity of nigrostriatal terminals or dopamine transporter ligands. These studies can also help to distinguish PD from essential tremor. However, investigations of presynaptic dopaminergic function are not useful in the differential diagnosis of parkinsonian syndromes. PET ligands, such as fluorodeoxyglucose (reflecting glucose metabolism and dopamine receptor ligands, reflecting striatal neuronal function are better in this respect. Cardiac sympathetic function studies represent a new and interesting approach to improve differential diagnosis of parkinsonian syndromes but more studies are needed in larger patient populations with longer follow-up to evaluate the usefulness of these investigations. Multitracer approach combining ligands reflecting different aspects of dopaminergic neurotransmission and other physiological function will increase differential diagnostic accuracy.

  9. Caecal pole tuberculosis - an often neglected differential diagnosis

    International Nuclear Information System (INIS)

    If the barium enema reveals stenosing changes of the terminal ileum and caecum, tuberculosis must be considered in differential diagnosis, even if pulmonary evidence of the illness is lacking. Since, however, radiographically no exclusive typical changes for the tuberculosis of the terminal ileum and caecum can be seen, the diagnosis must be checked histologically and bacteriologically. Under drug therapy an obvious decrease of the inflammation of the mucosa of the colon could be seen. (orig.)

  10. Hepatic adenoma and focal nodular hyperplasia: differential diagnosis and treatment.

    Science.gov (United States)

    Herman, P; Pugliese, V; Machado, M A; Montagnini, A L; Salem, M Z; Bacchella, T; D'Albuquerque, L A; Saad, W A; Machado, M C; Pinotti, H W

    2000-03-01

    The diagnosis of benign hepatic tumors as hepatic adenoma (HA) and focal nodular hyperplasia (FNH) remains a challenge for clinicians and surgeons. The importance of differentiating between these lesions is based on the fact that HA must be surgically resected and FNH can be only observed. A series of 23 female patients with benign liver tumors (13 FNH, 10 HA) were evaluated, and a radiologic diagnostic algorithm was employed with the aim of establishing preoperative criteria for the differential diagnosis. All patients were submitted to surgical biopsy or hepatic resection to confirm the diagnosis. Based only on clinical and laboratory data, distinction was not possible. According to the investigative algorithm, the diagnosis was correct in 82.6% of the cases; but even with the development of imaging methods, which were used in combination, the differentiation was not possible in four patients. For FNH cases scintigraphy presented a sensitivity of 38.4% and specificity of 100%, whereas for HA the sensitivity reached 60% and specificity 85.7%. Magnetic resonance imaging, employed when scintigraphic findings were not typical, presented sensitivities of 71.4% and 80% and specificities of 100% and 100% for FNH and HA, respectively. Preoperative diagnosis of FNH was possible in 10 of 13 (76.9%) patients and was confirmed by histology in all of them. In one case, FNH was misdiagnosed as HA. The diagnosis of HA was possible in 9 of 10 (90%) adenoma cases. Surgical biopsy remains the best method for the differential diagnosis between HA and FNH and must be performed in all doubtful cases. Surgical resection is the treatment of choice for all patients with adenoma and can be performed safely. With the evolution of imaging methods it seems that the preoperative diagnosis of FNH may be considered reliable, thereby avoiding unnecessary surgical resection. PMID:10658075

  11. Differential diagnosis of the adrenal masses. CT and MR

    International Nuclear Information System (INIS)

    The most important issue in the radiological diagnosis of adrenal lesions is the diagnosis of adrenal adenomas, which is the most common adrenal tumor. In this review article, the state-of-the-art CT/MR techniques for diagnosing adrenal adenomas are discussed, along with their technical problems and limitations. Also presented are an issue of preclinical Cushing syndrome and other rare tumorous conditions that should be differentiated from adrenal adenomas. (author)

  12. Clinical case: Differential diagnosis of idiopathic pulmonary fibrosis

    OpenAIRE

    Cordeiro, Carlos Robalo; Alfaro, Tiago M.; Freitas, Sara

    2013-01-01

    Background The diagnosis of idiopathic pulmonary fibrosis can be quite challenging, even after careful clinical evaluation, imaging and pathological tests. This case report intends to demonstrate and discuss these difficulties, especially those concerning the differential diagnosis with chronic hypersensitivity pneumonitis. Case presentation A 58-year-old white male presented with shortness of breath, dry cough, fatigue and weight loss for two months. He was a former smoker and had regular ex...

  13. Differential metabolic rates among the school going boys of a Central Indian Town (Sagar

    Directory of Open Access Journals (Sweden)

    R. Thakur

    2016-05-01

    Full Text Available The prime objective of the present study was to estimate the basal metabolic rate (BMR and resting metabolic rate (RMR among school going boys of 5-18 year of age. The subjects were recruited from government schools of Sagar town of Madhya Pradesh state of Indian Union. Height and weight of the boys were measured using standard anthropometric techniques. Body mass index (BMI and metabolic rates (BMR/RMR were computed for each individual. It was found that mean of BMI varies from 13.8±1.6 Kg m- 2 among boys of 8 year of age to 19.0±1.9 Kg m- 2 among boys of 17 year of age. Similarly, mean of Basal metabolic rate (BMR varies from 1219.0±106.9 K cal/day among boys aged 5 year of age to 2296.3±255.9 K cal/day among 17 year of age. Pre pubertal and pubertal boys have significant difference in their basal metabolic rates as well as stunted, underweight and undernourished boys have significant low BMR. The linear bivariate regression analysis shows that the BMR is dependent on BMI, weight and height. The RMR have highest regression coefficient (r2=0.935 on BMR, followed by Height (r2=0.664, weight (r2=0.631 and body mass index (r2=0.368. The similar trends can be seen for RMR also. The BMR is highly dependent on RMR followed by height, weight and BMI.

  14. Possibilities of differential diagnosis of liver damage in oncologic patients

    International Nuclear Information System (INIS)

    Double scintigraphy of the liver, using two radiopharmaceuticals (sup(99m)Tc-sulphur coloid, 67Ga-citrate), is a contribution to the differential diagnosis of malignant and benign lesions of the liver parenchyma. Apart from increased sensitivity it decreases the comparatively high percentage of falsely-positive results with a common radiocoloidal hepatoscan. The separation of isoenzymes of alcaline phosphatase and γ-glutamyltranspherase yields important information about the nature of the lesion of the hepatic parenchyma. The determination isoenzymes of lactate dehydrogenase and carcinoembryonal antigen has no differentiating value for the diagnosis. (author)

  15. Differential diagnosis of adrenal gland masses

    International Nuclear Information System (INIS)

    Computed tomography (CT) and magnetic resonance (MR) imaging are first line modalities in the evaluation of patients with adrenal gland masses, and have the potential to be very accurate for the localization of adrenal gland masses in patients with diseases associated with hyperfunctioning conditions of the adrenal gland. Both CT and MR imaging allow a specific diagnosis of acute adrenal hemorrhage, adrenal myelolipoma, and adrenal cysts. CT is also helpful in the assessment of patients with Addision's disease, particularly the subacute from secondary to granulomatous diseases. Quantitative evaluation of adrenal masses on unenhanced CT scans and/or qualitative analysis on chemical-shift MR imaging have been shown to be accurate in distinguishing adrenal adenomas from non-adenomas. Attenuation of 11 HE or less on unenhanced CT scans and/or signal loss on opposed phase MR images indicate adenoma with a high specificity and acceptable sensitivity. More recently, delayed-enhanced CT has yielded higher sensitivity and specificity values in distinguishing between adrenal adenomas and non-adenomas than both unenhanced CT and chemical-shift MR imaging do. On delayed-enhanced CT scans, adrenal adenomas exhibit a greater washout of contrast material than do adrenal non-adenomas. Therefore, adrenal non-adenomas have significantly higher attenuation than adenomas on delayed-enhanced CT scans obtained at several arbitrarily chosen time points (3-60 min) after the initiation of contrast material administration. (orig.)

  16. Historical background, definitions and differential diagnosis.

    Science.gov (United States)

    Sampson, Hugh A

    2015-01-01

    Although awareness that food can cause adverse symptoms and even death in some individuals has been present since the times of Hippocrates, it was not until the seminal experiment of Prausnitz that the investigation of food allergy had a more scientific basis. In the first half of the 20th century, there were periodic reports in the medical literature describing various food allergic reactions. Until the studies of Charles May and colleagues in the mid- to late '70s, there was a great deal of skepticism in the medical world about the relevance of food allergy and how to diagnose it, since standard skin testing was known to correlate poorly with clinical symptoms. With the introduction of the double-blind, placebo-controlled oral food challenge by May, the study of food allergy has become evidence based, and tremendous strides have been made in the study of basic immunopathogenic mechanisms and natural history as well as in the diagnosis and management of food allergies. Today, various IgE- and non-IgE-mediated food allergic disorders have been well characterized, and efforts to reverse these allergies using various immunotherapeutic strategies are well under way. PMID:26022859

  17. ICON: An artificial intelligence approach to radiologic differential diagnosis

    International Nuclear Information System (INIS)

    ICON is a computer system, developed using artificial intelligence techniques, that is designed to help radiologists manage the large body of knowledge needed to perform differential diagnosis in radiology. The system's domain is lung disease in patients with lymphoproliferative disorders. The radiologist proposes a diagnostic hypothesis which he or she thinks explains the known clinical and chest radiographic findings. ICON responds with an English-language prose critique that discusses how and why the proposed diagnosis is or is not supported by the clinical literature and suggests further findings or clinical information that might make the diagnosis more secure

  18. Tuberculosis in the head and neck - a forgotten differential diagnosis

    International Nuclear Information System (INIS)

    The aim of the present review is to illustrate the pathogenesis and imaging findings of tuberculosis in specific head and neck regions to avoid pitfalls in diagnosis. It is imperative to be aware of, and provide an early diagnosis for, extra-pulmonary tubercular lesions in the head and neck. A high index of suspicion combined with an appropriate clinical setting serves as an important background to diagnose tubercular lesions in the head and neck region and differentiate them from malignancy and other disease entities. Early diagnosis and treatment can prevent irreversible and debilitating complications and mortality from disseminated tuberculosis.

  19. Tuberculosis in the head and neck - a forgotten differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Vaid, S., E-mail: vaids@vsnl.co [Department of Radiology and Imaging, Grant Medical Foundation, Pune (India); Lee, Y.Y.P. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Hong Kong (China); Rawat, S.; Luthra, A.; Shah, D. [Department of Radiology and Imaging, Grant Medical Foundation, Pune (India); Ahuja, A.T. [Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hongkong, Hong Kong (China)

    2010-01-15

    The aim of the present review is to illustrate the pathogenesis and imaging findings of tuberculosis in specific head and neck regions to avoid pitfalls in diagnosis. It is imperative to be aware of, and provide an early diagnosis for, extra-pulmonary tubercular lesions in the head and neck. A high index of suspicion combined with an appropriate clinical setting serves as an important background to diagnose tubercular lesions in the head and neck region and differentiate them from malignancy and other disease entities. Early diagnosis and treatment can prevent irreversible and debilitating complications and mortality from disseminated tuberculosis.

  20. Differential diagnosis of solitary pulmonary nodule : chest radiography vs CT

    International Nuclear Information System (INIS)

    The purpose of this study was to compare the diagnostic accuracies of chest radiographs and chest CT in the diagnosis of a solitary pulmonary nodule(SPN), and to determine the role of CT and CT findings which aid in the differential diagnosis of nodules. A retrospective study was done on 54 patients in whom SPN was found on chest radiographs and chest CT was carried out. The study involved 25 benign and 29 malignant nodules, confirmed histopathologically and clinically. Chest radiographs and CT scans were reviewed separately in randomized order by two chest radiologists who for each film listed the three most likely diagnoses in descending order. The radiologists recorded the confidence value of the most probable diagnosis, and also the marginal and internal characteristics of nodules and their size, as nodules seen on chest CT scans. Diagnostic rates in the differential diagnosis of benign and malignant nodules were 65.7% by radiography and 77.8% by CT. Correct first-choice diagnosis was by radiography in 30.6% of cases, and by CT in 41.7%. Using radiographs, and the correct diagnosis was among the top-three choices in 61.1% of cases;with CT, the corresponding figure was 76.8%. Overall, a confident diagnosis was reached more often with the CT(41.7%) than with the chest radiograph(21.4%); diagnostic accuracy was 60.0% and 52.2%, respectively. CT findings which imply a benign nodule include smooth margins and diffuse internal calcifications, whereas marginal lobulations, air-bronchograms, internal low density without cavitation, eccentric calcifications, and large size suggest malignancy. We found that CT findings such as well-defined margins, spiculations, pleural tail or internal homogeneity did not contribute in the differentiation between benign and malignant nodules. CT is superior to chest radiography in the differential diagnosis of the solitary pulmonary nodule. Using CT, diagnosis was accurate and made with a high level of confidence, especially with the

  1. [Differential Diagnosis of ADHD from Personality Disorders].

    Science.gov (United States)

    Ushijima, Sadanobu

    2015-01-01

    The author discussed some points regarding the process of differentially diagnosing ADHD from antisocial personality disorder with antisocial behaviors, such as the use of amphetamines, theft, and violence, and borderline personality disorder with eating disorder, self-harming, overdose, and domestic violence. Firstly, the characteristics of ADHD are a lack of interest in criminal activity, cunning, cruelty, or coming from a broken home, which are frequently observed in cases of conduct disorder. The second point concerns the main anxieties and conflicts of those with ADHD and borderline personality disorder. ADHD patients usually do not have anxieties regarding sensitiveness in interpersonal relationships, which borderline patients are likely to have. The characteristic anxieties of ADHD patients usually involve self-reproach, self-deprecation, and self-hatred derived from various kinds of mistake associated with ADHD symptoms, such as a short attention span, restlessness, and impulsiveness. Finally, the author points out that we also have to be aware of the various kinds of identity problem, even in the case of patients with typical symptoms of ADHD. PMID:26721071

  2. Acute colitis: differential diagnosis using multidetector CT

    International Nuclear Information System (INIS)

    Aim: To investigate the utility of multidetector CT (MDCT) in helping to establish the underlying cause of acute colitis. Methods and materials: All patients who had acute colitis with a well-identified cause and underwent abdomen 64-MDCT were included in the study. MDCT images were retrospectively analysed in a blinded fashion and the CT findings were correlated with the eventual aetiological diagnosis. Results: The study population included 105 patients. Acute colitis was related to inflammatory bowel disease in 43 cases. MDCT was used to identify six relevant signs of inflammatory colitis: the “comb” sign (p < 0.001), enlarged lymph nodes (p < 0.001), abscess (p = 0.026), fibro-fatty infiltration (p = 0.007), small bowel involvement (p < 0.001), and the absence of an “empty colon” sign (p = 0.045). Multivariate logistic regression analysis identified three independent signs of inflammatory colitis: the “comb” sign, small bowel involvement, and enlarged lymph nodes. Acute colitis was related to bacterial infection in 35 cases. Five signs were significantly associated with infectious colitis: continuous distribution (p = 0.020), an “empty colon” sign (p = 0.002), absence of fat stranding (p = 0.013), and absence of a “comb” sign (p = 0.010) and absence of enlarged lymph nodes (p = 0.035). Multivariate analysis identified three independent signs: the “empty colon” sign and absence of fat stranding and of a “comb” sign. The remaining causes were ischaemic colitis (n = 21) and drug-related colitis (n = 6). MDCT examination provided five relevant signs of ischaemic colitis: fat stranding (p = 0.002), discontinuous distribution (p < 0.001), and absence of enlarged lymph node (p < 0.001), a “comb” sign (p = 0.006) and small bowel involvement (p = 0.037). Conclusions: MDCT provides certain suggestive signs that may be helpful in distinguishing the underlying aetiological cause of acute colitis

  3. Differential diagnosis of mesiotemporal lesions: case report of neurosyphilis

    Energy Technology Data Exchange (ETDEWEB)

    Vieira Santos, A.; Matias, S.; Saraiva, P.; Goulao, A. [Garcia de Orta Hospital, Neuroradiology Department, Almada (Portugal)

    2005-09-01

    We report a clinical and imaging case of suspected herpes simplex encephalitis subsequently diagnosed as neurosyphilis based on positive antibodies in the CSF. MRI of the brain showed cortical and subcortical lesions in the mesial temporal region, septal area, insula and cingulated gyrus of the right cerebral hemisphere. Neurosyphilis should be included in the differential diagnosis of mesial temporal region lesions on MRI. (orig.)

  4. Autism and Rett Syndrome: Behavioural Investigations and Differential Diagnosis.

    Science.gov (United States)

    Olsson, Bo; Rett, Andreas

    1987-01-01

    Differential diagnosis of Rett syndrome and infantile autism among 63 female patients (22 months to 15 years) was investigated. Conclusions concerned: characteristics of some Rett subjects but no autistic subjects, characteristics of all Rett subjects but not all autistic subjects, and characteristics of most Rett subjects and some autistic…

  5. When to consider acute HIV infection in the differential diagnosis.

    Science.gov (United States)

    Grimes, Richard M; Hardwicke, Robin L; Grimes, Deanna E; DeGarmo, D Sean

    2016-01-16

    Patients presenting with fever, pharyngitis, and lymphadenopathy are likely to have mononucleosis; however, patients with acute HIV infection may present with similar symptoms. Acute HIV infection should be considered as a differential diagnosis if test results for mononucleosis are negative. This article describes when to order HIV testing and discusses the importance of early intervention for acute HIV infection. PMID:26678418

  6. Differential diagnosis in computerized tomography. 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    The book on differential diagnosis in computerized tomography is aimed to support radiologists and physicians with experience concerning the interpretation of computerized tomography images by detailed descriptions of CT diagnoses. The book covers the following topics: intracranial indications, head and neck, spinal cord, muscle-skeleton system, thorax, abdomen and pelvis.

  7. HYPERMOBILITY SYNDROME: CLINICAL MANIFESTATIONS, DIFFERENTIAL DIAGNOSIS, THERAPY APPROACHES

    OpenAIRE

    N. A. Shostak; N. G. Pravdyuk

    2016-01-01

    Connective tissue dysplasia (CTD) represents special ontogenetic abnormality which is a complex problem of contemporary medicine. The principles of differential diagnosis of various forms of CTD are considered. A clinical estimation and therapy approaches are discussed with focus on hypermobility syndrome as one of undifferentiated form of CTD.

  8. HYPERMOBILITY SYNDROME: CLINICAL MANIFESTATIONS, DIFFERENTIAL DIAGNOSIS, THERAPY APPROACHES

    Directory of Open Access Journals (Sweden)

    N. A. Shostak

    2016-01-01

    Full Text Available Connective tissue dysplasia (CTD represents special ontogenetic abnormality which is a complex problem of contemporary medicine. The principles of differential diagnosis of various forms of CTD are considered. A clinical estimation and therapy approaches are discussed with focus on hypermobility syndrome as one of undifferentiated form of CTD.

  9. Isolated femoral hypoplasia: an intrauterine differential diagnosis to campomelia

    Energy Technology Data Exchange (ETDEWEB)

    Koerber, Friederike; Benz-Bohm, Gabriele [University of Cologne, Department of Paediatric Radiology, Cologne (Germany); Schoenau, Eckard [University of Cologne, Department of Paediatrics, Cologne (Germany); Horwitz, A.Eldad [Klinikum Krefeld, Department of Paediatric Radiology, Krefeld (Germany)

    2005-06-01

    The isolated form of femoral bowing is an important differential diagnosis of campomelia. Therefore, knowledge of isolated anomalies is fundamental for prenatal diagnosis, especially for the differential diagnosis from severe syndromes. Four cases are presented to discuss the differential diagnosis of femoral bowing including a review of the literature. We report four newborn babies with unilateral bowing and shortening of the femur. Three had no further anomaly; one child had additional abnormalities due to coumarin embryopathy. The radiological findings were shortened femora with bowing and varus deformity and cortical thickening on the concave side. All other parts showed normal bone structure. The aetiology of femoral bowing is unknown. Early damage of the cartilaginous model followed by remodelling with thickening on the concave side of the bone similar to the healing of malaligned fractures is suspected. The isolated form of femoral bowing without any other anomalies has to be differentiated from complex and more often severe congenital syndromes such as campomelia. Postpartum radiological examination should be reduced to a single exposure of the affected limb and follow-up should be done by clinical examination. (orig.)

  10. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years After Initial Diagnosis.

    Science.gov (United States)

    Gillberg, I Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had never met criteria for an additional psychiatric/neurodevelopmental diagnosis and more than half had ongoing comorbidity (most commonly either ADHD or depression or both). Any psychiatric comorbidity increased the risk of poorer outcome. The minority of the AS group who no longer met criteria for a full diagnosis of an autism spectrum disorder were usually free of current psychiatric comorbidity. The high rate of psychiatric/neurodevelopmental comorbidities underscores the need for a full psychiatric/neurodevelopmental assessment at follow-up of males with AS. PMID:26210519

  11. Diagnosis and Treatment of Odontogenic Cutaneous Sinus Tracts in an 11-Year-Old Boy

    Science.gov (United States)

    Chen, Ke; Liang, Yun; Xiong, Huacui

    2016-01-01

    Abstract Odontogenic cutaneous sinus tracts (OCSTs) are generally primarily misdiagnosed and inappropriately treated by virtue of their rarity and the absence of dental symptoms. Accurate diagnosis and treatment and the elimination of the source of infection can reduce the incidence of complications and relieve the pain of the patient. In this case report, we present the case of an 11-year-old patient with an apparent abscess but an unobvious draining sinus tract in his left cheek. Intraorally, a glass-ionomer-cement filling on the occlusal surface of the left mandibular first molar (tooth 36) was noted. Radiographic examination revealed a radiopaque mass inside the crown and pulp chamber and an irregular, radiolucent periapical lesion surrounding the distal root apex. He was diagnosed with an OCTS secondary to a periapical abscess of tooth 36. Precise root canal therapy (RCT) and chronic granuloma debridement was performed; 6 months later, the abscess and sinus had healed completely, and the periapical lesion had resolved. Odontogenic cutaneous sinus tracts are uncommon in the clinic. This case report reminds us of the significance of OCSTs and provides some implications for their diagnosis and treatment. PMID:27196471

  12. Oral angioleiomyoma: a case report and considerations on differential diagnosis

    Directory of Open Access Journals (Sweden)

    Carlos Augusto Galvão Barboza

    2013-12-01

    Full Text Available Angioleiomyomas are benign mesenchymal tumors derived from smooth muscle, which rarely occur in the oral cavity. We report a case of an angioleiomyoma occurring in the maxillary gingiva. The lesion was painless, with a lobulated surface, fibrous in consistency, and firm upon palpation. Microscopic examination showed an encapsulated tumor mass composed of large vascular channels of varying calibers, surrounded by thick walls of irregularly arranged, spindle-shaped cells, which were immunopositive for smooth-muscle actin. It is sometimes difficult to differentiate an angioleiomyoma from other spindle-cell tumors, thus we emphasize its histological differential diagnosis.

  13. Roentgenological differential diagnosis in diseases of the sacroiliac joints

    International Nuclear Information System (INIS)

    Conventional diagnostic radiology lends itself to the diagnosis of diseases of the sacroiliac joints and tomography in the dorsal position is useful in the identification of discrete changes. Processes of either an inflammatory or a degenerative etiology can be differentiated roentgenologically. Inflammatory disorders can be defined and differentiated to some extent radiomorphologically; this requires to analyse the dimension and temporal sequence of reaction forms of the sacroiliac joints - destruction, sklerosis, ankylosis. The 'colourful picture' is characteristic of morbus Bechterew; however, it is no exclusive proof since a number of other disorders cause similar changes. (orig.)

  14. Roentgenological differential diagnosis in diseases of the sacroiliac joints

    Energy Technology Data Exchange (ETDEWEB)

    Erlemann, R.; Peters, P.E.

    1985-12-01

    Conventional diagnostic radiology lends itself to the diagnosis of diseases of the sacroiliac joints and tomography in the dorsal position is useful in the identification of discrete changes. Processes of either an inflammatory or a degenerative etiology can be differentiated roentgenologically. Inflammatory disorders can be defined and differentiated to some extent radiomorphologically; this requires to analyse the dimension and temporal sequence of reaction forms of the sacroiliac joints - destruction, sklerosis, ankylosis. The 'colourful picture' is characteristic of morbus Bechterew; however, it is no exclusive proof since a number of other disorders cause similar changes.

  15. Infective endocarditis: the specific features of its course, the criteria for diagnosis, differential diagnosis (part II

    Directory of Open Access Journals (Sweden)

    B S Belov

    2008-01-01

    Full Text Available Infective endocarditis (IE is today characterized by polyetiology due to a wide range of pathogens. The paper describes the specific features of the clinical picture of the disease in relation to the etiological agent, which have, in some cases, a crucial role in the choice of empiric antibiotic therapy. Significant clinical polymorphism, obscure symptoms, and monosyndromic onset as guises all enhance the importance of the differential diagnosis of IE, at its early stages in particular. Basic approaches to differentiating IE from the diseases in which differentially diagnostic problems arise to the utmost are outlined.

  16. Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder

    Directory of Open Access Journals (Sweden)

    Michelle Nigri Levitan

    2013-12-01

    Full Text Available Objective: To present the most relevant findings regarding the Brazilian Medical Association guidelines for the diagnosis and differential diagnosis of panic disorder. Methods: We used the methodology proposed by the Brazilian Medical Association for the Diretrizes Project. The MEDLINE (PubMed, Scopus, Web of Science, and LILACS online databases were queried for articles published from 1980 to 2012. Searchable questions were structured using the PICO format (acronym for “patient” [or population], “intervention” [or exposure], “comparison” [or control], and “outcome”. Results: We present data on clinical manifestations and implications of panic disorder and its association with depression, drug abuse, dependence and anxiety disorders. In addition, discussions were held on the main psychiatric and clinical differential diagnoses. Conclusions: The guidelines are proposed to serve as a reference for the general practitioner and specialist to assist in and facilitate the diagnosis of panic disorder.

  17. Application of 1H magnetic resonance spectroscopy in diagnosis and differential diagnosis of cerebral infection

    International Nuclear Information System (INIS)

    Objective: To study the application of single voxel proton magnetic resonance spectroscopy in diagnosis and differential diagnosis of cerebral infection according to manifestations of the 8 patients with cerebritis and 13 patients with gliomas. Methods: The patients including 8 cerebral abscess and 13 gliomas were examined with MRS. And the quantity of the NAA, Cho, Cr, Lip, Lac, AA were measured and compared. Results: There were differences between cerebral abscess and tumors on MRS. NAA/Cr and Cho/Cr of abscess were 4.114±3.637 and 3.084±0.933. NAA/Cr and Cho/Cr of tumors were 1.064±0.823 and 5.987±4.380. There was amino acids (AA) could be seen in some of cerebral abscess. Conclusion: 1H magnetic resonance spectroscopy can supply important information in diagnosis cerebral infection and differentiate information with tumor. (authors)

  18. Radiography of the equine thorax and its differential diagnosis relevance

    International Nuclear Information System (INIS)

    Commonly chronic obstructive pulmonary disease (COPD) is the cause of dyspnoe or loss of performance in the horse. Tracheobronchoscopy, cytology of tracheobronchial aspirates, interpleural pressure measurement, and arterial blood gas analysis improved diagnosis of equine respiratory disorders. Yet some intrathoraeie diseases, especially chronic pneumonia, are differential diagnosis problems. Radiography of the thorax improves the diagnosis of pneumonia and some other intrathoraeie diseases. The technique of the radiography of the thorax is described and radiographic findings in 166 horses suffering from respiratory diseases are evaluated. Theses horses showed pathologic radiographic findings caused by COPD (n =61), pneumonia (67), pleuritis (12), exercise-induced pulmonary haemorrhage (8), aspiration pneumonia (7), hydrothorax (6), pneumothorax (2), lung abseess (1); mediastinal tumor (1), and diaphragmatie hernia (1)

  19. Clinical-morphological peculiarities of osteoblastomata and their differential diagnosis

    OpenAIRE

    Hryhorovskyi, Valeriy; Hryhorovska, Anastasiya

    2011-01-01

    Osteoblastoma (OB) is a rare benign osteogenic tumour formed by interwoven with one another osteal trabeculae, which are surrounded by a lot of osteoblasts. The purpose of the present work was to elucidate the nomenclature and main clinical-visualizing pathohistologic features of OB as a true osteogenic tumor, as well as some aspects of its differential diagnosis with other osteogenic tumors and tumor-like bone lesions. Forty-three cases of biopsies obtained from 39 patients with OB served as...

  20. [Anorexia nervosa as differential diagnosis in underweight patients].

    Science.gov (United States)

    Rapps, Nora; Skoda, Eva; Zipfel, Stephan

    2016-02-01

    Anorexia nervosa is a differential diagnosis in underweight patients, especially in young underweight women. Diagnostic criteria for anorexia nervosa are self-induced weight loss due to restrictive eating or purging behaviour, intense fear of gaining weight and disturbance in the way in which one`s shape is experienced, undue influence of body weight on self-evaluation and persistent lack of recognition of the seriousness of the current low body weight. Anorexia nervosa is associated with numerous medical complications. PMID:26886039

  1. Ultrasound in differential diagnosis of periapical radiolucencies: A radiohistopathological study

    Science.gov (United States)

    Khambete, Neha; Kumar, Rahul

    2015-01-01

    Objectives: To evaluate the efficacy of ultrasound in differential diagnosis of periapical radiolucencies. Materials and Methods: Ten patients aged between 19 years and 40 years with periapical lesions associated with anterior maxillary or mandibular teeth were selected and consented for the study. Pre-operative periapical radiographs were obtained. Measurements and provisional diagnoses of the apical areas were made by two specialist observers on two separate occasions. Preoperative ultrasound examinations with Doppler flowmetry were then performed and the images assessed by two specialist observers for the size, contents, vascular supply and a provisional diagnosis made as to whether the lesion was a cyst or granuloma. Endodontic surgery was performed including curettage of the apical tissues to enable histopathological investigation, which provided the gold standard diagnosis. All measurements and findings were compared and statistically analyzed. Results: Total 10 lesions were identified in 10 patients. On periapical radiographs, lesions were readily identified but observers were unable to differentiate granuloma from cyst using either modality. Where sufficient buccal cortical bone had been resorbed, ultrasound imaging was simple but underestimated the size of the lesions compared with periapical radiographs. In all cases, the ultrasound diagnosis agreed with the histopathological gold standard. Conclusion: Ultrasonography (USG) can provide accurate information about the nature of intraosseous lesions of the jaws before any surgical procedure. It is proposed that USG with Doppler flowmetry can provide an additional diagnostic tool without invasive surgery, where treatment option is nonsurgical. PMID:25657525

  2. Differential diagnosis of middle ear inflammatory diseases by MRI findings

    International Nuclear Information System (INIS)

    Although computed tomography can reveal a soft tissue mass in middle ear diseases as an area of increased density, it cannot differentiate cholesteatoma from other inflammatory tissue. We prospectively studied 30 patients with various middle ear inflammatory diseases, including inflammatory granulation tissue, cholesteatoma and cholesterin granuloma with magnetic resonance imaging (MRI) with or without Gd-DTPA enhancement. Cholesteatoma and inflammatory granulation tissue showed intensity ranging from low to high on T1-weighted images and from high to very high on T2-weighted images. However, cholesteatoma showed either no enhancement or ring enhancement on MR imagings with Gd-DTPA, and it could be differentiated from the Gd-DTPA-enhanced inflammatory granulation tissue. Cholesterin granuloma showed very high intensity on both T1 and T2-weighted images. Therefore, MRI with Gd-DTPA is considered to be useful in the differential diagnosis of these middle ear diseases. (auhtor)

  3. The CT diagnosis and differential diagnosis of malignant tumours of the paranasal sinuses

    International Nuclear Information System (INIS)

    The CT appearances of malignant tumours of the paranasal sinuses are illustrated on the basis of 15 patients, and the differential diagnosis discussed. Malignant soft tissue tumours in the paranasal sinuses are characterised on CT by their non-homogeneous structure; they may destroy the bony margins of the sinus and infiltrate neighbouring regions in certain preferred directions, and they may enhance following the administration of contrast. Precise definition of the malignant tumour by CT permits their exact staging, may help to determine therapy and is valuable for serial observation. It remains to be seen, however, whether the improved radiological diagnosis results in improved prognosis of malignant tumours of the paranasal sinuses. (orig.)

  4. Parkinsonian syndroms: Clinical phenotype, differential diagnosis and disease progression

    International Nuclear Information System (INIS)

    Parkinsonian syndromes include idiopathic Parkinson's disease (IPD), other neurodegenerative diseases with parkinsonism, the so-called atypical parkinsonian syndromes, and symptomatic parkinsonian syndromes, such as Wilson's disease. IPD is the most frequent disease with parkinsonism as the main clinical feature and is responsible for approx. 80% of all parkinsonian syndromes. Atypical parkinsonian syndromes are the most important differential diagnoses of IPD. The two most frequent types are multiple system atrophy (MSA) and progressive supranuclear palsy (PSP). For clinical diagnosis it is essential to take a careful medical history and to examine the patients physically in regular intervals. However, various clinico-pathological studies have shown that approx. 25% of patients with clinical diagnosis of IPD may have other causes of parkinsonism. Selected technical investigations, in particular functional imaging of the central dopaminergic system using PET or SPECT, may help to make clinical diagnosis more secure. This paper reviews the clinical features and diagnostic findings in diseases with parkinsonism and summarises the difficulties in establishing early and differential diagnoses. (orig.)

  5. The reversed halo sign: update and differential diagnosis.

    Science.gov (United States)

    Godoy, M C B; Viswanathan, C; Marchiori, E; Truong, M T; Benveniste, M F; Rossi, S; Marom, E M

    2012-09-01

    The reversed halo sign is characterised by a central ground-glass opacity surrounded by denser air-space consolidation in the shape of a crescent or a ring. It was first described on high-resolution CT as being specific for cryptogenic organising pneumonia. Since then, the reversed halo sign has been reported in association with a wide range of pulmonary diseases, including invasive pulmonary fungal infections, paracoccidioidomycosis, pneumocystis pneumonia, tuberculosis, community-acquired pneumonia, lymphomatoid granulomatosis, Wegener granulomatosis, lipoid pneumonia and sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation therapy and radiofrequency ablation of pulmonary malignancies. In this article, we present the spectrum of neoplastic and non-neoplastic diseases that may show the reversed halo sign and offer helpful clues for assisting in the differential diagnosis. By integrating the patient's clinical history with the presence of the reversed halo sign and other accompanying radiological findings, the radiologist should be able to narrow the differential diagnosis substantially, and may be able to provide a presumptive final diagnosis, which may obviate the need for biopsy in selected cases, especially in the immunosuppressed population. PMID:22553298

  6. Differential diagnosis of pain around the hip joint.

    Science.gov (United States)

    Tibor, Lisa M; Sekiya, Jon K

    2008-12-01

    The differential diagnosis of hip pain is broad and includes intra-articular pathology, extra-articular pathology, and mimickers, including the joints of the pelvic ring. With the current advancements in hip arthroscopy, more patients are being evaluated for hip pain. In recent years, our understanding of the functional anatomy around the hip has improved. In addition, because of advancements in magnetic resonance imaging, the diagnosis of soft tissue causes of hip pain has improved. All of these advances have broadened the differential diagnosis of pain around the hip joint and improved the treatment of these problems. In this review, we discuss the causes of intra-articular hip pain that can be addressed arthroscopically: labral tears, loose bodies, femoroacetabular impingement, capsular laxity, tears of the ligamentum teres, and chondral damage. Extra-articular diagnoses that can be managed arthroscopically are also discussed, including: iliopsoas tendonitis, "internal" snapping hip, "external" snapping hip, iliotibial band and greater trochanteric bursitis, and gluteal tendon injury. Finally, we discuss extra-articular causes of hip pain that are often managed nonoperatively or in an open fashion: femoral neck stress fracture, adductor strain, piriformis syndrome, sacroiliac joint pain, athletic pubalgia, "sports hernia," "Gilmore's groin," and osteitis pubis. PMID:19038713

  7. Double-Fock superposition interferometry for differential diagnosis of decoherence

    International Nuclear Information System (INIS)

    Interferometric signals are degraded by decoherence, which encompasses dephasing, mixing and any distinguishing which-path information. These three paradigmatic processes are fundamentally different, but, for coherent, single-photon and N00N-states, they degrade interferometric visibility in the very same way, which impedes the diagnosis of the cause for reduced visibility in a single experiment. We introduce a versatile formalism for many-boson interferometry based on double-sided Feynman diagrams, which we apply to a protocol for differential decoherence diagnosis: twin-Fock states ∣N,N〉 with N⩾2 reveal to what extent decoherence is due to path distinguishability or to mixing, while double-Fock superpositions ∣N:M〉=(∣N,M〉+∣M,N〉)/√2 with N>M>0 additionally witness the degree of dephasing. Hence, double-Fock superposition interferometry permits the differential diagnosis of decoherence processes in a single experiment, indispensable for the assessment of interferometers. (paper)

  8. Differential Diagnosis of Chronic Rhinosinusitis with Nasal Polyps.

    Science.gov (United States)

    London, Nyall R; Reh, Douglas D

    2016-01-01

    Nasal polyps are semi-translucent mucosal outgrowths of the paranasal sinuses which typically arise in the setting of chronic rhinosinusitis (CRS). Nasal polyps are also associated with asthma, aspirin sensitivity, cystic fibrosis and allergic fungal rhinosinusitis (AFS). The majority of nasal polyps are bilateral and characterized by tissue edema and eosinophil infiltration. Patients with nasal polyps often present with complaints including nasal obstruction, congestion, rhinorrhea or altered sense of smell. The differential diagnosis ranges from benign masses such as schneiderian papilloma, antrochoanal polyp, angiofibroma and encephalocele to malignant neoplasms such as squamous cell carcinoma (SCC), esthesioneuroblastoma, nasal lymphoma and rhabdomyosarcoma. These lesions may have a similar appearance as nasal polyps and particular attention to an alternative diagnosis for nasal polyps should be entertained if the mass is unilateral or congenital in nature. Workup for patients with a unilateral mass should include radiographic imaging, possible biopsy and careful follow-up when appropriate. Here, we review the disease etiology of nasal polyps and describe the approach to the patient with nasal polyps with emphasis on differential diagnosis and workup. PMID:27466841

  9. Poroma with sebaceous differentiation: Dermoscopy for the diagnosis of skin tumor with sebaceous differentiation

    Directory of Open Access Journals (Sweden)

    Takamichi Ito

    2015-01-01

    Full Text Available Although divergent adnexal differentiations are occasionally seen in poroma, poroma with sebaceous differentiation is extremely rare. We present here the second case of dermoscopy on poroma with sebaceous differentiation. A 38-year-old Japanese female presented with a 2-year history of a slow-growing nodule on her left forearm. Dermoscopically, fine hairpin-like vessels, beige lobular structures were seen in the nodule. Many small yellow dots were scattered between beige lobular structures, giving orange-beige in color as a whole. On the basis of histopathologic findings, a diagnosis of poroma with sebaceous differentiation was made. Some sebaceous tumors are known to exhibit yellowish structures on dermoscopy. Tumors with sebaceous differentiation, as well as conventional sebaceous tumors, can show yellow structures on dermoscopy.

  10. The evaluation of MR in the diagnosis, differential diagnosis and therapy control of Perthes' disease

    International Nuclear Information System (INIS)

    59 children were examined by MR, including 31 with Perthes' disease, 7 with subluxating Perthes' disease and 12 with hip pain of unknown origin; the results were compared with conventional radiological findings. MR was superior for the early recognition and for the exact determination of the extent and localisation of juvenile femoral epiphyseal necrosis. It was also of great help in differential diagnosis. It appears to be a suitable method for judging the effect of therapy at an early stage. (orig.)

  11. Radioimmunoscintigraphy in the differential diagnosis of hepatic mass lesion

    International Nuclear Information System (INIS)

    A patient with suspected recurrent cancer of the colon underwent a variety of imaging procedures for the differential diagnosis of a hepatic mass lesion. Computed tomography (CT) showed a low-density lesion in the left hepatic lobe, and the initial CT-guided biopsy of the liver mass was reported to demonstrate a benign lesion. Ultrasonography (US) showed a hypoechoic lesion, and technetium-99m red blood cell (RBC) scan failed to suggest a hemangioma. However, radioimmunoscintigraphy (RIS) using 99mTc- labeled anti-carcinoembryonic antigen (CEA) monoclonal antibody clearly demonstrated increase uptake of antibody in the liver lesion. Scheduled hepatic angiography was canceled and subsequent exploratory laparotomy confirmed liver metastasis. RIS appears most helpful in the diagnosis of hepatic metastasis in patients with colorectal cancer and a rising CEA level. CT, US, and 99mTc-RBC studies for the investigation of hepatic masses are briefly discussed. (orig.)

  12. [Ultrasonic nephrotomography in the differential diagnosis of renal tumors].

    Science.gov (United States)

    Proca, E; Jovin, G; Lucan, M; Ioiart, I

    1977-01-01

    Renal ultrasonography was performed in 40 patients. Complex exploration was carried out in 12 patients with renal tumours, such as: urography, renal scintigrams, renal arteriography, ultrasonography and cavography. Laminography was proved to be an useful method in the positive and differential diagnosis of renal tumours, especially of cystic ones. Informations provided by this technique are not absolute, and these are some possibilities for errors which operate both ways: omission of malignancies or affirmation of malignancy when the lesion is benign. The method should be considered as complementary in the field of renal investigations and will be interpreted in the general context. PMID:147495

  13. Small Fiber Neuropathy: Differential Diagnosis and Treatment Implications.

    Science.gov (United States)

    Barrett, Stephen L; Dellon, A Lee

    2016-04-01

    Burning sensation in the feet is a common problem encountered in podiatric medicine. When this pain is bilateral, symmetric, and includes the top and bottom of both feet, small nerve fiber involvement must be considered in the differential diagnosis. With the now available, in-office, skin biopsy quantification of intraepidermal nerve fibers, documentation of the presence of small fiber involvement in the pain mechanism is possible. Technical details of performing the skin biopsy are reviewed and the legal implications of a positive abnormal skin biopsy for intraepidermal nerve fibers is discussed. PMID:27013410

  14. Radiological findings and differential diagnosis in childhood asthma

    International Nuclear Information System (INIS)

    In children with asthma, routine chest X-ray typically shows bilaterally increased air volume, low diaphragms, wide diaphragmatic angles, and often a slender cardiac silhouette with a prominent pulmonic arch. Such an X-ray is not diagnostic of asthma itself, however, but rather of its complications: pneumonitis (particularly in toddlers with infectious asthma), atelectasis due to mucus obstruction, and, rarely, extra-alveolar air trapping (pneumomediastinum with or without cutaneous emphysema more often than pneumothorax). The differential diagnosis has to rule out 'pseudoasthma' due to cystic fibrosis, alveolitis, achalasia, and foreign body aspiration. (orig.)

  15. Differential diagnosis of the chronic peripancreatic pseudocyst in CT

    International Nuclear Information System (INIS)

    Cystic masses within the pancreas and in its neighbourhood are often really pseudocysts. In most cases, centrally necrotic solid tumours or genuine cystic neoplasms are easy to differentiate from such pseudocysts. They are in fact rare pathologic conditions. The exclusion of a pseudocyst is sometimes more difficult, especially in peripancreatic cystic masses. Computed tomography has significantly improved the diagnostics of the upper abdomen. Nevertheless, it sometimes creates new problems. This study is a selection of cases pointing to differential diagnostic difficulties that may become pitfalls for the examiner. An image-immanent approximative diagnosis is attempted. The importance of the localisation of these lesions and of the topographical anatomy of the upper abdomen are pointed out. (orig.)

  16. Multivariable Discriminant Analysis for the Differential Diagnosis of Microcytic Anemia

    Directory of Open Access Journals (Sweden)

    Eloísa Urrechaga

    2013-01-01

    Full Text Available Introduction. Iron deficiency anemia and thalassemia are the most common causes of microcytic anemia. Powerful statistical computer programming enables sensitive discriminant analyses to aid in the diagnosis. We aimed at investigating the performance of the multiple discriminant analysis (MDA to the differential diagnosis of microcytic anemia. Methods. The training group was composed of 200 β-thalassemia carriers, 65 α-thalassemia carriers, 170 iron deficiency anemia (IDA, and 45 mixed cases of thalassemia and acute phase response or iron deficiency. A set of potential predictor parameters that could detect differences among groups were selected: Red Blood Cells (RBC, hemoglobin (Hb, mean cell volume (MCV, mean cell hemoglobin (MCH, and RBC distribution width (RDW. The functions obtained with MDA analysis were applied to a set of 628 consecutive patients with microcytic anemia. Results. For classifying patients into two groups (genetic anemia and acquired anemia, only one function was needed; 87.9% β-thalassemia carriers, and 83.3% α-thalassemia carriers, and 72.1% in the mixed group were correctly classified. Conclusion. Linear discriminant functions based on hemogram data can aid in differentiating between IDA and thalassemia, so samples can be efficiently selected for further analysis to confirm the presence of genetic anemia.

  17. Clinical presentation of inappropriate sinus tachycardia and differential diagnosis.

    Science.gov (United States)

    Peyrol, Michael; Lévy, Samuel

    2016-06-01

    Inappropriate sinus tachycardia (IST) is a syndrome characterized by a sinus tachycardia not related to a medical condition, to a physiological response, or to medication or drugs and associated with symptoms, often invalidating and altering the quality of life of affected patients. It occurs predominantly in adolescents and young adults, and in the female sex. The diagnosis requires a complete work-up in order to exclude other causes of sinus tachycardia and one or several additional tests: 24-h ECG ambulatory recordings, echocardiogram, exercise testing, and autonomous nervous system assessment. It should be differentiated from the postural orthostatic tachycardia syndrome, with which it shares a number of symptoms, and other supraventricular tachycardias originating in the high right atrium. An electrophysiological study should be considered in selected cases in order to differentiate IST from other supraventricular tachycardias. The mechanism is still unclear, and possible etiologies may include intrinsic abnormality of the sinus node, autonomic dysfunction, hypersensitivity of the sinus node to catecholamines, blunted vagal system, or a combination of the above. The authors emphasize the wide spectrum of clinical presentations and the need to better define the IST and the criteria required to ascertain its diagnosis. PMID:26329720

  18. Differential diagnosis of cervical radiculopathy and superior pulmonary sulcus tumor

    Institute of Scientific and Technical Information of China (English)

    GU Rui; KANG Ming-yang; GAO Zhong-li; ZHAO Jian-wu; WANG Jin-cheng

    2012-01-01

    Background The result would be disastrous if the superior pulmonary sulcus tumor (Pancoast tumor) was misdiagnosed as degenerative cervical spine diseases.The aim of this study was to investigate the differential diagnosis methods of cervical radiculopathy and superior pulmonary sulcus tumor.Methods Clinical manifestations,physical,and radiological findings of 10 patients,whose main complaints were radiating shoulder and arm pain and later were diagnosed with superior pulmonary sulcus tumor,were reviewed and compared with those of cervical radiculopathy.Results Superior pulmonary sulcus tumor patients have shorter mean history and fewer complaints of neck pain or limitation of neck movement.Physical examination showed almost normal cervical spine range of motion.Spurling's neck compression test was negative in all patients.Anteroposterior cervical radiographs showed the lack of pulmonary air at the top of the affected lung in all cases and first rib encroachment in one case.The diagnosis of superior pulmonary sulcus tumor can be further confirmed by CT and MRI.Conclusions By the method of combination of history,physical examination,and radiological findings,superior pulmonary sulcus tumor can be efficiently differentiated from cervical radiculopathy.Normal motion range of the cervical spine,negative Spurling's neck compression test,and the lack of pulmonary air at the top of the affected lung in anteroposterior cervical radiographs should be considerad as indications for further chest radiograph examinations.

  19. DIFFERENTIAL DIAGNOSIS OF ORGANIC ACIDEMIA: CLINICAL AND NEUROIMAGING FINDINGS

    Directory of Open Access Journals (Sweden)

    Mahmoud Reza ASHRAFI

    2012-03-01

    Full Text Available Clinical differential DiagnosisThe organic acidemias are important in the differential diagnosis of metabolic and neurologic derangement in the neonate and of new-onset neurologic signs in the older child.A-Organic aciduriaSeveral disorders, not classified as primary disorders of organic acid metabolism, have a characteristic urinary organic acid profile that suggests the appropriate diagnosis.• Mevalonicaciduria, a disorder of cholesterol biosynthesis, shows mevalonic acid in the urine.• Glutaricacidemia type II, a disorder of fatty acid oxidation, has multiple organic acids in abnormal concentration in urine. These organic acids include ethylmalonic acid, glutaric acid, dicarboxylic acids, and glycine conjugates of medium chain dicarboxylic acids.• The fatty acylCoA-glycine conjugates that signal incomplete fatty acid oxidation and serves as signals to the diagnosis of MCAD defeciency and other disorders of fatty acid oxidation and transport.• Biotinidase deficiency, a disorder of biotin recycling, results in the urinary excretion of several unusual organic acids, including 3-hydroxy-isovaleric, 3-hydroxypropionic, 3-hydroxybutyric acids, and acetoacetate. Propionyl glycine may also be seen.• Mitochondrial diseases with disordered oxidative phosphorylation often demonstrate the presence of abnormal organic acids in the urine.B-AcidosisNon-genetic conditions, such as shock, sepsis, DKA, liver and kidney failure, thiamine deficiency, RTA, some drug intoxication cause acidosis- genetic conditions are include: inherited metabolic disorders of lactate and pyruvate metabolism and oxidative phosphorylation, disorders of the Krebs cycle such as fumarase deficiency.C-HyperammonemiaDisorders of the urea cycle and the hyperammonemia-hypoglycemia syndrome.Neuroimaging• A variety of MRI abnormalities have been described in the organic academia, including distinctive basal ganglia lesions in glutaricacidemia type I (GA I, white matter changes in

  20. Neuropsychological differential diagnosis of mild traumatic brain injury.

    Science.gov (United States)

    Larrabee, Glenn J; Rohling, Martin L

    2013-01-01

    The diagnosis and evaluation of mild traumatic brain injury (mTBI) is reviewed from the perspective of meta-analyses of neuropsychological outcome, showing full recovery from a single, uncomplicated mTBI by 90 days post-trauma. Persons with history of complicated mTBI characterized by day-of-injury computed tomography or magnetic resonance imaging abnormalities, and those who have suffered prior mTBIs may or may not show evidence of complete recovery similar to that experienced by persons suffering a single, uncomplicated mTBI. Persistent post-concussion syndrome (PCS) is considered as a somatoform presentation, influenced by the non-specificity of PCS symptoms which commonly occur in non-TBI samples and co-vary as a function of general life stress, and psychological factors including symptom expectation, depression and anxiety. A model is presented for forensic evaluation of the individual mTBI case, which involves open-ended interview, followed by structured interview, record review, and detailed neuropsychological testing. Differential diagnosis includes consideration of other neurologic and psychiatric disorders, symptom expectation, diagnosis threat, developmental disorders, and malingering. PMID:24105915

  1. Differential diagnosis of neurodegenerative dementias with nuclear medicine methods

    International Nuclear Information System (INIS)

    Full text: Neurodegenerative dementias (NDD) are characterized by insidious onset and gradual progression of cognitive dysfunction, initially relatively focal with respect to cognitive domains and brain regions involved. Nuclear medicine techniques help to clarify differential diagnoses of syndromes such as Alzheimer’s disease (AD), dementia with Lewy bodies (DlB), posterior cortical atrophy (PCA), logopenic primary progressive aphasia (PPA), agrammatic PPA, semantic dementia (SD), behavioral variant frontotemporal dementia (bvFTD) and progressive supranuclear palsy syndrome (PSPS). The process of pathologic changes in the brain may start decades before first clinical symptoms become evident. An early diagnosis already in the pre-clinical phase of the diseases will be of immense importance when expected effective therapeutic options have been introduced. NDDs are histopathologically characterized by accumulation of pathological proteins in the brain like beta amyloid or protein tau. While radiotracers for labeling of protein tau are in preclinical evaluation, different radiotracers labeling amyloid plaques ([11C]PIB, [18F]Florbetapir (Amyvid, Fa. EliLilly), [18F]Florbetaben (Neuraceq, Fa. Piramal), [18F]Flutemetamol (vVzamyl, Fa. Ge) have already been established in clinical use during the last years. In AD these tracers are intensively accumulated in the whole cortical brain. Even an early disease can be excluded in case of a negative amyloid PET. The method is, however, not highly specific since amyloid plaques may also be present in DlB (70 – 80%), FTD (30%) orlogopenicPPA (100%). Neuronal dysfunction goes along with decreased glucose consumption. Different diseases are characterized by different topographical zones of reduced [18F]FDG uptake. In AD the posterior cingular, temporopariatal and (later) frontal cortex are affected, in DlB the pattern is similar, including the occipital cortex, in FTD the frontal cortex is affected, in nonfluent PPA the

  2. Radiological diagnosis and differential diagnosis of headache; Radiologische Diagnostik und Differenzialdiagnostik bei Kopfschmerzen im Erwachsenenalter

    Energy Technology Data Exchange (ETDEWEB)

    Langner, S.; Kirsch, M. [University Medicine Greifswald (Germany). Inst. for Diagnostic Radiology and Neuroradiology

    2015-10-15

    Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome.

  3. Differential diagnosis of depression: relevance of positron emission tomography

    International Nuclear Information System (INIS)

    The proper differential diagnosis of depression is important. A large body of research supports the division of depressive illness into bipolar and unipolar subtypes with respect to demographics, genetics, treatment response, and neurochemical mechanisms. Optimal treatment is different for unipolar and bipolar depressions. Treating a patient with bipolar depression as one would a unipolar patient may precipitate a serious manic episode or possibly even permanent rapid cycling disorder. The clinical distinction between these disorders, while sometimes difficult, can often be achieved through an increased diagnostic suspicion concerning a personal or family history of mania. Positron emission tomography and the FDG method, which allow in vivo study of the glucose metabolic rates for discrete cerebral structures, provide new evidence that bipolar and unipolar depression are two different disorders

  4. Olfactory Reference Syndrome: Diagnostic Criteria and Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Lochner C

    2003-01-01

    Full Text Available Olfactory reference syndrome (ORS has been defined as a psychiatric condition characterized by persistent preoccupation about body odour accompanied by shame, embarrassment, significant distress, avoidance behaviour and social isolation. ORS has however not been included in the Diagnostic and Statistical Manual of Mental Disorders (4th edition (DSM-IV and, given that its primary symptoms may be found in various other disorders, differential diagnosis can be problematic. Using an illustrative case of ORS, we propose diagnostic criteria for ORS. We also argue that ORS represents a unique cluster of symptoms that can be delineated as a separate diagnostic entity, and that ORS falls on a spectrum of social anxiety disorders that includes social anxiety disorder, taijin kyofusho, and body dysmorphic disorder.

  5. Ewing sarcoma versus osteomyelitis: differential diagnosis with magnetic resonance imaging

    International Nuclear Information System (INIS)

    To find and evaluate characteristic magnetic resonance imaging (MRI) patterns for the differentiation between Ewing sarcoma and osteomyelitis. We identified 28 consecutive patients referred to our department for MRI (1.5 T) of an unclear bone lesion with clinical symptoms suggestive of Ewing sarcoma or osteomyelitis. MRI scans were re-evaluated by two experienced radiologists, typical MR imaging features were documented and a diagnostic decision between Ewing sarcoma and osteomyelitis was made. Statistical significance of the association between MRI features and the biopsy-based diagnosis was assessed using Fisher's exact test. The most clear-cut pattern for determining the correct diagnosis was the presence of a sharp and defined margin of the bone lesion, which was found in all patients with Ewing sarcoma, but in none of the patients with osteomyelitis (P < 0.0001). Contrast enhancing soft tissue was present in all cases with Ewing sarcoma and absent in 4 patients with osteomyelitis (P = 0.0103). Cortical destruction was found in all patients with Ewing sarcoma, 4 patients with osteomyelitis did not present any cortical reaction (P = 0.0103). Cystic or necrotic areas were identified in 13 patients with Ewing sarcoma and in 1 patient with osteomyelitis (P = 0.004). Interobserver reliability was very good (kappa = 1) in Ewing sarcoma and moderate (kappa = 0.6) in patients with osteomyelitis. A sharp and defined margin, optimally visualized on T1-weighted images in comparison to short tau inversion recovery (STIR) images, is the most significant feature of Ewing sarcoma in differentiating from osteomyelitis. (orig.)

  6. Ewing sarcoma versus osteomyelitis: differential diagnosis with magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Henninger, B.; Glodny, B.; Rudisch, A.; Trieb, T.; Loizides, A.; Judmaier, W.; Schocke, M.F. [Innsbruck Medical University, Department of Radiology, Innsbruck (Austria); Putzer, D. [Innsbruck Medical University, Department of Nuclear Medicine, Innsbruck (Austria)

    2013-08-15

    To find and evaluate characteristic magnetic resonance imaging (MRI) patterns for the differentiation between Ewing sarcoma and osteomyelitis. We identified 28 consecutive patients referred to our department for MRI (1.5 T) of an unclear bone lesion with clinical symptoms suggestive of Ewing sarcoma or osteomyelitis. MRI scans were re-evaluated by two experienced radiologists, typical MR imaging features were documented and a diagnostic decision between Ewing sarcoma and osteomyelitis was made. Statistical significance of the association between MRI features and the biopsy-based diagnosis was assessed using Fisher's exact test. The most clear-cut pattern for determining the correct diagnosis was the presence of a sharp and defined margin of the bone lesion, which was found in all patients with Ewing sarcoma, but in none of the patients with osteomyelitis (P < 0.0001). Contrast enhancing soft tissue was present in all cases with Ewing sarcoma and absent in 4 patients with osteomyelitis (P = 0.0103). Cortical destruction was found in all patients with Ewing sarcoma, 4 patients with osteomyelitis did not present any cortical reaction (P = 0.0103). Cystic or necrotic areas were identified in 13 patients with Ewing sarcoma and in 1 patient with osteomyelitis (P = 0.004). Interobserver reliability was very good (kappa = 1) in Ewing sarcoma and moderate (kappa = 0.6) in patients with osteomyelitis. A sharp and defined margin, optimally visualized on T1-weighted images in comparison to short tau inversion recovery (STIR) images, is the most significant feature of Ewing sarcoma in differentiating from osteomyelitis. (orig.)

  7. Imaging of the dopaminergic system in differential diagnosis of dementia

    International Nuclear Information System (INIS)

    Neurodegenerative dementia is an increasingly common disorder with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) accounting for most cases. Due to the overlap in clinical symptoms, their differential diagnosis may be challenging. As clinical classification is not completely satisfying, there is a need to improve the diagnostic accuracy by complementary methods such as functional single-photon emission computed tomography (SPECT) and positron emission tomography (PET) imaging. The latter may be helpful to address one distinct biological difference between DLB and AD, the severe nigrostriatal degeneration which occurs in DLB, but not to any significant extent in AD. Based on this principle, autoradiographic studies targeting presynaptic dopaminergic functions have consistently demonstrated the ability to distinguish DLB from AD in postmortem series. At the same time, several single-site and one multicentre study have independently confirmed - no matter what technique was used (SPECT or PET) and which presynaptic function was addressed (dopamine turnover, dopamine transporter, vesicular monoamine transporter) - significantly compromised scan results in DLB subjects, whereas AD patients maintained almost normal findings. Even more important, in vivo findings of presynaptic dopaminergic imaging correlated well with neuropathological findings at autopsy, suggesting a remarkable sensitivity of 88% and a specificity of 100% for the imaging procedure to distinguish between DLB and AD. Taken together, imaging of presynaptic dopaminergic terminal functions with SPECT and PET has currently the greatest evidence base to support its use, and therefore, may be highly recommended to help in the discrimination between DLB and AD. Compared to presynaptic functions, corresponding data targeting postsynaptic dopamine receptors are comparatively rare, less conclusive and suggest a very limited role for this purpose. This review discusses the findings of studies

  8. [Tuberculous Otitis media - a rare differential diagnosis in Germany].

