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Results for “diagnostic pitfall”

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At least 469 records · Page 26Linked to original sources
PubMed2002

Increased signal intensity in the normal glenoid labrum in MR imaging: diagnostic pitfalls caused by the magic-angle effect.

PURPOSE: To determine the effect of the magic-angle effect on the MR signal in the posterosuperior portion of the glenoid labrum. METHODS: MR imaging of 15 arthroscopically evaluated shoulders, five with posterosuperior labrum injury and ten intact, was retrospectively reviewed. In the first part of the study, the signal intensity of the posterosuperior labrum on gradient-recalled echo (GRE) T2*-weighted axial images was correlated with the arthroscopy findings. The second part of the study was designed to illustrate the orientation-dependent signal that occurs in the posterosuperior labrum of three asymptomatic volunteers when imaged in the conventional supine position and in a position similar to Trendelenburg's. Another three volunteers were examined with GRE T2*-weighted axial images to assess the echo-time (TE)-dependent signal in the labrum. RESULTS: The signal increase in the posterosuperior labrum was identified not only in the injured labra but also in nine of 10 intact labra. In the volunteers' studies, the signal in the posterosuperior labrum changed according to the examinees' positions (conventional supine or similar to Trendelenburg's) and according to TE. CONCLUSIONS: Increased signal intensity due to the magic-angle effect may be misdiagnosed as a labrum injury. Awareness of this pitfall is particularly important in MR imaging of throwing athletes whose posterosuperior labra are frequently injured by posterosuperior glenoid impingement.

Adolescent↗
PubMed1996

Hb Sun Prairie: diagnostic pitfalls in thalassemic hemoglobinopathies.

We report an Asian Indian family in which two daughters have Hb Sun Prairie, a known unstable alpha 2-globin variant [codon 130, GCT-->CCT; alpha 2 130(H13)Ala-->Pro beta 2]. While the homozygous probands have chronic hemolysis-the same phenotype as previously reported, the heterozygous parents are asymptomatic with a thalassemia carrier phenotype, distinct from the chronic hemolytic state previously described in a heterozygote. Unlike the earlier cases in which family studies were not available, this family clearly exhibits autosomal recessive inheritance, unusual amongst variants within the same region of helix H. Globin chain biosynthesis ratios initially suggested a beta-thalassemic hemoglobinopathy-this was excluded by normal sequence analysis of both beta-globin genes. This case report further illustrates the complexity of phenotypes in the thalassemic hemoglobinopathies. It also demonstrates inversion of the alpha/beta-globin chain biosynthesis ratio, a phenomenon which had been noted in other alpha-globin variants and can be a confounding factor in the investigation of thalassemic hemoglobinopathies.

Adolescent↗
PubMed2004

Left ventricular hypertrophy: diagnostics pitfalls.

Isolated left ventricular hypertrophy, in the absence of hypertension or aortic stenosis, is commonly attributed to hypertrophic cardiomyopathy (HCM). According to the clinical setting, however, other differential diagnoses should be considered. The diagnosis of cardiac amyloidosis may be very challenging especially when the clinician is confronted with various aspects typical of both pathologies. The work-up of this case shows how non-invasive cardiac investigations are sometimes not sufficiently conclusive for distinguishing between the two pathologies, and that only endomyocardial biopsy (EMB) can confirm cardiac involvement secondary to systemic amyloidosis. The prognostic and therapeutic differences between the two diseases, as well as the contextual aspects of the case in point--namely a case of multiorgan failure--serve as an example of how a definitive diagnosis can be attained by means of a multidisciplinary approach in order to reach a definitive treatment plan.

Amyloidosis↗
PubMed2001

Cytokeratin-positive, CD45-negative primary centroblastic lymphoma of the adrenal gland: a potential for a diagnostic pitfall.

We report a case of cytokeratin-positive, CD45-negative primary polymorphic centroblastic lymphoma of the adrenal gland. Additional immunostaining, which demonstrated positivity for CD20 and kappa light chain, as well as detection of the monoclonal rearrangement of the immunoglobulin heavy chain gene, helped to establish the diagnosis of lymphoma and to rule out an initially favored diagnosis of poorly differentiated carcinoma.

Adrenal Gland Neoplasms↗
PubMed1999

[Biotin-rich pseudoherpetic intranuclear inclusions. A diagnostic pitfall].

Biotin-rich pseudoherpetic nuclear inclusions may be observed in endometrial epithelial cells during pregnancy, post-partum or in association with choriocarcinoma. They may be observed in tumor cells in a few papillary carcinomas of the thyroid gland in young women. These inclusions may be responsible for false diagnoses of herpesvirus infection at morphological and immunocytochemical examination. They may be responsible for false positives in immunocytochemistry and in situ hybridization.

Biotin↗
PubMed1999

["Early repolarization". The diagnostic pitfall of an atypical form of ST elevation].

The authors report the case of a coloured man who was treated with intravenous thrombolysis for chest pain and "atypical" ST elevation related to early repolarisation. The interest of this case is to underline the electrocardiographic criteria of early repolarisation and to propose, in appropriate conditions of management, emergency coronary angiography in patients with an uncertain diagnosis of infarct-like chest pain associated with suspicious electrocardiographic changes.

Angina Pectoris↗
PubMed1999

Solitary nodal metastases presenting as branchial cysts: a diagnostic pitfall.

Two patients with metastatic squamous cell carcinoma are presented. Both were initially clinically diagnosed as branchial cysts. The importance of a full examination of the upper aerodigestive tract, and fine needle aspiration cytology is emphasised to avoid the possibility of excision as a branchial cyst, which could lead to tumour dissemination.

Adult↗
PubMed2000

Cerebral MR venography: normal anatomy and potential diagnostic pitfalls.

BACKGROUND AND PURPOSE: MR venography is often used to examine the intracranial venous system, particularly in the evaluation of dural sinus thrombosis. The purpose of this study was to evaluate the use of MR venography in the depiction of the normal intracranial venous anatomy and its variants, to assess its potential pitfalls in the diagnosis of dural venous sinus thrombosis, and to compare the findings with those of conventional catheter angiography. METHODS: Cerebral MR venograms obtained in 100 persons with normal MR imaging studies were reviewed to determine the presence or absence of the dural sinuses and major intracranial veins. RESULTS: Systematic review of the 100 cases revealed transverse sinus flow gaps in 31% of the cases, with 90% of these occurring in the nondominant transverse sinus and 10% in the codominant transverse sinuses. No flow gaps occurred in the dominant transverse sinuses. The superior sagittal and straight sinuses were seen in every venogram; the occipital sinus was seen in only 10%. The vein of Galen and internal cerebral veins were also seen in every case; the basal veins of Rosenthal were present in 91%. CONCLUSIONS: Transverse sinus flow gaps can be observed in as many as 31% of patients with normal MR imaging findings; these gaps should not be mistaken for dural sinus thrombosis.

Adolescent↗
PubMed2000

[Diagnostic pitfalls in evaluating MR images of the uterus].

The pitfalls in evaluating MR images of the uterus are briefly reviewed. These pitfalls are roughly divided into physiological conditions that simulate organic lesions, benign conditions that simulate malignancy, and malignant diseases that simulate benign conditions. It is important to distinguish these mimicking lesions from real organic lesions.

Female↗
PubMed2000

[Psychiatric presentation of human African trypanosomiasis: overview of diagnostic pitfalls, interest of difluoromethylornithine treatment and contribution of magnetic resonance imaging].

We report a case of a western African man, residing in France for 4 years, who developed human African trypanosomiasis (HAT) caused by Trypanosoma brucei gambiense. Diagnosis was made at a late stage of the disease. The disease was misdiagnosed and untreated for several years because the clinical presentation was limited to psychiatric disorders and biological confirmation was difficult. Polysomnographic recordings demonstrated typical alterations of HAT. Difluoromethylornithine was effective in this late stage of the disease. Magnetic resonance imaging showed brain edema with demyelination and associated brain atrophy and abnormal signals in the brainstem and thalamus, both implied in sleep-wake cycle.

Adult↗
PubMed2000

[Acute dissection of the ascending thoracic aorta complicated by myocardial infarct: an unavoidable diagnostic pitfall?].

BACKGROUND: Acute dissection of the aorta during myocardial infarction is exceptional. In such cases, fibrinolysis can be fatal. CASE REPORTS: A 63-year-old woman with a history of hypertension was referred to our intensive care unit with the diagnosis of early stage inferior myocardial infarction. Thrombolysis was instituted and the patient rapidly developed cardiovascular collapse with global heart failure. Coronarography was attempted to revascularize the occluded coronary artery but the coronary arteries could not be catheterized. An aortography was performed and gave the diagnosis of De Bakey type I dissection of the aorta. The patient died from cardiac arrest after a phase of low cardiac output. DISCUSSION: This case illustrates how myocardial infarction can complicate or mask acute dissection of the aorta. It also raises the question of transthoracic echocardiography prior to institution of fibrinolysis.

Aortic Dissection↗