https://www.clinmedimagesjournal.com/feed Introduction Medical Imaging Technology has revolutionized health care in the past 30 years, assisting doctors to find disease earlier and improve patient outcomes. Medical imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention, as well as visual representation of the function of some organs or tissues. Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Medical imaging also establishes a database of normal anatomy and physiology to make it possible to identify abnormalities. Journal of Clinical, Medical and Experimental Images focuses on publishing PPT, flow chart and e-poster presentations on translational research and applications on medical/clinical/experimental imaging. The Journal of Clinical, Medical and Experimental research provides a unique platform to the doctors, scientists and researchers allows the researchers to communicate their ideas using images, graphical abstract submission and slogans effectively, without getting into description.  Reasons for Publishing Medical and Clinical Imaging give immense support in detecting and diagnosing disease at its earliest, in the most treatable stages and guides doctors as well as patients in determining the most appropriate and effective care. Innovations in medical and clinical imaging have turned countless patients into survivors. Hence, the Journal of Clinical, Medical and Experimental Images ranks imaging as one of the top medical developments in our world. The journal brings forth importance and empirical benefits of images in medical and clinical field. Case Report Mohammed Amine Elafari,Mamad Ayoub,Mohamed Amine Zaki,Mohammed Amine Bibat,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader 2026-04-01 12:21:58 Background: Bladder exstrophy is a rare congenital abnormality that is usually managed with multiple surgical interventions. Long-term consequences include recurrent urinary tract infections, bladder stones, fistulae, and metaplastic changes with malignant potential.Case Presentation: We present a case of a 21-year-old male with a history of failed childhood surgeries for bladder exstrophy who presented with a vesicocutaneous fistula and a 7 cm bladder stone. He underwent an open cystolithotomy with bladder augmentation and creation of a Benchekroun continent valve. However, the patient developed recurrent fistulae due to poor tissue quality. Histopathological examination confirmed early squamous metaplasia in the bladder mucosa. After discussion in a multidisciplinary meeting, the patient underwent a radical cystectomy with ileal conduit urinary diversion using the Bricker technique. He is doing well at 3 months with no evidence of any complication.Conclusion: This case illustrates the difficulties encountered in managing adult patients with bladder exstrophy and failed reconstructions. The presence of squamous metaplasia, poor bladder tissue, and recurrent complications all contributed to the decision for radical cystectomy. It is important to recognize these changes and address them appropriately in a timely manner to prevent further complications and possible malignant changes. https://www.clinmedimagesjournal.com/articles/jcmei-aid1044.pdf Case Presentation Mohammed Amine Elafari,Mamad Ayoub,Mohammed Amine Bibat,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader 2026-03-30 10:24:23 Inverted Urothelial Papilloma (IUP) is an unusual variety of urothelial tumors that typically occurs in adults, with a predominance in males. The definitive diagnosis of IUP relies on histopathological examination, as the clinical presentation and endoscopic appearance are non-specific. The recommended treatment for IUP includes the complete transurethral resection, with some controversy regarding the need for cystoscopic follow-up. In this case, we present an atypical instance of IUP in a 21-year-old male patient, diagnosed with gross hematuria and irritative lower urinary tract symptoms. A clinical assessment revealed a 3.0 × 2.6 cm intravesical mass. The definitive diagnosis was confirmed histopathologically and further substantiated by immunohistochemistry, which demonstrated low expression of p53 and Ki-67, effectively ruling out malignancy. This case underscores the diagnostic challenges posed by bladder masses in young adults, emphasizing the necessity of integrating morphological and immunohistochemical findings to prevent overdiagnosis of urothelial carcinoma. The paper focuses on the diagnostic approach and management of this rare condition in the young male population. https://www.clinmedimagesjournal.com/articles/jcmei-aid1043.pdf Case Presentation Mohammed Amine Elafari,Mamad Ayoub,Mohammed Amine Bibat,Maachi Youssef,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader 2026-03-16 00:00:00 Ureteral double-J stents are a commonly used device in urological practice to allow urinary drainage, avoid ureteral obstruction processes, and protect the upper urinary tract after surgical procedures. However, long indwelling time may give rise to numerous complications, such as infection, migration, and fragmentation of the stent, especially encrustation. Encrustation of stents is a well-known complication that has been closely related to the time active of the stent and can cause significant morbidity if not timely addressed. In severe cases, abundant mineral deposition can result in the development of large calculi encasing the stent and rarely progress to staghorn stones. These cases may pose challenges in terms of the extraction of the stent and may result