    Science.gov (United States)

    Teschner, M; Kramer, S; Donnerstag, F; Länger, F; Lenarz, Th; Schwab, B

    2008-07-01

    A 28-year-old female patient with a migrant background presented for surgery with a suspected cholesteatoma in the left ear. The patient reported having had an aural discharge for several months; otoscopic examination revealed a runny ear, and discrete granulation tissue was seen. Pure-tone audiometry showed conduction hearing loss of 30-40 dB across all frequencies in the left ear; high-resolution computed tomography of the temporal bone revealed that the mastoid and tympanic cavity were completely obscured. The intraoperative finding showed a caseous space-occupying mass that completely filled the tympanic cavity. The suspected diagnosis of tuberculosis was corroborated by pathohistological, microbiological and molecular biological tests. Tuberculostatic therapy was initiated at a different location. Although tuberculosis of the middle ear is a rare condition in Germany, it should nevertheless be considered when making a differential diagnosis, especially in high-risk patients where cholesteatoma is suspected on clinical and radiological evidence or in patients with a chronic middle ear process. PMID:18688924

  9. Differential diagnosis of breast lesions using ultrasound elastography

    Directory of Open Access Journals (Sweden)

    Ioana Andreea Gheonea

    2011-01-01

    Full Text Available Context: The recent introduction of elastography has increased the specificity of USG and enabled early diagnosis of breast cancer. Quantitative elastography, especially with strain ratio (SR index, improves diagnostic accuracy and decreased number of biopsies. Aims: The purpose of this study was to assess the role of USG elastography in the differential diagnosis of breast lesions. Settings and Design: This prospective study was conducted in the University of Medicine and Pharmacy Research Centre of Craiova. Materials and Methods: Fifty-eight patients diagnosed with breast lesions between January 2009 and January 2010 were included in this prospective study. All the patients were examined in the supine position, and the B-mode USG image was displayed alongside the elastography strain image. For obtaining the elastography images we used a EUS Hitachi EUB 8500 ultrasound system with a 6.5-MHz linear probe. The elastography strain images were scored according to the Tsukuba elasticity score. Statistical Analysis: We performed receiver operator characteristic (ROC analysis for assessment of the role of USG elastography in the diagnosis of breast lesions. Results: We obtained a sensitivity of 86.7% and a specificity of 92.9% for elasticity score and a sensitivity of 93.3% and a specificity of 92.9% for SR (when a cutoff point of 3.67 was used. There was very good correlation between SR and elasticity score (Spearman coefficient of 0.911. Conclusions: Elastography is a fast, simple method that can complement conventional USG examination. This method has the lowest cost/efficiency ratio and it is also the most noninvasive and accessible imaging method, with an accuracy comparable to MRI.

  10. Does Magnetization Transfer Ratio (MTR) contribute to the diagnosis and differential diagnosis of the dementias?

    International Nuclear Information System (INIS)

    Purpose: The magnetization transfer ratio (MTR) is a MR-based neuroimaging procedure aiming at the quantification of the structural integrity of brain tissue. Its contribution to the differential diagnosis of dementias was examined and discussed in relation to the pathogenesis of age-related dementias. Materials and Methods: Sixty-one patients from a memory clinic were diagnosed by general physical and neuropsychiatric examination, and underwent neuropsychologic testing and neuroimaging using MRI. Their clinical diagnoses were based on standard operational research criteria. Additionally, the MTR in 10 defined regions of interest (ROI) was determined. This investigation was performed using a T1-weighted SE sequence. Average MTR values were determined in the individual ROI and their combinations and correlated with the age gender, cognitive impairment and clinical diagnosis. Sensitivity, specificity, positive and negative predictive value were determined, as well as the rate of correct classifications. Results: For cognitive healthy subjects, the MRT values correlate only mildly, though significantly, with age in the hippocampus and with gender in the dorsal corpus callosum. In contrast, the MTR in the frontal white matter correlates strongly and highly significantly with cognitive impairment in patients with dementia. The differential diagnostic assignment of Alzheimer's disease versus vascular dementia by MTR provides a correct classification of approximately 50% to 70%. PPV for no dementia vs. vascular dementia or the NPV for vascular vs. Alzheimer's disease are considerably higher exceeding 80%. For no dementia vs. Alzheimer's disease, the NPV was over 90%. (orig.)

  11. The application of DWI in the differential diagnosis between malignant glioma and solitary metastases

    International Nuclear Information System (INIS)

    Glioma and brain metastases are common tumors in clinical practice. It's difficult to diagnose and differentiate glioma from solitary metastases, because they have similar clinical characters and conventional imaging manifestations. Because of different treatments and prognosis for the two types of tumor, it's important for us to accurately diagnose and differentiate them. Some scholars have used diffusion weighted imaging in diagnosis and differential diagnosis of brain tumors. In this paper, we reviewed the usefulness of diffusion weighted imaging in diagnosis and differential diagnosis between glioma and solitary metastases. (authors)

  12. Gender stereotype endorsement differentially predicts girls' and boys' trait-state discrepancy in math anxiety

    Directory of Open Access Journals (Sweden)

    Madeleine eBieg

    2015-09-01

    Full Text Available Mathematics is associated with anxiety for many students; an emotion linked to lower well-being and poorer learning outcomes. While findings typically show females to report higher trait math anxiety than males, no gender differences have to date been found in state (i.e., momentary math anxiety. The present diary study aimed to replicate previous findings in investigating whether levels of academic self-concept was related to this discrepancy in trait versus state anxiety measures. Additionally, mathematics-related gender stereotype endorsement (mathematics is a male domain was investigated as an additional predictor of the trait-state discrepancy. The sample included 755 German 9th and 10th graders who completed self-report measures of trait math anxiety, math self-concept, and gender stereotype endorsement, in addition to state measures of anxiety after math classes by use of a standardized diary for 2-3 weeks (Nwithin = 6207. As expected, females reported higher trait math anxiety but no gender differences were found for state math anxiety. Also in line with our assumptions, multilevel analyses showed the discrepancy between trait and state anxiety to be negatively related to students’ self-concept (i.e., a lower discrepancy for students with higher self-concepts. Furthermore, gender stereotype endorsement differentially predicted the trait-state discrepancy: When controlling for self-concept in mathematics, females who endorsed the gender stereotype of math being a male domain more strongly overestimated their trait math anxiety as compared to their state anxiety whereas this effect was not significant for males. The present findings suggest that gender stereotype endorsement plays an important role in explaining gender differences in math anxiety above and beyond academic self-concept. Implications for future research and educational practice are discussed.

  13. Rabies encephalomyelitis vs. ADEM: Usefulness of MR imaging in differential diagnosis

    OpenAIRE

    Asokan Santhoshkumar; Devadathan Kalpana; Rajanna Sowrabha

    2012-01-01

    We report a case of rabies encephalomyelitis in a 12-year-old boy who had received anti-rabies vaccine 6 weeks after being bitten by a puppy. The MR (magnetic resonance) imaging helped to differentiate rabies from acute disseminated encephalomyelitis (ADEM). ADEM involves the white matter predominantly, whereas rabies has a predilection for grey matter, that too of midline regions. This report emphasizes the usefulness of MRI in differentiating rabies and ADEM when encephalomyelitis occurs in...

  14. Restless legs syndrome: differential diagnosis and management with pramipexole

    Directory of Open Access Journals (Sweden)

    Francesca Brindani

    2009-06-01

    Full Text Available Francesca Brindani, Francesca Vitetta, Franco GemignaniDepartment of Neurosciences, University of Parma, ItalyAbstract: Restless legs syndrome (RLS is a condition characterized by discomfort at rest and urge to move focused on the legs. RLS may occur as an idiopathic, often hereditary condition (primary RLS, or in association with medical conditions (secondary RLS including iron deficiency, uremia, and polyneuropathy. Current understanding of the pathophysiology of RLS points to the involvement of three interrelated components: dopaminergic dysfunction, impaired iron homeostasis, and genetic mechanisms. The diagnosis of RLS is made according to the consensus criteria by a National Institutes of Health panel: 1 an urge to move the legs, usually accompanied by uncomfortable sensations; 2 beginning or worsening during rest; 3 relieved by movement; and 4 worse, or only occurring, in the evening or at night. The differential diagnosis of RLS aims to: 1 distinguish RLS from other disorders with RLS-like symptoms and 2 identify secondary forms, with investigation of underlying diseases. The treatment of RLS demands a clinical evaluation to rule out and cure causes of secondary RLS, including iron supplementation when deficient, and to eliminate the triggering factors. The presence of neuropathy should be especially investigated in nonhereditary, late-onset RLS, in view of a possible treatment of the underlying disease. The first line treatment for idiopathic RLS is represented by dopamine agonists, in particular nonergot-derived ropinirole and pramipexole, whereas ergot dopamine agonists (cabergoline and pergolide are no longer in first-line use given the risks of cardiac valvulopathy. Although no comparative trials have been published, a meta-analysis of pramipexole versus ropinirole suggests differences in efficacy and tolerability favoring pramipexole.Keywords: restless legs syndrome, pramipexole, dopamine, agonists, small fiber neuropathy

  15. Elastofibroma dorsi – differential diagnosis in chest wall tumours

    Directory of Open Access Journals (Sweden)

    Steinau Hans-Ulrich

    2007-02-01

    Full Text Available Abstract Background Elastofibromas are benign soft tissue tumours mostly of the infrascapular region between the thoracic wall, the serratus anterior and the latissimus dorsi muscle with a prevalence of up to 24% in the elderly. The pathogenesis of the lesion is still unclear, but repetitive microtrauma by friction between the scapula and the thoracic wall may cause the reactive hyperproliferation of fibroelastic tissue. Methods We present a series of seven cases with elastofibroma dorsi with reference to clinical findings, further clinical course and functional results after resection, as well as recurrence. Data were obtained retrospectively by clinical examination, phone calls to the patients' general practitioners and charts review. Follow-up time ranged from four months to nine years and averaged 53 months. Results The patients presented with swelling of the infrascapular region or snapping scapula. In three cases, the lesion was painful. The ratio men/women was 2/5 with a mean age of 64 years. The tumor sizes ranged from 3 to 13 cm. The typical macroscopic aspect was characterized as poorly defined fibroelastic soft tissue lesion with a white and yellow cut surface caused by intermingled remnants of fatty tissue. Microscopically, the lesions consisted of broad collagenous strands and densely packed enlarged and fragmented elastic fibres with mostly round shapes. In all patients but one, postoperative seroma (which had to be punctuated occurred after resection; however, at follow-up time, no patient reported any decrease of function or sensation at the shoulder or the arm of the operated side. None of the patients experienced a relapse. Conclusion In differential diagnosis of soft tissue tumors located at this specific site, elastofibroma should be considered as likely diagnosis. Due to its benign behaviour, the tumor should be resected only in symptomatic patients.

  16. IMPORTANCE OF LIVER FUNCTION TESTS IN DIFFERENTIAL DIAGNOSIS OF JAUNDICE

    Directory of Open Access Journals (Sweden)

    Sandeep

    2015-11-01

    marked elevation in serum direct bilirubin along with marked elevated levels of Serum alkaline phosphatase. CONCLUSION: Liver function tests are used as a primary tool by the clinicians in differential diagnosis of a case of jaundice as they definitely give us a clue to reach to the root cause of jaundice.

  17. Mucins in the diagnosis and differential diagnosis of pancreatic cystic neoplasms: report of 40 cases

    Institute of Scientific and Technical Information of China (English)

    JI Yuan; TAN Yun-shan; XU Jian-fang; QI Wei-dong; LI Xiao-ping; SU-JIE Ake-su; ZHU Xiong-zeng

    2006-01-01

    @@ Cystic neoplasms of the pancreas account for 10% to 15% of all cystic pancreatic lesions.The majority (85% to 90%) of cystic lesions of the pancreas are pseudocysts. Although cystic neoplasms of the pancreas are rare, they range from benign to malignant neoplasms. The clinical challenge is the differential diagnosis and management of the cystic neoplasms, which represent 10% to 25% of primary pancreatic neoplasms. Pancreatic neoplasms and tumour like lesions with cystic features have been recently reviewed. The incidence of pancreatic cystic neoplasms reported is variable. Because there is no large, systematic study on tne cases from China comparing the incidence and biology of cystic neoplasms of pancreas to that of Western series, we reviewed all the cases of cystic neoplasms from Zhongshan Hospital over 6 years. Most of the neoplasms in our series were classified according to the recent World Health Organization (WHO)classification.1,2

  18. CT differential diagnosis of stroke in subacute and chronic stage

    International Nuclear Information System (INIS)

    Computed tomography (CT) is a very useful method for the diagnosis of cerebrovascular diseases, especially in the acute stage. In the subacute stage, however, it is difficult to determine whether a lesion is a hematoma or an ischemia. It is necessary to use contrast agents to differentiate these two types of lesions. Therefore, it is very important to study the plain and the enhanced CT findings of these lesions in the acute and subacute stages. The author analysed the sequential CT findings of cerebral hemorrhage (60 cases), ischemic infarction (22 cases), and hemorrhagic infarction (22 cases) and reaches the following conclusions: 1) In cerebral hemorrhage, the high-density area disappears within weeks at a rate related with the length (cm) of the maximum diameter of the high-density area in the first week, contrast enhancement also disappears within months in parallel with the length of the maximum diameter of the high-density area in the first week. 2) In contrast-enhanced CT, cerebral hemorrhage showed a ring enhancement in all stages and sometimes showed a slit enhancement in the chronic stage. In general however, ischemic infarction did not show ring enhancement. 3) Mass effect and contrast enhancement disappear within the first month in ischemic infarction, but continue for two months in hemorrhagic infarction. (author)

  19. Differential diagnosis between odontogenic keratocyst and ameloblastoma by computed tomography

    International Nuclear Information System (INIS)

    The objective of this study is to find the differentiating characteristics of ameloblastomas and odontogenic keratocysts of the jaw by analyzing computed tomography (CT) images of the lesions, clarify radiological characteristics associated with jaw lesions, and to make a diagnosis based on these findings. Test subjects were chosen among the patients who were diagnosed as having an odontogenic keratocyst or ameloblastoma at the Yonsei University Dental Hospital from January 1996 to December 2000 and had CT scans taken preoperatively. The subject pool was comprised of 51 cases of odontogenic keratocyst and 37 cases of ameloblastoma. The following measures were used for image analysis of the lesion : the anatomic location, CT pattern, mesiodistal width, buccolingual width, the ratios between mesiodistal width and buccolingual width, height, CT number, homogeneity of radiodensity, the appearance of a sclerotic rim, continuity of adjacent cortical bone, and displacement and resorption of adjacent teeth. Comparing the CT patten, mesiodistal width, buccolingual width, height, CT number, homogeneity, appearance of sclerotic rim, continuity of adjacent cortical bone, there were statistically significant differences between ameloblastoma and odontogenic keratocyst test subjects (p0.05). We compared odontogenic keratocysts and ameloblastomas in CT scans. They occurred most frequently in the posterior to the ramus of the mandible. The findings of patterns of the CT images showed that size and border of lesions were more aggressive in ameloblastomas than in odontogenic keratocysts. The internal contents represented an increased attenuation area (IAA) in odontopenic keratocyst. Odontogenic keratocysts were shown to have higher CT numbers than ameloblastomas.

  20. CT differential diagnosis of stroke in subacute and chronic stage

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzaki, T.; Mizukami, M.; Kawase, T.; Tazawa, T.; Araki, G. (Mihara Memorial Hospital, Isesaki, Gunma (Japan). Inst. of Brain and Blood Vessels)

    1981-02-01

    Computed tomography (CT) is a very useful method for the diagnosis of cerebrovascular diseases, especially in the acute stage. In the subacute stage, however, it is difficult to determine whether a lesion is a hematoma or an ischemia. It is necessary to use contrast agents to differentiate these two types of lesions. Therefore, it is very important to study the plain and the enhanced CT findings of these lesions in the acute and subacute stages. The author analysed the sequential CT findings of cerebral hemorrhage (60 cases), ischemic infarction (22 cases), and hemorrhagic infarction (22 cases) and reaches the following conclusions: 1) In cerebral hemorrhage, the high-density area disappears within weeks at a rate related with the length (cm) of the maximum diameter of the high-density area in the first week, contrast enhancement also disappears within months in parallel with the length of the maximum diameter of the high-density area in the first week. 2) In contrast-enhanced CT, cerebral hemorrhage showed a ring enhancement in all stages and sometimes showed a slit enhancement in the chronic stage. In general however, ischemic infarction did not show ring enhancement. 3) Mass effect and contrast enhancement disappear within the first month in ischemic infarction, but continue for two months in hemorrhagic infarction.

  1. Multiple sclerosis: imaging, diagnostic criteria and differential diagnosis

    International Nuclear Information System (INIS)

    Multiple sclerosis (MS) is the most common demyelinating inflammatory disease of the central nervous system (CNS), presenting with multifocal, disseminated inflammatory lesions referred to as plaques. Magnetic resonance imaging (MRI) typically depicts multiple, round to oval, circumscript lesions predominantly involving periventricular and subcortical white matter, brainstem and cerebellum. More recent investigations have demonstrated that the macroscopically visible plaques only present the tip of the iceberg: Already early in its course, MS causes neuroaxonal damage and diffusely involves the entire brain parenchyma including normal appearing white matter. These changes are reflected by strongly T1w hypointense lesions and atrophy of early onset, by reduction of the neuronal Marker N-acetylaspartate (NAA) on spectroscopy, by a decrease of the magnetization transfer ratio (MTR), by an increased in diffusibility and decreased anisotropy on diffusion-weighted imaging (DWI). MRI imaging is an important tool in the diagnosis of MS by revealing the characteristic spatial and temporal dissemination of the cerebral and spinal manifestations of this disease. Diagnostic criteria increase the diagnostic specificity and allow better differentiation from other diseases with multifocal white matter abnormalities. (orig.)

  2. Differential diagnosis of inflammatory lung affections by X-ray in children

    International Nuclear Information System (INIS)

    As a consequence of the rise in neonatal infections by β-streptococci the clinical respiratory distress syndrome in neonates is becoming increasingly important for differential diagnosis. The present paper reports on special problems in differential X-ray diagnosis of β-streptococcus pneumonia as compared to inflammatory lung affections attributable to various causes. (orig.)

  3. Eosinophilic granuloma of the bone: Considerations of differential diagnosis exemplified by three cases

    International Nuclear Information System (INIS)

    To the radiologist, eosinophilic granulomas of the bone impose in the shape of osteolyses. Depending on localization and anamnestic/clinical data, various other bone diseases are to be differentiated; when doing so, however, accuracy of diagnostic radiology prior to histological verification is varying. The article presents considerations of differential diagnosis exemplified by three cases with diagnosis confirmed by histological findings. (orig.)

  4. Differential diagnosis of neurodegenerative diseases using structural MRI data.

    Science.gov (United States)

    Koikkalainen, Juha; Rhodius-Meester, Hanneke; Tolonen, Antti; Barkhof, Frederik; Tijms, Betty; Lemstra, Afina W; Tong, Tong; Guerrero, Ricardo; Schuh, Andreas; Ledig, Christian; Rueckert, Daniel; Soininen, Hilkka; Remes, Anne M; Waldemar, Gunhild; Hasselbalch, Steen; Mecocci, Patrizia; van der Flier, Wiesje; Lötjönen, Jyrki

    2016-01-01

    Different neurodegenerative diseases can cause memory disorders and other cognitive impairments. The early detection and the stratification of patients according to the underlying disease are essential for an efficient approach to this healthcare challenge. This emphasizes the importance of differential diagnostics. Most studies compare patients and controls, or Alzheimer's disease with one other type of dementia. Such a bilateral comparison does not resemble clinical practice, where a clinician is faced with a number of different possible types of dementia. Here we studied which features in structural magnetic resonance imaging (MRI) scans could best distinguish four types of dementia, Alzheimer's disease, frontotemporal dementia, vascular dementia, and dementia with Lewy bodies, and control subjects. We extracted an extensive set of features quantifying volumetric and morphometric characteristics from T1 images, and vascular characteristics from FLAIR images. Classification was performed using a multi-class classifier based on Disease State Index methodology. The classifier provided continuous probability indices for each disease to support clinical decision making. A dataset of 504 individuals was used for evaluation. The cross-validated classification accuracy was 70.6% and balanced accuracy was 69.1% for the five disease groups using only automatically determined MRI features. Vascular dementia patients could be detected with high sensitivity (96%) using features from FLAIR images. Controls (sensitivity 82%) and Alzheimer's disease patients (sensitivity 74%) could be accurately classified using T1-based features, whereas the most difficult group was the dementia with Lewy bodies (sensitivity 32%). These results were notable better than the classification accuracies obtained with visual MRI ratings (accuracy 44.6%, balanced accuracy 51.6%). Different quantification methods provided complementary information, and consequently, the best results were obtained by

  5. Differential diagnosis of neurodegenerative diseases using structural MRI data

    Science.gov (United States)

    Koikkalainen, Juha; Rhodius-Meester, Hanneke; Tolonen, Antti; Barkhof, Frederik; Tijms, Betty; Lemstra, Afina W.; Tong, Tong; Guerrero, Ricardo; Schuh, Andreas; Ledig, Christian; Rueckert, Daniel; Soininen, Hilkka; Remes, Anne M.; Waldemar, Gunhild; Hasselbalch, Steen; Mecocci, Patrizia; van der Flier, Wiesje; Lötjönen, Jyrki

    2016-01-01

    Different neurodegenerative diseases can cause memory disorders and other cognitive impairments. The early detection and the stratification of patients according to the underlying disease are essential for an efficient approach to this healthcare challenge. This emphasizes the importance of differential diagnostics. Most studies compare patients and controls, or Alzheimer's disease with one other type of dementia. Such a bilateral comparison does not resemble clinical practice, where a clinician is faced with a number of different possible types of dementia. Here we studied which features in structural magnetic resonance imaging (MRI) scans could best distinguish four types of dementia, Alzheimer's disease, frontotemporal dementia, vascular dementia, and dementia with Lewy bodies, and control subjects. We extracted an extensive set of features quantifying volumetric and morphometric characteristics from T1 images, and vascular characteristics from FLAIR images. Classification was performed using a multi-class classifier based on Disease State Index methodology. The classifier provided continuous probability indices for each disease to support clinical decision making. A dataset of 504 individuals was used for evaluation. The cross-validated classification accuracy was 70.6% and balanced accuracy was 69.1% for the five disease groups using only automatically determined MRI features. Vascular dementia patients could be detected with high sensitivity (96%) using features from FLAIR images. Controls (sensitivity 82%) and Alzheimer's disease patients (sensitivity 74%) could be accurately classified using T1-based features, whereas the most difficult group was the dementia with Lewy bodies (sensitivity 32%). These results were notable better than the classification accuracies obtained with visual MRI ratings (accuracy 44.6%, balanced accuracy 51.6%). Different quantification methods provided complementary information, and consequently, the best results were obtained by

  6. Differential diagnosis of myelodysplastic syndrome and aplastic anemia using MRI

    International Nuclear Information System (INIS)

    To assess the patterns of myelodysplastic syndrome (MDS) and aplastic anemia (AA) on MRI of the spinal bone marrow and to find the differential points between the two groups. Fourteen patients with MDS (n=7) and AA (n=7) were studied using magnetic resonance imaging. Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on T1-weighted and STIR images. Five distinct patterns of signal intensity of the T1-weighted and STIR images were classified. T1 and T2 relaxation times and T1 marrow/fat signal intensity ratio were measured and analyzed (t-test). The cellularity of bone marrow was evaluated on histologic slides. MDS showed homogeneously low signal intensity on T1WI and high signal intensity on STIR image, indicating hypercellular marrow, whereas AA showed relative high signal intensity on T1WI and low signal intensity on STIR image, representing fatty marrow. T1 and T2 relaxation time (T1 for MDS=750.26 msec ± 177.50, T1 for AA=413.21 msec ± 167.39 (ρ < 0.000), T2 for MDS=91.86 msec ± 14.16, T2 for AA=81.44 msec ± 15.31 (ρ < 0.001) and T1 marrow/fat signal intensity ratio (0.22 ± 0.048 in MDS, 0.30 ± 0.083 in AA (ρ < 0.000) revealed statistically significant difference between the two groups. Although the marrow aspiration and needle biopsy are mandatory in hematologic disease for diagnosis, there are limited in assessing the change of total marrow mass. Therefore MRI of bone marrow might be useful in distinguishing MDS from AA because of its ability of representation of total marrow mass

  7. Differential diagnosis of myelodysplastic syndrome and aplastic anemia using MRI

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Seung Eun; Park, Jung Mi; Lee, Jae Mun; Kim, Ki Tae; Kim, Dong Wook; Kim, Chun Choo; Kim, Chun Yul; Shinn, Kyung Sub [Catholic University Medical College, Seoul (Korea, Republic of)

    1995-04-15

    To assess the patterns of myelodysplastic syndrome (MDS) and aplastic anemia (AA) on MRI of the spinal bone marrow and to find the differential points between the two groups. Fourteen patients with MDS (n=7) and AA (n=7) were studied using magnetic resonance imaging. Sagittal images from the lower thoracic and lumbar vertebral marrow were evaluated on T1-weighted and STIR images. Five distinct patterns of signal intensity of the T1-weighted and STIR images were classified. T1 and T2 relaxation times and T1 marrow/fat signal intensity ratio were measured and analyzed (t-test). The cellularity of bone marrow was evaluated on histologic slides. MDS showed homogeneously low signal intensity on T1WI and high signal intensity on STIR image, indicating hypercellular marrow, whereas AA showed relative high signal intensity on T1WI and low signal intensity on STIR image, representing fatty marrow. T1 and T2 relaxation time (T1 for MDS=750.26 msec {+-} 177.50, T1 for AA=413.21 msec {+-} 167.39 ({rho} < 0.000), T2 for MDS=91.86 msec {+-} 14.16, T2 for AA=81.44 msec {+-} 15.31 ({rho} < 0.001) and T1 marrow/fat signal intensity ratio (0.22 {+-} 0.048 in MDS, 0.30 {+-} 0.083 in AA ({rho} < 0.000) revealed statistically significant difference between the two groups. Although the marrow aspiration and needle biopsy are mandatory in hematologic disease for diagnosis, there are limited in assessing the change of total marrow mass. Therefore MRI of bone marrow might be useful in distinguishing MDS from AA because of its ability of representation of total marrow mass.

  8. Equilibrium disorders in elderly: diagnostic classification and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Alessandro Castiglione

    2013-04-01

    Full Text Available Background: Balance is primarily related to the proper functioning of three sensory input: vestibular, visual and proprioceptive. The integration of these different afferences contributes to the proper attitude of the body in static and dynamic conditions. Equilibrium disorders are common among elderly patients and are responsible for falls and fractures, leading sometimes to catastrophic outcomes, representing a serious health and social problem. Approximately one third of elderly patients at home and about 50% of institutionalized, over 75 year-old, suffer from this particular condition, with at least one fall a year and almost 50% of these with recurrent episodes. Females are more affected than males. Attempts to ascertain the underlying cause of unbalance should be done, leading then to specific treatment. Nevertheless, many elderly patients do not have a single disease but rather a multitude of medical conditions which may cause dizziness, imbalance and vertigo: effects of ageing, drugs, cardiovascular and neurological disorders, ocular and orthopaedic diseases. Aim of the study: A literature review was carried out with the intention to offer practical and useful notions for the management and treatment of equilibrium disorders. Discussion: In clinical practice, the main challenge is to distinguish between peripheral and central imbalance disorders. The data collected from history and clinical exams should be integrated with the intent to include the patient in one of the following clinical conditions: vertiginous syndrome, pre-syncope and/or syncope, neurological diseases, other conditions.Conclusions: Following the differential diagnosis, treatment mainly consists in drug administration (antiemetic and vestibular suppressor drugs and vestibular rehabilitation (physiotherapy and vestibular exercises.

  9. [Differential diagnosis of pulmonary tuberculosis and community-acquired pneumonia].

    Science.gov (United States)

    Deĭkina, O N; Mishin, V Iu; Demikhova, O V

    2007-01-01

    The purpose of this investigation was to enhance the efficiency of differential diagnosis of pneumonia and pulmonary tuberculosis. A hundred and fifty-nine adult patients were examined. These included 78 patients with pulmonary tuberculosis and 81 with community-acquired p neumonia. The clinical features of infiltrative pulmonary tuberculosis (n = 48) and mild community-acquired pneumonia (n = 51) were compared. The course of caseous pneumonia (n = 30) was compared with that of moderate and severe community-acquired pneumonia (n = 30). Significant differences in the manifestations of the intoxication and bronchopulmonary syndrome were not found in patients with community-acquired pneumonia and infiltrative pulmonary tuberculosis. Physical studies showed that in patients with community-acquired pneumonia, moist rale (54.9%) and crepitation (11.8%) were prevalent, but in those with infiltrative tuberculosis rale was absent in 60.4% of cases and the pattern of respiration was unchanged in 79.2%. Chest X-ray studies indicated that in patients with community-acquired pneumonia, lower lobar inflammatory changes were predominant in 62.8% of cases whereas in those with infiltrative pulmonary tuberculosis the process was mainly bilateral (43.8%) with the presence of destructive changes (83.3%) and bronchogenic dissemination (66.7%). In patients with caseous pneumonia, the intoxication syndrome was more significant than in those with severe community-acquired pneumonia. Chest X-ray studies demonstrated that in patients with caseous pneumonia, specific changes were bilateral with the involvement of 2 lobes or more, with destruction and bronchogenic dissemination while in those with community-acquired pneumonia, the pulmonary processes were predominantly bilateral (76.6%) at the lower lobar site (36.7%). PMID:17338353

  10. Second Malignancy in Pediatric Patients: Imaging Findings and Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    N. Tayari

    2010-05-01

    Full Text Available Therapeutic advances in the treatment of pediatric neoplasms have improved the prognosis but have also increased the risk of developing rare second malignancies."nPrimary neoplasms which are often associated with second malignancies include lymphoma, retinoblas-toma, medulloblastoma and leukemia. The most common second malignancies are central nervous system (CNS tumors, sarcomas, thyroid and parathyroid gland carcinoma and leukemia, particularly acute myeloblastic leukemia. Genetic predisposition, chemotherapy, and especially radiation therapy are included as pathogenic factors in second malignancies. We know all survivors of childhood cancer should have lifelong follow-up, preferably with US, magnetic resonance imaging and other procedures with no ionizing radiation. A new progressive lesion may represent recurrence of the primitive neoplastic process, late radiation injury, or more infrequently, a second malignancy. Differential diagnosis may be very difficult and the outcome is often fatal. "nTreatment protocols should be modified to reduce the risk of second malignancies without compromising the effectiveness of initial therapy. "nClinicians should individualize treatment for patients who are genetically predisposed. In addition, radiologists should be familiar with the long-term consequences of antineoplastic therapy."nIn a report of new England journal of medicine in 2007, 357:227-2284 by Dr. Brenner and Hall, 2% of all carcinomas in U.S.A are due to more use of CT exam and children are three to four times more sensitive to ionization radiation. "nSo all the radiologists and clinicians should be aware of the complications and should recommend follow up exams in children who have had previous treatments for such carcinomas.

  11. CT manifestation of the carcinoma of ovary: diagnosis and differential diagnosis

    International Nuclear Information System (INIS)

    Objective: To study the CT manifestations of carcinoma of ovary and the CT findings that mimic the carcinoma of ovary. Methods: CT findings were retrospectively studied in 47 cases of pelvic masses including 42 cases of carcinoma of ovary and 5 misdiagnosed as carcinoma of ovary. Misdiagnosis was made in 8 of the 42 cases of carcinoma of ovary. Non-contrast and enhanced CT scan were performed in all cases. Results: Pelvic or abdominal-pelvic masses were demonstrated in 92.4% cases. The lesions were parenchymatous, cystic, or cystic-parenchymatous masses, in which the parenchyma and septum were remarkably enhanced after the contrast agent was given intravenously. No mass was found in 7.6% cases, in which the ascites and thickening of the omentum were noted on CT images. Ascites was shown in 57.2% cases. Calicification was manifested in 19.0% cases. Abscess or tuberculosis located in pelvis could have the similar CT findings with cystic carcinoma of ovary, while these infectious lesions presented with regular or smooth wall and septum, instead of mural nodule. Another characteristic sign of abscess or tuberculosis was air density identified within the cavity of the cysts. Chocolate cysts with recent hemorrhage or subserous leiomyoma uteri with cystic degeneration were cystic-parenchymatous mass during the non-contrast enhanced scan. No enhancement could be revealed in parenchyma of the former and slight enhancement could be identified in the parenchymatous component of the latter. Conclusion: Contrast enhanced CT scan can demonstrate the structure of the mass and the adjacent organs, and reveal the enhancement of the lesions, which plays a valuable role in diagnosis or differential diagnosis of carcinoma of ovary with atypical CT findings. (authors)

  12. ON DIFFERENTIAL DIAGNOSIS BETWEEN AUTISTIC DISORDER AND ASPERGER’S SYNDROME

    Directory of Open Access Journals (Sweden)

    Stefan Todorov

    2012-11-01

    Full Text Available The differential diagnosis between Autistic disorder (AD and Asperger’s syndrome (AS in most cases is quite difficult since most of the symptoms are clinically undistinguished. Several factors complicate the diagnosis of AS- an autism spectrum disorder (ASD. It is considered by some authors to be simply a milder version of autistic disorder. Problems in diagnosis include disagreement among diagnostic criteria, controversy over the distinction between AS and other ASD forms or even whether AS exists as a separate syndrome, and over- and under-diagnosis. Our paper is based on the diagnostic and differential diagnostic criteria of DSM-IV, ICD-10 and our clinical experience.In the process of diagnosis and differential diagnosis we, naturally, illustrate and discuss the similarities and differences between the two disorders.

  13. The ultrasonographic features of endometriomas: morphologic analysis and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sung; Park, Chan Sup; Song, Soon Young; Lee, Eun Ja; Park, No Hyuck [College of Medicine, Kwandong Univ., Koyang (Korea, Republic of); Park, Cheol Min [College of Medicine, Korea Univ., Seoul (Korea, Republic of); Kim, Bo Hyun; Kim, Chan Kyo [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)

    2003-12-01

    To analyze the sonographic, morphologic, and internal echo patterns of endometriomas, and thus determine which ultrasonographic (US) findings assist diagnosis. One hundred and forty-seven eases of pathologically proven adnexal masses in 130 women were divided into three groups: group I, in which endometriomas were diagnosed at both preoperative US and surgery (true positive) (n=97); group II, in which endometriomas were misdiagnosed at preoperative US, and were confirmed after surgery to be other pathologic entities (false positive) (n=10); group III, in which other adnexal masses were misdiagnosed at preoperative US, but were proven after surgery to be endometriomas (false negative) (n=40). The US findings in these cases were retrospectively reviewed in terms of (a) morphologic type: unilocular, multiseptated, multilobulated, solid and cystic, or mixed; (b) internal echo pattern: homogeneous fine, anechoic, fine septation, or complex; (c) size; (d) wall thickness; (e) the presence or absence of septation; (f) wall nodularity; (g) echogenic wall foci; and (h) a solid area. In group I, the most common morphological type was unilocular cyst (n=63; 65%). In lesions most commonly emitted homogeneous fine echoes (n=76; 78%). In this group, most masses (86%) were less than 10 cm in diameter and the wall thickness in 65% of cases was less than 3 mm. Additionally, internal septation, wall nodularity, focal echogenic wall foci, and a solid area were observed at US. Group II, cases were pathologically confirmed as mucinous cystadenoma (n=3), mucinous cystadenoma with borderline malignancy, hemorrhagic cyst, functional cyst, endometrioid carcinoma, and hematoma. In group III, cases were misdiagnosed as cystadenoma (n=15), hemorrhagic cyst, teratoma, ovarian cancer, functional cyst and ectopic pregnancy at preoperative US. There were no significant differences in size or wall thickness between groups II and III, and group I. At US, groups II and III also showed internal

  14. Mucocele appendix: A rare differential diagnosis of pelvic mass

    Directory of Open Access Journals (Sweden)

    Vishal Yadav

    2013-01-01

    Full Text Available Mucocele of the appendix is a descriptive term that implies a dilated appendiceal lumen caused by abnormal accumulation of mucus. Mucocele is found in 0.2-0.3% of all appendectomy specimens. The male to female ratio is 1:4 and the average age at the time of diagnosis is over 50 years. Ultrasonography and computed tomography are useful tools for the diagnosis of appendiceal mucocele. Pre-operative diagnosis is a major component for minimizing intra operative and post-operative complications. We herein report a case of 40-year-old female presented as pelvic mass and this pose a diagnostic challenge

  15. Differential diagnosis of neurodegenerative diseases using structural MRI data

    Directory of Open Access Journals (Sweden)

    Juha Koikkalainen

    2016-01-01

    The results prove that automatic quantification methods and computerized decision support methods are feasible for clinical practice and provide comprehensive information that may help clinicians in the diagnosis making.

  16. Pulmonary tuberculosis as differential diagnosis of lung cancer

    OpenAIRE

    MLB Bhatt; Surya Kant; Ravi Bhaskar

    2012-01-01

    Patients with lung cancer are often misdiagnosed as pulmonary tuberculosis leading to delay in the correct diagnosis as well as exposure to inappropriate medication. Several factors are responsible for this situation in developing countries, including lack of awareness, inadequate infrastructure and socio-economic factors. This article outlines the differences between the two diseases as well as features that would make a clinician suspect the right diagnosis early.

  17. Rabies encephalomyelitis vs. ADEM: Usefulness of MR imaging in differential diagnosis

    Directory of Open Access Journals (Sweden)

    Asokan Santhoshkumar

    2012-01-01

    Full Text Available We report a case of rabies encephalomyelitis in a 12-year-old boy who had received anti-rabies vaccine 6 weeks after being bitten by a puppy. The MR (magnetic resonance imaging helped to differentiate rabies from acute disseminated encephalomyelitis (ADEM. ADEM involves the white matter predominantly, whereas rabies has a predilection for grey matter, that too of midline regions. This report emphasizes the usefulness of MRI in differentiating rabies and ADEM when encephalomyelitis occurs in a vaccinated child.

  18. Diagnostic Value of Urine Microscopy for Differential Diagnosis of Acute Kidney Injury in Hospitalized Patients

    OpenAIRE

    Perazella, Mark A.; Coca, Steven G.; Kanbay, Mehmet; Brewster, Ursula C.; Parikh, Chirag R.

    2008-01-01

    Background and objectives: Urine microscopy is the oldest and one of the most commonly used tests for differential diagnosis of acute kidney injury (AKI), but its performance has not been adequately studied in the setting of AKI.

  19. Metastatic changes to the colon - a differential diagnosis to Crohn's disease

    International Nuclear Information System (INIS)

    Metastatic seeding of malignomas in the peritoneum infiltrating the colon may cause changes which may suggest regional enteritis in terms of differential diagnosis, too. Such findings must be clarified histologically. (orig.)

  20. DIFFERENTIAL DIAGNOSIS OF ROSACEA AND SKIN TUBERCULOSIS AS AN EXAMPLE OF A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    M. L. Aripova

    2014-01-01

    Full Text Available In this paper for a clinical observation of a patient with rosacea, and patients with a flat form of lupus tuberculosis presented a differential clinical diagnosis of tuberculosis of the skin.

  1. The clinical assessment of intraductal ultrasonography in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To assess and compare the clinical value of intraductal ultrasonography (IDUS) in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis with conventional imaging methods. Methods: IDUS was carried out in eighteen patients with pancreatic carcinoma and chronic pancreatitis

  2. Boys with Asperger Syndrome Grow Up: Psychiatric and Neurodevelopmental Disorders 20 Years after Initial Diagnosis

    Science.gov (United States)

    Gillberg, I. Carina; Helles, Adam; Billstedt, Eva; Gillberg, Christopher

    2016-01-01

    We examined comorbid psychiatric and neurodevelopmental disorders in fifty adult males (mean age 30 years) with Asperger syndrome (AS) diagnosed in childhood and followed up prospectively for almost two decades (13-26 years). Only three of the 50 men had "never" met criteria for an additional psychiatric/neurodevelopmental diagnosis and…

  3. Contrast-Enhanced Ultrasonography in Differential Diagnosis of Benign and Malignant Ovarian Tumors

    OpenAIRE

    Qiao, Jing-Jing; Yu, Jing; Yu, Zhe; Li, Na; Song, Chen; Li, Man

    2015-01-01

    Objective To evaluate the accuracy of contrast-enhanced ultrasonography (CEUS) in differential diagnosis of benign and malignant ovarian tumors. Methods The scientific literature databases PubMed, Cochrane Library and CNKI were comprehensively searched for studies relevant to the use of CEUS technique for differential diagnosis of benign and malignant ovarian cancer. Pooled summary statistics for specificity (Spe), sensitivity (Sen), positive and negative likelihood ratios (LR+/LR−), and diag...

  4. [Desmoplastic fibroma. Differential diagnosis of a periapical lesion from endodontic failure].

    Science.gov (United States)

    Zabalegui, B; Gil, J; Zabalegui, I

    1989-01-01

    Treatment of endodontically involved teeth requires accurate diagnosis of the clinical pulpal condition to determine the primary cause of pathosis. The case presented shows the differential diagnosis between a desmoplastic fibroma and a failure of a misdiagnosed endodontic treatment. The initial direction of treatment should had never been the endodontic therapy but local surgical curettage of the lesion. PMID:2638020

  5. Staphylococcal Scalded Skin Syndrome: Criteria for Differential Diagnosis from Lyell's Syndrome. Two Cases in Adult Patients

    OpenAIRE

    Napoli, B.; D'Arpa, N.; D'Amelio, L.; S. Chimenti; Pileri, D.; Accardo-Palumbo, A.; F. Conte

    2006-01-01

    A review of the relative international literature of the last few years is followed by a description of two cases of staphylococcal scalded skin syndrome in adults. As in both cases the initial diagnosis was that of Lyell's syndrome, the main criteria for the differential diagnosis of the two pathologies are considered in order to permit specific and effective treatment.

  6. The differential diagnosis of primary multiple lesions seen on brain CT

    International Nuclear Information System (INIS)

    The diagnosis of primary multiple lesions in the brain presents considerable difficulties. In the absence of a primary tumour or generalised systemic disease, the differential diagnosis includes cerebral involvment by lymphoma, histiocytosis X, granulomatoses and the very rare occurrence of cerebral metastases from a cerebral tumour. The findings in a three year observation period, and the results of treatment, are discussed. (orig.)

  7. ON DIFFERENTIAL DIAGNOSIS BETWEEN AUTISTIC DISORDER AND ASPERGER’S SYNDROME

    OpenAIRE

    Stefan Todorov; Mariana Arnaoudova

    2012-01-01

    The differential diagnosis between Autistic disorder (AD) and Asperger’s syndrome (AS) in most cases is quite difficult since most of the symptoms are clinically undistinguished. Several factors complicate the diagnosis of AS- an autism spectrum disorder (ASD). It is considered by some authors to be simply a milder version of autistic disorder. Problems in diagnosis include disagreement among diagnostic criteria, controversy over the distinction between AS and other ASD forms or even whether ...

  8. Asthma in elite athletes: pathogenesis, diagnosis, differential diagnoses, and treatment

    DEFF Research Database (Denmark)

    Pedersen, Lars; Elers, Jimmi; Backer, Vibeke

    2011-01-01

    Elite athletes have a high prevalence of asthma and exercise-induced bronchoconstriction. Although respiratory symptoms can be suggestive of asthma, the diagnosis of asthma in elite athletes cannot be based solely on the presence or absence of symptoms; diagnosis should be based on objective...... measurements, such as the eucapnic voluntary hyperpnea test or exercise test. When considering that not all respiratory symptoms are due to asthma, other diagnoses should be considered. Certain regulations apply to elite athletes who require asthma medication for asthma. Knowledge of these regulations is...... essential when treating elite athletes. This article is aimed at physicians who diagnose and treat athletes with respiratory symptoms. It focuses on the pathogenesis of asthma and exercise-induced bronchoconstriction in elite athletes and how the diagnosis can be made. Furthermore, treatment of elite...

  9. Differential diagnosis of seizure disorders: a conversation analytic approach.

    Science.gov (United States)

    Schwabe, Meike; Howell, Stephen J; Reuber, Markus

    2007-08-01

    "Taking the history" remains the most important diagnostic tool in the assessment of people who have lost consciousness. The distinction of epileptic and non-epileptic seizures (NES) is particularly difficult and relevant. Whereas epileptic seizures can usually be controlled with antiepileptic drugs, NES are considered an expression of psychosocial distress and may improve with psychotherapy. The recording of typical seizures with simultaneous video and electroencephalography (EEG) can produce almost complete certainty about the diagnosis but access to video-EEG is limited, the test is very expensive and often video-EEG fails to capture typical seizures. A German research group used conversation analysis (CA) to examine patients' descriptions of seizures to their doctors. They found that certain linguistic and interactional features clustered together and that these clusters were usually concordant with particular medical diagnoses. This study was undertaken to establish whether the observations made in German-speaking patients could be replicated in English speakers presenting to a less specialised epilepsy service. The findings presented here are based on transcripts of interviews with 11 patients admitted to a neurology ward in England because their consultant felt unable to make a clear diagnosis clinically. Transcripts were only analysed if the diagnosis of epilepsy or NES had been proven with video-EEG. The medical diagnosis was only disclosed to the linguist once a linguistic hypothesis of the diagnosis had been formulated to ensure that the linguist's decision would not be influenced by factors not contained in the 30-min-interview between doctor and patient. The linguist predicted the correct diagnosis in all cases. PMID:17482737

  10. Differential diagnosis of acute abdominal pain – acute intermittent porphyria

    Directory of Open Access Journals (Sweden)

    Mislav Klobučić

    2011-08-01

    Full Text Available Acute intermittent porphyria (AIP is a rare autosomal dominant disorder of heme biosynthesis in liver due to deficiency of porphobilinogen deaminase enzyme. Clinically, AIP is dominatedby a colicky type pain, which does not subside after taking usual analgesics. Additional frequent symptoms are vomiting, hypertension, peripheral neuropathy, seizures, depression, delirium and coma. This paper reported a case of a twenty-fi- ve-year-old female patient, who had undergone a period of six days between the first presentationto the medical department and the diagnosis confirmation. It has accentuated possible mistakes in symptomatic therapy administration as well as dangers of a delayed diagnosis.

  11. Clinicoradiologic Differential Diagnosis of Odontogenic Keratocyst and Ameloblastoma

    International Nuclear Information System (INIS)

    To clarify the clinical and radiologic parameters that can be used to differentiate odontogenic keratocyst and ameloblastoma. The records of 46 patients of ameloblstoma and 48 patients of odontogenic keratocyst at the Yonsei University Dental Hospital during the period of 1979 to 1995 were retrospectively reviewed. As a possible means for differentiating between the odontogenic keratocyst and ameloblastoma, the clinical parameters and the radiologic parameters were evaluated. In the clinical parameters, there was no significant deference in age, sex, and sign and symptoms (p>0.05).In the radiologic parameters, there was significant difference in site, shape of the lesion, and external root resorption of adjacent teeth (p<0.05). The site, shape of the lesion, and external root resorption of adjacent teeth can be the parameters to differentiate odontogenic keratocyst and ameloblastoma, but a definite differentiation of these two lesions needs a more specialized imaging modality.

  12. Imaging and differential diagnosis of pediatric spinal tuberculosis

    Directory of Open Access Journals (Sweden)

    Xiao-ying Xing

    2015-03-01

    Conclusion: Pediatric spinal tuberculosis often occurs in the cervical and thoracic vertebrae with typical imaging findings. The cases with atypical manifestations should be differentiated from other diseases such as Langerhans cell histiocytosis and metastatic neoplasm.

  13. DIFFERENTIAL DIAGNOSIS OF PRIMARY AND METASTATIC OVARIAN TUMORS IN PATIENTS WITH COLONIC CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Komarov

    2013-01-01

    Full Text Available This report summarizes existing data on differential diagnosis between primary and metastatic ovarian cancer in patients with colorectal cancer (CRC. The results obtained in N.N. Blokhin Russian Cancer Research Center on the management of this malignancy are also presented. The evidence in favour of the need of genetic counseling and monitoring of the patients with aggravated familial history for early diagnosis of synchronous and metachronous ovarian cancer in patients with CRC is produced. A number of clinical, laboratory and diagnostic methods in addition to immunohistology and molecular genetics should be used for differential diagnosis of primary and metastatic ovarian cancer in patients with CRC.

  14. High-resolution CT in the differential diagnosis of consolidative lung processes. Pt. 2. Chronic processes

    International Nuclear Information System (INIS)

    Consolidations are characterized on CT by the presence of one or more air-space opacities with little or no volume loss. Because HRCT findings overlap among various entities, it may be sometimes to be impossible to make a definite diagnosis with imaging criteria alone. If the symptoms are chronic (weeks to months) the differential diagnosis may include alveolar proteinosis, bronchioloalveolar carcinoma, lymphoma as well as inflammatory diseases. This review describes the most common types of lung diseases associated with chronic appearance of consolidation and discuss the differential diagnosis. (orig.)

  15. Morphological differential diagnosis of the main types of inflammatory myopathies

    Directory of Open Access Journals (Sweden)

    S. G. Radenska-Lopovok

    2015-02-01

    Full Text Available The review provides an update on the diagnosis of the main subtypes of inflammatory myopathies. Proper choice of biopsied muscle and histological methods of investigation are presented. Histochemical and immunohistochemical characteristic of tissue markers in inflammatory myopathies are given. Some dilemmas, as well as the most common errors of histological diagnostics are discussed.

  16. Contribution to differential diagnosis of lumbar spine disc hernia by computerized tomography

    International Nuclear Information System (INIS)

    The significance is discussed of computerized tomography in differential diagnosis of disc hernias of the lumbar spine. A simple technique is described that allows to differentiate disc hernias from epidural vein varices. It mostly includes repeat imaging of the same body section and/or the application of a contrast medium. (L.O.). 2 figs., 4 refs

  17. Diagnosis and Treatment of Odontogenic Cutaneous Sinus Tracts in an 11-Year-Old Boy: A Case Report.

    Science.gov (United States)

    Chen, Ke; Liang, Yun; Xiong, Huacui

    2016-05-01

    Odontogenic cutaneous sinus tracts (OCSTs) are generally primarily misdiagnosed and inappropriately treated by virtue of their rarity and the absence of dental symptoms. Accurate diagnosis and treatment and the elimination of the source of infection can reduce the incidence of complications and relieve the pain of the patient.In this case report, we present the case of an 11-year-old patient with an apparent abscess but an unobvious draining sinus tract in his left cheek. Intraorally, a glass-ionomer-cement filling on the occlusal surface of the left mandibular first molar (tooth 36) was noted. Radiographic examination revealed a radiopaque mass inside the crown and pulp chamber and an irregular, radiolucent periapical lesion surrounding the distal root apex. He was diagnosed with an OCTS secondary to a periapical abscess of tooth 36. Precise root canal therapy (RCT) and chronic granuloma debridement was performed; 6 months later, the abscess and sinus had healed completely, and the periapical lesion had resolved.Odontogenic cutaneous sinus tracts are uncommon in the clinic. This case report reminds us of the significance of OCSTs and provides some implications for their diagnosis and treatment. PMID:27196471

  18. Hypertrophic pachymeningitis: Current criteria for diagnosis and differentiation (Clinical case and review of literature

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2015-06-01

    Full Text Available The paper describes a 44-year-old male patient with an about 6-year history of hypertrophic pachymeningitis. The major clinical symptoms were characterized by headache, exophthalmos, and blindness in one eye. The data for differential diagnosis of the disease are given. The current literature on the clinical manifestations of hypertrophic pachymeningitis, its differential diagnosis, and the results of magnetic resonance imaging (MRI is reviewed. Diagnostic difficulties at the stage of a clinical observation are due to the nonspecificity of neurological manifestations and the need for a comprehensive examination to detect a somatic disease. MRI can diagnose the disease-specific phenomenon of damage to the meninges, which calls for further careful differentiation. Clinicians must be familiar with alternative differential diagnosis, as a rapid specific therapeutic approach will help avoid long-term or irreversible neurological complications.

  19. Tuberculosis of the calcaneus. Treatment and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Richter, R.; Koehler, G.; Michels, P.

    1981-11-01

    Eight lesions in the calcaneus have been treated surgically between 1955 and 1979; of these, six were due to tuberculosis, one to chronic osteomyelitis and the other was a cyst. The diagnosis was confirmed bacteriologically and histologically. In all cases (average age 49.1 years) the human bacillus was proved to be the cause of an haematogenous infection. The lesion was confined to the posterior part of the bone and there was no extension into the calcaneo-navicular joint. One focus extended into the ankle joint. Two patients presented with fistulae. The interval from the onset of symptoms to confirmation of the diagnosis averaged 9.1 months. Three patients had previously been treated for tuberculosis (lung, pleura, kidney) and another patient, who had a simultaneous tuberculous infection of a sternoclavicular joint had suffered from tuberculous cervical lymphadenitis at the age of nine years.

  20. [Kala azar. Rare import and significant differential diagnosis].

    Science.gov (United States)

    Sudeck, H

    2006-08-01

    After traveling into regions endemic for leishmaniasis all patients presenting with generalized febrile symptoms, pancytopenia, hepatosplenomegaly and symptoms as well as laboratory parameters also seen in autoimmune diseases should be screened for leishmaniasis even after a longer time period. Doctors should bear in mind that especially immunosuppressed patients can present with atypical and abortive symptoms and that in this group of patients immune diagnosis is unreliable. A diagnosis of a lymphoma related only to the spleen should not be made and splenectomy must not be carried out before reliable exclusion of kala azar, using modern diagnostic tools like PCR. Patients should be referred to specialized centers e.g. institutes for tropical medicine and therapy must follow actual guidelines, such as the German guidelines published by the AWMF. PMID:16819655

  1. Diabetic mastopathy - an unusual differential diagnosis: a case report

    International Nuclear Information System (INIS)

    Diabetic mastopathy affects premenopausal women with longstanding type 1 diabetes mellitus. The diagnosis is based on clinical findings (uni or bilateral hardened, palpable mass) associated with radiological (increase in breast density), sonographic (marked posterior acoustic shadowing), and histopathological (fibrosis and perivascular and periductal lymphocytic infiltration) findings. This disease may clinically simulate a breast carcinoma. The case of a patient with diabetic mastopathy is reported. (author)

  2. Idiopathic pulmonary hemorrhage: morphology and differential diagnosis. Case report

    OpenAIRE

    Eduardo Cambruzzi; Karla Lais Pêgas; Túlio Vedana

    2013-01-01

    Idiopathic pulmonary hemorrhage (IPH) is a rare cause of alveolar hemorrhage (AH) with unknown etiology that primarily affects children. The process has a variable clinical progression, and its diagnosis is established after excluding all causes of AH. Herein, the authors report a case of IPH in an adult male patient referring cough and hemoptysis. The conventional radiography computed tomography imaging identified zones of consolidation and areas of ground-glass attenuation in the lower lobe...

  3. Loin to groin pain: The importance of a differential diagnosis

    Directory of Open Access Journals (Sweden)

    Alexander E.P. Smith

    2015-01-01

    Conclusion: Assessment of patients with loin pain requires a systematic approach. PVCS is a rare cause of lumbar back and loin pain but one that should be considered, particularly in active young males. Early diagnosis is key to prevent the potential sequalae of untreated rhabdomyolysis. There is currently no consensus on management option for PVCS with only a few cases being reported in the literature. We describe successful management with supportive non operative treatment.

  4. Differential diagnosis of the signal-compromised lunate in MRI

    International Nuclear Information System (INIS)

    Purpose: To define both the underlying pathology and diagnostic criteria in lunates presenting with conspicuous signal pattern in MRI. Materials and Methods: The retrospective evaluation of 2940 MRI examinations revealed 203 patients with signal alterations of the lunate. All MRI examinations were performed on 1.5-Tesla platforms using dedicated surface coils and an intravenous contrast agent. To establish a definitive diagnosis, a total of 252 MRI examinations (49 follow-ups), 22 CT examinations and 4 arthroscopic studies were obtained in addition to the obligatory conventional radiographs. Results: Incorporating all clinical data, radiographs and MRI examinations succeeded in assigning a diagnosis in 136 signal-compromised lunates (67.0%), whereas additional diagnostic procedures or follow-up examinations were required for the definitive diagnosis in 57 cases (33.0%). The most frequent entities were 51 cases of Kienboeck's disease (25.1%), 47 cases of ulnolunate-(triquetral) impaction syndromes (23.2%) and 44 cases of intra-osseous ganglion cysts (21.7%). Other pathologies included 23 degenerative, 19 traumatic and 10 inflammatory changes as well as 9 congenital conditions. For MRI assessment of the altered lunate, the most important parameters were location and morphology as well as involvement of the articular and osseous structures of the carpus. Conclusion: The lunate may be affected by different pathological states of the wrist. In total, only one quarter of the signal-compromised lunate represented Kienboeck's disease. (orig.)

  5. Somatostatinoma syndrome: a challenging differential diagnosis among pancreatic tumors

    Directory of Open Access Journals (Sweden)

    Paula Martinez Vianna

    2013-03-01

    Full Text Available Among the neuroendocrine neoplasia, the pancreatic somatostatin-producing tumors are very rare. Usually functional, these tumors produce the somatostatinoma syndrome, which encompasses diabetes mellitus, diarrhea/steatorrhoea, and cholelithiasis. Other symptoms may include dyspepsia, weight loss, anemia, and hypochlorhydria. All theses symptoms are explained by the inhibitory actions of the somatostatin released by tumoral cells originated from pancreatic delta cells or endocrine cells of the digestive tract. The diagnosis is easy to overlook since these symptoms are commonly observed in other more common syndromes. Besides the clinical features, diagnosis is based on serum determination of somatostatin, and imaging exams, such as ultrasound, computer tomography and positron emission tomography. Pathologic examination is characterized by the positivity of immunohistochemical reaction for synaptophysin, chromogranin, and somatostatin. These tumors can be classified according to tumor size, mitotic index, neural or vascular invasion, and distant metastases. The authors describe the case of a 61-year-old female patient who sought medical care because of a 6-month history of watery diarrhea, weight loss, and depression. She was diagnosed with diabetes mellitus 3 years ago. Imaging examination revealed a tumoral mass of 4 cm in its longest axis in the topography of the head of the pancreas and calculous cholecistopathy. The patient’s clinical status was unfavorable for a surgical approach. She died after 20 days of hospitalization. The definitive diagnosis was achieved with the autopsy findings, which disclosed a pancreatic somatostatinoma.

  6. Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas.

    Science.gov (United States)

    Ozkur, Ezgi; Falay, Tugba; Turgut Erdemir, Asli Vefa; Gurel, Mehmet Salih; Leblebici, Cem

    2016-01-01

    Most authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva. PMID:27136629

  7. Computerized tomography in the differential diagnosis of extremity edema

    International Nuclear Information System (INIS)

    Computerized tomography provides valuable information for differentiating some cases of extremity edemas of acute and chronic venostatic origin and lymphedema - primary and secondary, in malignant processes. Graphic representation of individual kinds of changes and observed densities in 33 patients are presented. (author). 9 figs., 1 tab., 6 refs

  8. Scintigraphic differential diagnosis in painful hip endoprothesis with labelled leukocytes

    International Nuclear Information System (INIS)

    In patients with painful prosthetic joints of the hip scintigraphy with white blood cells is a useful method to differentiate between loosening and infection. Examinations of 34 patients after labelling of autologous leukocytes with 111In-oxinate or with 99mTc-DPO gave good results, involving decisive advantages (availability, acquisition time, costs) of 99mTc-DPO. (author)

  9. Application of 18F-FDG PET for the diagnosis and differential diagnosis of Alzheimer's disease and Lewy body dementia

    International Nuclear Information System (INIS)

    Alzheimer's disease and Lewy body dementia are the two most frequent disorders among degenerative dementias. Their clinical identification and differential diagnosis are often difficult in the early stages when, on the other hand treatment is most effective. FDG-PET assessment of region brain metabolism is a proven method and its application demented patients ensures a higher diagnostic accuracy even at the preclinical stage. It helps resolving cases with difficult differential diagnosis as well. In this paper we discuss the application of the method in Alzheimer's disease and Lev body dementia; we present typical cases of both disorder which were assessed by FDG-PET for the first time in Bulgaria highlighting the methodology and the characteristic imaging findings

  10. Patient exposure in the basic science classroom enhances differential diagnosis formation and clinical decision-making

    Directory of Open Access Journals (Sweden)

    Justin G. Peacock

    2015-02-01

    Full Text Available Purpose. The authors proposed that introducing real patients into a pathology classroom early in medical education would help integrate fundamental principles and disease pathology with clinical presentation and medical history. Methods. Three patients with different pathologies described their history and presentation without revealing their diagnosis. Students were required to submit a differential diagnosis in writing, and then were able to ask questions to arrive at the correct diagnosis. Students were surveyed on the efficacy of patient-based learning. Results. Average student scores on the differential diagnosis assignments significantly improved 32% during the course. From the survey, 72% of students felt that patient encounters should be included in the pathology course next year. Seventy-four percent felt that the differential diagnosis assignments helped them develop clinical decision-making skills. Seventy-three percent felt that the experience helped them know what questions to ask patients. Eighty-six percent felt that they obtained a better understanding of patients’ social and emotional challenges. Discussion. Having students work through the process of differential diagnosis formulation when encountering a real patient and their clinical presentation improved clinical decision-making skills and integrated fundamental concepts with disease pathology during a basic science pathology course.

