Involvement of temporomandibular joint (TMJ) in rheumatoid arthritis (RA) patients is described, but the incidence varies greatly. In this study our aim was to determine the frequency and character of TMJ involvement in RA patients asymptomatic for this joint, to investigate the relationship with disease activity, and to evaluate the early diagnostic value of imaging techniques. Twenty patients were included in this study, ten were evaluated with computed tomography (CT) and ten with magnetic resonance imaging (MRI). Among the 20 patients 45% had TMJ involvement detected by imaging techniques. The most frequent pathological signs were osteophyte formation, erosion of the mandibular condyle and decreased joint space (40%). Age, duration of disease, number of swollen joints. CRP and RF levels were found to be correlated with TMJ involvement. It is concluded that TMJ involvement may be detected even in asymptomatic patients with RA and there is a positive correlation between the severity of disease and involvement of TMJ.
The authors present an extremely rare case of secondary multiple cerebral echinococcosis caused by presumed intracerebral and arterial embolism of cardiac hydatidosis in a 7-year-old girl. The first manifestations were symptoms of raised intracranial pressure. Unfortunately, before the primary ruptured echinococcosis cyst was detected in the myocardium of the left ventricle, the patient underwent nine operations over an 8-year period for hydatid embolism affecting the brain and the femoral artery and was treated with concurrent mebendazole therapy. The combined therapy would not have been successful without removal of the intracardiac hydatid cyst. This case is unusual because of the multiplicity of intracranial hydatid cysts and its embolic origin from cardiac echinococcosis. The present case is believed to be the first one in which the development of an embolism in the brain was studied by magnetic resonance imaging.
Multiple meningiomas are relatively rare tumors without known neurofibromatosis. In this paper, such eight cases of multiple meningiomas as described by CUSHING and EISENHARDT are presented. Certain aspects of diagnosis and surgical management of this rare condition are discussed with particular emphasis on the importance of the distinction among multiple meningioma, meningiomatosis, or recurrences of these tumors. Fortunately, many of these patients tolerate multiple surgical interventions well, although the removal of these tumors in critical areas is a difficult problem. Thus, we think that it is important to examine and supervise all patients who have had a meningioma for a possible occurrence of a second meningioma.
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