Acta Medica Lituanica最新文献

{"title":"The Influence of Different Factors on Brain Weight.","authors":"Eglė Skukauskaitė, Greta Asadauskaitė, Sigitas Laima, Sigitas Chmieliauskas, Jurgita Stasiūnienė, Diana Vasiljevaitė, Paulius Petreikis","doi":"10.15388/Amed.2025.32.2.2","DOIUrl":"10.15388/Amed.2025.32.2.2","url":null,"abstract":"<p><strong>Background: </strong>A postmortem brain weight examination can provide valuable diagnostic information on probable causes of death. Deviations from normal brain weight can indicate the presence of different factors such as psychoactive substance use, the presence of neurological conditions, tumours, brain oedema or traumatic brain injury. The aim of this study is to analyse these factors and their role in understanding the underlying causes of death.</p><p><strong>Materials and methods: </strong>This research was designed as a retrospective study. The study sample consisted of 651 autopsy cases from 2013 to 2023. The brain weight was compared between people who died from traumatic brain injury, by hanging, of other sudden causes, and were intoxicated by alcohol or drugs. The collected data were processed by using <i>R</i> software. <i>P</i> values less than 0.05 were considered significant.</p><p><strong>Results: </strong>The mean brain weight of the control group was 1274.93 ± 124.74 g. The mean brain weight of males was greater than that of females. The brain weight was lower in children and the elderly, whereas the greatest in adults between the ages 21-30. In the ethyl alcohol-intoxicated group, the mean brain weight was 1344.01 ± 148.69 g, whereas, in the drug-intoxicated group, it measured 1418.45 ± 125.45 g. The mean brain weight of subjects with strangulation asphyxia was 1372.13 ± 128.83 g, while for those with traumatic brain injury it was 1358.27 ± 150.42 g. The highest brain weight was observed in subjects with epidural hematoma and with subarachnoid haemorrhage. The most frequent complications in patients who died after brain injury were cerebral herniation and pneumonia. The mean brain weight of subjects with cerebral herniation was 1376.95 ± 164.29 g. After traumatic brain injury, skull fractures, brain surgery and cerebral herniation were associated with a higher brain weight. There was a negative correlation between the brain weight and the <i>Glasgow Coma Scale</i> score.</p><p><strong>Conclusions: </strong>A greater brain mass was observed in subjects with ethyl alcohol and drug intoxication, in the groups with strangulation asphyxia and traumatic brain injury compared to the control group. In the traumatic brain injury group, a greater brain weight was observed in men, in those with skull fractures, with epidural haemorrhage, with herniation signs, and after brain surgery.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"322-332"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Deep Learning Based Cardiac Quantification in Hypertrophic Cardiomyopathy: A Comparative Study with Manual Segmentation.","authors":"Shivam Angiras, Deb Kumar Boruah, Pranjal Phukan, Kalyan Sarma, Prince Das, Rajeev Bharadwaj, Harshit Jain, Ajmal Roshan","doi":"10.15388/Amed.2025.32.2.8","DOIUrl":"10.15388/Amed.2025.32.2.8","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic CardioMyopathy (HCM) is the most prevalent inherited cardiac disorder, where accurate assessment of Left Ventricular (LV) function and Mitral Regurgitation (MR) is crucial. Cardiac Magnetic Resonance (CMR) imaging is considered the gold standard for evaluating these parameters. Recently, Deep Learning (DL) algorithms have emerged to automate cardiac quantification, but their performance in complex pathologies such as HCM still requires validation.</p><p><strong>Purpose: </strong>To compare the performance of a fully automated deep learning-based cardiac segmentation software (SW 2) (SuiteHEART) with conventional manual segmentation (SW 1) (syngo.Via) for quantifying crucial cardiac parameters in patients with HCM.</p><p><strong>Materials and methods: </strong>In this prospective study, 25 consecutive adult patients (mean age 49±12 years) with HCM referred for CMR at our institute were included. CMR examinations were performed by using a 3.0 Tesla scanner (Siemens Vida). The key parameters assessed included Left Ventricular Ejection Fraction (LVEF), End-Diastolic Volume (LVEDV), Stroke Volume (LVSV), Aortic Forward Flow (AoF), Mitral Regurgitation (MR), and Pressure Gradient (PG) across the LVOT. Manual and automated segmentations were performed by using syngo.Via (SW 1) and SuiteHEART software (SW 2), respectively. Statistical analysis included paired t-tests, linear regression, and Bland-Altman analysis.