  11. Nasal obstruction of the newborn: a differential diagnosis

    Directory of Open Access Journals (Sweden)

    Silva, Daniela Brunelli e

    2009-09-01

    Full Text Available Introduction: The nasal obstruction is potentially severe when affecting newborns, preferential nasal breathers. The newborns with nasal obstruction may present from an asymptomatic affection up to a severe situation of airway obstruction, with cyclical cyanosis. The cyanosis worsens with feeding and improves with crying. Despite the most common cause of obstruction in the newborn is mucosa edema secondary to viral rhinitis or idiopathic rhinitis of the child, it is important to be attentive to the diagnosis of the nasal anatomic alterations. Although not much frequent, they represent affections in which the early diagnosis and management are basic to prevent airway obstruction and feeding difficulties with recurrent aspiration. Objective: The objective of this case report is to describe the three most common causes of anatomic nasal obstruction in newborns: the choanal atresia, dacryocystocele and anterior piriform opening stenosis. Final Comments: The clinical characteristics, diagnostic investigation and treatment of these three pathologies are presented. Therefore, we seek to alert as to the importance that the nasal probe passage be part of the physical exam of every newborn, specially when it has breathing disorder upon birth and/or cyanosis when breastfeeding.

  12. Renal Adenomas: Pathological Differential Diagnosis with Malignant Tumors

    Directory of Open Access Journals (Sweden)

    F. Algaba

    2008-10-01

    Full Text Available The renal adenomas can be confused by imaging diagnosis with malignant renal tumors, but there are also real biological dilemmas to determine their behavior. The consensus decisions are the following. (1 The adenoma of clear cells is not accepted, instead it is considered that all the clear-cell tumors are carcinomas, with greater or lesser aggressiveness. (2 Among the papillary neoplasms the WHO 2004 renal cell tumors classification are considered as papillary adenomas tumors with a maximum diameter of 5 mm and may represent a continuum biological process to papillary renal cell carcinoma. The papillary adenomas associated with End-kidney and/or acquired cystic disease may have a different pathogenesis. (3 To consider a tumor as an oncocytoma the size is not important, only the cytological features, microscopic, ultrastructural, and immunohistochemically can help, but some chromosomal observations introduce some questions about its relation with the chromophobe renal cell carcinoma. (4 Finally, the metanephric adenoma, a tumor with some morphological similarity with the nephroblastoma must be considered in the renal adenomas diagnosis.

  13. Septic Bursitis in an 8-Year-Old Boy

    OpenAIRE

    Panagiotis Kratimenos; Ioannis Koutroulis; Dante Marconi; Jennifer Ding; Christos Plakas; Margaret Fisher

    2014-01-01

    Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If unt...

  14. [Vocal cord dysfunction. An important differential diagnosis to bronchial asthma].

    Science.gov (United States)

    Kothe, C; Schade, G; Fleischer, S; Hess, M

    2004-03-01

    Vocal cord dysfunction (VCD) is described as a functional disorder of the vocal folds which leads to an intermittent, inspiratory 'paradoxical' glottal closure. We report on three women with frequent repetitive shortness of breath attacks caused by VCD. This was diagnosed by transnasal videofiberendoscopy, with glottal closure being seen during inspiration. Because of the different etiologies, one of the patients was treated with breathing and speech therapy, another received Omeprazol for laryngopharyngeal reflux, and the third was treated by intralaryngeal botulinum toxin injections. All three patients showed a reduction in attacks. Clinically, VCD seems to mimic asthma. However, with a thorough patient history and diagnostics, especially with transnasal laryngoscopy during a (triggered) attack, a precise diagnosis seems possible. PMID:15007522

  15. An unknown mass: the differential diagnosis of digit tumors.

    Science.gov (United States)

    Longhurst, William D; Khachemoune, Amor

    2015-11-01

    There is little discussion of tumors arising in the digits in the dermatology literature. The patient with an undifferentiated mass of the finger is frequently encountered in the clinic, and variances in presentation of common and uncommon entities pose a challenge that may prompt further investigation for proper diagnosis and treatment. In this review, the authors illustrate the approach and work-up of an unknown digit mass of a 45-year-old female patient. They go on to discuss the presentation and treatment of common tumor lesions of the finger likely to be encountered in the dermatologist's clinic including: ganglion cyst/mucous cyst, giant-cell tumor, verruca vulgaris, epidermal inclusion cyst, poroma, porocarcinoma, squamous cell carcinoma, basal cell carcinoma, melanoma, infantile digital fibromatosis, acquired digital fibrokeratoma, Koenen's tumor, schwannoma, cutaneous neurofibroma, pyogenic granuloma, hemangioma, glomus tumor, epithelioid sarcoma, and metastatic disease. PMID:26235189

  16. Spectrophotometric intracutaneous analysis for differential diagnosis of pigmented skin lesions

    Directory of Open Access Journals (Sweden)

    Е. V. Filonenko

    2013-01-01

    Full Text Available The non-invasive diagnosis of pigmented skin lesions by spectrophotometric intracutaneous analysis (SIA-scopy using device for dermatoscopy (SIAscope V by Astron Clinica, Ltd was approved in P.A.Herzen Moscow Cancer Research Institute. The method is based on analysis of light interaction with wavelength of 440–960 nm anf human skin, which is recorded by change of image on scan. The comparative analysis of SIA-scopy and histological data in 327 pigmented skin lesions in 147 patients showed, that SIA had high diagnostic efficiency for cutaneous melanoma: the sensitivity was 96%, specifity – 94%, diagnostic accuracy – 94%. For study of malignant potential of pigmented lesions by SIA-scopy the most informative capacity was obtained for assessment of melanin in papillary dermis, status of blood vessels and collagen fibres (SIA-scans 3, 4, 5.

  17. Preoperative differential diagnosis of adnexal lesions: Double contrast-MRI

    International Nuclear Information System (INIS)

    46 patients with benign (n=42) and malignant (n=4) cystic adnexal tumours underwent MRI of the pelvis. Transaxial and coronal images were acquired using conventional T1- and T2-weighted SE-sequences after oral administration of superparamagnetic iron oxide particles (Ferristene). Additional T1-weighted SE-images were obtained immediately following gadoliamide (Gd DTPA-BMA) injection. MRI correctly classified the four malignant lesions, whereas nine histologically benign lesions were misdiagnosed as malignant. Intravenous contrast yielded a superior delineation of intratumoural architecture. Due to exclusion of solid structures, MRI with oral and i.v. contrast enables to dismiss suspected malignity in cystic adnexal lesions. Because of the non-specificity of the macroscopic criteria of dignity, the MR diagnosis 'malignity' is of limited value. (orig./MG)

  18. [The Interesting Case No. 42. Differential diagnosis of epistaxis].

    Science.gov (United States)

    Koch, O; Jecker, P; Maurer, J

    2001-02-01

    Epistaxis is a symptom and one of the most frequent medical emergencies. In most cases haemorrhages concern the anterior parts of the septum, in particular the Locus Kiesselbachi. Thus they are harmless and therapy is easy to handle. We report a case of a 55-year-old lady with relapsing epistaxis due to a pseudoaneurysm after surgery of a meningioma of the sphenoid bone. This type of epistaxis is rare and may culminate into a life-threatening event. The case demonstrates the importance of an exact differential diagnostic evaluation by use of modern imaging techniques for severe and life-threatening symptomatic nose-bleeding. PMID:11253565

  19. A Case of Senile Chorea: Considering Huntington’s Disease and Neuroacanthocytosis in differential diagnosis

    Directory of Open Access Journals (Sweden)

    Ayşe Deniz Elmalı

    2015-09-01

    Full Text Available Sporadic chorea presenting after the age of 50 is called “senile chorea”. Senile chorea is a rare entity with a wide differential diagnosis list. Causes of senile chorea include vascular and metabolic diseases, adverse events related to medications, hematologic and immune system diseases, genetic and sporadic neurodegenerative syndromes, and paraneoplastic disorders. Although the most common etiologies are vascular and metabolic disorders, neuroacanthocytosis, Wilson and Huntington diseases are included in the differential diagnosis. Here, we discuss differential diagnosis and approach to late onset chorea based on a case with late onset chorea, whose clinical findings suggested chorea-acanthocytosis at first, but revealed to be Huntington disease after detailed laboratory studies.

  20. Sphenoid masses in children: radiologic differential diagnosis with pathologic correlation.

    Science.gov (United States)

    Lui, Y W; Dasari, S B; Young, R J

    2011-04-01

    Childhood central skull base masses are rare, often difficult to diagnose, and have overlapping imaging findings. In this review, we provide an overview of the epidemiology, clinical findings, and management of pediatric sphenoid bone and sphenoid sinus masses with an emphasis on imaging findings that may help to differentiate lesions. Radiologic-pathologic correlation is provided. Finally, an imaging-based algorithm is presented as a guide to help radiologists narrow their differential diagnoses. Some of the entities discussed are virtually unique to the pediatric population; others occur rarely in this age group but should be considered in the appropriate clinical setting. Entities included in the discussion are grouped into 2 categories: those that cause nonaggressive osseous remodeling and those that are more commonly associated with aggressive bone changes. Mucocele, aneurysmal bone cyst, giant cell lesions, meningioma, and fibrous dysplasia tend to remodel bone, while entities such as chordoma, craniopharyngioma, rhabdomyosarcoma, sinonasal carcinoma, and neuroblastoma may cause more aggressive local bone changes. PMID:20595365

  1. Differential diagnosis of vertebral lesions with paraspinal mass with MRI

    International Nuclear Information System (INIS)

    To assess the characteristic features of MR findings which would be useful for the differentiation of various spinal diseases involving paraspinal soft tissue mass. We retrospectively reviewed MR findings in 31 cases(M : F = 20 : 11) of spinal disease in which paraspinal mass was involved. The breakdown of cases was as follows : spinal tuberculosis, 12; spinal metastasis, 13; multiple myeloma, 3; pyogenic spondylitis, 2; spinal aspergillosis, 1. The pattern of bone marrow invasion in spinal metastasis, multiple myeloma, spinal tuberculosis and aspergillosis was mixed; focal, homogeneously diffuse and inhomogeneously patterns were seen. Pyogenic spondylitis showed inhomogeneously diffuse invasion; an intravertebral abscess was seen in the only five cases of spinal tuberculosis. Vertebral posterior compartment invasion was observed in seven cases of spinal tuberculosis, two of multiple myeloma, the one case of spinal aspergillosis and in all 13 cases of spinal metastasis. This and multiple myeloma showed no disc space invasion, in any case, but all cases of infectious spondylitis showed such invasion. Peripheral rim-enhancement in the paravertebral mass was seen in 11 cases of spinal tuberculosis, one case of pyogenic spondylitis and the case of aspergillosis. Bilobate anterior epidural mass was noted in 60% of spinal tuberculosis cases, 36% of spinal metastasis and one case of pyogenic spondylitis. MR findings of spinal disease involving a paraspinal soft tissue mass were useful for differentiation

  2. Lung ultrasound: a valid help in the differential diagnosis between pneumothorax and pulmonary blebs

    OpenAIRE

    Francesca Sandionigi; Francesca Cortellaro; Elisa Forni; Daniele Coen

    2013-01-01

    Spontaneous pneumothorax is a relatively common disease but its radiological diagnosis can be difficult because of the insufficient sensitivity of chest X-rays. This is even more so when bullous emphysema and acute pneumothorax co-exist. There is evidence that lung ultrasound is a valid instrument to detect a pneumothorax and a valid help in the differential diagnosis between pneumothorax and pulmonary blebs. We present a case which suggests the potential superiority of lung ultrasound on che...

  3. Improving the Differential Diagnosis of Chronic Obstructive Pulmonary Disease in Primary Care

    OpenAIRE

    Price, David B.; Yawn, Barbara P; Rupert C M Jones

    2010-01-01

    Chronic obstructive pulmonary disease (COPD) and asthma represent a substantial portion of primary care practice. In adults, differentiating asthma from COPD can be difficult but is important because of the marked differences in treatment, disease progression, and outcomes between the 2 conditions. Currently, clinical COPD is often misdiagnosed or undiagnosed until late in the disease. Earlier diagnosis could markedly reduce morbidity and improve quality of life. Establishing a diagnosis of C...

  4. Clinical application of neutrophil CD64 quantification for differential diagnosis of acute scrotum.

    Science.gov (United States)

    Hayashi, Hirofumi; Mochizuki, Taku; Sanjo, Hiroyuki; Komiya, Akiko; Matsui, Toshihiro; Tohma, Shigeto; Hirai, Kotaro

    2016-03-01

    The management of acute scrotum can be challenging, especially in infants or patients with a neurological or neurodevelopmental disorder in whom presentation, diagnosis and definitive management tends to be delayed. This leads to poor outcomes, such as loss of the affected testis. Here we present two cases of testicular torsion in patients with neurodevelopmental disorders, and a further two cases of epidydimo-orchitis in whom measurement of CD64 expression on neutrophils was helpful for differential diagnosis. These data suggest that the levels of expression of CD64 by neutrophils, known as a marker of infection, could also be useful for differentiating between testicular torsion and infection in acute scrotum. PMID:26690883

  5. X-ray computerized tomography in the differential diagnosis of gastric ulcerations

    International Nuclear Information System (INIS)

    The results of more than 3000 gastric examinations were used to study the potentialities of X-ray computerized tomography in the differential diagnosis of benign and malignant gastric ulceration. CT evidence for benign and malignant gastric ulcerations is outlined. The place and role of CT in the diagnostic algorithm for gastric ulcerations are defined. In the authors' opinion, CT is a supplementary study and should be used purposefully after preliminary X-ray, endoscopic, and morphological examinations in difficult clinical situations associated with the differential diagnosis of gastric ulcerations

  6. Infectious spondylitis and its differential diagnosis; Spondylitis und ihre Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Erlemann, Rainer [Helios St. Johannes Klinik, Duisburg (Germany). Inst. fuer Radiologie; Hoogeveen, Anja [AKH Viersen (Germany)

    2012-06-15

    Infectious spondylitis can be diagnosed early and reliably by MRI, given that the most important diagnostic criteria are present. These criteria are bone marrow edema adjacent to two contiguous vertebral end plates, disk space of high signal intensity and enhancement of bone adjacent to two contiguous vertebral end plates and of the disk space. If not all of these criteria are present, diagnostic accuracy decreases. Erosive osteochondritis, spondylarthritis, osteoporotic fractures of two contiguous vertebral end plates, active Schmorl's nodes as well as neuropathic spine may mimic an infectious spondylitis. This paper presents typical and atypical morphologic patterns of infectious spondylitis as well as the differentiation criteria from the above mentioned diseases. (orig.)

  7. Observational constraints and differential diagnosis for cosmic evolutionary models

    CERN Document Server

    Wang, Deng

    2016-01-01

    In this paper, we have proposed a plotting method based on the " natural plotting rule " (NPR) which can be used to distinguish different cosmological scenarios more efficiently and obtain more useful information. By using the NPR, we have avoided the blindness to use different diagnostics when discovering that some scenarios can be hardly differentiated from each other, and develop a logical line to adopt different diagnostics. As a concrete instance, we take this method based on the NPR to distinguish several Cardassian scenarios from the base cosmology scenario, and one from the other. We place constraints on three Cardassian cosmological scenarios and their flat versions by utilizing the Type Ia supernovae (SNe Ia), baryonic acoustic oscillations (BAO), cosmic microwave background (CMB) radiation, observational Hubble parameter (OHD) data-sets as well as the single data point from the newest event GW150914, and discover that our results are more stringent than previous results for constraining the cosmolo...

  8. Staging and differential diagnosis of renal cell carcinoma

    International Nuclear Information System (INIS)

    The usefulness of magnetic resonance imaging (MRI) was compared with that of computed tomography (CT). Twenty-nine patients with renal cell carcinoma, 3 with angiomyolipomas and 1 with renal pelvic cancer, were examined by both MRI and CT. MRI and CT showed similar results in staging cases of renal cell carcinoma. However, MRI may be more sensitive in detecting the venous extension, metastatic adenopathy, and adjacent organ invasion. In predicting the involvement of perinephric fat, however, MRI is only marginally superior to CT. To demonstrate the usefulness of MRI in differentiating renal cell carcinoma from other renal tumors, the density of renal tumor and that of the psoas muscle were determined using a densitiometer, and the percent (%) contrast (the intensity of the renal tumor / the intensity of the psoas muscle x100) was calculated. In most patients with clear cell type renal carcinoma, the % contrast value in the T1 weighted images was about 100. In the T2 weighted images, the maximum value of the % contrast value was 50 or less in most patients. In one patient with spindle cell type (sarcomatoid type) carcinoma, the % contrast value was 109 in the T1 weighted images, but was 65 - 85, at most, in the T2 weighted images. In patients with renal angiomyolipomas, the % contrast values were calculated exclusive of the fatty components. The % contrast value of the T1 weighted images was 50 or less in all 3 patients, and that of the T2 weighted images was 50 or more in 2 patients and 21 - 38 in the others. Calculation of the % contrast value may possibly enable one to differentiate between various types of renal cell carcinoma and other renal masses. (author)

  9. A precordial rub in a boy with a severe attack of ulcerative colitis.

    Science.gov (United States)

    Badina, Laura; Ferrara, Giovanna; Guastalla, Pierpaolo; Barbi, Egidio

    2014-04-01

    A case of a pneumomediastinum mimicking a pericarditis in a boy with an occult perforation due to ulcerative colitis is reported. Pneumomediastinum is a rare complication of severe attacks of ulcerative colitis, with or without the previous development of a toxic megacolon, that should be considered in the differential diagnosis. PMID:24694884

  10. Balloon Cell Urethral Melanoma: Differential Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    M. McComiskey

    2015-01-01

    Full Text Available Introduction. Primary malignant melanoma of the urethra is a rare tumour (0.2% of all melanomas that most commonly affects the meatus and distal urethra and is three times more common in women than men. Case. A 76-year-old lady presented with vaginal pain and discharge. On examination, a 4 cm mass was noted in the vagina and biopsy confirmed melanoma of a balloon type. Preoperative CT showed no distant metastases and an MRI scan of the pelvis demonstrated no associated lymphadenopathy. She underwent anterior exenterative surgery and vaginectomy also. Histology confirmed a urethral nodular malignant melanoma. Discussion. First-line treatment of melanoma is often surgical. Adjuvant treatment including chemotherapy, radiotherapy, or immunotherapy has also been reported. Even with aggressive management, malignant melanoma of the urogenital tract generally has a poor prognosis. Recurrence rates are high and the mean period between diagnosis and recurrence is 12.5 months. A 5-year survival rate of less than 20% has been reported in balloon cell melanomas along with nearly 20% developing local recurrence. Conclusion. To the best of our knowledge, this case is the first report of balloon cell melanoma arising in the urethra. The presentation and surgical management has been described and a literature review provided.

  11. Overactive bladder, differential diagnosis, and clinical utility of fesoterodine

    Directory of Open Access Journals (Sweden)

    Wyndaele J-J

    2012-11-01

    Full Text Available Jean-Jacques WyndaeleDepartment of Urology, Antwerp University, Antwerp, BelgiumAbstract: Overactive bladder is a symptom syndrome with urgency, frequency and, in many cases, nocturia. Urge incontinence is not present in all. There is no direct correlation with detrusor overactivity, an objective finding during urodynamic testing where involuntary contractions can be noticed. In the pathophysiology, much more attention has been given to the afferent/sensory arm of the micturition reflex in the last decade. Anatomical and infectious causes have to be diagnosed or ruled out. Diagnosis of overactive bladder is made mostly by history-taking, but other tests can be necessary in specific patients. Treatment consists of behavioral measures, a good explanation of the condition, training, and pelvic floor physiotherapy. Drugs are often used. Until recently, antimuscarinic drugs have been the mainstay of pharmacological therapy. Fesoterodine is a newer antimuscarinic agent which is more pharmacodynamically stable then tolterodine. Fesoterodine has been extensively researched using different dosages and compared with placebo and tolterodine, in different age groups, and under different conditions. Fesoterodine is superior to placebo and to tolterodine in the short term and long term. Its safety is very acceptable.Keywords: overactive bladder, fesoterodine, incontinence, urgency, lower urinary tract

  12. Differential diagnosis in the sonographic evaluation of adrenal metastases

    International Nuclear Information System (INIS)

    The sonographic detection of adrenal masses in patients with neoplasms, especially neoplasms of the lung, can be related to the presence of both metastases and adenomas. In order to assess the benign/malignant nature of the such lesions, the adrenal glands of 43 patients with neoplasms (36 of them lung cancers) were studied with sonography (US) and fine needle aspiration biopsy (FNAB): in all, 58 masses were seen (28 monolateral and 15 bilateral). Six lesions (13%) presented with cytological features of benignancy, and on US they appeared as hypoechoic (as compared to the liver), round masses, with regular margins, ranging in size from 1.2 cm to 3.4 cm (average: 2.6 cm). In the remaining 34 patients (80%), cellular material with features of malignancy was obtained with FNAB. The US appearence of these metastases was heterogenous, with the same echogenicity as the liver, and average size >3 cm. On the basis of data obtained, the limit of 3 cm (if we consider the average dimension), corresponds to the threshold of benignancy, as well as the monolateral and hypoechoic appearence of the lesion. To sum up, the use of FNAB should be limited to those lesions which present with typical adenomatous features and for borderline lesions, while the diagnosis of metastases is sufficiently accurate (p3 cm

  13. Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

    DEFF Research Database (Denmark)

    Duer, Anne; Østergaard, M; Hørslev-Petersen, K;

    2008-01-01

    OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which...... joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone...

  14. Gastric-Type Extremely Well-Differentiated Adenocarcinoma of the Stomach: A Challenge for Preoperative Diagnosis

    OpenAIRE

    Joo, Mee; Han, Song Hee

    2015-01-01

    Gastric-type extremely well-differentiated adenocarcinoma (EWDA) is a rare type of gastric adenocarcinoma characterized by infiltration of well-formed mucinous glands with little or no nuclear atypia, which resemble foveolar epithelium or pyloric glands. Because of its high degree of differentiation, preoperative biopsy diagnosis of gastric-type EWDA is very difficult. We encountered a case of gastric-type EWDA, manifesting as a Borrmann type 4 lesion, in a 47-year-old man. Despite four repea...

  15. Hemolytic anemia after kidney transplantation: case report and differential diagnosis.

    Science.gov (United States)

    Frohn, C; Jabs, W J; Fricke, L; Goerg, S

    2002-03-01

    A 58-year-old woman presented with hemolysis and thrombocytopenia 2 weeks after receiving a kidney graft. Hemolytic uremic syndrome was initially suspected, because in addition to hematological changes the graft function was missing. Unexpectedly, the results of the direct antiglobulin test became positive (4+), which is not normally observed in the hemolytic uremic syndrome. Differentiation of the eluted antibodies revealed anti-rhesus D specificity, which had to be interpreted either as an autoantibody of patient's origin or, hypothetically, as a "graft versus host" antibody of donor origin. Gm- and Km allotyping of these antibodies demonstrated a pattern which differed from the patient's but was identical to that of the kidney donor. Therefore hemolysis could be explained unambiguously by "graft versus host" antibodies. Whether the thrombocytopenia was also due to an immune process was not clear, although some evidence favors this hypothesis. Immunosuppressive treatment remained unchanged and several red blood cell transfusions were necessary before reactivity of the direct antiglobulin test diminished and became negative 7 weeks after kidney transplantation. The occurrence of hemolysis in the early posttransplantation period should thus draw attention to the possibility of "graft versus host" antibodies directed against red cells. Concomitant thrombocytopenia may occur. Donor screening for irregular erythrocyte antibodies should be performed whenever solid organ transplantation is intended. PMID:11904742

  16. Differential diagnosis of altered mind/body perception.

    Science.gov (United States)

    Gabbard, G O; Twemlow, S W; Jones, F C

    1982-11-01

    Considerable confusion exists in the psychiatric literature concerned with states of consciousness in which there is an altered perception of the mind/body relationship; related but different terms are often used interchangeably, with a lack of definitional rigor. The purpose of this paper is to bring clarity to this group of related phenomena by differentiating out-of-body experience (OBE) from depersonalization, autoscopic phenomena and schizophrenic body distortions (such as boundary loss), which are the principal entities with which the syndrome may be confused. The problem of variable definition of the syndromes is compounded by the fact that some studies deal with psychiatric or medical patients, others focus on nonpatients, and still others deal with both groups. The fact that some groups of persons with experiences of altered mind/body perception do not define themselves as patients, do not seek treatment, and may not need treatment underscores the need for clarification. Following an explication of the different syndromes and their characteristics, we will briefly consider treatment implications. PMID:7146229

  17. [S3 Guideline. Part 1: Diagnosis and Differential Diagnosis of Non-Traumatic Adult Femoral Head Necrosis].

    Science.gov (United States)

    Bohndorf, K; Beckmann, J; Jäger, M; Kenn, W; Maus, U; Nöth, U; Peters, K M; Rader, C; Reppenhagen, S; Roth, A

    2015-08-01

    Non-traumatic femoral head necrosis (FHN) is primarily a disease of the middle-aged adult. Early diagnosis, at a time with lacking or minimal clinical symptoms, is mandatory to consider conservative therapy or joint preserving operations as a therapeutic option. The new German S3 guideline about diagnosis and therapy of FHN is a cooperative effort of five professional medical societies, overall headed by the Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC). This review (part I/III) cites and explains the statements of the S3 guideline as agreed on the use of imaging methods for diagnosis of FHN. A diagnostic algorithm is presented. FHN clinically has to be considered in case of equivocal pain of a hip joint with a minimum of 6 weeks duration, when risk factors can be revealed, groin pain at clinical investigation, limping, pain or limitation of movement in case of load, and no obvious differential diagnoses. Is an FHN clinically suspected, primarily radiographs of the pelvis ap and a Lauenstein projection of the hip involved should be carried out. When the radiographs are normal, an MRI of the hips should follow routinely. MRI allows the diagnosis of FNH with high accuracy. Furthermore, MRI reveals the site and the size of the necrotic area involved and evaluates the integrity of the joint surface and subchondral fractures. When ARCO stage II (ARCO: Association Research Circulation Osseous) is diagnosed and MRI does not allow one to determine the joint surface with certainty, a CT of the hip joints should be performed. The S3 guideline explains and recommends the use of the ARCO classification. Although, this classification of 1993 is still largely based on radiographs, the pragmatic use of an "extended" version seems reasonable. Today, classical radiographic criteria like impression of the joint surface and subchondral fractures ("crescent sign") are better to be evaluated by MRI, in cases of subtle findings MRI is even surpassed by CT

  18. Differential diagnosis of changes in density and structure of the pedal skeleton

    International Nuclear Information System (INIS)

    Skeletal disorders of the foot can be assessed radiologically by changes in bone density, structure and/or form. The knowledge of specific morphological criteria is a precondition for differential diagnosis. Our classification of skeletal disorders of the foot is based on the specific signs that can be observed in systemic and local diseases affecting the pedal bones. (orig.)

  19. Mixed solid and cystic acoustic neuroma: MR features and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Denys, A. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Duvoisin, B. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)]|[Dept. of Radiodiagnosis, University Hospital, Lausanne (Switzerland); Fernandes, J.G. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France); Doyon, D. [Service de Neuroradiologie-CIERM Hopital de Bicetre, Univ. de Paris Sud, 78, 94 Kremlin-Bicetre (France)

    1991-11-01

    We present a very rare case of combined cystic and solid acoustic neuroma investigated by magnetic resonance imaging (MRI). This case illustrates the value of MRI in the characterization of tumours in the posterior cranial fossa, particularly acoustic neuromas, and its diagnostic impact in unusual situations. The differential diagnosis of cystic and mixed lesions in the cerebellopontine angle is discussed. (orig.)

  20. Cerebrospinal fluid P-tau(181P) : biomarker for improved differential dementia diagnosis

    NARCIS (Netherlands)

    Struyfs, Hanne; Niemantsverdriet, Ellis; Goossens, Joery; Fransen, Erik; Martin, Jean-Jacques; De Deyn, Peter P.; Engelborghs, Sebastiaan

    2015-01-01

    The goal of this study is to investigate the value of tau phosphorylated at threonine 181 (P-tau(181p)) in the Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarker panel for differential dementia diagnosis in autopsy confirmed AD and non-AD patients. The study population consisted of 140 aut

  1. Differential diagnosis in the pediatric radiology; Differenzialdiagnosen in der paediatrischen Radiologie

    Energy Technology Data Exchange (ETDEWEB)

    Rijn, Rick R. van [Academic Medical Center Amsterdam (Netherlands). Dept. of Radiology; Blickmann, Johan G. (eds.) [Univ. of Rocherster Medical Center, NY (United States). Dept. of Imaging Sciences URMC

    2012-11-01

    The book on differential diagnosis in the pediatric radiology covers the following issues: (1) Thorax, mediastinum, heart ad large blood vessels. (2) Abdomen and gastrointestinal tract. (3) Urogenital tract. (4) Skull, intracranial space and spinal cord. (5) Skeleton, bone joints and soft tissue. (6) Normative values.

  2. Ulno-volar bayonet hand: Its differential diagnosis from Madelung's deformity

    Energy Technology Data Exchange (ETDEWEB)

    Christ, F.

    1981-04-01

    The ulno-volar bayonet hand related to the mostly hereditary multiple exostoses is compared to Madelung's forearm deformity under clinical and roentgenological view in differential diagnosis. The ulno-volar bayonet hand is considerably more seldom, basing upon dysplasia of the lower part of the ulna, less inconvenient in function, and hardly tending to the development of early arthrosis.

  3. Bilateral Renal Lymphoma a Differential Diagnosis of Policyst Renal Disease. Case Report

    International Nuclear Information System (INIS)

    A case report of a patient with abdominal pain, diaphoresis and fever of three months duration imaging studies were interpreted as polycystic kidneys. The patient went to another institution, where a different approach led to a kidney biopsy that confirmed renal lymphoma. The case is interesting, by the way it is diagnosed and it is important to note the differential diagnosis.

  4. The use of computed tomography in the differential diagnosis of late epilepsy

    International Nuclear Information System (INIS)

    The report refers to 299 patients suffering from late epilepsies who were examined both clinically and by computed tomography. The cases were classified according to clinical tentative diagnoses and types of attacks. The objective was to find out how useful computerized tomography is in differential diagnosis concerning the aetiology of late epilepsies. (orig./MG)

  5. The use of expert systems on the differential diagnosis of urinary incontinence.

    Science.gov (United States)

    Lopes, Maria Helena Baena de Moraes; Marin, Heimar de Fátima; Ortega, Neli Regina Siqueira

    2009-09-01

    The differential diagnosis of urinary incontinence classes is sometimes difficult to establish. As a rule, only the results of urodynamic testing allow an accurate diagnosis. However, this exam is not always feasible, because it requires special equipment, and also trained personnel to lead and interpret the exam. Some expert systems have been developed to assist health professionals in this field. Therefore, the aims of this paper are to present the definition of Artificial Intelligence; to explain what expert system and system for decision support are and its application in the field of health and to discuss some expert systems for differential diagnosis of urinary incontinence. It is concluded that expert systems may be useful not only for teaching purposes, but also as decision support in daily clinical practice. Despite this, for several reasons, health professionals usually hesitate to use the computer expert system to support their decision making process. PMID:19842606

  6. Neoplastic lesions of the temporomandibular joint (TMJ): diagnosis, differential diagnosis and intervention

    International Nuclear Information System (INIS)

    Purpose. To evaluate the effectiveness of diagnostic and interventional radiological techniques for neoplastic lesions of the temporomandibular joint (TMJ). Material and methods. Modern diagnosis of the TMJ is based on the clinical use of conventional X-ray techniques, computed tomography (CT), magnetic resonance imaging (MRI) and interventional techniques like biopsies, vascular occlusion and ablation. Results. Conventional X-ray still forms the basic diagnostic procedure applied in open and closed mouth position. CT improves the diagnostic information and serves as the standard diagnostical instrument for cartaliganeous or osseous neoplastic lesions. MRI evaluates soft tissue infiltration in multiplanar techniques and high spatial resolution. Interventional vascular and ablative techniques improve the treatment of neoplastic disorders. (orig.)

  7. Clinical application and progress of PET and PET-CT for differential diagnosis of the benign or malignant pulmonary nodules

    International Nuclear Information System (INIS)

    To differential diagnosis the benign or malignant of pulmonary nodules is a medical difficult problem. As the development of medical imaging equipment and technology, PET-CT can identified benign or malignant lesions of pulmonary nodules though changes of metabolism. Researches about PET-CT for differential diagnosis pulmonary nodules benign or malignant are reviewed. (authors)

  8. The Potential of Gait Analysis to Contribute to Differential Diagnosis of Early Stage Dementia: Current Research and Future Directions

    Science.gov (United States)

    Morgan, Debra; Funk, Melanie; Crossley, Margaret; Basran, Jenny; Kirk, Andrew; Bello-Haas, Vanina Dal

    2007-01-01

    Early differential diagnosis of dementia is becoming increasingly important as new pharmacologic therapies are developed, as these treatments are not equally effective for all types of dementia. Early detection and differential diagnosis also facilitates informed family decision making and timely access to appropriate services. Information about…

  9. [Molecular diagnosis as a strategy for differential diagnosis and at early ages of neurofibromatosis type 1 (NF1)].

    Science.gov (United States)

    Gómez, Martha; Batista, Oriana

    2015-10-01

    Neurofibromatosis type 1 (NF1), is a haploinsufficient and multisystemic disease, caused by inherited or sporadic mutations in the NF1 gene. Its incidence is one in 2,500 to 3,000 individuals, it has an autosomal dominant pattern of inheritance, high clinical variability, complete penetrance and age-dependent complications. Neurofibromin is the product of the NF1 gene and is believed to act as a tumor suppressor since the loss of its function has been associated with benign and malignant tumors in neural crest-derived tissues. Only two correlations between clinical phenotype and mutant alleles in the NF1 gene have been observed. The established criteria for disease diagnosis are very efficient in adults and children older than 3 years of age, but not for children under this age. Mutational analysis is therefore recommended to confirm the disease in young children with a negative family history. A pathogenic mutation in the NF1 should be added to the list of diagnostic criteria. Mutational analysis is also recommended for differential diagnosis and for prenatal or pre-implantation genetic diagnosis, taking into consideration the family history and the type of method to be applied. Molecular studies of this disease using different complimentary molecular techniques and bioinformatics tools have characterized NF1 gene mutations at both the DNA and mRNA levels, increasing the mutational spectrum. Consequently, about 1,289 defects have been reported to date, mainly nonsense/missense mutations, deletions and splice site defects. PMID:26633276

  10. Compilation of a preliminary checklist for the differential diagnosis of neurogenic stuttering

    Directory of Open Access Journals (Sweden)

    Mariska Lundie

    2014-06-01

    Full Text Available Background: Neurogenic stuttering (NS is the most frequently occurring acquired form of stuttering in children and adults. This form of stuttering is primarily caused by neurological incidents. Owing to controversies with regard to similarities between developmental stuttering (DS and NS symptomatology, differential diagnosis is problematic. Differential diagnosis will guide the appropriate management of persons who stutter (PWS.Objectives: The aim of this study was to describe and highlight the characteristics of NS in order to compile a preliminary checklist for accurate diagnosis and intervention.Method: An explorative, applied mixed method, multiple case study research design was followed. Purposive sampling was used to select four participants. A comprehensive assessment battery was compiled for data collection.Results: The results revealed a distinct pattern of core stuttering behaviours in NS, although discrepancies existed regarding stuttering severity and frequency. It was also found that DS and NS can co-occur. The case history and the core stuttering pattern are important considerations during differential diagnosis, as these are the only consistent characteristics in people with NS.Conclusion: It is unlikely that all the symptoms of NS are present in an individual. The researchers scrutinised the findings of this study and the findings of previous literature to compile a potentially workable checklist.

  11. Differential diagnosis of Alzheimer-type dementia and vascular dementia based on neuroimaging study

    International Nuclear Information System (INIS)

    A new method for differential diagnosis of Alzheimer-type dementia (AD) and vascular dementia (VD) based on neuroimaging studies was developed by Hayashi's quantification theory II. Fifty-five patients with AD and 36 patients with VD underwent both SPECT and MRI studies. Both images in each subject were scored according to the extent of hypoperfusion in areas including frontal and temporoparietal regions and the severity of deep white matter lesions and medial temporal lobe atrophy. The scores of AD and VD patients were significantly different, and this difference was considered to contribute most to the differential diagnosis of AD and VD. The weight of each score of SPECT and MRI items was computed, and the sum of the weights was calculated as a score for each subject to best distinguish AD from VD patients. This method was designed to simplify the calculation of the sample scores, and the sum of the weights was established so that a positive score (0≤) indicated the probability of AD, while a negative score (<0) indicated the probability of VD. The correct diagnosis rate was 91% (50/55) for AD and 89% (32/36) for VD, for an overall discrimination of 90%. The present method seemed to be practically useful in the differential diagnosis of AD and VD. (author)

  12. Foreign Body Granuloma: A Diagnosis Not to Forget

    Directory of Open Access Journals (Sweden)

    I. El Bouchti

    2012-01-01

    The differential diagnosis for bony reaction to an unrecognised organic foreign body includes osteoid osteoma, chronic and acute osteomyelitis, tuberculosis granuloma, bone cyst, aneurysmal bone cyst, cortical fibrous defect, and neoplasm. We report the case of a boy suffering from a thorn inducing a lytic lesion of the fifth metatarsal that demonstrates the diagnosis difficulties of foreign body granuloma.

  13. CT-Guided Pancreatic Percutaneous Fine-Needle Biopsy in Differential Diagnosis between Pancreatic Cancer and Chronic Pancreatitis

    OpenAIRE

    Michele Carlucci; Alessandro Zerbi; Danilo Parolini; Sandro Sironi; Angelo Vanzulli; Carlo Staudacher; Agostino Faravelli; Paola Garancini; Alessandro del Maschio; Valerio di Carlo

    1989-01-01

    Differential diagnosis between pancreatic cancer and chronic pancreatitis is still difficult to establish. In 63 patients with suspected pancreatic neoplasm we performed: serum CA 19-9 assessment, abdominal ultrasound, CT scan and CT-guided pancreatic percutaneous fine-needle biopsy. The conclusive diagnosis was pancreatic cancer in 40 patients and chronic pancreatitis in 23 patients. With regard to the differential diagnosis, sensitivity and specificity were respectively 80% and ...

  14. Diagnosis and differential diagnosis of Graves' orbitopathy in MRI; Diagnose und Differenzialdiagnose der endokrinen Orbitopathie in der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Daubner, D.; Spieth, S.; Engellandt, K.; Kummer, R. von [Universitaetsklinikum Carl Gustav Carus, Technische Universitaet Dresden, Abteilung Neuroradiologie, Institut und Poliklinik fuer Radiologische Diagnostik, Dresden (Germany)

    2012-06-15

    Imaging of Graves' orbitopathy (GO) includes radiological and nuclear medicine procedures. Depending on the method used they provide information about the distribution and activity of the disease. Magnetic resonance imaging (MRI) is not only a helpful tool for making the diagnosis it also enables differentiation of the active and inactive forms of GO due to intramuscular edema. The modality is therefore appropriate to evaluate the disease activity and the course of therapy. The disease leads to the typical enlargement of the muscle bodies of the extraocular muscles. The inferior rectus, medial rectus and levator palpebrae muscles are mostly involved. Signal changes of the intraconal and extraconal fat tissue are possible and a bilateral manifestation is common. The differential diagnosis includes inflammatory diseases and tumors, of which orbital pseudotumor (idiopathic, unspecific orbital inflammation), ocular myositis and orbital lymphoma are the most important. The specific patterns (localization, involvement of orbital structures and signal changes) can be differentiated by MRI. (orig.) [German] Die Bildgebung der endokrinen Orbitopathie (EO) umfasst radiologische und nuklearmedizinische Verfahren, die je nach Methode Aussagen zur Verteilung und Aktivitaet der Erkrankung liefern. Die Magnetresonanztomographie (MRT) ist nicht nur zur Diagnosestellung hilfreich, sondern auch in der Lage, die aktive von der inaktiven Form anhand des intramuskulaeren Oedems zu unterscheiden. Das Verfahren eignet sich deshalb auch zur Aktivitaetsbeurteilung und zur Bewertung einer Therapie im Verlauf. Die Erkrankung fuehrt zu einer typischen Verdickung des Muskelbauchs der extraokulaeren Augenmuskeln, wobei die Mm. rectus inferior, rectus medialis und levator palpebrae am haeufigsten betroffen sind. Signalveraenderungen des intra- und extrakonalen Fettgewebes sind moeglich, und eine bilaterale Manifestation ist haeufig. Die Differenzialdiagnose umfasst neben anderen

  15. MDCT evaluation of congenital mitral-aortic intervalvular fibrosa aneurysm: implications for the aetiology and differential diagnosis

    International Nuclear Information System (INIS)

    Mitral-aortic intervalvular fibrosa aneurysm is a rare disease whose aetiology remains a matter of debate. Here we present the youngest reported patient with the disease, a 6-month-old boy, without a history of infection, which supports a congenital origin as initially proposed. Multidetector-row CT (MDCT) surpassed echocardiography in delineating the intracardiac anatomical details with high spatial resolution, confirming the important problem-solving role of MDCT in the diagnosis of congenital heart disease. (orig.)

  16. Lung ultrasound: a valid help in the differential diagnosis between pneumothorax and pulmonary blebs

    Directory of Open Access Journals (Sweden)

    Francesca Sandionigi

    2013-06-01

    Full Text Available Spontaneous pneumothorax is a relatively common disease but its radiological diagnosis can be difficult because of the insufficient sensitivity of chest X-rays. This is even more so when bullous emphysema and acute pneumothorax co-exist. There is evidence that lung ultrasound is a valid instrument to detect a pneumothorax and a valid help in the differential diagnosis between pneumothorax and pulmonary blebs. We present a case which suggests the potential superiority of lung ultrasound on chest radiography in distinguishing free air (pneumothorax from apical blebs, particularly when these are located in the posterior regions and may be easily confused with pneumothorax.

  17. Unilateral Intraparotid Swelling: A Case Report of Kimura’s Disease and Review of Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    N. W. Savage

    2013-01-01

    Full Text Available An interesting case of Kimura's disease was described in the 42-year-old patient manifesting itself as a unilateral parotid swelling, albeit the disease usually affects both parotid glands. Furthermore, first pathohistological finding was not suggestive of the disease, revealing only fatty tissue, but on the repeated biopsy together with CT the correct diagnosis was established. It should be emphasized that Kimura's disease has to be taken into account while making differential diagnosis in parotid gland swellings, especially in people of Oriental origin.

  18. Regional presentation of hepatic diseases: CT and MR imaging findings of differential diagnosis

    International Nuclear Information System (INIS)

    Neoplastic and nonneoplastic diseases may involve the liver with a regional distribution, which is defined as a non-focal process without any specific anatomic predilection. In this pictorial essay we review hepatic diseases commonly presenting with a regional distribution in the liver and describe the CT and MR imaging findings helpful for differential diagnosis. Knowledge of the characteristic imaging manifestations of neoplastic and non-neoplastic diseases affecting the liver regionally will facilitate an accurate diagnosis and result in the appropriate clinical management of these liver diseases

  19. CT diagnosis and differential diagnosis of otodystrophic lesions of the temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    D' Archambeau, O.; Parizel, P.M.; Schepper, A.M. De (Antwerp University Hospital (Belgium). Department of Radiology); Koekelkoren, E.; Van De Heyning, P. (Antwerp University Hospital (Belgium). Department of E.N.T.)

    The purpose of this study was to assess the diagnostic and differential diagnostic value of high-resolution computed tomography in the evaluation of temporal-bone dystrophies. The study group included 55 patients with osseous abnormalities of the temporal bone in general, and the labyrinthine capsule in particular. In 27 patients the CT scan revealed evidence of otodystrophic lesions. The CT findings in patients with otosclerosis (21 patients), osteogenesis imperfecta (two patients), fibrous dysplasia (one patient). Paget's disease (one patient) and osteoporosis (two patients) are described. The CT scans of 17 patients revealed secondary osseous lesions due to metastasis (five patients), post-inflammatory changes (10 patients) or labyrinthitis ossificans (two patients). Normal variants and congenital mineralization defects were diagnosed in nine patients, Down's syndrome in two. Our results indicate the importance of high-resolution computed tomography as the primary imaging modality in evaluating osseous lesions of the temporal bone and labyrinth. (author). 14 refs.; 13 figs; 2 tabs.

  20. Knowledge discovery in medical systems using differential diagnosis, LAMSTAR & k-NN.

    Science.gov (United States)

    Isola, Rahul; Carvalho, Rebeck; Tripathy, Amiya Kumar

    2012-11-01

    Medical data is an ever-growing source of information generated from the hospitals in the form of patient records. When mined properly the information hidden in these records is a huge resource bank for medical research. As of now, this data is mostly used only for clinical work. This data often contains hidden patterns and relationships, that can lead to better diagnosis, better medicines, better treatment and overall, a platform to better understand the mechanisms governing almost all aspects of the medical domain. Unfortunately, discovery of these hidden patterns and relationships often goes unexploited. However there is on-going research in medical diagnosis which can predict the diseases of the heart, lungs and various tumours based on the past data collected from the patients.They are mostly limited to domain specific systems that predict diseases restricted to their area of operation like heart, brain and various other domains. These are not applicable to the whole medical dataset. The system proposed in this paper uses this vast storage of information so that diagnosis based on this historical data can be made. It focuses on computing the probability of occurrence of a particular ailment from the medical data by mining it using a unique algorithm which increases accuracy of such diagnosis by combining the key points of Neural Networks, Large Memory Storage and Retrieval (LAMSTAR), k-NN and Differential Diagnosis all integrated into one single algorithm. The system uses a Service-Oriented Architecture wherein the system components of diagnosis, information portal and other miscellaneous services are provided.This algorithm can be used in solving a few common problems that are encountered in automated diagnosis these days, which include: diagnosis of multiple diseases showing similar symptoms, diagnosis of a person suffering from multiple diseases, receiving faster and more accurate second opinion and faster identification of trends present in the medical

  1. Fault detection and diagnosis in nonlinear systems a differential and algebraic viewpoint

    CERN Document Server

    Martinez-Guerra, Rafael

    2014-01-01

    The high reliability required in industrial processes has created the necessity of detecting abnormal conditions, called faults, while processes are operating. The term fault generically refers to any type of process degradation, or degradation in equipment performance because of changes in the process's physical characteristics, process inputs or environmental conditions. This book is about the fundamentals of fault detection and diagnosis in a variety of nonlinear systems which are represented by ordinary differential equations. The fault detection problem is approached from a differential algebraic viewpoint, using residual generators based upon high-gain nonlinear auxiliary systems (‘observers’). A prominent role is played by the type of mathematical tools that will be used, requiring knowledge of differential algebra and differential equations. Specific theorems tailored to the needs of the problem-solving procedures are developed and proved. Applications to real-world problems, both with constant an...

  2. On the differential diagnosis of the abdominal aorta aneurysm and retroperitoneal paraaortal hematoma

    International Nuclear Information System (INIS)

    Chronic retroperitoneal paraaortal hematoma appeared to be a rare disease. Paraaortal hematoma should be differentiated from abdomen aorta aneurysm and retroperitoneal tumor, for it requires no surgical intervention. Computerized tomography CT was shown to be the most sensitive method in differential diagnosis. CT with intravenous contrast intensification displayed complete information on aorta size, its aneurysms, extention of the disease, degree of dissemination into adjacent blood vessels and tissues. Retention of contrast media in the vessels occurred with 5 min delay and the blood was shown to free from the contrast substance up to that moment. The phenomenon permitted to distinguish thrombosed aneurysm from paraaortal tumor or hematoma

  3. The role of Tc-99m RBC scintigraphy in the differential diagnosis of orbital cavernous hemangioma.

    Science.gov (United States)

    Sayit, E; Durak, I; Capakaya, G; Yilmaz, M; Durak, H

    2001-04-01

    The cavernous hemangioma is the most common benign orbital tumor in adults. Its presentation is during the forth to fifth decades with a slowly progressive unilateral proptosis. Intraconal cavernous hemangiomas may be difficult to differentiate from other intraconal lesions such as schwannomas, meningiomas and hemangiopericytomas. We report a case of orbital cavernous hemangioma diagnosed by Tc-99m RBC scintigraphy. Tc-99m RBC scintigraphy revealed a typical scintigraphic pattern in which there is intense focally increased uptake on the delayed image. We conclude that Tc-99m RBC scintigraphy can be a useful method in the differential diagnosis of orbital cavernous hemangioma as in hepatic hemangioma. PMID:11448074

  4. Cystic lymph node enlargement of the neck: filariasis as a rare differential diagnosis in MRI

    Energy Technology Data Exchange (ETDEWEB)

    Schick, Christoph; Thalhammer, Axel; Balzer, Joern O.; Abolmaali, Nasreddin; Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, University of Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt/Main (Germany)

    2002-09-01

    Cervical lymph node enlargement is a common feature of most inflammatory and neoplastic entities of the head and neck. Filariasis can lead to lymphangiectasis resembling lymph node enlargement; however, this is a rare differential diagnosis in European patients. As ethnic minorities are increasing throughout Europe and personal mobility, e.g. during holidays, is increasing, such rare differential diagnoses have to be taken into consideration. We present the case of an Iraqi patient referred to as for a suspected cystic lymph node mass that was verified histologically by open MRI biopsy and proved to be a cystic manifestation of filariasis. (orig.)

  5. Differential diagnosis of Raynaud’s phenomenon based on modeling of finger thermoregulation

    International Nuclear Information System (INIS)

    Raynaud's phenomenon (RP) is a vasospastic disorder of small arteries, pre-capillary arteries, and cutaneous arteriovenous shunts of the extremities, typically induced by cold exposure and emotional stress. RP is either primary (PRP) or secondary to connective tissue diseases such as systemic sclerosis (SSc). Early differential diagnosis is crucial in order to set the proper therapeutic strategy. To this goal, thermal infrared imaging data from 18 healthy controls (HCs) and 48 RP patients (20 PRP, 28 SSc) were processed through a model for a second-order time-invariant system with exponential critically damped dynamic response. Subject classification on the basis of the model parameters provides 100% true-positive discrimination for RP patients (PRP and SSc) and healthy, and 90% of correct classification within the group of patients. The proposed method may provide useful hints for early differential diagnosis in the assessment of RP disease. (paper)

  6. Hypoxic ischemia encephalopathy leading to external hydrocephalus and the cerebral atrophy: mechanism and differential diagnosis

    International Nuclear Information System (INIS)

    Objective: It is a study of the mechanism and differential diagnosis of the infant external hydrocephalus and cerebral atrophy. Methods: In total 84 cases of neonatal hypoxic ischemia encephalopathy followed by infant external hydrocephalus were investigated, among which 26 patients gradually were found having developed cerebral atrophy in follow up. Results: Characteristic dilation of the frontal-parietal subarachnoid space and the adjacent cistern was noted on the CT images of the external hydrocephalus. CT revealed the enlarged ventricle besides the dilated subarachnoid space in the cases of cerebral atrophy, while these two entities were indistinguishable on CT in the early stage. Conclusion: Clinical manifestations make a major differential diagnosis of the external hydrocephalus and cerebral atrophy: tic and mild delayed development of locomotion over major presentation of external hydrocephalus, while cerebral atrophy is featured by remarkable dysnoesia and severe delayed development of locomotion. In addition, hemiplegia and increased muscular tension are presented in a few cases of cerebral atrophy

  7. Common recessive limb girdle muscular dystrophies differential diagnosis: why and how?

    Directory of Open Access Journals (Sweden)

    Ana Cotta

    2014-09-01

    Full Text Available Limb girdle muscular dystrophies are heterogeneous autosomal hereditary neuromuscular disorders. They produce dystrophic changes on muscle biopsy and they are associated with mutations in several genes involved in muscular structure and function. Detailed clinical, laboratorial, imaging, diagnostic flowchart, photographs, tables, and illustrated diagrams are presented for the differential diagnosis of common autosomal recessive limb girdle muscular dystrophy subtypes diagnosed nowadays at one reference center in Brazil. Preoperative image studies guide muscle biopsy site selection. Muscle involvement image pattern differs depending on the limb girdle muscular dystrophy subtype. Muscle involvement is conspicuous at the posterior thigh in calpainopathy and fukutin-related proteinopathy; anterior thigh in sarcoglycanopathy; whole thigh in dysferlinopathy, and telethoninopathy. The precise differential diagnosis of limb girdle muscular dystrophies is important for genetic counseling, prognostic orientation, cardiac and respiratory management. Besides that, it may probably, in the future, provide specific genetic therapies for each subtype.

  8. Differential diagnosis of pancreas cancer and chronic pancreatitis in computed tomography

    International Nuclear Information System (INIS)

    Differential diagnosis of pancreas cancer and chronic pancreatitis in Computed Tomography. CT pictures of 46 cases of pancreas cancer and 16 cases of chronic pancreatitis were reviewed to clarify a way of differential diagnosis of these two disorders. The conclusion obtained in this study is as below. 1) Well-defined cystic central low density is a sign of chronic pancreatitis, and in the other hand, the solid central low density is a sign of pancreas cancer. 2) Effect of contrast enhancement was greater in chronic pancreatitis than in pancreas cancer. 3) Possibility of pancreas cancer is high in a case which has a sign of vascular involvement but no definite sign of tumor. 4) Sensitivity, specificity, total accuracy is 76.7 %, 87.5 %, 75.8 % respectively. (author)

  9. Advances of imaging on differential diagnosis between recurrence of glioma and radiation-induced brain injury

    International Nuclear Information System (INIS)

    Differentiating recurrence of glioma from radiation-induced brain injury is a central challenge in neuro-oncology. The 2 very different outcomes after brain tumor treatment often appear similar on traditional imaging studies. They may even manifest with similar clinical symptoms. Distinguishing treatment injury from tumor recurrence is crucial for diagnosis and treatment planning. In this article, we reviewed the latest developments and key findings from research studies exploring the efficacy of structural and functional imaging modalities in differentiating treatment injury from tumor recurrence with DWI, MRS, DCE-MR, DSC-MR, PET, and SPECT. And we discussed the advantages and disadvantages of each approach to provide useful information for making proper diagnosis and treatment planning. (authors)

  10. Schnitzler's Disease as an Important Differential Diagnosis of Chronic Recurrent Multifocal Osteomyelitis: A Case Report

    Directory of Open Access Journals (Sweden)

    Kathrin Schrödl

    2012-01-01

    Full Text Available Introduction. At first sight, chronic recurrent multifocal osteomyelitis (CRMO and Schnitzler's disease are diagnoses of exclusion and can be similar in their manifestation. Methods. In this paper we present the reevaluation of the 13-year-old diagnosis of chronic recurrent osteomyelitis of a 58-year-old man with chronic ostealgia, night sweat, and pruritic urticarial lesions on the extremities and trunk. For further examination, we performed blood analysis, bone and skin biopsies, CT scans, and magnetic resonance imaging. Results. Laboratory findings showed increased inflammation parameters. Magnetic resonance imaging (MRI revealed a diffuse bone marrow infiltration. A bone and skin biopsy showed a sclerotic bone marrow involvement and a superficial dermal and perivascular infiltrate of neutrophils. Based on these findings, the diagnosis of Schnitzler’s disease was made. Conclusion. Here, we want to present Schnitzler's disease as an important differential diagnosis to CRMO in adults presenting with signs suggestive of CRMO.

  11. [Acute penetrating atherosclerotic ulcers in aortic arch: differential diagnosis of chest pain].

    Science.gov (United States)

    Rodrigues, Bruno; Ribeiro, Carla; Santos, Luis Ferreira; Moreira, Davide; Ferreira, Pedro; Pipa, João; Beirão, Ilídio; Santos, Oliveira

    2011-01-01

    Penetrating atherosclerotic ulcers (PAU) represent a pathological phenomenon in which ulceration of atheromatous lesions of the aorta penetrates the internal elastic lamina, reaching the middle muscular layer. These ulcers are more common in the descending thoracic aorta, being rare in the ascending aorta. The differential diagnosis between PAU and other entities of acute aortic syndromes (AAS) becomes difficult. The diagnosis of this disease is made through imaging studies: multidetector computed tomography (MDCT), magnetic resonance (MR) or transesophageal echocardiography (TEE). After diagnosis, the PAU of the ascending aorta should be treated surgically in an emergency context. In this paper the authors report a case of PAU in the aortic arch in a 84 years old patient admitted to the emergency room for chest pain. In this context a review of the natural evolution of this entity is made, with emphasis on diagnostic imaging modalities used for its characterization as well as their treatment options. PMID:23560267

  12. MANAGEMENT OF ENDOCRINE DISEASE: Pituitary 'incidentaloma': neuroradiological assessment and differential diagnosis.

    Science.gov (United States)

    Vasilev, Vladimir; Rostomyan, Liliya; Daly, Adrian F; Potorac, Iulia; Zacharieva, Sabina; Bonneville, Jean-François; Beckers, Albert

    2016-10-01

    Pituitary incidentalomas are a by-product of modern imaging technology. The term 'incidentaloma' is neither a distinct diagnosis nor a pathological entity. Rather, it is a collective designation for different entities that are discovered fortuitously, requiring a working diagnosis based on the input of the radiologist, endocrinologist and often a neurosurgeon. In addition to pathological conditions affecting the pituitary gland, a thorough knowledge of the radiological characteristics of normal variants and technical artifacts is required to arrive at an accurate differential diagnosis. After careful radiological and hormonal evaluation, the vast majority of pituitary incidentalomas turn out to be non-functioning pituitary microadenomas and Rathke's cleft cysts (RCCs). Based on the low growth potential of non-functioning pituitary microadenomas and RCCs, periodic MRI surveillance is currently considered the optimal management strategy. Stricter follow-up is required for macroadenomas, as increases in size occur more frequently. PMID:27068689

  13. Prolactinoma in a Diabetic Dialysis Patient with Erectile Dysfunction: A Difficult Differential Diagnosis

    OpenAIRE

    Piccoli, Giorgina B.; Bermont, Francesca; Magnano, Andrea; Soragna, Giorgio; Terzolo, Massimo

    2006-01-01

    Dialysis patients often suffer from erectile dysfunction. The prevalence of this symptom in the context of dialysis is as high as 90%. Diabetes, diffuse vascular disease and pharmacological therapy are attendant causes of this condition, severely impairing the quality of life. Due to the high frequency of erectile dysfunction in uremic patients, minimalist diagnostic approaches are often used. Nevertheless, a careful differential diagnosis is also warranted in well dialyzed patients to identi...

  14. Late presentation of hyperandrogenism in pregnancy: clinical features and differential diagnosis

    OpenAIRE

    Das, Gautam; Eligar, Vinay S; Govindan, Jyothish; Rees, D. Aled

    2013-01-01

    Summary Background Hyperandrogenic states in pregnancy are rare but arise most commonly due to new-onset ovarian pathology in pregnancy. We describe the case of a young woman who presented in the latter half of her pregnancy with features of hyperandrogenism. We review the biochemical and imaging findings and discuss the differential diagnosis. Case presentation A 26-year-old woman presented in the later part of her pregnancy with widespread hirsutism. Biochemical testing confirmed hyperandro...

  15. A Case of Senile Chorea: Considering Huntington’s Disease and Neuroacanthocytosis in differential diagnosis

    OpenAIRE

    Ayşe Deniz Elmalı; Ayşegül Gündüz; Zafer Başlar; Fatoş Sibel Ertan

    2015-01-01

    Sporadic chorea presenting after the age of 50 is called “senile chorea”. Senile chorea is a rare entity with a wide differential diagnosis list. Causes of senile chorea include vascular and metabolic diseases, adverse events related to medications, hematologic and immune system diseases, genetic and sporadic neurodegenerative syndromes, and paraneoplastic disorders. Although the most common etiologies are vascular and metabolic disorders, neuroacanthocytosis, Wilson and Huntington diseases a...

  16. Cognitive-style characteristics as criteria for differential diagnosis of delirium

    OpenAIRE

    I.V. Kuznetsov; Morozova, M. V.

    2014-01-01

    We present a psychological study of the relationship of cognitive styles with the development of delusional formations, overvalued ideas and simulative products in order to develop criteria of delirium differential diagnosis. We examined 118 men, ordered at forensic psychological and psychiatric examination, among them delusional symptoms were found in 68 people, and overvalued ideas in 26 people, 24 people simulated delirium. As a method of research, we used pathopsychological experiment and...

