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Biomedical subjects

W C G Peh

Publications and source records attributed to W C G Peh.

At least 19 recordsLinked to original sources
PubMed2006

Symptomatic accessory soleus muscle: diagnosis and follow-up on magnetic resonance imaging.

The accessory soleus muscle is a rare anatomical variant which, although congenital in origin, may manifest in the second and third decades of life as a painful ankle mass or an asymptomatic ankle soft tissue swelling. We report a symptomatic accessory soleus muscle in a 21-year-old male soldier that was diagnosed and followed-up on MRI. Initial MRI showed a mass with signal characteristics of normal muscle, but in an abnormal location. There was increased intrafascial fluid and perimuscular oedema around the accessory soleus muscle. Following conservative treatment, repeat MRI showed resolution of this intrafascial fluid collection and perimuscular oedema, concurrent with relief of the patient's painful symptoms.

Ankle Injuries↗
PubMed2005

Magnetic resonance imaging appearances of fibrous dysplasia.

Fibrous dysplasia is a developmental disorder in which normal bone marrow is replaced by fibro-osseous tissue. The radiographic, CT and scintigraphic appearances of this condition are well known. The MRI appearances of fibrous dysplasia have not been widely published. The lesions are largely isointense with areas of hypointensity on T(1) weighted images and appear heterogeneously hyperintense on T(2) weighted images. The enhancement pattern is patchy central, rim, homogeneous, or a combination. The MRI features reflect the variable tissue components of this entity. This pictorial review aims at highlighting the MRI appearances, with pathological correlation.

Adolescent↗
PubMed2004

Malignant germ cell tumours of undescended testes: imaging features with pathological correlation.

AIM: To illustrate the imaging features of malignant germ cell tumours complicating undescended testes, emphasizing the importance of recognizing this condition and providing a correct diagnosis to facilitate appropriate management. METHODS: The clinical presentation, ultrasonography (US) and computed tomography (CT) features of eight consecutive patients with malignant germ cell tumours of undescended testes were reviewed. RESULTS: CT performed in seven patients showed well-circumscribed soft-tissue masses with inhomogeneous enhancement in all cases. US in four patients showed circumscribed masses with inhomogeneous echogenicity. On pathological examination, there were two cases of embryonal carcinoma and six cases of seminoma. All tumours showed necrosis that correlated to inhomogeneous areas on imaging. CONCLUSION: The radiologist has an important role as he may be the first physician to suggest the diagnosis.

Adult↗
PubMed2004

Role of mammography in diagnosis of axillary abnormalities in women with normal breast examination.

The mammograms of 43 patients presenting with palpable unilateral masses in the axilla and normal breasts on physical examination were retrospectively reviewed to determine the cause and imaging characteristics of axillary abnormalities, and the usefulness of mammography in detecting occult breast carcinoma. Cytological or histological confirmation was obtained in all patients. Forty of 43 patients had axillary lymphadenopathy while three had lipoma, fibroadenoma and haematoma, respectively. Causes of malignant lymphadenopathy (n = 22) were metastatic diseases from non-mammary primary malignancy (n = 8), occult ipsilateral breast carcinoma (n = 5), and previous contralateral breast carcinoma (n = 9). Causes of benign lymphadenopathy (n = 18) were reactive nodal hyperplasia (n = 6), collagen vascular diseases (n = 2), and acute bacterial (n = 2) and tuberculous (n = 8) lymphadenitis. Nodal size was not significantly different between benign and malignant lymph nodes. Benign and malignant nodal margins were variable. Intranodal microcalcifications were found in two cases of breast carcinoma metastasis. Intranodal macrocalcifications were found in three cases of tuberculous lymphadenitis. Occult primary breast carcinoma was detected on mammograms in four of five patients with axillary lymphadenopathy due to ipsilateral breast carcinoma. Mammographical features of benign and malignant lymphadenopathy may be indistinguishable, but presence of intranodal calcifications is helpful. Mammography is also valuable in depicting occult primary breast carcinoma.

Adult↗
PubMed2004

Linking up and out.

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Abstracting and Indexing↗
PubMed2004

Clinics in diagnostic imaging (95). Os trigonum.

