A 32-year-old man presented to the emergency department with severe right lower limb pain and swelling of three days' duration. He had multiple prior admissions for recurrent seizures and suicide attempts. Markedly elevated serum creatine kinase levels and urine myoglobinuria were consistent with a diagnosis of rhabdomyolysis. Initial magnetic resonance imaging of the right lower limb revealed diffuse muscle oedema and features of myositis in the gluteal muscles and the adductor, anterior and posterior compartments of the thigh. Follow-up magnetic resonance imaging performed 11 days later showed interval development of areas of myonecrosis and haemorrhage. The causes, clinical presentation and imaging features of rhabdomyolysis are discussed.

A 39-year-old man presented with acute left knee pain and swelling. There was limitation of movement of the knee joint. His past medical history was significant for gout. Computed radiography showed bony erosions that were not typical of chronic tophaceous gout. Magnetic resonance (MR) imaging showed focal deposits within the knee joint, which demonstrated isointense signal to muscle on T1-weighted sequence and intermediate signal on proton density (PD) and PD fat-saturated sequences. There was extensive, similar signal abnormality in the cruciate ligaments, popliteus tendon and lateral meniscus. These findings were in keeping with an intra-articular manifestation of chronic tophaceous gout. The clinical presentation and imaging features are herein discussed, with an emphasis on MR imaging.

Biomarkers/blood* ; COVID-19/diagnosis* ; Chemokine CXCL10/blood* ; Humans ; Lung Diseases/virology* ; Severity of Illness Index

A 92-year-old woman presented to the emergency department with urinary symptoms, fever and suprapubic tenderness. Her inflammatory markers were raised. Urine and blood cultures were negative. Computed tomography performed to look for a source of sepsis showed distension of the uterine cavity with high-attenuation fluid, an air-fluid level and gas locules along the uterine wall. The causes, clinical presentation and imaging features of pyometra are discussed.

Antibodies, Viral ; Antibody Formation ; BNT162 Vaccine ; COVID-19/prevention & control* ; Female ; Humans ; Milk, Human ; Pilot Projects ; RNA, Messenger ; Vaccination

Betacoronavirus ; Coronavirus Infections ; diagnosis ; epidemiology ; Diagnostic Imaging ; methods ; Humans ; Pandemics ; Pneumonia, Viral ; diagnosis ; epidemiology ; Radiology Department, Hospital ; organization & administration

Sarcopenia, which is characterized by progressive and generalized loss of skeletal muscle mass and strength, has been well described to be associated with numerous poor postoperative outcomes, such as increased perioperative mortality, postoperative sepsis, prolonged length of stay, increased cost of care, decreased functional outcome, and poorer oncological outcomes in cancer surgery. Multimodal prehabilitation, as a concept that involves boosting and optimizing the preoperative condition of a patient prior to the upcoming stressors of a surgical procedure, has the purported benefits of reversing the effects of sarcopenia, shortening hospitalization, improving the rate of return to bowel activity, reducing the costs of hospitalization, and improving quality of life. This review aims to present the current literature surrounding the concept of sarcopenia, its implications pertaining to colorectal cancer and surgery, a summary of studied multimodal prehabilitation interventions, and potential future advances in the management of sarcopenia.

The coronavirus disease 2019 (COVID-19) is typically diagnosed by specific assays that detect viral nucleic acid from the upper respiratory tract; however, this may miss infections involving only the lower airways. Computed tomography (CT) has been described as a diagnostic modality in the COVID-19 diagnosis and treatment plan. We present a case series with virologically confirmed COVID-19 pneumonia. Variable CT features were observed: consolidation with ground-glass opacities, ground-glass opacities with subpleural reticular bands, and an anterior-posterior gradient of lung abnormalities resembling that of acute respiratory distress syndrome. Evolution of CT findings was observed in one patient, where there was interval resolution of bilateral lung consolidation with development of bronchiolectasis and subpleural fibrotic bands. While sensitive for detecting lung parenchymal abnormalities in COVID-19 pneumonia, the use of CT for initial diagnosis is discouraged and should be reserved for specific clinical indications. Interpretation of chest CT findings should be correlated with duration of symptoms to better determine the disease stage and aid in patient management.
Aged ; Betacoronavirus ; Coronavirus Infections ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; diagnosis ; Tomography, X-Ray Computed ; methods