  17. AB214. Application of ultrasonic measurement of epididymal width in differential diagnosis of azoospermia

    Science.gov (United States)

    Song, Yongsheng

    2016-01-01

    Objective To investigate the of epididymal width in identifying non obstructive azoospermia (NOA) and obstructive azoospermia (OA). Methods Using scrotal ultrasound to compare difference of epididymal width between OA (n=18) and NOA (n=10) patients. Results In the patients with OA average bilateral epididymal width is 0.7+0.1 cm, which is higher than the NOA patients (PNOA and OA, which is helpful for differential diagnosis of azoospermia.

  18. Differential diagnosis of particular interest - Osteoarthropathy induced by haemochromatosis; Die interessante Differentialdiagnose - die Haemochromatose-Osteoarthropathie

    Energy Technology Data Exchange (ETDEWEB)

    Kittner, T. [Universitaetsklinikum ``Carl Gustaf Carus``, TU Dresden, Inst. und Poliklinik fuer Radiologische Diagnostik (Germany); Nitzsche, H. [Universitaetsklinikum ``Carl Gustaf Carus``, TU Dresden, Inst. und Poliklinik fuer Radiologische Diagnostik (Germany); Klengel, S. [Universitaetsklinikum ``Carl Gustaf Carus``, TU Dresden, Inst. und Poliklinik fuer Radiologische Diagnostik (Germany)

    1996-01-01

    Two cases have been selected to explain the efficiency of X-radiography and MRI and the relevant diagnostic images leading to the diagnosis of haemochromatosis-induced osteoarthropathy of the hand joints, and to possible differential diagnoses. Clinical as well as paraclinical aspects are included in the report. (orig.) [Deutsch] Anhand zweier Fallbeispiele werden das konventionell-radiologische sowie kernspintomographische Erscheinungsbild der Haemochromatose-Osteoarthropathie der Handgelenke sowie moegliche Differentialdiagnosen beschrieben. Klinische sowie paraklinische Aspekte finden gleichfalls Beachtung. (orig.)

  19. Imaging of bronchiectasis: the great value of high-resolution CT in differential diagnosis

    International Nuclear Information System (INIS)

    Bronchiectasis is defined as localized irreversible dilatation of the bronchial tree. Brochiectasis has been associated with a wide variety of causes, but it is mostly caused by acute, chronic or recurrent infections. This paper should give a review about the manifestation of bronchiectasis and bronchioloectasis in HR-CT and discuss the causing entities. However, integration of bronchiectasis and other HR-CT findings may enable a narrower differential diagnosis, in some cases it is possible to give the correct diagnose directly. (orig.)

  20. Pyoderma Gangrenosum and Full-Thickness Burns: is there a Problem of Differential Diagnosis?

    OpenAIRE

    Napoli, B.; D’Arpa, N.; F. Conte

    2006-01-01

    A case is presented of pyoderma gangrenosum, describing its characteristic features with particular reference to the phenomenon of pathergy, which considerably limits the surgical approach to the disease. After an account of the numerous skin ulcerations that have to be taken into consideration in order to make a differential diagnosis, it is noted that pyoderma gangrenosum can only on rare occasions be confused with a full-thickness granulating burn.

  1. Infrared Thermometry in a Differential Diagnosis of the Benign and Malignant Formations of Skin

    Directory of Open Access Journals (Sweden)

    Kurnickov G.Yu.

    2010-09-01

    Full Text Available The possibilities of the infrared thermometry use for differential diagnosis of the benign and malignant melanocytic skin formations are demonstrated, which is confirmed by clinical observations and the histological investigation results. The elaborated method of measurements is characteristic of the accomplishment simplicity and rapidity, absolute safety, sufficient accuracy, which substantially extends the physician possibilities at the patient examination and decreases a risk of diagnostic error.

  2. Differential diagnosis of polyuric/polydipsic syndromes with the aid of urinary vasopressin measurement in adults.

    OpenAIRE

    Eckmanns, Tim

    2010-01-01

    OBJECTIVE: A water deprivation test or a hypertonic saline infusion test with the measurement of plasma osmolality and plasma vasopressin are the gold standard tests in the differential diagnosis of polyuric syndromes. Because commercially available vasopressin kits are too insensitive for this approach, and the concentration of vasopressin in urine is much higher than in plasma, urinary vasopressin measurements may be an alternative to the more difficult plasma vasopressin measurement. DESIG...

  3. The Application of Mediastinoscopy in the Differential Diagnosis 
and Preoperative Staging on Lung Cancer

    OpenAIRE

    Feng MAO; Zhang, Liang; Minghui CAI; Zhengping DING; Yang SHEN-TU

    2014-01-01

    Background and objective To discuss the clinical application of mediastinoscopy in the differential diagnosis and preoperative staging on lung cancer. Methods A total of 361 cases of patients were included in the study, of which 162 cases were undiagnosed mediastinal tumor patients before operation, and 199 patients were suspected or diagnosed with lung cancer or mediastinal lymph nodes enlargment(short diameter ≥1.0 cm). All patients underwent surgery, including 308 cases standard cervical m...

  4. Hashimoto's encephalitis as a differential diagnosis of Creutzfeldt-Jakob disease

    OpenAIRE

    Seipelt, M; Zerr, I.; Nau, R; Mollenhauer, B.; Kropp, S; Steinhoff, B; Wilhelm-Gossling, C; Bamberg, C; Janzen, R.; Berlit, P.; Manz, F; Felgenhauer, K; Poser, S

    1999-01-01

    OBJECTIVES—During an epidemiological study of Creutzfeldt-Jakob disease in Germany, Hashimoto's encephalitis was encountered as a differential diagnosis, which has not yet been described in this context.
METHODS—The symptoms and findings of seven patients who fulfilled the criteria for "possible"Creutzfeldt-Jakob disease are presented.
RESULTS—A Hashimoto's thyroiditis with antibodies against thyroglobulin or thyroid peroxidase, or both and a hypoechoic thyroid ultrasonog...

  5. Multiple Hypovascular Tumors in Kidney: A Rare Case Report and Differential Diagnosis

    OpenAIRE

    Pei-Yu Wu; Sheng-Fung Lin; Ping-Hsun Wu; Yi-Chun Tsai; Yu-Ting Kuo; Mei-Chuan Kuo; Hung-Chun Chen

    2013-01-01

    The most common malignant renal tumor is renal cell carcinoma and surgery is the standard treatment. The proportion of lymphoma with renal involvement is 2~15% and lymphoma could be cured by chemotherapy without nephrectomy. Sonography, computed tomography (CT), and magnetic resonance imaging (MRI) can detect and characterize a renal mass. We present a case of right renal hypovascular tumors and differential diagnosis of hypovascular tumors by image study. CT scan showed hypovascular tumors a...

  6. Limited value of serum holo-transcobalamin II measurements in the differential diagnosis of macrocytosis.

    OpenAIRE

    Wickramasinghe, S. N.; Ratnayaka, I D

    1996-01-01

    AIM: To study the value of serum holo-transcobalamin II (holo-TCII) measurements in the differential diagnosis of macrocytosis. METHODS: Holo-TCII concentrations were measured in serum samples from 50 healthy non-vegetarian subjects and 30 patients with macrocytosis, using a technique based on the adsorption of holo-TCII with amorphous, precipitated silica. Deoxyuridine (dU) suppression tests were performed on the bone marrow cells of all the patients. Haematological diagnoses were made using...

  7. Modern diagnosis of celiac disease and relevant differential diagnoses in the case of cereal intolerance

    OpenAIRE

    Hahn, Markus; Hagel, Alexander F; Hirschmann, Simon; Bechthold, Caroline; Konturek, Peter; Neurath, Markus; Raithel, Martin

    2014-01-01

    Summary At an incidence of 1:500, celiac disease (formerly sprue) is an important differential diagnosis in patients with malabsorption, abdominal discomfort, diarrhea and food intolerances. Celiac disease can induce a broad spectrum of both gastrointestinal and extraintestinal symptoms, e.g. dermatitis herpetiformis (Duhring’s disease). A variety of oligo- and asymptomatic courses (e.g. anemia, osteoporosis, depression) through to refractory collagenic celiac disease are seen. In HLA-DQ2 and...

  8. Differential diagnosis of rheumatic illnesses. 4. compl. rev. and enl. ed.; Differenzialdiagnose rheumatischer Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Zeidler, Henning [Rheumatologikum Hannover (Germany); Michel, Beat [UniversitaetsSpital Zuerich, Zurich (Switzerland). Rheumaklinik und Inst. fuer Physikalische Medizin

    2009-07-01

    The number of the possible differential diagnosis of rheumatic illnesses is extraordinarily high. This circumstance makes the diagnostics a difficult field with numerous pitfalls. The correct and complete diagnosis however is a condition for the correct therapy. This book facilitates this way from the symptom to the diagnosis for the reader: A detailed representation of the fundamentals (anamnesis, investigation findings, laboratory diagnostics and imaging) a detailed description of all important differential diagnosis follows. The meanwhile fourth edition of this standard work was completely revised and updated. An indispensable guide book for all persons which treat patients with rheumatic illnesses. [German] Die Zahl der moeglichen Differenzialdiagnosen rheumatischer Erkrankungen ist ausserordentlich hoch. Dieser Umstand macht die Diagnostik zu einem schwierigen Feld mit zahlreichen Fallstricken. Die korrekte und vollstaendige Diagnose ist aber Voraussetzung fuer die richtige Therapie. Dieses Buch erleichtert dem Leser diesen Weg vom Symptom zur Diagnose: Einer ausfuehrlichen Darstellung der Grundlagen (Anamnese, Untersuchungsbefund, Labordiagnostik und Bildgebung) folgt eine detaillierte Beschreibung aller wichtigen Differenzialdiagnosen. Die mittlerweile vierte Auflage dieses Standardwerks wurde komplett ueberarbeitet und aktualisiert. Ein unverzichtbarer Ratgeber fuer alle, die Patienten mit Erkrankungen aus dem rheumatologischen Formenkreis behandeln. (orig.)

  9. Infected aortic aneurysm and inflammatory aortic aneurysm. In search of an optimal differential diagnosis

    International Nuclear Information System (INIS)

    Infected aortic aneurysm and inflammatory aortic aneurysm each account for a minor fraction of the total incidence of aortic aneurysm and are associated with periaortic inflammation. Despite the similarity, infected aortic aneurysm generally shows a more rapid change in clinical condition, leading to a fatal outcome; in addition, delayed diagnosis and misuse of corticosteroid or immunosuppressing drugs may lead to uncontrolled growth of microorganisms. Therefore, it is mandatory that detection of aortic aneurysm is followed by accurate differential diagnosis. In general, infected aortic aneurysm appears usually as a saccular form aneurysm with nodularity, irregular configuration; however, the differential diagnosis may not be easy sometimes for the following reasons: symptoms, such as abdominal and/or back pain and fever, and blood test abnormalities, such as elevated C-reactive protein and enhanced erythrocyte sedimentation rate, are common in infected aortic aneurysm, but they are not found infrequently in inflammatory aortic aneurysm; some inflammatory aortic aneurysms are immunoglobulin (Ig) G4-related, but not all of them; the prevalence of IgG4 positivity in infected aortic aneurysm has not been well investigated; enhanced uptake of 18F-fluorodeoxyglucose (FDG) by 18F-FDG-positron emission tomography may not distinguish between inflammation mediated by autoimmunity and that mediated by microorganism infection. Here we discuss the characteristics of these two forms of aortic aneurysm and the points of which we have to be aware before reaching a final diagnosis. (author)

  10. Clustering and switching during a semantic verbal fluency test contribute to differential diagnosis of cognitive impairment

    Institute of Scientific and Technical Information of China (English)

    Qianhua Zhao; Qihao Guo; Zhen Hong

    2013-01-01

    The verbal fluency test (VFT) can be dissociated into "clustering" (generating words within subcategories)and "switching" (shifting between clusters),which may be valuable in differential diagnosis.In the current study,we investigated the validity of VFT in the differential diagnosis of Alzheimer's disease (AD,n=65),vascular dementia (VaD,n =65),mild cognitive impairment (MCI,n =92),and vascular cognitive impairment without dementia (VCIND,n =76) relative to cognitively normal senior controls (NC,n =374).We found that in the NC group,the total correct score was significantly correlated with age and education; males generated more subcategories; cluster size increased with education,and subcategory and switching decreased with age.A significantly progressive advantage was observed in VFT scores in the sequence NC > MCINCIND > ADNaD,and this significantly discriminated dementia patients from the other groups.AD patients performed better in all four VFT scores than VaD patients.Subcategory and switching scores significantly distinguished AD from VaD patients (AD > VaD; mean difference,0.50 for subcategory,P <0.05; 0.71 for switching,P <0.05).MCI patients scored higher than VCIND patients,but the difference did not reach statistical significance.These results suggest that semantic VFT is useful for the detection of MCI and VCIND,and in the differential diagnosis of cognitive impairment.

  11. Cd138 Expression in Renal Tumors and Its Usage in the Differential Diagnosis

    Directory of Open Access Journals (Sweden)

    Ayhan ÖZCAN

    2011-05-01

    Full Text Available Objective: The differential diagnosis of kidney tumors, especially those with eosinophilic cytoplasms, can be problematic due to overlapping morphologic features. CD138 is primarily a plasma cell marker but is known to be expressed in the proximal renal tubular epithelium as well. This study aims to investigate the possible contribution of CD138 expression in the differential diagnosis of kidney tumors with eosinophilic cytoplasm.Material and Method: The case series consisted of 15 chromophobe (ChRCC, 5 eosinophilic variant (EoRCC, 10 clear cell (CCRCC and 9 papillary (PRCC renal cell carcinomas, and 13 oncocytomas. Sections obtained from representative paraffin blocks were stained against CD138 antibody.Results: All CCRCC and PRCC showed membranous CD138 expression. In some of the other eosinophilic renal tumors, cytoplasmic CD138 labeling in varying degrees was detected. In CCRCC cases, CD138 expression was especially observed in low grade areas and areas showing cystic and pseudopapillary growth patterns. A similar pattern of cytoplasmic staining was seen in 3 of the EoRCC and the most of the PRCC cases (6/9.Conclusion: Our findings suggest that CD138 may contribute to the differential diagnosis of renal tumors because of the membranous staining pattern in CCRCC and EoRCC cases and the cytoplasmic staining in CHRCC and oncocytoma cases. Its contributory role may be improved by combined usage with markers like Cytokeratin 7 and RCC marker.

  12. Granulomatous disease in the head and neck: developing a differential diagnosis.

    Science.gov (United States)

    Nwawka, O Kenechi; Nadgir, Rohini; Fujita, Akifumi; Sakai, Osamu

    2014-01-01

    Granulomatous diseases have a varied etiology that includes autoimmune, infectious, idiopathic, and hereditary causes. The unifying factor in these diseases is the formation of granulomas, which histologically are mononuclear inflammatory cells or macrophages surrounded by lymphocytes. Granulomatous diseases often have systemic manifestations that affect organs throughout the body. Granulomatous diseases with head and neck manifestations include granulomatosis with polyangiitis, Churg-Strauss syndrome, Behçet disease, chronic granulomatous disease, and sarcoidosis. Infectious causes include tuberculosis, cat-scratch disease, syphilis, leprosy, actinomycosis, rhinoscleroma, and fungal infections. In the head and neck, granulomatous disease may affect the orbits, sinonasal cavities, salivary glands, aerodigestive tract, temporal bone, or skull base. Imaging findings include sinonasal opacification, ocular and other soft-tissue masses, osseous erosion, airway narrowing, lymphadenopathy, and salivary gland infiltration. Vascular involvement may also be evident, with displacement, narrowing, or occlusion of arteries and veins. Some radiologic findings of granulomatous processes have a considerable overlap with findings of malignancy, and a radiologic differential diagnosis inclusive of both is critical to avoid incorrect clinical treatment. Without the benefit of a prior clinical diagnosis, laboratory findings, or suggestive clinical signs and symptoms, granulomatous diseases may be difficult to differentiate radiologically. Although individual granulomatous diseases may have overlapping findings at imaging, certain radiologic findings should prompt the inclusion of granulomatous diseases in the differential diagnosis, thus facilitating appropriate clinical management. PMID:25208278

  13. Multiple biomarkers of colorectal tumor in a differential diagnosis model :A quantitative study

    Institute of Scientific and Technical Information of China (English)

    Wen Jin; Mei-Qin Gao; Zhi-Wu Lin; Dai-Xing Yang

    2004-01-01

    AIM: To evaluate the multiple biomarkers of colorectal tumor and their potential usage in early diagnosis of colorectal Cancers.METHODS: Multiple biomarkers (DNA contents, AgNOR,PCNA, p53, c-erbB-2) in 10 normal colorectal mucosae, 37 colorectal adenomas and 55 colorectal cancers were analyzed quantitatively in the computed processing imaging system.Discrimination patterns were employed to evaluate the significance of single and multiple indices in diagnosis of colorectal cancers.RESULTS: The mean values of the analyzed parameters increased in order of the normal mucosa, adenoma and adenocareinoma, and this tendency reflected the progression of colorectal malignancy. The parameters including DNA index, positive rates, densities of AgNOR, c-erbB-2, and p53,shape and density of nucleus were relatively valuable for diagnoses. Then a diagnostic discrimination model was established. The samples were confirmed with the model,the sensitivity rates in cancer group and adenoma group were 96.36% and 89.19%, respectively. The value of proliferating cell nuclear antigen (PCNA) in early diagnosis of colorectal cancers was uncertain.CONCLUSION: The quantitative evaluation of some parameters for colorectal tumor can provide reproducible data for differential diagnosis. The established diagnostic discrimination model may be of clinicopathological value,and can make the early diagnosis of colorectal cancer possible.

  14. Differential diagnosis of benign and malignant vertebral compression fractures with MR imaging

    International Nuclear Information System (INIS)

    42 patients with known malignancy and vertebral compressions underwent MRI. Sagittal T1-weighted spin-echo images pre and post Gd-DTPA, out of phase long TR gradient-echo images (GE) and short T1 inversion recovery images (STIR) were obtained at 1.0 T. In 39 of 42 cases a correct differentiation between osteoporotic and tumorous vertebral compression fractures was possible by quantification and correlation of SE and GE signal intensities. Gd-DTPA did not improve differential diagnosis, since both tumour infiltration and bone marrow oedema in acute compression fracture showed comparable enhancement. STIR-sequences were most sensitive for pathology but unspecific due to a comparable amount of water in tumour tissue and bone marrow oedema. Susceptibility-induced signal reduction in GE images and morphologic criteria proved to be most reliable for differentiation of benign and tumour-related fractures. (orig./GDG)

  15. Value of assessing adrenocorticotropic hormone (ACTH levels in differential diagnosis of hypercorticism

    Directory of Open Access Journals (Sweden)

    Penezić Zorana

    2004-01-01

    Full Text Available Diagnosis and differential diagnosis of Cushing's syndrome remains a challenge in clinical endocrinology. The aim of this study was to establish the value of assessing adrenocorticotropic hormone (ACTH levels in differential diagnosis of hypercorticism using receiver operating characteristic (ROC curve. We have evaluated 114 patients with Cushing's syndrome testing the value of pathohistological examination and postoperative testing. The control group consisted of 53 obese healthy persons. ACTH level was determined using a commercial RIA (CIS, France. ACTH secreting pituitary adenoma was found in 56.14% examinees, ectopic secretion in 6.14%, cortisol secreting adrenal adenoma in 37.57%, and adrenal carcinoma in 6.14% of all patients with Cushing's syndrome. Basal ACTH level for pituitary adenoma was 107.29±75.69 pg/mL; for ectopic secretion 181.63±149.84 pg/mL; for adrenal adenoma 4.22±2.32 pg/mL; for adrenal carcinoma 5.50 ±7.72 pg/mL; and 34.76 ±10.07 pg/mL in control group. Testing the value of assessing ACTH the area under ROC curve was 0.9965±0.0071. Test sensitivity was 99.89% and test specificity was 97%. For ACTH cut-off level of 8 pg/mL, test sensitivity was 88.50%, with specificity of 99%. For ACTH cut-off level of 22 pg/mL, test sensitivity was 99.30%, with specificity of 98%. Our intermediate zone from 8 to 22 pg/mL confirms that assessment of ACTH level is a reliable tool in differential diagnosis of Cushing's syndrome.

  16. Noninvasive differential diagnosis of dental periapical lesions in cone-beam CT scans

    International Nuclear Information System (INIS)

    Purpose: This paper proposes a novel application of computer-aided diagnosis (CAD) to an everyday clinical dental challenge: the noninvasive differential diagnosis of periapical lesions between periapical cysts and granulomas. A histological biopsy is the most reliable method currently available for this differential diagnosis; however, this invasive procedure prevents the lesions from healing noninvasively despite a report that they may heal without surgical treatment. A CAD using cone-beam computed tomography (CBCT) offers an alternative noninvasive diagnostic tool which helps to avoid potentially unnecessary surgery and to investigate the unknown healing process and rate for the lesions. Methods: The proposed semiautomatic solution combines graph-based random walks segmentation with machine learning-based boosted classifiers and offers a robust clinical tool with minimal user interaction. As part of this CAD framework, the authors provide two novel technical contributions: (1) probabilistic extension of the random walks segmentation with likelihood ratio test and (2) LDA-AdaBoost: a new integration of weighted linear discriminant analysis to AdaBoost. Results: A dataset of 28 CBCT scans is used to validate the approach and compare it with other popular segmentation and classification methods. The results show the effectiveness of the proposed method with 94.1% correct classification rate and an improvement of the performance by comparison with the Simon’s state-of-the-art method by 17.6%. The authors also compare classification performances with two independent ground-truth sets from the histopathology and CBCT diagnoses provided by endodontic experts. Conclusions: Experimental results of the authors show that the proposed CAD system behaves in clearer agreement with the CBCT ground-truth than with histopathology, supporting the Simon’s conjecture that CBCT diagnosis can be as accurate as histopathology for differentiating the periapical lesions

  17. Noninvasive differential diagnosis of dental periapical lesions in cone-beam CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Kazunori, E-mail: kazokada@sfsu.edu [Department of Computer Science, San Francisco State University, San Francisco, California 94132 (United States); Rysavy, Steven [Biomedical and Health Informatics Program, University of Washington, Seattle, Washington 98195 (United States); Flores, Arturo [Computer Science and Engineering, University of California, San Diego, California 92093 (United States); Linguraru, Marius George [Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Medical Center, Washington, DC 20010 and Departments of Radiology and Pediatrics, George Washington University, Washington, DC 20037 (United States)

    2015-04-15

    Purpose: This paper proposes a novel application of computer-aided diagnosis (CAD) to an everyday clinical dental challenge: the noninvasive differential diagnosis of periapical lesions between periapical cysts and granulomas. A histological biopsy is the most reliable method currently available for this differential diagnosis; however, this invasive procedure prevents the lesions from healing noninvasively despite a report that they may heal without surgical treatment. A CAD using cone-beam computed tomography (CBCT) offers an alternative noninvasive diagnostic tool which helps to avoid potentially unnecessary surgery and to investigate the unknown healing process and rate for the lesions. Methods: The proposed semiautomatic solution combines graph-based random walks segmentation with machine learning-based boosted classifiers and offers a robust clinical tool with minimal user interaction. As part of this CAD framework, the authors provide two novel technical contributions: (1) probabilistic extension of the random walks segmentation with likelihood ratio test and (2) LDA-AdaBoost: a new integration of weighted linear discriminant analysis to AdaBoost. Results: A dataset of 28 CBCT scans is used to validate the approach and compare it with other popular segmentation and classification methods. The results show the effectiveness of the proposed method with 94.1% correct classification rate and an improvement of the performance by comparison with the Simon’s state-of-the-art method by 17.6%. The authors also compare classification performances with two independent ground-truth sets from the histopathology and CBCT diagnoses provided by endodontic experts. Conclusions: Experimental results of the authors show that the proposed CAD system behaves in clearer agreement with the CBCT ground-truth than with histopathology, supporting the Simon’s conjecture that CBCT diagnosis can be as accurate as histopathology for differentiating the periapical lesions.

  18. HE4 in the Differential Diagnosis of a Pelvic Mass: A Case Report

    Directory of Open Access Journals (Sweden)

    Luigi Frati

    2011-01-01

    Full Text Available Neoplasms of the ovary present an increasing challenge to the physician. Neoplastic ovarian cysts can resemble endometriomas in ultrasound imaging and need to be carefully considered in the differential diagnosis. We report the case of a woman with a strong family history of hereditary breast and ovarian cancer, who presented with a pelvic mass. The young girl refused oncogenetic counseling and genetic testing, even though she had a 50% a priori probability of being a BRCA1 mutation carrier. Pelvic magnetic resonance imaging (MRI and a comparative analysis of the serum concentration of HE-4 and CA125 biomarkers provided accuracy and sensitivity in the diagnosis of a benign ovarian pathology. Based on this experience, we propose that the sensitivity of a screening program based on a HE4 and CA125 assay and MRI in high risk patients with mutations in the BRCA1 and BRCA2 genes may be considered a useful pre-operative tool for the differential diagnosis of pelvic masses.

  19. History of the infantile hepatic hemangioma: From imaging to generating a differential diagnosis.

    Science.gov (United States)

    Gnarra, Maria; Behr, Gerald; Kitajewski, Alison; Wu, June K; Anupindi, Sudha A; Shawber, Carrie J; Zavras, Nick; Schizas, Dimitrios; Salakos, Chris; Economopoulos, Konstantinos P

    2016-08-01

    We aim to provide an up-to-date summary of infantile hepatic hemangioma (IHH) and its misnomers and to dialectically present the differential diagnosis of these rare entities of the liver. Eligible peer-reviewed articles on hepatic infantile hemangiomas, published between 2000 and 2015, were reviewed for this study. IHH is the most common hepatic vascular tumor in children. Once a liver mass is identified in an infant, the differential diagnosis ranges from vascular malformations to benign and malignant tumors including mesenchymal hamartoma, hepatoblastoma, metastatic neuroblastoma, so careful physical examination, imaging studies, and, if indicated, tumor markers and biopsy, are of pivotal importance to ascertain the correct diagnosis. Despite the benign nature of IHHs, some of these lesions may demand medical and/or surgical intervention, especially for multiple and diffuse IHH. Complications can include hepatomegaly, hypothyroidism and cardiac failure. Therefore, a close follow-up is required until complete involution of the lesions. We propose an algorithm to guide the physicians towards the proper management of hepatic lesions. PMID:27610342

  20. Differential Diagnosis of the pancreatic disease : significance of perivascular changes at celiac trunk and superior mesenteric artery on CT

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Ryang; Kim, Ki Whang; Yu, Jeong Sik; Kim, Ji Hyung; Kim, Dong Guk; Lee, Sung Il; Ahn, Chang Soo; Oh, Sei Jung [Yonsei Univ., Seoul (Korea, Republic of). Coll. of Medicine; Kim, Young Hwan [Sanggye Paik Hospital, Seoul (Korea, Republic of)

    1998-03-01

    The purpose of this paper is to classify perivascular change in the celiac trunk and SMA occurring in pancreatic disease and to evaluate its significance in differential diagnosis. In 73 patients with pancreatic disease (42, acute pancreatitis; 14, chronic pancreatitis; 17, pancreatic cancer) abdominal CT findings were retrospectively reviewed. We defined infiltration as linear or irregular density and thickening as presence of a soft tissue mantle surrounding the vessel, and statistically evaluated the usefulness of these factors for the differential diagnosis of pancreatic diseases. Thickening of the celiac trunk and SMA is a valuable finding in the differential diagnosis of pancreatic inflammatory disease and pancreatic cancer. When applied to the differential diagnosis of pancreatic disease, perivascular change should be classified as either infiltration or thickening. (author). 10 refs., 1 tab., 2 figs.

  1. The use of differential scintigraphy in the clinical diagnosis of osseous and soft tissue changes affecting the diabetic foot

    International Nuclear Information System (INIS)

    Prompt recognition of cellulitis, osteomyelitis, diabetic osteolysis, Charcot neuroarthropathy, septic synovitis, and deep plantar abscesses in the diabetic foot is essential because the therapy is drastically different. Differential diagnosis has been greatly facilitated by recently developed scanning techniques

  2. Extrahepatic bile duct atresia from the pathologist’s perspective: pathological features and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Peter Van Eyken

    2014-06-01

    Full Text Available Extrahepatic biliary atresia (EHBA refers to stenosis or atresia of the extrahepatic biliary tree. It accounts for 25-30% of cases of neonatal cholestasis. If left untreated, EHBA progresses to biliary cirrhosis and is universally fatal within the first 2 years of life. Early diagnosis is crucial since surgical treatment (Kasai procedure is the only treatment option. Histopathologic examination of liver biopsy specimens is a key element in the diagnostic work-up of infants with suspected EHBA. Pathologic diagnosis aims at excluding non-surgically correctable causes of neonatal cholestasis thereby leading to surgical exploration for confirmation of the diagnosis. All published data indicate that pathologists can diagnose EHBA with high sensitivity, high specificity and reasonable interobserver agreement. The most useful histologic features in the diagnosis of EHBA are portal tract changes including ductular proliferation and bile plugs in ducts and ductules. These lesions are not pathognomonic but can be seen in extrahepatic obstruction of any cause. Total parenteral nutrition (TPN-associated cholestasis and alpha1-antitrypsin (A1AT deficiency cannot be differentiated from EHBA without access to clinical data and may lead to false-positive diagnosis. False-negative interpretation may be caused by early age at diagnosis or by small/indequate specimens. The pathologist also plays a role in the examination of the resected fibrotic segment and of explant specimens. Histopathology can yield prognostic information, being also an indispensable tool in research for the possible pathogenesis of this disease. A well-coordinated, multidisciplinary approach is required in the assessment of suspected cases of EHBA.  Proceedings of the International Course on Perinatal Pathology (part of the 10th International Workshop on Neonatology · October 22nd-25th, 2014 · Cagliari (Italy · October 25th, 2014 · The role of the clinical pathological dialogue in

  3. CLCA2 as a Novel Immunohistochemical Marker for Differential Diagnosis of Squamous Cell Carcinoma from Adenocarcinoma of the Lung

    OpenAIRE

    Kazuya Shinmura; Hisaki Igarashi; Hisami Kato; Yuichi Kawanishi; Yusuke Inoue; Satoki Nakamura; Hiroshi Ogawa; Takashi Yamashita; Akikazu Kawase; Kazuhito Funai; Haruhiko Sugimura

    2014-01-01

    Recent progress in targeted therapy for lung cancer has revealed that accurate differential diagnosis between squamous cell carcinoma (SCC) and adenocarcinoma (ADC) of the lung is essential. To identify a novel immunohistochemical marker useful for differential diagnosis between the two subtypes of lung cancer, we first selected 24 SCC-specific genes and 6 ADC-specific genes using data (case number, 980) from the Cancer Genome Atlas (TCGA) database. Among the genes, we chose the CLCA2 gene,...

  4. Differentiation of Pancreatic Cancer and Chronic Pancreatitis Using Computer-Aided Diagnosis of Endoscopic Ultrasound (EUS) Images: A Diagnostic Test

    OpenAIRE

    Maoling Zhu; Can Xu; Jianguo Yu; Yijun Wu; Chunguang Li; Minmin Zhang; Zhendong Jin; Zhaoshen Li

    2013-01-01

    BACKGROUND: Differentiating pancreatic cancer (PC) from normal tissue by computer-aided diagnosis of EUS images were quite useful. The current study was designed to investigate the feasibility of using computer-aided diagnostic (CAD) techniques to extract EUS image parameters for the differential diagnosis of PC and chronic pancreatitis (CP). METHODOLOGY/PRINCIPAL FINDINGS: This study recruited 262 patients with PC and 126 patients with CP. Typical EUS images were selected from the sample set...

  5. Using the Disease State Fingerprint Tool for Differential Diagnosis of Frontotemporal Dementia and Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Muñoz-Ruiz

    2016-07-01

    Full Text Available Background: Disease State Index (DSI and its visualization, Disease State Fingerprint (DSF, form a computer-assisted clinical decision making tool that combines patient data and compares them with cases with known outcomes. Aims: To investigate the ability of the DSI to diagnose frontotemporal dementia (FTD and Alzheimer's disease (AD. Methods: The study cohort consisted of 38 patients with FTD, 57 with AD and 22 controls. Autopsy verification of FTD with TDP-43 positive pathology was available for 14 and AD pathology for 12 cases. We utilized data from neuropsychological tests, volumetric magnetic resonance imaging, single-photon emission tomography, cerebrospinal fluid biomarkers and the APOE genotype. The DSI classification results were calculated with a combination of leave-one-out cross-validation and bootstrapping. A DSF visualization of a FTD patient is presented as an example. Results: The DSI distinguishes controls from FTD (area under the receiver-operator curve, AUC = 0.99 and AD (AUC = 1.00 very well and achieves a good differential diagnosis between AD and FTD (AUC = 0.89. In subsamples of autopsy-confirmed cases (AUC = 0.97 and clinically diagnosed cases (AUC = 0.94, differential diagnosis of AD and FTD performs very well. Conclusions: DSI is a promising computer-assisted biomarker approach for aiding in the diagnostic process of dementing diseases. Here, DSI separates controls from dementia and differentiates between AD and FTD.

  6. Histopathological Differential Diagnosis of Psoriasis and Seborrheic Dermatitis of the Scalp

    Science.gov (United States)

    Park, Ji-Hye; Park, Young Joon; Kim, Sue Kyoung; Kwon, Ji Eun; Kang, Hee Young; Lee, Eun-So; Choi, Jee Ho

    2016-01-01

    Background The differential diagnosis of psoriasis and seborrheic dermatitis can be difficult when both conditions are localized to the scalp without the involvement of other skin sites. Objective We aimed to evaluate the histopathological differences between psoriasis and seborrheic dermatitis on the scalp and identify favorable criteria for their differential diagnosis. Methods We evaluated 15 cases of psoriasis and 20 cases of seborrheic dermatitis of the scalp that had been clinicopathologically diagnosed. Skin biopsy sections stained with H&E were examined. Additional immunohistochemistry was performed, including Ki-67, keratin 10, caspase-5, and GLUT-1. Results On histopathological examination, mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, and clubbed and evenly elongated rete ridges were significantly more frequently observed in psoriasis. Follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis were significantly more common in seborrheic dermatitis. Moreover, significantly higher mitotic figures were observed in psoriatic lesions than in seborrheic dermatitis. Immunohistochemistry did not show any difference between psoriasis and seborrheic dermatitis. Conclusion Histopathological features favoring psoriasis include mounds of parakeratosis with neutrophils, spongiform micropustules of Kogoj, clubbed and evenly elongated rete ridges, and increased mitotic figures (≥6/high-powered field). Features indicating seborrheic dermatitis are follicular plugging, shoulder parakeratosis and prominent lymphocytic exocytosis. Immunohistochemistry was not helpful in differentiating psoriasis from seborrheic dermatitis. PMID:27489423

  7. Application evaluation of MR diffusion weighted imaging in the diagnosis and differential diagnosis of early prostate cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of diffusion weighted imaging (DWI) in the diagnosis and differential diagnosis of early prostate cancer. Methods: The data of 106 patients [35 with early prostate cancer (PCa), 55 with benign prostatic hyperplasia (BPH) and 16 with prostatitis] were retrospectively analyzed, who underwent T2WI, DWI, and T2WI + DWI examination and all patients were confirmed by pathology. The data obtained from T2WI, DWI, and a combination of T2WI and DWI were scored and compared with pathological findings. The receiver operating characteristic (ROC) curves were analyzed for the area under the curve (Az) using Z test. Specificities, sensitivities and accuracies of the three protocols to diagnose PCa were evaluated. The ADC values of each prostate lesion were measured and compared with ANOVA test. Results: DWI missed 7 in 35 early prostate cancer, misdiagnosed 2 in 55 BPH, and 11 in 16 prostatitis. The Az values of T2WI, DWI, and T2WI + DWI for the detection of early prostate cancer were 0.846, 0.874, and 0.947, respectively. There was significant differences between T2WI + DWI and T2WI alone (Z=3.262, P=0.001), and between T2WI + DWI and DWI alone (Z=2.402, P=0.016). There was no significant difference between T2WI alone and DWI alone (Z=0.630, P=0.528). The sensitivities, specificities, and accuracies of T2WI, DWI, and a combination of T2WI and DWI for the detection of early prostate cancer were 51.43% (18/35), 80.00% (28/35), and 85.71% (30/35); 90.14% (64/71), 81.69% (58/71), and 88.73% (63/71); 77.36% (82/106), 81.13% (86/106), and 87.74% (93/106) respectively. The ADC values for detecting early PCa, BPH, and prostatitis were (723 ± 183) ×10-3, (1 381 ± 117) × 10-3, and (957 ± 175) × 10-3 mm2/s.These ADC values showed statistical significance (F=131.94, P<0.01) among the three groups and also reached statistical significance between each two groups. Conclusions: DWI is valuable in detecting early prostate cancer, but there are some

  8. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy in the differential diagnosis of cerebral abscesses.

    Science.gov (United States)

    Spinelli, F; Sara, R; Milella, M; Ruffini, L; Sterzi, R; Causarano, I R; Sberna, M

    2000-01-01

    The diagnosis of brain abscess is often difficult, as the clinical symptoms are not specific. Computed tomography (CT) and magnetic resonance imaging (MRI) are highly sensitive, but different cerebral lesions, especially neoplasms, can have the same ring-like contrast enhancement. Brain abscess is a severe illness requiring rapid diagnosis to choose the most appropriate therapy. Technetium-99m hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy is commonly used to detect an inflammatory process. The aim of this study was to present the results obtained with leucocyte scintigraphy in 65 patients with intracranial mass lesions and clinical findings compatible to or suggestive of brain abscess. The final diagnosis, based on surgery, clinical findings and stereotatic puncture, was brain abscess in 17 patients, primary brain neoplasm in 22, brain metastasis in 16, lymphoma in 2, cysticercosis in 2, hematoma in 2 and cerebral infarction in 4. 99mTc-HMPAO leucocyte scintigraphy was positive in all abscess cases. The scan was negative in the rest of the patients examined, with the exception of one lesion, which was finally diagnosed as a tumour (1 false-positive). All patients who did not have false-negative scans were treated with steroids. The sensitivity, specificity and diagnostic accuracy of leucocyte scintigraphy was 100%, 97.8% and 98.4%, respectively. In conclusion, in our experience, leucocyte scintigraphy is a valuable aid in the differential diagnosis between abscess and neoplasm. PMID:10654146

  9. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy in the differential diagnosis of cerebral abscesses

    International Nuclear Information System (INIS)

    The diagnosis of brain abscess is often difficult, as the clinical symptoms are not specific. Computed tomography (CT) and magnetic resonance imaging (MRI) are highly sensitive, but different cerebral lesions, especially neoplasms, can have the same ring-like contrast enhancement. Brain abscess is a severe illness requiring rapid diagnosis to choose the most appropriate therapy. Technetium-99m hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy is commonly used to detect an inflammatory process. The aim of this study was to present the results obtained with leucocyte scintigraphy in 65 patients with intracranial mass lesions and clinical findings compatible to or suggestive of brain abscess. The final diagnosis, based on surgery, clinical findings and stereotatic puncture, was brain abscess in 17 patients, primary brain neoplasm in 22, brain metastasis in 16, lymphoma in 2, cysticercosis in 2, hematoma in 2 and cerebral infarction in 4. 99mTc-HMPAO leucocyte scintigraphy was positive in all abscess cases. The scan was negative in the rest of the patients examined, with the exception of one lesion, which was finally diagnosed as a tumour (1 false-positive). All patients who did not have false-negative scans were treated with steroids. The sensitivity, specificity and diagnostic accuracy of leucocyte scintigraphy was 100%, 97.8% and 98.4%, respectively. In conclusion, in our experience, leucocyte scintigraphy is a valuable aid in the differential diagnosis between abscess and neoplasm. (orig.)

  10. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy in the differential diagnosis of cerebral abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Spinelli, F.; Sara, R.; Milella, M.; Ruffini, L. [Dept. of Nuclear Medicine, Niguarda Ca' Granda Hospital, Milan (Italy); Sterzi, R.; Causarano, I.R. [Dept. of Neurology, Niguarda Ca' Granda Hospital, Milan (Italy); Sberna, M. [Dept. of Neuroradiology, Niguarda Ca' Granda Hospital, Milan (Italy)

    2000-01-01

    The diagnosis of brain abscess is often difficult, as the clinical symptoms are not specific. Computed tomography (CT) and magnetic resonance imaging (MRI) are highly sensitive, but different cerebral lesions, especially neoplasms, can have the same ring-like contrast enhancement. Brain abscess is a severe illness requiring rapid diagnosis to choose the most appropriate therapy. Technetium-99m hexamethylpropylene amine oxime (HMPAO)-labelled leucocyte scintigraphy is commonly used to detect an inflammatory process. The aim of this study was to present the results obtained with leucocyte scintigraphy in 65 patients with intracranial mass lesions and clinical findings compatible to or suggestive of brain abscess. The final diagnosis, based on surgery, clinical findings and stereotatic puncture, was brain abscess in 17 patients, primary brain neoplasm in 22, brain metastasis in 16, lymphoma in 2, cysticercosis in 2, hematoma in 2 and cerebral infarction in 4. {sup 99m}Tc-HMPAO leucocyte scintigraphy was positive in all abscess cases. The scan was negative in the rest of the patients examined, with the exception of one lesion, which was finally diagnosed as a tumour (1 false-positive). All patients who did not have false-negative scans were treated with steroids. The sensitivity, specificity and diagnostic accuracy of leucocyte scintigraphy was 100%, 97.8% and 98.4%, respectively. In conclusion, in our experience, leucocyte scintigraphy is a valuable aid in the differential diagnosis between abscess and neoplasm. (orig.)

  11. Synovial hemangioma: imaging features in eight histologically proven cases, review of the literature, and differential diagnosis

    International Nuclear Information System (INIS)

    This study was undertaken to describe the imaging characteristics of synovial hemangioma, with the goal of improving the disappointing rate (22%) of clinical diagnosis of this condition. A review of the literature and the differential diagnosis of intra-articular lesions, including synovial osteochondromatosis and pigmented villonodular synovitis, are also presented. Plain radiographs showed a soft tissue density suggesting either joint effusion or a mass in all patients. Phleboliths and bone erosions on plain films in four patients with extra-articular soft tissue involvement pointed to the correct diagnosis. Angiography, showing fine-caliber, smooth-walled vessels, contrast pooling indilated vascular spaces, and early visualization of venous structures, was diagnostic in two patients. Neither arthrography nor CT yielded specific enough findings. MRI was consistently effective in allowing the correct diagnosis to be made preoperatively, showing an intra-articular or juxta-articular mass of intermediate signal intensity on T1-weighted images and of high signal intensity on T2- or T2'-weighted images with low-signal channels or septa within it. A fluid-fluid level was found in two patients with a cavernous-type lesion. Despite the limited nature of this study, it shows clearly that MRI is the procedure of choice. (orig./MG)

  12. Leukoencephalopathy with swelling in children and adolescents: MRI patterns and differential diagnosis

    International Nuclear Information System (INIS)

    In children, several neurological disorders are characterised by spongiform leukoencephalopathy. MRI of the brain typically shows white matter swelling, but does not enable differentiation of the various underlying disorders. The aim of this article is optimisation of the diagnostic value of MRI in leukoencephalopathy accompanied by swelling. MRI-based inclusion criteria were met by 20 patients in our database. The images were analysed using a detailed scoring list. In 13 of the 20 patients the clinical diagnosis was known (11 definite and 2 probable diagnoses). Characteristic MRI abnormalities could be defined in these patients. Of the 7 patients without a diagnosis, 5 had identical MRI abnormalities: diffuse hemisphere swelling and typical cysts in frontoparietal subcortical white matter and the tips of the temporal lobes. The clinical picture was also similar in these patients, suggesting a similar disease. (orig.). With 10 figs., 2 tabs

  13. Leukoencephalopathy with swelling in children and adolescents: MRI patterns and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Knaap, M.S. van der [Department of Child Neurology, Free University Hospital, Amsterdam (Netherlands); Valk, J. [Department of Diagnostic Radiology, Free University Hospital, Amsterdam (Netherlands); Barth, P.G. [Department of Child Neurology, Academic Medical Center, Amsterdam (Netherlands); Smit, L.M.E. [Department of Child Neurology, Free University Hospital, Amsterdam (Netherlands); Engelen, B.G.M. van [Department of Neurology, Sint Radboud University Hospital, Nijmegen (Netherlands); Tortori Donati, P. [Department of Paediatric Neuroradiology, Giannina Gaslini Scientific Institute, Children`s Hospital, Genoa (Italy)

    1995-11-01

    In children, several neurological disorders are characterised by spongiform leukoencephalopathy. MRI of the brain typically shows white matter swelling, but does not enable differentiation of the various underlying disorders. The aim of this article is optimisation of the diagnostic value of MRI in leukoencephalopathy accompanied by swelling. MRI-based inclusion criteria were met by 20 patients in our database. The images were analysed using a detailed scoring list. In 13 of the 20 patients the clinical diagnosis was known (11 definite and 2 probable diagnoses). Characteristic MRI abnormalities could be defined in these patients. Of the 7 patients without a diagnosis, 5 had identical MRI abnormalities: diffuse hemisphere swelling and typical cysts in frontoparietal subcortical white matter and the tips of the temporal lobes. The clinical picture was also similar in these patients, suggesting a similar disease. (orig.). With 10 figs., 2 tabs.

  14. [Bursitis iliopectinea--a rare differential diagnosis of painful inguinal swelling].

    Science.gov (United States)

    Gresser, J; Bitz, K; Binswanger, R; Hegglin, J

    1992-08-01

    The syndrome of iliopectineal bursitis is an important differential diagnosis of a painful swelling in the inguinal region. Symptoms are local swelling and pain, radiation of pain along the femoral nerve, troubles of arterial or venous circulation and even dysuria or dysmenorrhoea in case the bursa penetrates into the pelvis. The diagnosis is established by conventional radiology (signs of osteoarthritis as one of the pathogenetic reasons), ultrasound (liquid mass lateral to the femoral vessels), punction (clear fluid, eventually synovial cells), contrast injection (dimension of the bursa and communication to the hip joint) and computed tomography (dimension, relation to hip and vessels). The treatment is the excision of the bursa, if conservative therapy is not successful. The excision requires tedious, cautious dissection because of the important structures adjacent and a possible communication to the hip joint must be eradicated. PMID:1428931

  15. Spre[ing amelanotic malignant melanoma: A rare differential diagnosis with tumors of the glandula submandibularis

    International Nuclear Information System (INIS)

    The case reported emphasizes the importance of immediate performance of imaging scans in case of the slightest suspicion that clinical symptoms might indicate malignancy of a detected lesion. Despite the superficially only marginal macroscopic findings, MR imaging as well as the CT scans revealed an [vanced, malignant process that h[ been spre[ing. Particularly the soft tissue differential diagnosis obtained with MRI yields the information required for diagnostic characterization of the space occupying tumor mass. It will however be necessary in any case to verify the diagnosis by biopsy or extirpation and cytologic examination of tissue, as the imaging methods do not always unambigiously reveal the malignant dignity of the tumor. (orig./CB)

  16. Survey of infectious laryngotracheitis outbreak in layer hens and differential diagnosis with other respiratory pathogens

    Directory of Open Access Journals (Sweden)

    JLV Chacón

    2007-03-01

    Full Text Available Trachea, lung, and conjunctive samples from 51 commercial layer farms from Bastos region, São Paulo, Brazil, were submitted to nested-PCR and virus isolation in SPF chicken embryos for ILT diagnosis. This region experienced an outbreak characterized by respiratory signs, decrease in egg production and increased mortality. Out of the 51 tested field samples, 23 were positive for ILT by nested-PCR, 22 were positive after the virus isolation, and 24 were positive when both techniques were used. Newcastle disease virus, Avian pneumovirus, or Mycoplasma gallisepticum were not detected. Infectious bronchitis virus was detected in one farm and Mycoplasma synoviae was detected in eight farms. The high incidence of infectious laryngotracheitis virus (ILTV detection, the high correlation between the observed clinical signs and the ILTV detection, and the results of differential diagnosis demonstrated that ILTV was the causative agent of the outbreak of respiratory disease observed in Bastos region, São Paulo, Brazil.

  17. Use of procalcitonin for the differential diagnosis of fever in cancer patients: an observational study

    Directory of Open Access Journals (Sweden)

    Daria Macchioni

    2013-09-01

    Full Text Available Fever often occurs in cancer patients and the possibility of having a reliable marker for the differential etiological diagnosis is desirable. The aim of this study was to investigate the eligibility of the use of procalcitonin (PCT in hemato-oncological patients for the differential diagnosis of fever. We prospectively enrolled 98 cancer patients and divided them into two groups: those with active disease and those with non-active disease. Procalcitonin was dosed at Time 0 (recruitment and at the onset of fever. On enrollment, PCT values were 0.1 ng/mL in 83% patients with active disease, and lower than 0.5 ng/mL in 23%, which is usually considered not suggestive of bacterial infection. Four percent of patients had values over 0.5 ng/mL and these were mainly patients with neuroendocrine tumors or affiliates. On enrollment, there were also no statistically significant differences in PCT values between the two groups of patients. This showed that active cancer is unable by itself to change PCT levels. In the active disease group, 21 episodes of fever due to bacterial infection were registered, and in all of them an increase in PCT values was observed. This demonstrates the ability of PCT to detect an infection-induced fever in cancer patients. Procalcitonin concentrations are not significantly altered by active neoplastic disease. On the contrary, in the course of fever due to a bacterial infection, PCT values increase and can, therefore, be considered a useful tool in the differential diagnosis between infection-induced fever and drug-related or tumor associated-fever. Procalcitonin may be a useful marker of bacterial infection even in cancer patients.

  18. Differential diagnosis of isolated calf muscle vein thrombosis and gastrocnemius hematoma by high-frequency ultrasound

    Institute of Scientific and Technical Information of China (English)

    SU Li-ya; GUO Fa-jin; XU Guang; HAN Xiu-jie; SUN Chang-kun; ZHANG Zheng; JING Qing-hong

    2013-01-01

    Background Differential diagnosis of isolated calf muscle vein thrombosis (ICMVT) and gastrocnemius hematoma is essential for early identification of deep vein thrombosis (DVT).This study aimed to investigate the diagnostic value of high-frequency color Doppler ultrasound for differential diagnosis of ICMVT and gastrocnemius hematoma.Methods A retrospective case series of 35 ICMVT (M∶F,21∶14; mean age (64.5±10.6) years) and 23 gastrocnemius hematoma (M∶F,16∶7; mean age (75.4±11.8) years) patients with bilateral/unilateral lower limb pain was conducted between January 2006 and September 2012.Characteristics and the morphology of high-frequency color Doppler ultrasonography of the lower limb deep vein,great saphenous vein,calf muscles,skin,and soft tissue were examined.Results ICMVT hypoechoic signals were characterized by long,tube-like masses on longitudinal sections and oval masses on transverse sections,with apparent muscle thrombosis boundaries,distal and proximal venous connections,and,often,lower limb DVT.Gastrocnemius hematoma hypoechoic signals were characterized by large volumes,enhanced posterior hematoma echo,hyperechoic muscle boundaries,no hematoma blood flow,and no DVT,and clear differences in trauma/exercise-and oral anticoagulant-induced hematomas were readily apparent.According to the measurement,the ratio of long diameter/transverse diameter (D/T) in ICMVT patients was about less than 2.0,whereas in gastrocnemius hematoma patients the ratio was more than 2.0.Early stage isoechoic and hypoechoic signals were detected with gradually increasing ovular anechoic areas.Partial muscle fibers in the hematoma due to muscle fractures were apparent.Conclusion High-frequency color Doppler ultrasound was found to be a sensitive and reliable method for differential diagnosis of ICMVT and gastrocnemius hematoma due to trauma and exercise or prolonged oral anticoagulant use.

  19. Differential diagnosis of infections in a patient with Chronic Obstructive Pulmonary Disease

    Directory of Open Access Journals (Sweden)

    Paolo Ghiringhelli

    2008-12-01

    Full Text Available We describe a case of a 65-years-old patient with Chronic Obstructive Pulmonary Disease (COPD, receiving oxygen therapy and resistant to antibiotic therapy. He was admitted with high fever, productive cough, marked leukocytosis, and chest X-ray findings of infiltration and fluid levels within lung cysts. A differential diagnosis was essential to start an adequate treatment and avoid the rapid worsening of patients respiratory status. In patients with chronic pulmonary diseases under immunotherapy, micotic infections should be considered. Aspergillus fumigatus was cultured from bronchial washing fluid and we diagnosed chronic necrotizing pulmonary aspergillosis (CNPA. Oral itraconazole was started and his symptoms and laboratory data markedly improved.

  20. Naked patients in the general hospital: differential diagnosis and management strategies.

    Science.gov (United States)

    Maytal, Guy; Smith, Felicia A; Stern, Theodore A

    2006-01-01

    Physicians and patients are frequently concerned, and, at times, distressed, by nakedness during clinical encounters. When nakedness appears, clinicians should attempt to establish the reason for it and determine whether it is appropriate for the situation. Establishing the etiology of nudity can facilitate care by hospital staff and help to modulate their countertransference reactions and behavior. The authors present and discuss three cases involving nudity at times other than during the physical examination, within the context of differential diagnosis and treatment alternatives. PMID:17116949

  1. The differential diagnosis and treatment of depressive disorders in menopausal women

    Directory of Open Access Journals (Sweden)

    Nina Arkad'evna Tyuvina

    2011-03-01

    Full Text Available Neuroendocrine reorganization in a menopausal woman is frequently accompanied by the development of the climacteric syndrome with concomitant mental disorders. Furthermore, various mental disorders, depressions in particular, can manifest themselves in this period. The paper presents the results of examining 150 women aged 41 to 65 years who had depressive disorders in menopause. Based on the findings, the author considers depressions of varying genesis occurring in women in the pre- and postmenopausal periods, their association with menopausal symptoms and social factors. She outlines the differential diagnosis of depressions and the basic principles of their therapy, including indications for and contraindications to hormone replacement therapy and the use of psychotropic drugs.

  2. Differential diagnosis of a cavitary lung lesion in 45-year old man

    Directory of Open Access Journals (Sweden)

    Tanseli Gönlügür

    2011-03-01

    Full Text Available Pulmonary cavity has infectious and non-infectious aetiologies. A 41-year old man was hospitalized with a 1-week history of productive cough, and pleuritic chest pain. A chest CT scan showed a cavitary lesion in left upper lobe. An open lung biopsy revealed the presence of connective tissue within alveolar ducts and bronchioles. In conclusion, cryptogenic organising pneumonia which is a rare cause of pulmonary cavitary lesion was diagnosed. The case was presented in order to emphasize such rare causes of cavitary lung lesions in the differential diagnosis of tuberculosis.

  3. The differential diagnosis of inflammatory joint disease in maternal-fetal microchimerism

    Directory of Open Access Journals (Sweden)

    Seme Youssef Reda

    2013-12-01

    Full Text Available This study aimed at making the differential diagnosis of joint disease in a case of genetic chimerism in a female multiparous donor from the Regional Blood Bank of Guarapuava-PR (Hemocentro Regional de Guarapuava-PR, who had had three pregnancies of male fetuses. The patient showed joint pain prior to the last donation. It was possible to identify fetal cells remaining in circulation 20 years after her last pregnancy. Laboratory tests for acute phase proteins revealed possible termination of immune tolerance to circulating fetal cells. Thus, a hypothesis of graft-versus-host disease was formulated to explain the joint disease manifested by the donor.

  4. [The differential diagnosis of the types of trauma caused by wheeled tractors].

    Science.gov (United States)

    Zaval'niuk, A Kh

    1993-01-01

    Examinations of 23 corpses and study of 282 expert conclusions concerning the deaths of subjects aged 6 to 78 dead because of wheeled tractor injuries under agricultural conditions helped detect the specific characteristic signs of tractor injury types. Mathematical method of analysis of the characteristic features' quantitative parameters permitted the author to find statistically reliable criteria for differential diagnosis of the types of injuries inflicted by wheeled tractors. The possibility of correct conclusions of an expert using this method is at least 95%. PMID:7940629

  5. The derivation and validation of a prediction rule for differential diagnosis of thyroid nodules

    Institute of Scientific and Technical Information of China (English)

    李拓

    2013-01-01

    Objective To set up a prediction rule for the pro-operative differential diagnosis of thyroid nodules and evaluate its clinical value.Methods All patients of thyroid nodules undergoing thyroid operations in Changzheng hospital from June,1997 to July,2012 were included in this study.They were randomly divided into the derivation cohort (2/3) and the validation cohort (1/3) .A prediction rule was developed based on the logistic regression model and the scoring system was established in accordance with assigning of the value of each variableβ

  6. Features of the differential diagnosis of persons with gender identity disorders

    Directory of Open Access Journals (Sweden)

    Z.D. Novikova

    2013-10-01

    Full Text Available We presented a study of the features of gender identity in people undergoing gender, psychological and psychiatric examination to address the issue of gender reassignment. We analyze the specifics of gender identity, levels of masculinity and femininity, the similarities and differentiation within four nosological groups, which include persons with gender identity disorders (GID with transsexualism, personality disorders, diseases of the schizophrenia spectrum, and with organic mental disorders. We address the question of the differential diagnosis in the process of psychological screening of people with transsexualism and other types of GID. The analytical description of the four algorithms and their comparison are psychologically specific, qualitative research, almost impossible using statistical method of data processing. The data presented may be useful to specialists involved in the study of persons with gender identity disorders

  7. Differential diagnosis of the chronic peripancreatic pseudocyst in CT. A study of possible pitfalls

    Energy Technology Data Exchange (ETDEWEB)

    Tremmel, K.; Zimmer, P.; Barth, V.

    1987-03-01

    Cystic masses within the pancreas and in its neighbourhood are often really pseudocysts. In most cases, centrally necrotic solid tumours or genuine cystic neoplasms are easy to differentiate from such pseudocysts. They are in fact rare pathologic conditions. The exclusion of a pseudocyst is sometimes more difficult, especially in peripancreatic cystic masses. Computed tomography has significantly improved the diagnostics of the upper abdomen. Nevertheless, it sometimes creates new problems. This study is a selection of cases pointing to differential diagnostic difficulties that may become pitfalls for the examiner. An image-immanent approximative diagnosis is attempted. The importance of the localisation of these lesions and of the topographical anatomy of the upper abdomen are pointed out.

  8. MRI of metastatic adenocarcinomas to the brain. Differential diagnosis of colorectal and pulmonary cancer

    International Nuclear Information System (INIS)

    To clarify the characteristic features of MR imagings of metastatic adenocarcinomas to the brain and search for differential points between the lesions from colorectal cancer and those of lung cancer, we evaluated retrospectively intraparenchymal metastatic lesions of 13 colorectal origins and 13 pulmonary origins on MR imagings, compared with resected specimens. Metastatic lesions from colorectal cancer showed marked hypointense solid components on T2WI, which correspond to the dense tumor cells and coagulated necrosis pathologically. Metastatic lesions from lung cancers showed mixed intensity and various components on T2WI, which correspond to various histological components, such as solid tumor cell's nests, hemorrhage, necrosis and cystic fluid collection. Pathological specimens suggested that the low signal intensity on T2WI of MRI derived from concentration of tumor cells and coagulated necrosis including macrophages and lymphocytes. This study may contribute to make the differential diagnosis of metastatic adenocarcinomas to the brain from colorectal and pulmonary cancers. (author)

  9. The Value of D-Dimer in Diagnosis of Acute Mesenteric Ischemia and Differential Diagnosis from Acute Pancreatitis and Acute Cholecystitis

    OpenAIRE

    Semih Hot; Nüvit Duraker; Ayhan Sarı; Kenan Çetin

    2016-01-01

    Objective: Because of its poor prognosis and high mor­tality rate, early diagnosis of acute mesenteric ischemia (AMI) is a challenge. The value of serum markers in the diagnosis of AMI is limited and the studies related with the D-dimer test carried out in recent years. In this prospec­tive study we investigated the value of the level of plasma D-dimer in the diagnosis of AMI and the differential diag­nosis from acute pancreatitis and acute cholecystitis. Methods: We included 89 patients w...

  10. The differential diagnosis of children with joint hypermobility: a review of the literature

    Directory of Open Access Journals (Sweden)

    Elliott Elizabeth J

    2009-01-01

    Full Text Available Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT. Results 3330 papers were identified: 1534 pertained to instability of a particular joint; 1666 related to the diagnosis of Ehlers Danlos syndromes and 330 related to joint hypermobility. There are inconsistencies in the literature on joint hypermobility and how it relates to and overlaps with milder forms of HDCT. There is no reliable method of differentiating between Joint Hypermobility Syndrome, familial articular hypermobility and Ehlers-Danlos syndrome (hypermobile type, suggesting these three disorders may be different manifestations of the same spectrum of disorders. We describe our approach to children presenting with joint hypermobility and the published evidence and expert opinion on which this is based. Conclusion There is value in identifying both the underlying genetic cause of joint hypermobility in an individual child and those hypermobile children who have symptoms such as pain and fatigue and might benefit from multidisciplinary rehabilitation management. Every effort should be made to diagnose the underlying disorder responsible for joint hypermobility which may only become apparent over time. We recommend that the term "Joint Hypermobility Syndrome" is used for children with symptomatic joint hypermobility resulting from any underlying HDCT and that these children are best described using both the term Joint Hypermobility Syndrome and their HDCT diagnosis.