in complex endourological intervention. The encrustation likelihood is substantially higher if stents are left forgotten or remain in place longer than the advised period. Most patients with heavily encrusted stents have symptoms including flank pain, urinary tract infection, hematuria, or obstructive uropathy, but can present without any symptoms, and this can delay the diagnosis. https://www.clinmedimagesjournal.com/articles/jcmei-aid1042.pdf Case Presentation Mohammed Amine Elafari,Mamad Ayoub,Mohammed Amine Bibat,Rhayour Anas,Maachi Youssef,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader 2026-03-05 17:11:57 Psoas abscess is a rare but potentially life-threatening condition with non-specific clinical manifestations. The condition may be primary or secondary, depending on whether it has an underlying cause. The condition may be diagnosed with the help of imaging studies, especially contrast-enhanced computed tomography (CT).A 55-year-old female patient with a history of treated hypertension presented with a 15-day history of fever and left-sided low back pain. Her laboratory parameters showed a high leukocyte count of 22,000 cells/mm³ and elevated levels of C-reactive protein (367 mg/L). Her renal functions were within normal limits, and the urine culture was negative. Contrast-enhanced CT revealed a large left-sided intra-abdominal fluid collection extending from the diaphragm to the left iliac fossa, measuring 66 x 305 mm with air bubbles. The collection also showed a left-sided intramuscular psoas collection of 66 x 50 x 131 mm. The patient received intravenous broad-spectrum antibiotics (third-generation cephalosporin, aminoglycoside, and metronidazole). The patient underwent mini-lumbotomy, and nearly 1 liter of pus was drained. The patient’s postoperative course was satisfactory with complete resolution of symptoms. The histopathological examination showed non-specific changes.Psoas abscess should be suspected in patients with febrile low back pain and inflammatory syndrome. Contrast-enhanced CT scans are essential for diagnosis and assessment of the extent of disease. In complicated cases with large abscess formation, early surgical drainage along with appropriate antibiotics will provide the best outcome.This case highlights the importance of early diagnosis and adapted management for successfully navigating the complexities associated with this condition. https://www.clinmedimagesjournal.com/articles/jcmei-aid1041.pdf Case Report Ayoub Mamad,Mohammed Amine Bibat,Mohammed Amine Elafari,Midaoui Moncef,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader 2026-02-19 10:27:38 Intravaginal erosion of synthetic mesh after laparoscopic promontofixation(sacrocolpopexy) is an uncommon but clinically relevant late complication. When mesh becomes exposed within the bladder, it may function as a persistent foreign body, encouraging chronic inflammation, bacterial colonization, recurrent lower urinary tract symptoms, and progressive encrustation that can culminate in bladder stone formation. We report a 60-year-old woman with a history of laparoscopic promontofixation using standard polypropylene mesh performed approximately five years earlier. She presented with progressive urinary symptoms. Bladder ultrasound demonstrated an intravesical calculus, and diagnostic cystoscopy confirmed a bladder stone developing on exposed intravesical mesh fibers, consistent with intravesical mesh erosion. Endoscopic management was performed with cystolithotripsy followed by section/resection and removal of the exposed intravesical mesh to eliminate the lithogenic nidus, with a favorable outcome. In women with prior promontofixation presenting with bladder stones, recurrent urinary tract infections, hematuria, or persistent irritative urinary symptoms, intravesical mesh erosion must be considered. Cystoscopy is essential for diagnosis because imaging may identify the stone but not the underlying foreign-body etiology, and definitive treatment requires both stone clearance and elimination of intravesical foreign material to prevent recurrence. https://www.clinmedimagesjournal.com/articles/jcmei-aid1040.pdf Case Report Ayoub Mamad,Mohammed Amine Elafari,Mohammed Amine Bibat,Midaoui Moncef,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader 2026-02-09 14:40:46 Iatrogenic ureteral injury is an uncommon but potentially severe complication of abdominopelvic surgery. When not identified intraoperatively, it may present days to weeks later with flank pain, fever, urinary tract infection, and imaging evidence of obstruction. Early recognition and timely urinary diversion are essential to prevent sepsis and preserve renal function.A 65-year-old patient underwent elective resection of an abdominal mass; pathology confirmed schwannoma. On postoperative day 15, the patient developed left flank pain and fever. Laboratory tests showed leukocytosis (WBC 15,000/mm³) and elevated C-reactive protein (150 mg/L); urine culture grew Escherichia coli. Contrast-enhanced CT demonstrated left hydronephrosis without stones, suggesting postoperative ureteral obstruction. Retrograde double-J stenting was attempted but failed. Urgent percutaneous nephrostomy achieved decompression with clinical improvement under targeted antibiotics. Definitive exploration revealed a 1 cm stricture of the lumbar ureter, managed by segmental resection and tension-free spatulated termino-terminal ureteroureterostomy over an internal stent. Postoperative recovery was uncomplicated; the stent was removed after 3 weeks. Follow-up