</p><p><strong>Results: </strong>There was a strong correlation between DL-based and manual measurements for LVEF (r=0.91), LVEDV (r=0.89), LVSV (r=0.87), AoF (r=0.86), MR (r=0.84), and PG (r=0.81) (all <i>p</i><0.001). Bland-Altman analysis demonstrated acceptable limits of agreement, with no significant bias. Automated segmentation significantly reduced post-processing time compared to manual methods (<i>p</i><0.001).</p><p><strong>Conclusion: </strong>Fully automated DL-based cardiac quantification provides accurate and reproducible assessment of the LV function, MR, and flow parameters in HCM patients, closely matching manual segmentation results. Incorporation of DL algorithms can substantially streamline the clinical workflow, although careful validation remains necessary in structurally complex cases such as HCM.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"333-347"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Flectamus genua</i>. Gonarthrosis in the Remains of the Blessed Giuseppe Benedetto Dusmet (Catania, Italy, 19th Century AD).","authors":"Dario Piombino-Mascali, Fausto Grimaldi, Aldo Liberto, Federica Ministeri, Federico Privitera, Cristoforo Pomara","doi":"10.15388/Amed.2025.32.1.24","DOIUrl":"10.15388/Amed.2025.32.1.24","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the bioanthropological and paleopathological features of the late Blessed Giuseppe Benedetto Dusmet, a revered 19^th-century archbishop of Catania. Dusmet's remains were examined during the most recent canonical recognition in 2021, providing an opportunity to study the skeletal characteristics that may reflect his lifestyle and health.</p><p><strong>Materials and methods: </strong>Paleopathological analysis focused on degenerative changes using macroscopic inspection to identify osteoarthritic conditions. Historical records were also consulted to understand the potential connection between his devout religious practices and his physical health.</p><p><strong>Results: </strong>Significant degenerative and osteoarthritic changes were observed, particularly in the knees. These changes are hypothesized to be linked to Dusmet's frequent practice of kneeling in prayer, a physical activity historically associated with knee osteoarthritis.</p><p><strong>Conclusion: </strong>This study highlights how bioanthropological and paleopathological analysis can provide insights into the health and lifestyle of historical figures. The observed knee osteoarthritis in the Blessed Giuseppe Benedetto Dusmet's remains suggests a possible link between his behavior and the development of joint degeneration. This research adds to our understanding of the physical impact of religious practices and contributes to the study of health in historical figures.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"236-239"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artery of Percheron Stroke: A Case Report.","authors":"Milda Navickaitė, Aleksandras Vilionskis, Austėja Dapkutė, Kristina Ryliškienė","doi":"10.15388/Amed.2025.32.1.14","DOIUrl":"10.15388/Amed.2025.32.1.14","url":null,"abstract":"<p><strong>Background: </strong>The <i>Artery of Percheron</i> (AOP) is a vascular variant supplying both sides of the thalamus, present in up to one-quarter of the general population. AOP occlusion is a rare cause of ischemic stroke, resulting in bilateral thalamic infarction. It typically manifests as altered consciousness, gaze abnormalities, and cognitive impairment. Neuroimaging of AOP stroke is challenging, as head CT is often unremarkable. However, a diagnostic 'V' sign can be identified on MRI. AOP stroke is treated as other types of ischemic stroke.</p><p><strong>Case description: </strong>We present a case of a 61-year-old male with a history of alcohol abuse, diagnosed with ischemic AOP stroke. He presented with sudden loss of consciousness, third nerve palsy, and vertical gaze palsy. MRI revealed bilateral paramedian thalamic infarction with midbrain involvement. Despite conservative treatment, his condition showed minimal improvement, leaving him lethargic and dysarthric. He was discharged to palliative care after two weeks.