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Hradec Králové, Czech Republic

We describe case of previously healthy 7-year-old boy examined for a 3-day history of cough and fever. A chest x-ray examination revealed a round solid opacity at the right upper lobe. Laboratory analysis suggested bacterial infection. Because of the atypical radiological features and location of the mass, a chest CT scan was performed confirming a large consolidation in the right upper lobe. The patient responded promptly to intravenous antibiotic treatment with complete resolution of clinical symptoms and radiological signs. Source


Brtkova J.,Radiologicka Klinika | Jirickova P.,Multiscan Radiologicke Centrum
Ceska Radiologie | Year: 2012

Aim. To summarize and display the imaging findings in patients with different types of both frequent and less frequent types of tarsal coalition, to discuss the imaging protocols, differential diagnoses and give brief information on clinical findings and treatment. Method. The authors display CT, MRI and X-ray findings in 8 patients with the main types of coalition (talocalcaneal, calcaneonavicular), with a bilateral talocalcaneal coalition and in a patient with a complex synostosis. Results. The encountered findings were: narrowed or absent joint space, thinned irregular cortical line, adjacent oedema and sclerosis and an unusual shape of the involved bones. Secondary degenerative changes in the adjacent joints were often encountered. Depending on the type of coalition and on the projection, this diagnosis presents with X-ray findings, which are either prominent (in calcaneonavicular coalition and an oblique X-ray) or subtle and indirect (all other cases). In MRI and CT the diagnosis is much more obvious. The pathognomonic signs as well as secondary degenerative signs will be pointed out together with the appropriate imaging protocols. A differential diagnosis will be discussed. The findings of the authors will be correlated with the literature. Conclusion. It is necessary to be aware of the findings in tarsal coalition, in order to establish the diagnosis even in cases unsuspected by the clinitian. This is more challenging in plain X-rays, in CT and MRI it is mandatory to include the subtalar and tarsal joints in the examination of the ankle. Source


Maly R.,Subkatedra Angiologie I. Interni Kliniky | Chovanec V.,Radiologicka Klinika
Vnitrni Lekarstvi | Year: 2010

Peripheral arterial disease (PAD) is a disease characterised by narrowing and blockade of peripheral arteries, usually based on underlying obliterating atherosclerosis. According to the results of large epidemiological studies, the risk of PAD in patients with diabetes me-PADtus (DM) is fourfold higher compared to non-diabetic population. Patients with DM and PAD have a high risk of cardiovascular morbidity and mortality. Diabetes worsens the prognosis of patients with PAD; the onset of PAD in diabetics occurs at an earlier age, the course is faster than in non-diabetic patients and the disease is often diagnosed at its advanced stages. All these factors reduce the likelihood of revascularisation in DM patients with PAD. A range of factors (higher age, arterial hypertension, smoking, obesity, hyperfibrinogenaemia, insulin resistance etc.) contribute to the development of PAD in DM. Diabetes control is an independent risk factor of PAD as every 1% increase of hemoglobin A1C is associated with 28% increase of PAD. There are different clinical signs of PAD in diabetic and non-diabetic patients. In addition to the history of claudications, PAD diagnostic criteria include the presence of murmur over the large arteries, signs of chronic ischemia on the skin and distal ulcerations and gangrene. Among the imaging techniques, non-invasive investigations including Doppler pressure measurement, ankle brachial pressure index, color duplex ultrasonography, plethysmography, transcutaneous tension measurement, MR and CT angiography are preferred. Ankle brachial pressure index measurement is the easiest and the main investigation technique. The key principles of PAD treatment in diabetic patients include modification of risk factors, pharmacotherapy and revascularisation interventions aimed at improving clinical signs and prevention of cardiovascular morbidity and mortality. Antiplatelet treatment may prevent PAD progression and reduce cardiovascular events in DM patients. Early diagnosis of PAD in DM patients, rigorous prevention and aggressive management of the risk factors may significantly impact on the high incidence of amputations and decrease cardiovascular morbidity and mortality. Source


Polak P.,Oddeleni Klinicke Hematologie | Husa P.,Oddeleni Klinicke Hematologie | Kerkovsky M.,Radiologicka Klinika
Interni Medicina pro Praxi | Year: 2016

The authors present a clinical case of a secondary relapsing Salmonella-sepsis in a patient with systemic lupus erythematodes. A multilevel spondylodiscitis with paravertebral abscesses as a cause of the disease was diagnosed. The choice of antibiotics was complicated by allergy to co-trimoxazole and manifestations of postantibiotic colitis during the ciprofloxacin treatment. Meropenem and doxycyclin were used in the treatment without any other complications. Source


Mihal V.,Ustav Molekularni A Translacni Mediciny | Neklanova M.,Detska Klinika | Michalkova K.,Radiologicka Klinika
Pediatrie pro Praxi | Year: 2016

Whilst pituitary adenomas are the most common cause of a sellar mass, there is a number of other neoplastic, infection, inflammatory, developmental and vascular aetiologies that should by considered by the radiologist. Intracranial lipomas are rare developmental lesions that occur because of abnormal differentiation of embryogenic meninges. We describe and illustrate a 7-year-old boy with suprasellar lipoma associated with fever-induced convulsions in course of respiratory infection. Intracranial lipoma was demonstrated with magnetic resonance imaging. Source

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