ultrasound showed no persistent pelvicalyceal dilatation.Delayed ureteral obstruction should be suspected in postoperative patients presenting with flank pain, fever, and hydronephrosis. When retrograde stenting fails in the setting of infection, percutaneous nephrostomy provides rapid decompression and source control, allowing delayed definitive reconstruction. For short-segment proximal or mid-ureter strictures, ureteroureterostomy remains a reliable option when performed according to reconstructive principles. https://www.clinmedimagesjournal.com/articles/jcmei-aid1039.pdf Case Report Ayoub Mamad,Mohammed Amine Bibat,Mohammed Amine Elafari,Youssef Maachi,Amine Slaoui,Tarik Karmouni,Abdelatif Koutani,Khalid Elkhader 2026-01-21 10:54:57 Penile fracture is a rare urological emergency typically characterized by an audible “cracking” sound, immediate detumescence, and rapid penile swelling following trauma to an erect penis. We present clinical and intra-operative images of a 37-year-old man with a proximal tunica albuginea tear confirmed at urgent exploration and repaired with absorbable sutures. Early surgical exploration with hematoma evacuation and primary repair remains the preferred approach to reduce long-term complications such as penile curvature and erectile dysfunction. https://www.clinmedimagesjournal.com/articles/jcmei-aid1038.pdf Research Article Andrew K Hillman,Phil Ramis,Patrick Nielsen,Sophia N Swanston,Dana Bonaminio,Eric M Rohren 2025-10-30 13:02:07 Purpose: To determine trends in breast imaging services utilization among privately and government-insured patients at a national radiology practice.Method: Monthly breast imaging volume data from January 2019 to September 2022 were analyzed across five insurance types: three commercial carriers (Com1-Com3), Medicaid, and Medicare. Primary analysis involved calculating quarterly volumes and standard errors of the mean, followed by a joinpoint regression to identify trend inflection points and quarterly percentage changes (QPC). In the secondary analysis, the entire period trend was obtained and measured as the average quarterly percentage change (AQPC).Results: Between 2019 Q1 and 2022 Q3, a total of 4,640,619 breast imaging services were accessed, including 2,034,833 2D screening mammograms, 1,640,689 screening digital breast tomosynthesis, 497,592 diagnostic mammograms, 452,549 breast ultrasounds, and 14,956 breast MRIs. AQPC values for imaging modalities varied across insurance types. Medicare and Medicaid patients showed the highest rates of utilization increases, particularly for modalities other than screening breast tomosynthesis, where private insurers dominated. Variations were observed between different commercial payors.Conclusion: Breast imaging utilization increased among patients insured by Medicare and Medicaid from 2019 to 2022, outpacing that of those with private insurance. These findings contrast previous research suggesting better access and utilization among privately insured individuals, highlighting increased access for government-insured patients in this study. https://www.clinmedimagesjournal.com/articles/jcmei-aid1037.pdf Review Article Neeraj Kumar,Dev Brat Mishra 2025-06-14 17:49:27 Microplastics (MPs) pose a significant risk to human health, particularly through seafood consumption. Once ingested, MPs can spread from the digestive system to other organs via phagocytosis and endocytosis, leading to toxicological effects. Accumulation of MPs in tissues causes swelling, blockages, oxidative stress, and Cytotoxicity. Studies show MPs alter metabolism, disrupt immune function, and contribute to autoimmune diseases. Chronic exposure has been linked to neurotoxicity, vascular inflammation, and increased cancer risk due to DNA damage. MPs can cross biological barriers, including the placenta, affecting fetal development. Additionally, they serve as vectors for pollutants and bacteria, further complicating health risks. MPs in the bloodstream can trigger inflammatory responses, endothelial adhesion, and red blood cell coagulation, leading to cardiovascular complications. In vitro studies indicate MPs impair renal function and cause long-term inflammation in distal tissues. Moreover, oxidative stress caused by MPs plays a critical role in carcinogenicity. Despite growing evidence of adverse health effects, further research is necessary to understand the full impact of MPs’ exposure on human health and develop effective mitigation strategies. https://www.clinmedimagesjournal.com/articles/jcmei-aid1036.pdf Mini Review Shiying Bai,Lufeng Bai 2025-03-23 11:49:54 This paper shows the developments and directions in feature processing. We begin by revisiting conventional feature processing methods, then focus on deep feature extraction techniques and the application of feature processing. The article also analyzes the current research challenges and outlines future development directions, providing valuable insights in related fields. https://www.clinmedimagesjournal.com/articles/jcmei-aid1035.pdf Literature Review Gargi J Trivedi 2025-03-06 15:42:17 Cardiovascular Diseases (CVDs) remain a major global health concern, necessitating accurate and comprehensive diagnostic techniques. Traditional medical imaging modalities, such as CT angiography, PET, MRI, and ultrasound, provide crucial but limited information when used independently. Image fusion techniques integrate complementary modalities, enhance visualization, and improve diagnostic accuracy. This paper presents a theoretical study of advanced image fusion methods applied to cardiovascular imaging. We explore wavelet-based, Principal Component Analysis (PCA), and deep learning-driven fusion models, emphasizing their theoretical underpinnings, mathematical formulation, and potential clinical applications. The proposed framework enables improved coronary artery visualization, cardiac function assessment, and real-time hemodynamic analysis, offering a non-invasive and highly effective approach to cardiovascular diagnostics.MSC Codes: 68U10,94A08,92C55,65T60,62H25,68T07. https://www.clinmedimagesjournal.com/articles/jcmei-aid1034.pdf Case Study Ceyhun Gökhan,Arslan Ümit,Dursun Lezgin,Aydin Muhammet,Şeker Cüneyt 2024-11-25 10:00:00 Ventricular Septal Defect, also known as VSD is a rare and life-threatening complication associated with MI. Therefore, it should be immediately diagnosed and treated. Transcatheter closure of the ventricular septal defect is a new alternative treatment approach compared to surgery. In this case, we presented a patient with post-infarct basal ventricular septal defect whose ventricular septal defect was closed using an atrial septal defect closure device. The ability to successfully close such a large defect via catheter is promising for the treatment of patients with VSD. https://www.clinmedimagesjournal.com/articles/jcmei-aid1033.pdf Observational Study Andrew K Hillman, Phil Ramis, Patrick Nielsen, Eric M Rohren* 2024-08-26 15:26:52 Purpose of the study:  To evaluate the performance of Best Practice Recommendation (BPR) compliance in reporting abdominal aortic aneurysm findings on imaging, comparing the results before and after its deployment.Methods: Best Practice Recommendations for AAA were deployed in 2020 at a large radiology practice site. Reports between January 2018 through October 2022 were reviewed, representing studies read prior to and subsequent to the implementation of the reporting standards. Cases of abdominal aortic aneurysms ≥ 2.6 cm were counted by year. Adherence to the BPR for each year was calculated as [total number of confirmed cases of ≥ 2.6 cm AAAs with compliant reports] * 100 / [the total number of confirmed ≥ 2.6 cm AAAs]. A secondary analysis was performed to determine whether there was a statistically significant difference in the proportion of BPR-compliant reports for AAA cases before (from 2018 to 2019) and after (from 2020 to 2022) BPR deployment using a chi-square test. Results: From January 2018 to December 2022, there were 8,693 reports referencing AAA. After excluding cases of suspected AAA (N = 2,131), confirmed AAAs with indeterminate sizes (N = 103), and confirmed AAAs with sizes < 2.6 cm (N = 85), the number of AAA cases ≥ 2.6 cm in size was 6,374. Concordance with the BPR standards for the remaining cases with sizes ≥ 2.6 cm were 1.6% and 4.1% in 2018 and 2019, respectively. Post-implementation of BPRs, there was a substantial improvement in guideline adherence to 32.1%, 84.3%, and 83.6% in 2020, 2021, and 2022, respectively. In general, the proportion of BPR-compliant reports of AAA cases in the pre-deployment (3.6%) period statistically differs (p - value < 0.0001) from those in the post-deployment period (73.9%)Conclusion: Adherence to reporting standards increased after the BPR deployment in 2020. The inclusion of management recommendations in the radiology report when AAA is identified is a simple and cost-effective way of improving outcomes for patients with AAAs through appropriate follow-up treatment. https://www.clinmedimagesjournal.com/articles/jcmei-aid1032.pdf Case Report Fawzi Irshaid*, Salim Alawneh, Qasim Al Souhail, Aisha Alshdefat, Bashar Irshaid, Ahmed Irshaid 2024-05-07 09:59:30 Objective: Alazami syndrome (AS) is an infrequent genetic disorder inherited in an autosomal recessive pattern, characterized by the presence of multiple congenital abnormalities. This study explores a case of a 4-year-old girl with AS, examining symptoms, genetic factors, and treatment efficacy. Case report: A 4-year-old girl, born to consanguineous Jordanian parents, displayed dysmorphic features including low birth weight, microcephaly, hyperthyroidism, short stature, blue sclera, triangular-shaped face, deep-set eyes, narrow palpebral fissures, and a prominent forehead. Examination revealed height (92 cm) and weight (7.7 kg) below the 5th and 3rd percentiles respectively. Blood tests and renal ultrasound were normal. Whole exome sequencing (WES) identified a homozygous eight-base pair deletion within exon 5 of the LARP7 gene on chromosome 4q25, confirming the diagnosis of AS, an autosomal recessive disorder. This variant induces frameshift mutations leading to premature stop codons, suggesting a probable mechanism of illness via loss of function. Treatment involving growth monitoring and therapy led to significant improvements in height, weight, and communication skills within three months. Conclusion: We describe a rare autosomal recessive AS case due to consanguinity, with a frameshift mutation in the LARP7 gene found via WES. Our AS treatment program effectively alleviates symptoms and enhances developmental progress. https://www.clinmedimagesjournal.com/articles/jcmei-aid1031.pdf Clinical Image Rony Varghese*, Amal Upadhyay, Pawan Kumar Jaiprakah Maniyar 2024-02-06 15:52:52 A 43-year-old man presented to the emergency department with syncope following hematemesis. He gave the history of melena for 3 days. https://www.clinmedimagesjournal.com/articles/jcmei-aid1030.pdf Research Article Ahsana Nazish 2023-12-26 09:51:40 Background: Clinician