Bone marrow edema

The most common secondary sign is a characteristic bone bruise pattern, seen in up to 80 % of ACL tears [26]. The pivot shift mechanism creates an impact between LFC and the posterior LTP, which shows an increased signal on T2-weighted images (Fig. 12.4B). These bone bruises evolve over time following the occurrence of the acute injury and resolve after varying periods of time. Previous studies show that bone bruises are seen within 4-6 weeks after ACL injury [16,26]. However, it should be noted that the presence of the translational bone marrow edema pattern created by the pivot shift is indicative of recent tibial translation, but not necessarily of the presence of an acute ACL injury, as these injuries may also be seen in cases... 

Sometimes nontumoral lesions like stress fractures may mimic a bone tumor, especially in MRI, where strong bone marrow edema and contrast enhancement may be misleading (Woertler 2003 Gould et al. 2007 Fig. 35.4). In those cases, CT may demonstrate subtle cortical fracture Hnes, which allows exclusion of... 

Mnscnioskeletal Bone pain occurred in a 6-year-old boy during infusion of ciclosporin [16 ]. An MRI scan showed periosteal soft tissue changes and mild bone marrow edema of the femora and tibiae. Ciclosporin was replaced by tacrolimus, and after 9 days the pain had abated it resolved... 

Acute benzene poisoning results in CNS depression and is characterized by an initial euphoria followed by staggered gait, stupor, coma, and convulsions. Exposure to approximately 4000 ppm benzene results in complete loss of consciousness. Insomnia, agitation, headache, nausea, and drowsiness may persist for weeks after exposure (126). Continued inhalation of benzene to the point of euphoria has caused irreversible encephalopathy with tremulousness, emotional lability, and diffuse cerebral atrophy (125). In deaths arising from acute exposure, respiratory tract infection, hypo- and hyperplasia of sternal bone marrow, congested kidneys, and cerebral edema have been found at autopsy. 

I 12. The answer is b. (Hardman, pp 1264-1265J Dactinomycin s major toxicities include stomatitis, alopecia, and bone marrow depression. Bleomycin s toxicities include edema of the hands, alopecia, and stomatitis. Mitomycin causes marked bone marrow depression, renal toxicity, and interstitial pneumonitis. Plicamycin causes thrombocytopenia, leukopenia, liver toxicity, and hypocalcemia. The latter may be of use in the treatment of hypercalcemia. Doxorubicin causes cardiotoxicity, as well as alopecia and bone marrow depression. The cardiotoxicity has been linked to a lipid peroxidation within cardiac cells. 

Postmortem examinations of persons who died as a result of exposure to H have shown depletion of lymphoid cells in the spleen, thymus, and other lymphatic organs depletion of hematopoietic cells of the bone marrow necrosis and desquamation of epithelium in the small intestine acute ulceration of the duodenum membranous laryn-gotracheobronchitls and pulmonary edema, congestion, and patchy emphysema that may be complicated by bronchopneumonia or other evidence of pulmonary infection.2>47... 

Recombinant human IL-11 (oprelvekin) is a polypeptide of 177 amino acids. It differs from natural IL-11 due to lack of glycosylation and the amino-terminal proline residue. Oprelvekin is administered by subcutaneous injection, usually 6-24 h after chemotherapy, at a dose of 25-50 p,g/kg per day. The drug has a half-life of about 7h. It is used to stimulate bone marrow to induce platelet production in nonmyeloid malignancies in patients undergoing chemotherapy. The common side effects of oprelvekin include fluid retention, tachycardia, edema, nausea, vomiting, diarrhea, shortness of breath and mouth sores. Other side effects include rash at the injection site, blurred vision, paresthesias, headache, fever, cough and bone pain. Rarely, CLS may occur. 

The dose-limiting and most common adverse effect wdth intravenous and oral ganciclovir is bone marrow suppression (anemia, leukopenia, neutropenia, and thrombocytopenia). These effects are usually reversible upon w ithdraw al of the drug. CNS side effects are less common and range in severity from headache to behavioral changes to convulsions and coma. Fever, edema, phlebitis, disorientation, nausea, anorexia, rash, and myalgias have also been reported w ith ganciclovir therapy (Markham and Faulds, 1994). 

Bilateral optic disc edema is sometimes associated with ciclosporin given for bone marrow transplantation, but unilateral papilledema with otherwise asymptomatic raised intracranial pressure can occur (42). Eight cases of optic disc edema have been reported in bone marrow transplant patients taking ciclosporin. In two of the patients there were other possible explanations, but in all cases withdrawal of ciclosporin resulted in resolution of the papilledema (43). 

Avery R, Jabs DA, Wingard JR, Vogelsang G, Saral R, Santos G. Optic disc edema after bone marrow transplantation. Possible role of cyclosporine toxicity. Ophthalmology 1991 98(8) 1294-301. 

An anaphylactic reaction has been attributed to etherified starches during re-infusion of autologous bone marrow in a man treated for malignant lymphoma (6). The re-infused material had been processed using etherified starches. The patient reported pruritus and carpal spasm. Edema and erythema of the hands were present, together with hypotension and tachycardia. A very small amount of etherified starches was present in the processed bone autograft. 

Case Conclusion CC s oncologist decides to stop the interferon therapy and initiate a trial of imatinib mesylate. She tolerated the imatinib well, with minimal complaints of lower extremity edema for which she was prescribed furosemide. Six weeks after starting imatinib, CC s peripheral blood smear appeared normal (hematologic response) and cytogenetic evaluation of her bone marrow revealed disappearance of the Philadelphia chromosome. 

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