Percutaneous vertebroplasty (PV) is a procedure commonly used for the treatment of vertebral compression fractures, and the number of procedures has been steadily increasing over the past decade. We report a case of an 81 year old female with a history of breast cancer that developed two vertebral body compression fractures and was subsequently treated with PV. The patient developed a subsegmental pulmonary polymethylmethacrylate (PMMA) embolus as a complication of the procedure. Ten years following the procedure, she remained asymptomatic with the PMMA embolus being discovered incidentally during workup for a suspected chronic obstructive pulmonary disease (COPD) exacerbation. In reviewing the case, we describe the typical presentation of a pulmonary PMMA embolus and consider methods to decrease the incidence of this complication.
The following case describes the presentation, diagnosis, and treatment of a 49 year-old patient with back pain in the thoracic spine and lower extremity edema. His initial presentation, coupled with a history of trauma, required an extensive work-up to determine the source of the back pain and edema. The patient was determined to have two thoracic vertebral compression fractures, bilateral lower extremity edema of unknown origin, and osteoporosis. After diagnosis, several specialists were consulted to determine the cause of the patient’s osteoporosis. Treatment consisted of kyphoplasty, physical therapy, and medication to prevent the progression of osteoporosis.
Bladder schwannomas are exceedingly rare, benign or malignant, nerve sheath tumors that are most often discovered in patients with a known diagnosis of Neurofibromatosis type 1 (NF1). A few sporadic case reports of bladder schwannoma have been published in urologic, obstetric/gynecologic, and pathologic journals. However, this is the first case report in the radiologic literature where computed tomography imaging and radiology-specific descriptions are discussed. Furthermore, the patient presented in this case is only the fifth published patient without NF1 to be diagnosed with a bladder schwannoma, to the best of our knowledge.
Known commonly as “broken heart syndrome,” takotsubo cardiomyopathy is a poorly understood heart condition that results in acute decompensation of cardiac function. We report a case of a 68-year-old female who developed acute shortness of breath status after chemotherapy and radiation treatment for Stage IV squamous-cell carcinoma. Computed tomography pulmonary angiogram (CTPA) revealed a single subsegmental pulmonary embolism, pulmonary edema, and left ventricular dilatation. Further evaluation revealed evidence of reversible cardiomyopathy with left ventricular apical ballooning, consistent with takotsubo cardiomyopathy. In reviewing the case, we cover the Mayo clinic criteria for diagnosis of takotsubo cardiomyopathy, and we consider pulmonary embolism as a precipitating factor.
Tarsometatarsal osseous coalition is extremely rare. Herein, we present a case of osseous coalition between the base of the third metatarsal and the lateral cuneiform. The patient is a 38-year-old male who presented with an acute episode of foot pain following strenuous activity. Radiographs of the left foot demonstrated an osseous coalition between the third metatarsal base and the lateral cuneiform. Tarsal coalition is a congenital defect that results when adjacent tarsals fail to separate during embryonic development. According to the literature, total osseous coalition is less common than cartilaginous coalition. This case serves as only the second known documented case of osseous coalition between the third metatarsal and the lateral cuneiform, with the first case published in an orthopedic journal. To our knowledge, no case of third metatarsal-lateral cuneiform coalition has been published in the literature otherwise. The intent of this publication is to add to the database of tarsometatarsal coalition cases with a specific emphasis on bony coalition between the third metatarsal and lateral cuneiform.
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