managers can play a crucial role in healthcare organizations, including hospitals, by combining their clinical expertise with managerial responsibilities. They bring valuable insights and firsthand experience of patient care to managerial positions, contributing to improved patient outcomes and hospital performance. However, they face unique challenges that require careful attention and solutions. Aim: This review aims to critically discuss the role of clinicians as managers, the challenges that they face, and how they exercise their influence in hospital settings. Key findings: The role of clinicians as managers is critical for effective leadership and delivery of high-quality patient care. Described as a two-way window, clinician managers bridge the gap between medicine and management by combining clinical expertise with managerial skills in a hybrid leadership approach. Studies have shown a positive impact on hospital performance, including enhanced quality care, improved patient outcomes, and potentially better financial performance. In addition, they play a vital role in fostering interdisciplinary collaboration and boosting staff engagement. However, challenges such as identity conflicts, and limited formal training, are present, especially for first-time managers. Conclusion: Adapting to the dual role of clinician and manager demands a mindset shift and the development of new skills, necessitating strategic support. This includes leadership education, organizational support, mentoring, and collaborative models to empower clinician managers. Targeted training programs, formal mentoring, and peer support networks equip them with essential skills, while workload management, well-being initiatives, and a culture of balance foster success and growth. https://www.clinmedimagesjournal.com/articles/jcmei-aid1029.pdf Case Report Han-Mei Chang, Chan-I Su, Ching-Ting Chang* 2023-09-04 10:04:53 The vast majority of urological complications occur at the ureterovesical junction and usually occur early after transplantation. The aim of this study is to enhance the quality of medical care provided to patients who undergo kidney transplantation. Cystography was conducted on renal transplant recipients utilizing computed tomography. The utilization of changes in the patient’s position and reconstructed images of the bladder can serve as a diagnostic tool to assess the normal functioning of the urinary tract system subsequent to kidney transplantation. To ensure adequate filling of the bladder and ureter, it is necessary to introduce varying amounts of contrast medium through the urinary catheter into these structures. This diagnostic procedure aims to verify the existence of stenosis or leakage occurring at the vesicoureteral junction. The evaluation and diagnosis of urinary tract problems subsequent to kidney transplantation can be effectively conducted. Furthermore, it has the potential to mitigate the adverse effects and alleviate the strain on the renal system resulting from the administration of contrast agents in computed tomography urography. CT-guided cystography can enhance the medical quality and comfort of Kidney transplantation patients. https://www.clinmedimagesjournal.com/articles/jcmei-aid1028.pdf Clinical Image Anubha Bajaj 2023-03-17 14:35:50 Spindle cell lipoma and pleomorphic lipoma emerge as benign, adipocytic neoplasms representing a morphologic continuum of a singular neoplasm. In addition to myofibroblastoma and cellular angiofibroma, spindle cell lipoma or pleomorphic lipoma configures as a constituent of chromosome 13q/RB1 family of tumors. Initially scripted by Enzinger and Harvey in 1975 with an obsolete terminology of dendritic fibromyxolipoma, aforesaid adipocytic neoplasms articulate an estimated 1.5% of lipomatous tumors. In contrast to conventional lipoma, spindle cell lipoma or pleomorphic lipoma is an uncommonly discerned variant, demonstrating a proportion of 1: 60. https://www.clinmedimagesjournal.com/articles/jcmei-aid1027.pdf Clinical Image Babty Mouftah,Slaoui Amine,Fouimtizi Jaafar,Mamad Ayoub,Karmouni Tarik,El Khadder Khalid,Koutani Abdellatif,Ibn Attya Ahmed 2022-08-30 11:07:49 Benign Prostatic Hyperplasia (BPH) refers to the nonmalignant growth or hyperplasia of prostate tissue and is a common cause of lower urinary tract symptoms in men [1]. https://www.clinmedimagesjournal.com/articles/jcmei-aid1026.pdf Case Report Hafedh Daly,Abdelbaki Bouallegue,Amira Horchani 2022-08-02 10:56:24 The radial artery shows great anatomical variability with respect to its origin [1]. Generally, its origin is located in the cubital fossa at the level of the neck of the radius [2]. However, the artery may have a high origin from the brachial artery or even the axillary artery [1]. https://www.clinmedimagesjournal.com/articles/jcmei-aid1025.pdf Clinical Image Abdallah Chaachou,Nizar Cherni,Wael Ferjaoui,Mohamed Dridi,Samir Ghozzi 2022-06-02 15:36:49 This is a 19-year-old patient. His clinical examination finds an empty bursa with a palpable left testicle at the level of the inguinal canal. https://www.clinmedimagesjournal.com/articles/jcmei-aid1024.pdf Clinical Image Prachi,Gaurav Sharma,Suparno Chakrabarti 2021-07-27 00:00:00 Haemophagocytosis is a dysregulated immune condition characterised by both inflammation and uncontrolled activation of macrophages and T-cells, which causes aberrant cytokine release, leading to cytokine storm [1] it can be primary or secondary, depending upon the etiology.  