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Matchynski JI, Manwar R, Kratkiewicz KJ, Madangopal R, Lennon VA, Makki KM, Reppen AL, Woznicki AR, Hope BT, Perrine SA, Conti AC, Avanaki K. Direct measurement of neuronal ensemble activity using photoacoustic imaging in the stimulated Fos-LacZ transgenic rat brain: A proof-of-principle study. Photoacoustics 2021; 24:100297. [PMID: 34522608 PMCID: PMC8426561 DOI: 10.1016/j.pacs.2021.100297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/28/2021] [Accepted: 08/28/2021] [Indexed: 05/16/2023]
Abstract
Measuring neuroactivity underlying complex behaviors facilitates understanding the microcircuitry that supports these behaviors. We have developed a functional and molecular photoacoustic tomography (F/M-PAT) system which allows direct imaging of Fos-expressing neuronal ensembles in Fos-LacZ transgenic rats with a large field-of-view and high spatial resolution. F/M-PAT measures the beta-galactosidase catalyzed enzymatic product of exogenous chromophore X-gal within ensemble neurons. We used an ex vivo imaging method in the Wistar Fos-LacZ transgenic rat, to detect neuronal ensembles in medial prefrontal cortex (mPFC) following cocaine administration or a shock-tone paired stimulus. Robust and selective F/M-PAT signal was detected in mPFC neurons after both conditions (compare to naive controls) demonstrating successful and direct detection of Fos-expressing neuronal ensembles using this approach. The results of this study indicate that F/M-PAT can be used in conjunction with Fos-LacZ rats to monitor neuronal ensembles that underlie a range of behavioral processes, such as fear learning or addiction.
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Key Words
- ANSI, American national standards institute
- AP, anterior-posterior
- Brain
- CNR, contrast-to-noise ratio
- Cocaine
- DMSO, dimethyl sulfoxide
- DV, dorsal-ventral
- F/M-PAT, functional molecular photoacoustic tomography
- FOV, field-of-view
- Fear conditioning
- Fos
- GRIN, gradient-index
- IL, infralimbic cortex
- ML, medial-lateral
- Neuronal ensemble
- OCT, optical coherence tomography
- OPO, optical parametric oscillator
- PA, photoacoustic
- PBS, phosphate buffer saline
- PL, prelimbic cortex
- Photoacoustic imaging
- SNR, signal-to-noise ratio
- US, ultrasound
- X-gal
- X-gal, beta-D-galactosidase
- fMRI, functional magnetic resonance imaging
- mPFC, medial prefrontal cortex
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Affiliation(s)
- James I. Matchynski
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Rayyan Manwar
- The Richard and Loan Hill Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, USA
| | - Karl J. Kratkiewicz
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA
| | - Rajtarun Madangopal
- The National Institute on Drug Abuse (NIDA) Intramural Research Program, Baltimore, MD, USA
| | - Veronica A. Lennon
- The National Institute on Drug Abuse (NIDA) Intramural Research Program, Baltimore, MD, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kassem M. Makki
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI, USA
| | - Abbey L. Reppen
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI, USA
| | | | - Bruce T. Hope
- The National Institute on Drug Abuse (NIDA) Intramural Research Program, Baltimore, MD, USA
| | - Shane A. Perrine
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Alana C. Conti
- John D. Dingell Veterans Affairs Medical Center, Detroit, MI, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kamran Avanaki
- The Richard and Loan Hill Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, USA
- Department of Dermatology, University of Illinois at Chicago, Chicago, USA
- Corresponding author at: The Richard and Loan Hill Department of Biomedical Engineering, University of Illinois at Chicago, Chicago, USA.