  11. Imaging-based differential diagnosis between multiple system atrophy and Parkinson's disease.

    Science.gov (United States)

    Sako, Wataru; Abe, Takashi; Murakami, Nagahisa; Miyazaki, Yoshimichi; Izumi, Yuishin; Harada, Masafumi; Kaji, Ryuji

    2016-09-15

    There are many tools for differentiating between multiple system atrophy with predominant parkinsonian features (MSA-P) and Parkinson's disease (PD). These include middle cerebellar peduncle (MCP) width, apparent diffusion coefficient (ADC) value of the putamen and cerebellum, and (123)I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy images. We aimed to directly compare the above-mentioned methods, and to determine the optimal tool for differential diagnosis. Eleven patients with MSA-P and 36 patients with PD were enrolled. Of these, 7 patients with MSA-P and 14 patients with PD were chosen as background-matched subjects. We measured MCP width, ADC value of the putamen and cerebellum, and MIBG myocardial scintigraphy images. Area under curve (AUC) of receiver operating characteristic (ROC) was assessed to compare the above-mentioned methods. MCP width and ADC value of the putamen may be helpful for differentiating between MSA-P and PD relative to other methods in background-matched patients (MCP, AUC=0.95; putamen ADC, AUC=0.88; cerebellar ADC, AUC=0.70; MIBG, AUC=0.78). Similar AUCs were seen in all patients with different backgrounds. Our findings suggested that MCP width and ADC value of the putamen could be superior to ADC value of the cerebellum and MIBG uptake for differentiating between MSA-P and PD. PMID:27538610

  12. Differential diagnosis of pancreatic cancer from other solid tumours arising from the periampullary area on MDCT

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Suk Ki [Bundang Jesaeng General Hospital, Departments of Radiology, Daejin Medical Center, Seognam-si, Gyeonggi-do (Korea, Republic of); Kim, Jung Hoon; Joo, Ijin; Jeon, Ju Hyun; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Chongno-gu, Seoul (Korea, Republic of); Shin, Kyung Sook [Chungnam National University School of Medicine, Department of Radiology, 266 Munhwa-ro, Jung-gu, Daejeon (Korea, Republic of)

    2015-10-15

    To investigate CT features and differential diagnosis of pancreatic adenocarcinoma compared to other solid tumours arising in the periampullary area. One hundred and ninety-five patients with pathologically proven, solid periampullary tumours, including pancreatic adenocarcinoma (n = 98), neuroendocrine tumours (n = 52), gastrointestinal stromal tumours (n = 31), and solid pseudopapillary neoplasms (n = 14), underwent preoperative CT. Two radiologists reviewed CT features and rated the possibility of pancreatic adenocarcinoma. Statistically common findings for pancreatic adenocarcinoma included: patient age >50 years; ill-defined margin; completely solid mass; homogeneous enhancement; hypoenhancement on arterial and venous phases; atrophy; and duct dilatation. Statistically common findings for GIST included: heterogeneous enhancement; hyperenhancement on arterial and venous phases; rim enhancement; and prominent feeding arteries. The hyperenhancement on arterial and venous phases is statistically common in NET, and heterogeneous enhancement, hypoenhancement on the arterial and venous phases are statistically common in SPN. Diagnostic performance of CT for differentiating pancreatic adenocarcinomas from other solid periampullary tumours was 0.962 and 0.977 with excellent interobserver agreement (κ = 0.824). CT is useful not only for differentiating pancreatic adenocarcinoma form other solid tumours but also for differentiating between other solid tumours, including NET, SPN, and GIST, arising in the periampullary area. (orig.)

  13. Differential diagnosis of pancreatic cancer from other solid tumours arising from the periampullary area on MDCT

    International Nuclear Information System (INIS)

    To investigate CT features and differential diagnosis of pancreatic adenocarcinoma compared to other solid tumours arising in the periampullary area. One hundred and ninety-five patients with pathologically proven, solid periampullary tumours, including pancreatic adenocarcinoma (n = 98), neuroendocrine tumours (n = 52), gastrointestinal stromal tumours (n = 31), and solid pseudopapillary neoplasms (n = 14), underwent preoperative CT. Two radiologists reviewed CT features and rated the possibility of pancreatic adenocarcinoma. Statistically common findings for pancreatic adenocarcinoma included: patient age >50 years; ill-defined margin; completely solid mass; homogeneous enhancement; hypoenhancement on arterial and venous phases; atrophy; and duct dilatation. Statistically common findings for GIST included: heterogeneous enhancement; hyperenhancement on arterial and venous phases; rim enhancement; and prominent feeding arteries. The hyperenhancement on arterial and venous phases is statistically common in NET, and heterogeneous enhancement, hypoenhancement on the arterial and venous phases are statistically common in SPN. Diagnostic performance of CT for differentiating pancreatic adenocarcinomas from other solid periampullary tumours was 0.962 and 0.977 with excellent interobserver agreement (κ = 0.824). CT is useful not only for differentiating pancreatic adenocarcinoma form other solid tumours but also for differentiating between other solid tumours, including NET, SPN, and GIST, arising in the periampullary area. (orig.)

  14. MR Cholangiography and Dynamic Examination of Duodenal Fluid in the Differential Diagnosis between Extrahepatic Biliary Atresia and Infantile Hepatitis Syndrome

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    In order to evaluate the value of magnetic resonance cholangiography (MRC) and dynamic examination of duodenal fluid in the differential diagnosis between extrahepatic biliary atresia (EHBA) and infantile hepatitis syndrome (IHS), 52 pa tients with infantile cholestatic jaundice were examined by MRC and duodenal fluid examination. Original interpretations were compared with clinical outcome. Calculated sensitivity of duodenal fluid examination in diagnosis of EHBA was 100%, and specificity was 91.1%. Sensitivity of MRC in the diagnosis of EHBA was 94.4 % and specificity 88.24 %. The sensitivity of MRC and examination of duodenal fluid combined in diagnosis of EHBA was 94.4 % and specificity 97.06 %. We are led to conclude that MRC and dynamic examination of duodenal fluid are useful in the differential diagnosis between IHS and EHBA and the combined use of the two techniques yield better resutls.

  15. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shirazi, P.; Konopka, L.; Crayton, J.W. [Loyola Univ. Medical Center, Maywood, IL (United States)] [and others

    1994-05-01

    Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.

  16. Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Vasconcellos, Luiz Felipe Rocha [1Hospital dos Servidores do Estado, Rio de Janeiro RJ (Brazil)], e-mail: luizneurol@terra.com.br; Novis, Sergio A. Pereira; Rosso, Ana Lucia Z. [Hospital Universitario Clementino Fraga Filho (HUCFF), Rio de Janeiro, RJ (Brazil); Moreira, Denise Madeira [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Inst. de Neurologia Deolindo Couto; Leite, Ana Claudia C.B. [Fundacao Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ (Brazil)

    2009-03-15

    The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism. (author)

  17. In vitro differential diagnosis of clavus and verruca by a predictive model generated from electrical impedance.

    Directory of Open Access Journals (Sweden)

    Chien-Ya Hung

    Full Text Available BACKGROUND: Similar clinical appearances prevent accurate diagnosis of two common skin diseases, clavus and verruca. In this study, electrical impedance is employed as a novel tool to generate a predictive model for differentiating these two diseases. MATERIALS AND METHODS: We used 29 clavus and 28 verruca lesions. To obtain impedance parameters, a LCR-meter system was applied to measure capacitance (C, resistance (Re, impedance magnitude (Z, and phase angle (θ. These values were combined with lesion thickness (d to characterize the tissue specimens. The results from clavus and verruca were then fitted to a univariate logistic regression model with the generalized estimating equations (GEE method. In model generation, log ZSD and θSD were formulated as predictors by fitting a multiple logistic regression model with the same GEE method. The potential nonlinear effects of covariates were detected by fitting generalized additive models (GAM. Moreover, the model was validated by the goodness-of-fit (GOF assessments. RESULTS: Significant mean differences of the index d, Re, Z, and θ are found between clavus and verruca (p0.7, the adjusted generalized R2 is 0.512 (>0.3, and the p value of the Hosmer-Lemeshow GOF test is 0.350 (>0.05. CONCLUSIONS: This technique promises to provide an approved model for differential diagnosis of clavus and verruca. It could provide a rapid, relatively low-cost, safe and non-invasive screening tool in clinic use.

  18. "Orbiting around" the orbital myositis: clinical features, differential diagnosis and therapy.

    Science.gov (United States)

    Montagnese, F; Wenninger, S; Schoser, B

    2016-04-01

    Orbital myositis (OM) is a rare disease whose clinical heterogeneity and different treatment options represent a diagnostic and therapeutic challenge. We aim to review the state of knowledge on OM, also describing a cohort of patients diagnosed in our centre, to highlight some remarkable clinical features. A literature review was conducted in PubMed and Medline databases. The herein described cohort is composed of seven OM patients, diagnosed according to clinical, laboratory and neuroradiological features, whose clinical data were retrospectively analysed. OM is a non-infectious, inflammatory process primarily involving extraocular eye-muscles. It typically presents as an acute to sub-acute, painful ophthalmoplegia with signs of ocular inflammation, but atypical cases without pain or with a chronic progression have been described. The wide range of OM mimicking diseases make a prompt diagnosis challenging but orbit MRI provides valuable clues for differential diagnosis. Timely treatment is greatly important as OM promptly responds to steroids; nevertheless, partial recovery or relapses often occur. In refractory, recurrent or steroid-intolerant cases other therapeutic options (radiotherapy, immunosuppressants, immunoglobulins) can be adopted, but the most effective therapeutic management is yet to be established. In this review, we provide a detailed clinical description of OM, considering the main differential diagnoses and suggesting the most useful investigations. In light of the currently available data on therapy efficacy, we propose a therapeutic algorithm that may guide neurologists in OM patients' management. PMID:26477021

  19. Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: Usefulness of the portal venous phase

    Energy Technology Data Exchange (ETDEWEB)

    Ishigami, Kousei, E-mail: Ishigamikousei@aol.co [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Tajima, Tsuyoshi; Nishie, Akihiro; Kakihara, Daisuke [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Fujita, Nobuhiro [Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Asayama, Yoshiki; Ushijima, Yasuhiro; Irie, Hiroyuki [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan); Nakamura, Masafumi; Takahata, Shunichi [Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Ito, Tetsuhide [Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan); Honda, Hiroshi [Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 (Japan)

    2010-06-15

    Purpose: To clarify if the portal venous phase is helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis. Materials and methods: MDCT and MRI of groove pancreatic carcinomas (n = 7) and groove pancreatitis (n = 15) were retrospectively reviewed by two radiologists independently. The signal intensity on T2-weighted images was subjectively assessed. The presence or absence of common bile duct (CBD) and main pancreatic duct (MPD) strictures, calcifications, and cystic lesions was evaluated. Additionally, the appearance of groove pancreatic carcinoma and that of groove pancreatitis in the portal venous phase on dynamic MDCT and MRI were compared. Results: There were no significant differences in the signal intensity on T2-weighted images and in the presence or absence of CBD and MPD strictures, calcifications, and cystic lesions between groove pancreatic carcinomas and groove pancreatitis. However, patchy focal enhancement in the portal venous phase was more commonly observed in groove pancreatitis than groove pancreatic carcinoma (Reviewers 1 and 2: 14/15 [93.3%] vs. 1/7 [14.3%], P < 0.0001). In addition, peripheral enhancement was only seen in groove pancreatic carcinomas (Reviewer 1: 4/7 [57.1%] vs. 0/15 [0%], P < 0.005, and Reviewer 2: 3/7 [42.9%] vs. 0/15 [0%], P < 0.05). Conclusion: The portal venous phase may be helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis.

  20. Differential diagnosis of groove pancreatic carcinomas vs. groove pancreatitis: Usefulness of the portal venous phase

    International Nuclear Information System (INIS)

    Purpose: To clarify if the portal venous phase is helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis. Materials and methods: MDCT and MRI of groove pancreatic carcinomas (n = 7) and groove pancreatitis (n = 15) were retrospectively reviewed by two radiologists independently. The signal intensity on T2-weighted images was subjectively assessed. The presence or absence of common bile duct (CBD) and main pancreatic duct (MPD) strictures, calcifications, and cystic lesions was evaluated. Additionally, the appearance of groove pancreatic carcinoma and that of groove pancreatitis in the portal venous phase on dynamic MDCT and MRI were compared. Results: There were no significant differences in the signal intensity on T2-weighted images and in the presence or absence of CBD and MPD strictures, calcifications, and cystic lesions between groove pancreatic carcinomas and groove pancreatitis. However, patchy focal enhancement in the portal venous phase was more commonly observed in groove pancreatitis than groove pancreatic carcinoma (Reviewers 1 and 2: 14/15 [93.3%] vs. 1/7 [14.3%], P < 0.0001). In addition, peripheral enhancement was only seen in groove pancreatic carcinomas (Reviewer 1: 4/7 [57.1%] vs. 0/15 [0%], P < 0.005, and Reviewer 2: 3/7 [42.9%] vs. 0/15 [0%], P < 0.05). Conclusion: The portal venous phase may be helpful for the differential diagnosis of groove pancreatic carcinomas and groove pancreatitis.

  1. Best practices in the differential diagnosis and reporting of acute transfusion reactions

    Directory of Open Access Journals (Sweden)

    Hillis CM

    2016-01-01

    Full Text Available Christopher M Hillis,1–3,* Andrew W Shih,1,3,* Nancy M Heddle1,3,4 1Department of Medicine, 2Department of Oncology, 3McMaster Transfusion Research Program, McMaster University, Hamilton, 4Centre for Innovation, Canadian Blood Services, Ottawa, ON, Canada  *These authors contributed equally to this work Abstract: An acute transfusion reaction (ATR is any reaction to blood, blood components, or plasma derivatives that occurs within 24 hours of a transfusion. The frequencies of ATRs and the associated symptoms, reported by the sentinel sites of the Ontario Transfusion Transmitted Injuries Surveillance System from 2008 to 2012, illustrate an overlap in presenting symptoms. Despite this complexity, the differential diagnosis of an ATR can be determined by considering predominant signs or symptoms, such as fever, dyspnea, rash, and/or hypotension, as these signs and symptoms guide further investigations and management. Reporting of ATRs locally and to hemovigilance systems enhances the safety of the blood supply. Challenges to the development of an international transfusion reaction reporting system are discussed, including the issue of jurisdiction and issues of standardization for definitions, investigations, and reporting requirements. This review discusses a symptom-guided approach to the differential diagnosis of ATRs, the evolution of hemovigilance systems, an overview of the current Canadian system, and proposes a best practice model for hemovigilance based on a World Health Organization patient safety framework. Keywords: blood transfusion, blood components, hemovigilance

  2. Neuroimaging in Parkinsonism: a study with magnetic resonance and spectroscopy as tools in the differential diagnosis

    International Nuclear Information System (INIS)

    The differential diagnosis of Parkinsonism based on clinical features, sometimes may be difficult. Diagnostic tests in these cases might be useful, especially magnetic resonance imaging, a noninvasive exam, not as expensive as positron emission tomography, and provides a good basis for anatomical analysis. The magnetic resonance spectroscopy analyzes cerebral metabolism, yielding inconsistent results in parkinsonian disorders. We selected 40 individuals for magnetic resonance imaging and spectroscopy analysis, 12 with Parkinson's disease, 11 with progressive supranuclear palsy, 7 with multiple system atrophy (parkinsonian type), and 10 individuals without any psychiatric or neurological disorders (controls). Clinical scales included Hoenh and Yahr, unified Parkinson's disease rating scale and mini mental status examination. The results showed that patients with Parkinson's disease and controls presented the same aspects on neuroimaging, with few or absence of abnormalities, and supranuclear progressive palsy and multiple system atrophy showed abnormalities, some of which statistically significant. Thus, magnetic resonance imaging and spectroscopy could be useful as a tool in differential diagnosis of Parkinsonism. (author)

  3. Segmental enhancement on breast MR images: differential diagnosis and diagnostic strategy

    Energy Technology Data Exchange (ETDEWEB)

    Yuen, Sachiko [Shizuoka Cancer Center Hospital, Division of Diagnostic Radiology, Shizuoka (Japan); Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan); Uematsu, Takayoshi [Shizuoka Cancer Center Hospital, Division of Diagnostic Radiology, Shizuoka (Japan); Masako, Kasami [Shizuoka Cancer Center Hospital, Division of Pathology, Shizuoka (Japan); Uchida, Yoshihiro [Shizuoka Cancer Center Hospital, Division of Breast Surgery, Shizuoka (Japan); Nishimura, Tsunehiko [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science, Kyoto (Japan)

    2008-10-15

    The histopathological variations of segmental enhancement on breast magnetic resonance imaging (MRI) were investigated, with the aim of identifying imaging characteristic clues to their differential diagnosis. We reviewed 70 breast MRI examinations demonstrating segmental enhancement, classified them based on their histopathology, and assessed their MRI findings as follows: (1) confluent or not confluent, (2) late enhancement pattern, and the absence or presence of (3) clustered ring enhancements and (4) surrounding high signal intensity (SI) on T2-weighted imaging. Thirteen lesions (18.5%) were benign, eight (11.5%) were high risk, 25 (36%) were ductal carcinoma in situ (DCIS) and 24 (34%) were infiltrating mammary carcinomas (IMC). Clustered ring enhancements were demonstrated in 74% of malignancies (high risk, DCIS and IMC) but no benign lesions (P = 0.0001). The surrounding high SI on T2-weighted imaging was seen in four of five IMC with marked lymphatic involvement. Clustered ring enhancement was not demonstrated in six of seven IMC of tubular and/or lobular types. Segmental enhancement was seen in not only DCIS but also IMC, high-risk and benign lesions. Clustered ring enhancement and surrounding high SI on T2-weighted imaging were clues to their differential diagnosis and helpful to decide their diagnostic strategy. (orig.)

  4. Diagnostic value of Tc-99m MIBI SPECT in the differential diagnosis of lung lesions

    International Nuclear Information System (INIS)

    Aim: This study was conducted to assess the feasibility of using Tc-99m labelled 2-methoxy isobutyl isonitrile (MIBI), which shows uptake in malignant lung lesions, to evaluate benign and malignant lung lesions and to assess the value in the differential diagnosis. Methods: The patients randomly selected among the patients examined at the Kocaeli University Pulmonary Clinic. (19 men, 18 women) who had a pathological PA chest x-ray and did not received any treatment. After intravenous injection of 15-25 mCi Tc-99m MIBI, early (10 minutes) and delayed (2,5 hours) static spot images of posterior and anterior thorax and SPECT images were obtained. The assessment of MIBI uptake was done visually and quantitatively. Results: Of the 18 patients with primary bronchial carcinoma, increased abnormal uptake of MIBI corresponding to the lesion location was found in 14 patients with planar imaging and in 15 patients with SPECT imaging. Three patients did not have any unusual activity accumulation. Of the 19 patients with benign lesions, 4 had abnormally increased uptake of MIBI. In the detection of malignant lesions Tc-99m MIBI was found to have 83.3% specificity, 78.9% sensitivity, 78.9% positive predictive value, and 81.1% negative predictive value. Conclusion: Tc-99m MIBI tumor scintigraphy might be a valuable non-invasive method for the differential diagnosis of malignant and benign lung lesions, however further studies are required as it has relatively low sensitivity and specificity

  5. Omental infarction in an obese 10-year-old boy

    Directory of Open Access Journals (Sweden)

    Katerina Kambouri

    2011-09-01

    Full Text Available Primary omental infarction (POI has a low incidence worldwide, with most cases occurring in adults. This condition is rarely considered in the differential diagnosis of acute abdominal pain in childhood. Herein, we present a case of omental infarction in an obese 10-year-old boy who presented with acute abdominal pain in the right lower abdomen. The ultrasound (US examination did not reveal the appendix but showed secondary signs suggesting acute appendicitis. The child was thus operated on under the preoperative diagnosis of acute appendicitis but the intraoperative finding was omental infarct. Since the omental infarct as etiology of acute abdominal pain is uncommon, we highlight some of the possible etiologies and emphasize the importance of accurate diagnosis and appropriate treatment of omental infarction.

  6. Hepatic tumors in children: Spiral CT findings and their significance for differential diagnosis

    International Nuclear Information System (INIS)

    Liver tumors in childhood are rare. They can be subdivided in benign or primary and secundary malignent liver tumors. The prognosis of malignant liver disease has improved due to extended therapy in the past few years. Thus, diagnosis of liver tumors in childhood gains in significance. After a suspect ultrasound diagnosis, usually computed tomography (CT) is used as a radiologic sectioning method. Guided by a retrospective analysis of 15 cases, the importance of the Helical-CT is presented. Helical-CT is a good diagnostic method for pediatric cases due to reduced scan times. By the basis of clinical data, distribution, and density, various differential diagnoses can be made. Benign liver tumors, especially cysts and frequently haemangioma, can easily be diagnosed and controlled because of their typical echogenicity and contrast visualisation. In cases of hamartoma, focal nodal hyperplasia, and adenoma computed tomography diagnosis is often necessary. Primary malignant liver tumors can prove to be unilocular hepatoblastomas or hepatocellular carcinomas, while disseminated liver invasions usually are considered as metastatic liver tumors of kidney or adrenal cancer. (orig.)

  7. Differential diagnosis of usual interstitial pneumonia: when is it truly idiopathic?

    Directory of Open Access Journals (Sweden)

    Wim A. Wuyts

    2014-09-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF, the most common and lethal of the idiopathic interstitial pneumonias, is defined by a radiological and/or pathological pattern of usual interstitial pneumonia (UIP. However, UIP is not synonymous with IPF as other clinical conditions may be associated with UIP, including chronic hypersensitivity pneumonitis, collagen vascular disease, drug toxicity, asbestosis, familial IPF and Hermansky–Pudlak syndrome. Differentiating IPF (“idiopathic UIP” from conditions that mimic IPF (“secondary UIP” has substantial therapeutic and prognostic implications. A number of radiological and histological clues may help distinguish IPF from other conditions with a UIP pattern of fibrosis, but their appreciation requires extensive expertise in interstitial lung disease as well as an integrated multidisciplinary approach involving pulmonologists, radiologists and pathologists. In addition, multidisciplinary discussions may decrease the time to initial IPF diagnosis and, thus, enable more timely management. This concept was strongly emphasised by the 2011 ATS/ERS/JRS/ALAT guidelines. This article highlights, with the aid of a clinical case, the difficulties in making a diagnosis of IPF in clinical practice. Yet, an accurate diagnosis is critical, particularly given the availability of drugs that may reduce the pace of functional decline and disease progression in IPF.

  8. Evaluation of bone scintigraphy in differential diagnosis of benign bone tumors

    International Nuclear Information System (INIS)

    Bone scintigraphy with sup(99m)Tc-phosphate compounds was evaluated from the analysis of 71 consecutive cases of various benign bone tumors whether the scintigrams could be helpful in their differential diagnosis. The characteristics of the scintigraphic image at the site of bone lesions were noticed as being marked (++), moderate (+) and poor or minimal (-), according to the degree of accumulation of the radioactivity. Fibrous dysplasia (8 among 9 cases) as well as aneurysmal bone cyst (3 among 4 cases) had strong tendency of marked accumulation. Poor or minimal accumulation was observed in almost all of the lesions of nonossifying fibroma including fibrous cortical defect (6 all cases), solitary bone cyst (4 among 6 cases) and enchondroma (3 among 4 cases). Moderate accumulation was said to be non-specific, since it could be encountered in any types of benign bone tumors. But it was noticed that the majority of the bone lesions of eosinophilic granuloma (7 among 9 cases) showed moderate accumulation and the scintigraphic evidence of the skeletal disease appeared to be less extensive than the roentgenogram. These scintigraphic characteristics realized in some benign bone tumors occasionally played an important role in clinical diagnosis, especially in the cases atypical on roentgenographic findings. Several instructive cases whose final diagnosis was strongly linked to the scintigraphic informations were demonstrated. (author)

  9. Ground-glass opacity at high resolution CT: an approach for differential diagnosis

    International Nuclear Information System (INIS)

    Purpose: To evaluate the Ground-Glass Opacity in high resolution computed tomography (HRCT) with its underlying abnormality and anatomic distribution and its correlation with different etiologies. Methods: A 38 patients series, (32 men, 16 women, mean age 54,6 years, range 20-28) was retrospectively analyzed. They were evaluated with high resolution computed tomography, 2 mm thick sections and 10 mm of interval. Contrast intravenous iodinated contrast (no-ionic) was injected in 11 patients. The final diagnosis was made with sputum analysis, bronchioalveolar lavage, trans bronchial biopsy and open lung biopsy. Results: The differential diagnosis of ground glass opacity is based on analyzing their anatomic resolution and the underlying pathology in the lung parenchyma. Centrilobular distribution indicated early air-spaces pathology produced in our series by 21 infections, 4 pulmonary hemorrhages, 1 hypersensitivity pneumonitis and 1 descamative interstitial pneumonitis. Panlobular distribution, alveolar proteinosis (1 case) sarcoidosis (1 case) drug toxicity 1 case and one case of pneumocystis carinii. Peripherical distribution typical of early idiopathic fibrosis (1). Bronchiolitis obliterans with organizing pneumonia (1). Structural alterations of the lung parenchyma with bronchiectasias was seen in 16 cases, cystic lesions in 3 cases, sub pleural linear opacities 4 cases, peribronchovascular interstitial thickening or nodularity and emphysema in 10 cases. Conclusion: HRCT is useful to evaluate ground glass opacities pattern with the anatomic distribution and the underlying structural pathology. These findings under some clinical circumstances can suggest a specific diagnosis in most cases, indicating a potentially treatable disease. (author)

  10. Diagnostic imaging and differential diagnosis of pathological processes of the sinus cavernosus

    International Nuclear Information System (INIS)

    To describe the different imaging modalities for the evaluation of pathological changes in the cavernous sinus as well as to compile criteria for differential diagnosis.Imaging of the cavernous sinus comprises the primary use of tomographic modalities such as CT or MRI. The continuing development of multislice-CT (MSCT) allows the depiction of bony structures of the cavernous sinus with a high resolution. Secondary reconstructions of the acquired data set allow a reliable evaluation especially of the bony topography including the foraminae of nerves and vessels. Uni- or bilateral structures can be visualized using contrast-enhanced CT. CT-angiography is capable of demonstrating the course of the internal carotid artery and its involvement in pathologies of the cavernous sinus, this recent achievement has only been made available by use of the current short scanning times.Contrast-enhanced MRI in axial and coronal orientation, optionally using fat saturation techniques as well as arterial and venous MRI-angiography (MRA) are used to depict the soft parts of the cavernous sinus. Care must be taken to cover all topographic detail including different signal intensities, as multiple inborn, neoplastic, infectious or traumatic changes can be present hampering the radiologic diagnosis of the cavernous sinus. Uni- and bilateral infiltration of the cavernous sinus as well as vascular involvement represent additional criteria leading to the differential diagnosis. The advent of dynamic sequences as well as diffusion and perfusion weighted MRI have broadened the spectrum of diagnostic modalities. Digital subtraction angiography as an invasive technique is used during therapeutic procedures such as the local treatment of aneurysms or carotid-cavernous fistulas. (orig.)

  11. Unveiling a novel biomarker panel for diagnosis and classification of well-differentiated thyroid carcinomas.

    Science.gov (United States)

    Paricharttanakul, N Monique; Saharat, Kittirat; Chokchaichamnankit, Daranee; Punyarit, Phaibul; Srisomsap, Chantragan; Svasti, Jisnuson

    2016-04-01

    Thyroid cancer is the most common human endocrine malignancy with increasing global incidence. Papillary thyroid carcinomas (PTC) and follicular thyroid carcinomas (FTC) are well-differentiated thyroid cancers (WDTC) accounting for 95% of all thyroid cancer cases, with survival rates of almost 100% when diagnosed early. Since PTC and FTC have different modes of metastasis, they require different treatment strategies. Standard diagnosis by fine needle aspiration with cytopathological examination can be inaccurate in approximately 10-30% of all cases and difficult to definitively classify as WDTC. Currently, there is no single or panel of biomarkers available for thyroid cancer diagnosis and classification. This study identified novel biomarkers for thyroid cancer diagnosis and classification using proteomics, which may be translated into a biomarker panel for clinical application. Two-dimensional SDS-PAGE and mass spectrometry were used to identify potential biomarkers in papillary and follicular thyroid carcinoma cell lines, and the biomarkers were validated in five PTC and five FTC tissues, with their adjacent normal tissues from Thai patients. Eight biomarkers could distinguish PTC from normal tissues, namely enolase 1, triose phosphate isomerase, cathepsin D, annexin A2, cofilin 1, proliferating cell nuclear antigen (PCNA), copine 1 and heat shock protein 27 kDa (HSP27). These biomarkers can also discriminate FTC from normal tissues, except for annexin A2. On the contrary, annexin A2, cofilin 1, PCNA and HSP27 can be used to classify the types of WDTC. These findings have potential for use as a novel multi-marker panel for more accurate diagnosis and classification to better guide physicians on thyroid cancer treatment. Moreover, our results suggest the involvement of proteins in cell growth and proliferation, and the p53 pathway in the carcinogenesis of WDTC, which may lead to targeted therapy for thyroid cancer. PMID:26782318

  12. Evidence for juvenile disc herniation in a Homo erectus boy skeleton

    OpenAIRE

    Häusler, Martin; Schiess, Regula; Böni, Thomas

    2013-01-01

    Study Design: An analysis and differential diagnosis of bony alterations in the lower lumbar vertebrae of a Homo erectus boy skeleton. Objective: To analyze low back problems during early human evolution. Summary of Background Data: Back problems in modern humans are often attributed to our upright, bipedal locomotion that is thought to place huge mechanical stresses on the vertebral column. However, little is known of this situation during the course of human evolution. Methods: We analyzed ...

  13. An Investigation of Narrative Ability in Boys with Autism and Fragile X Syndrome

    OpenAIRE

    Hogan-Brown, Abigail L; Losh, Molly; Martin, Gary E.; Mueffelmann, Deborah J.

    2013-01-01

    Whereas pragmatic language difficulties are characteristic of both autism and Fragile X syndrome, it is unclear whether such deficits are qualitatively similar or whether certain skills are differentially affected. This study compared narrative competence in boys with autism, Fragile X syndrome, Down syndrome, and typical development. Results revealed that an interaction between diagnosis and nonverbal mental age predicted narrative microstructure (e.g., complex syntax) but not macrostructure...

  14. Differential MRI Diagnosis Between Brain Abscess and Necrotic or Cystic Brain Tumors Using Diffusion Weighted Images

    Directory of Open Access Journals (Sweden)

    Zinat Miabi

    2009-01-01

    Full Text Available "nIntroduction: Differentiating brain abscesses from cystic or necrotic tumors by CT or MR imaging can be difficult. Difficulties in the diagnosis of intracranial abscess are mainly due to the combination of often unspecified clinical findings and similarities in the morphologic appearance of some intracranial mass lesions, such as cystic gliomas, metastases, and brain abscesses. Diffusion-weighted imaging provides a way to evaluate the diffusion properties of water molecules in tissue and has been used for diseases such as ischemia, tumors, epilepsy, and white matter disorders. The goal of this study was to evaluate the diagnostic utility of diffusion MRI to differentiate between brain abscesses and necrotic or cystic brain tumors. "nMaterials and Methods: MRI was performed in 17 patients (12 men and five women; age range, 19–74 years [mean, 55 years] with necrotic lesions and MR imaging evidence of ring-shaped enhancement after the injection of contrast material .In addition to standard MR sequences diffusion weighted MRI with apparent coefficient (ADC maps. "nResults: Eleven patients had tumors, and six had pyogenic abscesses. The tumors were glioblastomas (five patients, anaplastic astrocytoma (three patients, metastases (three patients, and primary malignancy, including lung (2 and breast (1 cancer. Surgical or stereotactic biopsies were obtained, and histologic studies were performed in all except one case (case 5. In the cases of abscess, bacteriologic analysis was also conducted. None of these lesions appeared hemorrhagic on T1-weighted images. "nConclusion: Diffusion-weighted imaging is useful for differentiating brain abscess from cystic or necrotic brain tumor, which is often difficult with conventional MR imaging. Diffusion-weighted imaging is useful as an additional imaging technique for establishing the differential diagnosis between brain abscesses and cystic or necrotic brain tumors. It requires less imaging time and is more

  15. The Value of D-Dimer in Diagnosis of Acute Mesenteric Ischemia and Differential Diagnosis from Acute Pancreatitis and Acute Cholecystitis

    Directory of Open Access Journals (Sweden)

    Semih Hot

    2016-03-01

    Full Text Available Objective: Because of its poor prognosis and high mor­tality rate, early diagnosis of acute mesenteric ischemia (AMI is a challenge. The value of serum markers in the diagnosis of AMI is limited and the studies related with the D-dimer test carried out in recent years. In this prospec­tive study we investigated the value of the level of plasma D-dimer in the diagnosis of AMI and the differential diag­nosis from acute pancreatitis and acute cholecystitis. Methods: We included 89 patients who admitted to our emergency department with abdominal pain. The number and the diagnosis of the patients were 17 AMI, 42 acute pancreatitis and 30 acute cholecystitis, respectively. We measured the levels of plasma D-dimer of all patients by using a latex agglutination ‘immunoassay’ method. Even­tually we calculated the sensitivity and specificity of D-dimer test in the diagnosis of AMI. Results: We determined the specificity of the D-dimer test in the differential diagnosis of AMI as 50% from acute pancreatitis, 70% from acute cholecystitis, 58.3% from all the control group and the sensitivity was 100%. Conclusion: The measurement of plasma D-dimer con­centration may be useful in the differential diagnosis of AMI from acute pancreatitis and acute cholecystitis. How­ever, to reveal the diagnostic value of D-dimer test more clearly, further studies with larger series are needed, where cut-off value is highly defined, and other patients with acute abdominal pain are added into the control group.

  16. Differential sialylation of serpin A1 in the early diagnosis of Parkinson's disease dementia.

    Directory of Open Access Journals (Sweden)

    Sarah Jesse

    Full Text Available The prevalence of Parkinson's disease (PD increases with age. Up to 50% of PD show cognitive decline in terms of a mild cognitive impairment already in early stages that predict the development of dementia, which can occur in up to 80% of PD patients over the long term, called Parkinson's disease dementia (PDD. So far, diagnosis of PD/PDD is made according to clinical and neuropsychological examinations while laboratory data is only used for exclusion of other diseases. The aim of this study was the identification of possible biomarkers in cerebrospinal fluid (CSF of PD, PDD and controls (CON which predict the development of dementia in PD. For this, a proteomic approach optimized for CSF was performed using 18 clinically well characterized patients in a first step with subsequent validation using 84 patients. Here, we detected differentially sialylated isoforms of Serpin A1 as marker for differentiation of PD versus PDD in CSF. Performing 2D-immunoblots, all PDD patients could be identified correctly (sensitivity 100%. Ten out of 24 PD patients showed Serpin A1 isoforms in a similar pattern like PDD, indicating a specificity of 58% for the test-procedure. In control samples, no additional isoform was detected. On the basis of these results, we conclude that differentially sialylated products of Serpin A1 are an interesting biomarker to indicate the development of a dementia during the course of PD.

  17. Comparison of multiplex-PCR and antigen detection for differential diagnosis of Entamoeba histolytica

    Directory of Open Access Journals (Sweden)

    Helena Lúcia Carneiro Santos

    2007-06-01

    Full Text Available Amebiasis is an infection caused by Entamoeba histolytica. However, differentiation between E. histolytica and Entamoeba dispar, which are morphologically identical species, is essential for treatment decision, precaution of the invasive disease and public health. The purpose of the present study was to evaluate a Multiplex -PCR for detection and differentiation of E. histolytica from E. dispar from fresh stool samples in comparison with the coproantigen commercial ELISA. Microscopic examination of stools using the Coprotest method, detection of stool antigen by enzyme-linked immunosorbent assay kit and a home made Multiplex-PCR, were used for the diagnosis of amoebiasis infection. Analysis of the 127 stools samples by microscopy examination demonstrated that only 27 (21% samples were positive for E. histolytica/E. dispar complex. Among these stool samples, 11 were positive by Multiplex-PCR, with nine presenting the diagnostic fragment characteristic of E. dispar (96 bp and two presenting diagnostic fragment of E. histolytica (132 bp. Among negative samples detected by microscopic examination, three positive samples for E. dispar and one positive for E. histolytica by Multiplex-PCR was observed. This denotes a low sensibility of microscopic examination when a single stool sample is analyzed. Assay for detection of E. histolytica antigen was concordant with multiplex-PCR in relation to E. histolytica. Statistical analysis comparing the sensibility tests was not done because of the low number of E. histolytica cases. The results demonstrate the importance of the specific techniques use for the differentiation between E. histolytica and E. dispar.

  18. Differential diagnosis and staging of urological tumors by magnetic resonance imaging compared with computed tomography

    International Nuclear Information System (INIS)

    Magnetic resonance imaging (MRI) was performed on 49 urological tumors (11 renal cell carcinomas, 3 renal pelvic cancers, 2 renal angiomyolipomas, 1 renal leiomyosarcoma, 1 large renal cvst, 4 adrenal tumors, 11 bladder cancers, 2 bone metastasis from bladder cancer, 10 prostatic cancers, 1 prostatic sarcoma, 1 urethral cancer, 1 penile cancer and 1 perivesical granuloma) since October 1985 to September 1986. MRI was performed using a Signa (G.E.) with a 1.5 T superconductive magnet and 3 images, including T1 weighted image, T2 weighted image, and proton density image, were obtained. In conclusion MRI is a noninvasive examination and gives more information than computed tomography despite its high cost. In renal cell carcinoma, the chemical shift in MRI and clear visualization of tumor thrombus enable accurate staging. Differential diagnosis from other renal mass lesions may be possible by the T2 weighted image. In adrenal disease, most of the adrenal masses can be differentiated, but in some cases it is impossible. In bladder cancer, wall invasion of tumor may be evaluated in T2 weighted image, and MRI is suitable for staging of locally advanced tumor. In prostatic cancer, visualization of periprostatic plexus and differentiation between internal and external gland may enable local staging and identification of low stage tumors. (author)

  19. Laser Raman detection of platelet as a non-invasive approach for early and differential diagnosis of Alzheimer's disease

    International Nuclear Information System (INIS)

    Early and differential diagnosis of Alzheimer's disease (AD) is a problem that puzzled many doctors. Reliable markers in easy-assembling samples are of considerable clinical diagnostic value. In this work, laser Raman spectroscopy (LRS) was developed a new method that potentially allows early and differential diagnosis of AD from the platelet sample. Raman spectra of platelets isolated from different ages of AD transgenic mice and non-transgenic controls were collected and analyzed. Multilayer perceptron networks (MLP) classification method was used to classify spectra and establish the diagnostic models. For differential diagnosis, spectra of platelets isolated from AD, Parkinson's disease (PD) and vascular dementia (VD) mice were also discriminated. Two notable spectral differences at 740 and 1654 cm-1 were revealed in the mean spectrum of platelets isolated from AD transgenic mice and the controls. MLP displayed a powerful ability in the classifying of early, advanced AD and the control group, and in differential diagnosis of PD and advanced AD, as well as VD and advanced AD. The results suggest that platelet detecting by LRS coupled with MLP analysis appears to be an easy and accurate method for early and differential diagnosis of AD. This technique could be rapidly promoted from laboratory to the hospital

  20. Differential Diagnosis Knowledge Building by Using CUC-C4.5 Framework

    Directory of Open Access Journals (Sweden)

    Kusrini

    2010-01-01

    Full Text Available Problem statement: The Case Based Reasoning (CBR method can be implemented in differential diagnosis analysis. C4.5 algorithm has been commonly used to help the method's knowledge building process. This process is completed by constructing decision tree from previously handled cases data. The C4.5 algorithm itself can be used with an assumption that all the cases has an exact and equal truth value thus have an exact contribution in decision tree building process. However, the decision makers sometimes not sure about the truth of the cases in the cases database, therefore the confidence value can be different for case by case. Besides that, the C4.5 algorithm can only handle cases that are stored in a flat table with data in form of categorized text or in discrete class. This algorithm has not yet explained about how is decision tree building mechanism in situation when the data are stored in relational tables. It also has not yet explained about the process of knowledge building when the data are in the form of number in continuous class. Meanwhile, the observed objects in this research, that is medical record data, are mostly stored in a complex relational database and have common form of categorized text, discrete number, continuous number and image. Therefore, the C4.5 is needed to be improved so it can handle decision building for cases database of medical record. Approach: We develop a knowledge building framework that can handle confidence level difference of cases in cases database. The framework we build also allows the data are stored in relational database. Moreover, our framework can process data in the form of categorized text, discrete number, continuous number and image. This framework is named CUC-C4.5, abbreviated from Complex Uncertain Case C4.5 as it is the improvement from C4.5 algorithm. Results: The CUC-C4.5 framework has been applied on the case of differential diagnosis knowledge building in a group decision support system

  1. Brucellosis: unusual presentations in two adolescent boys

    International Nuclear Information System (INIS)

    Two boys presented with variable signs and symptoms of infectious disease that challenged diagnosis. One of the two patients had aortic valve vegetations and lower extremity aneurysms, and the other had calvarial osteomyelitis, epidural abscess, pleural effusions, and pulmonary nodules. Only after a battery of bacterial and fungal agglutination tests was the unsuspected diagnosis made in each of brucellosis from Brucella canis. (orig.)

  2. Brucellosis: unusual presentations in two adolescent boys

    Energy Technology Data Exchange (ETDEWEB)

    Piampiano, P.; McLeary, M.; Young, L.W. [Dept. of Radiology, Division of Pediatric Radiology, Loma Linda University Children' s Hospital, Loma Linda, CA (United States); Janner, D. [Div. of Pediatric Infectious Disease, Loma Linda University Medical Center and Children' s Hospital, Loma Linda, CA (United States)

    2000-05-01

    Two boys presented with variable signs and symptoms of infectious disease that challenged diagnosis. One of the two patients had aortic valve vegetations and lower extremity aneurysms, and the other had calvarial osteomyelitis, epidural abscess, pleural effusions, and pulmonary nodules. Only after a battery of bacterial and fungal agglutination tests was the unsuspected diagnosis made in each of brucellosis from Brucella canis. (orig.)

  3. Differential protein profiling as a potential multi-marker approach for TSE diagnosis

    Directory of Open Access Journals (Sweden)

    Hogarth Caroline

    2009-11-01

    Full Text Available Abstract Background Transmissible spongiform encephalopathy describes a family of diseases affecting both man and animals. Current tests for the diagnosis of these diseases are based on the detection of an abnormal misfolded form of the host protein PrP which is found within the central nervous and lymphoreticular systems of affected animals. Recently, concern that this marker may not be as reliable as previously thought, coupled with an urgentneed for a pre-clinical live animal test, has led to the search for alternative assays for the detection of TSE disease. Methods This "proof of concept" study, examines the use of differential protein expression profiling using surface enhanced laser desorption and ionisationtime of flight mass spectrometry (SELDI-TOF for the diagnosis of TSE disease. Spectral output from all proteins selectively captured from individual murine brain homogenate samples, are compared as "profiles" in groups of infected and non-infected animals. Differential protein expression between groups is thus highlighted and statistically significant protein "peaks" used to construct a panel of disease specific markers. Studies at both terminal stages of disease and throughout the time course of disease have shown a disease specific protein profile or "disease fingerprint" which could be used to distinguish between groups of TSE infected and uninfected animals at an early time point of disease. Results Our results show many differentially expressed proteins in diseased and control animals, some at early stages of disease. Three proteins identified by SELDI-TOF analysis were verified by immunohistochemistry in brain tissue sections. We demonstrate that by combining the most statistically significant changes in expression, a panel of markers can be constructed that can distinguish between TSE diseased and normal animals. Conclusion Differential protein expression profiling has the potential to be used for the detection of disease in TSE

  4. Cough and dyspnoea of an asthmatic patient at Mt. Kilimanjaro: a difficult differential diagnosis.

    Science.gov (United States)

    Goebbels, K; Gieseler, U; Schöffl, Volker; Küpper, Thomas

    2010-01-01

    This case highlights the difficulties associated with the differential diagnosis of pulmonary symptoms in patients with pre-existing diseases in extreme environmental conditions. A 58-year-old man with child-onset allergic asthma developed dyspnoea and an acute non-productive cough during a trekking expedition on Mt. Kilimanjaro (5895m) in Tanzania. The symptoms were believed initially to be linked to the high altitude exposure (high altitude pulmonary oedema (HAPE) or high altitude cough) or his pre-existing asthma. However, he was later diagnosed correctly with a reinfection of Bordetella pertussis. Pertussis is a highly communicable disease with potentially serious medical consequences that could have affected all of the expedition members. The effectiveness of a pertussis vaccine declines 4-12 years after the vaccination. Thus, it is suggested that the status of immunisation against pertussis should be checked along with those of other infections prior to travel. PMID:20188301

  5. Differential diagnosis of several mechanisms of destruction in patients with dust diseases of lungs

    Energy Technology Data Exchange (ETDEWEB)

    Zhumabekova, B.K.; Nikolaeva, L.N.; Milishnikova, V.V.

    1982-11-01

    In pathogenesis of lung diseases destruction of bronchial passability plays a significant role. Differential diagnosis of the mechanisms of destruction in patients ill with dust diseases was conducted with inhalation of salbutamol, stimulator of beta-adrenoreceptors of bronchi. Investigations of function of breathing included determination of ventilation characteristics, gases of blood and resistance of bronchi. Sixty patients were studied, 30 with pneumoconiosis and 30 with chronic dust bronchitis. Combination of ventilation characteristics and inhalation of salbutamol over 10, 20, 30 and 40 minute periods was used to determine mechanisms causing destruction of function of breathing. Comparisons of results of pneumotaxometry and fibroscopy show changes in mucous envelope of trachea and bronchi, inflammation and hypersecretion causing obstruction of bronchi. It is possible that these mechanisms may be combined with other changes of the tracheobronchial tree (dyskinesia, dystonia, changes in architectonics of bronchial tree and others). Further investigation of these possible mechanisms of destruction of bronchial passability is needed. (5 refs.) (In Russian)

  6. Myelographic differential diagnosis of spinal arachnoiditis with an emphasis on Tbc arachnoiditis

    International Nuclear Information System (INIS)

    Spinal arachnoiditis is a rare condition. The arachnoiditis of various causes, leptomeningeal meatasis, leptomeningeal lymphoma, hypertrophic polyneuritis, etc. are known to have a similar radiologic manifestations. The authors reviewed myelographic findings of 20 patients with spinal arachnoiditis retrospectively to discovery any specific findings helpful to make a differential diagnosis. The causes of spinal arachnoiditis were tuberculous origin in 9 cases, pyogenic in 2, postoperative in one, lymphoma in 3 and leptomeningeal metastasis in 5. Myelographic findings of tuberculous spinal arachnoiditis were block of CSF (89%), especially at the conus medullar is level, multiple fine and/or coarse nodular filling defects (78%), nerve root thickening (56%), focal irregular adhesive filling defects (44%) and irregular or indistinct thecal sac margin (44%). Irregular adhesive band like filling defects and/or multiple fine nodular filling defects seem to be characteristics of the arachnoiditis. Myelographic findings showing coarse nodular filling defects without fine ones are suggestive of leptomeningeal metastasis.

  7. Spontaneous subarachnoid hemorrhage as a differential diagnosis of pre-hospital cardiac arrest

    Directory of Open Access Journals (Sweden)

    Sohil Pothiawala

    2012-01-01

    Full Text Available Spontaneous subarachnoid hemorrhage is the most common neurological disorder leading to pre-hospital cardiac arrest. ECG changes in SAH may mimic myocardial infarction or ischemia, and thus lead to delayed treatment of the primary problem. Early identification of SAH-induced cardiac arrest with the use of computed tomography scan of the brain obtained immediately after resuscitation will aid emergency physicians make further decisions. The overall prognosis of patients who are resuscitated is extremely poor. But, prompt neurosurgical referral and multidisciplinary intensive care management can improve the survival rate and the functional outcome. Thus, physicians should consider SAH as a differential diagnosis in patients presenting with pre-hospital cardiac arrest.

  8. Recurrent eccrine hidradenoma of the breast in a male patient: problems in differential diagnosis

    Directory of Open Access Journals (Sweden)

    Maria Orsaria

    2013-04-01

    Full Text Available Introduction: Hidradenoma is an uncommon usually benign tumor of the skin that grows slowly.Case presentation: We describe a case of a 39 patient with a breast mass. Physical examination revealed a solitary, well-circumscribed tumor, measuring 1 cm by 0.7 cm. No other skin abnormalities were found. A total surgical excision was performed and histologic examination concluded to an eccrine hidradenoma with clear cells.Conclusion: Here we discuss problems in the differentiate this tumor, mainly in this not common location, from a breast primary (ductal carcinoma or adenomyoepitelioma, from a metastatic clear cell carcinoma and from other types of skin tumors. Moreover, this patient presented with a recurrence of the tumor in the same location, suggesting a locally aggressive form of this neoplasia; few reports in the literature are described as at low malignant potential, but definite criteria for this diagnosis are not well defined.

  9. Polymerase chain reaction (PCR) for rapid diagnosis and differentiation of parapoxvirus and orthopoxvirus infections in camels

    International Nuclear Information System (INIS)

    Rapid identification and differentiation of camel pox (CMP) and camel contagious ecthyma (CCE) were achieved by polymerase chain reaction (PCR) with primers that distinguish Orthopoxvirus (OPV) and Parapovirus (PPV). Forty scab specimens collected from sick camels and sheep were treated by 3 different DNA extraction procedures and examined by PCR. The sensitivity of the PCR was compared with that of electron microscopy and virus isolation in cell culture. Procedure 1, in which viral DNA was extracted directly from scab specimens followed by PCR, proved to be superior and more sensitive. Procedure 2 enables a fast specific diagnosis of PPV and OPV infections directly from scab materials without the need for DNA extraction. These assays provide a rapid and feasible alternative to electron microscopy and virus isolation. (author)

  10. [Differential diagnosis of bluish and pigmented lesions of the oral mucosa].

    Science.gov (United States)

    Tsiklakis, K; Patsakas, A

    1989-01-01

    The clinical features of the most common bluish and pigmented lesions of the oral mucosa are discussed in this paper. Considerable attention is given to the findings from the medical and dental history of the patient, in the methodology of the clinical examination (inspection, palpation, digital pressure, aspiration) in the clinical characteristics of the lesions (location, size duration, consistency, prognosis) in the laboratory findings (radiographs and other supplementary examinations) and in the differential diagnosis. The bluish and pigmented lesions which are discussed include: melanoma, Albright's syndrome, Addison's diseases, Peutz-Jeghers's syndrome, arsening poisoning, hemangioma, hematoma, petechia and ecchymosis, Sturge-Weber syndrome, amalgam tatoo, heavy metal lines, mucocele and eruption cyst. PMID:2519153

  11. Comparative evaluations of zono- and tomography in differential diagnosis of small spherical formations of the lungs

    International Nuclear Information System (INIS)

    A comparative analysis of zono- and tomography in 69 patients with minor peripheral cancer of the lung (26), tuberculoma (24), hamartoma (19) was performed. Zonography was shown to improve differential diagnosis between them. However, its importance is limited and it helps to better visualize changes of the lung tissue around the formations, ''a path'' outgoing to the pulmonary root and chest wall, and to detect the enlarged intrathoracic lymph nodes. Tomography is of greater informative value for the evaluation of the skialogical features of the formations and pleural changes. The combined use of zono- and tomography results in a better detection of different pathological lung formations of small sizes and changes in the pulmonary tissue

  12. Isolated myeloid sarcoma of the neck and chest: differential diagnosis and therapeutic approach

    Directory of Open Access Journals (Sweden)

    Djurdjevic Predrag

    2015-01-01

    Full Text Available In this article, we present the case of a 57-yearold man with cervical and mediastinal tumor mass, normal blood count as well as virusological status. Cervical tumor tissue biopsy revealed cells positive for CD34, CD13, LCA, CD33, and CD163 but negative for T-cell and B-cell markers, NK-cell markers, plasmacytic markers and anaplastic large cell lymphoma markers. These features were consistent with myeloid sarcoma of the neck with involvement of the mediastinum. We discussed differential diagnosis and therapy of isolated myeloid sarcoma and suggest that clinical presentation, cell morphology, complete immunophenotype, and specific genotypic lesions in some cases, must be evaluated.

  13. Role of nuclear medicine imaging in differential diagnosis of accessory spleens in patients after splenectomy

    International Nuclear Information System (INIS)

    More than 10% of healthy population has one or more accessory spleens. The most common location is the hilum of the spleen or area near the tail of the pancreas. The radiological appearance of accessory spleens in oncologic patients who underwent splenectomy can be misinterpreted as a recurrence, especially in the case of compensatory growth of an accessory spleen in successive radiological examinations. We present the cases of three patients who underwent splenectomy for gastric carcinoid, gastric adenocarcinoma and cancer of the left adrenal gland, respectively. CT examination and/or PET-CT scan revealed suspicious findings in the left upper abdomen. In one patient, the dimensional increase of this finding in successive examinations was initially considered suggestive for cancer recurrence. Scintigraphy with 99mTc-nanocolloid was able to confirm the presence of an accessory spleen in all these patients. Splenic scintigraphy is an economical, accessible and accurate tool in differential diagnosis of accessory spleens in patients after splenectomy

  14. [Chondromyxoid fibroma. Morphological variations, site, incidence, radiologic criteria and differential diagnosis].

    Science.gov (United States)

    Engels, C; Priemel, M; Möller, G; Werner, M; Delling, G

    1999-07-01

    Chondromyxoid fibroma is a rare benign bone tumor, accounting for less than 1% of all bone tumors. The peak age incidence is the second and third decade of life. Chondromyxoid fibrom occurs in the metaphyseal parts of the major tubular bones, predominantly of the lower extremity. Roentgenograms show, in most cases, a well-demarcated radiolucent lesion. The classic histological feature of a chondromyxoid fibroma is stellate or spindle-shaped cells arranged in lobules in a myxoid or chondroid background. Analysis of 40 chondromyxoid fibromas demonstrates the morphological variation of this tumor. Cases were examined for age distribution, localization, and radiological and histological features. In 85% we found the typical histomorphological pattern. Recurrence rate was 12.5%. In four cases the appearance was uncharacteristic and differentiation from other tumors such as chondroblastoma or chondrosarcoma was quite difficult. By adhering to strict histomorphological criteria, definite diagnosis of chondromyxoid fibroma can be made in most cases. PMID:10478364

  15. Facial baroparesis: a critical differential diagnosis for scuba diving accidents--case report.

    Science.gov (United States)

    Iakovlev, E V; Iakovlev, V V

    2014-01-01

    Facial nerve baroparesis is a rare and potentially under-reported complication of scuba diving. A diver, after surfacing from a shallow dive, developed isolated left-sided facial palsy accompanied by pain and decreased hearing in the left ear. No other signs or symptoms attributable to a scuba diving accident were detected. Forty minutes later, he heard a "pop" in the affected ear, after which all symptoms quickly resolved. Repeat neurological and ear examinations were normal. He showed no residual or new symptoms 24 hours later. The differential diagnosis of facial neurological deficit after diving includes decompression sickness, cerebral air embolism due to pulmonary barotrauma, facial nerve barotrauma and common conditions such as stroke and Bell's palsy. It is important to recognize the condition since recompression treatment can further damage the facial nerve. PMID:25558550

  16. Differential diagnosis of dumbbell lesions associated with spinal neural foraminal widening: Imaging features

    International Nuclear Information System (INIS)

    Computed tomography (CT) and magnetic resonance imaging (MRI) reliably demonstrate typical features of schwannomas or neurofibromas in the vast majority of dumbbell lesions responsible for neural foraminal widening. However, a large variety of unusual lesions which are causes of neural foraminal widening can also be encountered in the spinal neural foramen. Radiologic findings can be helpful in differential diagnosis of lesions of spinal neural foramen including neoplastic lesions such as benign/malign peripheral nerve sheath tumors (PNSTs), solitary bone plasmacytoma (SBP), chondroid chordoma, superior sulcus tumor, metastasis and non-neoplastic lesions such as infectious process (tuberculosis, hydatid cyst), aneurysmal bone cyst (ABC), synovial cyst, traumatic pseudomeningocele, arachnoid cyst, vertebral artery tortuosity. In this article, we discuss CT and MRI findings of dumbbell lesions which are causes of neural foraminal widening.

  17. Radionuclide visualization of uterin fibromyoma as a new method of differential diagnosis

    International Nuclear Information System (INIS)

    Since fibromateous uterus is very vascularized, it is very promising to visualize this blood pool by using radionuclide technique. The study consists of 30 patients with fibromyoma, cyst and other diseases of genital system (salpingitis, ooforit etc.). Blood pool labeling was performed by ''in vivo'' labeling of red blood cells (chlorous tin injection followed by pertechnetate administration) or by intravenous injection of serum albumin labelled with Tc-99m. Both methods were found satisfactory. Gammacamera GKS-I (Soviet production) connected with data store and processing system (CINE-200) was positioned over region of uterus, radioactivity injected and data collected as dynamic study at I frame/sec during 60 seconds. Static visualization was performed 30 min after dynamic study. Radionuclide visualization can be considered as reliable and non-invasive tool in differential diagnosis of fibromyoma and cyst of uterus as well as of endometritis

  18. Maxillary sinusitis as a differential diagnosis in temporomandibular joint pain-dysfunction syndrome.

    Science.gov (United States)

    Rihani, A

    1985-01-01

    Maxillary sinusitis may be diagnosed incorrectly as TMJ pain-dysfunction syndrome because of a similarity of signs and symptoms. Both conditions can manifest with headache, facial pain radiating to the ear and the maxillary teeth, preauricular pain, and pain in the buccal vestibule posterior and superior to the maxillary tuberosity. It can be concluded that (1) more consideration should be given to sinus disturbances as a differential diagnosis in TMJ pain-dysfunction syndrome, (2) it may be preferable to refer some patients with TMJ pain to a medical center where specialists in dentistry, otolaryngology, neurology, rheumatology, and psychiatry can evaluate the patient, and (3) TMJ pain-dysfunction syndrome should be evaluated and treated by a dentist experienced in management of this disorder. PMID:3856028

  19. A controlled study of positron-emission-tomography and positron-emission-tomography/computed tomography in differential diagnosis of solitary pulmonary nodules-report of 60 cases

    Institute of Scientific and Technical Information of China (English)

    DING Qi-yong; HUA Yan-qing; ZHANG Guo-zhen; ZHAO Jun; GUAN Yi-hui; GE Xiao-jun; MAO Ding-biao; ZUO Chuan-tao

    2005-01-01

    @@ The differential diagnosis of solitary pulmonary nodules (SPNs) remains a challenge. It is acknowledged that combining positron-emission tomography (PET) and computed tomography (CT) offers the most reliable noninvasive method for the diagnosis of SPNs.

