Citations

AbstractA 60-year-old woman with chronic pain in the left long finger, occasionally involving the ring finger and intermittently extending to the hand, wrist, and distal forearm, was referred for radiographs and a triple-phase technetium-99m methylene diphosphonate bone scintigraphy to evaluate for possible complex regional pain syndrome. Initial radiographs were normal. A three-phase bone scan revealed focal radiotracer uptake at the distal aspect of the long finger during the blood pool phase only, with normal blood flow and delayed phases, suggesting a hypervascular soft tissue tumor. Follow-up magnetic resonance imaging showed a hypervascular nodule in the nail bed of the long finger. The lesion was surgically resected, and pathology results confirmed the diagnosis of a glomus tumor.

AbstractPortosystemic collateral pathways are a significant concern in interventional radiology, frequently manifesting in patients with cirrhosis or portal vein thrombosis. These pathways can lead to severe clinical complications, including gastrointestinal bleeding, hepatic encephalopathy, and liver failure. A thorough understanding of the anatomy, hemodynamic alterations, and clinical implications of these shunts is crucial for interventional radiologists to provide effective treatment while minimizing risks. This article reviews the clinical presentations associated with portosystemic shunts, explores the anatomical variants and altered flow dynamics, and discusses the latest endovascular treatment strategies to optimize patient outcomes.

AbstractThe vascular system is an intricate system that develops during early periods of embryogenesis. Through a complex signaling pathway of vasculogenesis and angiogenesis, embryonic vessels grow and coalesce, which allows nutrient and waste management. Dysfunction in these endothelial cells gives rise to vascular variants. Throughout gestational development, vascular variants can form in different organ systems such as the thoracic cavity, hepatic, renal, and lower pelvis. It is clinically very important for physicians to recognize these variants, as these variants can predispose to certain illnesses and treatment of patients surgically. This article discusses the embryology and vascular variants of the arterial system with a focus on the thoracic cavity, hepatic, renal, and pelvic variations to help aid in minimizing technical complications during procedures.

Cardiovascular disease (CVD) is the leading cause of mortality and morbidity worldwide. Low-dose colchicine is a novel and nonstandard management approach for patients with CVDs who are at an increased risk of adverse events. However, few studies have reported the risk of stroke with colchicine, with controversial results. This meta-analysis aimed to compare the efficacy of colchicine and placebo for stroke prevention in patients with CVD. Major electronic databases were screened for randomized controlled trials (RCTs) comparing colchicine and placebo in patients with CVDs from inception to June 2024. Pooled estimates were calculated as risk ratios (RRs) with 95% confidence intervals (CIs) using an inverse-variance random-effects model. Statistical significance was set at P < 0.05. A total of 15 RCTs encompassing 25,116 patients with CVDs were included (12,568: colchicine and 12,548: placebo). The pooled analysis demonstrated a significant reduction in stroke [RR, 0.80 (95% CI, 0.64–0.99); P = 0.04] with colchicine compared with placebo. The risk of all-cause mortality [RR, 1.00 (95% CI, 0.77–1.28)] was comparable between the 2 groups. On subgroup analysis, low-dose colchicine (0.5 mg/day) demonstrated a significantly lower risk of stroke compared with high-dose (>0.5 mg/day) colchicine, which failed to achieve statistical significance. Based on this meta-analysis, colchicine significantly reduced stroke in patients with CVDs compared with placebo. This effect was most significant with low-dose colchicine at 0.5 mg/day. However, no differences were observed in all-cause mortality. Further long-term RCTs are warranted to investigate stroke prevention using colchicine in this population.

Limbic encephalitis is associated with various tumours and antibodies. We describe a 33-year-old man with progressive cochleovestibular symptoms, cerebellar ataxia, myoclonus and antibodies against Kelch-like protein 11 (KLHL11). MR scan of the brain showed hippocampal T2 hyperintensities. FDG PET scan was normal. Biopsy of his enlarged left testes showed fibrosis without neoplasia. Immunotherapy so far has not helped significantly.

Background: Sarcoidosis is a multisystem disorder characterized by non-caseating granulomas in various organs. While cardiac sarcoidosis (CS) is clinically rare, it has significant implications, including heart failure, ventricular arrhythmias, and sudden cardiac death. Speckle-tracking echocardiography has emerged as a promising tool for detecting subclinical myocardial dysfunction, which is cost-efficient and readily available. This meta-analysis aims to evaluate differences in functional echocardiographic parameters between patients with CS and extracardiac sarcoidosis (ECS) to improve early recognition and management. Methods: A comprehensive search of major bibliographic databases was conducted to identify studies up to December 2024. Mean differences (MDs) with 95% CIs were pooled using the inverse-variance random-effect model. Results: Seven studies with 478 patients with sarcoidosis (CS: 159 and ECS: 319) were included. Patients with CS had a significant reduction in left ventricular global longitudinal strain (MD: −2.73; 95% CI: −4.09, −1.38; p < 0.0001) and tricuspid annular plane systolic excursion (MD: −0.59; 95% CI: −1.12, −0.05; p = 0.03) compared to patients with ECS. No significant differences in the LV global circumferential strain, interventricular septum thickness, left ventricular ejection fraction, E/A ratio, E/E’ ratio, LV end-diastolic diameter, and LV end-systolic diameter were noted. Conclusions: LV GLS and TAPSE are promising parameters for the early detection of cardiac involvement in sarcoidosis, with significant prognostic implications. Although STE provides a cost-effective and accessible alternative to CMR and FDG-PET, further research is needed to standardize its use and validate diagnostic cut-offs.