The use of extracorporeal shock wave therapy (ESWT) in treating osteonecrosis of the femoral head (AVNFH): a retrospective study.

Purpose: As most of the cases of avascular necrosis (AVN) in Saudi Arabia is seen in young population and as literature showed good effect of extracorporeal shock wave therapy (ESWT) in reducing pain and oedema in avascular necrosis and delaying the need of surgical intervention. Our purpose of this study is to assess the effectiveness of ESWT in reducing pain, improving range of motion (ROM) and delaying the surgical intervention in patient with AVN of femoral head and compare our results to published literature.

Material And Methods: We have treated 24 patients, 13 males and 11 females with a mean age of 29 years (range 14-48) with 34 hips affected.

Canal of Nuck hernia containing the internal reproductive organs of both gender in a neonate with disorder of sex development: a rare case presentation.

The combination of disorder of sex development and canal of Nuck hernia, in which the hernial sac contains the internal reproductive organs (gonads) of both genders, is exceedingly rare. We present a unique case of a neonate who presented with ambiguous genitalia and a lump in the left inguinal region. The child underwent various radiographic procedures and hernial repair.

Renal and mediastinal perivascular epithelioid cell tumors (PEComas) in a young child with tuberous sclerosis; a rare case report.

We describe a unique case of perivascular epithelioid cell tumors occurring as mediastinal and left renal soft tissue masses discovered incidentally in a 5-year-old tuberous sclerosis patient upon presentation to the emergency department for upper respiratory illness. The radiographic features were non-specific. However, the similar CT characteristics of both lesions and background history raised the suspicion of a synchronous mesenchymal tumor, and histopathology confirmed the diagnosis.

Spontaneous Spinal Epidural Hematoma in a 12-Year-Old Child.

Spontaneous spinal epidural hematoma (SSEH) is uncommon, with an estimated incidence of one per million per year in the general population. Since SSEH was first described, only 29 cases have been reported in children. This condition is difficult to diagnose and needs immediate surgical intervention for hematoma evacuation and cord decompression to obtain optimal functional and neurological outcomes.

Clinical characteristics and outcomes in patients with primary Sjogren's syndrome-associated interstitial lung disease.

Background: Diagnosing primary Sjogren's syndrome (pSS)-associated interstitial lung disease (ILD) is complex and can be very challenging. In addition, information about the prognostic factors is limited.

Aims: We aimed to determine the clinical characteristics and prognostic factors that impact pSS-ILD survival.

Clinical characteristics, comorbidities, and outcomes in patients with idiopathic pulmonary fibrosis.

Background: Idiopathic pulmonary fibrosis (IPF) is a common subtype of interstitial lung disease (ILD). Information about the associated comorbidities and predictors of survival among Saudi patients with IPF is limited.

Aims: The aim of the study was to determine the clinical characteristics, associated comorbidities, and prognostic factors that impact IPF survival.

Clinical significance of minor salivary gland biopsy in patients with idiopathic interstitial pneumonia.

Background: Significant overlap may occur between idiopathic interstitial pneumonia (IIP) and connective tissue diseases (CTDs) that do not meet the established classification criteria for any known CTDs (i.e., occult CTD).

Idiopathic myositis ossificans of the deltoid muscle: A case report with unique presentation and MRI findings.

Introduction: Myositis ossificans of the deltoid muscle is extremely rare. We present a case with unique presentation and MRI findings.

Case Report: A 21-year-old female presented with a 3-month history of a swelling in lateral aspect of the right arm.

Severe fibrosing mediastinitis with atypical presentation: Effective control with novel therapeutic approach.

Fibrosing mediastinitis (FM), also known as sclerosing mediastinitis, is an uncommon but serious disease involving the mediastinal structures. A high index of suspicion is essential to establish the diagnosis of FM and starting the appropriate therapy for patients. Here, we report a case of a young female who presented with chest symptoms and subsequently underwent different laboratory and radiologic investigations and an excisional biopsy.

A novel pathogenic mutation of the CYP27B1 gene in a patient with vitamin D-dependent rickets type 1: a case report.

Background: Rickets can occur due to Vitamin D deficiency or defects in its metabolism. Three rare genetic types of rickets with different alterations of genes have been reported, including: Vitamin D dependent rickets type 1, Vitamin D dependent rickets type 2 or also known as Vitamin D resistant rickets and 25 hydroxylase deficiency rickets. Vitamin D dependent rickets type 1 is inherited in an autosomal recessive pattern, and is caused by mutations in the CYP27B1 gene encoding the 1α-hydroxylase enzyme.

Autoimmune symptoms in idiopathic pulmonary fibrosis: clinical significance.

Background And Aims: Information regarding autoimmune symptoms that do not meet the diagnostic criteria for connective tissue disease in patients with idiopathic pulmonary fibrosis (IPF) is limited. The aim of the present study was to investigate differences in the clinical characteristics and prognosis of IPF patients with and without autoimmune symptoms.

