Clinical Medical Image Library (Index Copernicus Value: 93.51) offers an eclectic mixture of prime quality pictures on clinical and medical subjects, together with clinical drugs, up-to-date diagnostic scans, technical illustrations and research. The search results for clinical images and medical images - open access platform, remarkable or note-worthy clinical pictures. The definitive on-line case-based medical learning web site includes links to the most effective images from different departments.

Imaging modalities include clinical and medical field classified into sub fields - Radiology, Biological imaging which merges with Radiology which uses advanced techniques in MRI, X-ray, Ultra sonography, Clinical and Medical photography, Tactile imaging, Nuclear medicine imaging. Journal widely covers scientific investigative disciplines including biomedical engineering, medical sciences. Authors are invited to submit clinical, biomedical, anatomical, physiological pictures, photography work and image, image-guided procedures, tomography, radio imaging etc. The Journal accepts top quality works submission at this context and publishes among a month if the artworks are accepted for publication.

Journal Information

Title: Clinical Medical Image Library

ISSN: 2474-3682

Editor-in-chief: Euishin Edmund Kim

NLM title abbreviation: Clin Med Img Lib

ICV: 93.51

ISO abbreviation: Clin Med Img Lib

Other titles: CMIL

Category: Imaging

DOI: 10.23937/2474-3682

Peer review: Double blind

Review speed: 3 weeks

Fast-track review: 10 days

Publication format (s): Electronic and print

Publication policy: Open Access; COPE guide

Publication type(s): Periodicals

Publisher: ClinMed International Library

Country of publication: USA

Language: English

Contact email:

Articles Search by   Keyword   |   Journal title   |   Author name   |   DOI


 Open Access DOI:10.23937/2474-3682/1510234

Unilateral Renal Agenesis, Think in Zinner Syndrome

Marta Pelicano, Margarida Serôdio and Paula Nunes

Article Type: Clinical Image | First Published: 2024/02/25

Zinner syndrome is indeed a rare congenital condition characterized by urogenital system malformation, specifically involving abnormalities of the mesonephric/Wolffian duct. It typically presents with the triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ipsilateral ejaculatory duct obstruction. We present a case of an 8-year-old male child with a prenatal diagnosis of solitary kidney (right renal agenesis) and the subsequent identification of a globose right seminal vesi...

 Open Access DOI:10.23937/2474-3682/1510233

Verrucous Epidermal Hyperplasia in the Lower Lip

Edgar Bedang Mone Keby da Costa, El khalil El Bakali, Rachid Frikh, Naoufal Hjira and Youssef Zemmez

Article Type: Clinical Image | First Published: 2024/02/17

Verrucous hyperplasia is a pre-neoplastic lesion that inevitably progresses to verrucous carcinoma or squamous cell carcinoma. Diagnosis is histological; this lesion may exist alone or as part of the spectrum of lesions described in verrucous leukoplakia. The distinction is based on the endophytic and exophytic growth aspects of the epithelial proliferation: In verrucous carcinoma, in addition to surface projections, there are also extensions of the lesion into the underlying connective tissue t...

 Open Access DOI:10.23937/2474-3682/1510232

Posterior Segment Flail Chest: A Radiological Diagnosis

Yudhyavir Singh, Baby Pegu and Kapil Dev Soni

Article Type: Clinical Image | First Published: 2024/02/12

A 35-year-old male reported to the emergency department after a road traffic accident with complaints of chest pain on the left side and breathing difficulty. On the primary survey, his GCS was full, his airway was patent, breathing spontaneously with a respiratory rate of 28/min with paradoxical movement on the left of the chest, heart rate of 102/min, and blood pressure of 116/78 mmHg. On further evaluation, the chest compression test was positive on the left side, but FAST and eFAST scan were...

 Open Access DOI:10.23937/2474-3682/1510231

Neonatal Hemangioma: Key Role of Physical Assessment

Marta Figueiredo, Leonor Aires Figueiredo, Filipa Cirurgião, Joana Soares, Cristina Claro and Marta Aguiar

Article Type: Medical Image | First Published: 2024/01/31

A male newborn with a gestational age of 39 weeks and 2 days, with appropriate weight for gestational age, was born by eutocic delivery. Pregnancy surveillance was unremarkable, with maternal serologies and obstetric ultrasounds considered normal. In the delivery room, an adherent red-violaceous rounded lesion in the left gluteal region, with hard consistency, peripheral pale halo and telangiectasias, measuring approximately 5 cm, was observed (Figure 1). ...

 Open Access DOI:10.23937/2474-3682/1510230

Squamous Cell Carcinoma of the Inter-Toe Space: A Case Report

Elkhalil El Bakali, Edgar Keby, Youssef Zemmez, Rachid Frikh and Naoufal Hjira

Article Type: Clinical Image | First Published: 2024/01/25

A 73-year-old female patient, without any notable pathological history, who presented with an intertrigo of the 4th inter-toe space of the right foot for 6 years and refractory to antifungal treatment, evolving to a protruding lesion. Clinical examination revealed a bulging nodular lesion, filling the entire 4th inter-toe space, 2 × 1.5 cm in size, with a small ulceration and crusts on the surface and the lesion associated with deep cracking of the inter-toe space (Figure 1a, Figure 1b and Figu...

 Open Access DOI:10.23937/2474-3682/1510229

Recurrent Tongue Hyperpigmentation in Hidradenitis Suppurativa

Palmeiro AG and João Teles-Sousa

Article Type: Clinical Image | First Published: 2024/01/21

The authors present the case of a non-smoker, 40-year-old woman, with hidradenitis suppurativa (IHS4 9). When she presented for deroofing surgery she complained of an asymptomatic dark pigmentation of her tongue. She recalled three similar self-limited episodes, that coincided with doxycycline cycles, but denied a similar reaction when she took minocycline. A diagnosis of hairy black tongue induced by doxycycline was made and the patient was reassured (Figure 1)....

 Open Access DOI:10.23937/2474-3682/1510228

Cutaneous Lymphangioma Circumscriptum: Seeing Closer

Marcela de Oliveira Pires, Leonor Aires Figueiredo and Cristina Amaro

Article Type: Clinical Image | First Published: 2023/12/24

A previously healthy seven-year-old female presented to the Pediatric Dermatology clinic with multiple, grouped, red fluid-filled lesions on the left side of the torso, that appeared about one month earlier. No other symptoms, such as pain, pruritus or fever were present....

 Open Access DOI:10.23937/2474-3682/1510227

Mycobacterium abscessus Lung Infection Mimicking Lady Windermere Syndrome

Xin Ya See, MD, Yu-Cheng Chang, MD and Kuan-Yu Chi, MD

Article Type: Clinical Image | First Published: 2023/2/21

A 60-year-old non-smoking, slender woman without significant medial history presented with a 6-month history of intermittent low-grade fever, dyspnea, and productive cough with greenish sputum. Physical examination revealed crackles in both lung fields. Laboratory tests showed a white cell count of 21,700/μL (reference range 3,200 to 9,200). Chest radiography revealed multiple linear, nodular opacities, and infiltrates inboth lung fields (Figure 1). ...

 Open Access DOI:10.23937/2474-3682/1510226

Uterine Adenomyosis: An Uncommonly Oversized Uterus in a 30-Year-Old Patient

Fernanda Alves, Zélia Gomes, Yida Fan, Ana Moreira and Osvaldo Moutinho

Article Type: Image - New Technique | First Published: 2023/12/17

Uterine adenomyosis is a disorder in which endometrial glands and stroma are present within the myometrium, resulting in hypertrophy of the surrounding myometrium [1,2]. Its exact epidemiology is uncertain as data regarding this condition has often relied on the assessment of the uterus following hysterectomy. However, studies have reported that it seems to be present in a wide range of individuals undergoing hysterectomy (9-62%)....

 Open Access DOI:10.23937/2474-3682/1510225

Two-Finger Technique and No-Finger Technique of Holding a Face Mask

Bokinala Naveen, MBBS, MD

Article Type: Image - New Technique | First Published: 2023/12/11

The Figure 1 shown above depicts the method of holding a face mask in a paralyzed patient. The middle finger is used to lift the chin and thumb is used to hold the mask with direction of force towards the angle of mandible (arrow direction) making sure that the lower side of mask is in contact with the patient....

 Open Access DOI:10.23937/2474-3682/1510224

Emphysematous Pyelonephritis on Lithiasis Obstruction Complicated by Subcapsular Hematoma: A Double Urological Emergency

Nedjim A Saleh, Hagguir Hissein, Fadoul Achta, Moataz Amine, Dakir Mohamed, Debbagh Adil and Aboutaieb Rachid

Article Type: Clinical Image | First Published: 2023/09/04

Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma and surrounding tissues, characterized by the presence of gas. It is a serious infection whose main complications are septic shock, acute renal failure and disseminated intravascular coagulation [1]. Subcapsular haematoma secondary to pyelonephritis is an extremely rare complication whose clinical manifestations vary considerably according to terrain and severity [2]....

 Open Access DOI:10.23937/2474-3682/1510223

Transient Ipsilateral Horner's Syndrome after Ultrasound Guided Interscalene Brachial Plexus Nerve Block

Monica Yadav, MD, Yudhyavir Singh, MD and Abhishek Singh, MD

Article Type: Clinical Image | First Published: 2023/08/31

The brachial plexus which innervates the upper limb has afferent from the cervical and thoracic part of the spinal cord. Due to its proximity to the other important vascular and nervous structures, which is mainly responsible for the post block complications like temporary paralysis of the phrenic, recurrent laryngeal nerves or Horner's syndrome....

 Open Access DOI:10.23937/2474-3682/1510222

Progression and Resolution of a Post-Traumatic Pleurocutaneous Fistula

Benjamin O'Brien, BS, Aidan Farrell, BS and Pranav N Shah, MD

Article Type: ESSENTIAL IMAGES | First Published: 2023/08/02

A 45-year-old female with no known past medical history presented to the trauma unit as an unrestrained passenger in a motor vehicle accident. On arrival, her GCS was 8 and she was intubated. Focused Assessment with Sonography for Trauma (FAST) exam was negative, but initial chest imaging (Figure 1A and Figure 1B) revealed right-sided fractures of the first through seventh ribs, a fracture of the left first rib with bilateral consolidations, and a small right-sided hemopneumothorax. ...

 Open Access DOI:10.23937/2474-3682/1510221

Primary Aortoesophageal Fistula: A Rare Cause of Upper Gastrointestinal Bleeding

Ahmet Bozer, MD

Article Type: Clinical Image | First Published: 2023/07/31

Aortoesophageal fistula (AEF) is a rare but life-threatening condition characterized by a communication between the aorta and the esophagus. It is often associated with aortic aneurysm rupture and can present with gastrointestinal bleeding. Rapid diagnosis and treatment are crucial for optimal patient outcomes. Here, we present a case of AEF in a 73-year-old female patient who presented with bloody vomiting....

 Open Access DOI:10.23937/2474-3682/1510220

Purple Urine Bag Syndrome (PUBS): A Rare Disease

Addepalli Naga Sowmya and M Nagarjuna

Article Type: Clinical Image | First Published: 2023/07/21

A 68-year-old female with a known hypertensive, diabetic, and neurogenic bladder was brought to the hospital with complaints of fever and constipation. The urine bag and urine colour were found to be purple (Figure 1). The urinalysis showed alkaline urine, and the urinary sediment contained 15-20 white blood cells per high-power field. She was admitted under the impression that she had a Urinary Tract Infection (UTI) and constipation....

 Open Access DOI:10.23937/2474-3682/1510219

Fibrolamellar Hepatocellular Carcinoma

Scott Mu, MD, MHS, William Spataro, MD and Ravi Chokshi, MD, MPH

Article Type: Clinical Image | First Published: 2023/06/18

He denied previous alcohol or tobacco use, and his serum alpha fetoprotein level was normal at 3.8 ng/mL. Computed tomography (CT) imaging of his abdomen and pelvis demonstrated a 10.4 cm mass in the right liver with heterogeneous areas of mixed high and low attenuation (Figure 1A)....

 Open Access DOI:10.23937/2474-3682/1510218

Large Thoracoabdominal Pancreatic Pseudocyst in a COVID-19 Patient

Bhargav Kansara, BS and Harshna V Vadvala, MD

Article Type: Essential Images | First Published: 2023/06/16

A 38-year-old female with a history of pancreatitis presented with breathing difficulties and tested positive for COVID-19. A CT of her chest, abdomen and pelvis with contrast showed a 8.5 × 13.1 × 25.4 cm (AP × ML × CC) multilobulated abdominal cyst extending into the posterior mediastinum with bilateral pleural effusion (Figure 1A). CT scan MipPR reconstruction showed the relation of the pseudocyst with abdominal and thoracic vessels (Figure 1B). ...

 Open Access DOI:10.23937/2474-3682/1510217

Epidermodysplasia Verruciformis: A Late Presentation

Hasna Kerrouch, Youssef Zemmez, Rachid Frikh and Naoufal Hjira

Article Type: Clinical Image | First Published: April 03, 2023

A 35-years-old female patient presented with multiple asymptomatic raised lesions of 4 years duration on the legs. Examination revealed multiple verrucous plaques over the two legs, size ranged from 0.5-1 cm, round to oval, with normal surrounding areas (Figure 1). Systemic examination was normal....

 Open Access DOI:10.23937/2474-3682/1510216

Unique Ulcerating Lesion Revealing Adenocarcinoma of the Lung

Hasna Kerrouch, Youssef Zemmez, Rachid Frikh and Naoufal Hjira

Article Type: Clinical Image | First Published: April 03, 2023

A 57-year-old man was admitted to our department with a single ulcerated skin lesion on the right lumbar zone. The patient quit smoking 1 years ago, following a history of 35 years of smoking 13 cigarettes per day. There was no evidence of respiratory symptoms, or anorexia....

 Open Access DOI:10.23937/2474-3682/1510215

Frontotemporal Intradiploic Meningioma with Progressive Intraorbital Invasion: Case Report

O Hmamouche, F Lakhdar, M Benzagmout, K Chakour and MF Chaoui

Article Type: Clinical Image | First Published: March 19, 2023

Meningiomas are the most common primary brain tumors, Orbital invasion usually invades as an extension of the sphenoid wing meningiomas. We report the case of a 54-year-old man who presented with frontotemporal intraosseous meningioma with intraorbital invasion....

 Open Access DOI:10.23937/2474-3682/1510214

Palpebral Hidrocystomas

Hasnakerrouch, Edrar Bedang MoneKeby Dacosta, Rachid Frikh and Naoufal Hjira

Article Type: Clinical Image | First Published: March 19, 2023

Palpebral hidrocystomas are benign tumors originate from eccrine or apocrine sweat glands and often occur on the face and the eyelids. It appears as single or multiple cystic lesion. Their histogenesis is still uncertain. Here in we report a case of a 54-year-old women presenting with translucent nodule in the external canthus of the left eye....

 Open Access DOI:10.23937/2474-3682/1510213

Acquired Hypertrichosis Lanuginosa Associated with Lung Carcinoma

Hasnakerrouch, Meryemkhalidi, Youssef Zemmez and Naoufal Hjira

Article Type: Clinical Image | First Published: March 19, 2023

Hypertrichosis lanuginosa acquisita (HLA) is an acquired condition most of ten associated with medication use and endocrine or metabolic disorders. The association of HLA with malignancy has been also noted. Here in we report a case of HLA revealing a lung carcinoma....

 Open Access DOI:10.23937/2474-3682/1510212

Superficial Lipomatous Hamartoma: An Unusual Presentation

Hasna Kerrouch, Youssef Zemmez, Rachid Frikh and Naoufal Hjira

Article Type: Clinical Image | First Published: March 19, 2023

Superficial lipomatous hamartoma is a rare congenital and benign tumor characterized histologically by the presence of lipoblastic fat cells around the vascular pathways. We report a new observation of an atypical localization of this entity....

 Open Access DOI:10.23937/2474-3682/1510211

Giant Infantile Xanthomas Revealing Familial Hypercholesterolemia

Sara Kerroum, Hajare Daakir, Mariame Meziane, Nadia Ismaili, Laila Benzekri and Karima Senouci

Article Type: Image Article | First Published: March 19, 2023

Xanthomas are benign pseudotumours, most often related to a disorder of lipoprotein metabolism, which require screening. Early diagnosis determines the prognosis and enables the prevention, detection and treatment of premature cardiovascular complications....

 Open Access DOI:10.23937/2474-3682/1510210

Hepatic and Lung Histiocytosis

ADIOUI Tarik, AZAMMAM Salma, ROKHSI Soukaina, TAMZAOURTE Mouna and SMAALI Jihane

Article Type: Medical Image | First Published: March 06, 2023

A 52-year-old male was admitted for abdominal pain. He had a personal history of tobacco. The physical examination and laboratory tests were normal. A thoraco-abdominal computed tomography scan (CT) reveals a combination of a thin walled pulmonary cystic lesion, and an hepatic hypodense subcapsular lesion....

 Open Access DOI:10.23937/2474-3682/1510209

Recurrent Florid Glandular Cystitis: Case Report (15 Years Follow Up)

Achraf Chatar, Jihad El Anzaoui, Ali Akjay and Abdelghani Ammani

Article Type: Case Report | First Published: February 24, 2023

Glandular cystitis is a differential diagnosis of malignant bladder tumors. Only the Pathological examination can be used to make a diagnosis. Glandular cystitis has no specific clinical manifestation. The clinical signs are not very specific and suggest bladder carcinoma. Principles of treatment for Glandular cystitis were used to treat these causative factors. Trans-urethral resection of the bladder pseudotumoral forms. The course of glandular cystitis is controversial and primarily focuses on...

 Open Access DOI:10.23937/2474-3682/1510208

Vocal Cord Edema Leading to Complete Airway Obstruction in a Case of Traumatic Difficult Airway

Koninica Sanyal and Abhishek Singh2

Article Type: Clinical Image | First Published: December 05, 2022

A 31-year-old male had presented to the emergency department after road traffic accident. Primary investigation revealed presence of right clavicle fracture, bilateral LeFort 2 and 3 fractures along with displaced mandible. He was intubated in view of poor GCS and threatened airway. After 2 days of mechanical ventilation, he was extubated and posted for open reduction and internal fixation for LeFort 2 and 3 fractures....