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Wong JSL, Nasruddin AB, Selveindran NM, Latif KA, Kassim F, Nair SB, Hong JYH. Xanthomatous Hypophysitis Presenting in an Adolescent Girl: A Long-Term Follow-Up of a Rare Case and Review of the Literature. AACE Clin Case Rep 2021; 7:220-5. [PMID: 34095493 DOI: 10.1016/j.aace.2021.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 01/22/2023] Open
Abstract
Objective Primary hypophysitis refers to the isolated inflammation of the pituitary gland not associated with other secondary causes. Among its histopathologic subtypes, xanthomatous is the rarest. Methods We describe a 22-year-old woman with xanthomatous hypophysitis (XH), its clinical progression over 8 years as well as the treatment effects of prednisolone and azathioprine. Our patient was first referred for severe short stature and delayed puberty at the age of 14 years. Results Investigations revealed multiple pituitary deficiencies. Magnetic resonance imaging showed a pituitary mass whereby a partial resection was performed. A full resection was not feasible due to the location of the mass. The histopathologic analysis of the tissue was consistent with XH. The results of secondary workout for neoplasm, infection, autoimmune, and inflammatory disorders were negative. After surgery, a progressive enlargement of the mass was observed. Two courses of prednisolone were administered with a significant reduction in the mass size. Azathioprine was added due to the unsustained effects of prednisolone when tapered off and the concern of steroid toxicity with continued use. No further increase in the mass size was noted after 6 months on azathioprine. Conclusion Glucocorticoid and immunotherapy are treatment options for XH; however, more cases are needed to better understand its pathogenesis and clinical progression.
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Thomas M, De Roover R, van der Merwe S, Lambrecht M, Defraene G, Haustermans K. The use of tumour markers in oesophageal cancer to quantify setup errors and baseline shifts during treatment. Clin Transl Radiat Oncol 2020; 26:8-14. [PMID: 33251342 PMCID: PMC7677672 DOI: 10.1016/j.ctro.2020.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 12/24/2022] Open
Abstract
Implantation of solid gold markers safe. Inter-fractional motion for markers in distal oesophagus largest cranio-caudally. Reduced radiotherapy treatment margins with soft-tissue vs. bony-anatomy matching. Impact of intra-fractional baseline shifts on margin calculation rather small.
Purpose To prospectively evaluate the feasibility of solid gold marker placement in oesophageal cancer patients and to quantify inter-fractional and intra-fractional (baseline shift) marker motion during radiation treatment. Radiotherapy target margins and matching strategies were investigated. Materials/methods Thirty-four markers were implanted by echo-endoscopy in 10 patients. Patients received a planning 4D CT, daily pre-treatment cone-beam CT (CBCT) and a post-treatment CBCT for at least five fractions. For fractions with both pre- and post-treatment CBCT, marker displacement between planning CT and pre-treatment CBCT (inter-fractional) and between pre-treatment and post-treatment CBCT (intra-fractional; only for fractions without rotational treatment couch correction) were calculated in left–right (LR), cranio-caudal (CC) and anterior-posterior (AP) direction after bony-anatomy and soft-tissue matching. Systematic/random setup errors were estimated; treatment margins were calculated. Results No serious adverse events occurred. Twenty-three (67.6%) markers were visible during radiotherapy (n = 3 middle oesophagus, n = 16 distal oesophagus, n = 4 proximal stomach). Margins for inter-fractional displacement after bony-anatomy match depended on the localisation of the primary tumour and were 11.2 mm (LR), 16.4 mm (CC) and 8.2 mm (AP) for distal markers. Soft-tissue matching reduced the CC margin for these markers (16.4 mm to 10.5 mm). The mean intra-fractional shift of 12 distal markers was 0.4 mm (LR), 2.3 mm (CC) and 0.7 mm (AP). Inclusion of this shift resulted in treatment margins for distal markers of 12.8 mm (LR), 17.3 mm (CC) and 10.4 mm (AP) after bony-anatomy matching and 12.4 mm (LR), 11.4 mm (CC) and 9.7 mm (AP) after soft-tissue matching. Conclusion This study demonstrated that the implantation of gold markers was safe, albeit less stable compared to other marker types. Inter-fractional motion was largest cranio-caudally for markers in the distal oesophagus, which was reduced after soft-tissue compared to bony-anatomy matching. The impact of intra-fractional baseline shifts on margin calculation was rather small.
