Imaging
Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology.
The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend. Those who care for patients with pulmonary, critical care or sleep disorders rely heavily on chest radiology and pathology to determine diagnoses. The Southwest Journal of Pulmonary, Critical Care & Sleep publishes case-based articles with characteristic chest imaging and related pathology. The editor of this section will oversee and coordinate the publication of a core of the most important chest imaging topics. In doing so, they encourage the submission of unsolicited manuscripts. It cannot be overemphasized that both radiologic and pathologic images must be of excellent quality. As a rule, 600 DPI is sufficient for radiographic and pathologic images. Taking pictures of plain chest radiographs and CT scans with a digital camera is strongly discouraged. The figures should be cited in the text and numbered consecutively. The stain used for pathology specimens and magnification should be mentioned in the figure legend.
Medical Image of the Week: Trousseau’s Sign
Figure 1. Metacarpophalangeal joint flexion, extension of the distal interphalangeal and proximal interphalangeal joints and finger adduction (Trousseau’s sign) during blood pressure measurement.
A 22 year old woman was admitted for numbness and tingling of her hands, feet and face 72 hours after total thyroidectomy for a nonfunctional goiter. Initial ionized calcium was 3.2 mg/dL and magnesium 1.2 mg/dL. The patient received 1 ampule of calcium gluconate (90 mg calcium) and 2 mg MgSO4 intravenously. The next day a rapid response was called. The patient was lethargic, and said she felt very ill, although she could not be more specific. Her ionized calcium was 4.3 mg/dL. She demonstrated Trousseau's sign when her blood pressure was measured with an arm cuff (Figure 1). She also had a positive Chvostek's sign. She did not have stridor or papilledema. She received another ampule of calcium gluconate and 2 mg MgSO4 intravenously and was transferred to the ICU, where she had a 60 sec duration generalized seizure. A calcium gluconate infusion was started, that delivered 990 mg calcium as calcium gluconate over 20 hours. Oral calcium and vitamin D supplements were started. PTH levels confirmed hypoparathyroidism, likely secondary to a surgical mishap at the time of thyroidectomy.
Emad Wissa MD and Robert A. Raschke MD
Banner Good Samaritan Regional Medical Center
Phoenix, AZ
Reference as: Wissa E, Raschke RA. Medical image of the week: Trousseau's sign. Southwest J Pulm Crit Care. 2013;6(3):128. PDF