 Open Access DOI:10.23937/2474-3682/1510207

A Huge Chromophobe Renal Cell Carcinoma

Omar Jendouzi, Melang Alexis Mvomo, Larbi Hamdoune, Mohamed Alami and Ahmed Ameur

Article Type: Case Report | First Published: December 05, 2022

We report the clinical case of a 32-year-old female with no underlying disease who underwent in our structure a nephrectomy for a huge renal tumor. The histopathological finding revealed a chromophobe cell carcinoma and the evolution was favorable with no recurrence or metastasis....

 Open Access DOI:10.23937/2474-3682/1510206

A Lung Mass

J Smaali, R Lemouden, M Chiguer, N ElOmri, A ElKadiri, Y Sekkach and J Fatihi

Article Type: Image Article | First Published: October 21, 2022

A 29-year-old man with a history of bulbar ulcer treated 2 years previously and chronic smoking at 13 packs/year was hospitalized for respiratory symptoms made up of right basithoracic pain with cough and clear sputum without fever or progressive night sweats for six months in a context of deterioration in general condition. The clinical examination was unremarkable....

 Open Access DOI:10.23937/2474-3682/1510205

Branch Pulmonary Artery Stenosis in Chronic Myeloid Leukaemia: A Rare Presentation

Sudeb Mukherjee, MBBS, MD, DM and Suhana Datta, MBBS, MS

Article Type: Clinical Image | First Published: October 17, 2022

26-year-old lady admitted with shortness of breath and chest discomfort for last one and half months. She had no history of chest pain. She was not suffering from any major illness neither she was taking any medications on regular basis. On initial examination there was pallor and bipedal oedema. SpO2 was 94% in room air. Cardiovascular examinations reveal short systolic murmur in the pulmonary area with no radiation and continuous murmurs in left axillary area of same intensity. Chest examinati...

 Open Access DOI:10.23937/2474-3682/1510204

Unusual Presentation of Intramuscular Hemangioma in Anterior Abdominal Wall

Lobna Marsaoui, Lasaad Gharbi, Atef Mejri, Souhail Karwiya, Wael Ferjaoui, Dhouha Bacha

Article Type: Image in Medicine | First Published: July 07, 2022

The patient was a 15-year-old man with no known medical History. He had also no surgical history. Abdominal MRI with contrast showed a large intramuscular mass in the right anterior abdominal wall with presence of internal linear and nodular high T2 components....

 Open Access DOI:10.23937/2474-3682/1510203

Man with Sudden Loss of Consciousness

Mohammad Eftekhari, MD

Article Type: Image Challenge | First Published: May 16, 2022

A 51-year-old man with hypertension presented to the emergency department with sudden loss of consciousness (LOC). Two hours before presentation, his wife witnessed his abrupt collapse and called the emergency medical service....

 Open Access DOI:10.23937/2474-3682/1510202

Transcranial Color-Coded Duplex Ultrasonography in the Diagnosis of Brain Aneurysm

Issac Cheong, MD

Article Type: Clinical Image | First Published: April 28, 2022

A 50-year-old male with no relevant clinical history presented sudden headache accompanied by nausea, which evolved with facial paresis and drowsiness with a computed tomography (CT) showing bilateral subarachnoid bleeding, being admitted to the intensive care unit. We performed a transcranial color-coded duplex ultrasonography (TCCS) that showed the presence of a rounded image at M2 portion of the right middle cerebral artery (rMCA) that measured 20 mm × 21 mm with a positive color Doppler sig...

 Open Access DOI:10.23937/2474-3682/1510201

Simultaneous Complex Fracture of the Corpora Cavernosa Bilaterally with Total Disjunction of the Urethra: Case Report and Literature Review

Adil Mellouki, Ahsaini Mustapha, Mellas Soufiane, El-Ammari Jalal Eddine, Tazi Mohammed Fadl, Elfassi Mohammed Jamal and Farih Moulay Hassan

Article Type: Image Article | First Published: March 24, 2022

Penile fracture is a rare urological emergency described as the traumatic rupture of the tunica albuginea of an erect penis, it usually occurs during sexual intercourse. Patients typically report a sound at the time of the injury, described as a snapping sound, immediate detumescence, and subcutaneous hematoma. Prompt surgical exploration and corporal repair is the most effective therapy. Urethral injury associated with a penile fracture is reported to be between 2 and 27% of cases; this latter ...

 Open Access DOI:10.23937/2474-3682/1510200

When Hemophilia Comes Late: A Spontaneous psoas Hematoma Revealing Acquired Hemophilia a in a 50-Year-Old Woman

Adil Mellouki, Anas EL Allali, Rhyan Alami Ouadane, Ahsaini Mustapha, Mellas Soufiane, EL-Ammari Jalal Eddine, Tazi Mohammed Fadl, Elfassi Mohammed Jamal and Farih Moulay Hassan

Article Type: Case Report | First Published: March 19, 2022

Spontaneous hematoma of the psoas muscle is a rare entity whose incidence varies between 0.6% and 6.6% and is potentially fatal. Although hematomas of traumatic origin are reported, spontaneous hemorrhages are relatively more frequent. Spontaneous iliopsoas hematomas usually occur in patients with coagulopathy due to hemophilia or anticoagulants/antithrombotics. Clinically, patients present with pain in the right iliac fossa, groin or back, with a flexed hip and tenderness in passive extension, ...

 Open Access DOI:10.23937/2474-3682/1510199

CT Guided Biopsy Revealing Pseudotumoral Autoimmune Pancreatitis

Hajar EL AGOURI and Mustapha AZZAKHMAM

Article Type: Medical Image | First Published: March 19, 2022

Immunoglobulin G4-autoimmune pancreatitis (IgG4- AIP) is a relatively rare chronic inflammatory disease of the pancreas. The physiopathology of this disease is poorly understood and still unclear. Due to the lack of specific clinical symptoms and imaging findings, it is often misdiagnosed as pancreatic cancer which may lead to abusive surgery. Herein we are report a rare case of IgG4-AIP in a 70-year-old woman, admitted in hospital for chronic epigastric pain. Clinical investigations and CT-scan...

 Open Access DOI:10.23937/2474-3682/1510198

Tuberculous Pericardial Effusion in an Immunocompromised Patient- A Lethal Combination

Nishant Patel, Abhishek Singh, Rakesh kumar and Richa Aggarwal

Article Type: Clinical Image | First Published: March 09, 2022

A 23-year-old male was diagnosed with acute myelocytic leukemia was started on induction chemotherapy but despite treatment, he did not go into remission and developed fever, cough, and respiratory distress. He tested positive for COVID-19. Further investigation revealed the presence of pulmonary tuberculosis and antitubercular treatment was started. Two days later, he developed respiratory distress and 2D echocardiography along with High-resolution computed tomography was done which showed the ...

 Open Access DOI:10.23937/2474-3682/1510197

Tuberculosis Verrucosa Cutis Complicating Scrofuloderma in an Immunocompetent Child

Ihsane Hallab, Younes El Khachine, Abdessamad Sakkah, Abderrazak Jakar, Naoufel Hjira and Jalal El Benaye

Article Type: Case Report | First Published: January 26, 2022

Tuberculosis continues to be endemic in our country. Skin involvement would be underdiagnosed rather than rare. The combination of two clinical forms of skin tuberculosis is even rarer, especially in an immunocompetent boy. Young 11-years-old boy, with no tuberculosis contagion, has been presenting an asymptomatic plaque papulo-crouteuse on his right knee for 4 months (Figure 1 and Figure 2). Clinical examination reveals homolateral crural adenopathy; non-inflammatory, fistulized to the skin. Th...

 Open Access DOI:10.23937/2474-3682/1510196

A Rare Case of Primary Cutaneous Aspergillosis of the Scalp in an Immunocompetent Patient

I Hallab, A Kinany, H Kerrouch, H Titou, O Boudi, R Friekh, N Hjira and M Boui

Article Type: Case Report | First Published: January 26, 2022

Aspergillosis is a rare invasive fungal infection caused by numerous species of aspergillus. Few species of Aspergillus are pathogenic in human existence. The most frequent are aspergillus fumigatus and flavus. Cutaneous aspergillosis remain an uncommon form, it may be primary, affecting the site of skin trauma or secondary due to hematogenous spread from a contiguous anatomic location. Here we describe a rare case of primary cutaneous aspergillosis located on the scalp in an immunocompetent hos...

 Open Access DOI:10.23937/2474-3682/1510195

Atypical Seborrheic Keratosis of the Umbilicus

HAMICH Soumaya, BENAHMED Jihane, ZNATI Kaoutar and SENOUCI Karima

Article Type: Case Report | First Published: January 21, 2022

Seborrheic keratosis is one of the most common skin tumors. It most often presents as a light brown to brown nodule with a papillomatous or squamous surface. However, it may vary in color and shape and can thus resemble the pattern of other skin tumors. We report the case of an atypical seborrheic keratosis located at the umbilicus with misleading dermoscopy. We report the case of a 34-year-old female patient with a medical history of schizophrenia on antipsychotic medication. She presented to o...

 Open Access DOI:10.23937/2474-3682/1510194

Primary Cutibacterium Acnes Leptomeningeal Abscess Causing Focal Seizures

Waller S, Browning S, Pepper EM and Loewenthal MR

Article Type: Case Report | First Published: December 13, 2021

A previously well 71-year-old male presented with recurrent stereotyped episodes of right hemisensory disturbance, weakness, and expressive dysphasia lasting 10-20 minutes. Cognitive decline had been noted over the preceding 6-months. He was otherwise in good health with no history of infective symptoms or prior neurosurgical procedures. Interictal neurological examination was unremarkable. EEG was abnormal with asymmetrical slowing over the left hemisphere and he was commenced on sodium valproa...

 Open Access DOI:10.23937/2474-3682/1510193

Teleconsultation in COVID Era can be Unwholesome at Times

Bhushan Bhalgat, Suresh Singh, Pravin Kumar, Phanindra Kumar Swain, Kamal Kishore Lakhera and Raj Govind Sharma

Article Type: Images in Surgery | First Published: December 13, 2021

COVID-19 pandemic has led to a vast increase in the number of teleconsultations. These images alongside are a perfect example of misinterpreted diagnosis due to unwanted importance to radiological investigations without performing a proper clinical examination. The X-ray chest PA view (see Figure 1) was advised by family physician of the patient on a well-known multiplatform messaging app when the patient complained of 'chhati mai gaath hai' (translated to English: 'swelling in the chest'). Afte...

 Open Access DOI:10.23937/2474-3682/1510192

Candida Albicans Brain Microabscesses in a Preterm Neonate

António Bento Guerra, M Inês Nunes Marques, Sónia Antunes and Ana Serrano

Article Type: Clinical Image | First Published: November 20, 2021

We report the case of a male preterm at 27 weeks of gestational age, born by emergency cesarean section with 1195 g, of an untreated HIV-infected mother, with an unsupervised pregnancy. After immediate resuscitation, he was admitted to the neonatal intensive care unit (NICU). He was started on standard neonatal antiretroviral HIV prophylaxis and completed seven days of ampicillin and gentamicin. Due to Staphylococcus epidermidis late sepsis, he completed 21 days of cefotaxime and vancomycin, but...

 Open Access DOI:10.23937/2474-3682/1510191

Intraoperative Fluoroscopy for Central Venous Catheter Tip Position- “Use It When U Have It Modality”

Nishant Patel, Abhishek Singh, Saranlal AM and Naveen Bokinala

Article Type: Clinical Image | First Published: November 20, 2021

Central venous catheters (CVC) are a vital part of an anaesthetist’s armamentarium for resuscitation during intraoperative emergencies and they carry an inherent risk associated with tip malposition. Various sources recommend catheter tip position at the distant one-third of superior venecava (SVC) as ideal. Our principle concern is to place the tip above the pericardial reflection of SVC to avoid vascular erosion and consequent pericardial tamponade. There are multiple ways of ensuring that t...

 Open Access DOI:10.23937/2474-3682/1510190

COVID-19 Associated Cerebral Mucormycosis

Abhishek Singh, Kapildev Soni, Satish Kumar Verma and Anjan Trikha

Article Type: Clinical Image | First Published: October 30, 2021

A 33-year-old female was admitted to COVID ICU after testing positive for the disease with 7 days history of fever, cough, inability to open as well as pain in the left eye, and inability to speak with right sided hemiparesis. She was known diabetic and hypertensive. Clinical examination showed presence of multiple pus points in left infratemopral region. Its microscopic examination showed wide area of necrosis along with cluster of mucormycosis. Due to sudden deterioration of patients GCS, CECT...

 Open Access DOI:10.23937/2474-3682/1510189

Infected Multilocular Renal Cyst and its Challenging Approach

Carla Pereira Fontes, Andreia M Teixeira and Samuel Fonseca

Article Type: Medical Image | First Published: October 23, 2021

An 80-year-old woman with a history of metabolic syndrome, ischemic heart and cerebrovascular disease was admitted at the emergency department with asthenia and left abdominal and flank pain. She was on day 5th of empiric cefuroxime for urinary tract infection. On physical examination, the patient was febrile, but hemodynamically stable; an abdominal mass in the left flank was evident and painful on deep palpation; ipsilateral Murphy’s sign was present. Laboratory studies showed a marked eleva...

 Open Access DOI:10.23937/2474-3682/1510188

Incidental Acute Appendicitis due to Enterobius vermicularis

Mohammed Najih and Mohamed Fahsi

Article Type: Image Article | First Published: October 03, 2021

Simultaneous Enterobius vermicularis infection and appendicitis is rare. Nocturnal anal pruritus remains the most important clinical symptom of E. vermicularis infestation, a result of female pinworms laying eggs within the anal verge at night. Laparoscopic appendectomy is the definitive treatment for appendicitis, followed by either mebendazole or albendazole for complete pinworm eradication. A 20-year-old man presented to the emergency department with a 4-day history of pain in the right iliac...

 Open Access DOI:10.23937/2474-3682/1510187

A Rare Differential of a Large Abdominal Swelling!

Alhad Mulkalwar, Sujay Jaju and Jignesh Gandhi

Article Type: Image Article | First Published: October 03, 2021

A 42-year-old male presented with a gradually increasing round abdominal swelling following a blunt trauma to the abdomen 2 weeks back. The swelling was about 5 cm in size when first noticed, which gradually increased to its present size of around 20 cm (Figure 1). The swelling was accompanied with mild pain and discomfort, which increased with increase in size of the swelling. Clinical examination and radiological investigations revealed a large abdominal seroma. Owing to the size of the seroma...

 Open Access DOI:10.23937/2474-3682/1510186

Guide for Identification of Different Types of Hernias

Benatta Mahmoud

Article Type: Image Article | First Published: September 29, 2021

A 40-year-old man with left lumbar penetrating trauma 30 days ago. On the day of trauma, the urgency surgeon repaired multiple ileal injuries, and the patient returned home (Figure 1). We readmitted the patient because of left lumbar pain and sped up transit. Ultrasonography showed a retroperitoneal collection. Urography showed ureteral enteric communication We performed a left double J. Transit return to normality and lumbar pain disappeared. Three months later, we removed Double J removed. Go...

 Open Access DOI:10.23937/2474-3682/1510185

A Guide for Identification of Different Types of Hernias

Alhad Mulkalwar, Apoorva Doshi, Tanmay Jadhav and Samir Deolekar

Article Type: Image Article | First Published: September 29, 2021

A hernia is defined as an abnormal protrusion of a viscus or part of a viscus through a normal or abnormal opening in the cavity in which it is contained. It is an area of weakness or disruption of the fibromuscular tissues of the body wall. Inguinal hernia is the most common type of hernia (73%), followed by incisional (15%) and femoral hernia (7%). This article describes these common types of hernias with an example each, along with their major characteristics and identification points. This c...

 Open Access DOI:10.23937/2474-3682/1510184

A Guide for Identification of Ulcers of the Lower Limb

Alhad Mulkalwar, Apoorva Doshi and Samir Deolekar

Article Type: Image Article | First Published: September 18, 2021

An ulcer is defined as a breach in the continuity of the skin or a mucous membrane with molecular death of the cells due to underlying inflammation. Figure 1 depicts the different parts of an ulcer. The article describes four different types of ulcers of the lower limb commonly encountered in the surgical wards, with their major characteristics and markers of identification. There are certain distinct features to identify the trophic ulcer in Figure 2 on visual inspection. The location of the ul...

 Open Access DOI:10.23937/2474-3682/1510183

Vesico-Vaginal Fistulae

Benatta Mahmoud

Article Type: Image Article | First Published: September 18, 2021

42 years deaf virgin female consulted for urine permanent leakage through vagina. She had gynecologic surgery six months ago for uterine fibroids. Classic physical examination was limited. Digital touch and speculum and by methylene blue test, was not performed because the patient and her family did not agree. Diagnosis of vesico-vaginal fistula made mainly by radiology imaging (Figure 1 and Figure 2). Retrograde and mictionnal uretro-cystography showed a clear leakage of contrast from the bladd...

 Open Access DOI:10.23937/2474-3682/1510182

A Giant Bladder Stone in a Young Woman Complicated with Acute Renal Failure

Richepin TIDAHY, Ali KHAYAT, Oussama BENABDELHAK, Mustapha AHSAINI, Soufiane MELLAS, Jalal Eddine EL AMMARI, Mohammed FADLTAZI, Mohammed Jamal EL FASSI and Moulay Hassan FARIH

Article Type: Image Article | First Published: September 16, 2021

Bladder stones are an uncommon condition in women and according to the literature, less than 2% of all bladder stones occur in women. This condition is often overlooked because of its rarity, hence the diagnostic and therapeutic delay which can lead to potentially serious complications. Its treatment is essentially surgical and the choice between endoscopic, laparoscopic or open surgery methods depends mainly on the size of the stones and its etiology. In women, the occurrence of urinary bladder...

 Open Access DOI:10.23937/2474-3682/1510181

Congenital Absence of the Digital and Middle Phalanx

Okoye Ifeanyi Martins and Oluwatoyosi Mary Adeoye

Article Type: Clinical Medical Images | First Published: August 30, 2021

A-day-old neonate born through spontaneous vaginal delivery with a congenital absence of the digital phalanx of the thumb, index, middle and ring finger of the right hand. On physical examination, no other deformities were noted on the other part of the body. There was a history of intake of dry gin (alcohol) mixed with herbal medications (which she doesn’t remember the names) during the 1st trimester in multiple attempts to abort the pregnancy. There is no family history of similar condition ...