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Key Words
- 2D, two-dimensional
- 3D, three-dimensional
- 4D, four-dimensional
- AP, anterior-posterior
- CBCT, cone-beam computed tomography
- CC, cranio-caudal
- CT, computed tomography
- CTV, clinical target volume
- CTVtotal, total clinical target volume
- DoF, degree-of-freedom
- EUS, endoscopic ultrasound
- Esophageal cancer
- FDG-PET/CT, fluorodeoxyglucose positron emission tomography with integrated computed tomography
- Fiducial gold markers
- GM, grand mean
- GTV, gross tumour volume
- IMRT, intensity modulated radiation therapy
- Inter-fractional motion
- Intra-fractional baseline shifts
- LR, left-right
- MRI, magnetic resonance imaging
- Matching strategies
- OAR, organ at risk
- PTV, planning target volume
- Radiotherapy treatment margins
- iCTV, internal clinical target volume
- kV, kilovoltage
- nCRT, neoadjuvant chemoradiation
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Affiliation(s)
- Melissa Thomas
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Leuven, Belgium.,University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium
| | - Robin De Roover
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Leuven, Belgium.,University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium
| | - Schalk van der Merwe
- University Hospitals Leuven, Department of Gastroenterology and Hepatology, Leuven, Belgium
| | - Maarten Lambrecht
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Leuven, Belgium.,University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium
| | - Gilles Defraene
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Leuven, Belgium
| | - Karin Haustermans
- KU Leuven - University of Leuven, Department of Oncology - Laboratory of Experimental Radiotherapy, Leuven, Belgium.,University Hospitals Leuven, Department of Radiation Oncology, Leuven, Belgium
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Wineski RE, Panico EC, Bailey LN, Cardenas AM, Grayson JW, Wiatrak BJ. Flat sticker as a mobile airway foreign body: A case report and review of the literature. Radiol Case Rep 2020; 15:2391-2395. [PMID: 32994848 PMCID: PMC7516169 DOI: 10.1016/j.radcr.2020.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/18/2022] Open
Abstract
Diagnosis of an airway foreign body in the setting of an unwitnessed aspiration event remains a challenge for physicians in the emergency setting. We describe a case of a 2-year-old male who presented to the emergency department with atypical symptoms resulting from ingestion and aspiration of a large, flat sticker. The airway foreign body remained in place for over 24 hours despite obtaining appropriate airway imaging, and the object was later removed without complication via rigid bronchoscopy in the operating room. Further review of this case and the current literature highlighted multiple lessons. Initial evaluations should combine a rigorous history and physical with strict guidelines on usage of multiple imaging modalities (eg, plain radiographs and CT). Imaging should be obtained with the patient devoid of all obstructive materials in multiple positions (eg, upright, supine, lateral) in order to maximize the physician's ability to positively diagnose airway foreign bodies prior to definitive treatment with rigid bronchoscopy.
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Affiliation(s)
- Robert E. Wineski
- Department of Otolaryngology, Head and Neck Surgery, University of Alabama at Birmingham Medical Center
- Corresponding author.