  20. Multimodal EEG-MRI in the differential diagnosis of Alzheimer's disease and dementia with Lewy bodies.

    Science.gov (United States)

    Colloby, Sean J; Cromarty, Ruth A; Peraza, Luis R; Johnsen, Kristinn; Jóhannesson, Gísli; Bonanni, Laura; Onofrj, Marco; Barber, Robert; O'Brien, John T; Taylor, John-Paul

    2016-07-01

    Differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) remains challenging; currently the best discriminator is striatal dopaminergic imaging. However this modality fails to identify 15-20% of DLB cases and thus other biomarkers may be useful. It is recognised electroencephalography (EEG) slowing and relative medial temporal lobe preservation are supportive features of DLB, although individually they lack diagnostic accuracy. Therefore, we investigated whether combined EEG and MRI indices could assist in the differential diagnosis of AD and DLB. Seventy two participants (21 Controls, 30 AD, 21 DLB) underwent resting EEG and 3 T MR imaging. Six EEG classifiers previously generated using support vector machine algorithms were applied to the present dataset. MRI index was derived from medial temporal atrophy (MTA) ratings. Logistic regression analysis identified EEG predictors of AD and DLB. A combined EEG-MRI model was then generated to examine whether there was an improvement in classification compared to individual modalities. For EEG, two classifiers predicted AD and DLB (model: χ(2) = 22.1, df = 2, p < 0.001, Nagelkerke R(2) = 0.47, classification = 77% (AD 87%, DLB 62%)). For MRI, MTA also predicted AD and DLB (model: χ(2) = 6.5, df = 1, p = 0.01, Nagelkerke R(2) = 0.16, classification = 67% (77% AD, 52% DLB). However, a combined EEG-MRI model showed greater prediction in AD and DLB (model: χ(2) = 31.1, df = 3, p < 0.001, Nagelkerke R(2) = 0.62, classification = 90% (93% AD, 86% DLB)). While suggestive and requiring validation, diagnostic performance could be improved by combining EEG and MRI, and may represent an alternative to dopaminergic imaging. PMID:27060340

  1. Multimodal EEG-MRI in the differential diagnosis of Alzheimer's disease and dementia with Lewy bodies

    Science.gov (United States)

    Colloby, Sean J.; Cromarty, Ruth A.; Peraza, Luis R.; Johnsen, Kristinn; Jóhannesson, Gísli; Bonanni, Laura; Onofrj, Marco; Barber, Robert; O'Brien, John T.; Taylor, John-Paul

    2016-01-01

    Differential diagnosis of Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) remains challenging; currently the best discriminator is striatal dopaminergic imaging. However this modality fails to identify 15–20% of DLB cases and thus other biomarkers may be useful. It is recognised electroencephalography (EEG) slowing and relative medial temporal lobe preservation are supportive features of DLB, although individually they lack diagnostic accuracy. Therefore, we investigated whether combined EEG and MRI indices could assist in the differential diagnosis of AD and DLB. Seventy two participants (21 Controls, 30 AD, 21 DLB) underwent resting EEG and 3 T MR imaging. Six EEG classifiers previously generated using support vector machine algorithms were applied to the present dataset. MRI index was derived from medial temporal atrophy (MTA) ratings. Logistic regression analysis identified EEG predictors of AD and DLB. A combined EEG-MRI model was then generated to examine whether there was an improvement in classification compared to individual modalities. For EEG, two classifiers predicted AD and DLB (model: χ2 = 22.1, df = 2, p MTA also predicted AD and DLB (model: χ2 = 6.5, df = 1, p = 0.01, Nagelkerke R2 = 0.16, classification = 67% (77% AD, 52% DLB). However, a combined EEG-MRI model showed greater prediction in AD and DLB (model: χ2 = 31.1, df = 3, p < 0.001, Nagelkerke R2 = 0.62, classification = 90% (93% AD, 86% DLB)). While suggestive and requiring validation, diagnostic performance could be improved by combining EEG and MRI, and may represent an alternative to dopaminergic imaging. PMID:27060340

  2. Differential diagnosis of behavioral variant of fronto-temporal dementia (bvFTD)

    Science.gov (United States)

    Pąchalska, Maria; Bidzan, Leszek; Łukowicz, Małgorzata; Bidzan, Mariola; Markiewicz, Katarzyna; Jastrzębowska, Grażyna; Talar, Jan

    2011-01-01

    Summary Background The aim of the paper is the differential diagnosis of various types of Fronto-Temporal Dementia (FTD), with the focus on its behavioural variant (bvFTD). Material/Method Material and Method. Screening was done in order to assess the depth of dementia with the short version of MMSE, while evaluation of various variants of FTD was performed with the use of such neuropsychological tests as Newcomb and Chicago Fluency Tests, Wechsler Memory Scale - III (WMS-III), Western Aphasia Battery (WAB-R), and the Boston Naming Test (BNT). Behaviour was evaluated with a Polish version of the Frontal Behavioral Inventory (FBInv). The inventory consists of 24 questions which enable an evaluation of social behaviour disorders. The study included 112 patients - 68 men and 46 women treated in the Reintegrative -Training Centre of the Foundation for Persons with Brain Dysfunctions in Kraków and in the Clinic for Developmental Psychiatry, Psychotic Disorders and Old Age Psychiatry, of the Medical University at Gdańsk, who were suffering from various types of dementia. Results It was found that FTD patients scored the highest, while the VAD patients scored somewhat lower in the FBInv. At the same time the scores obtained by PPA patients were higher in comparison to the control groups, but not as high as in the case of patients with FTD. In the process of the neurotherapy of FTD patients we found a reduction of the behavioral disturbances, despite the progression of the illness. Conclusions The results obtained in the present study confirmed the diagnostic value of FBInv in the differential diagnosis of various types of FTD and in the evaluation of neurotherapy efficacy. PMID:21629185

  3. [Differential diagnosis in "undifferentiated" inflammatory diseases and dyskinesias of the large intestine].

    Science.gov (United States)

    Peleshchuk, A P; Revenok, K M

    2001-01-01

    The majority of foreign gastroenterologists have their doubts whether there exist "undifferentiated" colitisis. They consider these to be a variant of the irritable bowel syndrome. We have examined 173 patients. Of these, 67 percent were less than 45 years of age with significant intestinal disorders caused by chronic colitis. Diagnosis of Crohn's disease and nonspecific ulcerative colitis had been excluded. The main complaints of the patients were constipations alternated sometimes with short-time diarrhea (61%), diarrhea (13%), spasmodic pains in the inferior parts of the abdomen (20%), abdominal distention, and rumbling (74%). In 79% there was tenderness in the sygmoid colon and caecum and spasm thereof. Rectoromanoscopy (RRS) revealed normal mucosa of the rectum and sygmoid colon in 70%, proctosygmoiditis (predominantly catarrhal) in 30 percent of cases. In proctosygmoiditis (vs the normal mucosa) motor dysfunctions, disorders of the contrast mass passage through the intestine, gaustrations were more often seen but the relief of the mucosa was intact. Results of morphological investigations of biopsy specimens of rectal and sygmoidal mucosas were compared with endoscopy findings. No histological changes were revealed in 23% patients with proctosygmoiditis whereas in cases of endoscopically normal mucosa moderate inflammation was rarely detectable. Inflammatory changes in the mucosa were to be seen more frequently by cytologic analysis than by biopsy but more rarely than by RRS. In this way, 25% patients with endoscopical diagnosis of proctosygmoiditis had normal cytological picture. The increased amount of intestinal enzymes (enterokynase, alkaline phosphatase) in stools does not permit differentiating the functional and organic types of the disease, but it significantly contributes to endoscopical, morphological, cytological, and clinical data. Our investigations show that "undifferentiated" colitis is a rarity and that one finds difficulty in differentiating

  4. Differential diagnosis between Alzheimer's disease and dementia with Lewy bodies with DaTSCAN SPECT

    International Nuclear Information System (INIS)

    Aim. Dementia with Lewy bodies (DLB) is the second commonest cause of neuro degenerative dementia after dementia of the Alzheimer's type (DAT). Clinical misdiagnosis between the 2 diseases are frequent. Therefore we tested the hypothesis proposed by Walker Costa et al. that specific D2 dopaminergic degeneration in DLB could be demonstrated by SPECT imaging to make this differential diagnosis. We used DaTSCAN (123I-Ioflupane). Materials and methods. We prospectively currently included 7 patients. MMSE scores range from 18 to 24 (mean 21). DAT diagnosis was made on DSMIV criteria and DLB on international consensus criteria 96-97 (Mc Keith et al.). All patients underwent the following tests: UPDRS, Grober and Buschke memory test, one day fluctuation assessment and NPI scoring. Four patients were diagnosed as DLB and 3 as DAT. They underwent MRI and DaTSCAN SPECT. SPECT acquisition were performed 4 to 5 hours after the injection of 185 MBq of 123I-Ioflupane. We used a 3 headed Prism 3000 XP camera equipped with very high resolution low energy fan beam collimators. Images were evaluated visually and by measurement of the binding potential (BP). BP was measured by regions of interest: one (9x9 pixels) was placed on the caudate nucleus (CN) and the other (34 x 34 pixels) over the occipital area (OC) (unspecific binding). BP was calculated as BP= (CN-OC)/OC. Results. All 3 DAT patients had visually normal DaTSCAN striatal uptake and BP values ranged from 4,1 to 5,1. In all DLB patients, striatal uptake was significantly reduced with visually dramatic reduction of putamen uptake. BP values ranged from 1,4 to 2,9. Conclusion. On these preliminary results we obtained a clear separation, with no overlap, between DAT and DLB patients. These data confirm that DaTSCAN SPECT is able to demonstrate in vivo specific dopaminergic degeneration in DLB. It can be used to differentiate DLB from DAT

  5. The usefulness of diffusion weighted imaging in the differential diagnosis of various intracranial cystic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jun, Jeong Su; Hwang, Seong Su; Baik, Jun Hyun; Park, Young Ha [College of Medicine, The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2004-06-01

    The purpose of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differential diagnosis of various intracranial cystic lesions. This study included 19 patients (13 males, 6 females) with a mean age of 42.5 years. The final histopathological diagnoses for 14 patients were pyogenic brain abscess (n=3), glioblastoma (n=3), ependymoma (n=1), anaplastic astrocytoma (n=1), pilocytic astrocytoma (n=1), hemangioblastoma (n=2), arachnoid cyst (n=1), epidermoid (n=1) and schwannoma (n=1). The other cases of metastasis (n=4) and arachnoid cyst (n=2) were diagnosed on the basis of clinical, laboratory and imaging data. DWI imaging studies were performed with a 1.5 T MR system. A single shot spin echo EPI pulse sequence was applied. B values were set at 0 and 1000 sec/mm{sup 2}. The apparent diffusion coefficient (ADC) were calculated from the ADC map of 10 different cystic brain lesions. Conventional MR imaging included T2WI, T1WI, FLAIR and contrast enhanced T1WI. We analyzed the location, nature, signal intensity on DWI, and the enhancement pattern of the lesions. All of the 3 cases of brain abscess, 1 of 4 cases of metastasis and 1 case of epidermoid showed hyperintensity on DWI. The mean ADC value of brain abscess (2 cases) was less than 1.15 (0.13x10{sup -3} mm{sup 2}/s). The mean ADC values of the other cystic lesions (8 cases) were variable, ranging from 2.840.66 to 3.100.16 (10{sup -3} mm{sup 2}/sec). DWI and ADC values were useful in the differential diagnosis of various intracranial cystic lesions, but some metastatic tumors may mimic a brain abscess on DWI. Therefore, a clinical correlation is mandatory.

  6. The usefulness of diffusion weighted imaging in the differential diagnosis of various intracranial cystic lesions

    International Nuclear Information System (INIS)

    The purpose of this study was to evaluate the usefulness of diffusion-weighted imaging (DWI) for the differential diagnosis of various intracranial cystic lesions. This study included 19 patients (13 males, 6 females) with a mean age of 42.5 years. The final histopathological diagnoses for 14 patients were pyogenic brain abscess (n=3), glioblastoma (n=3), ependymoma (n=1), anaplastic astrocytoma (n=1), pilocytic astrocytoma (n=1), hemangioblastoma (n=2), arachnoid cyst (n=1), epidermoid (n=1) and schwannoma (n=1). The other cases of metastasis (n=4) and arachnoid cyst (n=2) were diagnosed on the basis of clinical, laboratory and imaging data. DWI imaging studies were performed with a 1.5 T MR system. A single shot spin echo EPI pulse sequence was applied. B values were set at 0 and 1000 sec/mm2. The apparent diffusion coefficient (ADC) were calculated from the ADC map of 10 different cystic brain lesions. Conventional MR imaging included T2WI, T1WI, FLAIR and contrast enhanced T1WI. We analyzed the location, nature, signal intensity on DWI, and the enhancement pattern of the lesions. All of the 3 cases of brain abscess, 1 of 4 cases of metastasis and 1 case of epidermoid showed hyperintensity on DWI. The mean ADC value of brain abscess (2 cases) was less than 1.15 (0.13x10-3 mm2/s). The mean ADC values of the other cystic lesions (8 cases) were variable, ranging from 2.840.66 to 3.100.16 (10-3 mm2/sec). DWI and ADC values were useful in the differential diagnosis of various intracranial cystic lesions, but some metastatic tumors may mimic a brain abscess on DWI. Therefore, a clinical correlation is mandatory

  7. 18F FDG PET/CT in differential diagnosis of Parkinsonian disorders

    International Nuclear Information System (INIS)

    Full text: Differential diagnosis of Parkinsonian disorders can be challenging in the early phase of disease course. Positron Emission Tomography (PET) imaging with 18F Fluorodeoxyglucose (FDG) has been used to identify characteristic patterns of glucose metabolism in patients with idiopathic Parkinson's Disease (PD) as well as variant forms of Parkinsonism such as Multisystem Atrophy (MSA), Progressive Supranuclear Palsy (PSP) and cortico basal ganglionic degeneration (CBGD). In this study we assessed the utility of 18F FDG PET/CT in the differential diagnosis Parkinsonian syndromes. 66 Parkinsonian patients with a mean age of 59.6 ± 11.50 years, male: female ratio of 3.12:1, age range of 35-84 years with a disease duration of 2.6 ± .68 years were referred for FDG PET to determine whether their scan patterns could distinguish idiopathic Parkinsons from the Parkinson plus syndromes. Approximately 60 minutes following intravenous injection of 370 MBq of 18F-FDG, PET/CT scan of the brain was acquired in a whole-body Full Ring PET/CT scanner (Discovery STE16 camera). A low dose CT was obtained on the same area without IV contrast for attenuation correction and coregistration. Images were reconstructed using a 3D VUE algorithm and slices were reformatted into transaxial, coronal and sagittal views. Subsequently the images were processed and visually analyzed on Xeleris workstation. Images were classified by visual analysis into the various subgroups, those with normal to increased basal ganglia uptake were classified into Idiopathic Parkinson's (40/45) and when basal ganglia uptake was decreased they were Parkinsons Plus (19/21). The study demonstrates that 18F FDG PET performed at the time of initial referral for parkinsonism could accurately classify patients into Parkinson's disease and Parkinson plus subtypes

  8. Differential diagnosis of white matter diseases in the tropics: An overview

    Science.gov (United States)

    Pandit, Lekha

    2009-01-01

    In hospitals in the tropics, the availability of magnetic resonance imaging (MRI) facilities in urban areas and especially in teaching institutions have resulted in white matter diseases being frequently reported in a variety of clinical settings. Unlike the west where multiple sclerosis (MS) is the commonest white matter disease encountered, in the tropics, there are myriad causes for the same. Infectious and post infectious disorders probably account for the vast majority of these diseases. Human immunodeficiency virus (HIV) infection tops the list of infective conditions. Central nervous system (CNS) tuberculosis occasionally presents with patchy parenchymal lesions unaccompanied by meningeal involvement. Human T cell leukemia virus (HTLV) infection and cystic inflammatory lesions such as neurocysticercosis are important causes to be considered in the differential diagnosis. Diagnosing post infectious demyelinating disorders is equally challenging since more than a third of cases seen in the tropics do not present with history of past infection or vaccinations. Metabolic and deficiency disorders such as Wernicke's encephalopathy, osmotic demyelinating syndrome associated with extra pontine lesions and Vitamin B12 deficiency states can occassionaly cause confusion in diagnosis. This review considers a few important disorders which manifest with white matter changes on MRI and create diagnostic difficulties in a population in the tropics. PMID:20151003

  9. Rare Solid Tumors of the Pancreas as Differential Diagnosis of Pancreatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Sabine Kersting

    2012-05-01

    Full Text Available Context Rare solid tumors of the pancreas can be misinterpreted as primary pancreatic cancer. Objective The aim of this study was to report our experience in the treatment of patients with rare tumor lesions of the pancreas and to discuss clinical and pathological characteristics in the context of the role of surgery. Design Data from patients of our prospective data-base with rare benign and malignant tumors of the pancreas, treated in our division from January 2004 to August 2010, were analyzed retrospectively. Results One-thousand and ninety-eight patients with solid tumors of the pancreas underwent pancreatic surgery. In 19 patients (10 women, 9 men with a mean age of 57 years (range: 20-74 years rare pancreatic tumors (metastasis, solid pseudopapillary tumor, teratoma, hemangioma, accessory spleen, lymphoepithelial cyst, hamartoma, sarcoidosis, yolk sac tumor were the reason for surgical intervention. Conclusion If rare benign and malignant pancreatic tumors, intrapancreatic metastasis, as well as pancreatic malformations or other abnormalities, present themselves as solid masses of the pancreas, they constitute an important differential diagnosis to primary pancreatic neoplasia, e.g. pancreatic ductal adenocarcinoma. Clinical imaging techniques cannot always rule out malignancy, thus operative exploration often remains the treatment of choice to provide the correct diagnosis and initiate adequate surgical therapy.

  10. Radiological differential diagnosis of rheumatoid arthritis; Radiologische Differenzialdiagnose der rheumatoiden Arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Wick, M.C.; Klauser, A.S. [Medizinische Universitaet Innsbruck, Department Radiologie, Innsbruck (Austria)

    2012-02-15

    Establishing an early and reliable diagnosis of rheumatoid arthritis (RA) is of major importance but can be a great clinical challenge leading to direct therapeutic consequences. No single epidemiological, genetic, clinical, serological or radiological test exists which can exclusively diagnose RA. In general diagnosis of RA includes a case history, clinical signs, laboratory abnormalities and radiological examinations, viz. conventional radiography of the joints of the hands and feet. This review summarizes the most important radiological features of RA and the radiological findings of its closest differential diagnoses. (orig.) [German] Eine fruehe Diagnosestellung bei rheumatoider Arthritis (RA) stellt eine grosse klinische Herausforderung dar, da sich daraus unmittelbare therapeutische Konsequenzen ableiten. Es gibt keinen epidemiologischen, genetischen, klinischen, serologischen oder radiologischen Test, mit dessen alleiniger Anwendung die Diagnose der RA definitiv gestellt werden kann. Die Diagnose der RA erfolgt durch die Kombination von Patientenanamnese, klinischen Zeichen und serologischen Biomarkern in Zusammenschau mit der radiologischen Diagnostik, allen voran der Anwendung konventioneller Roentgenbilder der Haende und Fuesse. In diesem Uebersichtsartikel werden die wichtigsten radiologischen Merkmale zur Diagnose der RA und der diagnostisch haeufigsten Differenzialerkrankungen dargestellt. (orig.)

  11. Clinical and economic analysis of methods of diagnosis of differentiated thyroid cancer relapses

    International Nuclear Information System (INIS)

    A pharmacoeconomic analysis of methods for detecting recurrences and / or metastases of differentiated thyroid cancer was performed and a comparative evaluation of the economic feasibility of the two strategies of relapse diagnosis of 45 patients was carried out. Patients with elevated thyroglobulin more than 2.1 ng / ml are consistently performed neck ultrasound, scintigraphy with 99mTc(V)-DMSA, computed tomography of the chest and scintigraphy with medical activities 131I. Reduction in the cost of diagnosis of recurrence and / or metastasis of DTC with using the proposed scheme is due to the fact that for the detection of recurrence and / or metastases the method of scintigraphy 99mTc(V)-DMSA of much less value is used, and the need to use one the most expensive of all the diagnostic tests - scintigraphy with 131I occurs for a small number of (few) patients. Thus, the administration of study with 99mTc(V)-DMSA into a diagnostic algorithm of relapse detection of patients with DTC reduces the value of the diagnostic complex by 18 %.

  12. Lymph Node Thyroglobulin Measurement in Diagnosis of Neck Metastases of Differentiated Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Luca Giovanella

    2011-01-01

    Full Text Available Aim. Enlarged cervical lymph nodes (LNs in patients with thyroid cancer are usually assessed by fine-needle aspiration cytology (FNAC. Thyroglobulin (Tg is frequently elevated in malignant FNAC needle wash specimens (FNAC-Tg. The objectives of the study were to (1 determine an appropriate diagnostic cut-off for FNAC-Tg levels (2 compare FNAC and FNAC-Tg results in a group of 108 patients affected by differentiated thyroid carcinoma (DTC. Methods. A total of 126 consecutive FNACs were performed on enlarged LNs and the final diagnosis was confirmed by surgical pathology examination or clinical follow-up. The best FNAC-Tg cut-off level was selected by receiver operating curve analysis, and diagnostic performances of FNAC and FNAC-Tg were compared. Results. The rate of FNAC samples adequate for cytological examination was 77% in contrast FNAC-Tg available in 100% of aspirates (<.01. The sensitivity, specificity, and accuracy of FNAC were 71%, 80%, 74%, 100%, 80%, and 94%, respectively. The most appropriate cut-off value for the diagnosis of thyroid cancer metastatic LN was 1.1 ng/mL (sensitivity 100%, specificity 100%. Conclusions. The diagnostic performance of needle washout FNAC-Tg measurement with a cut-off of 1.1 ng/mL compared favorably with cytology in detecting DTC node metastases.

  13. Tendinitis of the temporalis muscle: Differential diagnosis and treatment. A Case Report.

    Directory of Open Access Journals (Sweden)

    Verónica Iturriaga

    2016-03-01

    Full Text Available Introduction: The temporalis muscle plays an essential role in mastication and is actively involved in the mandibular closing movement. It is covered by a fibroelastic fascia that forms its tendon. Tendinitis is a degenerative and inflammatory process, which originates in the tendon-bone junction. Signs and symptoms such as swelling, pain, tenderness on palpation, limitation of movement and mouth opening are frequently associated with other temporomandibular disorders (TMD and not with tendinitis as a causal factor. Objective: To describe a clinical case identifying the diagnostic process and management of tendinitis of the temporalis muscle. Case report: A 30-yeard old male patient who sought treatment after continuous squeezing pain in the zygomatic and bilateral temporal regions with increased pain during mouth opening and mandibular function. The patient referred pain in the insertion region of the tendon of the temporalis muscle. Pain was removed after using anesthesia, consequently confirming the diagnosis of tendinitis of the temporalis muscle. Primary management measures were performed and then peritendinous corticosteroids were administered. The patient did not refer spontaneous or functional pain during check-up. Conclusion: Tendinitis of the temporalis muscle is a common condition, although frequently underdiagnosed. A good differential diagnosis must be performed to avoid confusion with other common conditions such as odontogenic pain, sinusitis, arthralgia, myofascial pain and migraine. Management depends on the type of tendinitis. It usually occurs in conjunction with other types of TMD or facial pain, so it is important to know the different clinical characteristics of pathologies with similar manifestations.

  14. Differential diagnosis of white matter diseases in the tropics: An overview

    Directory of Open Access Journals (Sweden)

    Pandit Lekha

    2009-01-01

    Full Text Available In hospitals in the tropics, the availability of magnetic resonance imaging (MRI facilities in urban areas and especially in teaching institutions have resulted in white matter diseases being frequently reported in a variety of clinical settings. Unlike the west where multiple sclerosis (MS is the commonest white matter disease encountered, in the tropics, there are myriad causes for the same. Infectious and post infectious disorders probably account for the vast majority of these diseases. Human immunodeficiency virus (HIV infection tops the list of infective conditions. Central nervous system (CNS tuberculosis occasionally presents with patchy parenchymal lesions unaccompanied by meningeal involvement. Human T cell leukemia virus (HTLV infection and cystic inflammatory lesions such as neurocysticercosis are important causes to be considered in the differential diagnosis. Diagnosing post infectious demyelinating disorders is equally challenging since more than a third of cases seen in the tropics do not present with history of past infection or vaccinations. Metabolic and deficiency disorders such as Wernicke′s encephalopathy, osmotic demyelinating syndrome associated with extra pontine lesions and Vitamin B12 deficiency states can occassionaly cause confusion in diagnosis. This review considers a few important disorders which manifest with white matter changes on MRI and create diagnostic difficulties in a population in the tropics.

  15. The role and rationale of nuclear medicine procedures in the differential diagnosis of renovascular hypertension

    International Nuclear Information System (INIS)

    The use of radionuclides in the differential diagnosis of renovascular hypertension has gone through many periods of enthusiasm and of disappointment. Regardless of the problems with the routine renogram, the availability of gamma camera renal evaluation makes possible meaningful preintervention of screening. The use of the test as a follow-up procedure is an extremely important but often overlooked application of radionuclides in the evaluation of renovascular hypertension. The radionuclide technique is a sensitive and accurate method of evaluating the results of percutaneous angioplasty or surgery or renal function in the affected kidney of patients with renovascular disease. A major change in our approach to the nuclear medicine diagnosis of renovascular hypertension has been the introduction of captopril renography. Although there is still a great deal of work to be done and many investigators are actively studying captopril renography, the potential of the test is clear. Captopril renography should include a baseline renogram, followed by the administration of 25 mg of captopril and a repeat study. Specificity and sensitivity data on this test probably will not be available for several years, but preliminary results are encouraging enough to justify routine use at this time in clinics in which screening for renovascular hypertension is carried out. (author)

  16. Nutrient vessel canals. Differential diagnosis of zystoid carpal lesions on MRI?

    International Nuclear Information System (INIS)

    Purpose: To find and describe potential MRI criteria of nutrient vessel canals of carpal bones. Methods and material: 16 wrists of 13 patients with pain and radiographic depiction of cystic changes within the lunate were examined. The MRI protocol included coronal and sagittal T1- and T2-weighted SE sequences (4 mm slices, 120 FOV, 256x256 matrix) as well as coronal STIR images. Final diagnosis was confirmed by surgery (n=5) and follow up. 10 cadaveric ossa lunata were studied to describe size, number, location and shape of nutrient vessel canals. Results: Ganglion cysts (n=6) showed characteristic signs. In ulnar impaction syndrome (n=1) small cystic lesions in the lunate were surrounded by a sclerotic rim and located near the proximal ulnar surface. In Kienboeck's disease (n=3) cystic components were irregular and surrounded by bone marrow edema. Nutrient vessel canals (n=7) imaged as 1 to 3 small cystic lesions within the palmar or dorsal subchondral region. Conclusion: MRI can aid in differential diagnosis of cystic carpal lesions. Nutrient vessel canals may not be mistaken for pathologic cystic lesions. Carpal ganglion cysts show distinct diagnostic patterns. (orig.)

  17. Diagnóstico diferencial del ojo rojo Guidelines for differential diagnosis of red eye

    Directory of Open Access Journals (Sweden)

    Francisco Umaña

    1993-03-01

    Full Text Available

    En este artículo se dan pautas para el diagnóstico diferencial en casos de ojo rojo en la práctica médica no especializada; se hace énfasis en la necesidad de descartar en primer término entidades como glaucoma, queratitis, iridociclitis, escleritis, eplescleritis y cuerpo extraño antes de concluir que se trata de una conjuntivitis.

    Guidelines for the differential diagnosis of red eye In the non-specialized medical practice are given in this review. Attention Is called to the need to rule-out, In the first place, the following conditions before arriving at a diagnosis of conjunctivitis: glaucoma, keratitis, iridocyclitis, escleritis, eplescleritis and foreign body.

  18. Value of ultrasound examination in differential diagnosis of pancreatic lymphoma and pancreatic cancer

    Institute of Scientific and Technical Information of China (English)

    Li Qiu; Yan Luo; Yu-Lan Peng

    2008-01-01

    AIM:To investigate the value of clinical manifestations and ultrasound examination in the differential diagnosis of pancreatic lymphoma and pancreatic cancer.METHODS:The clinical and ultrasonic characteristics of 12 cases of pancreatic lymphoma and 30 cases of pancreatic cancer were retrospectively analyzed.RESULTS:Statistically significant differences were found in the course of disease,back pain,jaundice,carcino-embryonic antigen (CEA) and CA19-9 increase,palpable abdominal lump,superficial lymph node enlargement,fever and night sweats,lesion size,bile duct expansion,pancreatic duct expansion,vascular involvement,retroperitoneal (below the renal vein level)lymph node enlargement,and intrahepatic metastasis between pancreatic lymphoma and pancreatic cancer.There were no significant differences in age of onset,gender ratio,weight loss,nausea and vomiting,lesion position,the echo of the lesion,and the blood flow of the lesion.CONCLUSION:Pancreatic lymphoma should be considered for patients with long lasting symptoms,superficial lymph node enlargement,palpable abdominal lump,fever and night sweats,relatively large lesions,and retroperitoneal (below the level of the renal vein) lymph node enlargement.A diagnosis of pancreatic cancer should be considered more likely in the patients with relatively short disease course,jaundice,back pain,CEA and CA19-9 increase,relatively small lesions,bile duct expansion,obvious pancreatic duct expansion,peripheral vascular wrapping and involvement,or intrahepatic metastases.

  19. Leptin levels in the differential diagnosis between benign and malignant ascites

    Institute of Scientific and Technical Information of China (English)

    Mehmet Buyukberber; Mehmet Koruk; M Cemil Savas; Murat T Gulsen; Yavuz Pehlivan; Rukiye Deveci; Alper Sevinc; Serdar Gergerlioglu

    2007-01-01

    AIM: To evaluate the role of leptin levels in the differential diagnosis of ascites.METHODS: Ascitic leptin, TNFα and serum leptin levels were measured in 77 patients with ascites (35 with malignancies, 30 cirrhosis and 12 tuberculosis). Control serum samples were obtained from 20 healthy subjects.Leptin and TNFα levels were measured by ELISA. Body mass index (BMI) and percentage of body fat (BFM) by skin fold measurement were calculated for all patients and control groups. Peritoneal biopsy, ascites cytology and cultures or biochemical values were used for the diagnosis of patients.RESULTS: In patients with malignancies, the mean serum and ascites leptin levels and their ratios were significantly decreased compared to the other patient groups and controls. In tuberculosis peritonitis, ascitic fluid TNFα levels were significantly higher than malignant ascites and cirrhotic sterile ascites. BMI and BFM values did not distinguish between patients and controls.CONCLUSION: In patients with malignant ascites,levels of leptin and TNFα were significantly lower than in patients with tuberculous ascites.

  20. Amyloid-plaque imaging in early and differential diagnosis of dementia

    International Nuclear Information System (INIS)

    The increasing life expectancy in our society results in a continuously growing number of patients suffering from neurodegenerative disorders, particularly Alzheimer's disease (AD). Apart from the deleterious consequences for patients and their relatives, this issue has also alarming effects on our social systems. These facts have justified increased scientific efforts regarding the identification of basic pathomechanisms of dementia and the development of new treatment options. Increased production of specific proteins and their pathologic aggregation in the brain appears to be a pathomechanism which occurs early in the course of many different neurodegenerative diseases. Among the most well-known of these protein aggregations are amyloid plaques, which arise from the aggregation of the β-amyloid protein. Currently, this amyloid-aggregation pathology is regarded as a key pathology, playing a causal role in the development of AD. Consequently, modern therapy approaches are directed towards this target. Limited access to brain tissue has so far restricted the definite diagnosis of AD to postmortem histopathological assessment of brain tissue. For the same reason, a clear association between extent of amyloid deposition pathology and clinical course of AD has not been established so far. However, particularly with regard to new therapeutic options, a reliable in vivo diagnosis is required. Modern molecular imaging tracers such as [11C]Pittsburgh Compound B (PIB) do now open the possibility to visualize amyloid depositions in vivo, using positron emission tomography. This type of ''in vivo histopathology'' approach allows the characterization of neurodegenerative disorders on the basis of the underlying pathology rather than on their symptomatic appearance. In this manuscript, we will discuss the options of amyloid-plaque imaging regarding early and differential diagnosis of different forms of dementia as well as for patient selection for therapy trials and for

  1. Molecular differential diagnosis of follicular thyroid carcinoma and adenoma based on gene expression profiling by using formalin-fixed paraffin-embedded tissues

    OpenAIRE

    Pfeifer, Aleksandra; Wojtas, Bartosz; Oczko-Wojciechowska, Malgorzata; Kukulska, Aleksandra; Czarniecka, Agnieszka; Eszlinger, Markus; Musholt, Thomas; Stokowy, Tomasz; Swierniak, Michal; Stobiecka, Ewa; Rusinek, Dagmara; Tyszkiewicz, Tomasz; Kowal, Monika; Jarzab, Michal; Hauptmann, Steffen

    2013-01-01

    Background Differential diagnosis between malignant follicular thyroid cancer (FTC) and benign follicular thyroid adenoma (FTA) is a great challenge for even an experienced pathologist and requires special effort. Molecular markers may potentially support a differential diagnosis between FTC and FTA in postoperative specimens. The purpose of this study was to derive molecular support for differential post-operative diagnosis, in the form of a simple multigene mRNA-based classifier that would ...

  2. FLAIR-HASTE sequence in differential diagnosis of focal hepatic lesions

    International Nuclear Information System (INIS)

    To assess the feasibility of using the FLAIR (fluid-attenuated inversion recovery)-HASTE (half-fourier acquisition single-shot turbo spin-echo) sequence for the differential diagnosis of focal hepatic lesions. During a 12-month period, 80 patients with 127 focal hepatic lesions [hemangiomas (n=60), hepatocellular carcinomas (HCC) (n=27), cysts (n=25), and metastases (n=15) underwent MR imaging using a 1.5-T scanner. Verification of the diagnosis was based on the findings of pathology (n=11), of angiography and clinical investigation (n=17), or of dynamic contrast-enhanced MR imaging (n=99). MR sequences included T2-weighted HASTE (TE, 134 ms ; echo space, 4.4 ms), FLAIR-HASTE (TE, 64 ms ; echo space, 4.4 ms ; inversion time, 2000 ms ; number of slices, 5-9 ; acquisition time, 13-20 s), and dynamic gadolinium-enhanced T1-weighted FLASH (TR, 131 ms ; TE, 4 ms). FLAIR-HASTE imaging was of any focal lesions seen on T2-weighted HASTE images was performed in the liver area, and their signal intensity was classified in one of five ways : very high (higher than the spleen), moderately high (similar to the spleen), slightly high (higher than the liver and lower than the spleen), intermediate (similar to the liver), or low (lower than the liver). The signal intensity of the 25 cysts, as determined by FLAIR-HASTE, was low in 21 cases (84%), intermediate in three (12%), and very high in one (4%), which was diagnosed as a complicated cyst in which ultrasound revealed internal septa. At FLAIR-HASTE, all 60 hemangiomas showed either very high (n=50, 83%) or moderately high (n=10, 17%) signal intensity, while that of 42 hepatic malignant tumors was very high in 14 cases (33%), moderately high in 8 (19%), slightly high in 18 (43%), intermediate in one (2.5%), and low in one (2.5%). FLAIR-HASTE showed that the signal intensity of the majority of hepatic cysts was low, while that of most hemangiomas and solid liver tumors was high. For the differential diagnosis of cystic and

  3. Significance of ambulatory electroencephalography for differential diagnosis of epilepsy and syncope

    Institute of Scientific and Technical Information of China (English)

    Xueling Zhang; Lingli Zhang; Deyun Zhu; Lan Wei; Xuehong Wang

    2008-01-01

    BACKGROUND: Twenty-four hour ambulatory electroencephalography (AEEG) provides advantages for continuous electroencephalogram, monitoring brief loss of consciousness complicated by suspect or mild limb spasm. OBJECTIVE: To explore the significance of AEEG for differentially diagnosing epilepsy and syncope, compared to EEG. DESIGN, TIME AND SETTING: Sixty patients with brief loss of consciousness, complicated by suspect or mild limb spasm, were selected from Suqian People's Hospital between January 2006 and June 2007. PARTICIPANTS: Sixty participants comprised 34 males and 26 females, aged 13-64 years. According to clinical symptoms prior to the study, 36 patients were initially diagnosed with epilepsy and 24 with syncope. METHODS AND MAIN OUTCOME MEASURES: Abnormalities and epileptiform discharge were detected using EEG and AEEG, and the diagnostic value of the two methods for epilepsy and syncope was compared. RESULTS: A total of sixty patients were included in the final analysis. Abnormal AEEGs were observed in 37 cases (62%) and epilcptitorm discharge AEEGs in 23 cases (38%), both of which were significantly greater than EEGs [37% (22/60), 18% ( 11/60), respectively, P < 0.01, 0.05]. The detection rate of abnormal AEEG and epileptiform discharge in the epilepsy group [75% (27/36), 47% (17/36), respectively] was significantly greater than in the syncope group [42% (10/24), 25% (6/24), respectively, P < 0.01, 0.05 ]. CONCLUSION: AEEG can improve detection probability of epileptiform discharge and exhibits significant differences in the differential diagnosis of epilepsy and syncope.

  4. Perfusion MR imaging: clinical utility for the differential diagnosis of various brain tumors

    International Nuclear Information System (INIS)

    To determine the utility of perfusion MR imaging in the differential diagnosis of brain tumors. Fifty-seven patients with pathologically proven brain tumors (21 high-grade gliomas, 8 low-grade gliomas, 8 lymphomas, 6 hemangioblastomas, 7 metastases, and 7 various other tumors) were included in this study. Relative cerebral blood volume (rCBV) and time-to-peak (TTP) ratios were quantitatively analyzed and the rCBV grade of each tumor was also visually assessed on an rCBV map. The highest rCBV ratios were seen in hemangioblastomas, followed by high-grade gliomas, metastases, low-grade gliomas, and lymphomas. There was no significant difference in TTP ratios between each tumor group (p>0.05). At visual assessment, rCBV was high in 17 (81%) of 21 high-grade gliomas and in 4 (50%) of 8 low-grade gliomas. Hemangioblastomas showed the highest rCBV and lymphomas the lowest. Perfusion MR imaging may be helpful in the differentiation of the various solid tumors found in the brain, and in assessing the grade of the various glial tumors occurring there

  5. Dynamic MR imaging of neurohypophyseal germ cell tumors for differential diagnosis of infundibular diseases

    International Nuclear Information System (INIS)

    To investigate the MR dynamic patterns of neurohypophyseal germ cell tumors (GCTs) for differential diagnosis of infundibular diseases affecting young people. Material and Methods: Eleven patients with neurohypophyseal GCTs underwent dynamic MR studies with T1-weighted spin-echo (SE) or turbo SE techniques. Other infundibular lesions, including adenohypophysitis (n=3), Langerhans' cell histiocytosis (LCH, n=2), and 1 hemangioblastoma from von Hippel-Lindau disease, were also evaluated. Serial images were obtained every 15 s (turbo SE) or 30 s (SE technique) for 240 s after rapid injection of contrast medium. The dynamic patterns were analyzed quantitatively with the contrast medium enhancement ratio. Results: On dynamic MR images, GCTs typically showed a gradual enhancement increase with a peak between 105 s and 180 s, while two showed a relatively rapid increase. LCH and hemangioblastoma showed a dynamic pattern similar to GCTs, while adenohypophysitis demonstrated a sharp rise and a steeper wash-out with an obvious peak before 90 s. Conclusion: Typical dynamic pattern of GCTs was the gradual enhancement increase without wash-out. Dynamic MR imaging can distinguish GCTs from adenohypophysitis, but is not useful for differentiation from LCH

  6. Dynamic MR imaging of neurohypophyseal germ cell tumors for differential diagnosis of infundibular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Liang, L.; Korogi, Y.; Sugahara, T.; Ikushima, I.; Shigematsu, Y.; Okuda, T.; Takahashi, M. [Kumamoto Univ. School of Medicine (Japan). Radiology Dept.

    2000-11-01

    To investigate the MR dynamic patterns of neurohypophyseal germ cell tumors (GCTs) for differential diagnosis of infundibular diseases affecting young people. Material and Methods: Eleven patients with neurohypophyseal GCTs underwent dynamic MR studies with T1-weighted spin-echo (SE) or turbo SE techniques. Other infundibular lesions, including adenohypophysitis (n=3), Langerhans' cell histiocytosis (LCH, n=2), and 1 hemangioblastoma from von Hippel-Lindau disease, were also evaluated. Serial images were obtained every 15 s (turbo SE) or 30 s (SE technique) for 240 s after rapid injection of contrast medium. The dynamic patterns were analyzed quantitatively with the contrast medium enhancement ratio. Results: On dynamic MR images, GCTs typically showed a gradual enhancement increase with a peak between 105 s and 180 s, while two showed a relatively rapid increase. LCH and hemangioblastoma showed a dynamic pattern similar to GCTs, while adenohypophysitis demonstrated a sharp rise and a steeper wash-out with an obvious peak before 90 s. Conclusion: Typical dynamic pattern of GCTs was the gradual enhancement increase without wash-out. Dynamic MR imaging can distinguish GCTs from adenohypophysitis, but is not useful for differentiation from LCH.

  7. Differential Diagnosis of Thyroid Nodules Using Gray-Scale and Color Doppler Ultrasonography

    International Nuclear Information System (INIS)

    To assess the differential points between benign and malignant thyroid nodules, we retrospectively analysed the gray-scale and color Doppler ultrasovograms, radioisotope(RI) scans, and thyroid function tests of lO4 cases. The pathology of the lesion was confirmed as benign in 80 cases and malignant in 24 case, either at operation orby fine needle aspiration biopsy. Gray-scale ultrasonographic findings were analysed in terms of lymphadenopathy,size, and multiplicity. Color Doppler ultrasonography was performed in 40 case, and color singals were graded from type 0 to type III according to color flow distributions. There were no statistically significant differences inperipheral halo, size, multiplicity, color Doppler ultrasonograms, and findings at RI scan and thyriod functiontest between benign and malignant nodules(Chi-square test : P>0.05). However, internal punctate calcification,solid and hypoechoic pattern, cervical lymphadenopathy, irregular and illdefined outer margin, male gender weremore common in malignant thyroid nodules, while smooth and well-defined outer margin, complex echogenicity weremore common in benign nodules(P<0.05). Although color Doppler examination did not contribute to the differentialdiagnosis of benign and malignant nodules, complete halo in grat-scale ultrasonographt and color signal type II (prominent color flow at the periphery of the nodules; color 'halo' sihn) showed statistically significantcorrelation. In conclusion, gray-scale ultrasonography is a useful imaging modality for differential diagnosis of thyroid nodules, and further studies may be requires to clarify the availability of color Doppler ultrasonography

  8. Multimodality imaging of intraosseous ganglia of the wrist and their differential diagnosis.

    Science.gov (United States)

    Paparo, F; Fabbro, E; Piccazzo, R; Revelli, M; Ferrero, G; Muda, A; Cimmino, M A; Garlaschi, G

    2012-12-01

    Intraosseous ganglion (IOG) is the most frequently occurring bone lesion within the carpus and is often an incidental finding on radiographs obtained for other reasons. Two types of IOG have been described: an "idiopathic" form (or type I), the pathogenesis of which has not been completely clarified, and a "penetrating" form (or type II), caused by the intrusion of juxtacortical material (often a ganglion cyst of the dorsal soft tissue) into the cancellous bone compartment. The differential diagnosis for IOG is wide-ranging and complex, including lesions of posttraumatic (posttraumatic cystlike defects), degenerative (subchondral degenerative cysts), inflammatory [cystic rheumatoid arthritis, chronic tophaceous gout (CTG)], neoplastic (benign primary bone tumours and synovial proliferative lesions), ischaemic (Kienböck's disease or avascular osteonecrosis of the lunate) and metabolic (amyloidosis) origin. Multimodality imaging of IOGs is a useful diagnostic tool that provides complete morphological characterisation and differentiation from other intraosseous cystic abnormalities of the carpus. Thin-slice multidetector computed tomography (MDCT) can provide high-spatial-resolution images of the cortical and cancellous bone compartments, allowing detection of morphological findings helpful in characterising bone lesions, whereas magnetic resonance (MR) imaging can simultaneously visualise bone, articular surfaces, hyaline cartilage, fibrocartilage, capsules and ligaments, along with intra- and periarticular soft tissues. PMID:22986695

  9. A case with oto-spondylo-mega-epiphyseal-dysplasia (OSMED): the clinical recognition and differential diagnosis.

    Science.gov (United States)

    Karaer, Kadri; Rosti, Rasim Ozgür; Torun, Deniz; Sanal, Hatice Tuba; Bahçe, Muhterem; Güran, Sefik

    2011-01-01

    The oto-spondylo-mega-epiphyseal-dysplasia (OSMED) phenotype is an autosomal recessive trait that is a skeletal dysplasia with the hallmark findings of limb shortening, multiple skeletal and radiological abnormalities, mid-face hypoplasia with a flat nasal bridge, small upturned nasal tip, and sensorineural hearing loss. A 3.5-year-old girl born to consanguineous Turkish parents had characteristic facial features at birth: mid-face hypoplasia, mild hypertelorism, upslanting palpebral fissures, prominent supraorbital ridges, depressed nasal bridge, small upturned nasal tip, long philtrum, and micrognathia. Radiological examination at three years of age revealed large flaring metaphyses and wide flat epiphyses. The humerus and femur showed the characteristic dumbbell shape. She had bilateral hearing loss with no ophthalmologic findings. There is continuing debate over the clinical overlap and differential diagnosis of OSMED syndrome. The patient was examined considering Weissenbacher-Zweymuller, Stickler type 3, Marshall syndrome, and Kniest dysplasia as possible differential diagnoses. We believe that the presented patient clinically manifested features of OSMED syndrome. We would like to point out that the management of OSMED calls for a coordinated multidisciplinary approach. PMID:21980822

  10. Intraventricular tumors around the foramen of Monro. Neuroimaging features and differential diagnosis

    International Nuclear Information System (INIS)

    The clinical and neuroimaging features of 12 patients with lateral ventricular tumors located around the foramen of Monro were reviewed retrospectively with special emphasis on the differential diagnoses. In this series, there were 4 neurocytomas, 3 subependymal giant cell astrocytomas (SEGAs), 3 subependymomas, and one each of pilocytic astrocytoma and malignant astrocytoma. The mean age of patients with neurocytoma was 30.5 years, with SEGA 9.7 years, and with subependymoma 57 years. On neuroimaging studies, all tumors were well-circumscribed, and most of them appeared nodular in shape. On computed tomography, neurocytomas showed heterogeneous density, all SEGAs were isodense, and all subependymomas were lowdense with the brain. On magnetic resonance imaging, the signal characteristics of the 4 neurocytomas and 3 SGCAs were nonspecific, while 2 subependymomas were hypointense on T1-weighted images and hyperintense on T2-weighted images. After administration of contrast medium, all tumors except the subependymomas showed contrast enhancement. Since there are no absolutely specific features for each tumor type, differential diagnosis should be based not only on these neuroimaging features but also on clinical features such as age of the patient and neurocutaneous symptoms. (author)

  11. Intraventricular tumors around the foramen of Monro. Neuroimaging features and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Nishio, Shunji; Morioka, Takato; Suzuki, Satoshi; Kira, Ryutaro; Mihara, Futoshi; Fukui, Masashi [Kyushu Univ., Fukuoka (Japan). Graduate School of Medical Sciences

    2000-06-01

    The clinical and neuroimaging features of 12 patients with lateral ventricular tumors located around the foramen of Monro were reviewed retrospectively with special emphasis on the differential diagnoses. In this series, there were 4 neurocytomas, 3 subependymal giant cell astrocytomas (SEGAs), 3 subependymomas, and one each of pilocytic astrocytoma and malignant astrocytoma. The mean age of patients with neurocytoma was 30.5 years, with SEGA 9.7 years, and with subependymoma 57 years. On neuroimaging studies, all tumors were well-circumscribed, and most of them appeared nodular in shape. On computed tomography, neurocytomas showed heterogeneous density, all SEGAs were isodense, and all subependymomas were lowdense with the brain. On magnetic resonance imaging, the signal characteristics of the 4 neurocytomas and 3 SGCAs were nonspecific, while 2 subependymomas were hypointense on T1-weighted images and hyperintense on T2-weighted images. After administration of contrast medium, all tumors except the subependymomas showed contrast enhancement. Since there are no absolutely specific features for each tumor type, differential diagnosis should be based not only on these neuroimaging features but also on clinical features such as age of the patient and neurocutaneous symptoms. (author)

  12. Herlyn-werner-wunderlich syndrome: MRI findings, radiological guide (two cases and literature review), and differential diagnosis

    International Nuclear Information System (INIS)

    Herlyn-Werner-Wunderlich (HWW) syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures, and it is characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain shortly following menarche, causing a delay in the diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Müllerian duct anomalies (MDA) are infrequently encountered in a routine clinical setting. two cases of HWW syndrome in adolescents and a differential diagnosis for one case of a different MDA, and the impact of magnetic resonance (MR) imaging technology to achieve the correct diagnosis. MR imaging is a very suitable diagnostic tool in order to perform the correct diagnosis of HWW syndrome

  13. Herlyn-werner-wunderlich syndrome: MRI findings, radiological guide (two cases and literature review, and differential diagnosis

    Directory of Open Access Journals (Sweden)

    Del Vescovo Riccardo

    2012-03-01

    Full Text Available Abstract Background Herlyn-Werner-Wunderlich (HWW syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures, and it is characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain shortly following menarche, causing a delay in the diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Müllerian duct anomalies (MDA are infrequently encountered in a routine clinical setting. Cases presentation two cases of HWW syndrome in adolescents and a differential diagnosis for one case of a different MDA, and the impact of magnetic resonance (MR imaging technology to achieve the correct diagnosis. Conclusions MR imaging is a very suitable diagnostic tool in order to perform the correct diagnosis of HWW syndrome.

  14. Spectral CT imaging in the differential diagnosis of necrotic hepatocellular carcinoma and hepatic abscess

    International Nuclear Information System (INIS)

    Aim: To explore the value of CT spectral imaging in the differential diagnosis of necrotic hepatocellular carcinoma (nHCC) and hepatic abscess (HA) during the arterial phase (AP) and portal venous phase (PP). Materials and methods: Sixty patients with 36 nHCCs and 24 HAs underwent spectral CT during AP and PP. Iodine or water concentration were measured and the normalized iodine concentration (NIC) and lesion-normal parenchyma iodine concentration ratio (LNR) were calculated. The two-sample t-test was used to compare quantitative parameters. Two readers qualitatively assessed lesion types according to imaging features. Sensitivity and specificity were compared between the qualitative and quantitative studies. Results: NIC and LNR in the AP for the wall of nHCC (0.14 ± 0.04 mg/ml; 2.77 ± 0.74) were higher than those of HA (0.13 ± 0.02 mg/ml; 1.4 ± 0.9). NIC and LNR in the PP for the wall of HA (0.66 ± 0.05 mg/ml; 1.2 ± 0.2) were higher than those of nHCC (0.5 ± 0.11 mg/ml; 0.94 ± 0.12). The differences in NIC in the AP were not significant but the differences in LNR in AP, and NIC and LNR in the PP were significant. The best quantitative parameter was LNR in AP, and a threshold of 1.52 would yield a sensitivity and specificity of 100% and 91.7%, respectively, for differentiating nHCC from HA. Conclusion: CT spectral imaging with quantitative iodine concentration analysis may help to increase the accuracy of differentiating nHCC from HA. - Highlights: • We preliminarily investigate the usefulness of CT spectral imaging in differentiating nHCC from HA. • CT spectral imaging may help differentiate necrotic hepatocellular carcinoma from hepatic abscess. • CT spectral imaging can evaluate the blood supply and necrotic degree of lesions. • Quantitative analysis of iodine concentration provides greater diagnostic confidence

  15. The role of ADC measurement in differential diagnosis of focal hepatic lesions

    International Nuclear Information System (INIS)

    Purpose: To evaluate the utility of apparent diffusion coefficient (ADC) measurement in characterization of focal solid hepatic lesions and determine the role of ADC values in differentiation of solid benign and solid malignant hepatic lesions. Materials and methods: Between June 2006 and December 2010, a total of 95 focal solid hepatic lesions in 95 consecutive patients were evaluated by abdominal MRI. Diffusion weighted MRI was performed with b 100, b 600 and b 1000 gradients with ADC measurements. Comparison of mean ADC values between solid benign (focal nodular hyperplasia and other solid benign lesions) and solid malignant lesion (hepatocellular carcinoma, metastasis, and cholangiocarcinoma) groups and between each benign and malignant lesion was done. The ROC analyses were performed in order to determine cut-off ADC values for differentiation of benign and malignant lesion groups at 3 different gradients. Results: Twenty-six of 95 lesions were benign and 69 were malignant. Mean ADC values of solid benign lesions at b 100, b 600 and b 1000 gradients were 2.25 ± 0.54 × 10−3, 1.97 ± 0.64 × 10−3 and 1.52 ± 0.47 × 10−3 mm2/s, respectively. Mean ADC values of solid malignant lesions at b 100, b 600 and b 1000 gradients were 1.84 ± 0.57 × 10−3, 1.37 ± 0.38 × 10−3 and 1.08 ± 0.22 × 10−3 mm2/s, respectively. The ADC values of solid benign lesions were significantly higher than solid malignant lesions at all 3 gradients (P < 0.05). Differentiation of benign and malignant subtype lesions from each other in their groups did not yield as significant findings as comparing results between benign and malignant lesions. Conclusion: Although ADC measurements were not helpful for differentiating subtypes of solid benign or solid malignant lesions, ADC measurements at 3 different gradients may be useful in differential diagnosis of benign lesions from malignant ones.

  16. MR imaging findings of pineal germinoma: focus on differential diagnosis from other germ cell tumors

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jin; Lee, Ho Kyu; Kim, Jae Kyun; Shin, Ji Hoon; Choi, Choong Gon; Lee, Myung Jun; Ham, Soo Youn; Lee, Jong Hwa; Suh, Dae Chul [Ulsan Univ. College of Medicine, Seoul (Korea, Republic of)

    1998-10-01

    To determine the characteristic MR imaging findings of pineal germinoma, and differential diagnosis from other germ cell tumors. MR images of patients with histopathologically proven pineal germinoma(n=3D14) and other pineal germ cell tumors(n=3D10) were retrospectively analyzed with regard to size, signal intensity and homogeneity, enhancing features, cyst formation, and multiplicity of lesions. Other pineal germ cell tumors were the mixed germ cell tumors (n=3D4), malignant teratomas (n=3D3), choriocarcinoma(n=3D1), embryonal carcinoma(n=3D1), and endodermal sinus tumor(n=3D1). Tumor markers were evaluated. On T1-weighted images, germinomas showed homogeneous(86%) or iso signal intensity (93%), while other germ cell tumors showed inhomogeneous(70%) or iso signal intensity(70%). On T2-weighted images, germinomas showed homogeneous(64%) or iso signal intensity(57%), while other germ cell tumors showed inhomogeneous(70%) or high signal intensity(80%). On Gd-DTPA enhanced images, germinomas showed homogeneous (93%) or strong enhancement (64%), while other germ cell tumors showed homogeneous(60%) or strong enhancement (70%). Cyst formation was noted in ten Patients (71%) with germinoma and in six (60%) with other germ cell tumors. Invasion on surrounding structures was seen in 11 patients (79%) with germinoma and in five (50%) with other germ cell tumors. Lesions were multiple in three patients(21%) with germinoma. Thirteen of 14 patients with germinoma had normal serum {alpha}-FP(tetoprotein) and {beta}-HCG(human chononic gonafotrophin) levels. Two of four patients with mixed germ cell tumors had elevated serum {beta}-FP and {alpha}-HCG levels; in the ther two, elevated serum {alpha}-FP or {beta}-HCG levels were noted. In the malignant teratoma and embryonal carcinoma patients, serum {alpha}-FP and {beta}-HCG levels were normal. The patient with choriocarcinoma had an elevated serum {beta}-HCG level. On T1W1, the only significant differential point (p<0.01) between

  17. Differential diagnosis of Parkinsonism using dual phase F 18 FP CIT PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Jin, So Young; Oh, Min Young; Ok, Seung Jun; Oh, Jung Su; Lee, Sang Ju; Chung, Sun Ju; Lee, Chong Sik; Kim, Jae Seung [Univ. of Ulsan, Seoul (Korea, Republic of)

    2012-03-15

    Dopamine transporter (DAT) imaging can demonstrate presynaptic dopaminergic neuronal loss in Parkinson's disease (PD). However, differentiating atypical parkinsonism (APD) from PD is often difficult. We investigated the usefulness of dual phase F 18 FP CIT positron emission tomography (PET) imaging in the differential diagnosis of parkinsonism. Ninety eight subjects [five normal, seven drug induced parkinsonism (DIP), five essential tremor (ET), 24 PD, 20 multiple system atrophy parkinson type (MSA-P), 13 multiple system atrophy cerebellar type (MSA-C), 13 progressive supranuclear palsy (PSP), and 11 dementia with Lewy bodies(DLB)] underwent F 18 FP CIT PET. PET images were acquired at 5 min (early phase) and 3 h (late phase) after F 18 FP CIT administration (185MBq). Regional uptake pattern of cerebral and cerebellar hemispheres was assessed on early phase images, using visual, quantitative, and statistical parametric mapping (SPM) analyses. Striatal DAT binding was normal in normal, ET, DIP, and MSA C groups, but abnormal in PD, MSA P PSP, and DLB groups. No difference was found in regional uptake on early phase images among normal DAT binding groups, except in the MSA C group. Abnormal DAT binding groups showed different regional uptake pattern on early phase images compared with PD in SPM analysis (FDR<0.05). When discriminating APD from PD, visual interpretation of the early phase image showed high diagnostic sensitivity and specificity (75.4% and 100%, respectively). Regarding the ability to distinguish specific APD, sensitivities were 81% for MSA P, 77% for MSA C, 23% for PSP, and 54.5% for DLB. Dual phase F 18 FP CIT PET imaging is useful in demonstrating striatal DAT loss in neurodegenerative parkinsonism, and also in differentiating APD, particularly MSA, from PD.

  18. Differential diagnosis of Parkinsonism using dual phase F 18 FP CIT PET imaging

    International Nuclear Information System (INIS)

    Dopamine transporter (DAT) imaging can demonstrate presynaptic dopaminergic neuronal loss in Parkinson's disease (PD). However, differentiating atypical parkinsonism (APD) from PD is often difficult. We investigated the usefulness of dual phase F 18 FP CIT positron emission tomography (PET) imaging in the differential diagnosis of parkinsonism. Ninety eight subjects [five normal, seven drug induced parkinsonism (DIP), five essential tremor (ET), 24 PD, 20 multiple system atrophy parkinson type (MSA-P), 13 multiple system atrophy cerebellar type (MSA-C), 13 progressive supranuclear palsy (PSP), and 11 dementia with Lewy bodies(DLB)] underwent F 18 FP CIT PET. PET images were acquired at 5 min (early phase) and 3 h (late phase) after F 18 FP CIT administration (185MBq). Regional uptake pattern of cerebral and cerebellar hemispheres was assessed on early phase images, using visual, quantitative, and statistical parametric mapping (SPM) analyses. Striatal DAT binding was normal in normal, ET, DIP, and MSA C groups, but abnormal in PD, MSA P PSP, and DLB groups. No difference was found in regional uptake on early phase images among normal DAT binding groups, except in the MSA C group. Abnormal DAT binding groups showed different regional uptake pattern on early phase images compared with PD in SPM analysis (FDR<0.05). When discriminating APD from PD, visual interpretation of the early phase image showed high diagnostic sensitivity and specificity (75.4% and 100%, respectively). Regarding the ability to distinguish specific APD, sensitivities were 81% for MSA P, 77% for MSA C, 23% for PSP, and 54.5% for DLB. Dual phase F 18 FP CIT PET imaging is useful in demonstrating striatal DAT loss in neurodegenerative parkinsonism, and also in differentiating APD, particularly MSA, from PD

  19. Supporting Boys as Readers

    Science.gov (United States)

    Serafini, Frank

    2013-01-01

    The challenges associated with boys and reading are focused on such factors as society's lack of focus on literacy skills, parents failings to inspire reading in boys, and internal motivational factors rather than looking at the environments created for reading in and out of school. In this column, several ideas for helping boys develop a…

  20. Doppler ultrasound in the diagnosis and follow-up of the muscle rupture and an arteriovenous fistula of the thigh in 12 year boy

    International Nuclear Information System (INIS)

    Background. With this case report the authors wish to present the accuracy of non-invasive vascular imaging methods, especially Doppler ultrasound, in the evaluation of the muscular trauma and periskeletal soft tissue vascular anomalies. Case report. Twelve year-old boy has been admitted with the right femoral quadriceps muscle traumatic rupture. Postoperative B-mod sonography (US) visualised recidivuous haematoma and Power Doppler depicted hypervascularized area, suspected vascular malformation (angioma). Doppler findings obtained on the right thigh vasculature gave us reasons to think about posttraumatic arteriovenous fistula. Doppler has been repeated in the specialized paediatric institution with the same results. Digital subtraction angiography, 8 months after trauma, did not confirm suspicions reported in US findings. Spiral computed tomographic angiography (CTA) performed 11 months after trauma clearly depicted a lesion which had been repeatedly described in US findings. Fourteen months after trauma the vascular surgeon performed the deep femoral artery muscular branches ligation, but in the official report only arteriovenous fistula was mentioned. After the surgery the patient was clinically better. The aetiology of the right femoral arteriovenous fistula and hypervascularized structure remains unclear. Conclusions. Every inadequately behaving, recidivous posttraumatic haematoma should be evaluated with Doppler ultrasound. CTA can be performed if it is needed to clarify US findings. (author)

  1. Application of dual phase imaging of 11C-acetate positron emission tomography on differential diagnosis of small hepatic lesions.