https://www.clinmedimagesjournal.com/articles/jcmei-aid1023.pdf Clinical Image Jean-Baptiste Rieu,Francois Vergez,Jill Corre,Aurore Perrot,Pierre-Luc Mouchel 2021-07-21 00:00:00 A 66-year-old patient, diagnosed κ light chains MM with t(11;14), presented before second cycle with bendamustine-dexamethasone. A complete remission was initially obtained with bortezomib-cyclophosphamide-dexamethasone and autologous HSCT. After relapse, he was successively treated with bortezomib-dexamethasone, carfilzomib-dexamethasone, daratumumab-dexamethasone and benda-mustine-dexamethasone. https://www.clinmedimagesjournal.com/articles/jcmei-aid1022.pdf Clinical Image Yogendra Mishra,Satish Kumar,Meghna K 2021-07-20 00:00:00 A 78-year-old man, known case of, diabetes mellitus, and hypertension presented with fever, dry cough and dyspnea of five-day duration. He tested positive for SARS-CoV-2 infection and was admitted to the intensive care unit as a case of severe COVID -19 pneumonia. Evaluation revealed raised inflammatory markers CRP: 92.2 mg/ml, LDH: 556 IU/L, Ferritin: 286 ng/ml, D-dimer: 3716 ng/ml. On day 9 of illness, he developed numbness, pain and discoloration of right hand. https://www.clinmedimagesjournal.com/articles/jcmei-aid1021.pdf Clinical Image Bilgehan Erkut,Hakan Usta,Izatullah Jalalzai,Ferhat Borulu,Yasin Kilic 2021-04-16 00:00:00 Acute pulmonary damage and vascular coagulopathy appear to be frequent in patients with SARS-CoV-2 infection relation to corona-virus. The inflammatory process accompanying the infection and excessive coagulation state is one of the most important causes of patient loss. https://www.clinmedimagesjournal.com/articles/jcmei-aid1020.pdf Clinical Image Sung-Yuan Hu,Yi-Hsuan Chen,Shian-Shiang Wang 2021-03-18 00:00:00  23-year-old man had a 2-year history of ketamine abuse and presented intermittent abdominal pain, urinary urgency and dysuria for one year. Two weeks ago, laboratory analysis showed within normal limits. This time, he visited our emergency department due to hematuria and bilateral flank pain. CT scan and MRI revealed bilateral hydronephrosis, hydroureter, irregular thickened wall of urinary bladder, and fusiform common bile duct with distal stenosis https://www.clinmedimagesjournal.com/articles/jcmei-aid1018.pdf Clinical Image Sung-Yuan Hu,Chun-Cheng Chen,Hung-Wen Tsai 2021-03-18 00:00:00 A 58-year-old hypertensive man presented to our insti-tution with acute chest pain and dizziness. Electrocardiogram revealed inferior wall myocardial infarction with suspected right ventricular involvement (Figure 1A). Computed tomographic aortography (CTA) depicted ascending aortic dissection (AAD) with involvement of bilateral carotid, subclavian, and right common iliac arteries (Figure 1B). Replacements of aortic valve and ascending aorta with CABG (Ao-RSVG1-LAD and Ao-RSVG2-RCA) were conducted.  https://www.clinmedimagesjournal.com/articles/jcmei-aid1019.pdf Clinical Image Roberto Benavides Arenas,Juan Camilo Jaramillo 2021-03-09 00:00:00 A 79 years old woman presented with one-day history of pain, redness, pain and swelling without discharge in her left ear, later her right ear started with the same symptoms as in her contralateral ear spreading around the scalp and the forehead (Figure 1), she denied fever, or other constitutional symptoms.  https://www.clinmedimagesjournal.com/articles/jcmei-aid1017.pdf Clinical Image Elvis Piñeres,Carlos Ospina 2020-10-22 00:00:00 A 34-week premature newborn, child of a mother without prenatal controls, a marijuana user, with gestational syphilis with a positive rapid plasma reagin test (RPR) titer 1:16, did not receive treatment during pregnancy. The newborn presented congenital syphilis, RPR titer 1: 256 positive test. https://www.clinmedimagesjournal.com/articles/jcmei-aid1016.pdf Clinical Image Gautam Mullick,Ajay Handa,Vikas Chauhan 2020-05-28 00:00:00 A 42 years old gentleman who was a known case of Psoriasis vulgaris since last 5 years presented to the Rheumatology clinic with inflammatory arthritis predominantly involving the joints of the upper extremities. Musculoskeletal examination of both hands revealed dactylitis and distal interphalangeal joint arthritis. He had a shortened right ring finger with excessive transverse skin folding suggestive of an Opera-Glass hand https://www.clinmedimagesjournal.com/articles/jcmei-aid1015.pdf Clinical Image Touimi SH,Daoudi S,Mbarki I,Adrif I,Elkacemi H,Elmajjaoui S,Kebdani T,Errihani H,Benjaafar N 2020-02-18 00:00:00 It’s a 24 years old female patient who presented with rhinological burning pain evolving since 1 year. She didn’t consult until a blistering lesion filled half of the oral cavity. The initial biopsy of the tumor was interpreted as a round cell tumor process. https://www.clinmedimagesjournal.com/articles/jcmei-aid1014.pdf Clinical Image Pérez J,Pozo D 2019-12-07 00:00:00  62-year-old female with a history of arterial hypertension, attended the emergency department due to pain in the left flank. On physical examination no showed signs of peritoneal irritation. Urinalysis was indicated, that reported microscopic hematuria and negative abdominal ultrasound. https://www.clinmedimagesjournal.com/articles/jcmei-aid1013.pdf Case Report Okacha Naama,Abdelilah Idir,Omar Boulahroud 2019-09-19 00:00:00 Intraparenchymal cysts without communication to the ventricles or the subarachnoid space are named ependymal or epithelial cysts. The estimated ratio of their incidence compared with arachnoid cysts is 1:10. Neurologic deficit can occur when the cyst exerts mass effect on its surroundings. We report a case of cerebral ependymal