| | - Emma C. Panico
- Department of Otolaryngology, Head and Neck Surgery, University of Alabama at Birmingham Medical Center
| | - Luke N. Bailey
- Department of Otolaryngology, Head and Neck Surgery, University of Alabama at Birmingham Medical Center
| | | | - Jessica W. Grayson
- Department of Otolaryngology, Head and Neck Surgery, University of Alabama at Birmingham Medical Center
| | - Brian J. Wiatrak
- Department of Otolaryngology, Head and Neck Surgery, University of Alabama at Birmingham Medical Center
- Pediatric ENT Associates of Alabama, Children's of Alabama Hospital Birmingham, AL
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Miller Koop M, Ozinga SJ, Rosenfeldt AB, Alberts JL. Quantifying turning behavior and gait in Parkinson's disease using mobile technology. IBRO Rep 2018; 5:10-16. [PMID: 30135951 PMCID: PMC6095098 DOI: 10.1016/j.ibror.2018.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 06/16/2018] [Indexed: 11/08/2022] Open
Abstract
Improvements in mobility were detected from meds using a mobile device IMU in PD. Algorithms using mobile device IMU data can segment the TUG into subtasks. The Cleveland Clinic Mobility App can provide an objective assessment of mobility.
Gait and balance impairments associated with Parkinson’s disease (PD) are often refractory to traditional treatments. Objective, quantitative analysis of gait patterns is crucial in successful management of these symptoms. This project aimed to 1) determine if biomechanical metrics from a mobile device inertial measurement unit were sensitive enough to characterize the effects of anti-parkinsonian medication during the Timed Up and Go (TUG) Test, and 2) develop the Cleveland Clinic Mobility and Balance application (CC-MB) to provide clinicians with objective report following completion of the TUG. The CC-MB captured 3-dimensional acceleration and rotational data from people with PD (pwPD) to characterize center of mass movement while performing the TUG. Trials were segmented into four components: Sit-to-Walk, Gait, Turning, and Stand-to-Sit. Thirty pwPD were tested On and Off (12 h) anti-PD medication. Significant improvements (p < 0.05) between On versus Off conditions included: reduction in MDS-UPDRS III motor scores (10.7%), faster trial times (9.3%), more dynamic walking as evident by increased normalized jerk scores (vertical: 17.3%, medial-lateral: 12.3%), shorter turn durations (10.4%), and faster turn velocities (8%). Measures in Sit-to-Walk and Stand-to-Sit did not show significant changes. Trial time and turn velocity showed excellent test-retest reliability (ICC range: 0.83-0.96) across both medication states. A mobile device platform provided quantitative measures of gait and turning during the TUG that detected significant improvements from anti-parkinsonian medications. This platform is a low-cost, easy-to-use tool that can provide objective reports immediately following the clinical assessments, making it ideal for use in and outside the clinical setting.
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Key Words
- AP, anterior-posterior
- CC-MB, Clinic Mobility and Balance Application
- Consumer electronics device
- ICC, IntraClass Correlation Coefficient
- IMU, inertial monitoring unit
- ML, medial-lateral
- NJS, Normalized jerk scores
- PD, Parkinson’s disease
- Parkinson’s disease
- RMS, root mean square
- STW, Sit-to-Walk
- TTS, Turn-to-Sit
- TUG, Timed-Up-And-Go-Test
- Timed Up and Go
- V, vertical
- cvCadence, coefficient of variation for cadence
- pwPD, people with Parkinson’s disease
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Affiliation(s)
- Mandy Miller Koop
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Sarah J Ozinga
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Anson B Rosenfeldt
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Jay L Alberts
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.,Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, United States
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McEvoy SD, Lee A, Poliakov A, Friedman S, Shaw D, Browd SR, Ellenbogen RG, Ojemann JG, Mac Donald CL. Longitudinal cerebellar diffusion tensor imaging changes in posterior fossa syndrome. Neuroimage Clin 2016; 12:582-590. [PMID: 27689022 PMCID: PMC5031477 DOI: 10.1016/j.nicl.2016.09.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 11/30/2022]
Abstract
Posterior fossa syndrome is a severe transient loss of language that frequently complicates resection of tumors of the cerebellum. The associated pathophysiology and relevant anatomy to this language deficit remains controversial. We performed a retrospective analysis of all cerebellar tumor resections at Seattle Children's Hospital from 2010 to 2015. Diffusion tensor imaging was performed on each of the patients as part of their clinical scan. Patients included in the study were divided into groups based on language functioning following resection: intact (N = 19), mild deficit (N = 19), and posterior fossa syndrome (N = 9). Patients with posterior fossa syndrome showed white matter changes evidenced by reductions in fractional anisotropy in the left and right superior cerebellar peduncle following resection, and these changes were still evident 1-year after surgery. These changes were greater in the superior cerebellar peduncle than elsewhere in the cerebellum. Prior to surgery, posterior fossa patients did not show changes in fractional anisotropy however differences were observed in mean and radial diffusivity measures in comparison to other groups which may provide a radiographic marker of those at greatest risk of developing post-operative language loss.
