Reconstruction of A Type IIIB Hypoplastic Thumb with A Huber Opposition Transfer in A Five-Year-Old Girl: Redefining Surgical Treatment.

Thumb hypoplasia, a congenital deficiency of bony and soft tissue of thumb, is often associated with systemic syndromes like Holt-Oram syndrome, and is the second most common thumb anomaly after duplicated thumb. It has traditionally been classified into six categories, which help guide treatment including reconstruction versus pollicization (transfer of the index finger to thumb). Amputation of the thumb and pollicization is the traditional treatment for a IIIB hypoplastic thumb.

Cerebral Venous Thrombosis Mimicking a Discrete Brain Mass: A Case Report and Literature Review.

The differential diagnosis for a focal brain lesion in a patient with systemic lupus erythematosus (SLE) is broad and includes infection, malignancy, and vascular and inflammatory etiologies. One rarely considered vascular pathology is cerebral venous thrombosis (CVT), which is often associated with a delay in diagnosis because of variable presentation and rare incidence. We present the case of a young woman with a new discrete brain lesion that appeared in the context of highly active SLE and was ultimately diagnosed with a CVT.

High-Resolution Isotropic Three-Dimensional MR Imaging of the Extraforaminal Segments of the Cranial Nerves.

High-resolution isotropic 3-dimensional (D) MR imaging with and without contrast is now routinely used for imaging evaluation of cranial nerve anatomy and pathologic conditions. The anatomic details of the extraforaminal segments are well-visualized on these techniques. A wide range of pathologic entities may cause enhancement or displacement of the nerve, which is now visible to an extent not available on standard 2D imaging.

BWH emergency radiology--surgical correlation: traumatic spigelian hernia with right colonic injury.

We present a case of a young man who fell off his motorbike 2 days before presentation to the hospital with a complaint of gastrointestinal upset and abdominal pain. Contrast-enhanced CT of the abdomen and pelvis demonstrated a right-sided traumatic spigelian hernia and an ascending colon injury necessitating operative repair of both.

The Use of an Integrated Website to Enhance the Educational Experience in a Medical School Radiology Clerkship Course.

The purpose of this study was to demonstrate the feasibility of creating an integrated website for the medical students enrolled in a core radiology clerkship and to assess the impact of this website on students' overall educational experience. An integrated website was created for the medical students and hosted on the main departmental website. The components of the website included: announcements and password-protected schedule, curriculum, student assessment, information about different radiology sections, digital resources, and fourth year opportunities.

BWH emergency radiology--surgical correlation: sigmoid volvulus.

We describe the radiological and intraoperative correlation of large bowel obstruction due to sigmoid volvulus in a 52-year-old female. The purpose of this article is to emphasize the importance of recognizing sigmoid volvulus as a cause of bowel obstruction in patients presenting with abdominal pain, since it can lead to bowel ischemia and necrosis.

Correction of a contour deformity associated with frontal pneumosinus dilatans using surgical navigation technology.

Pneumosinus dilatans (PD) is a pathologic hyperaeration of the paranasal sinuses of unknown etiology. Although benign itself, PD has been associated with a number of serious concomitant conditions, including meningioma, optic nerve tumors, and visual loss. Patients with PD often present with cosmetic complaints, desiring recontouring of the facial bones to achieve an improved appearance of the face.

Neuroimaging and renal ultrasound manifestations of Oculocerebrorenal syndrome of Lowe.

Oculocerebrorenal syndrome of Lowe (OCRL) is a multisystem disorder characterized by congenital cataracts, hypotonia, and cognitive developmental delay with renal complications developing in the first few months of life. Clinical and laboratory findings of Lowe syndrome are well documented. Though a small number of case reports describe the neuroimaging features and the renal ultrasound manifestations of this disease, a comprehensive review of all the imaging manifestations has not been reported.

BWH emergency radiology-surgical correlation: pancreatic laceration.

We describe the radiological and intraoperative correlation of pancreatic laceration in a 76-year-old unrestrained motor-vehicle driver following blunt abdominal trauma. The purpose of this article is to emphasize the importance of recognizing pancreatic injuries in trauma patients, as these injuries are rare and can be overlooked on CT.

Diffuse cutaneous allergic reaction to Dermabond.

Wound closure with 2-octyl cyanoacrylate (Dermabond; Ethicon, Somerville, New Jersey USA) has recently increased in popularity across a wide spectrum of physicians ranging from surgeons to emergency medicine practitioners. Generally, very few complications are associated with Dermabond and are usually related to application techniques. Uncommonly, patients present with allergic reactions to the adhesive compounds; these allergies are often misdiagnosed as cellulitis or another infectious process, and are incorrectly treated.