cyst in a 75-year-old lady who presented with history of headache, vomiting and left incomplete homonymous hemianopsia. Neuroimaging studies showed a large right occipital cyst. She underwent the neurosurgical procedure of marsupialization. Histologic findings and the immunophenotype was consistent with a diagnosis of ependymal cyst. The patient made an excellent recovery after the procedure. https://www.clinmedimagesjournal.com/articles/jcmei-aid1012.pdf Review Article Syed Abdul Kade 2019-06-04 00:00:00 This article reflects the opinion on a few of my clinical experiences involving symptoms and signs which are not mentioned in standard textbooks on medicine or clinical methods. These are clinical and a few radiological signs which I think worth discussing by clinical community, includes Muslim prayer’s feet, hyponatraemic bullae, early signs of oedema, PCV sign, hemi-semi-Hoffman’s sign and a few more. https://www.clinmedimagesjournal.com/articles/jcmei-aid1011.pdf Clinical Image Salwa Samir Anter 2019-02-07 00:00:00 Flexible magnifying endoscopy with narrow band imaging (ME-NBI) has outstanding diagnostic correctness for gastrointestinal metaplsia and is hope for to be highly useful for imaging stage cervixcal metaplsia beginning by imaging the first stage of metaplasia by imaging single layer of subcolmnar reserve cells reserve cells hyperplasia, the reserve cells are round to cuboid with large oval or round nuclei, seen below the surface columnar cells and the columnar https://www.clinmedimagesjournal.com/articles/jcmei-aid1010.pdf Clinical Image Astrit Gashi M,Gent Sopa,Ilir Kadiri,Majlinda Bala,Petrit Pupa 2018-02-22 00:00:00 A 36-year-old woman pregnant, G2 P1, presented at 27 weeks of gestation after two previous visits elsewhere, as an outpatient in a gynecological clinic. An ultrasound examination revealed bilateral hydronephrosis. Also, ureteral dilation and bladder overdistension was present (Figures 1-3). We evaluated that the cause was a urinary tract obstruction. Specifically, we are dealing with posterior urethral valves. The anteroposterior diameter of the pelvis on a transverse view of the abdomen was 6 mm. The amniotic fluid index (AFI) was 3 cm, so, oligohydramnios. https://www.clinmedimagesjournal.com/articles/jcmei-aid1009.pdf Clinical Image Pirabu Sakthivel,Chirom Amit Singh,Chandra Sharma 2017-09-22 00:00:00 A 63 year old gentleman presented with ulcer over the lower alveolus for the past 4 months duration. The patient also had pain, loose lower central incisors and occasional bleeding from the ulcer while brushing. On examination an ulceroproliferative growth was seen involving lower alveolus along with adjoining mucosa of the lower lip with mobile central incisors. There was associated bilateral submandibular area lymphadenopathy.  https://www.clinmedimagesjournal.com/articles/jcmei-aid1008.pdf Case Report Mariusz Dyląg,Emilia Flisowska,Patryk Bielecki,Maria Kozioł-Gałczyńska,Weronika Jasińska 2017-04-25 00:00:00 The authors describe the unusual case of subungual onychomycosis, due to fluconazole and itraconazole resistant Candida albicans after using the hybrid and acrylic lacquers and nail tips. The etiology of these atypical changes was supported by isolation of the fungus from the nail lesions, and its consistent identification by means of morphological and molecular diagnosis. In the presented case, topical treatment with ciclopirox 8% nail lacquer allow to fight the pathogenic fungus but did not restore the natural appearance of the nails. https://www.clinmedimagesjournal.com/articles/jcmei-aid1007.pdf Research Article Wolfgang Freund,Frank Weber,Reinhard Meier,Stephan Klessinger 2017-03-27 00:00:00 Background: Low back pain has recently been reported as the leading cause for disability worldwide. The diagnostic value of imaging has been estimated low. Led by own positive experience, however, we hypothesized that MRI can detect signs of facet joint pain. Methods: 15 patients and 15 controls were retrospectively assessed by two readers. They compared de-identified T2 weighted lumbar spine MRI scans. Facet joint size, shape, angle, joint space signal and degeneration were rated. Pain aetiology was proven with the diagnostic gold standard of medial branch blocks. Results: Facet joint angles and joint diameters were significantly larger in symptomatic patients, who also showed significantly higher grades of degeneration but no difference in joint space distances or shape or signal intensity. The readers were able to correctly identify symptomatic patients with good interrater reliability (kappa 0.5, sensitivity and specificity 0.87-0.93), positive (LR+= 6.7-7.2) and negative likelihood ratios (LR-=0.15). Conclusion: Contrary to recent publications, we could demonstrate differences between asymptomatic and symptomatic subjects showing the latter to have larger joints and more signs of degeneration. One can conclude from the strong LR+ and LR- values that MRI is a useful investigation to rule in or rule out facet pain. https://www.clinmedimagesjournal.com/articles/jcmei-aid1006.pdf Research Article Farzad Najafipour,Farshad Najafipour,Mohammad Hassan Majlesi,Milad Darejeh 2017-03-23 00:00:00 Introduction: Ankle sprain is a widespread impairment in sport groups; this impairment leads to an absence from the workplace. The ankle sprains incidence rates are induced by height, weight, BMI, physical fitness, level of match, classification of sport, and personal exposure to sport. Methods: A longitudinal case-control study was executed to verify the outcome