 Open Access DOI:10.23937/2474-3682/1510180

A Large Lipoma of Neck

Alhad Mulkalwar, Sujay Jaju and Samir Deolekar

Article Type: Image Article | First Published: August 21, 2021

A 30 year-old female presented with a gradually increasing painless swelling in the back of the neck, growing since the last two years. The swelling was about 2 cm in size when first noticed, which gradually increased to its present size (Figure 1). Examination revealed a large, soft, globular swelling in the back of the nape of the neck. Surface was lobulated and the margins were rounded, well defined and slipped under the finger. Fluctuation and transillumination tests were negative. The skin ...

 Open Access DOI:10.23937/2474-3682/1510179

Intrathoracic Extramedullary Hematopoesis in a Patient with Thalassemia Intermedia

Emine Afsin, MD

Article Type: Image Article | First Published: May 31, 2021

A 52-year-old male patient was referred to our outpatient clinic with complaints of cough, hemoptysis (minimal), and chest pain radiating to the back. The patient’s smoking history was five packs/year, and he was yet an active smoker. On physical examination, respiratory sounds and other system examinations were normal. In laboratory tests, the hemoglobin level was 6.7 g/dL, platelet was 986000 u/L, leukocyte was 13500 u/L, ferritin was > 2000 ng/ml, sedimentation was 2 mm/h, and C-reactive pr...

 Open Access DOI:10.23937/2474-3682/1510177

Association Pyoderma Gangrenosum and Systemic Lupus Erythematosus

A Rkiouak, PhD, I El Kassimi, MD, N Sahel, MD, M Zaizae, MD and Y Sekkach, PhD

Article Type: Image Article | First Published: April 26, 2021

19-year-old patient, follow-up for 8 years for SLE treated with hydroxychloroquine 400 mg/day and who had been in remission for a year. SLE diagnosis was based on the association of a malar rash, photosensitivity, lymphopenia, autoimmune hemolytic anemia, antinuclear antibodies positivity, anti-DNA antibodies identified and lupus nephritis. On December 2019, patient noticed a well-defined irregular popular lesion on left leg (Figure 1) associated with ulcerations appeared 1 month later. Treatmen...

 Open Access DOI:10.23937/2474-3682/1510176

Dyshidrotic Eczema: Difficulty of Etiological Diagnosis and Therapeutic Management

S. Belmourida, M. Meziane, N. Ismaili, L. Benzekri and K. Senouci

Article Type: Image Article | First Published: April 07, 2021

Dyshidrotic eczema or acute palmoplantar eczema is a common cause of hand and foot dermatitis in adults. It is a recurrent vesicular eruption affecting the soles, palms, or both. It is very pruriginous and generally appears suddenly. It creates vesicles that, on physical examination, can look similar to “tapioca pudding”, which is the characteristic clinical feature of this disorder. It is more common in young adults and affects men and women equally. In this report, we present the case of a...

 Open Access DOI:10.23937/2474-3682/1510175

Intravesical Stone Necklace

MZYIENE Mohammed, ZIBA Ouima Justin Dieudonné, ENNACIRI Soufiane, MARRAKCHI Jaafar, BENAAMAR Mohammed, RAJI Youness, AHSAINI Mustapha, MELLAS Soufiane, TAZI Mohammed Fadl, EL-AMMARI Jalal Eddine, ELFASSI Mohammed Jamal and FARIH Moulay Hassan

Article Type: Image Article | First Published: March 18, 2021

The incidence of bladder stones in Western countries is relatively low, most commonly found in developing countries due primarily to dietary factors. The most affected areas are the countries of the Middle East, North Africa and Thailand, Indonesia and Myanmar. We report the case of a 73-years-old patient, followed For Low Urinary Tract Symptoms (LUTS) treated by alpha- blocker complicated by acute urinary retention and finally carrier of a vesical catheter. The ultrasound exploration showed a p...

 Open Access DOI:10.23937/2474-3682/1510174

Giant Seborrheic Keratoses: An Historical Case

S. Belmourida, M. Meziane, N. Ismaili, L. Benzekri and K. Senouci

Article Type: Image Article | First Published: March 08, 2021

Seborrhoeic keratoses are benign tumors that mainly occur in the head and in the trunk. Their size generally varies from a few millimeters up to a few centimeters. Giant lesions are very rare but pose a problem in terms both of treatment and transformation. We report a case of giant seborrhoeic keratoses in an elderly man remarkable for their chronic evolution and their impressive size. We report the case of a 90-year-old man, with no particular past medical history, who presented with asymptoma...

 Open Access DOI:10.23937/2474-3682/1510173

Natal Teeth: Baby Born with Two Teeth

Rafia Jabbar, MBBS and Arsia Hanif, MBBS

Article Type: Image Article | First Published: March 04, 2021

A 27-year-old female gave birth to a baby boy via spontaneous vaginal delivery at term. The mother had an uneventful prenatal course. The APGAR scores were 9 at 1 minute, 9 at 5 minutes, and 10 at 10 minutes. The baby weighed 2.9 kgs, had no signs of distress, and had a normal head-to-toe examination. During examination of the oral cavity, crowns of two teeth were observed in the anterior mandible, i.e., in the lower jaw. The teeth exhibited grade II mobility. The gingivae, tongue, and buccal mu...

 Open Access DOI:10.23937/2474-3682/1510172

Patellar Epithelioid Malignant Peripheral Nerve Sheath Tumour (MPNST) Mimicking Sebaceous Cyst

Nurwahyuna ROSLI, TAN Geok Chin and Wan Syahira Ellani WAN AHMAD KAMMAL

Article Type: Image Article | First Published: March 04, 2021

A 75-year-old man presented with a slow-growing patellar swelling with no history of pain or trauma to the site. The mass was clinically diagnosed as sebaceous cyst as it is well-circumscribed and located at the dermal-subcutanoeus tissue junction. Macroscopic cut section of the 40 mm, encapsulated mass showed variegated tan-yellowish cut surface with areas of haemorrhage and necrosis (Figure 1a and Figure 1b). Microscopically, it was well-circumscribed, composed of lobules of neoplastic cells s...

 Open Access DOI:10.23937/2474-3682/1510171

Malignant Melanoma of Gingiva

Seck Birame and Diallo Moussa

Article Type: Image Article | First Published: March 04, 2021

A 57-year-old Senegalese woman consulted to us for a pigmented mass inside the oral cavity evolving since 10 months. She had history of repetitive traditional tattoousing thorns on the gingiva. Intraoral examination showed a large pigmented tumour extending from the right maxillary gingiva to the left maxillary gingiva. It was 7 × 4 cm in size, firm in consistency with slight bleeding on touch. The patient also presented sub-mandibular lymphadenopathies and significant weight loss. An incisiona...

 Open Access DOI:10.23937/2474-3682/1510170

Trichoscopic Features of a Folliculotropic Mycosis Fungoides: A Case Report

Asmae Abdelmouttalib, Mariame Meziane and Karima Senouci

Article Type: Image Article | First Published: February 10, 2021

Mycosis fungoides represents the majority of the primary cutaneous T-cell lymphomas. Folliculotropic Mycosis Fungoides (FMF) is an aggressive variant of Mycosis Fungoides (MF) with a tropism at the follicular epithelium. Trichoscopic features of FMF are rarely studied in the literature. A case of FMF of the scalp in a 38-year-old female is discussed. Folliculotropic Mycosis Fungoides (FMF) is an aggressive variant of mycosis fungoides characterized by preferential infiltration of the follicular ...

 Open Access DOI:10.23937/2474-3682/1510169

Extensive Calcinosis Cutis Universalis in a Patient with Systemic Lupus Erythematosus Associated with Lupus Panniculitis: A Case Report

Abdelmouttalib A, Sialiti S, Benzekri L and Senouci K

Article Type: Image Article | First Published: February 08, 2021

Calcinosis cutis is a condition in which calcium salts are deposited in the skin and subcutaneous tissue. It may be associated with connective tissue disease and rarely with lupus disease. We report a historical case of extensive calcinosis cutis universalis secondary to Systemic Lupus Erythematosus (SLE) associated with lupus panniculitis. Calcinosis cutis is a condition in which calcium salts are deposited in the skin and subcutaneous tissue. They constitute a heterogeneous group of connective...

 Open Access DOI:10.23937/2474-3682/1510168

Retronychia: About Two New Cases

Meryem Khalidi, Hasna Kerrouch, Mohammed El Amraoui, Naoufal Hjira and Mohammed Boui

Article Type: Image Article | First Published: February 05, 2021

Retronychia is a rare form of proximal incarnation of the nail plate, responsible for inflammation of the proximal suprungual fold. This little-known pathology is often found in the feet, and is often underdiagnosed. We report two new cases of this onychopathy, with an atypical location and mechanism of occurrence. A 24-year-old patient presented for 2 months a chronic paronychia of the proximal fold of the nail of the 3rd left finger, hindering the daily activities of the young soldier. The exa...

 Open Access DOI:10.23937/2474-3682/1510167

Atrial Septal Aneurysm Associated with Mitral Valve Prolapse Syndrome

Satyajit Singh, MBBS, MD, DM, Chandraprakash Thakur, MBBS, MD, Muneshwar Kumar, MBBS, MD , Manish Jain, MBBS, MD and Vishal Agrawal, MBBS, DNB

Article Type: Image Article | First Published: February 05, 2021

A 68-year-old male presented to the out-patient clinic with history of intermittent palpitations and fatigability for past seven months. On cardiovascular system examination, mid-systolic click and pan-systolic murmur grade III/VI were audible at the apex with radiation to the base of heart. Echocardiographic study revealed atrial septal aneurysm (Figure 1, Figure 2, Video 1 and Video 2), along with prolapse of Posterior Mitral Leaflet (PML) into left atrium (Figure 3 and Figure 4). Color-dopple...

 Open Access DOI:10.23937/2474-3682/1510166

Drug Rash with Eosinophilia and Systemic Symptoms Syndrome Associated with Isoniazid

M. Elqatni, J. Fatihi, M. Jira, Y. Sekkach, T. Amezyane, K. Ennibi and A. Abouzahir

Article Type: Image Article | First Published: February 04, 2021

A 57-year-old man, admitted for inflammatory back pain lasting for 03 months before admission in the context of weight loss and night sweats. The images showed spondylodiscitis D6-D7 with a collection whose paravertebral, biopsy favored location tuberculosis. Patient was put under antibacillary, quadruple (rifampin, isoniazid, ethambutol and pyrasinamide). 15 days after starting treatment, erythematous lesions squamous (Figure 1, Figure 2 and Figure 3) whole body with facial edema and jaundice. ...

 Open Access DOI:10.23937/2474-3682/1510165

Post Covid Skin Lesions

M. Elqatni, J. Fatihi, M. Jira, Y. Sekkach, T. Amezyane, K. Ennibi and A. Abouzahir

Article Type: Image Article | First Published: February 03, 2021

A 16-years-old patient, with no particular medical history, including no medication, admitted for erythematous lesions on the second right toe, papular lesions on the sole of the foot (feet si les 2 pieds) in addition to lesions on the palms of both hands, without fever or associated respiratory or digestive symptoms. An indepth medical interview revealed that the patient had a nasopharyngitis during the previous 3 weeks, that his sister had a dry cough and his father had a cough and anosmia. Th...

 Open Access DOI:10.23937/2474-3682/1510164

A Large Left Atrium Myxoma Presenting as ‘Positional Pre-Syncope’

Satyajit Singh, MBBS, MD, DM, Chandraprakash Thakur, MBBS, MD, Muneshwar Kumar, MBBS, MD, Samdish Sethi MBBS and Nitin Kashyap, MCh

Article Type: Image Article | First Published: January 30, 2021

A 45-year-old male was referred to the out-patient clinic of Cardiology department with complaints of recurrent lightheadedness and dizziness on standing and changing postures in bed for past 3 months. He was normotensive, and non-diabetic person with no history of chest pain, dyspnea, palpitations, TIA or stroke. His ECG was unremarkable. CVS examination revealed a low pitch, early diastolic sound along with a soft systolic murmur at the apex. 2D-Echocardiographic study revealed a large, pedunc...

 Open Access DOI:10.23937/2474-3682/1510163

A Case of Erysipelatoid Carcinomatous Lymphangitis of Skin Revealing Breast Adenocarcinoma

Asmae Abdelmouttalib, Sanae Sialiti, Mariame Meziane, Nadia Ismaili, Leila Benzekri and Karima Senouci

Article Type: Image Article | First Published: January 30, 2021

Cutaneous Carcinomatous Lymphangitis (CCL) is one of the rare clinical forms of cutaneous metastasis that generally occurs late in the history of the cancer. It is generally misrecognized and wrongly treated as antibiotic-resistant erysipele. Clinically, lesions are polymorphic and mimicking different skin diseases, thus delaying the diagnosis and the treatment. We report a case of CCL with atypical lesions. Skin metastases accounts for 2% of all metastases. During breast carcinoma, they occur i...

 Open Access DOI:10.23937/2474-3682/1510162

Myocardial Bridges a Forgotten Condition: A Review

Martín Ibarrola, MD

Article Type: Image Article | First Published: January 30, 2021

Myocardial Bridging (MB) is a congenital anomaly in which a segment of a coronary artery takes a “tunneled” intramuscular course under a “bridge” of overlying myocardium. The first reference of MB in coronary arteries, the association with angina and anatomically as referred by Reyman in 1737. Considered a “benign” finding since the myocardial bridge causes coronary artery narrowing during systole therefore myocardial bridges should not compromise blood supply to the musculature duri...

 Open Access DOI:10.23937/2474-3682/1510161

Infant's Black Hairy Tongue (Lingua Villosa Nigra)

Teresa L. Almeida and Dora Fontes

Article Type: Image Article | First Published: January 07, 2021

A two-month-old term female presented at routine pediatric consultation with painless dark discoloration of the tongue for two weeks. Gastroesophageal reflux and colic were present from one month of age and medicated with probiotics. Weight gain was steady in the 85th percentile with exclusive breast milk feeding. She was taking cholecalciferol. No family history or risk factors were identified....

 Open Access DOI:10.23937/2474-3682/1510160

Isolated Macrodactyly

Arsia Hanif and Sana Shahid

Article Type: Image Article | First Published: November 14, 2020

A 5-year-old boy was brought to the outpatient department by his parents with complaints of the enlarged index finger of the left hand since birth. According to the mother, at birth, the index finger of the left hand was larger and longer than the other fingers of the same hand. The index finger grew out of proportion since then. The parents gave no history of congenital anomalies, limb defects, overgrowth syndromes, or similar complaints in any of their family members. On general physical exami...

 Open Access DOI:10.23937/2474-3682/1510159

A Neglected Case of Popliteal Pterygium Syndrome Presenting in Adulthood

Shilpi Karmakar, M.Ch and Brijesh Mishra, M.Ch

Article Type: Image Article | First Published: October 26, 2020

Popliteal Pterygium Syndrome (PPS) is autosomal dominant syndrome with incomplete penetrance and variable expressivity. We report a case of 18-year-old female, who had repair of cleft of lip and palate in childhood, and now presented with paramedian bilateral lower lip pits. Examination revealed her to be a case of sporadic PPS. A comprehensive plan of management was formed, but the patient was lost to follow-up. We report the case for the purpose of educating the clinicians of this rare syndrom...

 Open Access DOI:10.23937/2474-3682/1510158

Large Left Atrium Myxoma Protruding into Left Ventricle

Sudeb Mukherjee, MBBS, MD, DM and Suhana Datta, MBBS, MS

Article Type: Image Article | First Published: October 21, 2020

44-year-old male presented with shortness of breath for last 8 months. He had history suggestive of paroxysmal nocturnal dyspnoea. He had no history of rheumatic fever and had no complains of chest pain, palpitation or syncope. His ECG revealed no significant abnormalities, Auscultation revealed mid diastolic rumbling murmur best heard in the apical region. This murmur was changing in intensity and duration along with positional changes from standing to supine. Tumour plop was audible distinctly...

 Open Access DOI:10.23937/2474-3682/1510157

Clinical Image: Porcelain Gallbladder

Nada Mustafa, MD and Shinil K Shah, DO

Article Type: Image Article | First Published: October 10, 2020

A 68-year-old man with a known history of cholelithiasis presented with worsening epigastric and right upper quadrant discomfort. He was afebrile, with mild leukocytosis (13.3 K/CMM) and normal liver function tests. Ultrasound and CT (abdomen/pelvis) showed cholelithiasis with gallbladder wall calcifications, arrow indicates calcifications) and an incidental 7 cm right renal mass. Patient underwent laparoscopic cholecystectomy in conjunction with laparoscopic radical nephrectomy. Intraoperative ...

 Open Access DOI:10.23937/2474-3682/1510156

Clinical Image: Gallstone Ileus

Nada Mustafa, MD and Shinil K Shah, DO

Article Type: Image Article | First Published: October 10, 2020

A 90-year-old lady with dementia, coronary artery disease, and hypertension and no prior abdominal surgeries presented with three days of nausea/vomiting. She had normal vitals and generalized abdominal tenA 90-year-old lady with dementia, coronary artery disease, and hypertension and no prior abdominal surgeries presented with three days of nausea/vomiting. She had normal vitals and generalized abdominal tenA 90-year-old lady with dementia, coronary artery disease, and hypertension and no prior...

 Open Access DOI:10.23937/2474-3682/1510155

Complications of Infective Endocarditis: Septic Emboli Induced Cavitary Lung Disease

Nathaniel Rosal, DO, Shafaq Tariq, MD and John C Madara, MD

Article Type: Image Article | First Published: October 09, 2020

A 29-year-old female with an extensive history of polysubstance abuse presented to an outside hospital for symptoms of myalgias, malaise, and a dry cough for one week in duration. Additional imaging was obtained, most notable for multiple cavitary lung lesions, a possible bronchopleural fistula, and tricuspid valve vegetation. The patient was transferred to our institution for consideration for cardiothoracic surgical intervention. Upon arrival, the patient was found to be hypoxic with an oxygen...

