1,721,027 research outputs found
Musculoskeletal MRI at 7 T: do we need more or is it more than enough?
Full text linkUltra-high field magnetic resonance imaging (UHF-MRI) provides important diagnostic improvements in musculoskeletal imaging. The higher signal-to-noise ratio leads to higher spatial and temporal resolution which results in improved anatomic detail and higher diagnostic confidence. Several methods, such as T2, T2*, T1rho mapping, delayed gadolinium-enhanced, diffusion, chemical exchange saturation transfer, and magnetisation transfer techniques, permit a better tissue characterisation. Furthermore, UHF-MRI enables in vivo measurements by low-γ nuclei (23Na, 31P, 13C, and 39K) and the evaluation of different tissue metabolic pathways. European Union and Food and Drug Administration approvals for clinical imaging at UHF have been the first step towards a more routinely use of this technology, but some drawbacks are still present limiting its widespread clinical application. This review aims to provide a clinically oriented overview about the application of UHF-MRI in the different anatomical districts and tissues of musculoskeletal system and its pros and cons. Further studies are needed to consolidate the added value of the use of UHF-MRI in the routine clinical practice and promising efforts in technology development are already in progress
A possible case of juvenile idiopathic arthritis from Renaissance Lucca (Tuscany, central Italy)
No full textA case of secondary hypertrophic osteoarthropathy from medieval Tuscany (central Italy, 10th-12th centuries CE)
No full textObjectives: This study aims to provide a detailed evaluation of a case of secondary hypertrophic osteoarthropathy (HOA) and to explore insights into the presence and consequences of disease in medieval rural Italy. Materials: The skeleton of a male (US 4405) with an estimated age at death of 51-69 years excavated from the medieval rural site of Pieve di Pava (Siena, Italy). Methods: Macroscopic and radiological (x-ray, CT) analyses were performed. Results: Symmetrical extensive periosteal new bone formation on the diaphyseal and metaphyseal regions of this individual's long bones; the lower limbs were more extensively and severely affected than the upper limbs and the distal segments were more severely altered in comparison to the proximal ones. Conclusions: The macroscopic and radiological features are highly consistent with a diagnosis of secondary HOA. Significance: The excellent state of preservation allowed the evaluation of rarely noted skeletal manifestations of HOA and provided insight into aspects of rural life in medieval Italy. Limitations: Molecular analysis was not successful in sequencing the aDNA of tuberculosis, therefore the underlying primary cause of secondary HOA, whether pulmonary or extrapulmonary, remains obscure in this case. Suggestion for the future research: It is advisable to regularly revisit the data available from osteoarchaeological collections in order to identify further cases of HOA, along with to further investigate the known cases to search for the underlying primary disease
SKELETAL TRAUMA OR POST-MORTEM DAMAGE? EXPLORING THE ROLE OF TAPHONOMY IN A PREHISTORIC SKULL FROM ERIMI LAONIN TOU PORAKOU (CYPRUS)
No full textCurrent Value of Biparametric Prostate MRI with Machine-Learning or Deep-Learning in the Detection, Grading, and Characterization of Prostate Cancer: A Systematic Review
Full text linkProstate cancer detection with magnetic resonance imaging is based on a standardized MRI-protocol according to the PI-RADS guidelines including morphologic imaging, diffusion weighted imaging, and perfusion. To facilitate data acquisition and analysis the contrast-enhanced perfusion is often omitted resulting in a biparametric prostate MRI protocol. The intention of this review is to analyze the current value of biparametric prostate MRI in combination with methods of machine-learning and deep learning in the detection, grading, and characterization of prostate cancer; if available a direct comparison with human radiologist performance was performed. Pub-Med was systematically queried and 29 appropriate studies were identified and retrieved. The data show that detection of clinically significant prostate cancer and differentiation of prostate cancer from non-cancerous tissue using machine-learning and deep learning is feasible with promising results. Some techniques of machine-learning and deep-learning currently seem to be equally good as human radiologists in terms of classification of single lesion according to the PIRADS score
Humeral greater tuberosity osteolysis as a complication of intraosseous calcification migration: Natural history depicted by imaging
Full text linkMigration of calcification within the bone leading to greater tuberosity osteolysis is a peculiar complication of the calcifying tendinitis of the rotator cuff. The case of a 38-year-old woman complaining of right shoulder pain, which had been going on for one year, is hereby described. The evolution of the infraspinatus tendon calcifying tendinitis leading to osteolysis of the greater tuberosity of the humerus is depicted by imaging and, particularly, by the MR and CT features changing over time. In this paper we focus on the importance of both MR and CT exams in the diagnostic process of the different phases of the disease. The correlation between clinical symptoms and imaging features is also helpful for imaging interpretation: the most painful phase corresponds to the migration of the calcification, whereas pain tends to decrease when the osteolysis develops. Awareness of the existence of this condition may prevent unnecessary invasive procedures. (www.actabiomedica.it)
Application of CT analysis for the study of a fossil sperm whale from the Miocene of southern Italy
No full textA case report of solitary osteochondroma from 4th c. BC Pontecagnano (southern Italy) and review of the literature.
