8/22/2023 0 Comments Anatomical phenomena definitionWhile “vacuum disk” findings are mostly associated with degenerative disk changes or benign vertebral collapse, the sign might be important due to the association with various underlying medical conditions including spinal infection with gas production. 1 The prevalence of that sign based on plain spinal images varies from 1% to 3% in the general population to 20% among elderly individuals. This unique finding was first described more than 80 years ago. In the spine, VP reflects a radiologic symptom of the gaseous collection in an intervertebral disk or in the spinal vertebra itself. The arrows indicate the area of translucency in all intervertebral disks from L1 to S1 vertebrae, consistent with the vacuum phenomenon.ĭiscussion. Abdominal CT reconstructions in sagittal (A) and coronal (B) planes of an 81-year-old woman. We have noticed that many internists are not familiar with the interpretation of this finding and its clinical correlation.įigure. The patient was treated successfully with intravenous antibiotics and was discharged, with follow-up scheduled in the clinic.ĭuring the initial workup in the ED, computed tomography (CT) of the abdomen and pelvis revealed mild right hydroureteronephrosis with no visible stone or obstructing lesion, as well as vacuum phenomena (VP) in the intervertebral disks on the levels L1 through S1 ( Figure). Urinalysis results were suggestive of a urinary tract infection the blood urea nitrogen level was elevated to 45 mg/dL and the creatinine level was elevated to 1.6 mg/dL. Physical examination revealed mild to moderate right costovertebral angle tenderness. The patient had a history of chronic lower back pain. Consultant. 2019 59(8):254-255.Īn 81-year-old woman with a history of type 2 diabetes mellitus and degenerative joint disease was referred to our emergency department (ED) with nausea, intermittent moderate abdominal pain, and bilious vomiting. Joint pain joint pathology vacuum joint vacuum phenomenon.Department of Medicine, NYC Health + Hospitals/Metropolitan, New York, New Yorkĭrozdov A, Chaudhari S. By identifying true anatomic VP, we can prevent harm from suboptimal treatment of patients. Underreporting of this phenomenon shows a lack of awareness of VP on the part of physicians. We have proposed criteria for diagnosing VP and generated a basic algorithm for its workup. VP should be on the differential diagnosis for joint pain, especially in the elderly. VP outside the spine is an underreported finding on imaging studies. Although most cases of VP are benign, it can be associated with clinical signs and symptoms. CT, GRE-MRI, and multipositional views are the best imaging studies to view VP. The formation of VP can be explained by gas solubility, pressure-volume relationships, and human physiology. We reviewed the literature to determine underlying mechanism, symptomology, associated pathologies, and clinical importance of VP. Two problematic scenarios can occur: a false-positive diagnosis of serious pathology instead of benign VP and a false-negative diagnosis of benign VP with a more serious underlying process Despite this potential for confusion, criteria for distinguishing VP from other causes of joint pain and for evaluating a suspected case of VP have not been fully established. Although VP is most often associated with degenerative joint disease, it is observed with other pathologies. Observation of this phenomenon has been demonstrated on basic radiographs, computed tomography, and magnetic resonance imaging. Vacuum phenomenon (VP) is an anatomical entity of potential confusion in the diagnosis and evaluation of joint pathology.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |