A case is presented of synovial chondromatosis within a bursal sac overlying an osteochondroma in a patient with osteochondromatosis. This condition presented with a symptomatic soft tissue mass containing calcified bodies. It can be mistaken clinically and radiographically for malignant degeneration of an osteochondroma with development of chondrosarcoma. Magnetic resonance findings have not previously been described in this entity and proved helpful in the preoperative diagnosis. Magnetic resonance imaging was also helpful in defining the extent of the lesion. Ultrasound and other imaging modalities are also discussed, including the pathologic basis for the radiographic findings.
Cystic hygromas arising outside of the cervicofacial, thoracic, and abdominal areas are extremely rare. Detailed descriptions of this lesions along with its MRI findings, in the extremities are lacking in the literature. The following case report describes such a lesion occurring in the arm.
Supraglottic infections are not limited to the epiglottis and are not always caused by Haemophilus influenza type b (Hib). We present an unusual case of supraglottitis that illustrates the expanded spectrum of organisms that may cause illness. Case ReportThis three-year-old white male in good general health, presented to the pediatric clinic with a fever of 38.6°C, abdominal pain and emesis of less than 24 hours duration. Shortly before admission, he developed a hoarse cry, drooling and difficulty swallowing.He had been seen two weeks previously for impetigo and given a 10 day course of amoxicillin. Although he attended day care three days a week, he had no known diseased contacts. He had received a Hib vaccine eight months before admission. On physical examination he had a rectal temperature of 34.4°C, pulse of 166/min and respirations of 22/min. He was lying quietly in his mother's arms. When disturbed, he became stridorous and drooled. His examination revealed only shotty cervical adenopathy and clear breath sounds. Direct visualization of the epiglottis was deferred pending preparation for possible elective intubation.Admitting laboratory tests were remarkable for white blood cell count of 21,000/mm3 with many immature forms. Lateral neck radiograph showed marked enlargement of the aryepiglottic folds and minimal swelling of the epiglottis (Figure).A prompt fiberoptic examination was performed which revealed erythema and swelling of the supraglottic larynx, with only slight swelling of the epiglottis. He was taken to the operating room for elective intubation, which was completed within 45 minutes. At the time of this second visualization, the process had advanced, and the entire supraglottis was erythematous and swollen, including the epiglottis. Nasotracheal intubation was performed and therapy was started with ampicillin and chloramphenicol. A post-intubation chest roentgenogram showed a right middle lobe infiltrate. Within 12 hours of intubation, the patient extubated himself. He no longer appeared to have airway compromise at this time and fiberoscopy revealed decreased edema and erythema of the supraglottic region
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