 Open Access DOI:10.23937/2474-3682/1510154

Dilated Pulmonary Artery Containing Swirling Smoke (SEC)

Sudeb Mukherjee, MBBS, MD, DM and Suhana Datta, MBBS, MS

Article Type: Image Article | First Published: September 23, 2020

Cases of dilatation of pulmonary artery in medical literature are not very uncommon. However presence of swirling smoke in dilated pulmonary arteries is very rare. Detection and management of such cases are very urgent to prevent fatal complications. Here I have reported one such rare case of dilated pulmonary artery with spontaneous echo contrast/smoke in a case of idiopathic pulmonary artery dilatation. 55-year-old female presented with shortness of breath on minimal exertion for last 4 months...

 Open Access DOI:10.23937/2474-3682/1510153

Subperiosteal Abscess with Pediatric Acute Osteomyelitis

Yuki Yoshida, MD and Atsushi Yoshida, MD

Article Type: Image Article | First Published: September 13, 2020

A previously healthy 9-year-old girl presented with a 3-day history of high fever (> 40 °C) and acute pain in the right shoulder. A blood chemical profile showed a C-reactive protein level of 9.7 mg per liter and a white cell count of 12,500 per cubic millimeter. Shoulder radiographs were normal, but magnetic resonance imaging showed acute osteomyelitis around proximal humeral epiphyseal plate and a subperiosteal abscess around the humeral neck (Figure 1). Vancomycin was empirically started aft...

 Open Access DOI:10.23937/2474-3682/1510152

Pacemaker Lead Vegetation

Sudeb Mukherjee

Article Type: Image Article | First Published: September 10, 2020

Pacemaker implantation has a very fascinating history. Since the first implantation of human pacemaker technological advancement has helped tremendously in the evolution of different types of pacemaker. Dedicated work by different scientist at different times has enriched the knowledge of several aspects of implantation gradually. Over the time the technology has been modernized to adapt the need of pacing in different clinical situations. However one thing remained constatnt throughout this lon...

 Open Access DOI:10.23937/2474-3682/1510142

Renal Artery Thrombosis Following Synthetic Cannabinoid Ingestion

Joyce L Ho, MD, Youhanna Gad, MD and Remus Popa, MD

Article Type: Image Article | First Published: February 29, 2020

Cannabis and synthetic cannabinoids have been associated with cardiovascular events including myocardial infarction, arrhythmias, and stroke. The psychoactive cannabinoid delta-9-tetrahydrocannabinol (THC) is a partial agonist for cannabinoid receptors found in the brain, vascular endothelium, liver, and adipose tissue. THC has been implicated in cases of cannabis arteritis and vasculopathy. We describe a case of acute renal artery infarction following synthetic cannabinoid ingestion, with succe...

 Open Access DOI:10.23937/2474-3682/1510151

Type A Aortic Dissection Presenting with Paraplegia & Urinary Retention

Sun Yong Lee, MD and Siamak Mehdizadehseraj, MD

Article Type: Image Article | First Published: August 31, 2020

A 60-year-old female with history of hypertension presented to the emergency department following a sudden fall while walking 3 hours prior. The patient was unable to move her both legs and unable to void. During evaluation, she also developed a sudden onset of sharp mid-sternal chest pain. Her blood pressure was 213/126 mmHg in right arm and 170/131 mmHg in left arm and heart rate was tachycardic at 110. Bilateral lower extremities motor strengths were not present with intact sensory functions....

 Open Access DOI:10.23937/2474-3682/1510150

Left Atrium Swirling Smoke (SEC) in TEE

Sudeb Mukherjee, MBBS, MD, DM and Suhana Datta, MBBS, MS

Article Type: Image Article | First Published: August 20, 2020

24-year-old male with very severe mitral stenosis of rheumatic etiology presented with one episode of transient left sided hemiparesis with full recovery within 24 hours. He was on optimum medical management that includes diuretics, beta blocker and digoxin. Her heart rate was 62/minutes and BP was 110/64 mm of Hg. She was also receiving injection benzathine penicillin once every three weeks. Transthoracic Echocardiography (TTE) was done which revealed thickened anterior and posterior mitral lea...

 Open Access DOI:10.23937/2474-3682/1510149

Septal CRT-D Pacemaker

Sudeb Mukherjee, MBBS, MD, DM

Article Type: Image Article | First Published: August 08, 2020

CRT-D implantation has become a standardised treatment for patients suffering from Heart Failure with reduced Ejection Fraction (HFrEF). Patients with left ventricular ejection fraction (LVEF) below 35% along with Left Bundle Branch Block (LBBB) pattern with wide QRS duration are the most benefitted one post placement. Implantation of CRT-D needs expertise so that proper left ventricular lead placement can be done. It also depends on anatomical suitability of Coronary Sinus (CS)....

 Open Access DOI:10.23937/2474-3682/1510148

Wandering Left Atrium Clot Ball

Sudeb Mukherjee, MBBS, MD, DM

Article Type: Image Article | First Published: August 06, 2020

43-year-old lady presented with shortness of breath for past 7 months. She had history suggestive of Paroxysmal Nocturnal Dyspnoea (PND). She had also few episodes of palpitations. She had no history of rheumatic fever in the past. On physical examination mid diastolic rumbling murmur was audible at the apex which changed with posture. There was no history of fever and/or any embolic manifestations. Electrocardiogram revealed left atrial abnormalities. Transthoracic Echocardiogram was done which...

 Open Access DOI:10.23937/2474-3682/1510147

Vitamin-K Dependent Protein Deficiency and Pseudoxanthoma Elasticum

Manish Kumar

Article Type: Image Article | First Published: July 25, 2020

27-year-old male referred from Dental clinic, due to asymptomatic incidental abnormal coagulation parameters. Clinical examination showed loose skin folds of axilla, anterior abdominal wall and chest which were suggestive of Pseudoxanthoma Elasticum. Rest systemic examinations WNL. Patient has similar family history. Coagulation profile showed PT-46 seconds, (control 12.50), INR 4.64 seconds, APTT 61.30 seconds (control 23.80), Mixing Studies-PT 13.8 seconds, PTT-29.7 Seconds....

 Open Access DOI:10.23937/2474-3682/1510146

A Rare Case of Idiopathic Petrified Ear or Calcified Pinna

Ranjit Meher, MBBS, MD, Varsha M Khalkho, MBBS, DNB, and Anwesha D Patel, MBBS, MDRD

Article Type: Image Article | First Published: July 23, 2020

Calcification or ossification of the auricular cartilage, also known as “petrified ears”, was first described by Bochdalek in 1866. In our article, a seventy-two years-old male was evaluated for stiffed left ear over few years. No obvious cause was demonstrated on laboratory tests. Calcification or ossification of the left external auricular cartilage was demonstrated on non-contrast temporal bone Computed Tomography (CT) scan and therefore a rare case of idiopathic petrified left ear was di...

 Open Access DOI:10.23937/2474-3682/1510145

RSOV in a 6-Year-Old Boy Diagnosed by TEE

Sudeb Mukherjee, MBBS, MD, DM and Suhana Datta, MBBS, MS

Article Type: Image Article | First Published: June 29, 2020

Ruptured Sinus of Valsalva (RSOV) is very rare in paediatric age group, 3rd decade being the usual presentation age. Patient may present with asymptomatic murmur to cardiogenic shock and fatal outcomes. High degree of suspicion and expertise is required to confirm or rule out diagnosis. Here we have reported a case of RSOV in 6-year-old boy who presented with features of hyperdynamic circulation. Transesophageal Echocardiography (TEE) images are shown here which confirm the presence of RSOV and ...

 Open Access DOI:10.23937/2474-3682/1510144

An Echocardiographic Image of a Massive RV Thrombus that Led to Circulatory Collapse in a Patient with COVID Pneumonitis

Shashank Danndhiganahalli, Nehal Patel and Nageswar Bandla

Article Type: Image Article | First Published: June 13, 2020

A 70-year-old gentleman with a background of ischaemic heart disease and esophagectomy was admitted to Critical Care Unit with hypoxemic respiratory failure secondary to COVID pneumonitis. Prior to Critical Care admission, he was discovered to have deep venous thrombosis and he was commenced on treatment dose low molecular weight heparin....

 Open Access DOI:10.23937/2474-3682/1510143

A Conservative Management of a Duodenal Diverticulitis

Wael Ferjaoui, Wafa Ghariani, Mohamed Ali Chaouch, Mehdi Khalfallah, Hichem Jerraya and Ramzi Nouira

Article Type: Image Article | First Published: April 30, 2020

We present the case of a 78-year-old female patient. Past medical history was unremarkable. She presented with abdominal pain in the epigastric and right upper quadrant region, associated with dyspepsia since 3 months before admission. Physical examination showed tenderness and distension of the abdomen without peritoneal signs. Blood tests showed elevated inflammatory markers (C-reactive protein = 60 mg/l and white blood cell = 19000/mm3). All other blood tests were normal Radiography of abdome...

 Open Access DOI:10.23937/2474-3682/1510141

Hemorrhagic Telangiectasia

Rkiouak, M Zaizae, I El Kassimi, N Sahel and Y Sekkach

Article Type: Image Article | First Published: February 13, 2020

A 45-year-old woman came to the internal Medical School A of Mohammed V Military Hospital, complaining of mild recurrent epistaxis related to telangiectasia at the nasal septum and chronic iron deficiency anemia requiring frequent blood transfusions with iron infusions. During his physical exam, we noticed telangiectasia lesions spread throughout her lower lip, tongue (Figure 1A), face, soft palate (Figure 1B) and outer ear (Figure 1C). Doing anterior rhinoscopy, we noticed hematic points on her...

 Open Access DOI:10.23937/2474-3682/1510140

Sporotrichoid Leishmaniasis

Ilyass ANOUAR, MD and Naoufal HJIRA, MD

Article Type: Image Article | First Published: October 24, 2019

A 39-year-old patient, who travels 2 years ago to a desert area in south-eastern Morocco, presented with an ulcerous and crusty plaque on his left leg. The clinical exam founds numerous, ulcerous and crusty nodules, confluent to form a plaque of about 5 cm long (Figure 1A), painless with some smaller satellite lesions (arrows) arranged on sporotrichoïd pattern (Figure 1B). Parasitological examination found numerous amastigotes within mononuclear cells and pathology shows a granulomatous infiltr...

 Open Access DOI:10.23937/2474-3682/1510139

Urine Sediment Abnormalities with Sedimax® Contrust PRO in CKD

Sulejmani A, Falbo R, Giacobone C, Spiti S, Sala MR and Brambilla P

Article Type: Image Article | First Published: September 07, 2019

Chronic Kidney Disease (CKD) is an increasing global public health problem and usually occurs as a silent disease, often diagnosed in advanced stages of renal dysfunction. An estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m2 and/or markers of kidney damage for > 3 months are the criteria that define CKD. Among the markers of kidney damage, urine sediment abnormalities are a simple means to facilitate the diagnosis of CKD. Chronic Kidney Disease (CKD) is an increasing global pub...

 Open Access DOI:10.23937/2474-3682/1510138

Left Atrial Mass

Umar Khan

Article Type: Image Article | First Published: August 22, 2019

81-year-old man presented with one day history of visual disturbance with associated chest discomfort. At the time of initial assessment his visual deficits had resolved. Initial CT brain showed area of hypoattenuation involving right occipital lobe concerning for an infarct. His background history included atrial fibrillation for which he was therapeutically anticoagulated with warfarin and INR was 2.7. Transthoracic echocardiogram showed a severely dilated leftatrium with a large mobile mass a...

 Open Access DOI:10.23937/2474-3682/1510137

Retained Foreign Body in Urinary Bladder Presenting as Acute Renal Failure

Asma Jamil MD, Ayesha Jamil MD, Rajesh Gulati MD and Alina Popa MD

Article Type: Image Article | First Published: August 03, 2019

A 57-year-old male with a past medical history of benign prostate hypertrophy (BPH) was admitted with altered mental status. Due to patient altered mental status history was obtained from family members. Patient used to live alone and was able to take care of his activities of daily living. He was found confused and covered in feces and urine by his family members. Last well known was 1 week ago. The patient was seen in hospital 5 years ago for urinary retention. A temporary Foley catheter was p...

 Open Access DOI:10.23937/2474-3682/1510136

A Great Mimicker of Acute Cholecystitis in Young Population: A Case Report and Literature Review

Mehmet Karagulle, Fatma Zeynep Arslan, Esra Bilgi, Suleyman Oncu1, Samet Simsek and Mehmet Oncu

Article Type: IMAGE ARTICLE | First Published: August 02, 2019

Gallbladder agenesis is a rare biliary anomaly which can be important for patients complaining of chronic abdominal pain. Gallbladder agenesis can mimic cholecystitis by causing recurrent upper abdominal pain and tenderness. In a significant number of patients with gallbladder agenesis, unnecessary surgical procedures are performed because of the misdiagnosis. The morbidity of the disease can reduce, since the correct diagnosis of gallbladder agenesis decrease unnecessary surgical procedures. Th...

 Open Access DOI:10.23937/2474-3682/1510135

Rhabdomyosarcoma of the Tongue


Article Type: IMAGE ARTICLE | First Published: June 29, 2019

The clinical examination finds an exophytic mass at the expense of the tongue, measuring 3 by 2 cm in diameter. The mass is of muscular consistency, not painful, deeply indurated extending on the left edge of the tongue with infra-centimeter and sub-mandibular cervical lymphadenopathy. The examination also finds 6 coffee-and-milk spots. A CT scan was immediately performed, showing a lingual process weakly heterogeneously after injection of contrast medium, measuring approximately 35*45 mm locall...

 Open Access DOI:10.23937/2474-3682/1510134

Hemophagocytic Lymphohistiocytosis

Nwabundo Anusim

Article Type: IMAGE ARTICLE | First Published: June 20, 2019

A 66-year-old male with a history of sarcoidosis, chronic kidney disease, hodgkin's and non-hodgkin's lymphoma presents with shortness of breath and lethargy after failing outpatient treatment of an upper respiratory tract infection. White count on admission was 2.6 (3.5 -10bil/l), with normal absolute neutrophil count (ANC) and hemoglobin was 9.9 (13.5-17 g/dl). During the course of his admission, he was found to have a fever of 101.5 and progressive pancytopenia {ANC 0.9 (1.6-7.2 bil/L)....

 Open Access DOI:10.23937/2474-3682/1510133

Cobra Head Sign

Yih Chyn Phan and Wasim Mahmalji

Article Type: IMAGE ARTICLE | First Published: June 20, 2019

A 62-year-old man was referred by his general practitioner to the urology outpatient clinic as his routine blood test showed a raised prostate-specific antigen (PSA) of 10 ug/l. On further questioning, he has minimal lower urinary tract symptoms and there was no symptom to suggest that he had a urinary tract infection recently. Examinations of his abdomen and male genitalia including a digital rectal examination were normal. As recommended by the latest National Institute for Health and Care Exc...

 Open Access DOI:10.23937/2474-3682/1510132

A Human Oocyte Stained for Zona Pellucida Glycoproteins

Mario Sousa

Article Type: Image Article | First Published: March 21, 2019

Donor surplus human oocytes were transferred to adhesive slides. Oocytes were fixed with 1% paraformaldehyde in PBS. For permeabilization, cells were incubated in 0.1% Triton X-100 (Sigma) plus 0.1% sodium citrate in PBS. Cells were then incubated with 5% Bovine Serum Albumin (BSA; Sigma) to inhibit non-specific binding. Afterwards cells were incubated with a primary monoclonal antibody against human ZP1 (ZP1: sc-365435...

 Open Access DOI:10.23937/2474-3682/1510131

The Rare but Fatal Connection: Atrio-Esophageal Fistula

Tom Kai Ming Wang and Jen-Li Looi

Article Type: Image Article | First Published: March 20, 2019

A 64-year-old man underwent catheter ablation for atrial fibrillation (AF) a month ago, which involved isolation of pulmonary veins with wide area circumferential ablation and posterior left atrial wall with roof and inferior line at 30-35 watts radiofrequency energy delivery. He presented initially with fever and palpitation, but subsequently collapsed with ventricular tachycardia and transient lateral ST elevation on electrocardiogram, and developed dysphasia with right arm weakness. Transthor...

 Open Access DOI:10.23937/2474-3682/1510130

Subarachnoid Hemorrhage due to a Ruptured Arteriovenous Malformation

J Kelly Smith

Article Type: IMAGE ARTICLE | First Published: March 08, 2019

Brain arteriovenous malformations (bAVMs) have an estimated prevalence of 10-18 per 100,000 persons. They consist of a nidus which connects arteries and veins in the absence of an intervening capillary bed. The absence of a capillary network allows for high-flow AV shunting that can be sufficient in some cases to increase cardiac output and cause a systolic-diastolic bruit heard over the ipsilateral cranium, eye, and/or forehead. Resulting shear stresses on the vessel walls can dilate and cause ...

 Open Access DOI:10.23937/2474-3682/1510129

Stages of Oral Cancers Images Associated with Tobacco and Other Social Behaviours among Patients in Banglore State, India

Prerna Thaker, Peter Asaga Mac and Ravi Rao J

Article Type: IMAGE ARTICLE | First Published: February 27, 2019

Cancer has slowly but steadily become one of the most common causes of morbidity and mortality today. World over the burden of cancer is distributed unequally between developed and developing countries with cancer types exhibiting different patterns of distribution. In India the five most frequent cancers were cancer of the lung, lip and oral cavity, other pharynx, esophagus and stomach. The incidence of oral cancer in India is about 3-7 times more common as compared to other developed nations o...

 Open Access DOI:10.23937/2474-3682/1510128

Necrotizing Nasal and Sinus Inflammation in an Adult Diabetic Patient with Ketoasidosis

Nasuhi Engin Aydin, MD, Haktan Altinova, MD

Article Type: IMAGE ARTICLE | First Published: February 27, 2019

A 58-year-old poorly controlled diabetic and hypertensive male patient with ketoasidosis was admitted to the ENT clinic due to ptosis and edema of left eyelid and facial pain of nine days. Paranasal sinus CT revealed destruction of the left maxillary, ethmoid and sphenoid sinuses. MRI also showed erosion of the lateral, medial and inferior orbital walls. Surgical debridement of the sinuses and left nasal cavity were performed following a rapid endoscopic diagnostic biopsy from the necrotic tissu...