</p><p><strong>Conclusions: </strong>AOP infarction, though rare, should be considered in patients with altered consciousness. Early MRI is essential for accurate diagnosis and timely treatment, highlighting the importance of physician awareness of this condition.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"145-152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging Risks of Amanita Muscaria: Case Reports on Increasing Consumption and Health Risks.","authors":"Emilija Savickaitė, Gabija Laubner-Sakalauskienė","doi":"10.15388/Amed.2025.32.1.23","DOIUrl":"10.15388/Amed.2025.32.1.23","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing popularity of <i>Amanita muscaria</i>, driven by its hallucinogenic properties, has raised significant public health concerns, particularly as it remains largely unregulated across most European Union countries. The mushroom contains muscimol, a compound that induces euphoria, altered perception, and hallucinations, and its precursor, ibotenic acid, converts to muscimol when dried or heated, reducing toxicity while preserving psychoactive effects. The growing trend in intentional consumption of <i>A. muscaria</i> reflects evolving patterns of intoxication despite its known toxicity risks. The <i>European Food Safety Authority</i> has flagged <i>A. muscaria</i> as an emerging risk, highlighting concerns over its increasing availability and potential for misuse.</p><p><strong>Materials and methods: </strong>Four cases of <i>Amanita muscaria</i> consumption and subsequent intoxication have been documented in Lithuania in 2023. To further investigate this topic, a systematic search was conducted using the <i>PubMed</i> database with the following keyword combinations: '<i>Amanita muscaria'</i>, '<i>Amanita muscaria</i> toxicity', 'muscimol', 'ibotenic acid', 'psilocybin', and 'hallucinogenic fungi'. After screening for relevance and eligibility, a total of 27 publications met the inclusion criteria and were incorporated into the final analysis.</p><p><strong>Case reports: </strong>In 2023, four cases of intentional <i>A. muscaria</i> poisoning were reported in Lithuania, linked to recreational consumption. Symptoms included tremors, respiratory failure, dizziness, and paranoia. All patients were male and required hospitalization, but all were discharged in stable condition.</p><p><strong>Conclusion: </strong>The unregulated status and increasing accessibility of <i>A. muscaria</i> pose significant public health concerns. While <i>A. muscaria</i> remains largely unstudied in medical contexts, its toxicity risks are well-documented. Misleading online information contributes to uninformed consumption, especially among younger individuals. Further research is needed to elucidate its chemical composition, therapeutic potential, and health effects to inform regulatory policies.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"182-189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney Agenesis and Müllerian Duct Anomalies: A Report of Two Cases and Literature Review.","authors":"Kamilė Donielaitė-Anisė, Rytis Marozas, Žana Bumbulienė, Augustina Jankauskienė","doi":"10.15388/Amed.2025.32.1.7","DOIUrl":"10.15388/Amed.2025.32.1.7","url":null,"abstract":"<p><strong>Background: </strong>The association between urinary tract anomalies and <i>Müllerian duct anomalies</i> (MDA) is well-known, due to their shared embryonic origin. Disruptions in early development can significantly affect both the kidney and reproductive systems. This article presents two cases illustrating the coexistence of kidney agenesis and MDA in girls, followed by a literature review.</p><p><strong>Materials and methods: </strong>A literature search was conducted on <i>PubMed</i>, focusing on publications from 2000 to 2024 by using keywords: 'kidney agenesis', 'renal agenesis', 'Müllerian duct anomalies', 'OHVIRA' (obstructed hemivagina and ipsilateral renal anomaly), and 'Herlyn-Werner-Wunderlich syndrome'. The PRISMA guidelines were followed for the study selection. Additionally, two cases managed at Vilnius University Hospital Santaros Klinikos between 2022 and 2024 are presented.