A 19-year-old boy presented to the Accident and Emergency Department after sustaining trauma to his left ankle and foot while playing soccer. The radiograph of his left ankle showed a well-corticated triangular fragment of bone posterior to the left talus, typical of an os trigonum. This accessory bone was initially mistaken for a fracture fragment and a plaster cast was applied. The term, do not touch lesion, has been coined to describe this group of benign bony entities which may be classified into three broad categories, namely: normal variants, lesions that are real but obviously benign, and lesions that are related to degenerative disease. The importance of recognising the characteristic radiographical appearances of these entities is emphasised, as the need for further imaging or diagnostic tests can usually be avoided.

Adult↗
PubMed2004

A ton of Clinics.

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Diagnostic Imaging↗
PubMed2004

Clinics in diagnostic imaging (100). Migrated pharyngeal fish bone.

A 71-year-old man presented with a suspected swallowed fish bone. The lateral radiograph of the neck showed a curvilinear radio-opaque density in the swollen pre-vertebral soft tissues. The diagnosis of a migrated fish bone was confirmed on computed tomography and during subsequent surgery. The patient made a good recovery. As calcified normal structures, particularly the laryngeal cartilages, can mimic abnormal radio-opaque foreign bodies, it is important to be able to recognise the normal calcified structures seen on the neck radiograph. A sound knowledge of radiological anatomy is required in order to avoid unnecessary investigation and to provide prompt and appropriate management.

Aged↗
PubMed2004

Imaging of tuberculosis of the spine.

Tuberculosis (TB) is the leading cause of death worldwide that can be attributed to a single infectious agent. With the onset of the AIDS epidemic, there has been a resurgence of TB in recent years. Skeletal TB constitutes 1% to 3% of extrapulmonary cases, and typically involves the spine. TB of the spine should be considered in the differential diagnosis of many spinal conditions affecting patients of all ages. The pathophysiology, clinical and imaging features of TB of the spine are reviewed, with illustrations of findings on radiography, computed tomography and magnetic resonance imaging. Familiarity with the imaging features of TB of the spine may enable a more rapid diagnosis to be made, thereby preventing a delay in diagnosis with its consequent complications.

Diagnosis, Differential↗
PubMed2003

Percutaneous vertebroplasty: indications, contraindications, and technique.

Percutaneous vertebroplasty is an emerging interventional technique in which surgical polymethylmethacrylate is injected via a large bore needle into a vertebral body under imaging guidance. This technique provides increased strength and pain relief in vertebrae weakened by a variety of bone diseases. The current indication for vertebroplasty is intractable non-radicular pain caused by compression fractures due to osteoporosis, myeloma, metastases and aggressive vertebral haemangioma. Contraindications include bleeding disorder, unstable fracture and lack of definable vertebral collapse. Our technique of percutaneous vertebroplasty is illustrated in this pictorial review.

Back Pain↗
PubMed2003

Clinics in diagnostic imaging (83). Occult tibial condylar fracture.

A 39-year-old man who presented with right knee pain following trauma was found to have a radiographically-occult fracture of the lateral tibial condyle on magnetic resonance (MR) imaging. The intra-articular fracture was seen as a curvilinear area of hypointensity on both T1- and T2- weighted MR images, with surrounding bone bruising. The MR appearances of occult fractures and bone bruising, and the role of MR imaging in the detection of these injuries in various other regions, such as the ankle, hip, elbow and wrist, are discussed.

Adult↗
PubMed2003

Clinics in diagnostic imaging (82). Lesser trochanter metastasis.

A 73-year-old woman who had previous mastectomy for breast carcinoma presented with persistent pain over the left hip area for two to three months. Pelvic radiograph showed an expanded osteolytic lesion involving the lesser trochanter of the left femur, with adjacent ill-defined destructive changes. She subsequently developed a displaced pathological fracture through the lesser trochanteric metastasis. The clinical features and pathophysiology of bone metastases are discussed. The role of imaging, with additional illustrative examples, is emphasised.

Accidental Falls↗
PubMed2003

Clinics in diagnostic imaging (87). Subcutaneous lipoma.

A 40-year-old man presented with recent increase in size of a painless long-standing soft mass over the right shoulder. Magnetic resonance (MR) imaging showed a lobulated mass located within the subcutaneous layer overlying the deltoid muscle. It was homogeneously T1-hyperintense, T2-hyperintense, and non-enhancing. Signal characteristics were those of a simple lipoma. The diagnosis was confirmed on histopathological examination of the excised specimen. Musculoskeletal lipomas are discussed, with emphasis on their characteristic appearances on various imaging modalities, and illustrated by additional examples.

Adult↗