Methods: Consecutive patients diagnosed with IPF (N = 96) from January 2008 to December 2012 were included.

Outcome of pulmonary embolism and clinico-radiological predictors of mortality: Experience from a university hospital in Saudi Arabia.

Objectives: The objective of this study is to determine the outcome of pulmonary embolism (PE) and the clinico-radiological predictors of mortality in a university hospital setting.

Methods: A Prospective observational study conducted at King Khalid University Hospital, Riyadh Saudi Arabia between January 2009 and 2012. A total of 105 consecutive patients (49.

Managing traumatic brain injury in children: When do we need a computed tomography of the head?

Accidents still represent a major cause of death and disability in children. The resultant traumatic brain injury (TBI) usually needs a multidisciplinary approach of management. Although computed tomographic (CT) head scan is generally a preferred investigation in TBI, however, clear guidelines are required to help decision making by different team members on "when a head CT scan is needed", its limitations, and "when it is likely to be informative".

Cytokine gene polymorphisms and serum cytokine levels in patients with idiopathic pulmonary fibrosis.

Background: Studies have demonstrated associations between cytokine gene polymorphisms and the risk of idiopathic pulmonary fibrosis (IPF). We therefore examined polymorphisms in the genes encoding interleukin (IL)-6, IL-10, interferon gamma (IFN-γ), tumor necrosis factor alpha (TNF-α), and transforming growth factor-beta 1 (TGF-β1), and compared the serum levels of these cytokines in IPF patients and healthy controls. Furthermore, we examined the association of the studied genotypes and serum cytokine levels with physiological parameters and the extent of parenchymal involvement determined by high-resolution computed tomography (HRCT).

Hyperphosphatasemia in an adult. Clinical, conventional roentgenographic, and CT findings.

A 47-year-old Saudi deaf lady with short stature presented being unable to walk. She had long standing diffuse skeletal deformities, and progressive head enlargement. She had markedly elevated serum alkaline phosphatase.

Normal knee angles in the adult Saudi population.

Objective: To study knee angles in the adult Saudi population and compare their values to the published data from other populations.

Methods: Antero-posterior bilateral radiographs of 333 normal knees of 120 males and 213 females, with age range of 18-65 years, were studied retrospectively at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, from January 2009 to December 2009. Tibiofemoral (TFA), lateral distal femoral (LDFA), and lateral proximal tibial (LPTA) angles were measured and the mean of each angle was calculated.

Prevalence of adult paraumbilical hernia. Assessment by high-resolution sonography: a hospital-based study.

Background: Abdominal wall hernias are a common imaging finding in the abdomen. Ultrasonography (US) is noninvasive and allows the examination of the patient in a physiological manner. High-frequency annular US probes have become an increasingly important diagnostic tool for detecting pathological lesions in superficial organs.

Prediction of pulmonary hypertension in patients with or without interstitial lung disease: reliability of CT findings.

Purpose: To study the reliability of pulmonary vascular measurements based on computed tomography (CT) in the prediction of pulmonary hypertension (PH) in patients with advanced interstitial lung disease (ILD) compared with those without ILD.

Materials And Methods: The study was approved by the Institutional Review Board. All patients gave written informed consent.

Pictorial Essay: Infants of diabetic mothers.

About 3 to 10% of pregnancies are complicated by glycemic control abnormalities. Maternal diabetes results in significantly greater risk for antenatal, perinatal, and neonatal morbidity and mortality, as well as congenital malformations. The number of diabetic mothers is expected to rise, as more and more of the obese pediatric female population in developed and some developing countries progresses to childbearing age.

Bilateral intraductal papillomas arising in ectopic axillary breast tissue synchronously with right breast intraductal carcinoma.

This study describes a case of 45-year-old woman with a mass developed in the right breast. Physical examination revealed a 3 cm painless mass in the right breast as well as diffuse bulge in both axillary regions, though no significant lymphadenopathy was evident. Mammogram and ultrasound examination were carried out and showed malignant mass in the right breast and ectopic breast tissue in both axillae with multiple intraductal papillomas.

Mycobacterium chelonae complex bacteremia from a post-renal transplant patient: case report and literature review.

In this report we present a case of a young lady with abdominal abscesses and septicemia caused by Mycobacterium chelonae complex. Identification of the organism and initiation of the appropriate antimicrobial therapy was delayed, resulting in significant morbidity and multiple hospital admissions. Gram staining of these organisms from blood culture can be easily overlooked or confused with either debris or diptheroids.

Magnetic resonance imaging evaluation of temporomandibular joint derangement in symptomatic and asymptomatic patients.

Objective: To highlight the importance of MRI in evaluation of the tempromandibular joint (TMJ).

Methods: The MRI examination was performed at King Khalid University Hospital, Riyadh, Saudi Arabia with the approval from the local ethics committee, on 34 patients (68 joints) between January 2006 and November 2007, in which 10 were considered asymptomatic subjects (control). The remaining had symptoms and signs of TMJ pain or dysfunction, including limitation of movement and clicking.