</p><p><strong>Results: </strong>The literature search yielded 32 articles encompassing data on 43 girls with an average age of 11.8 years. In 54% of the cases, the diagnosis of kidney agenesis was concurrent with identifying MDA. In other cases, kidney anomalies were detected earlier, including 6 cases identified prenatally. Type III MDA, as classified by the <i>American Fertility Society</i>, was the most common variety. Premenarche diagnosis of MDA was made in 11.9% of the cases. In more than half of the cases, MDA was identified due to complaints necessitating consultations, mostly leading to urgent surgical interventions. At our hospital, a 9-year-old and a 14-year-old were diagnosed with Herlyn-Werner-Wunderlich syndrome. Kidney agenesis was diagnosed prior to MDA in both cases. For the 9-year-old girl, MDA was found incidentally on ultrasound, while the other required consultation and an urgent surgery due to symptoms.</p><p><strong>Conclusions: </strong>Unilateral kidney agenesis frequently co-occurs with Müllerian duct anomalies, highlighting the need for comprehensive evaluations in affected patients. An early diagnosis and management of MDA are crucial to prevent complications. An increased clinical awareness and further research are necessary to enhance early detection and patient outcomes.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 1","pages":"229-235"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Traumatic Internal Mammary Artery Pseudoaneurysm Causing Hemopericardium: Endovascular Management and Literature Review.","authors":"Shritik Devkota, Rajan Mani Bhandari, Jasmine Sethi, Harish Bhujade","doi":"10.15388/Amed.2025.32.2.16","DOIUrl":"10.15388/Amed.2025.32.2.16","url":null,"abstract":"<p><strong>Background: </strong>Traumatic <i>Internal Mammary Artery</i> (IMA) pseudoaneurysms can be associated with severe complications, including hemopericardium, pericardial tamponade, diaphragmatic paralysis, hemoptysis, and hemorrhagic shock. Early recognition of this rare condition is essential to reduce the risk of significant morbidity and mortality.</p><p><strong>Case details: </strong>We present a case of IMA pseudoaneurysm that was promptly diagnosed by using contrast-enhanced CT and successfully managed with endovascular embolization, leading to the patient's complete and uneventful recovery.</p><p><strong>Conclusion: </strong>This case emphasizes the importance of early recognition and endovascular management of rare but potentially life-threatening internal mammary artery pseudoaneurysms following thoracic trauma.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"431-437"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality Rates of Minor vs Major Lower Extremity Amputations in Diabetic Patients.","authors":"Karolis Strašunskas, Vėtra Markevičiūtė","doi":"10.15388/Amed.2025.32.2.3","DOIUrl":"10.15388/Amed.2025.32.2.3","url":null,"abstract":"<p><strong>Background: </strong>Mortality rates between minor (e.g., removal of toes or part of the foot) and major (e.g., below- or above-the-knee) lower extremity amputations (LEA) vary significantly in diabetic patients. Other factors, including survival rates, rehabilitation outcomes, and healthcare burden, are also notably impacted by the type of amputation performed.</p><p><strong>Objective: </strong>This narrative review aims to analyze and compare mortality rates following minor and major LEA in diabetic patients, by highlighting key risk factors and their impact on patient outcomes.</p><p><strong>Methods: </strong>A narrative review of existing literature was conducted by using searches of <i>PubMed</i> and <i>Google Scholar</i>. Studies reporting mortality rates, risk factors, comorbidities, functional outcomes, and management strategies among diabetic patients undergoing minor and major LEA were included.</p><p><strong>Results: </strong>Major LEA is associated with significantly higher short- and long-term mortality rates, with five-year survival ranging from 10% to 48%, compared to 29% to 69% for minor LEA. The key risk factors for mortality include chronic renal disease, peripheral arterial disease, sepsis, and poor glycemic control. While minor LEA offers better survival rates, it carries a higher risk of progression to major amputation if diabetes-related complications persist.