of risk factors for ankle sprain at a Military Male School between 2012 and 2013 of 4987 people at risk for ankle sprain, a total of 234 cadets sustained new ankle sprains during the study, 432 non-injured cadets randomly selected as the control group. Results: Regarding to the total people at risk in our study the incidence rate was approximately 5/1000 ankle sprain-years. Cadets with ankle sprains had higher weight, BMI and higher scores in Army Physical Fitness test than the control group. Ankle sprain occurred most commonly during athletics (51.4%). Ankle sprain incidence rate did not significantly vary from different athletic competitions after controlling for athlete-exposure. Soccer and Ball Games had the highest ankle sprain incidence rate. Conclusion: Higher weight, increased BMI, greater physical conditioning and athlete exposure to selected sports were all risk factors for ankle sprain. https://www.clinmedimagesjournal.com/articles/jcmei-aid1005.pdf Case Report Jorge F Cameselle-Teijeiro,Javier Valdés-Pons,Lucía Cameselle-Cortizo,Isaura Fernández-Pérez,MaríaJosé Lamas-González,Sabela Iglesias-Faustino,Elena Figueiredo Alonso,María-Emilia Cortizo-Torres,María-Concepción Agras-Suárez,Araceli Iglesias-Salgado,Marta Salgado-Costas,Susana Friande-Pereira,Fernando C Schmitt 2017-01-30 03:00:00 A histopathological review preliminary of 429 patients diagnosed with tumours of the uterine corpus (TUC) cancer between 1984- 2010 in the Vigo University Hospital Complex (Spain) were evaluated prospectively for over 5 years. Of these 403 (93.9%) were epithelial tumours: 355 (82.7%) were adenocarcinomas of the endometrioid type, 5 (1.1%) mucinous adenocarcinoma, 10 (2.3%) serous adenocarcinoma, 17 (3.9%) clear cell carcinomas, 11 (2.5%) mixed adenocarcinoma, 4 (0.9%) undifferentiated carcinomas and 1 (0.2%) squamous cell carcinomas. A total 20 (4, 6%) were mesenchymal tumours: 4 (0.9%) endometrial stromal sarcoma, 7 (1.6%) Leiomyosarcoma, 9 (2%) Mixed endometrial stromal and smooth muscle tumour. A total 1 (0.2%) were mixed epithelial and mesenchymal tumours: (0.2%) Adenosarcoma 1. And 5 (1.1%) were Metastases from extragenital primary tumour (3 carcinomas of the breast, 1 stomach and 1 colon). The mean age at diagnosis from total series were 65, 4 years (range 28-101 years). Age was clearly related to histologic type: Endometrial stromal sarcoma 46.0 years, Leiomyosarcomas 57.1 years, Adenocarcinomas of the endometrioid type 65.4 years, Clear cell carcinomas 70.1 years and mixed endometrial stromal and smooth muscle tumours 71.2 years. Five-year disease-free survival rates for the entire group were: Endometrial stromal sarcoma 50%, Leiomyosarcomas 28.6%, Adenocarcinomas of the endometrioid type 83.7%, Clear cell carcinomas 64.7% and mixed endometrial stromal and smooth muscle tumours 44.4%. The 5-year disease-free survival rates of patients with Adenocarcinomas of the endometrioid type tumors were 91.4% for grade 1 tumors, 77.5% for grade 2, and 72.7% for grade 3. In conclusion, we describe 5-year histological and disease-free survival data from a series of 429 patients with TUC, observing similar percentages to those described in the medical literature. The only difference we find with other published series is a slightly lower percentage of serous carcinomas (ESC) that the Western countries but similar to the 3% of all ESC in Japan. Our investigation is focus at the moment on construct genealogical trees for the possible identification of hereditary syndromes and to carry out germline mutation analysis. https://www.clinmedimagesjournal.com/articles/jcmei-aid1004.pdf Case Report Angela Jordão Camargo,Mayara Cheade,Celso Martinelli,Plauto Christopher Aranha Watanabe 2017-01-30 02:00:00 Ameloblastoma is the second most common odontogenic tumor being back only for the odontoma. An unusual case of recurrent peripheral ameloblastoma in the mandible from the site of previous occurrence, reducing oropharyngeal space due compression by lesion. Panoramic radiography not showed presence of lesion, except one step in left side of mandible angle. Multislice CT scans revealed presence of hypoattenuated image, well-defined, histopathological exam suggesting Ameloblastoma Follicular. https://www.clinmedimagesjournal.com/articles/jcmei-aid1003.pdf Clinical Image Antonacci F,Belliato M,Bortolotto C,Di Perna D,Dore R,Orlandoni G,D’Armini AM 2017-01-30 00:00:00 his patient (male, 59 years old) underwent cardiac re-transplantation for chronic rejection. Prior to re-transplantation, the patient was in NYHA class IV, with a clear chest x ray. On 14th postoperative day, he presented hemoptysis. On chest x-ray, a left lower lobe opacity was seen. Therefore, a chest CT scan was done and it showed a round mass within a pulmonary cavity surrounded by airspace in proximity of the pulmonary artery. https://www.clinmedimagesjournal.com/articles/jcmei-aid1002.pdf Case Report Mona Mlika,Adel Marghli ,Faouzi Mezni 2017-01-20 00:00:00 Micronodular thymoma is a rare subtype of thymoma with less than 20 cases published in the English literature. These tumours have been reported with thymoma or thymic cyst. The authors describe a new case of micronodular thymoma in a 68-year-old-patient which is well documented and particular by its cystic degeneration which hasn’t been described yet. Micronodular thymoma is a rare variant of thymoma with a challenging diagnosis. Clinicians must be aware of this entity in order not to confuse it with a thymic cyst. https://www.clinmedimagesjournal.com/articles/jcmei-aid1001.pdf