No full textOsteochondroma is one of the most common benign bone tumors in current clinical medicine; by contrast, their evidence in paleopathology is scant.
The aim of this study is twofold: 1) to present a new case of solitary osteochondroma in an individual from the necropolis of Pontecagnano (southern Italy) dated to the 4th century BC; 2) to provide a literature review concerning paleopathological evidence of solitary osteochondromas in osteoarchaeological collections globally in order to assess the current state of research on this topic.
Macroscopical examination revealed the presence of a large exophytic formation located that arises from the anteromedial portion of the proximal metaphyseal region and extends to the posteromedial aspect of the proximal diaphysis extremity of the right tibia belonging to an adult male individual. The radiological analysis revealed its structure being composed of regular trabecular bone tissue with cortico-medullary continuity, features that are diagnostic for a sessile osteochondroma.
A review of primary peer-reviewed literature allowed us to ascertain a total of 12 cases of solitary osteochondromas, ranging from prehistory to the post-medieval period.
A critical appraisal of diagnosis performed in published cases of osteochondromas is a valuable tool for detecting the limitations of some case reports, in particular those lacking imaging technique (e.g. radiology) which is crucial for confirming the diagnosis of osteochondroma.
Finally, we advocate that paleo-oncology should not be limited to malignant neoplasms, rather it should incorporate the neglected area of benign tumors as they may provide additional information on their presence and natural history in bioarchaeological contexts
Solitary osteochondroma in palaeo-oncology: a case report from 4th century BC Pontecagnano (southern Italy)
No full textMuch of the research focus in palaeo‐oncology is dominated by malignant neoplasms, either primitive or metastatic, while benign tumours are seen as a neglected area of palaeopathological investigation, especially for the idea that they do not provide contribution to the knowledge of health conditions in past communities.1
This study pertains to a case of benign bone tumour diagnosed in a male individual aged 40-50 years and brought to light from the necropolis of Pontecagnano (southern Italy); the tomb (T. 4439) in which the osteological remains were found was located in “Sica de Conciilis” property. The skeleton laid supine in a travertine stone lined grave exhibiting a bronze belt and pottery as grave goods, which allowed archaeologists to define the precise chronology of the third quarter of the 4th century BC.2
Macroscopic and radiological assessment were performed, while histological analysis was avoided as a conservative approach. The metaphysis of the right tibia exhibited a large exophytic formation (c. 10x5 cm) characterised by normal trabecular bone tissue with cortical and medullary continuity. The differential diagnosis suggested a case of sessile osteochondroma, a benign bone tumour that develops during adolescence. Its large dimension could have caused both aesthetic concern and compression of adjacent neurovascular structures, with consequent pain and partial impingement; moreover, the presence of cavitations on the posterior surface of the mass was interpreted as evidence of a possible superinfection of the bone tissue. Slight osteoarthritic changes and medium enthesis development of this mature male seems to indicate a limited physical activity. Despite osteochondromas are the most common benign bone tumours in current clinical medicine,3 their evidence in palaeopathology is not abundant; therefore, any report about new evidence of this benign neoplasm in ancient human remains is important in order to evaluate its presence in past times
Histology of pulmonary tuberculosis in a 19th-century mummy from Comiso (Sicily, Italy)
No full textObjective: The aim of this study is to investigate potential evidence of tuberculosis in mummified remains. Materials: The natural mummy of an anonymous friar from the mortuary chapel of the church of Santa Maria della Grazia in Comiso (Sicily) METHODS: The mummy was studied through macroscopic examination; tissue sampling was conducted through breaches in the dorsal surface of the thorax. Radiological, histological and immunohistochemical analyses were performed on the pulmonary parenchyma. Results: The mummified remains are those of an adult male approximately 25-45 years old. In the left lung, 7 intra parenchymal calcified nodules were detected. The fibrocalcific nodules showed some lacunae surrounded by fibrous tissue containing amorphous necrotic, most probably caseous, material. Conclusions: These findings are compatible with a chronic infectious-inflammatory disease, likely a calcification of a previous Ghon complex of an apical nodular tuberculosis. Significance: Our study supports the great spread of the disease in the 19th century; a time when it reached its maximum peak in Europe. Limitations: Molecular investigations failed to detect traces of Mycobacterium tuberculosis DNA in the sample. Suggestions for further research: The investigation on the mummies from Comiso is still in progress, and further analyses will potentially provide paleopathological data on this community of Modern Age which could be integrated with historical and archival sources
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