Evidence-based medicine in plastic surgery: where did it come from and where is it going?

Objectives: Evidence-based medicine, particularly randomized controlled trials, influence many of the daily decisions within plastic surgery as well as nearly every other medical specialty, and will continue to play a larger role in medicine in the future. Even though it is certainly not a new idea, evidence-based medicine continues to remain a hot topic among members of the healthcare community. As evidence-based medicine continues to grow and evolve, it is becoming more important for all physicians to understand the fundamentals of evidence-based medicine: how evidence-based medicine has changed, and how to successfully incorporate it into the daily practice of medicine.

BWH emergency radiology-surgical correlation: omental hematoma with active extravasation: a rare diagnosis.

We describe the radiological and intraoperative correlation of a large omental hematoma with active intra-abdominal bleeding secondary to omental lacerations in a 75-year-old man following blunt trauma from a motor vehicle accident. The purpose of this article is to emphasize the importance of recognizing omental and mesenteric injuries in trauma patients, as these injuries are rare and can be overlooked on CT.

Imaging in laparoscopic cholecystectomy--what a radiologist needs to know.

Laparoscopic cholecystectomy is the gold standard treatment option for cholelithiasis. In order to properly assess for the complications related to the procedure, an understanding of the normal biliary anatomy, its variants and the normal postoperative imaging is essential. Radiologist must be aware of benefits and limitations of multiple imaging modalities in characterizing the complications of this procedure as each of these modalities have a critical role in evaluating a symptomatic post-cholecystectomy patient.

Pneumosinus dilatans: is it more than an aesthetic concern?

Background: Pneumosinus dilatans (PD) is a pathologic condition involving the hyperaeration of one or several of the paranasal sinuses that can lead to significant deformation of the overlying bone. Although the presenting complaint of patients with PD is most commonly aesthetic in nature, the condition has also been associated with intracranial tumors and several other serious conditions.

Materials And Methods: A meta-analysis of all available clinical publications on the subject of PD was conducted.

Traumatic lumbar hernia: can't afford to miss.

We describe the radiological and surgical correlation of an uncommon case of a traumatic lumbar hernia in a 22-year-old man presenting to the emergency department following a motor vehicle accident. Computed tomography (CT) of the abdomen revealed a right-sided traumatic inferior lumbar hernia containing a small amount of fat through the posterior lateral internal oblique muscle with hematoma in the subcutaneous fat and adjacent abdominal wall musculature, which was repaired surgically via primary closure on emergent basis. The purpose of this article is to emphasize the importance of diagnosing traumatic lumbar hernia on CT and need for urgent repair to avoid potential complications of bowel incarceration and strangulation.

Aortic intramural hematoma and hepatic artery pseudoaneurysm: unusual complication following resuscitation.

We present a case of a 71-year-old woman with an unusual complication of aortic intramural hematoma and hepatic artery pseudoaneurysm following cardiopulmonary resuscitation and thrombolysis done for sudden cardiopulmonary arrest and pulmonary embolism. Patient was on Warfarin treatment for a prior history of pulmonary embolism and experienced recurrent cardiac arrests, which finally resolved after intravenous administration of thrombolytic agents. However, follow-up computed tomographic angiography revealed descending aortic intramural hematoma with intramural blood pool and concomitant liver laceration with hepatic artery pseudoaneurysm.

Imaging findings of spontaneous bilateral renal artery dissection.

Bilateral spontaneous renal artery dissection is extremely rare with computed tomography angiography being an efficient noninvasive alternative to catheter angiography for its diagnosis. We report the case of a 65-year-old woman with bilateral spontaneous renal artery dissection resulting in bilateral renal infarctions and hydroureteronephrosis.

Factors contributing to ventriculostomy infection.

Objective: Catheter-related infection remains a cause of morbidity in the use of external ventricular drains (EVDs). The aim of this retrospective single-center study was to assess the rate and factors related to ventriculostomy infections in the setting of the published literature.

Methods: Patients that underwent EVD placement in a single-center were retrospectively reviewed.

Optical coherence tomography in the diagnosis and treatment of neurological disorders.

Optical contrast is often the limiting factor in the imaging of live biological tissue. Studies were conducted in postmortem human brain to identify clinical applications where the structures of interest possess high intrinsic optical contrast and where the real-time, high-resolution imaging capabilities of optical coherence tomography (OCT) may be critical. Myelinated fiber tracts and blood vessels are two structures with high optical contrast.