 Open Access DOI:10.23937/2474-3682/1510127

Pulmonary Ultrasonography: Its Usefulness in Differentiating Pneumothorax vs. Bulla Pulmonar Gigante

Jose Luis do Pico and Miguel Angel Landa

Article Type: Image Article | First Published: January 30, 2019

A 66-year-old patient with air flow chronic obstructive who attends the emergency service due to aggravation of his usual restlessness and dyspnea. He recorded multiple admissions in the last year for the same reason, requiring mechanical ventilation and tracheotomy. It enters from the emergency service to the Critical Care Unit poorly perfused, lucid with restlessness, intermittent paroxysmal atrial tachycardia on the electrocardiogram. There is no air intake in both hemithorax. Non-invasive ve...

 Open Access DOI:10.23937/2474-3682/1510126

A Ghost Behind the Rectum: Extramedullary Hematopoiesis Diagnosed by Endoscopic Ultrasound Fine Needle Biopsy

Silvia Carrara, Daoud Rahal, Alessandro Fugazza, Milena Di Leo and Alessandro Repici

Article Type: Image Article | First Published: January 30, 2019

A 76-year-old woman underwent abdominal CT (Figure 1) to explore anemia and fatigue after negative results from upper and lower GI endoscopy. CT scan showed a large heterogeneous pre-sacral mass with a long axis of 60 mm. At digital rectal examination a solid mass was palpable from the posterior rectal wall. At rectal endoscopic ultrasound (EUS), the mass showed an intense hyperechoic in homogeneous echotexture, with hypovascularization and with a soft pattern at elastography (Figure 2)....

 Open Access DOI:10.23937/2474-3682/1510125

Young Woman with a Foreign Body into the Bladder

Kostas Chondros, Ioannis Konsolakis and Konstantinos Graikos

Article Type: Image Article | First Published: December 29, 2018

Bladder's foreign bodies represent an uncommon finding in patients with lower urinary tract symptoms. In most of the cases, patients report themselves the induction of a foreign object into their bladder and it is usually related to altered sexual behavior. These foreign bodies may vary from small everyday objects to larger ones such as catheters or wires. We present a case of a young woman with a history of neurogenic bladder who accidentally misplaced a single-use catheter into her bladder dur...

 Open Access DOI:10.23937/2474-3682/1510124

Utility of Functional MRI and 3D Tractography in Presurgical Planning in Patients with Glioblastoma

Chaudhry Ammar, Badie Behnam, Jandial Rahul, Chen Mike, Korn Ron and Rahmanuddin Syed

Article Type: Image Article | First Published: December 07, 2018

Glioma (astrocytoma) is one of the most common primary intra-axial CNS neoplasm and glioblastoma (GBM) is the most aggressive form of astrocytoma (grade IV). According to Central Brain Tumor Registry of the United States (CBTRUS), GBM is the most common primary malignant primary CNS neoplasm with median survival of only 15 months. With emergence of new treatment options on the horizon, imaging precision is important to treatment planning. In this mini-review, we aim to demonstrate utility of eff...

 Open Access DOI:10.23937/2474-3682/1510123

Rare Case of Lung Adenocarcinoma Invading the Inferior Vena Cava with Neoplastic Thrombus Extending into the Right Atrium

Miriam Patella, Francesco Proietti, Francesco Mongelli and Stefano Cafarotti

Article Type: Image Article | First Published: November 26, 2018

Lung cancer, Inferior vena cava thrombosis, Right atrium thrombosis. A 40-years-old patient with M1a lung adenocarcinoma. CT scan showed a mass directly invading the inferior vena cava (IVC) with neoplastic thrombus in the right atrium (Figure 1A and Figure 1B). Echocardiogram confirmed solid mass floating in the right atrium, connected with tumour invading the IVC (Figure1C)....

 Open Access DOI:10.23937/2474-3682/1510122

Pressure Ulcers due to a Tunneled Central Venous Catheter in a Patient on Chronic Maintenance Hemodialysis

Gaetano Alfano, Ferrari Annachiara , Francesco Fontana and Gianni Cappelli

Article Type: Image Article | First Published: November 26, 2018

We describe a rare complication given by tunneled central venous catheter in a 95-years-old woman on chronic maintenance hemodialysis (HD). The cause of end-stage renal disease was hypertensive nephrosclerosis. She suffered from ischemic heart disease and mild cognitive impairment. Her weight was 85.9 Ib (39 kg), resulting in a body mass index (BMI) of 18.1 kg/m2. She started hemodialysis in 2002 at age of 79-years-old with a dialysis regimen of 3 hours and a half, three days a week....

 Open Access DOI:10.23937/2474-3682/1510121

A Case of Gastric Obstruction: A Giant Stomach

Yao Yu and Yisen Zhang

Article Type: Image Article | First Published: November 24, 2018

A seventeen-month-old boy presented with a seven-day history of vomit and abdominal pain. After treatment of prokinetics agents, his symptoms of vomiting remitted. However, he began to have continuous abdominal distension with worse mental status and his stomach is giant. Gastric obstruction was caused by eating myrica rubra. The patient have congenital malformation which make the condition even worse. Gastric obstruction complicated with congenital malformation is easy to be misdiagnosed in chi...

 Open Access DOI:10.23937/2474-3682/1510120

Blue Urine

Lorna Ting and Liew Yew Toong

Article Type: Image Article | First Published: November 24, 2018

A 25-year-old gentleman presented with recurrent right lower neck swelling for 2 years. The recurrent attack of infections were always precipitated by upper respiratory tract infection. On clinical examination, there was a cystic swelling located at right lower neck, and anterior to sternocleidomastoid muscle. It measured 5 cm by 5 cm in diameter, with a sinus opening (Figure 1). Computed Tomography fistulogram of the neck showed similar findings that was suggestive of branchial cleft cyst witho...

 Open Access DOI:10.23937/2474-3682/1510119

Midgut Volvulus: The Whirlpool and Corkscrew Signs

Jessica Kris and Monica Epelman

Article Type: Image Article | First Published: November 03, 2018

An 8-week-old male was referred to the emergency room from his primary care physician, with bile-tinged vomiting since birth increasing in frequency over the past 2 days. He was born at 39 weeks via spontaneous vaginal delivery, and has been otherwise a healthy child. His examination was rather unremarkable; his vitals were stable, he was mildly dehydrated, but alert, and had a soft, non-tender, non-distended abdomen with normal bowel sounds. The clinical concern was for pyloric stenosis, so an ...

 Open Access DOI:10.23937/2474-3682/1510118

Electric Stimulation of Human Nasal Conchae towards Reproduction of Olfactory Sensations

Kasun Karunanayaka, Sharon Kalu Ufere, Hanis Camelia and Adrian David Cheok

Article Type: Image Article | First Published: October 31, 2018

The human nose is a complicated and smart part of the chemosensory system. Humans have multifaceted olfactory bulbs and orbitofrontal cortices, which provide them with more sensitive and dynamic abilities for the sense of smell, and as such humans could detect at least 1 trillion different smells. In the olfactory epithelium, odour molecules bind to olfactory receptors which are expressed in olfactory sensory neurons in the nose. Once an odorant binds to the receptor, the olfactory receptors tri...

 Open Access DOI:10.23937/2474-3682/1510117

An Unusual Cause of Lung Micro-Nodules: Pulmonary Ossification

Caio Julio Cesar dos Santos Fernandes and Christina Shiang

Article Type: Image Article | First Published: October 04, 2018

An 81-years-old patient presented himself with dyspnea on exercise and dry cough, for 3 months. He was being treated to Waldenstrom's Macroglobulinemia in the prior 6 months and had non-requiring dialysis chronic renal failure as a consequence of the disease. High-resolution CT scan showed pulmonary micro-nodules with some predominance in the bronchial-vascular axis (Figure 1). Due to the findings in the CT scan and the high prevalence of the disease in Brazil, the patient was being treated empi...

 Open Access DOI:10.23937/2474-3682/1510116

Bilateral Isolated Lateral Semicircular Canals Aplasia: MRI Findings

Serdar Arslan, Hasan Erdogan, Mehmet Sedat Durmaz, Fatma Zeynep Arslan, Fatih Oncu and Ismet Tolu

Article Type: Image Article | First Published: October 04, 2018

A 38-year-old man was admitted to our department due to recurrent sensations of imbalance and vertigo for two years. Moderate bilateral sensorineural hearing loss was detected. Magnetic resonance imaging demonstrated bilateral isolated aplasia of the lateral semicircular canals (Figure 1). Bilateral superior and posterior semicircular canals were normal. No cochlear malformation and no pathological contrast enhancement were detected. The internal auditory canal and the cerebellopontine angle wer...

 Open Access DOI:10.23937/2474-3682/1510115

Coronary-Bronchial Collaterals in Chronic Thromboembolic Pulmonary Hypertension

Caio Julio Cesar dos Santos Fernandes, Monique S Pessi, Ellen Pierre de Oliveira, Daniela Calderaro and Rogerio de Souza

Article Type: Image Article | First Published: October 03, 2018

Chronic thromboembolic pulmonary hypertension (CTEPH) is a form of hypertension pulmonary due to a mechanical obstruction of pulmonary arteries, which is caused by organized fibrotic thrombi. Consequences of pulmonary artery obstruction are an increase in pulmonary vascular resistance with pulmonary hypertension and heart failure. The main chest CT findings in CTEPH are the artery pulmonary enlargement and failure fill branches. Since there is a network of anastomotic channels linking the pulmon...

 Open Access DOI:10.23937/2474-3682/1510114

Meyerson Phenomenon Simulating a Halo Nevus

Salma Salim, Senouci Karima, Znati Kaoutar and Badredine Hassam

Article Type: Image Article | First Published: October 01, 2018

Meyerson phenomenon (MP) is an uncommon clinical condition that is characterized by an eczematous halo surrounding a preexisting melanocytic nevus (MN) and numerous other lesions. The etiology is unknown and the main concern is malignant transformation. We report an original case of a MP simulating a halo nevus. MP is an uncommon clinical condition that is characterized by an eczematous halo surrounding a preexisting MN and numerous other lesions. We report a case of a 40-year-old woman, with no...

 Open Access DOI:10.23937/2474-3682/1510113

Cavernous Hemangioma of Spinal Cord: A Clinical Image

Seyed Ahmad Mirhosseini, Mohammad Ebrahim Ghanei, Ehsan Zarepur and Reza Bidaki

Article Type: Image Article | First Published: October 01, 2018

The patient is a 40-year-old married man was referred with the complaint of low back pain. The pain was referred to proximal of lower limbs. Past medical history was negative. The cranial nerves exam were normal. The first diagnosis was a discal hernia. After lumbar MRI, a thickening was determined in the upper section. Therefore, another MRI with gastrographine was done for upper parts. A mass was detected in spinal foramen. Following surgery, the extradural lesion without extension to vertebra...

 Open Access DOI:10.23937/2474-3682/1510112

Purpura Fulminans and Refractory Shock in a Child

Madhuradhar Chegondi and Adalberto Torres

Article Type: Image Article | First Published: September 29, 2018

A previously healthy, 5-year-old boy was visiting the USA from Europe one week ago. He presented to our hospital with 18 hours history of high-grade fever, rash, vomiting, and progressive lethargy. On physical exam, he was obtunded, febrile, tachycardic, tachypneic, hypotensive and with a nonblanchable purpuric rash on the face and extremities. A possibility of Meningococcemia considered. Fluid resuscitation, broad-spectrum antibiotic therapy started after obtaining blood cultures. Vasopressor t...

 Open Access DOI:10.23937/2474-3682/1510111

Coronary to Pulmonary Artery Fistula as a Main Source of Pulmonary Blood Flow in Pulmonary Atresia and Ventricular Septal Defect

Isam Bsisu, Ali Abualhija and Iyad Al-Ammouri

Article Type: Image Article | First Published: September 28, 2018

We report a large fistula between left main coronary artery and pulmonary trunk as major source of pulmonary blood flow in a patient with pulmonary atresia and ventricular septal defect.Pulmonary atresia with ventricular septal defect is associated with variable aortic to pulmonary arterial connections. Coronary artery to pulmonary artery collaterals are rare sources of pulmonary blood flow, and when present, they are associated with other major aortopulmonary collaterals, and will have no signi...

 Open Access DOI:10.23937/2474-3682/1510110

Giant Congenital Melanocytic Nevus: About a Case

Salma Salim, El Meknassi Ilham, Sqalli Asmae and Badredine Hassam

Article Type: Image Article | First Published: September 27, 2018

Giant congenital melanocytic nevi (GCMN) are a rare occurrence. They arise from mutations in either BRAF or NRAS genes. The major complications associated with GCMN are malignant melanoma and neurocutaneous melanosis. Management of GCMN is symptomatic. We present a rare case of a 20-year-old woman born with GCMN. Congenital melanocytic nevi (CMN) are large brown-to-black skin lesions caused due to genetic mutations which leads to abnormal proliferation of embryonic melanoblasts....

 Open Access DOI:10.23937/2474-3682/1510109

Significance of 3D Imaging in Oncologic Assessment

Rahmanuddin Syed, Korn Ron, Cridebring Derek, Burkett Doug and Von Hoff Daniel

Article Type: Image Article | First Published: September 27, 2018

3D Advanced imaging including Artificial Intelligence is becoming very important tool in diagnosing cancer and playing vital role in surgical and oncological assessment. This technology is advancing further to play major role in the early detection of the cancer. In this picture author is showing pancreatic cancer and its relationship with the vessels which elaborate the tumor growth and severity on each pixel basis. Pancreas on image shows tumor on the right hand side in green (Figure 1). Showi...

 Open Access DOI:10.23937/2474-3682/1510108

Revision Total Hip Arthroplasty Surgery with a Modular Coned Hemipelvic Implant in a Young Patient for the Treatment of Septic Hip Arthroplasty

Bahtiyar Haberal, Orcun Sahin and Huseyin Demirors

Article Type: Image Article | First Published: September 26, 2018

38-year-old male patient who had total hip arthroplasty surgery for the treatment of coxarthrosis 5 years ago due to a childhood hip septic arthritis was admitted to our department. He had a complaint of left hip pain while walking and infected drainage from the iliac region which had started approximately 6 months ago (Figure 1A). After the laboratory results of high sedimentation rate and C-reactive protein and positive culture of drainage, the patient was operated again with the diagnosis of ...

 Open Access DOI:10.23937/2474-3682/1510107

Long-Term Outcome of Oncologic Right Pulmonary Artery Occlusion

Daniel B Takizawa, Alexandre Kawasaki and Caio J Fernandes

Article Type: Image Article | First Published: September 03, 2018

A 53-year-old female presented chronic dry cough and mild dyspnea, for 6 months. Due to an erroneous interpretation of CT findings (Figure 1A), she was diagnosed as pulmonary embolism, but without improvement with 6 months of anticoagulation. Evaluated at our service with progressive dyspnea, CTPA demonstrated complete occlusion of the right pulmonary artery (Figure 1A and Figure 1B). At echo, initial systolic pulmonary artery pressure 30 mmHg, not suggestive of pulmonary hypertension. A biopsy ...

 Open Access DOI:10.23937/2474-3682/1510106

Incidental Breast Carcinoma in Myocardial Perfusion Imaging Cine Mode

Aylin Akbulut, Suleyman Kalayci, Gokhan Koca and Meliha Korkmaz

Article Type: Image Article | First Published: September 03, 2018

Review of raw data cine mode is essential in the interpretation of myocardial perfusion SPECT imaging (MPI) for not only distinguishing the potential artifacts but also giving further diagnostic information by identifying incidental non-cardiac uptakes. Here, we report an incidental finding of invasive breast carcinoma detected during MPI cine mode....

 Open Access DOI:10.23937/2474-3682/1510105

Mapping of M2 and 5-HT1A Receptors in the Human Amygdala

Olga Kedo, Karl Zilles, Nicola Palomero-Gallagher and Katrin Amunts

Article Type: Image Article | First Published: September 03, 2018

Subdivisions of the amygdala were identified in the color-coded receptor autoradiographs immediately adjacent to Nissl-stained sections in the right hemisphere at the level of the central nucleus. Color scales visualize the concentrations for each receptor (cholinergic muscarinic M2 or serotoninergic 5-HT1A receptors). After incubation of 20-μm thick coronal sections with the respective tritium-labelled ligand and exposition of the sections against the tritium-sensitive films, the films were de...

 Open Access DOI:10.23937/2474-3682/1510104

Coronary Artery Ectasia in Patients Presenting with Acute Coronary Syndrome, A Mini Case Series: Presentation, Angiographic Findings and Management

Marian SOBHI, Harb ABUBARKA and Nadim SHAH

Article Type: Image Article | First Published: September 01, 2018

Coronary artery ectasia (CAE) is defined as dilatation of the coronary artery one and a half times greater than that of an adjacent normal segment [1]. It usually accompanies coronary artery disease (CAD). Our objective in this study was to examine the clinical characteristics of CAE and its prognosis. We recognized CAE in five patients between February 2016 and June 2016 admitted to Rashid Hospital, Dubai, United Arab Emirates. The patients presented with chest pain and were diagnosed as acute ...

 Open Access DOI:10.23937/2474-3682/1510103

An Unusual Variant of Cutaneous Sarcoidosis

Mansouri Siham, Sqalli Asmaa, Ismaili Nadia, Benzekri Laila, Hassam Badr and Senouci Karima

Article Type: Image Article | First Published: August 29, 2018

Sarcoidosis is a multisystem inflammatory disease of unknown etiology, characterized by noncaseating granuloma variably infiltrating the respiratory tract, ganglions, eyes, internal organs and the skin. The heterogeneity of cutaneous sarcoidosis represents a diagnostic challenge for physicians and affirms its reputation as a "great imitator". Common specific lesions associated with sarcoidosis are papules, plaques, nodules, scar sarcoidosis and lupus pernio. Atypical presentations of sarcoidosis...

 Open Access DOI:10.23937/2474-3682/1510102

Chronic Splenic Q Fever?