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Key Words
- AD, axial diffusivity
- AP, anterior-posterior
- CBW, cerebellar white matter
- CTC, cerebellar-thalamic-cortical
- Cerebellar mutism syndrome (CMS)
- Diffusion tensor imaging
- FA, fractional anisotropy
- KW, kruskal-wallis
- MCP, middle cerebellar peduncle
- MD, mean diffusivity
- MPRAGE, Magnetization Prepared Rapid Acquisition Gradient Echo
- PFS, posterior fossa syndrome
- Posterior fossa syndrome (PFS)
- RD, radial diffusivity
- RESTORE, Robust Estimation of Tensors by Outlier Rejection
- SCP, superior cerebellar peduncle
- SWI, Susceptibility weighted imaging
- TE, echo time
- TORTOISE, Tolerably Obsessive Registration and Tensor Optimization Indolent Software Ensemble
- TR, relaxation time
- Tumor
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Affiliation(s)
- Sean D McEvoy
- University of Washington, Department of Neurological Surgery, 325 Ninth Avenue, Seattle, WA 98104-2499, USA
| | - Amy Lee
- University of Washington, Department of Neurological Surgery, 325 Ninth Avenue, Seattle, WA 98104-2499, USA; Seattle Children's Hospital, Division of Neurosurgery, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Andrew Poliakov
- Seattle Children's Hospital, Division of Radiology, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Seth Friedman
- Seattle Children's Hospital, Division of Radiology, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Dennis Shaw
- Seattle Children's Hospital, Division of Radiology, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Samuel R Browd
- University of Washington, Department of Neurological Surgery, 325 Ninth Avenue, Seattle, WA 98104-2499, USA; Seattle Children's Hospital, Division of Neurosurgery, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Richard G Ellenbogen
- University of Washington, Department of Neurological Surgery, 325 Ninth Avenue, Seattle, WA 98104-2499, USA; Seattle Children's Hospital, Division of Neurosurgery, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Jeffrey G Ojemann
- University of Washington, Department of Neurological Surgery, 325 Ninth Avenue, Seattle, WA 98104-2499, USA; Seattle Children's Hospital, Division of Neurosurgery, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Christine L Mac Donald
- University of Washington, Department of Neurological Surgery, 325 Ninth Avenue, Seattle, WA 98104-2499, USA
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Abstract
We report a case of an adolescent female who had an initial outside clinical and imaging presentation that was considered highly suspicious for metastatic osteosarcoma. Extensive evaluation led to the diagnosis of chronic recurrent multifocal osteomyelitis. If this etiology had been considered earlier in the patient's clinical course, her diagnostic evaluation may have been less involved and treatment could have commenced sooner. When this entity is a diagnostic possibility along with neoplasm, strong consideration should be given to proceeding directly to open surgical biopsy due to the difficulty in diagnosing this lesion from small percutaneously-obtained biopsy samples.
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Key Words
- AP, anterior-posterior
- CC, cranial-caudal
- CRMO, chronic recurrent multifocal osteomyelitis
- CT, computed tomography
- ESR, erythrocyte sedimentation rate
- ML, medial-lateral
- MRI, magnetic resonance imaging
- SAPHO, synovitis, acne, pustulosis, hyperostosis
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