</p><p><strong>Conclusion: </strong>The findings highlight the critical importance of early intervention, strict glycemic control, and multidisciplinary care to improve the survival and quality of life in diabetic patients undergoing LEA. Limb preservation strategies should be prioritised whenever possible, as minor amputations lead to better long-term outcomes. Future research should focus on refining risk stratification and optimizing rehabilitation programs to enhance patient prognosis post-amputation.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"289-300"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Bifurcation of the Common Carotid Artery with Pentafurcation of the External Carotid Artery: Case Series with Review of Literature.","authors":"Aarthi Manokaran, Manisha R Gaikwad, Baskar A, Murugan Gopalakrishnan, Praveen Kumar Ravi","doi":"10.15388/Amed.2025.32.2.12","DOIUrl":"10.15388/Amed.2025.32.2.12","url":null,"abstract":"<p><p>The bifurcation of the <i>Common Carotid Artery</i> (CCA) is a pivotal anatomical landmark in head and neck surgeries, particularly affecting procedures such as carotid endarterectomy. Typically occurring around the C3-C4 intervertebral disc, variations in its location can complicate surgical access and pose risks of nerve injury. In this case report, three rare bilateral high bifurcations of the CCA at the C2 and C2/3 vertebrae levels are documented. Additionally, an unusual pentafurcation of the <i>External Carotid Artery</i> (ECA) and bilateral superior thyroid artery are observed, arising directly from the CCA. The high bifurcation presents challenges due to its proximity to nerves such as the hypoglossal nerve, potentially leading to complications such as dysphagia or speech impairment. Furthermore, it complicates procedures like carotid endarterectomy, necessitating additional techniques for adequate exposure and increasing risks of <i>Internal Carotid Artery</i> (ICA) thrombosis. Detailed preoperative imaging before surgery is important for effective planning and minimizing the surgical risk. Anatomical variation, such as the vascular structure, can significantly affect surgical and interventional outcomes. Identifying these differences through meticulous evaluation enables surgeons to anticipate potential challenges, reduce complications, and enhance patient outcomes.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"404-412"},"PeriodicalIF":0.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Olecranon and Left Lesser Trochanter Avulsion Fractures in Renal Osteodystrophy: A Rare Case Report and Comprehensive Review.","authors":"Vijay Ram Kumar Papineni, Rajesh Botchu, Kartikeyan P Iyengar, Shashank Chapala, Asad Rabbani Shah, Balamurugan Rathinavelu","doi":"10.15388/Amed.2025.32.2.1","DOIUrl":"10.15388/Amed.2025.32.2.1","url":null,"abstract":"<p><p><i>Chronic Kidney Disease-Mineral and Bone Disorder</i> (CKD-MBD) disrupts phosphorus and calcium metabolism, leading to skeletal disorders such as demineralization, weakened bones, and an increased fracture risk. These disorders, known as renal osteodystrophy, vary widely and are classified into secondary hyperparathyroidism, adynamic bone, and osteomalacia based on bone turnover. Fracture risk increases with the severity of CKD, particularly in advanced stages (creatinine clearance <15-20 mL/min), but even patients with mild to moderate CKD are at risk of fractures. Fractures of the <i>Lesser Trochanter</i> (LT) in adults are rare, and most are caused by underlying malignancies. We present a case of simultaneous avulsion fractures in the left lesser trochanter and bilateral olecranon processes secondary to minor trauma in a young patient with End Stage Renal Disease, which has not been previously reported, and review the literature. This review summarizes the role of imaging (Radiography, US, Computed Tomography, and Magnetic Resonance Imaging) in assessing avulsion fractures in patients with end-stage renal disease. Ultrasound serves as a supportive tool in evaluating the neuromusculoskeletal system; however, in patients with end-stage renal disease, radiography, CT, and MRI remain the primary imaging modalities for assessing avulsion fractures.</p>","PeriodicalId":34365,"journal":{"name":"Acta Medica Lituanica","volume":"32 2","pages":"313-321"},"PeriodicalIF":0.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12875559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}