Gianfilippo Nifosi and Mariateresa Zuccarello

Article Type: Image Article | First Published: August 09, 2018

A 53-year-old man, with history of paranoid schizophrenia, depression, alcohol abuse, type 2 diabetes mellitus, comes to our observation for the discovery of focal splenic lesions. He presented fatigue and weight loss. Her past clinical history was negative for infection, abdominal pain, fever or sweat. Physical examination was characterized by cachexia in the absence of lymphadenomegaly and hepatosplenomegaly. Laboratory tests was negative, except for the C. burnetii antibodies (phase I IgG 1/1...

 Open Access DOI:10.23937/2474-3682/1510101

The Neumann Type of Pemphigus Vegetans

Ahmed Bouhamidi, Youssef Zemmez, Hafsa Chahdi, Mohamed Oukabli and Naoufal Hjira

Article Type: Image Article | First Published: August 09, 2018

Pemphigus vegetans is a variant of pemphigus vulgaris and is the rarest form of pemphigus. It is classified based on the clinical picture and evolution as the Neumman type or Hallopeau type. We report a 50-year-old woman with a Neumann type of pemphigus vegetans who was successfully treated with corticosteroids....

 Open Access DOI:10.23937/2474-3682/1510100

Ellis Van Creveld Syndrome - A Diagnosis to be Considered in Every Case of Polydactyly

Praneet Lale, Neeraj Aggarwal, Mridul Agarwal, Raja Joshi and Reena Joshi

Article Type: Image Article | First Published: August 04, 2018

1 year 2-months-old female child presented to our institution with complains of rapid breathing, failure to gain weight and increase precordial activity. There is no history of consanguineous marriage. Antenatal, natal and post-natal history were not contributory. Elder sibling had similar history. On general examination patient had a short stature with bilateral postaxial polydactyly of hands and feet (Figure 1a and Figure 1b). Cardiovascular examination revealed increased precordial pulsations...

 Open Access DOI:10.23937/2474-3682/1510099

Penile Squamous Cell Carcinoma

Ahmed Bouhamidi, Mohamed El Amraoui, Mustapha Azzakhmam, Mohamed Oukabli and Naoufal Hjira

Article Type: Image Article | First Published: August 02, 2018

Penile tumors are the rarest tumors of the male urogenital tract (1%). Squamous cell carcinoma is the most common histological type. Squamous cell carcinoma of the penis is most often presents between 50 and 70-years-old. Early diagnosis is imperative to avoid lymphatic spread that is associated with poor prognosis. We report the case of a 56-year-old man with squamous cell carcinoma of the penis present for 6 years....

 Open Access DOI:10.23937/2474-3682/1510098

Huge Aneurysmal Bone Cyst of the Sacrum: A Case Report and Review of the Literature

Hasan Erdogan, Mehmet Sedat Durmaz, Serdar Arslan, Fatih Oncu, Fatma Zeynep Arslan and Ismet Tolu

Article Type: Image Article | First Published: July 27, 2018

A 20-year-old man presented with a 2-year history of severe pain in his sacral region. He described an intermittent pain of moderate to severe intensity, localized in the left flank region, increasing at night. Pain is partially relieved by rest, supine position and is lately associated with a limp. Magnetic Resonance Imaging (MRI) revealed an expansive destructive cystic lesion at the S1, S2 and S3 vertebral levels, lesion's close association with S1 and S2 sacral nerve roots, and extending pos...

 Open Access DOI:10.23937/2474-3682/1510097

A Rare Case Report: Cystic Spinal Meningioma

Serdar Arslan, Hasan Erdogan, Fatma Zeynep Arslan, Mehmet Sedat Durmaz, Fatih Oncu and Ismet Tolu

Article Type: Image Article | First Published: July 26, 2018

A 41-year-old woman was admitted to our department presented with a 1-year history of persistent weakness and progressive numbness in the left lower limb. MRI revealed that there was a well-circumscribed intraspinal extradural lesion at L1 and L2 vertebral levels (Figure 1). The lesion was isointense on T1- and T2-weighted images and it was shown strongly enhancing except a small nodular cystic component in superior part of the lesion (Figure 2). The patient was operated and histopathological st...

 Open Access DOI:10.23937/2474-3682/1510096

Mild Encephalopathy with a Reversible Splenial Lesion Mimicking Transient İschemic Attack

Serdar Arslan, Hasan Erdogan, Fatma Zeynep Arslan, Mehmet Sedat Durmaz, Nahide Baran and Ismet Tolu

Article Type: Image Article | First Published: July 25, 2018

A 21-year-old man was admitted to emergency department due to slurred speech, weakness and loss of consciousness. The previous history is unremarkable except a slight cold 2 weeks ago. The first magnetic resonance imaging (MRI) revealed a distinct lesion involving in the splenium of the corpus callosum. This lesion showed restricted diffusion with hyperintense signal on diffusion-weighted imaging (DWI) and hypointense signal on apparent diffusion coefficient (ADC) sequence....

 Open Access DOI:10.23937/2474-3682/1510095

A Rare Case Report: The Giant Cell Tumor of the Tendon Sheath in Wrist

Serdar Arslan, Hasan Erdogan, Mehmet Sedat Durmaz, Fatma Zeynep Arslan, Fatih Oncu and Vefa Oner

Article Type: Image Article | First Published: July 04, 2018

A 21-year-old woman was admitted to our department due to left wrist pain and swelling. Magnetic resonance imaging showed a T1W hypointense, T2W heterogeneously hyperintense mass in the medial aspect of her left wrist, encasing the pollicis tendons (Figure 1). The lesion was shown heterogeneous contrast enhancement (Figure 2). The patient was operated and the lesion was proved to be giant cell tumor of the tendon sheath histopathologically....

 Open Access DOI:10.23937/2474-3682/1510094

Unexplained Irreversible Sudden Termination of an Atypical Atrial Tachycardia for Atrial Fibrillation - What is the Mechanism?

Naoto Kino, Toshiya Kurotobi, Kazato Ito, Daisuke Tonomura, Kentaro Yano, Chiharu Tanaka and Yoshihisa Shimada

Article Type: Image Article | First Published: June 27, 2018

A 56-year-old woman without any significant past illnesses was suffering from frequent palpitations due to drug refractory paroxysmal atrial fibrillation (AF). The findings from the chest X-ray, laboratory data including the thyroid hormone level, and echocardiography data including the left atrial diameter were within normal limits. Catheter ablation was performed in other hospitals, however, 5 ablation sessions were required to cure the AF in this case....

 Open Access DOI:10.23937/2474-3682/1510093

Pseudotumor of the Hip after Arthroplasty

Ana Zao and Pedro Cantista

Article Type: Image Article | First Published: June 04, 2018

We present an 82-year-old woman with a history of hip arthroplasty due to femur fracture during a road accident 30 years ago. She was admitted to a hospital for fever, asthenia and a large swelling in the hip. Analytic study revealed microcytic anemia and the Computed tomography showed a 7.9 inches mass surrounding the arthroplasty. It was diagnosed a Pseudotumor associated with the hip arthroplasty....

 Open Access DOI:10.23937/2474-3682/1510092

Sturge-Weber Syndrome: A Diagnosis Not to be Ignored

Salma Salim, Jamila Bouhelab and Badredine Hassam

Article Type: Image Article | First Published: May 09, 2018

Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome characterized by angiomas involving the face, choroid, and leptomeninges. The early diagnosis and the prompt treatment may reduce the incidence of neurologic sequelae, and may prevent irreversible blindness. We report a case of a 32-year-old man with SWS....

 Open Access DOI:10.23937/2474-3682/1510091

Pectoralis Muscle Aplasia in Poland's Syndrome

Hasan Erdogan, Fatih Oncu, Fatma Zeynep Arslan, Mehmet Sedat Durmaz, Serdar Arslan and Ismet Tolu

Article Type: Image Article | First Published: May 07, 2018

A 20-year-old male patient was admitted to our department due to asymmetrical appearance of the right chest wall. On physical examination, it was seen that right chest wall was asymmetrical and there was right nipple hypoplasia and syndactyly between third and fourth fingers in the right hand. Chest computed tomography (CT) demonstrated the absence of right pectoralis major muscle (Figure 1). No bone anomalies were found....

 Open Access DOI:10.23937/2474-3682/1510090

A Rare Case: Intrabiliary Obstruction due to Ruptured Hepatic Hydatid Cyst

Serdar Arslan, Hasan Erdogan, Fatma Zeynep Arslan, Mehmet Sedat Durmaz, Fatih Oncu and Ozgur Oner

Article Type: Image Article | First Published: May 05, 2018

A 69-year-old man was admitted to our department with a 2-day history of jaundice, nausea, and vomiting. MRCP showed that dilatation of the intra and extrahepatic bile ducts and fragmented membranes in the common biliary duct (Figure 1). Additionally, a hydatid cyst which is lost of volume tension was detected in segment 6 of liver (Figure 2). Impaction of hydatid material into the common bile duct was relieved endoscopically....

 Open Access DOI:10.23937/2474-3682/1510089

A Rare Case Report: Urothelial Carcinoma Arising from a Bladder Diverticulum

Hasan Erdogan, Serdar Arslan, Fatih Oncu, Nahide Baran, Fatma Zeynep Arslan and Mehmet Sedat Durmaz

Article Type: Image Article | First Published: May 04, 2018

A 73-year-old man was admitted our hospital with gross hematuria. Abdominal ultrasonography (US) and computed tomography (CT) revealed a bladder diverticulum with a irregular wall thickening that was concerning for tumor (Figure 1). Subsequent cystoscopy and transurethral resection of bladder tumor revealed urothelial carcinoma. Cystoprostatectomy was performed and revealed invasive urothelial carcinoma in the diverticulum extending through the diverticular wall and into peridiverticular adipose...

 Open Access DOI:10.23937/2474-3682/1510088

Black Henna Contact Eczema: Getting Handsome with Poison

Mohamed El Amraoui, Ahmed Bouhamidi, Karima Senouci and Badreddine Hassam

Article Type: Image Article | First Published: May 04, 2018

Black henna contact eczema is common and continues to increase. Paraphenyldiamine (PPD) in addition to its systemic toxicity not only exposes to a selective allergy to (PPD) but also to several of these derivatives and metabolites with cross reactions. We present a case of this irreflected practice....

 Open Access DOI:10.23937/2474-3682/1510087

Giant Inguinal Mass Diagnosed as Testicular Mixed Germ Cell Tumor

Hasan Erdogan, Fatih Oncu, Serdar Arslan, Fatma Zeynep Arslan, Mehmet Sedat Durmaz and Ismet Tolu

Article Type: Image Article | First Published: April 05, 2018

A 19-year-old man was admitted our hospital with right inguinal mass. Ultrasonography (US) showed an irregular, heterogeneous mass lesion in the right ingunal region. Right testis was not seen in scrotum. The patient had no history of any operation. Magnetic resonance imaging (MRI) demonstrated a giant mass which was size of 24 × 17 × 15 centimeter. The mass was hypointense on T1-weighted images, heterogeneous hyperintense on T2-weighted images and heterogeneous contrast enhancement was observ...

 Open Access DOI:10.23937/2474-3682/1510086

Cutaneous Horn of the Eyelid: The Tip of the Iceberg

Mohamed El Amraoui, Rachid Frikh, Naoufal Hjira and Mohammed Boui

Article Type: Image Article | First Published: April 04, 2018

A 35-year-man, without significant pathological history, with a notion of significant solar exposure seen his profession. Has consulted for a verrucous tumor of the free edge of the right upper eyelid, obstructing the vision, longer than broad, measuring about one centimeter, rolled up on itself with an erythematous base surmounted by a yellow keratin (Figures 1 and Figure 2). View the young age of the patient, the typical character of the lesion and the first episode of the disease, an electro ...

 Open Access DOI:10.23937/2474-3682/1510085

Serious Erysipelas Revealing an Iatrogenic Hematotoxicity to Tamoxifen

El Amraoui Mohamed, Meziane Mariam, Ismaili Nadia, Benzekri Laila, Senouci Karima and Hassam Badredine

Article Type: Image Article | First Published: April 02, 2018

Tamoxifen is an anti estrogen recommended in the treatment of estrogendé pendants cancers. Its side effects are rare and haematological toxicity is extremely rare. We relate an original case of severe erysipelas which revealed a toxic myelopathy to tamoxifen....

 Open Access DOI:10.23937/2474-3682/1510084

Incidentally Diagnosed Asymptomatic Primary Hydatid Cyst of Brain

Gokhan CANAZ, BekirMahmut KILINC, Nur TOPYALIN, Zeynep AKMAN, Izzet Durmusalioglu, Ali Osman AKDEMIR and Gulbin GOKCAY

Article Type: Image Article | First Published: March 30, 2018

Turkey is an endemic country to hydatid disease. The definite hosts of echinococcus are various carnivores, the common being the dog. Neurohydatosis is a rare presentation and primary cerebral involvement is even rarer. Intracranial cases become symptomatic depending on location, size and growth rate of the cyst. This is an interesting case of asymptomatic primary hydatid cyst diagnosed after a traffic accident....

 Open Access DOI:10.23937/2474-3682/1510083

A Rare, Incidentally Found Lesion: Calvarial Hemangioma

Ender Alkan, Hasan Erdogan, Serdar Arslan , Mehmet Sedat Durmaz, Muhsin Nuh Aybay and Ismet Tolu

Article Type: Image Article | First Published: March 16, 2018

A Rare, Incidentally Found Lesion: Calvarial Hemangioma...

 Open Access DOI:10.23937/2474-3682/1510082

Infiltrating Squamous Cell Carcinoma of the Penis

Mohamed El Amraoui, Rachid Frikh, Naoufal Hjira and Mohammed Boui

Article Type: Image Article | First Published: February 21, 2018

Infiltrating squamous cell carcinoma (SCC) of the penis is a rare tumor of easy diagnosis. The poor prognosis of this cancer justifies a rigorous oncological management which is often mutilating and badly accepted in our context. We present a case in an elderly man....

 Open Access DOI:10.23937/2474-3682/1510081

When a Psoriasis Shows Its Claws!!!

Mohamed El Amraoui, Naoufal Hjira and Mohammed Boui

Article Type: Image Article | First Published: February 21, 2018

Secondary amyloidosis (AA) is a real complication of chronic inflammatory diseases, including chronic inflammatory rheumatism. It is associated with a reserved prognosis justifying the use of all available therapies for the control of inflammation, the sole guarantor of a more favorable evolution. However, it rarely complicates the inflammatory dermatosis including psoriasis and remains far from the minds of young practitioners, hence the interest of recalling, through this clinical case, to wat...

 Open Access DOI:10.23937/2474-3682/1510080

Pseudoxanthoma Elasticum: Beyond the Skin

Mohamed El Amraoui, Rachid Frikh, Naoufal Hjira and Mohammed Boui

Article Type: Image Article | First Published: February 21, 2018

The pseudoxanthoma elasticum (PXE) is a metabolic genetic disorder affecting connective tissue characterized by calcification and fragmentation of elastic fibers, which essentially affects the skin, the eyes and the cardiovascular system. We presented a typical example of a pseudoelastic xanthoma in a patient followed in ophthalmology and cardiology and it was the dermatological lesions that had helped to correct the diagnosis....

 Open Access DOI:10.23937/2474-3682/1510079

Ludwig's Angina: A Rapid Radiological and Clinical Nightmare

Fatma Zeynep Arslan, Ayşegul Altunkeser, Bekir Turgut and Hasan Erdogan

Article Type: Image Article | First Published: December 02, 2017

Ludwig's Angina (LA) is a life-threatening emergency disease characterized with mouth floor and submandibular space cellulitis. LA frequently begins from submandibular region first and the tongue is pushed forward. Diabetic patients, immunocompromised conditions such as chronic hepatitis, chronic renal failure....

 Open Access DOI:10.23937/2474-3682/1510078

Elevated Shear Wave Elastography Values as a New Malignancy Criteria Despite Normal Biopsy Results

Fatma Zeynep Arslan, Aysegul Altunkeser, Bekir Turgut and Hasan Erdogan

Article Type: Image Article | First Published: December 01, 2017

Shear Wave Elestography (SWE) is a recently developed technique that enables detailed information on characterization of breast lesions. We reported a case that is elastography findings of breast lesion which is high grade DCIS focus within papilloma in 58-year-old female whose tru-cut biopsy has formerly resulted as benign....

 Open Access DOI:10.23937/2474-3682/1510077

Iris Lesion Causing Recalcitrant Unilateral Glaucoma

Luv Girish Patel, Jonathan Kim and Jesse Berry

Article Type: Image Article | First Published: November 06, 2017

Iris nevi are a common finding on anterior segment exam with growth and conversion to melanoma a relatively rare event. A retrospective case series found that of 1611 lesions referred to a tertiary ocular oncology service, only 8% converted in 15 years....

 Open Access DOI:10.23937/2474-3682/1510076

Extra-Cephalic Involvement in the Syndrome of Parry Romberg

Naciri Ilhame, Ebongo Christelle, Meziane Mariam, Senouci Karima and Hassam Badredine

Article Type: Image Article | First Published: November 06, 2017

Parry-Romberg Syndrome (PRS) is an uncommon disorder characterized by a slowly and acquired progressive atrophy involving skin, soft tissue, cartilage, and bony structures. Accompanying atrophies of the other parts of the body are rarely reported....

 Open Access DOI:10.23937/2474-3682/1510075

Transillumination of Testicular Hydrocele

David Bryson

Article Type: Image Article | First Published: November 01, 2017

Transillumination is a useful and inexpensive clinical tool that can be used for a range of conditions including testicular hydrocele. This paper gives a brief overview of the clinical use of transillumination in general, for testicular hydroceles and guidance for photography....

 Open Access DOI:10.23937/2474-3682/1510074

Pre-Operative Evaluation of an Orbital Injury

Valerio Massimo Magro and Maria Cristina Magnotti

Article Type: Image Article | First Published: October 30, 2017

Intraocular foreign bodies are a major cause of ocular trauma and blindness. Young adults, especially men, are the most likely victims, as a result of industrial or agricultural injuries. The management of orbital foreign bodies remains a serious diagnostic problem....

 Open Access DOI:10.23937/2474-3682/1510073

Subjective Cognitive Decline as a Clinical Manifestation is Not Yet Fully Understood

Cecilia Vellani, Elisabetta Brugola, Giuseppe Trifiro, Irene Bossert, Daniela D'ambrosio and Carlotta Benedetta Colombo

Article Type: Image Article | First Published: October 28, 2017

Studies on patients with SCD who underwent annual cognitive assessments show that they are almost three times as likely to be diagnosed with mild cognitive decline or dementia. Interestingly, the first complaints of memory decline occurred on an average of six years before mild cognitive impairment....

