Brain metastases from adenocarcinoma of the lung with truly cystic magnetic resonance imaging appearance.

Metastatic disease represents over half of all malignancies in brain parenchyma, and carcinoma when metastatic will often spread to the brain, with lung and breast tumors being the most common culprits. The suggestive features of metastatic disease on magnetic resonance imaging include peritumoral, vasogenic edema and avid postcontrast enhancement. We present the case of a 50-year-old male with an established diagnosis of metastatic adenocarcinoma of the lung treated with erlotinib who developed multiple cystic brain lesions on surveillance MRI.

Stump Appendicitis.

Abdominal pain is a frequent problem encountered in the emergency department, and acute appendicitis is a well-recognized diagnosis. Laparoscopic appendectomy has become one of the most common surgical procedures in the United States. Patients with a history of appendectomy may experience recurrent right lower quadrant abdominal pain from an infrequently encountered complication that may occur when the residual appendix becomes obstructed and inflamed.

Sonographic Evaluation of Pediatric Thyroid Nodules.

A thyroid nodule detected clinically or incidentally at medical imaging is a common indication for ultrasonography (US) in the adult population. This scenario is less frequently the case in pediatric patients, and the approach to evaluation of thyroid nodules deserves modification in these patients because of the increased probability of malignancy in children, compared with adults. Evaluating a thyroid nodule with US in a systematic way requires familiarity with a number of features that can be assessed and the terms that the radiologist uses in each category.

A case of reactive arthritis due to Clostridium difficile colitis.

Reactive arthritis is an acute, aseptic, inflammatory arthropathy following an infectious process but removed from the site of primary infection. It is often attributed to genitourinary and enteric pathogens, such as Chlamydia, Salmonella, Shigella, Campylobacter, and Yersinia, in susceptible individuals. An uncommon and less recognized cause of this disease is preceding colonic infection with Clostridium difficile, an organism associated with pseudomembranous colitis and diarrhea in hospitalized patients and those recently exposed to antibiotics.

Emergency department recidivism in adults older than 65 years treated for fractures.

Objectives: Fractures in older adults are a commonly diagnosed injury in the emergency department (ED). We performed a retrospective medical record review to determine the rate of return to the same ED within 72 hours (returns) and the risk factors associated with returning.

Methods: A retrospective medical record review of patients at least 65 years old discharged from a large, academic ED with a new diagnosis of upper extremity, lower extremity, or rib fractures was performed.

Respiratory Disease following Illicit Injection of Silicone: A Case Report.

Unregulated, pseudomedical procedures risk serious sequelae even when otherwise safe compounds are used. Silicone is commonly used legally in cosmetic procedures owing to its durability, resistance to heat and aging, and low immunogenicity. However, inappropriate or illegal silicone injection can pose severe local and systemic complications including serious pulmonary compromise.