    Directory of Open Access Journals (Sweden)

    Li Huo

    Full Text Available OBJECTIVE: Previously we observed that dual phase 11C-acetate positron emission tomography (AC-PET could be employed for differential diagnosis of liver malignancies. In this study, we prospectively evaluated the effect of dual phase AC-PET on differential diagnosis of primary hepatic lesions of 1-3 cm in size. METHODS: 33 patients having primary hepatic lesions with size of 1-3 cm in diameter undertook dual phase AC-PET scans. Procedure included an early upper-abdomen scan immediately after tracer injection and a conventional scan in 11-18 min. The standardized uptake value (SUV was calculated for tumor (SUVT and normal tissue (SUVB, from which 11C-acetate uptake ratio (as lesion against normal liver tissue, SUVT/SUVB in early imaging (R1, conventional imaging (R2, and variance between R2 and R1 (ΔR were derived. Diagnoses based on AC-PET data and histology were compared. Statistical analysis was performed with SPSS 19.0. RESULTS: 20 patients were found to have HCC and 13 patients had benign tumors. Using ΔR>0 as criterion for malignancy, the accuracy and specificity were significantly increased comparing with conventional method. The area under ROC curve (AUC for R1, R2, and ΔR were 0.417, 0.683 and 0.831 respectively. Differential diagnosis between well-differentiated HCCs and benign lesions of FNHs and hemangiomas achieved 100% correct. Strong positive correlation was also found between R1 and R2 in HCC (r2 = 0.55, P<0.001. CONCLUSIONS: Dual phase AC-PET scan is a useful procedure for differential diagnosis of well-differentiated hepatocellular carcinoma and benign lesions. The dynamic changes of 11C-acetate uptake in dual phase imaging provided key information for final diagnosis.

  2. Peak systolic velocity of superior thyroid artery for the differential diagnosis of thyrotoxicosis.

    Directory of Open Access Journals (Sweden)

    Xiaolong Zhao

    Full Text Available AIM: The differentiation of destruction-induced thyrotoxicosis and Graves' disease (GD is of great importance for selection of proper therapy. Radioactive iodine uptake (RAIU is the gold standard for differentiating these two conditions but its application has remained somewhat limited. Thyroid color Doppler flow sonography (CDFS is a potential alternative of RAIU but more supporting evidence is warranted. In the present study, a standard operative procedure was developed to measure the mean peak systolic velocity of superior thyroid artery (STA-PSV and evaluate its role in the differential diagnosis of thyrotoxicosis. METHODS: A total of 135 patients with untreated thyrotoxicosis were enrolled into one retrospective study (GD, n = 103; thyroiditis, n = 32 and another prospective study recruited 169 patients (GD, n = 118; thyroiditis, n = 51. Thirty normal controls were also enrolled. Thyroid function, anti-TSH-receptor antibody (TRAb, RAIU, CFDS of thyroid and STA-PSV were performed for each patient. Receiver operator curve (ROC was used to evaluate the diagnostic value of STA-PSV in a retrospective study so as to seek the optimal cutoff point. Then the cutoff point value was used to validate its diagnostic value in a prospective study and in another thyrotoxicosis population. RESULTS: STA-PSV of GD was significantly higher than that of thyroiditis in both retrospective and prospective studies. The area under the ROC curve of mean STA-PSV was 0.8799 and 0.9447 in the retrospective and prospective studies respectively. If a mean STA-PSV cutoff point of 50.5 cm/s was set from the retrospective analysis for the prospective study, the sensitivity and specificity in distinguishing GD from thyroiditis were 81.04% and 96.08% respectively. Mean STA-PSV and TRAb had similar area under ROC. The coefficients of variation in STA-PSV measurement were lower than 10% for the euthyroid, thyroiditis and GD groups. CONCLUSIONS: STA-PSV is a feasible supplement

  3. The Asperger personality - psychopathology, personality structure, and differential diagnosis of adults with autism spectrum disorder without accompanying intellectual impairment

    OpenAIRE

    Strunz, Sandra

    2015-01-01

    Introduction: Autism Spectrum Disorders (ASD) are classified as pervasive developmental disorders and are characterised by impairments in social interaction and communication and by repetitive stereotyped pattern of behaviour and restricted interests. Individuals with ASD without accompanying intellectual impairment often already reached adulthood before an ASD diagnosis is made. Diagnosing ASD in adults is challenging, especially because of difficulties in differentiating ASD from personalit...

  4. Genome sequences of three live attenuated vaccine strains of Brucella species and implications for pathogenesis and differential diagnosis.

    Science.gov (United States)

    Wang, Yufei; Ke, Yuehua; Wang, Zhoujia; Yuan, Xitong; Qiu, Yefeng; Zhen, Qing; Xu, Jie; Li, Tiefeng; Wang, Dali; Huang, Liuyu; Chen, Zeliang

    2012-11-01

    Live attenuated vaccines play essential roles in the prevention of brucellosis. Here, we report the draft genome sequences of three vaccine strains, Brucella melitensis M5-10, B. suis S2-30, and B. abortus 104M. Primary genome sequence analysis identified mutations, deletions, and insertions which have implications for attenuation and signatures for differential diagnosis. PMID:23045513

  5. Genome Sequences of Three Live Attenuated Vaccine Strains of Brucella Species and Implications for Pathogenesis and Differential Diagnosis

    OpenAIRE

    Wang, Yufei; Ke, Yuehua; Wang, Zhoujia; Yuan, Xitong; Qiu, Yefeng; Zhen, Qing; Xu, Jie; Li, Tiefeng; Wang, Dali; Huang, Liuyu; Chen, Zeliang

    2012-01-01

    Live attenuated vaccines play essential roles in the prevention of brucellosis. Here, we report the draft genome sequences of three vaccine strains, Brucella melitensis M5-10, B. suis S2-30, and B. abortus 104M. Primary genome sequence analysis identified mutations, deletions, and insertions which have implications for attenuation and signatures for differential diagnosis.

  6. The radiological and histopathological differential diagnosis of chordoid neoplasms in skull base

    Directory of Open Access Journals (Sweden)

    PAN Bin-cai

    2013-07-01

    Full Text Available Background Chordoid neoplasms refer to tumors appearing to have histological features of embryonic notochord, which is characterized by cords and lobules of neoplastic cells arranged within myxoid matrix. Because of radiological and histological similarities with myxoid matrix and overlapping immunohistochemical profile, chordoma, chordoid meningioma, chordoid glioma, and rare extraskeletal myxoid chondrosarcoma enter in the radiological and histological differential diagnosis at the site of skull base. However, there is always a great challenge for histopathologists to make an accurate diagnosis when encountering a chordoid neoplasm within or near the central nervous system. The aim of this study is to investigate and summarize the radiological, histological features and immunohistochemical profiles of chordoid neoplasms in skull base, and to find a judicious panel of immunostains to unquestionably help in diagnostically challenging cases. Methods A total of 23 cases of chordoid neoplasms in skull base, including 10 chordomas, 5 chordoid meningiomas, 3 chordoid gliomas and 5 extraskeletal myxoid chondrosarcomas, were collected from the First Affiliated Hospital, Sun Yat-sen University and Guangdong Tongjiang Hospital. MRI examination was performed on the patients before surgical treatment. Microscopical examination and immunohistochemical staining study using vimentin (Vim, pan-cytokeratin (PCK, epithelial membrane antigen (EMA, S?100 protein (S-100, glial fibrillary acidic protein (GFAP, D2-40, Galectin-3, CD3, CD20, Ki-67 were performed on the samples of cases. The clinicopathological data of the patients was also analyzed retrospectively. Results Most of chordomas were localized in the clivus with heterogeneous hyperintensity on T2WI scanning. The breakage of clivus was observed in most cases. Histologically, the tumor cells of chordoma exhibited bland nuclear features and some contained abundant vacuolated cytoplasm (the so

  7. Diagnóstico diferencial das demências The differential diagnosis of dementia

    Directory of Open Access Journals (Sweden)

    José Gallucci Neto

    2005-06-01

    Full Text Available As síndromes demenciais são caracterizadas pela presença de déficit progressivo na função cognitiva, com maior ênfase na perda de memória, e interferência nas atividades sociais e ocupacionais. O diagnóstico diferencial deve, primeiramente, identificar os quadros potencialmente reversíveis, de etiologias diversas, tais como alterações metabólicas, intoxicações, infecções, deficiências nutricionais etc. Nas demências degenerativas primárias e nas formas seqüelares, o diagnóstico etiológico carrega implicações terapêuticas e prognósticas. Sabe-se que o diagnóstico definitivo da maioria das síndromes demenciais depende do exame neuropatológico. Entretanto, uma avaliação clínica cuidadosa incluindo anamnese detalhada, exames físico e neurológico, associado a determinações bioquímicas e de neuroimagem, podem possibilitar maior acurácia no diagnóstico diferencial. Inovações tecnológicas servindo-se de métodos de neuroimagem estrutural e funcional, bem como de técnicas de biologia e genética molecular, têm apresentado perspectivas para o diagnóstico precoce das demências, particularmente da doença de Alzheimer. As diversas etiologias implicadas no desenvolvimento de síndromes demenciais, bem como as respectivas condutas diagnósticas, serão revistas neste artigo.Dementia is a syndrome characterized by progressive impairment of cognitive functions, particularly in memory, which affects social and occupational activities. The differential diagnosis must, firstly, identify potentially treatable causes of cognitive impairment, addressing the different etiologies of reversible dementia such as metabolic alterations, intoxications, CNS infections, and nutritional deficiencies. The correct and early diagnosis of primary degenerative dementia carries therapeutic and prognostic implications, which may attenuate the inevitable cognitive and behavioral deficits. Definitive diagnoses of most primary dementia

  8. Spectral CT imaging in differential diagnosis of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms

    International Nuclear Information System (INIS)

    Objective: To investigate the CT spectral imaging features of pancreatic serous oligocystic adenoma and mucinous cystic neoplasms and to assess the value of spectral CT in differentiating between pancreatic serous oligocystic adenoma and mucinous cystic neoplasms. Methods: From Feb. 2010 to Dec. 2010, 27 patients with cystic neoplasms of the pancreas (group one with 15 serous oligocystic adenomas and group two with 12 mucinous cystic neoplasms) underwent dual-phase CT spectral imaging followed by surgery. Quantitative values (age, tumor size, CT value change as function of photon energy, effective-Z, iodine-water concentration, and calcium-water concentration) were compared with independent samples t test and Mann-Whitney test and non-quantitative parameters (gender, symptom, and tumor location) were compared with Chi-square test (Fisher exact). The parameters with significant differences between two groups were analyzed further and the performance of multiple parameters for joint differential diagnosis was evaluated with discriminant analysis. Results: Compared to patients with mucinous cystic neoplasms, patients with serous oligocystic adenoma had younger age, lower frequency of being symptomatic and smaller tumor size. The CT values on 40 keV to 60 keV (with 10 keV increment) in late arterial phase [(36±13) HU vs. (62±23) HU, (26±8) HU vs. (40±15) HU, and (19±6) HU vs. (27±10) HU respectively] and 40 keV to 50 keV (with 10 keV increment) in portal venous phase [(43±14) HU vs. (61±25) HU and (30±10) HU vs. (40±16) HU respectively], effective-Z (late arterial phase 7.80± 0.16 vs. 8.05±0.21, and portal venous phase 7.87±0.15 vs 8.02±0.22), concentration of calcium (water) [late arterial phase (5±3) g/L vs. (11±4) g/L, t=-3.836, P=0.001 and portal venous phase (7±3) g/L vs. (10±5) g/L, t=-2.071, P=0.049] and iodine (water) [late arterial phase (0.38±0.24) g/L vs. (0.78±0.32) g/L, t=-3.755, P=0.001 and portal venous phase (0.48± 0.24) g/L vs. (0

  9. Radiographic features of Mycoplasma pneumoniae pneumonia: differential diagnosis and performance timing

    International Nuclear Information System (INIS)

    The Japanese Respiratory Society guidelines propose a differential diagnosis for atypical pneumonia and bacterial pneumonia using a scoring system for the selection of appropriate antibiotic. In order to improve this scoring system, the guidelines are seeking new specific parameter. The purpose of this study was to clarify the pattern of abnormalities with Mycoplasma pneumoniae pneumonia on chest computed tomography (CT) and whether the radiographic findings could distinguish M. pneumoniae pneumonia from Streptococcus pneumoniae pneumonia. A retrospective review was performed of the CT findings of 64 cases and 68 cases where M. pneumoniae and S. pneumoniae, respectively, were the only pathogen identified by the panel of diagnostic tests used. Of the 64 patients with M. pneumoniae pneumonia, bronchial wall thickening was observed most frequently (81%), followed by centrilobular nodules (78%), ground-glass attenuation (78%), and consolidation (61%). Bronchial wall thickening and centrilobular nodules were observed more often in M. pneumoniae patients than in S. pneumoniae patients (p < 0.0001). The presence of bilateral bronchial wall thickening or centrilobular nodules was only seen in patients with M. pneumoniae pneumonia. Using the scoring system of the Japanese Respiratory Society guidelines and chest CT findings, 97% of M. pneumoniae patients were suspected to be M. pneumoniae pneumonia without serology. When comparing the CT findings between early stage and progressed stage in the same patients with severe pneumonia, the radiographic features of early stage M. pneumoniae pneumonia were not observed clearly in the progressed stage. The present results indicate that the diagnosis of M. pneumoniae pneumonia would appear to be reliable when found with a combination of bronchial wall thickening and centrilobular nodules in the CT findings. However, these CT findings are not observed in progressed severe M. pneumoniae pneumonia patients

  10. Diagnostic value of CD117 in differential diagnosis of acute leukemias.

    Science.gov (United States)

    Ahmadi, Abbas; Poorfathollah, Ali-Akbar; Aghaiipour, Mahnaz; Rezaei, Mansour; Nikoo-ghoftar, Mahin; Abdi, Mohammad; Gharib, Alireza; Amini, Amir

    2014-07-01

    C-kit receptor (CD117) and its ligand, stem cell factor, play a key role in normal hematopoiesis. It has been demonstrated that its expression extremely increases in leukemias with myeloid commitment. We analyzed findings on CD117 expression together with other myeloid related markers in 203 de novo acute leukemias, referred to Iranian immunophenotyping centers: Iranian Blood Transfusion Organization (IBTO) and Baghiatallah Hospital (BH). All cases were characterized based on the French American British cooperative group (FAB) and European Group for Immunological Classification of Leukemias (EGIL). The cases comprised of 111 acute myeloblastic leukemia (AML), 86 acute lymphoblastic leukemia (ALL), and 6 acute undifferentiated leukemia (AUL). CD117 was positive in 75 % of AML and 50 % of AUL, whereas none of the ALL cases was positive for this marker. Although CD117 was positive in 100 % of M5a cases, no M5b positive was found (p = 0.036). The calculated specificity for myeloid involvement was 100 % for CD117 and CD33, and 98 % for CD13 and CD15 (p < 0.001). The calculated sensitivity for myeloid involvement was 83, 76, 64, and 41 % for CD13, CD117, CD33, and CD15, respectively (p < 0.001). We concluded that CD117 expression is a specific and rather sensitive marker for differential diagnosis between AML and ALL, and except for M5 subtypes, it fails to determine FAB subtypes; lack of expression in M5 can identify M5b. Therefore, it should be included in the routine primary panel for diagnosis of acute leukemias. PMID:24722823

  11. 131I-metaiodobenzylguanidine as an aid in the differential diagnosis af small and round cell tumors

    International Nuclear Information System (INIS)

    131I-MIBG scintigraphy has proven to be highly sensitive (>90%) and specific (almost 100%) in locating neuroblastoma (NB). This may be useful in staging and restaging NB. Another possible value of MIBG scintigraphy is demonstrated: small and round cell tumors (especially in childhood) can present difficult diagnostic problems. NB belongs to this histologic group. Differential diagnosis also includes EWING's sarcoma, rhabdomyosarcoma and malignant lymphoma. Since MIBG is known to concentrate only in NB, this radiopharmaceutical may narrow down the differential diagnosis. This could be demonstrated in four cases: in one of these, the diagnosis of NB was established, in the other three, NB was ruled out; further pathologic work-up in these cases revealed an ALL, a rhabdomyosarcoma and a NHL, respectively. (orig.)

  12. Determining level of endogenous serum erythropoietin for differential diagnosis of polycythemia vera and symptomatic polycythemia

    Directory of Open Access Journals (Sweden)

    Kostyukevych O.M.

    2013-06-01

    Full Text Available The article deals with determining possibility of the assessment of the level of endogenous serum erythropoietin (EPO for differential diagnosis of polycythemia vera (PV and secondary erythrocytosis (SE. The determination of subnormal level of this cytokine for the diagnosis of PV has been detected. The relation between the level of endogenous erythropoietin and iron metabolism also has been analyzed. The study involved 88 patients with PV and 119 patients with SE. Statistically significant decrease in EPO concentration level has been detected in PV patients. The mean EPO level was equal to 6.38 ± 0.84 mIU/mL and 17.98 ±2.48 mIU/mL in PV and SE patients respectively. In control group of individuals EPO concentration was equal to 9,81 ±0,58 mIU/mL, the significant difference was found between all studied groups (р<0.01. According to our data, EPO was increased in 28 SE patients (23.53%, it was not observed in control group and in group of PV patients (φ*emp = 4.355, р<0.01. The decrease of EPO level in PV patients has been detected more often than in SE patients (84.09% versus 11.76% , φ*emp = 5.218, р<0.01, it has not been observed in control group. Only 14 (15.91% PV patients had normal EPO level, in contrast 77 (64.71% SE patients demonstrated normal EPO level (φ*emp = 4.578, р<0.01. The average level of ferritin was equal to 57.41 ± 9.74 ng/mL in PV patients and 199.77 ± 14.32 ng/mL in SE patients (р<0.01. Significantly more patients with PV demonstrated decrease of ferritin level (31.81% versus 7.56%, φ*emp = 4.438, р<0.01. Patients with SE more often had raised level of EPO than PV patients (15.12% versus 4.54%, φ*emp = 2.453, р<0.01. The sensitivity of test with detecting of the reduced level of EPO for the diagnosis of PV was 84.1%, specificity - 87.4%, positive predictive value - 83.1%, negative predictive value - 88.1%. Normal range of EPO significantly (rs = 0,5494 correlated with decreased levels of serum ferritin in

  13. Dynamic contrast enhanced MRI in the differential diagnosis of adrenal adenomas and malignant adrenal masses

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of dynamic MR imaging in the differential diagnosis of adrenal adenomas and malignant tumors, especially in cases with atypical adenomas. Materials and methods: Sixty-four masses (48 adenomas, 16 malignant tumors) were included in this prospective study. Signal loss of masses was evaluated using chemical shift MR imaging. Five dynamic series of T1-weighted spoiled gradient echo (FFE) images were obtained, with the acquisition starting simultaneously with i.v. contrast administration (0-100 s) followed by a T1-weighted FFE sequence in the late phase (5th minute). Contrast enhancement patterns in the early (25th second) and late (5th minute) phase images were evaluated. For the quantitative evaluation, signal intensity (SI)-time curves were obtained according to the SIs on the 0th, 25th, 50th 75th and 100th second. Also, the wash-in rate, maximum relative enhancement, time-to-peak, and wash-out of contrast at 100 s of masses in both groups were calculated. The statistical significance was determined by Mann-Whitney U test. To evaluate the diagnostic performance of the quantitative tests, receiver operating characteristic (ROC) analysis was performed. Results: Chemical shift MR imaging was able to differentiate 44 out of 48 adenomas (91.7%) from non-adenomas. The 4 adenomas (8.3%) which could not be differentiated from non-adenomas by this technique did not exhibit signal loss on out-of-phase images. With a cut-off value of 30, SI indices of adenomas had a sensitivity of 93.8%, specificity of 100% and a positive predictive value of 100%. On visual evaluation of dynamic MR imaging, early phase contrast enhancement patterns were homogeneous in 75% and punctate in 20,83% of the adenomas; while patchy in 56.25% and peripheral in 25% of the malignant tumors. On the late phase images 58.33% of the adenomas showed peripheral ring-shaped enhancement and 10.41% showed heterogeneous enhancement. All of the malignant masses showed heterogeneous

  14. Differential diagnosis of truly suprasellar space-occupying masses: synopsis of clinical findings, CT, and MRI

    International Nuclear Information System (INIS)

    This review demonstrates the features of truly suprasellar masses in modern imaging based on the clinical, CT, and MRI findings of 42 patients with suprasellar masses in correlation to the histologic findings. The radiologic examinations were evaluated retrospectively to determine if diagnosis can be made based on specific imaging patterns. The most frequent clinical findings of space-occupying suprasellar masses were visual disturbances, diabetes insipidus, and symptoms and signs of occlusive hydrocephalus. There were no clinical features specific for any of the observed masses. Craniopharyngiomas were the most frequent tumors. They appeared in two different forms, as cystic and as solid enhancing masses. The cystic tumors could not be differentiated from cystic hamartomas or cystic gliomas by CT or MRI. The solid craniopharyngiomas were similar to meningiomas and hamartomas. In craniopharyngiomas of adults calcifications were not common. In CT and especially in MRI gliomas were characterized by the diffuse infiltration of the adjacent brain tissue or optic nerve. Except for meningiomas, all lesions were highly variable in appearance, making a reliable characterization by CT and MRI difficult in many cases. However, administration of contrast media in some cases resulted in a better tumor delineation. Compared with unenhanced MRI the enhanced scans did not increase diagnostic efficacy for neoplasms, but were helpful in the differentiation from inflammatory diseases. The MRI technique was superior to CT in demonstrating the anatomic relationships, thus facilitating evaluation of origin and extent of the lesions. The CT technique, of course, was more reliable in the detection of calcifications. Both CT and MRI are not tissue-specific, however, and suprasellar tumors as well as many other neoplasms cannot be classified using only one of these imaging techniques. (orig.)

  15. Radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst: with emphasis on CT

    International Nuclear Information System (INIS)

    To evaluate clinical and radiographic differential diagnosis between ameloblastoma and odontogenic keratocyst (OKC) using clinical data, plain radiographs, and CT. 25 cases of ameloblastoma and 44 cases of OKC diagnosed in biopsy, were selected from the files stored in Department of Oral and Maxillofacial Radiology, Seoul National University Dental Hospital from 1999 to 2001, and evaluated using following criteria: sex and age, location, shape, border to normal bone tissue, effect to adjacent tissues, homogeneity in the lumen of the lesion, response of the cortical bone, long-to-short length (L/S) ratio of the lesion, and expansion angle of the cortex. Ameloblastoma and OKC were seen most frequently in third decades and no statistical significance was noted between both sexes. Ameloblastoma occurred most frequently in mandibular angle and ramus area (68%) and OKC at the maxillary molar (34.1%), and mandibular angle and ramus area (43.2%). The root resorption of the adjacent teeth, mandibular canal displacement, and the impaction of teeth were seen more frequently in ameloblastoma than in OKC. The L/S ratio measured in CT was largest in maxillary OKC cases, followed by mandibular ameloblastoma, and mandibular OKC (1.2, 1.8 and 2.4 respectively). The expansion angle of the cortex shows a statistically significant difference between ameloblastoma (48.8 .deg. C) and OKC (31.5 .deg. C). The numeric morphology (L/S ratio) and expansion angle of the cortical bone of the lesion measured in computed tomography can be used to differentiate the ameloblastoma and odontogenic keratocyst.

  16. Update on laboratory tests for the diagnosis and differentiation of hereditary angioedema and acquired angioedema.

    Science.gov (United States)

    Frazer-Abel, Ashley; Giclas, Patricia C

    2011-01-01

    The importance of laboratory testing in the diagnosis of hereditary angioedema (HAE) has increased with the advent of new treatment options in recent years. It has been 50 years since HAE was linked to a decrease of C1INH (the inhibitor of complement enzyme, C1 esterase), a link that provided for the first laboratory test available for this disorder. HAE is subdivided into types that can be differentiated only by laboratory testing. The Type I form is characterized by low levels and function of C1INH in the circulation. The Type II form is characterized by normal levels of C1INH, but low function. Sample collection and handling is critical for the functional assays. The serum samples for the functional analysis must be collected, separated, and frozen at less than -60°C within 2 hours of the blood draw. Additionally some suspected Type II patients may benefit from looking closely at what method is used for the functional testing. The acquired forms of angioedema (AAE) can benefit from the same clinical testing, because most are ultimately due to decreased C1INH. Measurement of C1q levels and testing for anti-C1INH autoantibodies can help differentiate AAE from HAE. Diagnostic testing for the third hereditary form, alternately called estrogen-dependent HAE, HAE with Normal C1INH or HAE Type III, still presents challenges, and definitive testing may have to wait until there is a more complete understanding of this mixed group of patients. The next steps will include genetic analysis of C1INH and other proteins involved in HAE. PMID:22195757

  17. Differential diagnosis of lung lesion in breast carcinoma: a metachronous neoplasm or metastasis?

    Science.gov (United States)

    Maddala, Raja Naga Mahesh; Udupa, Karthik; Thomas, Joseph; Pai, Kanthilatha

    2016-01-01

    A 34-year-old woman-a diagnosed case of pT1N1MO, stage IIa, estrogen and progesterone receptor positive (ER, PR) positive, Her2 negative carcinoma of the left breast-was managed with modified radical mastectomy and adjuvant chemotherapy. While planning for radiotherapy, she was found to have a well-defined enhancing lesion with spiculated margins in the superior segment of the right lower lobe along with a heterogeneously enhancing right hilar lymph node on CT. Histopathological evaluation of the lesion was suggestive of adenocarcinoma. The lesion was negative for ER, PR receptors, mammoglobin and gross cystic disease fluid protein. Thyroid transcription factor 1 (TTF-1) was positive, suggesting a primary lung adenocarcinoma rather than metastatic lesion from the breast. This case clearly signifies the importance of histopathological diagnosis of suspicious metastatic lesions in the setting of early breast cancer. We would also like to highlight the importance of TTF-1 in differentiating primary lung malignancy from metastasis. PMID:27170610

  18. Differential diagnosis of thyroid nodules with virtual touch tissue imaging of ARFI elastography

    Science.gov (United States)

    Li, Tao; Zhou, Pei; Ding, Mingyue; Mi, Yongwei; Li, Yiyong; Zhang, Ji

    2016-04-01

    The aim of this study was to evaluate the diagnostic performance of virtual touch tissue imaging (VTI) based on ARFI elastography technique for differentiating malignant from benign thyroid nodules. One hundred pathologically proven thyroid nodules (80 benign, 20 malignant) in 76 participants were recruited in this study. The likelihood of malignancy in the light of VTI features was scored into 6 levels by one experienced sonogist who was blinded to pathological results. In addition, the mean gray value within the thyroid nodule (mGVTN) derived from VTI image was calculated for quantitative analysis. Receiver-operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance of VTI score and mGVTN. The frequency of malignant nodules (11/20) classified between VTI levels 4 to 6 was more than that of benign nodules (6/80) (p thyroid nodules. The diagnosis performance of mGVTN was almost consistent with that of VTI score, which indicated that the mGVTN as a quantitative parameter might facilitate doctors diagnosing malignant thyroid nodules by VTI.

  19. Focal adenomyosis (intramural endometriotic cyst) in a very young patient - differential diagnosis with uterine fibromatosis.

    Science.gov (United States)

    Manta, L; Suciu, N; Constantin, A; Toader, O; Popa, F

    2016-01-01

    Introduction. Adenomyosis is a widespread disease usually affecting the late reproductive years of the women's life, which has a great impact on their fertility. The most common form is diffuse adenomyosis, while focal adenomyosis, a cystic variant, is very rare, particularly in patients younger than 30 years old. Materials and methods. We reported a rare case of a 20-year-old Caucasian woman with cystic adenomyosis who was admitted in our service with severe chronic pelvic pain, dysmenorrhea, and menorrhagia, who had received conservative surgical treatment to preserve fertility and improve her obstetrical prognosis. Results and Discussions. Although the necrobiosis of a uterine fibroid was suspected preoperatively, the extemporaneous histopathological exam revealed adenomyosis associated with fibroleiomyoma with hyaline dystrophy and multiple foci of endometriosis of cystic formation in the wall of a young woman without any risk factors. Conclusion. Although a rare lesion in young patients, cystic adenomyosis should be considered when chronic pelvic pain is exacerbated during menstruation and is associated with a uterine tumor. In young patients, the differential diagnosis should be made with uterine malformations (hematometra), necrobiosis of uterine fibroids, pelvic endometriosis. The surgical treatment should be conservative with the excision of the lesion, always taking into account fertility preservation in young patients. PMID:27453751

  20. Differential diagnosis and prognosis of T1-weighted post-gadolinium intralabyrinthine hyperintensities

    Energy Technology Data Exchange (ETDEWEB)

    Dubrulle, F.; Puech, P.; Ernst, O. [University Nord of France, Department of Radiology, CHU Lille, Huriez Hospital INSERM, Lille (France); Kohler, R. [CHU Lille, Huriez Hospital, Department of Radiology, Lille (France); Vincent, C. [CHU Lille, Department of Otology and Oto-neurosurgery, Lille (France)

    2010-11-15

    The aim of this longitudinal study is to describe the different intralabyrinthine lesions yielding high signal intensity on T1-weighted (T1W) images after intravenous gadolinium and then to analyze the follow-up of these patients. Thirty-seven patients were included and followed clinically and radiologically. A precise analysis of MR labyrinthine signals allowed exact depiction of the different lesions. Special interest is focused on the intralabyrinthine fluid signal on 3D high-resolution T2W images. The enhanced T1W labyrinthine hyperintensities correspond to two different categories: intralabyrinthine enhancement (15 intralabyrinthine schwannomas, 13 labyrinthitis, 1 inflammatory granuloma) and spontaneous T1W hyperintensities (8 intralabyrinthine hemorrhages). Hemorrhagic lesions show a substantial decrease of the intralabyrinthine fluid signal on the 3D HRT2 that evolves to ossification. In labyrinthitis, the importance of the initial labyrinthine fluid signal decrease on the 3D HRT2 is well correlated with the hearing prognosis. A meticulous analysis of inner ear lesions allows various intralabyrinthine lesions, in particular schwannomas, to be differentiated from labyrinthitis. T1W imaging without gadolinium is essential for the correct diagnosis of rapidly evolving hearing loss. In labyrinthitis and intralabyrinthine hemorrhage, 3D HRT2 brings an interesting prognostic factor for the chance of hearing recovery. (orig.)

  1. MR Imaging Findings of Ovarian Cystadenofibroma and Cystadenocarcinofibroma: Clues for the Differential Diagnosis

    International Nuclear Information System (INIS)

    We wanted to assess the MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma, and we wanted to find clues for making the differential diagnosis between them. The MR images of 12 pathologically proven cystadenofibromas and two cystadenocarcinofibromas were reviewed, with a focus on the internal architecture, signal intensity and enhancement. All the tumors appeared as multilocular cysts, except for a single unilocular cystic mass and a single solid mass. The previously reported characteristic MR findings of cystadenofibroma (a multilocular cystic mass with a T2- dark-signal-intensity solid component containing small cystic locules) were found in only 43% of the tumors (6/14). Diffuse or partial thickening of the cyst wall with T2-dark signal intensity without a definite solid component was as common as the previous reported findings (6/14). Two cystadenocarcinofibromas showed more prominent solid portions with higher T2-signal intensities and stronger enhancement than did the cystadenofibromas. Diffuse or partial thickening of the cyst wall with dark-signal-intensity in multilocular cystic masses may suggest ovarian cystadenofibroma, and this type of appearance may be as common as the previously reported characteristic appearance. A prominent solid component with a higher T2-signal intensity and strong enhancement are the typical findings of cystadenocarcinofibroma

  2. MR Imaging Findings of Ovarian Cystadenofibroma and Cystadenocarcinofibroma: Clues for the Differential Diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Dae Chul; Kim, Sun Ho; Kim, Seung Hyup [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2006-09-15

    We wanted to assess the MR imaging findings of ovarian cystadenofibroma and cystadenocarcinofibroma, and we wanted to find clues for making the differential diagnosis between them. The MR images of 12 pathologically proven cystadenofibromas and two cystadenocarcinofibromas were reviewed, with a focus on the internal architecture, signal intensity and enhancement. All the tumors appeared as multilocular cysts, except for a single unilocular cystic mass and a single solid mass. The previously reported characteristic MR findings of cystadenofibroma (a multilocular cystic mass with a T2- dark-signal-intensity solid component containing small cystic locules) were found in only 43% of the tumors (6/14). Diffuse or partial thickening of the cyst wall with T2-dark signal intensity without a definite solid component was as common as the previous reported findings (6/14). Two cystadenocarcinofibromas showed more prominent solid portions with higher T2-signal intensities and stronger enhancement than did the cystadenofibromas. Diffuse or partial thickening of the cyst wall with dark-signal-intensity in multilocular cystic masses may suggest ovarian cystadenofibroma, and this type of appearance may be as common as the previously reported characteristic appearance. A prominent solid component with a higher T2-signal intensity and strong enhancement are the typical findings of cystadenocarcinofibroma.

  3. Chronic pulmonary embolism - radiological imaging and differential diagnosis; Chronische Lungenembolie - Radiologische Bildmorphologie und Differenzialdiagnose

    Energy Technology Data Exchange (ETDEWEB)

    Coppenrath, E.; Herzog, P.; Attenberger, U.; Reiser, M. [Klinikum Innenstadt der Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Klinische Radiologie, Muenchen (Germany)

    2007-08-15

    In chronic pulmonary embolism branches of the pulmonary arterial tree remain partially or totally occluded. This may lead to pulmonary hypertension with the development of right ventricular hypertrophy as well as structural changes of pulmonary arteries. Imaging of chronic pulmonary embolism should prove vessel occlusions (pulmonary angiography, MSCT, MRI) and reduction of regional lung perfusion (lung scanning, MSCT, MRI). According to current guidelines ventilation-perfusion lung scanning and pulmonary angiography are still recommended as the methods of choice. MSCT and MRI provide technical alternatives which are helpful in differential diagnosis versus other types of pulmonary hypertension. In spite of medical and surgical measures (in rare cases pulmonary thromboendarterectomy) the prognosis of chronic pulmonary embolism remains unfavourable. (orig.) [German] Bei der chronischen Lungenembolie sind Abschnitte der arteriellen Lungenstrombahn dauerhaft verschlossen. Dies kann zu einer Erhoehung des pulmonal-arteriellen Drucks mit den Folgen einer Rechtsherzbelastung und strukturellen Veraenderungen der Pulmonalarterien fuehren. Bildmorphologisch nachzuweisen sind Gefaessverschluesse (Pulmonalisangiographie, MSCT, MRT) und die Minderperfusion des Lungenparenchyms (Szintigraphie, MSCT, MRT). Nach den bisherigen Empfehlungen gelten fuer die Diagnostik der chronischen Lungenembolie die Lungenszintigraphie (Ventilation/Perfusion) und die Pulmonalisangiographie als Methoden der ersten Wahl. Die MSCT und MRT (Angiographie/Perfusion) stellen technische Alternativen dar. Differenzialdiagnostisch sind andere Formen der pulmonalen Hypertonie abzugrenzen. Trotz medikamentoeser und chirurgischer Therapiemassnahmen (z. B. pulmonale Thrombendarterektomie) bleibt die Prognose der chronischen Lungenembolie unguenstig. (orig.)

  4. Primary Synovial Sarcoma of Kidney: A Rare Differential Diagnosis of Renomegaly

    Directory of Open Access Journals (Sweden)

    Gaurang Modi

    2014-01-01

    Full Text Available Synovial sarcomas (SS are classified as subgroup of soft tissue sarcomas affecting mainly extremities of young adults. Primary SS of kidney are very rare tumours with poor prognosis. Though they have characteristic histology and immunohistochemistry (IHC due to rarity of incidence it is difficult to diagnose them. Sometimes chromosomal rearrangement studies are required to confirm the diagnosis. We are presenting a case of 41-year-old male who was referred to our cancer centre for evaluation of left renal mass. CT scan of abdomen revealed a large left renal mass encasing the aorta. Biopsy of renal mass revealed poorly differentiated sarcoma and IHC was positive for vimentin, CD99, and BCL2 and negative for AE1, epithelial membrane antigen, and leukocyte common antigen. The patient was clinically inoperable as renal mass was encasing the aorta. So he was subsequently offered palliative chemotherapy in form of ifosfamide and adriamycin. CT abdomen shows partial response after 3 cycles of chemotherapy according to RECIST criteria.

  5. Non-functioning parathyroid adenoma: a rare differential diagnosis for vocal-cord paralysis.

    Science.gov (United States)

    Kamali, D; Sharpe, A; Nagarajan, S; Elsaify, W

    2016-07-01

    Introduction Adenomas of the parathyroid gland typically present with symptoms of hyperparathyroidism, manifested by fatigue, bone pain, abdominal pain, weakness, dyspepsia, nephrolithiasis and skeletal bone disease. Here, we describe, for the first time, a case of a non-functioning benign tumour of the parathyroid gland presenting as vocal-cord paralysis. Case History A 49-year-old male presented with a 10-week history of dysphonia and the feeling of having 'something stuck in my throat'. History-taking elicited no other associated symptoms. Flexible nasal endoscopy demonstrated paralysis of the left vocal cord. Computed tomography of the neck revealed a cystic lesion, 18mm in diameter adjacent to the oesophagus. After more rigorous tests, a neck exploration, left hemithyroidectomy, excision of the left paratracheal mass and level-VI neck dissection was undertaken, without incident to the patient or surgical team. Histology was consistent with a parathyroid adenoma. Conclusions This case emphasises the importance of including adenomatous disease of the parathyroid gland in the differential diagnosis despite normal parathyroid status as a cause of vocal cord palsy. PMID:27055408

  6. Most frequent causes, complications and differential diagnosis of neonatal respiratory distress in chest X-ray

    Energy Technology Data Exchange (ETDEWEB)

    Ponhold, W. (Vienna Univ. (Austria). Kinderklinik)

    1982-01-01

    The radiologic changes of the chest X-ray of 270 newborns with respiratory distress were analyzed. In cases of Hyaline Membranes the chest X-Ray showed finely granular evenly disseminated structures combined with signs of hypoventilation. Localized, patchy, streaky, homogenous and reticulonodular shadows were found in cases of pneumonia and hemorrhage. Hyperinflation were an additional sign for an inflammatory disease. This symptom was also demonstrated in pulmonary bleeding, but was less common. The bilateral interstitial augmentation of the pulmonary structure in combination with cardiomegaly was mainly a symptom for cardial insufficiency and transient tachypnea. The differentiation between fine granular and reticulo-nodular structures should create no problem if the chest X-ray is of good quality. Extrapulmonary air collections were found in a high percentage in the course of artificial ventilation as a consequence of the 'baro-trauma'. The radiologic diagnosis of BPD was no problem. The value of the chest X-ray lies in the demonstration of a pulmonary cause for the respiratory distress, in the demonstration of complications and in the radiological observation of the disease.

  7. Differential diagnosis of adrenal masses by chemical shift and dynamic gadolinium enhanced MR imaging

    International Nuclear Information System (INIS)

    Chemical shift MRI is widely used for identifying adenomas, but it is not a perfect method. We determined whether combined dynamic MRI methods can lead to improved diagnostic accuracy. Fifty-seven adrenal masses were examined by chemical shift and dynamic MR imaging using 2 MR systems. The masses included 38 adenomas and 19 non-adenomas. In chemical shift MRI studies, the signal intensity index (SI) was calculated, and the lesions classified into 5 types in the dynamic MRI studies. Of the 38 adenomas studied, 37 had an SI greater than 0. In the dynamic MRI, 34 of 38 adenomas showed a benign pattern (type 1). If the SI for the adenomas in the chemical shift MRI was considered to be greater than 0, the positive predictive value was 0.9, and the negative predictive value was 0.94 and κ=0.79. If type 1 was considered to indicate adenomas in the dynamic MRI, the corresponding values were 0.94, 0.81 and κ=0.77 respectively. The results obtained when the 2 methods were combined were 1, 0.95 and κ=0.96 respectively. The chemical shift MRI was found to be useful for identifying adenomas in most cases. If the adrenal mass had a low SI (0< SI<5), dynamic MRI was also found to be helpful for making a differential diagnosis. (author)

  8. CT classification of chronic pancreatitis and the significance for differential diagnosis

    International Nuclear Information System (INIS)

    Objective: To study the CT characteristics of chronic pancreatitis and a classification based on the CT manifestations was established. Methods: In total 59 patients with chronic pancreatitis, 43 males and 16 females, with an average age of 40 years old were enrolled in the study. History of acute pancreatitis was positive in 36 patients. Non contrast enhanced and contrast enhanced CT scans were performed. The sizes of lesions, contour of pancreas, as well as the number, density and margin of lesions were investigated on the CT images. Results: Atrophy of the entire pancreas was revealed in 27 patients (46%), complicated with different degree of calcification. Solitary cyst with amorphous wall calcification was demonstrated in 13 patients (22%); multiple intra-pancreatic and peri-pancreatic pseudo-cysts were shown in 7 patients (12%); dilated pancreatic duct was seen in 7 patients (12%); and regional well demarcated bulging of pancreas was presented in 5 patients (8%). Conclusion: The CT findings of chronic pancreatitis in our study could be classified into 5 types: atrophy type, solitary cystic type, multicystic type, pure pancreatic duct dilatation type and mass type. The classification had certain significance for the differential diagnosis and the etiological analysis of chronic pancreatitis. (authors)

  9. The value of electroencephalography in differential diagnosis of altered mental status in emergency departments

    International Nuclear Information System (INIS)

    Objective: To evaluate the value of electroencephalography in patients with altered mental status in emergency departments. Methods: Demographical characteristics, types and aetiologies of seizures, and clinical outcomes of the patients were recorded. Patients were divided into 4 groups according to the complaints of admission: findings and symptoms of seizure; stroke and symptoms of stroke-related seizures; syncope; and metabolic abnormalities and other causes of altered mental status. The electroencephalography findings were classified into 3 groups: epileptiform discharges; paroxysmal electroencephalography abnormalities; and background slowing. Electroencephalography abnormalities in each subgroup were evaluated. SPSS 21 was used for statistical analysis. Results: Of the total 190 patients in the study, 117(61.6%) had pathological electroencephalography findings. The main reason for electroencephalography in the emergency department was the presence of seizure findings and symptoms in 98(51.6%) patients. The ratio of electroencephalography abnormality was higher in patients who were admitted with complaints of metabolic abnormality-related consciousness disturbances (p<0.001). A total of 124(65.3%) patients had neuroimagings. Electroencephalography abnormalities were found to be significantly higher in patients with neuroimagings compared to those without neuroimagings (p<0.003). Conclusion: Despite advanced neuroimaging techniques, electroencephalography is still an important tool in the differential diagnosis of altered mental status such as epileptic seizures, metabolic abnormalities, pseudo-seizures and syncope. (author)

  10. Dynamic automated synovial imaging (DASI) for differential diagnosis of rheumatoid arthritis

    Science.gov (United States)

    Grisan, E.; Raffeiner, B.; Coran, A.; Rizzo, G.; Ciprian, L.; Stramare, R.

    2014-03-01

    Inflammatory rheumatic diseases are leading causes of disability and constitute a frequent medical disorder, leading to inability to work, high comorbidity and increased mortality. The gold-standard for diagnosing and differentiating arthritis is based on patient conditions and radiographic findings, as joint erosions or decalcification. However, early signs of arthritis are joint effusion, hypervascularization and synovial hypertrophy. In particular, vascularization has been shown to correlate with arthritis' destructive behavior, more than clinical assessment. Contrast Enhanced Ultrasound (CEUS) examination of the small joints is emerging as a sensitive tool for assessing vascularization and disease activity. The evaluation of perfusion pattern rely on subjective semiquantitative scales, that are able to capture the macroscopic degree of vascularization, but are unable to detect the subtler differences in kinetics perfusion parameters that might lead to a deeper understanding of disease progression and a better management of patients. We show that after a kinetic analysis of contrast agent appearance, providing the quantitative features characterizing the perfusion pattern of the joint, it is possible to accurately discriminate RA from PSA by building a random forest classifier on the computed features. We compare its accuracy with the assessment performed by expert radiologist blinded of the diagnosis.

  11. Clinical Relevance of Compression Elastography in Differential Diagnosis of Pancreatic Cystic Masses

    Directory of Open Access Journals (Sweden)

    Morozova Т.G.

    2014-06-01

    Full Text Available The aim of the investigation was to assess the capabilities of compression elastography in differential diagnosis of pancreatic cystic tumors. Materials and Methods. 15 patients with pancreatic cystic masses were examined. There were the following clinical forms: pancreatic pseudocysts in chronic pancreatitis — 9 (60%, pancreatic cystadenocarcinoma — 4 cases (26.7%, pancreatic cyst in intraductal papillary-mucinous adenoma — 2 cases (13.3%. The patients underwent pancreatic and hepatic sonography, fibrogastroduodenoscopy and compression elastography with endosonography. Referential techniques were helical computed tomography and ultrasound-guided pancreatic paracenthesis. The patients were operated on within 3–4 months, the diagnoses were histologically verified. Compression elastographic strain ratio (SR was calculated by the program in ultrasonic apparatus, i.e.: the image was fixed in “an interest area” (a focal lesion, from two to three measuring points were established using a special cursor, and the program calculated SR. Results. We determined optimal threshold values of compression elastography indices, when diagnostic sensitivity, specificity and accuracy of the technique were maximum; and showed significant clinical capabilities and prospects of compression elastography applied in endosonography. SR in cystadenocarcinoma was 34.1–42.5 RU, in solid pseudopapillary tumor — from 44.7 RU, in postnecrotic cysts — from 13 to 25 RU. Conclusion. The data analysis showed that the application of compression elastography in endosonography enabled to increase the informative value of clinical laboratory examination of patients with pancreatic cystic masses.

  12. CT characterization of bile duct dilatation: Differential diagnosis of obstructive jaundice

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Jae Hoon; Yoon, Hyp; Ko, Young Tae; Lee, Dong Ho; Yang, Ik [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    1992-07-15

    Each disease affecting the bile ducts tends to produce characteristic pattern of biliary dilatation: recurrent pyogenic cholangitis causes dilatation and straightening of the larger (central) intrahepatic ducts: clonorchiasis causes dilatation of the smaller (peripheral) intrahepatic ducts; and carcinoma along the extrahepatic ducts causes (proportional) dilatation and tortuosity of both larger and smaller intrahepatic ducts. To evaluate the specificity of the pattern and morphology of the dilated biliary tree on CT scans (CT characterization) three independent radiologists who were unifamiliar with the cases were asked to classify 62 CT scans in patients with obstructive jaundice. The case population consisted of 14 cases with recurrent pyogenic cholangitis, 18 cases with clonorchiasis and 30 cases with carcinoma along the extrahepatic ducts, which were intermixed randomly. Classification was made only on the basis of CT characterization: those scans showing primary lesions, i.t., stone , aggregate of flukes, or tumor mass were excluded or masked. All the scans of every cases showing the extrahepatic bile duct were masked . Radiologists correctly classified 54 of the 62 cases (87%): ten of the 14 patients with recurrent pyogenic cholangitis (71%). 17 of the 18 patients with clonorchiasis (94%) and 27 of the 30 patients with carcinoma along the extrahepatic bile ducts (90%). We believe that CT characterization of bile dust dilatation is useful in the differential diagnosis of obstructive jaundice, especially when a primary pathologic lesion is not depicted in CT scans.

  13. Differential diagnosis of solitary pulmonary nodules by computerized statistical analysis using CT number

    International Nuclear Information System (INIS)

    There have been previous reports on the differentiation of benign pulmonary nodules from malignant ones using CT number. However, most of the nodules were without calcification, and diagnosis could be made only in limited cases. In the present study we established new multiple variables such as relative high density over the 75th percentile, inner gradient number (inner irregular rate), edge gradient number (edge irregular rate) and increased area rate (IAR). They are automatically calculated from CT data by computer. These variables are transformed into relative values, enabling comparisons of nodules without a standard reference phantom. With IAR, pulmonary nodules were classified into three types: type 1 (IAR 1.0-1.4), a high-density solid mass with well-defined margin; type 2 (IAR 1.4-2.0) between type 1 and type 3; and type 3 (IAR>2.0) a low-density infiltrated mass with ill-defined margin. We studied 52 cases with solitary pulmonary nodules, whose diagnoses were confirmed either histologically or on follow-up. There were 34 benign nodules and 18 primary lung cancers. Using step-wise multiple regression with three variables, 42 of 52 cases were correctly diagnosed. Twenty-four of 28 type 1 cases and all 14 of type 2 cases were correctly diagnosed. This computer analysis is considered to be useful in distinguishing between benign and malignant solitary pulmonary nodules. (author)

  14. Differential diagnosis in patients with ring-like thallium-201 uptake in brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kinuya, Keiko; Ohashi, Masahiro; Itoh, Syotaro [Tonami General Hospital, Toyama (Japan)] (and others)

    2002-09-01

    This study was performed to investigate lesions with ring-like thallium-201 ({sup 201}Tl) uptake and to determine whether SPECT provides any information in differential diagnosis. A total of 244 {sup 201}Tl SPECT images were reviewed. In each study, early (15 min postinjection) and late (3 hr) brain SPECT images were obtained with 111 MBq of {sup 201}Tl. The early uptake ratio (ER; lesion to normal brain average count ratio) and the late uptake ratio (LR) and the L/E ratio (ratio of LR to ER) were calculated. Ring-like uptake was observed in pre-therapeutic 26 SPECT images, including ten glioblastoma multiformes (ER, 3.45{+-}0.64; LR, 2.74{+-}0.54; L/E ratio 0.80{+-}0.13), five meningiomas (6.48{+-}2.34; 4.41{+-}1.41; 0.72{+-}0.19), four metastatic lung cancers (3.47{+-}1.23; 2.40{+-}0.98; 0.70{+-}0.14), four brain abscesses (2.48{+-}1.06; 1.59{+-}0.30; 0.78{+-}0.15), one invasive lesion of squamous cell carcinoma from the ethmoid sinus (1.54; 1.52; 0.99), one medulloblastoma (3.53; 3.52; 1.00) and one hematoma (3.32; 2.36; 0.71). The ER of meningioma was significantly higher than those of glioblastoma multiforme (p<0.0005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0005). There were no significant differences among these three entities. The LR of meningioma was significantly higher than those of glioblastoma multiforme (p<0.005), metastatic lung cancer (p<0.005) and brain abscess (p<0.0001). The LR of brain abscess was significantly lower than that of glioblastoma multiforme (p<0.05). The L/E ratio could not differentiate these four entities. High ER and high LR in a lesion with ring-like uptake is likely an indicator of meningioma. The LR of brain abscess was significantly lower than that of glioblastoma multiforme, but {sup 201}Tl SPECT has still difficulty in differentiating abscess from brain tumor. (author)

  15. Depressive and adjustment disorders – some questions about the differential diagnosis: case studies

    Directory of Open Access Journals (Sweden)

    A Presicci

    2010-07-01

    Full Text Available A Presicci1, P Lecce1, P Ventura1, F Margari2, S Tafuri3, L Margari11Child Neuropsychiatric Unit, Department of Neurologic and Psychiatric Science, Aldo Moro University of Bari, Bari, Italy; 2Psychiatric Unit, Department of Neurologic and Psychiatric Science, Aldo Moro University of Bari, Bari, Italy; 3Hygiene Section, Department of Biomedical Science and Human Oncology, Aldo Moro University of Bari, Bari, ItalyBackground: Diagnosis and treatment of mood disorders in youth are still problematic because in this age the clinical presentation is atypical, and the diagnostic tools and the therapies are the same as that used for the adults. Mood disorders are categorically divided into unipolar disorders (major depressive disorder and dysthymic disorder and bipolar disorder in Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition, Text Revision, but mood symptoms are also comprised in the diagnostic criteria of the adjustment disorder (AD, which occur in many different psychiatric disorders, and may also be found in some physical conditions. The differential diagnosis is not much addressed in the midst of clinical ­investigation and so remains the major problem in the clinical practice.Aims: The associations between some variables and the depressive disorder and AD were analyzed to make considerations about differential diagnosis.Patients and methods: We reported a retrospective study of 60 patients affected by ­depressive disorder and AD. The analysis has evaluated the association between some variables and the single diagnostic categories. We have considered 10 variables, of which 6 are specific to the ­disorders, and 4 have been considered related problems.Results: The statistical analysis showed significant results for the associations of 3 variables (prevalent symptoms, treatment, and family history with the single diagnostic categories.Conclusion: The discriminate analysis resulted in statistically significant differences

  16. 眩晕的诊断与鉴别诊断%The diagnosis and differential diagnosis of vertigo

    Institute of Scientific and Technical Information of China (English)

    潘婕; 罗本燕

    2011-01-01

    Summary: Vertigo refers to an illusion of motion between the body and the surroundings, which is one of the common chief complainsin clinies of neurology.This study shed light on the diagnosis and diferential diagnosis of vertigo based on the authors'clinical experience and new advances in vertigo studies during the recent years.%眩晕是指发生于自身与周围物体之间的运动幻觉,是神经内科门诊常见主诉之一.文章将以临床经验为基础,结合近年来的研究进展,将眩晕的诊断与鉴别诊断做一概述.

  17. Prenatal Diagnosis of Treacher-Collins Syndrome Using Three-Dimensional Ultrasonography and Differential Diagnosis with Other Acrofacial Dysostosis Syndromes

    OpenAIRE

    Daniela Cardoso Pereira; Luiz Claudio de Silva Bussamra; Edward Araujo Júnior; Carolina Leite Drummond; Luciano Marcondes Machado Nardozza; Antonio Fernandes Moron; José Mendes Aldrighi

    2013-01-01

    Treacher-Collins syndrome (TCS) is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS) is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS) has the capacity to spatially di...

  18. MAGNETIC RESONANCE IMAGING OF THE SACROILIAC JOINT IN DIFFERENTIAL DIAGNOSIS OF EARLY POLYARTICULAR PSORIATIC AND RHEUMATOID ARTHRITIS (STUDY DATA REMARKA)

    OpenAIRE

    Elena Yu Loginova; T. V. Korotaeva; E L Luchihina; Smirnov, A. V.; A A Glazkov; D E Karateev

    2014-01-01

    Diagnosis of lesions of the spine and sacroiliac joints may be helpful in discrimination between early psoriatic arthritis (ePsA) and early rheumatoid arthritis (eRA).Objective. To assess the significance of inflammatory back pain (IBP), HLA-B27, and active sacroiliitis (ASI) confirmed by magnetic resonance imaging (MRI) for differential diagnosis of polyarticular ePsA and eRA.Materials and Methods. The study included 29 patients with ePsA (13 males and 16 females, mean age 36.52 ± 11.27 year...

  19. Dermatoscopic fi ndings as a complementary tool in the differential diagnosis of the etiological agent of tinea capitis*

    Science.gov (United States)

    Schechtman, Regina Casz; Silva, Nanashara Diane Valgas; Quaresma, Maria Victória; Bernardes Filho, Fred; Buçard, Alice Mota; Sodré, Celso Tavares

    2015-01-01

    Tinea capitis is a scalp infection caused by fungi. In Brazil, the main causative agents are Microsporum canis and the Trichophyton tonsurans. Etiological diagnosis is based on suggestive clinical findings and confirmation depends on the fungus growth in culture. However, it is not always possible to perform this test due to lack of availability. We reveal the dermoscopic findings that enable distinction between the main causative agents of Tinea capitis, M. canis and T. tonsurans. The association of clinical and dermatoscopic findings in suspected Tinea capitis cases may help with the differential diagnosis of the etiological agent, making feasible the precocious, specific treatment. PMID:26312662

  20. Dermatoscopic findings as a complementary tool in the differential diagnosis of the etiological agent of tinea capitis.

    Science.gov (United States)

    Schechtman, Regina Casz; Silva, Nanashara Diane Valgas; Quaresma, Maria Victória; Bernardes Filho, Fred; Buçard, Alice Mota; Sodré, Celso Tavares

    2015-01-01

    Tinea capitis is a scalp infection caused by fungi. In Brazil, the main causative agents are Microsporum canis and the Trichophyton tonsurans. Etiological diagnosis is based on suggestive clinical findings and confirmation depends on the fungus growth in culture. However, it is not always possible to perform this test due to lack of availability. We reveal the dermoscopic findings that enable distinction between the main causative agents of Tinea capitis, M. canis and T. tonsurans. The association of clinical and dermatoscopic findings in suspected Tinea capitis cases may help with the differential diagnosis of the etiological agent, making feasible the precocious, specific treatment. PMID:26312662

  1. Dynamic contrast enhanced MRI in the differential diagnosis of soft tissue tumors

    Energy Technology Data Exchange (ETDEWEB)

    Tuncbilek, Nermin; Karakas, Hakki Muammer; Okten, Ozerk Omur

    2005-03-01

    Purpose: The value of the dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) in differentiating benign and malignant soft tissue tumors was investigated. Materials and methods: Turbo FLASH DCE-MRI was performed on 22 subjects (2-74 years) with soft tissue tumors. Enhancement in the first min (E{sub max/1}), second min (E{sub max/2}) and maximum peak enhancement (E{sub max}), and steepest slope were calculated. Discriminant analyses were performed to reveal parametric differences of benign and malignant lesions. Results: Diagnosis of benign (N = 10) tumors were hemangioma (n = 3), neurogenic tumor (n = 3) lipoma (n = 2), giant cell tumor (n = 1) and desmoid (n = 1), whereas malignant lesions (N = 12) were classified as liposarcoma (n = 5), malignant fibrous histiocytoma (n = 5) and synovial sarcoma (n = 2). For malignant lesions E{sub max/1} was 65-198%, E{sub max/2} was 65-145%, E{sub max} was 78-198%, and steepest slope was 1.45-4.06. For benign lesions these values were 4-98%, 5-105%, 7-125% and 0.67-2.57, respectively. To determine the relation between the variables analysed, Pearson correlation coefficients were calculated. E{sub max} was found to be highly correlated with other variables (rxy>0.86, P < 0.0001). Consequently, this variable was excluded from the discriminant analysis. In order to determine discrimination of malignant and benign tumors using E{sub max/1}, E{sub max/2,} and steepest slope of the enhancement curve logistic regression was applied to the above mentioned data. When combined these parameters had a 95.5% of overall accuracy in classifying benign and malignant lesions (P = 0.004). Conclusion: DCE-MRI parameters that thought to be the surrogate markers of tumoral microcirculation and tissue perfusion provides a specific preoperative diagnosis. Dynamic imaging parameters are therefore advocated for monitoring the effect of chemotherapy in soft tissue tumors.

  2. Some boys' problems in education

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms

    2015-01-01

    The last two decades have seen an increasing political concern in the high dropout rates and low performance in education of boys compared to girls – at times in the form of a ‘moral panic’. This has also been the case in Denmark where ‘the boy problem’ in education now is placed high on the agenda...... have in VET. Secondly, it explores the role of VET for students at risk of dropping out based on individual qualitative interviews with 106 students, two-thirds male, attending vocational schools in Denmark. The analyses show that most students experience the dual system of VET as a valuable...... alternative to general education, but social and institutional processes of differentiation in the vocational schools place a significant group of students in a position where they have little chance of completing the programme. In the conclusion, some reflections are made on the effect of a recent reform of...

  3. Prenatal Diagnosis of Treacher-Collins Syndrome Using Three-Dimensional Ultrasonography and Differential Diagnosis with Other Acrofacial Dysostosis Syndromes

    Directory of Open Access Journals (Sweden)

    Daniela Cardoso Pereira

    2013-01-01

    Full Text Available Treacher-Collins syndrome (TCS is a rare dominant autosomal anomaly resulting from malformation or disruption of the development of the first and second branchial arches. It is characterized by micrognathia, malar hypoplasia, and malformations of the eyes and ears. The prenatal diagnosis using two-dimensional ultrasonography (2DUS is characterized by identification of facial malformations together with polyhydramnios. Three-dimensional ultrasonography (3DUS has the capacity to spatially display these facial malformations, thus making it easy for the parents to understand them. We present a case of TCS diagnosed in the 33rd week using 3DUS, with postnatal confirmation using cranial computed tomography and anatomopathological analysis.