 Open Access DOI:10.23937/2474-3682/1510072

Gastric Duplication Cyst as an Unusual Cause of Gastric Outlet Obstruction in an Adult

Shinil K Shah, Sheilendra S Mehta and Kulvinder S Bajwa

Article Type: Image | First Published: September 06, 2017

The patient is a 29-year-old man with no significant medical or surgical history who presented with 2 months of nausea, emesis, and 20 pounds of unintentional weight loss. On initial presentation, he was afebrile with normal vital signs. His abdomen was soft, non-distended and non-tender....

 Open Access DOI:10.23937/2474-3682/1510071

Pyogenic Sacroiliitis and Multilocular Abscess Involving the Sacroiliac Joints in a Patient with Lumbar Pain

Ibrahim Guler, Emine Uysal, Nazlım Aktug Demir, Hakan Cebeci and Mustafa Koplay

Article Type: Image | First Published: September 06, 2017

A 21-year-old female patient applied to our hospital with gluteal and lumbar pain. Physical examination revealed tenderness in the bilateral sacral-lumbar area and limitation of the bilateral hip joint. Sacroiliac joint MRI showed the bone marrow oedema, overlying soft tissue swelling, right gluteal muscles abscess and multilocular abscess involving the bilateral sacroiliac joint....

 Open Access DOI:10.23937/2474-3682/1510070

Multimodality Imaging of a Huge Subaortic Left Ventricular Aneurysm in a Child

Humberto Morais, Albino Pedro, Maria Ana Sampaio Nunes, Maria Joao Reis4 and Joao Carlos Costa

Article Type: Image | First Published: September 04, 2017

A 13-year-old girl, born from term pregnancy and normal delivery was referred to our institution for signs and symptoms of decompensated heart failure. The patient was polypneic and, jugular engorgement, positive hepatojugular reflux, a 4/6 systolic murmur in the mitral area radiating to the axilla, and a hepatomegaly was observed on physical examination. Chest radiography revealed cardiomegaly. Electrocardiogram revealed sinus rhythm and signs of biatrial overload....

 Open Access DOI:10.23937/2474-3682/1510069

Eye for IgG4-Related Disease

Divya Jayakumar, Suneesh Anand and Stephen A Lobo

Article Type: Clinical Images | First Published: August 30, 2017

IgG4-related disease is a relatively new disease which has gained significant recognition in the last decade. It is an immune mediated disease and diagnosis is often missed because of limited awareness and a typical presentation....

 Open Access DOI:10.23937/2474-3682/1510068

An Unusual Cause of Shortness of Breath in an Adult Man: Alveolar Microlithiasis

Ali Cengiz, Meral Buyukterzi, Muhsin Nuh Aybay, Mesut Sivri, Arzu Cengiz and Fatma Zeynep Arslan

Article Type: Image Article | First Published: August 28, 2017

A 51-year-old non-smoking man, refered to our pulmonary medicine clinic with a 3 years history of severe shortness of breath. His complaints has increased even more in the last 1 year. There was no history of fever, weight loss, hemoptysis and old cronic infections like tuberculosis....

 Open Access DOI:10.23937/2474-3682/1510067

Diastematomyelia Type 1 with Multiple Spinal Cord and Vertebral Abnormalities in a Child

Serdar Arslan, Hasan Erdogan, Muhsin Nuh Aybay, Ender Alkan, Arzu Cengiz and Mehmet Sedat Durmaz

Article Type: Image | First Published: June 14, 2017

A 7-year-old male was brought with a marked spinal deformity. Physical examination showed rotational scoliosis and loss of lumbar lordosis. The patient was referred for a Magnetic Resonance Imaging (MRI) of the lumbosacral spine. MRI showed a left-convex rotational scoliosis and loss of lumbar lordosis....

 Open Access DOI:10.23937/2474-3682/1510066

Magnetic Resonance Imaging Findings of Central Diabetes Insipidus in a Child

Serdar Arslan, Hasan Erdogan, Muhsin Nuh Aybay, Arzu Cengiz, Fatma Zeynep Arslan and Ismet Tolu

Article Type: Image | First Published: June 14, 2017

An 18-year-old male patient presented to our hospital with polyuria, polydipsia and nocturia. He reports drinking 4-5 gallons of water every day due to extreme thirst. Her laboratory tests revealed serum sodium in the range of 140-145 mEq/L, serum osmolality of 295 mOsm/kg, with a concomitant urine osmolality of 279 mOsm/kg....

 Open Access DOI:10.23937/2474-3682/1510065

Dehiscent High Jugular Bulb

Hasan Erdogan, Serdar Arslan, Fatma Zeynep Arslan, Mehmet Sedat Durmaz and Arzu Cengiz

Article Type: Image | First Published: June 14, 2017

A 41-year-old female patient with 2-year history of tinnitus in right ear admitted to our clinic. The patient underwent temporal bone CT imaging. CT demonstrated right dehiscent high riding jugular bulb with absence of the right sigmoid plate....

 Open Access DOI:10.23937/2474-3682/1510064

Kallmann Syndrome: MRI Findings

Ender Alkan, Hasan Erdogan, Muhsin Nuh Aybay, Serdar Arslan and Mehmet Sedat Durmaz

Article Type: Image | First Published: June 12, 2017

A 14-years-old male was consulted for cryptorchidism and anosmia. There was decrease of LH, FSH and testosterone in the laboratory examinations of the patient. We used Magnetic Resonance Imaging (MRI) to visualize the olfactory tract and evaluate the olfactory sulci in patient whose clinical and laboratory findings were compatible with Kallmann syndrome....

 Open Access DOI:10.23937/2474-3682/1510063

A Rare Cause of Ortner's Syndrome: Pulmonary Artery Aneurysm

Hasan Erdogan, Fatma Zeynep Arslan, Ali Cengiz, Serdar Arslan and Mehmet Sedat Durmaz

Article Type: Image | First Published: June 10, 2017

A 37-year-old non-smoker male patient with a 6-month history of hoarseness admitted to our hospital. Laryngoscopic examination revealed left vocal cord paralysis with immobile vocal cord in paramedian position. The patient underwent neck and chest CT imaging....

 Open Access DOI:10.23937/2474-3682/1510062

Interval Form of Carbon Monoxide Intoxication

Ee Wei Lim, Yee Hau Pang and Pavanni Ratnagopal

Article Type: Image Article | First Published: April 22, 2017

A 41-year-old gentleman attempted suicide by burning charcoal in an enclosed room. He was found unconscious and was intubated for poor Glasgow Coma Scale (GCS). He was successfully extubated and transferred to our hospital on day 6. Initial physical examination showed no neurological deficits with normal scoring of Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA)....

 Open Access DOI:10.23937/2474-3682/1510061

Sarcoidosis on Traditional Tattoo: A Complication to Know

Hafsae Bounniyt and Meriame Meziane

Article Type: Image Article | First Published: April 21, 2017

The introduction of an exogenous pigment in the dermis is not without risk. We report a case of a sarcoidosis complicating a traditional tattoo after several years. Currently only temporary henna tattoos are subject to frequent publications in the literature. It must be known to the dermatologist ahead this type of skin lesions will have to undertake explorations necessary for the identification of systemic sarcoidosis....

 Open Access DOI:10.23937/2474-3682/1510060

Giant Vegetation in a Mitral Prosthetic Valve

Julio Cesar Sauza-Sosa and Nilda Gladys Espinola-Zavaleta

Article Type: Image Article | First Published: April 21, 2017

Forty-eight-year-old woman with history of mechanical prosthetic replacement of mitral and aortic valves in February 2005, came to emergency department with fatigue, weakness and chills since two months and dyspnea and edema of lower limbs from three days. The physical examination revealed jugular engorgement, peripheral edema, normal prosthetic clicks and mitral regurgitant murmur II/IV....

 Open Access DOI:10.23937/2474-3682/1510059

Central Neurocytoma Presenting as Large Intraventricular Mass Diagnosed by Stereotactic Biopsy

Nasuhi Engin Aydin

Article Type: Image Article | First Published: April 20. 2017

A 40-year-old man presenting with headache and dizziness of several months duration was found to have a large intraventricular mass during the clinical workup (Figure 1). A stereotactic biopsy of the mass revealed cellular neoplastic tissue with monotonous round cells (Figure 2)....

 Open Access DOI:10.23937/2474-3682/1510058

Microsporidia Stromal Keratitis

Sarah Farukhi Ahmed, Donald Minckler and Hans E Grossniklaus

Article Type: Image Article | First Published: April 17, 2017

Microsporidia Stromal Keratitis presents more commonly in immune competent patients. Risk factors include contact lens wear, trauma or travel to Southeast Asian countries with exposure to contaminated water. Patients present unilateral progressive eye redness, vision loss and pain. This presentation is often misdiagnosed as herpes simplex virus, so a corneal scraping or biopsy should be performed to confirm the diagnosis....

 Open Access DOI:10.23937/2474-3682/1510057

Aortic Branch Aneurysm in the Patient with Behcet's Disease

Katsuhisa Miyake, Naoko Ueki and Hitoshi Nakashima

Article Type: Clinical Image | First Published: November 25, 2016

A 35-year-old male patient presented with fever. Chest X-ray revealed a mass lesion in right upper field. The enhanced pulmonary CT showed the aneurysm and occlusion of left subclavian artery....

 Open Access DOI:10.23937/2474-3682/1510056

Chondrodermatitis Nodularis Chronica Helicis Mimicking Metastazis

Ali Cengiz, Hasan Erdogan, Muhsin Nuh Aybay, Mehmet Sedat Durmaz, Fatma Zeynep Arslan, Ozgur Oner and Arzu Cengiz

Article Type: Case Study | First Published: November 18, 2016

A 66-year-old male patient who underwent operation on the left temporal region due to squamous cell cancer and has been followed for a year admitted to our hospital for right ear swelling and ear pain which is worse at night....

 Open Access DOI:10.23937/2474-3682/1510055

Free Floating Ball Thrombus in the Left Atrium in a Child with Restrictive Cardiomyopathy

Iyad Al-Ammouri

Article Type: Clinical Image | First Published: November 15, 2016

A large free floating ball thrombus was diagnosed in an 8-year-old girl with severe restrictive cardiomyopathy following transient loss of vision....

 Open Access DOI:10.23937/2474-3682/1510054

Giant Malignant Phyllodes Tumor of the Breast: A Case Report

Gianluca Franceschini, Danilo Di Giorgio, Sabatino D'Archi, Alba Di Leone, Alejandro Martin Sanchez and Riccardo Masetti

Article Type: Case Report | First Published: November 11, 2016

Phyllodestumours (PTs) of the breast are rare fibroepithelial neoplasms with risks of local recurrence and uncommon metastases....

 Open Access DOI:10.23937/2474-3682/1510053

A Giant Calcified Hepatic Hemangioma

Cheng-Yi Wang, Wu-Hsien Kuo, Chen-Yi Liao and En-Hua Huang

Article Type: Case Study | First Published: August 20, 2016

A 57-year-old Taiwanese hepatitis B carrier female presented with a one-week history of epigastric pain, anorexia, malaise, intermittent nausea and vomiting in the preceding 6 months....

 Open Access DOI:10.23937/2474-3682/1510052

A Two Valve Fungic Endocarditis in a Lupic Patient

Filipa Brito Mendes, Ana Paula Silva, Nelson Tavares and Pedro Neves

Article Type: Case Study | First Published: August 18, 2016

A 38-years-old female patient, with the diagnosis of Systemic Lupus Erythematosus and antiphospholipid syndrome (APS). Under hemodialysis for the last 3 years (by a humerus-cefalic arteriovenous fistula) after an 8 years period of peritoneal dialysis which started 4 years after renal transplantation in a patient with Lupus Nephritis....

 Open Access DOI:10.23937/2474-3682/1510051

A Rare Cause of Persistent Dysphagia: Dysphagia Lusoria

Ali Cengiz, Serdar Arslan, Mehmet Sedat Durmaz , Ender Alkan, Hasan Erdogan, Aysegul Kayhan and Arzu Cengiz

Article Type: Case Presentation | First Published: August 15, 2016

A 50-year-old woman referred to our internal medicine clinic complaining of recurrent solid food dysphagia at her upper-middle chest for a year. The patient's history and laboratory test results were unremarkable....

 Open Access DOI:10.23937/2474-3682/1510050

Vascular Calcifications in Calcific Uremic Arteriolopathy

Filipa Brito Mendes, Andre Fragoso, Ana Paula Silva and Pedro Neves

Article Type: Case Study | First Published: August 13, 2016

Calcific Uremic Arteriolopathy (CUA) or Calciphylaxis, is a severe morbid and life-threatening condition 1. Ischemic subcutaneous necrosis with vulnerable skin ulcerations are some of the characteristics of this rare but global spread disease....

 Open Access DOI:10.23937/2474-3682/1510049

Occlusive Intestinal Invagination as First Presentation of Melanoma

Enrico Pinotti, Silvia Frassani, Giulia Lo Bianco, Luca Degrate and Fabrizio Romano

Article Type: Case Presentation | First Published: July 24, 2016

Intestinal metastasis are a common finding in patients affected with melanoma; only exceptionally they can cause enteric intussusceptions and present clinically as bowel obstruction....

 Open Access DOI:10.23937/2474-3682/1510048

Lemierre's Syndrome: A Case Report with Fatal CNS Complications

Jocelyn Zee, Manuel Lois and Donna Cota

Article Type: Case Report | First Published: June 24, 2016

Lemierre's syndrome is a rare disorder of young adults, usually caused by the anaerobic bacterium, Fusobacterium necrophorum and occasionally by other Fusobacterium species....

 Open Access DOI:10.23937/2474-3682/1510047

Elephantiasis neuromatosa in Type 1 Neurofibromatosis

Haber R, Kechichian E and Tomb R

Article Type: Case Report | First Published: June 16, 2016

Type 1 neurofibromatosis (NF-1), or Von Recklinghausen disease, is an autosomal dominant genetic disorder. It is characterized by the presence of multiple neurofibromas....

 Open Access DOI:10.23937/2474-3682/1510046

Treatment of Caustic Ingestion Associated Esophageal Stricture with Budesonide

Marisa L Gallant, Sabina A Mir and Steven N Lichtman

Article Type: Case Presentation | First Published: June 13, 2016

We present the images from the upper endoscopy of a 5 year-old patient who developed an esophageal stricture from caustic ingestion. These images are from before and after a two-week course of topical budesonide....

 Open Access DOI:10.23937/2474-3682/1510045

Subcutaneous Scar Retraction Release after Breast Reduction Using Percutaneous Needle Cordotomy

T Wagner, N Slater, M Hameeteman and D Ulrich

Article Type: Clinical Case | First Published: June 08, 2016

Hypertrophic scarring with scar retraction is a well known problem in breast reduction mammaplasty with occasional unpleasant results for both the patient and surgeon. Even with many different therapeutic options, success can be limited in some cases....

 Open Access DOI:10.23937/2474-3682/1510044

Supratentorial Primitive Neuroectodermal Tumor in an Adult

Ali Cengiz, Hasan Erdogan, Vefa Oner and Arzu Cengiz

Article Type: Clinical Image | First Published: May 17, 2016

A 53-year-old man admitted to our emergency service with symptoms of intermittent vomiting and headache for a week. In the hospital the patient swiftly deteriorated to coma....

 Open Access DOI:10.23937/2474-3682/1510043

Pseudothrombus - An Echocardiographic Illusion

Rishi Vinod Lohiya and Sunil Washimkar

Article Type: Clinical Image | First Published: May 16, 2016

Cardiovascular complications like hypertension, premature atherosclerosis, coronary arteritis and myocarditis are not infrequent in systemic lupus erythematosus (SLE)....

 Open Access DOI:10.23937/2474-3682/1510042

Pancreatitis Gone Nuts: Scrotal Hydrocele as a Complication of Severe Acute Pancreatitis

Ryan R Gaffney and Matthew T Moyer

Article Type: Clinical Image | First Published: May 12, 2016

A 33-year-old male with acute gallstone pancreatitis complicated by pancreatic fluid collection formation developed intense right-sided scrotal pain and swelling one week into his hospitalization....

 Open Access DOI:10.23937/2474-3682/1510041

High-Resolution 7T EPI Magnitude/Phase Cortex Image Co-localization

Zikuan Chen, Jennifer Robinson, Arvind Caprihan and Vince Calhoun

Article Type: Image | First Published: May 07, 2016

A gradient-recalled echo (GRE) echo-planar imaging (EPI) sequence was used to acquire ultra high-resolution functional magnetic resonance imaging (fMRI) data from a healthy volunteer on a 7T Siemens MAGNETOM system....

 Open Access DOI:10.23937/2474-3682/1510040

Aortobiiliaca Endoprosthesis Inflammation Diagnosed with 18F-FDG PET/CT

Maria del Puig Cozar Santiago, Raul Sanchez Jurado, Jose Enrique Aguilar Barrios, Rocio Brisa Vazquez and Jose Ferrer Rebolleda

Article Type: Clinical Image | First Published: April 27, 2016

A 79 year-old man arrived at emergency department because of having abdominal pain for several months (almost one year). Abdominal pain was located in mesogastrio, it was late postpandrial, associated with paresthesias in the left lower limb and irradiated through both iliac fosses getting to the back....

 Open Access DOI:10.23937/2474-3682/1510039

Reducing Corneal Astigmatism Using Cataract and LRI Incisions

Noel Alpins

Article Type: Image | First Published: April 22, 2016

Astigmatism analysis of corneal incisions can be used to reduce the amount of corneal astigmatism at the time of surgery....

 Open Access DOI:10.23937/2474-3682/1510038

Exstrophy of Bladder

Birendra Rai and Prof Farhana Sharif

Article Type: Clinical Image | First Published: April 17, 2016

A male infant was born at 38 weeks of gestation by normal delivery. Physical examination revealed exteriorly lying bladder with deformed penis and low lying umbilicus....

