Journal of clinical ultrasound : JCU
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Case Reports
Sonographic findings in Nicolau syndrome following intramuscular diclofenac injection: a case report.
Nicolau syndrome (also known as embolia cutis medicamentosa and livedoid dermatitis) is a rare but severe localized adverse drug reaction of intramuscular injection of various drugs. The typical presentation is pain around the injection site soon after injection, followed by erythema, livedoid patch, hemorrhagic patch, and finally necrosis of skin, subcutaneous fat, and muscle tissue. We report a case that occurred in a 34-year-old woman after intramuscular injection of diclofenac sodium. Sonography showed diffuse thickening with increased echogenicity of the skin and subcutaneous fat layer, while MRI revealed extensive edema involving gluteal and piriformis muscles and deep fascia, and fluid collection.
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To determine the feasibility and accuracy of ultrasound (US) -guided gadolinium injection for MR arthrography of shoulders, wrists, hips, and knee joints as an alternate technique to fluoroscopy. ⋯ US is an effective alternate guidance technique for the injection of gadolinium into shoulder, hip, knee, and wrist joints for MR arthrography. Its advantages are cost effectiveness, ease of performance, and lack of radiation.
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Case Reports
A survival case of painless chronic type A aortic dissection with a history of stroke and anticoagulant use.
We report the case of a patient with completely painless chronic aortic dissection, who presented to another hospital with a left hemiparesia 3 months ago and received anticoagulation therapy with a diagnosis of ischemic stroke. Most of her symptoms had resolved when she presented to our outpatient clinic except for numbness of her left hand and dysphasia. ⋯ Surgery was performed successfully and the patient was discharged. This case emphasizes that the diagnosis of a completely painless aortic dissection with only neurologic symptoms at presentation can be extremely difficult and should always be considered as a cause of ischemic stroke to avoid catastrophic antithrombolytic or anticoagulation therapy.
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Cardiac resynchronization therapy with biventricular pacing has been shown to be beneficial in improving heart failure in patients with prolonged QRS duration (≥120 ms) and low ejection fraction (≤35%). Unsuccessful cannulation of the coronary sinus (CS) has been reported in up to 10% of cases. The feasibility of the transthoracic continuous cardiac imaging for coronary sinus cannulation has not been previously demonstrated. ⋯ We demonstrated the feasibility of using the CONTISON echography transducer for the guidance CS cannulation. This technique could expedite CS cannulation and reduce radiation exposure. Further studies comparing ultrasound versus fluoroscopy for CS cannulation appear warranted.
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To evaluate the feasibility and effectiveness of preoperative localization of cystic lesions in the knee using ultrasound-guided indigo carmine injection. ⋯ Preoperative localization of cystic lesions in the knee joint region using ultrasound-guided indigo carmine injection is a feasible technique and can be easily and safely be performed.