  4. Neuro-Spect and neuropsychological test in the differential diagnosis of dementia

    International Nuclear Information System (INIS)

    differential diagnosis of dementia. However, these are preliminary results that needed to be confirmed in larger number of patients

  5. A boy with sudden headache.

    Science.gov (United States)

    Norbedo, Stefania; Naviglio, Samuele; Murru, Flora Maria; Cavallin, Roberta; Giurici, Nagua; Rabusin, Marco; Barbi, Egidio

    2014-03-01

    Headache is a common presenting complaint in pediatric emergency departments. The goal of emergent evaluation is to identify those children with potentially life-threatening conditions. We present the case of an adolescent boy presenting with headache and hypertension who was diagnosed with a catecholamine-secreting abdominal paraganglioma. Genetic testing eventually led to the diagnosis of SDHB-related hereditary paraganglioma-pheochromocytoma syndrome. Alarm features ("red flags") in children presenting with headache are reviewed, as well as the main features of paragangliomas and the indications for genetic testing. PMID:24589807

  6. Differential diagnosis of parotid gland tumours: which magnetic resonance findings should be taken in account?

    Science.gov (United States)

    Tartaglione, T; Botto, A; Sciandra, M; Gaudino, S; Danieli, L; Parrilla, C; Paludetti, G; Colosimo, C

    2015-10-01

    Our aim was to define typical magnetic resonance (MRI) findings in malignant and benign parotid tumours. This study is based on retrospective evaluation of pre-surgical MRI of 94 patients with parotid gland tumours. Histology results were available for all tumours. There were 69 cases of benign (73%) and 25 cases of malignant (27%) tumours, including 44 pleomorphic adenomas, 18 Warthin's tumours, 7 various benign tumours, 6 squamous cell carcinomas, 3 carcinoma ex pleomorphic adenomas, 2 mucoepidermoid carcinomas, 1 adenoid cystic carcinoma and 13 various malignant tumours. The following MRI parameters were evaluated: shape, site, size, margins, signal intensity (SI) on T1w and T2w images, contrast enhancement, signal of cystic content, presence or absence of a capsule, perineural spread, extraglandular growth pattern and cervical adenopathy. Statistical analysis was performed to identify the MRI findings most suggestive of malignancy, and to define the most typical MRI pattern of the most common histologies. Ill-defined margins (p < 0.001), adenopathies (p < 0.001) and infiltrative grown pattern (p < 0.001) were significantly predictive of malignancy. Typical findings of pleomorphic adenoma included hyperintensity on T2w images (p = 0.02), strong contrast enhancement (p < 0.001) and lobulated shape (p = 0.04). Typical findings of Warthin's tumour included hyperintense components on T1w images (p < 0.001), location in the parotid inferior process (p < 0.001) and mild or incomplete contrast enhancement (p = 0.01). SI on T1w and T2w images and contrast enhancement enables differential diagnosis between pleomorphic adenoma and Warthin's tumour. PMID:26824912

  7. Efficacy of thyroid ultrasound elastography in differential diagnosis of small thyroid nodules

    International Nuclear Information System (INIS)

    Objective: To explore the efficacy of thyroid ultrasound (US) elastography in differential diagnosis of small thyroid nodules. Methods: This HIPAA-compliant study was approved by the Institutional Review Board and all patients provided written informed consent. Thirty-five patients with 38 small thyroid nodules as seen on transverse ultrasound image formed our study population. An US examination and a separate thyroid elastography examination with pulsation from the carotid artery used as the compression source were performed before fine-needle aspiration. Baseband US data were acquired for off-line elastography processing, where a semi-quantitative index for each nodule was calculated. The Kruskal–Wallis nonparametric rank sum test was used to assess equality of population means among the different types of thyroid nodules. Maximum likelihood estimation of the curve parameters for a binomial receiver operating characteristic (ROC) curve was performed. Results: Elasticity contrast index calculated with elastography was effective in distinguishing between small papillary thyroid carcinomas (PTMC, n = 8) and other lesions (n = 30) in small thyroid nodules (p = 0.0036). The area under the ROC curve for diagnosing PTMCs was 0.812 with a 95% confidence interval of 0.653–0.920. The cut-off value of ECI of 3.6 led to a sensitivity of 100% and a specificity of 60% for detecting PTMCs. Conclusion: Noninvasive evaluation of small thyroid nodules is possible using thyroid US elastography with in vivo compression to pick out the most suspicious thyroid nodules for fine-needle aspiration (FNA) and avoid FNA in benign nodules

  8. Contrast-enhanced sonography versus biopsy for the differential diagnosis of thrombosis in hepatocellular carcinoma patients

    Institute of Scientific and Technical Information of China (English)

    Paolo Sorrentino; Salvatore D'Angelo; Luciano Tarantino; Umberto Ferbo; Alessandra Bracigliano; Raffaela Vecchione

    2009-01-01

    AIM: To clarify which method has accuracy: 2nd generation contrast-enhanced ultrasound or biopsy of portal vein thrombus in the differential diagnosis of portal vein thrombosis. METHODS: One hundred and eighty-six patients with hepatocellular carcinoma and portal vein thrombosis underwent in blinded fashion a 2nd generation contrastenhanced ultrasound and biopsy of portal vein thrombus; both results were examined on the basis of the follow-up of patients compared to reference-standard. RESULTS: One hundred and eight patients completed the study. Benign thrombosis on 2nd generation contrast- enhanced ultrasound was characterised by progressive hypoenhancing of the thrombus; in malignant portal vein thrombosis there was a precocious homogeneous enhancement of the thrombus. On follow-up there were 50 of 108 patients with benign thrombosis: all were correctly diagnosed by both methods. There were 58 of 108 patients with malignant thrombosis: amongst these, 52 were correctly diagnosed by both methods, the remainder did not present malignant cells on portal vein thrombus biopsy and showed on 2nd generation contrast-enhanced ultrasound an inhomogeneous enhancement pattern. A new biopsy during the follow-up, guided to the area of thrombus that showed up on 2nd generation contrast-enhanced ultrasound, demonstrated an enhancing pattern indicating malignant cells. CONCLUSION: In patients with hepatocellular carcinoma complicated by portal vein thrombosis, 2nd generation contrast-enhanced ultrasound of portal vein thrombus is very useful in assessing the benign or malignant nature of the thrombus. Puncture biopsy of thrombus is usually accurate but presents some sampling errors, so, when pathological results are required, 2nd generation contrast-enhanced ultrasound could guide the sampling needle to the correct area of the thrombus.

  9. Differential diagnosis among pituitary and juxtasellar tumors on the basis of NMR images

    International Nuclear Information System (INIS)

    Proton nuclear magnetic resonance (NMR) scans were performed on 18 patients with pituitary and parasellar tumors and compared with X-ray computed tomography (CT) scans. NMR images were also compared with the operative findings and the pathological changes in the tumors. NMR scans lack bone artifacts and are superior to X-ray CT scans in terms of soft-tissue contrasts, including the marked gray-white-matter contrast. Pituitary adenomas exhibited a high-intensity on SRsub(2000/1000) and a low-intensity on IRsub(1400/400). The diverse histological changes in tumor tissue are not reflected in the changes in the NMR images. Meningiomas were seen as high-intensity on SRsub(2000/1000) and as low-intensity on IRsub(1400/400). On IR images, meningiomas exhibited a higher intensity than pituitary adenomas. Rathke's cleft cyst showed a high-intensity on SRsub(2000/1000) and a high-intensity with a peripheral low-intensity on IRsub(1400/400). These findings on the NMR scans may contribute to the differential diagnosis, because tumors in parasellar regions have, in general, longer T1 relaxation times than brain tissues. Craniopharyngiomas were demonstrated to have two components, a solid part and a cystic part. Both were shown as high-intensity on SRsub(2000/1000). The solid part was seen as low-intensity on IRsub(1600/600) and IRsub(1400/400). The cystic part was shown to be low-intensity on IRsub(1400/400). Cystic-membrane and intracystic-niveau formation were revealed on IRsub(1600/600). In many cases, the craniopharyngioma contains small or large calcifications. It is a drawback of the NMR scans that such calcifications are not visualized. (J.P.N.)

  10. Fat-containing Retroperitoneal Lesions: Imaging Characteristics, Localization, and Differential Diagnosis.

    Science.gov (United States)

    Shaaban, Akram M; Rezvani, Maryam; Tubay, Marc; Elsayes, Khaled M; Woodward, Paula J; Menias, Christine O

    2016-01-01

    The complex anatomy of the retroperitoneum is reflected in the spectrum of neoplastic and nonneoplastic conditions that can occur in the retroperitoneum and appear as soft-tissue masses. The presence of fat within a retroperitoneal lesion is helpful in refining the differential diagnosis. Fat is easily recognized because of its characteristic imaging appearance. It typically is hyperechoic at ultrasonography and demonstrates low attenuation at computed tomography (-10 to -100 HU). Magnetic resonance imaging is a more ideal imaging modality because it has better soft-tissue image contrast and higher sensitivity for depicting (a) microscopic fat by using chemical shift imaging and (b) macroscopic fat by using fat-suppression techniques. Whether a lesion arises from a retroperitoneal organ or from the soft tissues of the retroperitoneal space (primary lesion) is determined by examining the relationship between the lesion and its surrounding structures. Multiple imaging signs help to determine the organ of origin, including the "beak sign," the "embedded organ sign," the "phantom (invisible) organ sign," and the "prominent feeding artery sign." Adrenal adenoma is the most common adrenal mass that contains microscopic fat, while myelolipoma is the most common adrenal mass that contains macroscopic fat. Other adrenal masses, such as pheochromocytoma and adrenocortical carcinoma, rarely contain fat. Renal angiomyolipoma is the most common fat-containing renal mass. Other fat-containing renal lesions, such as lipoma and liposarcoma, are rare. Fatty replacement of the pancreas and pancreatic lipomas are relatively common, whereas pancreatic teratomas are rare. Of the primary retroperitoneal fat-containing lesions, lipoma and liposarcoma are common, while other lesions are relatively rare. (©)RSNA, 2016. PMID:27163589

  11. Clinical Significance of Auditory Target P300 Subcomponents in Psychosis: Differential Diagnosis, Symptom Profiles, and Course

    Science.gov (United States)

    Perlman, Greg; Foti, Dan; Jackson, Felicia; Kotov, Roman; Constantino, Eduardo; Hajcak, Greg

    2015-01-01

    Background Reduced auditory target P300 amplitude is a leading biomarker for psychotic disorders, although its relevance for differential diagnosis and link to specific clinical features (symptom profiles, functional impairment, and course) is unclear. This study aims to clarify the clinical significance of auditory target P300 using concurrent and retrospective clinical data from a longitudinal cohort with psychosis. Methods 92 cases from an epidemiological study of first-admission psychosis were assessed using an auditory oddball paradigm at 15-year follow-up along with 44 never-psychotic adults. Subcomponents of auditory target P300 amplitude (i.e., a central positive P3a, a parietal positive P3b, and a frontal negative slow wave) were isolated using temporal-spatial principal components analysis. Results P3a amplitude was blunted across psychotic disorders relative to non-psychotic adults. P3b amplitude was reduced in schizophrenia specifically, including cases initially misclassified at baseline. The frontal negative slow wave did not distinguish among groups. P3b amplitude reduction was associated with several clinical features at the concurrent assessment, as well as previous time points, including recovery from psychosis even 5 years earlier and functioning even 15 years earlier. Conclusions Auditory target P300 amplitude yields both a schizophrenia-specific component (i.e., P3b) and a transdiagnostic psychosis component (i.e., P3a). The P3b component may also shed light on prognosis, real-world functioning, and course, as well as help to reduce misdiagnosis of psychotic disorders. Prospective studies are needed to test whether P3b tracks or predicts clinical status. PMID:25934167

  12. [Endocrine diagnosis in puberty--pathophysiologic bases].

    Science.gov (United States)

    Girard, J

    1994-05-01

    Puberty is characterized by activation of the maturing gonads and by the thus started increased secretion of sexual steroids. Consequences are the appearance of secondary signs of puberty sensu strictori, i. e. the development of breasts in girls, the increase of testicle volume in boys, often followed by growing pubic hair, axillary hair, menarche or laryngeal growth (puberty vocal change) respectively. The most important accompanying symptom is the spurt of growth starting around 12 to 18 months after the onset of the development of the secondary pubertal signs. From the time sequence of the development and the possible delays, valuable diagnostic hints can be gained, giving rise to a more precise analysis of the hormonal phenomena of adolescence. In cases of pubertas tarda a primary malfunction must be differentiated from secondary hypogonadotropic functional defect. The syndromes should be classified correctly according to their etiology. The most frequent diagnosis is that of a simply delayed puberty. Acne, hypertrichosis, hirsutism are concomitant phenomena of puberty development which can indicate a hormonal imbalance (differential diagnosis AGS, ovarian hyperandrogeny). The swelling of breasts in boys (gynecomastia) is a common transitory phenomenon in male adolescence (DD, tumor of the gonads or Klinefelter syndrome). Interesting considerations of differential diagnosis apply also to the assessment of the enlargement of the thyroid gland in puberty, which affects more often girls than boys. PMID:8016754

  13. Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [{sup 18}F]FP-CIT PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Eunkyung; Hwang, Yu Mi; Lee, Channyoung; Oh, Sun Young; Kim, Young Chul; Choe, Jae Gol; Park, Kun Woo [Korea Univ., Seoul (Korea, Republic of); Kim, Sujin [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [{sup 18}F]FP-CIT PET. Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson's disease or drug-induced parkinsonism ('PD/DIP'), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor ('PD/ET'), and six patients who were alleged to have either PD or atypical parkinsonian syndrome ('PD/APS'). Brain PET images were obtained 120 min after injection of 185 MBq [{sup 18}F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses. Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period. [{sup 18}F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD.

  14. Differential Diagnosis of Patients with Inconclusive Parkinsonian Features Using [18F]FP-CIT PET/CT

    International Nuclear Information System (INIS)

    It is often difficult to differentiate parkinsonism, especially when patients show uncertain parkinsonian features. We investigated the usefulness of dopamine transporter (DAT) imaging for the differential diagnosis of inconclusive parkinsonism using [18F]FP-CIT PET. Twenty-four patients with inconclusive parkinsonian features at initial clinical evaluation and nine healthy controls were studied. Patients consisted of three subgroups: nine patients whose diagnoses were unclear concerning whether they had idiopathic Parkinson's disease or drug-induced parkinsonism ('PD/DIP'), nine patients who fulfilled neither the diagnostic criteria of PD nor of essential tremor ('PD/ET'), and six patients who were alleged to have either PD or atypical parkinsonian syndrome ('PD/APS'). Brain PET images were obtained 120 min after injection of 185 MBq [18F]FP-CIT. Imaging results were quantified and compared with follow-up clinical diagnoses. Overall, 11 of 24 patients demonstrated abnormally decreased DAT availability on the PET scans, whereas 13 were normal. PET results could diagnose PD/DIP and PD/ET patients as having PD in six patients, DIP in seven, and ET in five; however, the diagnoses of all six PD/APS patients remained inconclusive. Among 15 patients who obtained a final follow-up diagnosis, the image-based diagnosis was congruent with the follow-up diagnosis in 11 patients. Four unsolved cases had normal DAT availability, but clinically progressed to PD during the follow-up period. [18F]FP-CIT PET imaging is useful in the differential diagnosis of patients with inconclusive parkinsonian features, except in patients who show atypical features or who eventually progress to PD

  15. CT-stereotactic biopsy for differential diagnosis of deep localized intracerebral hematoma

    International Nuclear Information System (INIS)

    The diagnosis of intracerebral haematomas, especially of those which are relatively small, occupy little space and are deeply situated, presents considerable problems. The problem is even greater when the expected acute case history and the acute beginning of the symptoms do not occur and unusual localisations are found. The consequences of this are false diagnoses and the treatment of these patients within the framework of blanket diagnosis ''intracerebral tumours'' or ''space occupying processes'' without any confirmation of the histological diagnosis. Using a sample of 26 patients where the histological diagnosis of non-recent intracerebral hemorrhages had been confirmed (out of a series of 818 CT-stereotactically biopsied patients punctured by us from the beginning of 1983 until the end of 1984), the problem of establishing a diagnosis is exposed. A histological diagnosis should in any case be confirmed before any thorough and depp-reaching therapy is begun, since false diagnoses and misinterpretations can cause serious consequences for the patient. (orig.)

  16. Evaluation of Clinical Examination for Differential Diagnosis of Lameness by Navicular Apparatus or Heel Pain in Horses

    OpenAIRE

    Kamran Sardari; Hossain Kazemi

    2008-01-01

    To evaluation of clinical examination for differential diagnosis of navicular region pain from other forms of palmar heel pain in the forelimb in horses the present study was undertaken. Thirty four horses with lameness referable to the palmar aspect of the hoof based on their response to the palmar digital nerves analgesia were divided into 2 groups based on their response to both distal interphalangeal joint and navicular bursa analgesia. Horses that were profoundly improved by both ...

  17. Trigeminal electrophysiology: a 2 × 2 matrix model for differential diagnosis between temporomandibular disorders and orofacial pain

    OpenAIRE

    Chessa Giacomo; Frisardi Gianni; Sau Gianfranco; Frisardi Flavio

    2010-01-01

    Background Pain due to temporomandibular disorders (TMDs) often has the same clinical symptoms and signs as other types of orofacial pain (OP). The possible presence of serious neurological and/or systemic organic pathologies makes differential diagnosis difficult, especially in early disease stages. In the present study, we performed a qualitative and quantitative electrophysiological evaluation of the neuromuscular responses of the trigeminal nervous system. Using the jaw jerk reflex (JJ...

  18. Impact of d-Dimers on the Differential Diagnosis of Acute Chest Pain: Current Aspects Besides the Widely Known

    OpenAIRE

    Hahne, Kathrin; Lebiedz, Pia; Breuckmann, Frank

    2014-01-01

    d-dimers are cleavage products of fibrin that occur during plasmin-mediated fibrinolysis of blood clots. In the emergency department, d-dimer measurement represents a valuable and cost-effective tool in the differential diagnosis of acute chest pain including the main life-threatening entities: acute coronary syndrome, pulmonary embolism, and acute aortic syndrome. Whereas the diagnostic and prognostic values of d-dimer testing in acute coronary syndrome is of less priority, increases of d-di...

  19. A Challenging Case of Metastatic Intra-Abdominal Synovial Sarcoma with Unusual Immunophenotype and Its Differential Diagnosis

    OpenAIRE

    Yi-Che Changchien; Uhrin Katalin; János Fillinger; László Fónyad; Gergő Papp; Ferenc Salamon; Zoltán Sápi

    2012-01-01

    The primary and metastatic gastrointestinal synovial sarcoma is rare with a wide differential diagnosis. It usually expresses cytokeratins EMA, BCL2 with an occasional CD99, and S100 positivity but not desmin. We present a case of metastatic synovial sarcoma with unusual immunophenotype causing diagnostic challenges. The tumor cells showed focal cytokeratin, EMA, and, unexpectedly, desmin positivity. Additional intranuclear TLE-1 positivity and negativity for CD34 and DOG-1 were also identifi...

  20. Disease profile and differential diagnosis of hereditary transthyretin-related amyloidosis with exclusively cardiac phenotype: An Italian perspective

    OpenAIRE

    Rapezzi, Claudio; Quarta, Candida Cristina; Obici, Laura; Perfetto, Federico; Longhi, Simone; Salvi, Fabrizio; Biagini, Elena; Lorenzini, Massimiliano; Grigioni, Francesco; Leone, Ornella; Cappelli, Francesco; Palladini, Giovanni; Rimessi, Paola; Ferlini, Alessandra; Arpesella, Giorgio

    2013-01-01

    AIMS: Hereditary transthyretin (TTR)-related amyloidosis (ATTR) is mainly considered a neurologic disease. We assessed the phenotypic and genotypic spectra of ATTR in a Caucasian area and evaluated the prevalence, genetic background, and disease profile of cases with an exclusively cardiac phenotype, highlighting possible hints for the differential diagnosis with hypertrophic cardiomyopathy (HCM) and senile systemic amyloidosis (SSA). METHODS AND RESULTS: In this Italian multicentr...

  1. Procalcitonin for the differential diagnosis of infectious and non-infectious systemic inflammatory response syndrome after cardiac surgery

    OpenAIRE

    Zhao, Dong; Zhou, Jianxin; Haraguchi, Go; Arai, Hirokuni; Mitaka, Chieko

    2014-01-01

    Background This study was performed to assess the value of procalcitonin (PCT) for the differential diagnosis between infectious and non-infectious systemic inflammatory response syndrome (SIRS) after cardiac surgery. Methods Patients diagnosed with SIRS after cardiac surgery between April 1, 2011 and March 31, 2013 were retrospectively studied. A total of 142 patients with SIRS, infectious (n = 47) or non-infectious (n = 95), were included. The patients with infectious SIRS included 11 with ...

  2. An Evaluation on the Importance of Phosphotungstic Acid Haematoxyiin (PTAH) Staining in Differential Diagnosis of Salivary Gland Neoplasms

    OpenAIRE

    E Yazdi; F Baghaie Naeini; M Seyed Majidi

    2003-01-01

    The differential diagnosis between pleomorphic adenoma, the most common salivary gland neoplasm, microscopically, and two other common salivary gland neoplasms, meaning adenoid cystic carcinoma and mucoepidermoid carcinoma, is difficut.The purpose of this study was to determine the differences between pleomorphic adenoma, adenoid cystic carcinoma and mucoepidermoid carcinoma regarding the staining intensity with PTAH and H&E and also to investigate the relationship between staining intensity ...

  3. The differential diagnosis of children with joint hypermobility: a review of the literature

    OpenAIRE

    Elliott Elizabeth J; Tofts Louise J; Munns Craig; Pacey Verity; Sillence David O

    2009-01-01

    Abstract Background In this study we aimed to identify and review publications relating to the diagnosis of joint hypermobility and instability and develop an evidence based approach to the diagnosis of children presenting with joint hypermobility and related symptoms. Methods We searched Medline for papers with an emphasis on the diagnosis of joint hypermobility, including Heritable Disorders of Connective Tissue (HDCT). Results 3330 papers were identified: 1534 pertained to instability of a...

  4. Turn Your Boys into Readers!

    Science.gov (United States)

    Allyn, Pam

    2011-01-01

    Girls outscore boys in reading proficiency levels; the gender gap is startling and concerning. The myth that boys won't read or that it's not "cool" for boys to love reading plays a big part in how these low levels come to be. Low expectations from teachers, and an assumption that boys prefer physical activity, mean that boys often don't find…

  5. National Boy Scout Jamboree

    Science.gov (United States)

    1989-01-01

    This video looks at a NASA sponsored exhibit at the National Boy Scout Jamboree in Fredricksburg, VA. Boy Scouts are shown interacting with NASA researchers and astronauts and touring mockups of Space Station Freedom and Apollo 11. NASA's program to encourage the researchers of tomorrow is detailed.

  6. Eskimo Boy Today.

    Science.gov (United States)

    Fish, Byron

    "Eskimo Boy Today" provides the reader with an account of what it is like to be a young Eskimo boy living in Barrow, Alaska, today. Accounts of his life at school depict the typical curriculum and learning activities, while accounts of his home life depict typical foods, clothing, and housing. The natural resources and their relationship to the…

  7. Case study: the use of technescan HIG to differentiate between old damage and active inflammation in arthritis in a 11-year-old-boy

    International Nuclear Information System (INIS)

    Full text: A 99mTc Technescan HIG (Polyclonal Human Immunoglobulin G, 'Mallinkrodt Medical') scan was undertaken on an 11 year old boy with a nine year history of juvenile arthritis. He recently suffered in creased pain in his neck with tenderness over the right C6 dorsal facet joint. The question was posed as to whether this represented an area of old damage or new active inflammation. Whole body imaging was carried out following an IV injection of 600 MBq of 99mTc HIG at four and 24 hours using a rectangular Millenium gamma camera. (GE Milwaukee) Both four and 24 hour images failed to show any area of focal uptake in the neck. Focal uptake was demonstrated in both knees, the right more pronounced than the left in keeping with the patient current symptoms. From this scan it was decided that the cervical problem was related to old damage. Scintigraphy with HIG labelled with either 111ln or 99mTc is recognised as a reliable method for the detection of infection and inflammation. Recently, reports have suggested that it may be useful in detecting synovitis, identifying those joints which have current active inflammation. We conclude that this modality is a non-invasive accurate diagnostic tool which may be used to routinely monitor the status of arthritic joints. In addition, we feel that serial scanning may provide a more accurate insight into the nature of the disease progression within an individual than is available with current practices

  8. The specific case: cardiac amyloidosis as differential diagnosis in case of restricted cardiac pump function

    International Nuclear Information System (INIS)

    The NMR imaging data in combination with clinical characterization and echocardiography are consistent with the diagnosis of a cardiac amyloidosis. The article describes disease pattern and diagnosis based on contrast agent accumulation and diastolic functional disturbances. CT was performed to exclude pulmonary embolism.

  9. Neoplastic lesions of the temporomandibular joint (TMJ): diagnosis, differential diagnosis and intervention; Neoplasien des Temporomandibulargelenks (TMG). Diagnostik, Differenzialdiagnostik und Intervention

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J.; Abolmaali, N.; Schedel, H.; Bergh, B. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Maeurer, J. [Radiologische Praxis am Prinzregentenplatz, Muenchen (Germany)

    2001-09-01

    Purpose. To evaluate the effectiveness of diagnostic and interventional radiological techniques for neoplastic lesions of the temporomandibular joint (TMJ). Material and methods. Modern diagnosis of the TMJ is based on the clinical use of conventional X-ray techniques, computed tomography (CT), magnetic resonance imaging (MRI) and interventional techniques like biopsies, vascular occlusion and ablation. Results. Conventional X-ray still forms the basic diagnostic procedure applied in open and closed mouth position. CT improves the diagnostic information and serves as the standard diagnostical instrument for cartaliganeous or osseous neoplastic lesions. MRI evaluates soft tissue infiltration in multiplanar techniques and high spatial resolution. Interventional vascular and ablative techniques improve the treatment of neoplastic disorders. (orig.) [German] Zielsetzung. Vorstellung der Wertigkeit bildgebender Verfahren fuer die diagnostische und interventionelle Radiologie des Temporomandibulargelenks (TMG). Material und Methodik. Die moderne Radiologie des TMG basiert auf dem Einsatz der konventionellen Roentgendiagnostik, der Computertomographie (CT) und der Magnetresonanztomographie (MRT), sowie interventioneller Verfahren wie der Biopsie, vaskulaerer Embolisationsverfahren und tumorablativer Verfahren. Ergebnisse. Als Basisdiagnostik dient die konventionelle Diagnostik in offener und geschlossener Mundposition der Erfassung von Funktionsstoerungen sowie ossaerer Destruktionen. Die CT erweitert das diagnostische Spektrum und verbessert die Differenzialdiagnostik fuer ossifizierende Prozesse. Der Einsatz der MRT erlaubt die Erfassung der Weichteilinfiltration sowie der Gelenkstrukturen. Vaskulaere interventionelle Verfahren dienen der praetherapeutischen Okklusion bzw. der palliativen Tumortherapie in Form der okklusiven Embolisation, der Chemoembolisation, oder auch der Tumorablation. (orig.)

  10. Differential diagnosis of gallbladder wall thickening by two phase spiral CT : gallbladder carcinoma versus cholicystitis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sun; Cho, Soon Gu; Kim, Mi Young; Woo, Je Hong; Shin, Seok Hwan; Lee, Kykung Hee; Suh, Chang Hae [Inha Univ. College of Medicine, Inchon (Korea, Republic of)

    2001-04-01

    To determine whether an analysis of two-phase CT features provides a sound basis for differential diagnosis between gallbladder carcinoma and cholecystitis. We reviewed a total of 89 cases of gallbladder carcinoma (n=35) or cholecystitis (n=54) in patients who had undergone two-phase spiral CT. For this, a GE Highspeed Advantage scanner (GE Medical Systems, Milwaukee, U . S . A .) was used. A total of 120ml of contrast material was injected at a rate of 2-3 ml/sec. Arterial and venous phase scans were obtained 35 and 65 seconds, respectively, after the initiation of contrast infusion. All cases of gallbladder carcinoma and 468 of cholecystitis (of a total of 482) were confirmed by histopathology. We reviewed the two phase spiral CT features, analyzing and assessing thickness of the lesion, the enhancement pattern seen during the arterial and the venous phase, invasion of liver, pericholecystic fat infiltration, dilatation of intrahepatic ducts, and other associated findings. Mean wall thickness was 12.6 mm in the gallbladder carcinoma group, and 7.2 mm in the cholecystitis group. The common enhancement patterns seen in gallbladder carcinoma were 1) a highly enhanced thick inner wall layer during the arterial phase which became iso attenuated with adjacent liver parenchyma during the venous phase (16/35; 45.7%) and 2) highly enhanced thick inner wall layer during both the arterial and venous phase (8/35; 22.9%). The most common enhancement pattern in cholecystitis cases was an iso attenuated thin inner wall layer during both the arterial and the venous phase (44/54; 81.5%). Findings of intrahepatic mass formation by direct invasion (9/35), lymph node enlargement (12/35), and metastasis to other organs (7/35) occurred only in cases of gallbladder carcinoma (18/35, 51.4%) than of cholecystitis (10/54, 18.5%). The incidence of pericholecystic fat infiltration and fluid collection was not significantly different between the gallbladder cancer and cholecystitis groups

  11. Ductal adenocarcinoma and unusual differential diagnosis; Duktales Adenokarzinom und ungewoehnliche Differenzialdiagnosen

    Energy Technology Data Exchange (ETDEWEB)

    Haage, P.; Schwartz, C.A.; Scharwaechter, C. [Universitaet Witten/Herdecke, Zentrum fuer Radiologie HELIOS Universitaetsklinikum Wuppertal, Wuppertal (Germany)

    2016-04-15

    Ductal pancreatic adenocarcinoma is by far the most common solid tumor of the pancreas. It has a very poor prognosis, especially in the more advanced stages which are no longer locally confined. Due to mostly unspecific symptoms, imaging is key in the diagnostic process. Because of the widespread use of imaging techniques, incidental findings are to a greater extent discovered in the pancreas, which subsequently entail further work-up. Ductal pancreatic adenocarcinoma can be mimicked by a large number of different lesions, such as anatomical variants, peripancreatic structures and tumors, rarer primary solid pancreatic tumors, cystic tumors, metastases or different variants of pancreatitis. Additionally, a number of precursor lesions can be differentiated. The correct classification is thus important as an early diagnosis of ductal pancreatic adenocarcinoma is relevant for the prognosis and because the possibly avoidable treatment is very invasive. All major imaging techniques are principally suitable for pancreatic imaging. In addition to sonography of the abdomen, usually the baseline diagnostic tool, computed tomography (CT) with its superior spatial resolution, magnetic resonance imaging (MRI) with its good soft tissue differentiation capabilities, possibly in combination with MR cholangiopancreatography (MRCP), endosonography with its extraordinary spatial resolution, conceivably with additional endoscopic retrograde CP or the option of direct biopsy and finally positron emission tomography CT (PET-CT) as a molecular imaging tool are all particularly useful modalities. The various techniques all have its advantages and disadvantages; depending on the individual situation they may need to be combined. (orig.) [German] Das duktale Adenokarzinom ist der weitaus haeufigste solide Tumor des Pankreas. Die Prognose ist sehr schlecht, insbesondere bei fortgeschrittenen, nicht mehr lokal begrenzten Tumoren. Bei meist unspezifischen geringen Beschwerden kommt der

  12. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    International Nuclear Information System (INIS)

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ42, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ42 ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ42 ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  13. Cross-validation of biomarkers for the early differential diagnosis and prognosis of dementia in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Perani, Daniela [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy); Cerami, Chiara [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Caminiti, Silvia Paola [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); Santangelo, Roberto; Coppi, Elisabetta; Ferrari, Laura; Magnani, Giuseppe [San Raffaele Hospital, Department of Neurology, Milan (Italy); Pinto, Patrizia [Papa Giovanni XXIII Hospital, Department of Neurology, Bergamo (Italy); Passerini, Gabriella [Servizio di Medicina di Laboratorio OSR, Milan (Italy); Falini, Andrea [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); San Raffaele Hospital, CERMAC - Department of Neuroradiology, Milan (Italy); Iannaccone, Sandro [San Raffaele Hospital, Clinical Neuroscience Department, Milan (Italy); Cappa, Stefano Francesco [San Raffaele Scientific Institute, Division of Neuroscience, Milan (Italy); IUSS Pavia, Pavia (Italy); Comi, Giancarlo [Vita-Salute San Raffaele University, Milan (Italy); San Raffaele Hospital, Department of Neurology, Milan (Italy); Gianolli, Luigi [San Raffaele Hospital, Nuclear Medicine Unit, Milan (Italy)

    2016-03-15

    The aim of this study was to evaluate the supportive role of molecular and structural biomarkers (CSF protein levels, FDG PET and MRI) in the early differential diagnosis of dementia in a large sample of patients with neurodegenerative dementia, and in determining the risk of disease progression in subjects with mild cognitive impairment (MCI). We evaluated the supportive role of CSF Aβ{sub 42}, t-Tau, p-Tau levels, conventional brain MRI and visual assessment of FDG PET SPM t-maps in the early diagnosis of dementia and the evaluation of MCI progression. Diagnosis based on molecular biomarkers showed the best fit with the final diagnosis at a long follow-up. FDG PET SPM t-maps had the highest diagnostic accuracy in Alzheimer's disease and in the differential diagnosis of non-Alzheimer's disease dementias. The p-tau/Aβ{sub 42} ratio was the only CSF biomarker providing a significant classification rate for Alzheimer's disease. An Alzheimer's disease-positive metabolic pattern as shown by FDG PET SPM in MCI was the best predictor of conversion to Alzheimer's disease. In this clinical setting, FDG PET SPM t-maps and the p-tau/Aβ{sub 42} ratio improved clinical diagnostic accuracy, supporting the importance of these biomarkers in the emerging diagnostic criteria for Alzheimer's disease dementia. FDG PET using SPM t-maps had the highest predictive value by identifying hypometabolic patterns in different neurodegenerative dementias and normal brain metabolism in MCI, confirming its additional crucial exclusionary role. (orig.)

  14. Case study: the use of technescan HIG to differentiate between old damage and active inflammation in arthritis in a 11-year-old-boy

    Energy Technology Data Exchange (ETDEWEB)

    Moorin, R.E.

    1997-09-01

    Full text: A {sup 99m}Tc Technescan HIG (Polyclonal Human Immunoglobulin G, `Mallinkrodt Medical`) scan was undertaken on an 11 year old boy with a nine year history of juvenile arthritis. He recently suffered in creased pain in his neck with tenderness over the right C6 dorsal facet joint. The question was posed as to whether this represented an area of old damage or new active inflammation. Whole body imaging was carried out following an IV injection of 600 MBq of {sup 99m}Tc HIG at four and 24 hours using a rectangular Millenium gamma camera. (GE Milwaukee) Both four and 24 hour images failed to show any area of focal uptake in the neck. Focal uptake was demonstrated in both knees, the right more pronounced than the left in keeping with the patient current symptoms. From this scan it was decided that the cervical problem was related to old damage. Scintigraphy with HIG labelled with either {sup 111}ln or {sup 99m}Tc is recognised as a reliable method for the detection of infection and inflammation. Recently, reports have suggested that it may be useful in detecting synovitis, identifying those joints which have current active inflammation. We conclude that this modality is a non-invasive accurate diagnostic tool which may be used to routinely monitor the status of arthritic joints. In addition, we feel that serial scanning may provide a more accurate insight into the nature of the disease progression within an individual than is available with current practices.

  15. Assessing significance of peripheral blood indicators for differential diagnosis and prognosis of thrombotic complications in polycythemia vera and secondary erythrocytosis

    Directory of Open Access Journals (Sweden)

    Kostiukevych O.M.

    2014-03-01

    Full Text Available The aim of the study – determining of changes in peripheral blood (PB in patients with secondary erythrocytosis (SE and polycythemia vera (PV, detection of discriminatory parameters levels of PB indicators and analyzing of their operating characteristics for differentiation of erythrocytosis and predicting of thrombotic events in patients with PV. Materials and methods. The material for the study was the results of clinical trials of 210 patients with erythrocytosis who underwent differential diagnosis between PV and SE. Results and discussion. The optimal threshold for differential diagnosis of red blood cells content between PV and SE is >6.08•1012/ L, the diagnostic value of the marker equals to the level of a good diagnostic marker (AUC=0.82; 95% CI=0.77-0.87, p 57.5% with its capacity – 0.72 (0.66-0.78, p 8.9•109/L, and the boundary of marker is consistent with a good level of efficiency (AUC=0.79, 95% CI=0.72-0.84, p287•109 /L" to differentiate erythrocytosis is 0.90 (0.86-0.94, p 55%" and "WBC >12.3•109 /L", according to the AUC (AUC=0.65; 95% CI=0.52-0.79, p=0.021 and AUC=0.66; 95% CI=0.55-0.77, p=0.003, respectively, corresponds to the average power level. Conclusion. Hemoglobin has not confirmed its value for the differential diagnosis between PV and SE. Using other parameters of PB with the aim of differentiating PV and SE is rational, but their discriminatory power levels greatly depend on the group erythrocytosis. In our cohort were obtained the following most appropriate criteria for inclusion of patients in the group of patients with PV: "WBC >8.9•109/L", "red blood cells >6.08•1012/L" and "hematocrit >57.5%". The most significant marker of general clinical blood test to differentiate between PV and SE is "platelets >287•109/L". Hematocrit over 55% and WBC over 12.3•109/L are valuable prognostic markers of thrombosis in PV patients, but their use is appropriate only in a cohort of patients with PV without

  16. Ureteritis Cystica: Important Consideration in the Differential Diagnosis of Acute Renal Colic

    OpenAIRE

    Padilla-Fernández, B.; FJ. Díaz-Alférez; M. Herrero-Polo; M. Martín-Izquierdo; JM. Silva-Abuín; MF. Lorenzo-Gómez

    2012-01-01

    Ureteritis cystica is an uncommon cause of acute renal pain. The aetiology remains unclear and the diagnosis may be difficult to establish. We report the case of a 29 year old woman with a history of repeated urinary tract infections presenting with acute renal colic in the absence of lithiasis. We review the diagnostic tools available to make the diagnosis and the recent pertinent literature.

  17. Differential diagnosis in pediatric radiology. Vol. 1. Skull, spine, skeleton; Differentialdiagnostik in der paediatrischen Radiologie. Bd. 1. Schaedel, Wirbelsaeule, Skelett

    Energy Technology Data Exchange (ETDEWEB)

    Ebel, K.D. [ed.; Willich, E. [ed.; Richter, E. [ed.; Benz-Bohm, G.; Bliesener-Harzheim, J.A.; Ebel, K.D.; Oestreich, A.E.; Reinwein, H.; Schaper, J.; Schumacher, R.; Stoever, B.

    1995-06-01

    The book presents in-depth material covering the full scope of tasks and problems of differential diagnostic radiology in children. The particular approach chosen by the authors provides information that will solve even the most difficult cases, guiding the reader on his way from radiographic findings to appropriate diagnosis. All radiographic findings have been characterized and classified and put into a tabulated system relating them to the relevant differential diagnosis. The system of reference adopted specifies a given lesion or disease by reference to the most significant diagnostic keywords obtained from anamnesis, clinical data, and further diagnostic evaluation. The tentative diagnosis is taken as the basis for further specification illustrated by the characteristic X-ray pictures and full-text descriptions. Almost all diagnoses are accompanied by a comprehensive image documentation obtained by all currently available imaging methods. (MG) [Deutsch] Das vorliegende Buch gibt einen kompletten Ueberblick ueeber die gesamte Bandbreite der Differentialdiagnostik in der Paediatrischen Radiologie und soll so auch in schwierigen Faeellen den Weg vom Roentgensymptom zur Diagnose ermoeglichen. Alle relevanten Roentgensymptome werden systematisch charakterisiert und die entsprechenden Differentialdiagnosen tabellarisch zusammengestellt. Jede Erkrankung wird durch Verweise auf die wichtigsten differentialdiagnostischen Stichworte aus Anamnese, Klinik und weiterfuehrende Diagnostik naeher eingegrenzt. Ausgehend von der Verdachtsdiagnose werden wegweisende Roentgenbefunde in Wort und Bild dargestellt. Fast alle erwaehnten Befunde werden durch Abbildungen unter Beruecksichtigung aller moderner bildgebenden Verfahren dokumentiert. (MG)

  18. Septic Bursitis in an 8-Year-Old Boy

    Directory of Open Access Journals (Sweden)

    Panagiotis Kratimenos

    2014-01-01

    Full Text Available Background. The prepatellar bursa can become inflamed owing to repeated trauma. Prepatellar bursitis is extremely rare in children. Methods. We report the case of an 8-year-old boy who was treated for an erythematous, swollen, and severely painful right knee, fever, inability to bear weight on the leg, and purulent material draining from a puncture wound. We describe the differential diagnosis for tender swollen knee, including infection, gout, rheumatoid arthritis, and osteoarthritis. If untreated, prepatellar bursitis can progress to patellar osteomyelitis. Results. Wound cultures grew Streptococcus pyogenes, with the infection resolving with amoxicillin. Conclusions. A high index of suspicion is necessary in children presenting with prepatellar bursitis to prevent potentially devastating sequelae of infection of the septic joint.

  19. CLCA2 as a Novel Immunohistochemical Marker for Differential Diagnosis of Squamous Cell Carcinoma from Adenocarcinoma of the Lung

    Directory of Open Access Journals (Sweden)

    Kazuya Shinmura

    2014-01-01

    Full Text Available Recent progress in targeted therapy for lung cancer has revealed that accurate differential diagnosis between squamous cell carcinoma (SCC and adenocarcinoma (ADC of the lung is essential. To identify a novel immunohistochemical marker useful for differential diagnosis between the two subtypes of lung cancer, we first selected 24 SCC-specific genes and 6 ADC-specific genes using data (case number, 980 from the Cancer Genome Atlas (TCGA database. Among the genes, we chose the CLCA2 gene, which is involved in chloride conductance and whose protein expression in lung cancer is yet to be characterized, and evaluated its protein expression status in 396 cases of primary lung cancer at Hamamatsu University Hospital. Immunohistochemical analysis revealed a significantly higher CLCA2 expression level in the SCCs than in the ADCs (P<0.0001 and also a significantly higher frequency of CLCA2 protein expression in the SCCs (104/161, 64.6% as compared with that in the ADCs (2/235, 0.9% (P<0.0001; sensitivity 64.6%, specificity 99.1%. The CLCA2 protein expression status was associated with the histological tumor grade in the SCCs. These results suggest that CLCA2 might be a novel excellent immunohistochemical marker for differentiating between primary SCC and primary ADC of the lung.

  20. Validation of Standard and New Criteria for the Differential Diagnosis of Narrow QRS Tachycardia in Children and Adolescents.

    Science.gov (United States)

    Deutsch, Karol; Stec, Sebastian; Kukla, Piotr; Morka, Aleksandra; Jastrzebski, Marek; Baszko, Artur; Pitak, Maciej; Sledz, Janusz; Fijorek, Kamil; Mazij, Mariusz; Ludwik, Bartosz; Gubaro, Marcin; Szydlowski, Leslaw

    2015-12-01

    To establish an appropriate treatment strategy and determine if ablation is indicated for patients with narrow QRS complex supraventricular tachycardia (SVT), analysis of a standard 12-lead electrocardiogram (ECG) is required, which can differentiate between the 2 most common mechanisms underlying SVT: atrioventricular nodal reentry tachycardia (AVNRT) and orthodromic atrioventricular reentry tachycardia (OAVRT). Recently, new, highly accurate electrocardiographic criteria for the differential diagnosis of SVT in adults were proposed; however, those criteria have not yet been validated in a pediatric population.All ECGs were recorded during invasive electrophysiology study of pediatric patients (n = 212; age: 13.2 ± 3.5, range: 1-18; girls: 48%). We assessed the diagnostic value of the 2 new and 7 standard criteria for differentiating AVNRT from OAVRT in a pediatric population.Two of the standard criteria were found significantly more often in ECGs from the OAVRT group than from the AVNRT group (retrograde P waves [63% vs 11%, P ECGs from the AVNRT group than from the OAVRT group (pseudo r' wave in V1 lead [39% vs 10%, P ECG parameters may predict a final diagnosis with better accuracy. PMID:26705217

  1. CONTRIBUTION OF THE AUDIOLOGICAL AND VESTIBULAR ASSESSMENT TO THE DIFFERENTIAL AND ETIOLOGICAL DIAGNOSIS OF PERIPHERIC VESTIBULAR SYNDROMES

    Directory of Open Access Journals (Sweden)

    Loreta Ungureanu

    2012-09-01

    Full Text Available Scope of the study: Vestibular pathology is a complex one, requiring a minute clinical evaluation, as well as numerous paraclinical investigations. The present study analyzes the contribution of the modern methods of vestibular and auditive investigation to the diagnosis of dizziness. Materials and method: The results of the investigations performed on 84 patients with peripheric vestibular syndrome, on whom a complete audiological and vestibular assessment had been also made, have been retrospectively analyzed. Results: Anamnestic data and the results of evaluation permitted classification of peripheric vestibular pathology according to topo-lesional and etiological criteria. The most frequently diagnosed diseases were: benign paroxysmal positional vertigo, Ménière syndrome and vestibular neuronitis. Conclusions: Testing of the vestibulo-ocular and vestibulo-spinal reflexes through videonystagmoscopy and, respectively, computerized dynamic posturography, besides tonal vocal audiometry and precocious auditive potentials, is especially important for a positive diagnosis and etiological differentiation of vestibular syndromes.

  2. The diagnosis and differential diagnosis of granulocytic sarcoma%探讨粒细胞肉瘤的诊断与鉴别诊断

    Institute of Scientific and Technical Information of China (English)

    Xiaoli Feng; Jianming Ying; C. Cameron Yin; Ling Li; Susheng Shi; Hongtu Zhang; Yuntian Sun

    2008-01-01

    Objective: To discuss the diagnosis and differential diagnosis of granulocytic sarcoma (GS). Methods: Six cases were reported in this paper. They were assessed by pathologists. Immunohistochemistry (IHC) stain and routine hematoxylin and eosin (H&E) stain were applied. Results:All patients involved in different anatomic sites respectively including skin, lymph node, soft tissue, breast, cervix and penis. All cases were previously error diagnoses. Three of them were initially diagnosed as non-Hodgkin lymphoma (NHL). One case of cervical lymph node lesion was first considered as metastasized carcinoma by clinician. One biopsied skin sample was initially reported as Karposi's sarcoma. And one breast case was suspicious of the Iobular carcinoma with the frozen samples without antecedent clinical history information. GS was accompanied with acute myeloid leukemia (AML) in one case and with acute lymphocytic leukemia (ALL) in one case. Histopathologically, blastic, immature and differentiated variants were found in four, one and one, respectively. Immunohistochemistry (IHC) showed that myeloperoxidase (MPO) and lysozyme were both found to be positive in all cases, CD43 was found in 5 of 6 cases. Three of six cases were CD68, CD15 and LCA positive. CD34 and CD117 were positive in 1/5 and 1/6 cases, respectively. However, CD20 and CD3 were negative in all cases. Conclusion: GS was uncommon and it may be misdiagnosed easily in routine practice. Each area had its own character, but they had the common features too. It can be correctly diagnosed by combination of H&E stain, IHC stain, peripheral blood and bone marrow. MPO and Lysozyme were necessary for the nature of granulocytes. In addition, CD43, CD68 and CD15 were very helpful.

  3. HR 3 tesla MRI for the diagnosis of endolymphatic hydrops and differential diagnosis of inner ear tumors. Demonstrated by two cases with similar symptoms

    International Nuclear Information System (INIS)

    The synchronous appearance of different inner ear pathologies with a nearly equivalent clinical manifestation such as Meniere's disease and vestibular schwannoma is very rare but leads to a relevant dilemma concerning therapy options. MRI is the method of choice to detect intralabyrinthine tumors. Since endolymphatic hydrops is considered the morphological equivalent of Meniere's disease, magnetic resonance imaging including hT2w-FLAIR sequences 4 h after i.v. administration of gadolinium-based contrast agents (GBCA) allows the diagnosis and grading of endolymphatic hydrops in vivo synchronous to diagnosis and monitoring of ILT. To this day, only a few cases of intralabyrinthine schwannoma could be shown to appear simultaneously with endolymphatic hydrops by MRI, but to our knowledge the dedicated distinction of endolymphatic space has not been previously demonstrated. The aim of this work was not only to detect the coincidence of endolymphatic hydrops and vestibular schwannoma, but also to differentiate tumor tissue from endolymphatic space by 3 Tesla MRI. This enables therapy options that are originally indicated for Meniere's disease. The aim of this work was to describe the feasibility and usefulness of endolymphatic hydrops MRI on intralabyrinthal tumors in a special case of intravestibular schwannoma to demonstrate the high clinical relevance and impact in therapeutic decision-making for the synchronous appearance of endolymphatic hydrops and intralabyrinthine tumors. Therefore, we present a typical case of Meniere's disease in contrast to a patient with an intralabyrinthine schwannoma and Meniere's-like symptoms. (orig.)

  4. The differential diagnosis of pulmonary inflammatory mass and peripheral lung cancer by computed tomography

    International Nuclear Information System (INIS)

    Objective: To analyze the CT characteristic of pulmonary inflammatory mass and peripheral lung cancer, and to look for the method of diagnosis solitary pulmonary nodule. Methods: 28 patients of pulmonary inflammatory masses and 33 patients of peripheral lung cancers were included in the study, all patients conformed by pathology. The lesions were divided into typical and atypical masses according to morphology. Observing the signs of lesions and using the results ameliorate the morphological classification. Tested the method by ROC. Results: According to the standard of morphology, the diagnosis sensitivity, specificity and accuracy of inflammatory mass are 64.3%, 72.7% and 68.9% respectively. The ameliorated sensitivity, specificity and accuracy are 75%, 81.8% and 78.7% respectively. Conclusion: The method of making morphology as basement and sign as supplement can improve the sensitivity, specificity and accuracy of diagnosis

  5. Acute disseminated encephalomyelitis in children: differential diagnosis from multiple sclerosis on the basis of clinical course

    Directory of Open Access Journals (Sweden)

    Yun Jin Lee

    2011-06-01

    Full Text Available Acute disseminated encephalomyelitis (ADEM is a demyelinating disease of the central nervous system (CNS that typically presents as a monophasic disorder associated with multifocal neurologic symptoms and encephalopathy. ADEM is considered an autoimmune disorder that is triggered by an environmental stimulus in genetically susceptible individuals. The diagnosis of ADEM is based on clinical and radiological features. Most children with ADEM initially present with fever, meningeal signs, and acute encephalopathy. The level of consciousness ranges from lethargy to frank coma. Deep and subcortical white-matter lesions and gray-matter lesions such as thalami and basal ganglia on magnetic resonance imaging (MRI are associated with ADEM. In a child who presents with signs of encephalitis, bacterial and viral meningitis or encephalitis must be ruled out. Sequential MRI is required to confirm the diagnosis of ADEM, as relapses with the appearance of new lesions on MRI may suggest either multiphasic ADEM or multiple sclerosis (MS. Pediatric MS, defined as onset of MS before the age of 16, is being increasingly recognized. MS is characterized by recurrent episodes of demyelination in the CNS separated in space and time. The McDonald criteria for diagnosis of MS include evidence from MRI and allow the clinician to make a diagnosis of clinically definite MS on the basis of the interval preceding the development of new white matter lesions, even in the absence of new clinical findings. The most important alternative diagnosis to MS is ADEM. At the initial presentation, the 2 disorders cannot be distinguished with certainty. Therefore, prolonged follow-up is needed to establish a diagnosis.

  6. On differential diagnosis of dyskinesia and inflammatory processes of biliary tract in children according to the cholecystography data

    International Nuclear Information System (INIS)

    Children with diseases of biliferous system were examined. Cholecystograms were used to study the following characteristics: girth and log of bile cyst before and after reception of yolks, the volume of bile cyst before and after reception of yolks, the volume of residual bile, the degree of girth and log reduction before and after reception of yolks, the difference of ratios of girth to log of bile cyst before and after reception of yolks. The distinguished characteristics were summarized in the tables, which are recommended to use in infantile gastroenterological departments during differential diagnosis of dyskinesia and inflammatory processes of biliary tract

  7. [Calcified portal vein thrombosis in the follow-up of surgical portocaval shunt: Sonographic findings and differential diagnosis].

    Science.gov (United States)

    Danse, E; Horsmans, Y

    2006-11-01

    The case of a patient with large hepatic calcifications along the portal vascular network caused by long-standing portal vein thrombosis is presented. These calcifications appeared in extended portal thrombosis and were confirmed in follow-up for a surgical portocaval shunt related to portal hypertension. The differential diagnosis should distinguish these from hyperechoic patterns observed along the periportal vascular network, including intraductal biliary stones, portal venous gas, gas in the biliary tract, biliary comet tail artifacts, periportal fibrosis in parasitosis, and calcifications of the hepatic arteries. PMID:17095965

  8. Perinatal differential diagnosis of cystic kidney disease and urinary tract obstruction: anatomic pathologic, ultrasonographic and genetic findings.

    Science.gov (United States)

    Friedmann, W; Vogel, M; Dimer, J S; Luttkus, A; Büscher, U; Dudenhausen, J W

    2000-04-01

    According to the classification of Osathanondh and Potter of cystic kidney diseases an antenatal differential diagnosis is presented, which is based on the anatomic pathologic, ultrasonographic and genetic findings. Since the ultrasound evaluation influences the obstetric and neonatal management, each second and third trimester sonography should consider the most common malformations in pediatric autopsies. The autosomal recessive polycystic kidney disease (ARPK), autosomal dominant polycystic kidney disease (ADPK), multicystic renal dysplasia, obstructive multicystic kidneys and cystic renal malformations found in other syndromes with genetic linkage are discussed in this review. PMID:10725570

  9. Application of contrast enhanced sonography combined with time-intensity analysis in the differential diagnosis of breast lesions

    International Nuclear Information System (INIS)

    Objective: To explore the value of contrast enhanced sonography combined with time-intensity curve analysis in breast lesions. Methods: Based on pathologic analysis, thirty-six lesions were examined by contrast enhanced sonography, the time-intensity curve were evaluated respectively. Results: Typical malignant solid breast lesions had some characteristic enhancement modes. The time-intensity curve of malignant lesion was rather different form that of surround- ing tissues, but the time-intensity curve of benign mass was close to that of surrounding tissues. Conclusion: Contrast enhanced sonography combined with time-intensity analysis was helpful in the differential diagnosis of breast masses. (authors)

  10. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    International Nuclear Information System (INIS)

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children

  11. Primary renal undifferentiated sarcoma as an infiltrative mass in a 12 year old boy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Hee; Kim, Myung Joon; Lee, Mi Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Children' s Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Se Hwa [Dept. of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2015-09-15

    Undifferentiated sarcomas are rare tumors not classified into any sarcoma subtype. Due to their rarity, imaging findings of undifferentiated sarcomas are poorly characterized. The purpose of this report was to present imaging findings of a pathologically confirmed undifferentiated sarcoma originated from the left kidney of a 12-year-old boy. The mass was infiltrative involving the renal pelvis. It mimicked massive hilar lymphadenopathy with a preserved renal contour visible by both ultrasonography and CT. Renal vein thrombosis was also observed. Although undifferentiated sarcomas are rare, they should be considered in differential diagnosis of infiltrative renal masses with renal pelvis invasion in children.

  12. Angiography in differential diagnosis of volumetric formations of the left half of the abdominal cavity

    International Nuclear Information System (INIS)

    Results of angiographic studies made in 52 patients with a palpable tumour in the left part of the abdomen having an asymptomatic course were analyzed. A volumetrical process in the left kidney was diagnosed angiographically in 14 patients. An enlarged spleen was seen on the angiograms of 13 patients. A pancreatic cyst was revealed in 10 patients during angiography. When examining patients with tumours of transperitoneal space angiography confirmed the diagnosis in 2 patients. It specified it in 4 patients and appeared ineffective in 4. Angiography revealed tumour of the adrenal gland in 5 patients. Causes of difficulties encountered in making a diagnosis prior to angiography are discussed

  13. Use of fluid-attenuated inversion recovery (FLAIR) pulse sequences for differential diagnosis of hepatic hemangiomas and hepatic cysts

    International Nuclear Information System (INIS)

    Fluid-attenuated inversion recovery (FLAIR) imaging of hepatic hemangiomas (10 patients, 16 lesions) and hepatic cysts (8 patients, 10 lesions) was performed. All hemangiomas were hypointense on T1-weighted images and hyperintense on T2-weighted images. With Gd-DTPA (O.1 mmol/kg), all hemangiomas were enhanced but not all cysts. It was necessary to perform contrast enhanced imaging to differentiate hepatic hemangiomas from hepatic cysts. However, on FLAIR imaging, hepatic hemangiomas were strongly hyperintense and 9 of the 10 hepatic cysts were isointense. One of the hepatic cysts was slightly hyperintense. FLAIR images were useful in differential diagnosis of hepatic hemangiomas and hepatic cysts without using Gd-DTPA. (author)

  14. Congenital malaria in a neonate: case report with a comprehensive review on differential diagnosis, treatment and prevention in Indian perspective.

    Science.gov (United States)

    Rai, Preeti; Majumdar, Kaushik; Sharma, Sunita; Chauhan, Richa; Chandra, Jagdish

    2015-06-01

    Although malaria in pregnancy, lactation and congenital malaria can be a disease burden in the endemic zones of Africa and Indian sub-continent, it is still epidemiologically less investigated in India. As it may lead to considerable maternal and perinatal morbidity and mortality, awareness and timely intervention is necessary for desirable outcome and prevention of the condition. Very few reports of congenital malaria are available in the literature from an endemic country like India. Herein we describe a case of congenital malaria from north India in a 21-day neonate. Clinical presentation of this condition in the neonate may offer a considerable diagnostic challenge, and differentiation from vector borne malaria in infants may be important from the management point of view. Hence a review of the differential diagnosis, management and prevention of congenital malaria has been attempted in the Indian perspective. PMID:26064034

  15. Eagle’s syndrome—A non-perceived differential diagnosis of temporomandibular disorder

    Directory of Open Access Journals (Sweden)

    P. Thoenissen

    2015-01-01

    Conclusion: Making use of low cost and easily accessible diagnostic workup techniques can reveal this particular cause for chronic pain restricting quality of life. Thereby differentiation from the TMD symptomatic complex is possible.

  16. 壶腹周围癌早期诊断和鉴别诊断%Eady and differential diagnosis of periampullary cancer

    Institute of Scientific and Technical Information of China (English)

    赵玉沛

    2008-01-01

    Periampullary cancer is a kind of malignant cancer of digestive tract.It arises within 2 cm of the major duodenal papilla and eomprises cancers of the ampulla,distal comliiOll bile duct,pancreas and duodenum.Their clinical features and anatomic locations are similar,as are the therapeutic approaches.However,their long-term outcomes vary.Due to the bad prognosis,it is very important to make an early,accurate diagnosis and differential diagnosis of periampullary cancer.This article summarizes some basic methods and new developments of early and differential diagnosis of poriampullary cancer.

  17. Pompe disease is a differential diagnosis in case of reduced physical capacity and abnormal muscular fatigue

    DEFF Research Database (Denmark)

    Hansen, Julie Schjødtz; Ellingsen, Anne R; Andreasen, Caroline M;

    2014-01-01

    Late-onset Pompe disease is an inherited metabolic myopathy with low activity of alpha glucosidase and variable clinical symptoms. In this case report we describe a woman with long standing muscular fatigue and malaise with the diagnosis initially established by pathologic findings in the muscle...

  18. Laryngeal neurinoma. Differential diagnosis of submucosal laryngeal tumors; Neurinoma laringeo. Diagnostico diferencial de tumoraciones submucosas laringeas

    Energy Technology Data Exchange (ETDEWEB)

    Higuera, A.; Palomo, V.; Munoz, R.; Sanchez, F.

    2002-07-01

    Laryngeal neurinoma is a rare benign tumor that appears as a submucosal mass, generally in the supraglottic region. We report the case of a patient with dysphonia of long evolution caused by a neurinoma. We discuss the radiological findings of the tumor and the value of computed tomography (CT) in the diagnosis of this and other submucosal laryngeal lesions. (Author) 16 refs.

  19. Opacification of the middle ear and mastoid: imaging findings and clues to differential diagnosis.

    Science.gov (United States)

    Lo, A C C; Nemec, S F

    2015-05-01

    Opacification of the middle ear and mastoid represents a spectrum of inflammatory, neoplastic, vascular, fibro-osseous, and traumatic changes. This article reviews the most important clinical and pathological characteristics, emphasizing CT and MRI findings. Knowledge of subtle patterns of middle ear and mastoid opacification at CT and MRI provide guidance towards the correct diagnosis. PMID:25573814

  20. Opacification of the middle ear and mastoid: imaging findings and clues to differential diagnosis

    International Nuclear Information System (INIS)

    Opacification of the middle ear and mastoid represents a spectrum of inflammatory, neoplastic, vascular, fibro-osseous, and traumatic changes. This article reviews the most important clinical and pathological characteristics, emphasizing CT and MRI findings. Knowledge of subtle patterns of middle ear and mastoid opacification at CT and MRI provide guidance towards the correct diagnosis