 Open Access DOI:10.23937/2474-3682/1510037

PET Molecular Imaging of the Dopaminergic System in Parkinson's Disease

A Avendano-Estrada, I Madrazo, O Kopyov, H Carrasco-Vargas, J Altamirano-Ley and MA Avila-Rodriguez

Article Type: Clinical Cases | First Published: March 28, 2016

It is well known that the dopaminergic system plays a major role in Parkinson's disease (PD). Current technological developments in molecular imaging have made it possible to evaluate the dopaminergic system in vivo....

 Open Access DOI:10.23937/2474-3682/1510036

What is the Best 'Adviser' in the Emergency?

Sofia Lazaro Mendes, Ana Rita Ferreira, Rui Martins, Domingos Ramos and Mariano Pego

Article Type: Case Presentation | First Published: March 25, 2016

A 18 years-old woman presented to the Emergency Department with shortness of breath, pleuritic chest pain and syncope. She denied cough, sputum production, hemoptysis, wheezing, fever or leg pain....

 Open Access DOI:10.23937/2474-3682/1510035

Clinical and Radiographic Characteristics of Hereditary Gingival Fibromatosis

Jing Qiao, Feng Liu and Zu-Yan Zhang

Article Type: Clinical Image | First Published: March 24, 2016

Hereditary gingival fibromatosis, also known as congenital familial fibromatosis or idiopathic fibromatosis, is a rare genetic disorder with prevalence of 1/750000....

 Open Access DOI:10.23937/2474-3682/1510034

Advances in Cytoarchitectonic Mapping of the Human Amygdala and the Hippocampus

Olga Kedo, Karl Zilles and Katrin Amunts

Article Type: Case Presentation | First Published: March 23, 2016

The human amygdala and hippocampus are key structures for emotion and memory processing. They are involved in various neurological and psychiatric disorders....

 Open Access DOI:10.23937/2474-3682/1510033

Neck at Risk Due to Infectious Disease

KP Schepman and JMA Kuijlen

Article Type: Clinical Case | First Published: March 05, 2016

A 23 year old man was referred to the emergency room of our hospital because of a large swelling in de neck. The patient originated from Somalia and stayed in a centre for asylum seekers in The Netherlands for 6 months....

 Open Access DOI:10.23937/2474-3682/1510032

The Real Risks of Nasogastric Tubes: 'Nutrothorax' Complicating a Misplaced Nasogastric Feeding

Joaquin Valle Alonso, F Javier Fonseca del Pozo, Miguel Angel Aguayo and Jorge Pedraza

Article Type: Clinical Case | First Published: February 29, 2016

A 75-year-old female patient with past medical history of severe Alzheimer's disease, totally dependent with nasogastric tube feeding (NGT) presented to the emergency department with worsening dyspnea in the past 48 hours....

 Open Access DOI:10.23937/2474-3682/1510031

Dynamic Dedicated Breast PET (Dbpet) Imaging to Discriminate between Benign and Malignant Pathologies: Galactocele

Anais Garcia-Barredo, Victoria Sampayo-Montenegro, Sonia Argibay, Ines Dominguez-Prado, Pablo Aguiar, Alvaro Ruibal and Michel Herranz

Article Type: Case Note | First Published: February 29, 2016

Twenty two years old female with left mammary gland lesion due to hyperprolactinaemia (32 ng/ml), nipple secretion and pain under pressure was referred to our Department....

 Open Access DOI:10.23937/2474-3682/1510030

Tamponade of a True Heart

Omar S Darwish

Article Type: Case Presentation | First Published: February 27, 2016

A 53-year-old man was an avid soccer player and still played in the same regular Friday games he had played for years. On the day of admission, he developed a sudden onset of epigastric pain and syncope during his regular Friday match....

 Open Access DOI:10.23937/2474-3682/1510029

Parapancreatic Castleman Disease

Leilei Liu, Zhuo Wang and Dianbo Cao

Article Type: Clinical Image | First Published: February 26, 2016

A 32-year-old man was referred to us with an abdominal mass detected by ultrasonographic examination during phyisical checkup....

 Open Access DOI:10.23937/2474-3682/1510028

Gastrointestinal Tract Bleeding Secondary to Blind Pouch Syndrome

Leilei Liu, Zhuo Wang, Dianbo Cao and Yang Zhao

Article Type: Clinical Image | First Published: February 24, 2016

A 60-year-man was admitted to our hospital with the complaints of intermittent hematemasis for 6 months. The patients underwent side-to-side enteroanastomosis because of intestinal tuberculosis 30 years prior....

 Open Access DOI:10.23937/2474-3682/1510027

Radiologic-Pathologic Correlation: Primary Breast Lymphoma

Bernardo Procaci Kestelman

Article Type: Case Study | First Published: February 24, 2016

A 59-year-old woman presented with a 1-week history of a palpable lump in the right breast. She denied any other symptoms and was otherwise in good health, without any significant findings in the medical or surgical history....

 Open Access DOI:10.23937/2474-3682/1510026

A Different Form of Acute Myocardial Infarction!

Rita Ferreira

Article Type: Case Study | First Published: January 30, 2016

A 50-year old man was admitted to the emergency room due to severe dyspnea and thoracic pain with 3 hours of onset. He had no known history of cardiovascular disease, but he was recovering from drug addict....

 Open Access DOI:10.23937/2474-3682/1510025

Clinical, Radiographic, Gammagraphic and Anatomical Characteristics of Active Condylar Hyperplasia

Diego Fernando Lopez B

Article Type: Clinical Case | First Published: January 27, 2016

Condylar hyperplasia is a pathologic condition due to progressive overgrowth of one or both mandibular condyles, causing either secondary facial asymmetry or mandibular prognathism. Although it is self-limiting, the overgrowth may continue even after skeletal growth stops....

 Open Access DOI:10.23937/2474-3682/1510024

Magnetic Resonance Images of the Structure and Tissue Organization of a Fetal Heart

Eleftheria Pervolaraki, Richard A Anderson, Alan P Benson and ArunV Holden

Article Type: Image | First Published: January 25, 2016

A 20 week gestational age human fetal heart was imaged at a 100 μm cubic voxel resolution, using a standard diffusion tensor magnetic resonance imaging (DTMRI) protocol in a 9.4 tesla Bruker NMR. The three-dimensional cardiac data set is visualized by its surface and a transparent wireframe....

 Open Access DOI:10.23937/2474-3682/1510023

An Uncommon Cause of Upper Gastrointestinal Bleeding

Michalis Galanopoulos and Apostolis Papaefthymiou

Article Type: Case Presentation | First Published: January 23, 2016

An 80-year-old man suffering from dementia and Parkinson disease was admitted to our hospital for investigation of 2 to 3 daily episodes of melena stools 20 days now....

 Open Access DOI:10.23937/2474-3682/1510022

Pneumothorax and Subcutaneous Emphysema. When Assessing Chest Tube Placement

Ana Patricia Ovejero Diaz, Gemma Maria Munoz Molina and Ana Paz Valdebenito Montecino

Article Type: Clinical Image | First Published: January 08, 2016

Subcutaneous emphysema occurs when air gets into tissues under the skin. It occurs mainly in the neck, chest and face when air travel to these areas of the chest cavity through the fascia....

 Open Access DOI:10.23937/2474-3682/1510021

Coiled Nasogastric Tube in Oesophagus

Sameer Sethi

Article Type: Image | First Published: January 06, 2016

This is a image of an plain X-Ray Chest PA view of a 32 year old female postoperative patient of liver transplant. In this X- ray a nasogastric tube (NG) is seen coiled in the oesophagus which is a rare event....

 Open Access DOI:10.23937/2474-3682/1510020

Mitral Valve Perforation: The Value of Real Time Three-Dimensional Transesophageal Echocardiography

Humberto Morais and Valdano Manuel

Article Type: Clinical Image | First Published: December 14, 2015

A 63-year-old man was referred to perform a transesophageal echocardiography (TEE) for suspicion of mitral endocarditis. The 2-Dimensional TEE showed a solution of continuity in the anterior leaflet of the mitral valve compatible with mitral perforation....

 Open Access DOI:10.23937/2474-3682/1510019

Images of Iatrogenic Pneumopericardium

Josephine Pressacco

Article Type: Clinical Image | First Published: December 11, 2015

A 76-year-old man presenting with cardiac tamponade underwent urgent pericardial drainage using ultrasound guided pericardial puncture. A pericardial drainage catheter was left in place....

 Open Access DOI:10.23937/2474-3682/1510018

Giant Floating Right Atrial Thrombus Following Balloon Mitral Valvuloplasty

Georgina Fuertes Ferre, Maria Carmen Aured Guallar, Esther Sanchez Insa and Jose Gabriel Galache Osuna

Article Type: Clinical Image | First Published: December 06, 2015

A 83 years-old woman underwent percutaneous balloon mitral valvuloplasty (PBMV) due to symptomatic rheumatic mitral stenosis. The transesophageal echocardiogram before PBMV revealed no atrial thrombus. PMBV was performed under fluoroscopic guidance....

 Open Access DOI:10.23937/2474-3682/1510017

Radiological Diagnosis of a Neonate with Mucolipidosis II (I-Cell Disease)

Yo Niida

Article Type: Clinical Image | First Published: November 28, 2015

Mucolipidosis II (ML II) or inclusion cell disease (I-cell disease) (OMIM 252500) is an autosomal recessive lysosomal enzyme targeting disorder. ML II is usually presents between 6 and 12 months of age with a clinical phenotype resembling Hurler syndrome and a radiological picture of dysostosis multiplex....

 Open Access DOI:10.23937/2474-3682/1510016

Drive Line Infection and Colonic Erosion: A Rare Complication of Left Ventricular Assist Device Placement Demonstrated on PET/CT

Kanchan Kulkarni

Article Type: Clinical Image | First Published: November 23, 2015

Left ventricular assist device (LVAD) placement is now commonly performed as both bridge to transplant and as destination therapy in end stage cardiomyopathy with high associated prevalence of sepsis (up to 58%) and mortality (up to 44%)....

 Open Access DOI:10.23937/2474-3682/1510015

Paediatric Lingual Thyroid: Cause of Chronic Cough

Gautam Bir Singh, Mayank Yadav and Shruti Ranjan

Article Type: Clinical Image | First Published: November 12, 2015

A 10 year old female child was referred to us from the paediatric department with the chief complaints of chronic cough and an occasional history of odynophagia for the past 6 months, especially following attack of upper respiratory tract infection....

 Open Access DOI:10.23937/2474-3682/1510014

Modified Titanium Discs Enhance the Growth of Osteoblasts

Gabriel Castillo-Dali, Elena Campano-Cuevas, Jean L. Saffar, Jose L. Gutierrez-Perez and Daniel Torres-Lagares

Article Type: Image | First Published: November 3, 2015

The image shows the growth of osteoblasts (NHOst) on Titanium discs whose surface had been previously modified with an external recorder....

 Open Access DOI:10.23937/2474-3682/1510013

Severe Complications of Laparoscopic Surgery as a Result of Incorrect Abdominal Wall Closure

Sheila Serra Pla, Xavier Serra Aracil, Pere Rebasa Cladera, Laura Mora Lopez and Salvador Navarro Soto

Article Type: Clinical Image | First Published: October 30, 2015

The appearance of hernias at laparoscopic trocar incision sites remains one of the unresolved complications of laparoscopic surgery. Closure of these incisions is difficult, and in fact complete closure is not usually achieved....

 Open Access DOI:10.23937/2474-3682/1510012

Colonic Atresia in 69-Day-Old Infant

Sabriye Dayi, Sabriye Korkut and Sukru Yildirim

Article Type: Image | First Published: October 30, 2015

The girl baby, 28 weeks of gestation, was followed in neonatal intensive care unit because of prematurity. She has passed meconium in time. She had been feeding orally but the amount of feeding could not been increased gradually....

 Open Access DOI:10.23937/2474-3682/1510011

Unfavorable Hip Stress Distribution in a Patient with Cerebral Palsy as a Cause for Hip Dislocation

Petra Schara, Karin Schara and Veronika Kralj-Iglic

Article Type: Image | First Published: October 30, 2015

Hip dislocation is a relatively common complication in cerebral palsy. Surgical intervention in the early phase is the preferred choice of treatment which however requires following the migration of femoral head with respect to acetabulum in hips at risk....

 Open Access DOI:10.23937/2474-3682/1510010

Talc, over the Nails

Shilpa Y Krishnegowda and Sudhir Kumar N

Article Type: Image | First Published: September 21, 2015

A 40-year-old male was referred for evaluation of nail changes present since 2 years. The patient had a 10 - year history of HIV infection and was on antiretroviral therapy....

 Open Access DOI:10.23937/2474-3682/1510009

Symmetric Peripheral Gangrene

Shilpa Y Krishnegowda and Sudhir Kumar N

Article Type: Image | First Published: September 21, 2015

A 60 year old female was referred for evaluation of blackish fingers and toes since 2 days. Her heart rate (130 beats/minute), blood pressure (70/40 mmHg), respiratory rate (28 cycles/minute) and raised total cell counts revealed that she was in septic shock....

 Open Access DOI:10.23937/2474-3682/1510008

Sub-RPE Desposits - Ex Vivo Hyperspectral Autofluorescence (AF) Image of Drusen from 84-Year-Old Male Donor with late Age-Related Macular Degeneration

R. Theodore Smith, Tal Ben-Ami and Yuehong Tong

Article Type: Image | First Published: August 25, 2015

The image is an overlay of 3 images representing the distribution of the 3 most abundant fluorophore signals that were extracted using advanced factorization algorithms....

 Open Access DOI:10.23937/2474-3682/1510007

Drusen on Fire: Ex Vivo Hyperspectral Autofluorescence (AF) Image of Drusen from 81-Year-Old Male Donor with Age-Related Macular Degeneration

R. Theodore Smith, Tal Ben-Ami and Yuehong Tong

Article Type: Image | First Published: August 25, 2015

The image is an overlay of 3 images representing the distribution of the 3 most abundant fluorophore signals that were extracted using advanced factorization algorithms....

 Open Access DOI:10.23937/2474-3682/1510006

Geographic Atrophy: Ex Vivo Hyperspectral Autofluorescence (AF) Image of an Eye with Geographic Atrophy from 81-Year-Old Male Donor

R. Theodore Smith, Tal Ben-Ami and Yuehong Tong

Article Type: Image | First Published: August 25, 2015

The image is an overlay of 3 images representing the distribution of the 3 most abundant fluorophore signals that were extracted using advanced factorization algorithms....

 Open Access DOI:10.23937/2474-3682/1510005

Carcinoid in Ebstein's Anomaly - What are the odds!

Jen-Li Looi, Selwyn Wong, Ruvin Gabriel and William Harrison

Article Type: Clinical Image | First Published: June 30, 2015

On the parasternal RV inflow view, the tricuspid valve leaflets were severely tethered (arrows) with poor coaptation resulting severe/free tricuspid regurgitation....

 Open Access DOI:10.23937/2474-3682/1510004

Pulmonary Embolism and Disseminated Intravascular Coagulopathy Associated with Right Atrial Mass

Jen-Li Looi and Selwyn Wong

Article Type: Clinical Image | First Published: June 29, 2015

30-year-old man normally fit and healthy presented with collapse and palpitation. He was tachycardic with a heart rate of 120 beats/min and hypoxic with oxygen saturation of 85% on arrival....

 Open Access DOI:10.23937/2474-3682/1510003

Open Repair of a Renal Artery Aneurysm with Hypogastric Artery Autograft and Hypothermic Perfusion Preservation

Nelson De Luccia, Andre Brito Queiroz, Grace Carvajal Mulatti, Fabio Rodrigues Ferreira do Espirito Santo and Karina Paulo Domingos Rosa Schneidwind

Article Type: Clinical Image | First Published: June 29, 2015

A 32-year-old woman presented with a one-year history of mild abdominal pain in the left upper quadrant and a palpable pulsatile abdominal mass on physical examination. The results of laboratory investigations, including serum urea and ceatinine levels, were unremarkable....

 Open Access DOI:10.23937/2474-3682/1510002

Small cell variant of Anaplastic large cell lymphoma

Neerja Vajpayee

Article Type: PPT | First Published: May 22, 2015

Small cell variant of Anaplastic large cell lymphoma....

 Open Access DOI:10.23937/2474-3682/1510001

Filarial Nematode that Induce Lymphatic Filariasis

Denis Voronin

Article Type: Clinical Image | First Published: May 20, 2015

Parasite attacks its own symbionts. Elimination of Wolbachia, mutualistic endobacteria of filarial nematodes of medical and veterinary importance, by induction of authopahgy, parasite's intracellular defense mechanism....


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Articles Published

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ClinMed Journals Index Copernicus Values

Clinical Medical Image Library: 93.51

International Journal of Critical Care and Emergency Medicine: 92.83

International Journal of Sports and Exercise Medicine: 91.84

International Journal of Womens Health and Wellness: 91.79

Journal of Musculoskeletal Disorders and Treatment: 91.73

Journal of Geriatric Medicine and Gerontology: 91.55

Journal of Infectious Diseases and Epidemiology: 91.55

Clinical Medical Reviews and Case Reports: 91.40

International Archives of Nursing and Health Care: 90.87

International Journal of Ophthalmology and Clinical Research: 90.80

International Archives of Urology and Complications: 90.73

Journal of Clinical Nephrology and Renal Care: 90.33

Journal of Family Medicine and Disease Prevention: 89.99

Journal of Clinical Gastroenterology and Treatment: 89.54

Journal of Dermatology Research and Therapy: 89.34

International Journal of Clinical Cardiology: 89.24

International Journal of Radiology and Imaging Technology: 88.88

Obstetrics and Gynaecology Cases - Reviews: 88.42

International Journal of Blood Research and Disorders: 88.22

International Journal of Diabetes and Clinical Research: 87.97

New Issues


International Journal of Clinical Cardiology

ISSN: 2378-2951 | ICV: 89.24



Obstetrics and Gynaecology Cases - Reviews

ISSN: 2377-9004 | ICV: 88.42



Journal of Hypertension and Management

ISSN: 2474-3690 | ICV: 87.69



International Journal of Diabetes and Clinical Research

ISSN: 2377-3634 | ICV: 87.97



Journal of Infectious Diseases and Epidemiology

ISSN: 2474-3658 | ICV: 91.55