Background:Systemic sclerosis is a generalized disorder of connective tissue affecting skin and internal organs. Lung involvement accounts for significant morbidity and is a leading cause of mortality in patients.Objectives:This study intends to study the frequency of occurrence of pulmonary involvement in progressive systemic sclerosis (PSS) and to describe the clinical and radiological picture of pulmonary involvement in PSS.Materials and Methods:This was a descriptive cross-sectional study. A detailed history, modified Rodnan score, clinical examination, routine investigation, antinuclear antibody, immuno biot, chest X-ray (CXR), pulmonary function test (PFT), and 6 min walk test (6MWT) were performed on all patients. High resolution computed tomography was done on those who consented.Results:Hundred subjects with PSS were included in the study; 90 were females and 10 were males. Common presenting complaints were skin thickening in 98% and Raynaud's phenomenon in 98%. Skin thickening of digits beyond metacarpo phalangeal was seen in 98%, face and neck in 92%, and hands in 92%. Chest wall thickening was seen in 40 subjects (40%). 90 (90%) of the studied subjects had pulmonary involvement, longer duration of disease was significantly associated with pulmonary involvement (P < 0.05). Dyspnea, cough, bilateral crepitations, CXR, Borg score, and Rodnan score was found to be significantly associated with severe pulmonary involvement (P < 0.05).Conclusion:The prevalence of pulmonary involvement in this cohort study was 90%. Almost 1/3rd of patients, that is 29 (29%) were detected to have pulmonary involvement despite being asymptomatic for respiratory complaints, hence early screening and evaluation is recommended. PFT and 6MWT are noninvasive, cost-effective, and easily available screening tests which can be used in resource-limited settings.
Morel-Lavallee lesion (MLL) entity represents as a haemolymph mass as a result of closed degloving injury following focal trauma. The swelling can be mistaken as a tumor or simple hematoma formation, and it can be of concern as it gradually increases in size. It is important to diagnose the entity promptly as proper management can avoid skin necrosis and further complications. We present a 20-year-old female nursing student who fell down from a scooter and developed painful massive right thigh swelling over a 3-week course following trauma. She underwent plain radiography which was unremarkable. Ultrasound and magnetic resonance imaging revealed the diagnosis of MLL and she was treated accordingly.
The incidence of aneurysmal bone cyst in the maxillofacial region is rare and may remain undiagnosed for a long period prior to becoming symptomatic. This may cause associated issues secondary to compression by extending to the surrounding vital anatomical areas. An aggressive course can lead to bony destruction with intracranial extension. We present a case of a 23-year-old man who presented with bilateral exorbitism with nasal obstruction.
Tuberous sclerosis complex is a genetic disorder, which affects many organs in the body manifesting spectrum of symptomatology. The severity of the disease can be gauged from the extent of involvement of a particular system. Since the disease runs a long course from its presentation at childhood till adulthood and hence the monitoring is very important to have some qualitative life. Other than the common symptomatology and a few laboratory tests, radiological investigations viz. ultrasound, color Doppler sonography, computedtomography and magnetic resonance imaging play a major role in follow-up for the management map road and associated complications. We present a case where a female child had a follow-up from the age of 8 years till 20 years of age. The follow-up and the management were designed mainly as per the radiological findings. The radiological findings have indicated the time for the patient to undergo surgical intervention in addition to the ongoing medical management.
Background: Coccydynia is pain around the coccygeal region without any definite point. This remains unclear in the beginning about the origin and nature of pain. Presacral epidermoids can either be diagnosed as an incidental finding or when these become symptomatic. Case Presentation: We present 35-years old female having coccydynia of one year duration. There was no relief of pain with symptomatic management as plain X-ray study was unremarkable. She was found to be having presacral epidermoid on imaging studies by Computerized Tomography (CT) and Magnetic Resonance Imaging (MRI). Conclusion: Being asymptomatic in nature Presacral Epidermoids remains undiagnosed for a long time. The cross-sectional imaging modalities as MRI is the key investigation for the diagnosis. DWI sequences play a key role in the work up diagnosis of Presacral Epidermoids.
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