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Voriconazole-related periostitis presenting on magnetic resonance imaging. (2)
Voriconazole-related periostitis presenting on magnetic resonance imaging. (2)

(A) Anteroposterior radiograph of the right hip and (B) anteroposterior radiograph of the left hip demonstrate multifocal areas of irregular, dense and fluffy periostitis (black arrows) spanning the femoral necks to proximal shafts in both hips.

Voriconazole-related periostitis presenting on magnetic resonance imaging. (1)
Voriconazole-related periostitis presenting on magnetic resonance imaging. (1)

(A) Axial T2-weighted turbo spin echo fat-suppressed and (B) coronal STIR-weighted magnetic resonance imaging of the hips demonstrate thick and irregular periosteal edema (white arrows) along the outer cortical surfaces of the bilateral proximal femoral shafts indicative of periostitis.

Percutaneous Lung Biopsy
Percutaneous Lung Biopsy

Under CT scan guidance, with the patient lying on their front, a percutaneous biopsy needle is seen vertically above the back, penetrating the skin, subcutaneous tissue and between 2 ribs. It is aimed at a an inflammatory area in the upper lobe of the lung, which defied diagnosis by other means. This area is much larger to access than the tiny nodule seen in in an identical location in the other lung. The lungs show considerable destruction of normal architecture, typical of emphysema with bullae, indicating that the patient was a heavy smoker.

Hickman Line
Hickman Line

Chest Xray showing the normal course of a Hickman line, usually used for delivering intravenous medication, and taking blood, in leukaemia patients. The line as shown is partly in the body and partly over the skin of the chest. The Hickman line is placed just below the clavicle (collar bone) on the patients right side (it can be on the left) into the subclavian vein. It is then fed through to the superior vena cava which drains blood from the upper body, head and neck into the heart. The end of the line lies in the superior vena cava about 6 inches (15 cm) above the heart (right atrium).

Percutaneous lung biopsy Percutaneous biopsy needle is seen vertically above the back Percutaneous biopsy needle is seen vertically above the back
Percutaneous biopsy needle is seen vertically above the back Percutaneous lung biopsy Percutaneous biopsy needle is seen vertically above the back

Under CT scan guidance, with the patient lying on their front, a percutaneous biopsy needle is seen vertically above the back, penetrating the skin, subcutaneous tissue and between 2 ribs. It is aimed at a an inflammatory area in the upper lobe of the lung, which defied diagnosis by other means. This area is much larger to access than the tiny nodule seen in in an identical location in the other lung. The lungs show considerable destruction of normal architecture, typical of emphysema with bullae, indicating that the patient was a heavy smoker.

Hickman line Chest Xray showing the normal course of a Hickman line Chest Xray showing the normal course of a Hickman line
Chest Xray showing the normal course of a Hickman line Hickman line Chest Xray showing the normal course of a Hickman line

Chest Xray showing the normal course of a Hickman line, usually used for delivering intravenous medication, and taking blood, in leukaemia patients. The line as shown is partly in the body and partly over the skin of the chest. The Hickman line is placed just below the clavicle (collar bone) on the patients right side (it can be on the left) into the subclavian vein. It is then fed through to the superior vena cava which drains blood from the upper body, head and neck into the heart. The end of the line lies in the superior vena cava about 6 inches (15 cm) above the heart (right atrium).

PtDS2 - Repeated chest infections halted by itraconazole in ABPA and bronchiectasis PtDS2 –Repeated chest infections arrested by itraconazole therapy in ABPA and bronchiectasisDS2 developed asthma age 24 and now aged 62. From about age 30 she started getting repeated chest infections and a few years later ABPA and bronchiectasis read more... Image A., Image B., Image C.
Image A., Image B., Image C. PtDS2 - Repeated chest infections halted by itraconazole in ABPA and bronchiectasis PtDS2 –Repeated chest infections arrested by itraconazole therapy in ABPA and bronchiectasisDS2 developed asthma age 24 and now aged 62. From about age 30 she started getting repeated chest infections and a few years later ABPA and bronchiectasis read more...

Sputum typical of bronchiectasis Image 2
Sputum typical of bronchiectasis Image 1
Airways (tracheobronchial) Aspergillus hyphae (arrow) in the lumen without invasion of the necrotic bronchial wall (*) (Nicod 2001).
Airways (tracheobronchial) Aspergillus hyphae (arrow) in the lumen without invasion of the necrotic bronchial wall (*) (Nicod 2001).

Featured as part of Airways (tracheobronchial) in the treatment section.

Nicod LP, Pache JC, Howarth N. Fungal infections in transplant recipients. Eur Respir J. 2001 Jan;17(1):133-40 Article

Airways (tracheobronchial) fibrinonecrotic material (arrow) from the airway shown in A, with subocclusion of the bronchial lumen (*)
Airways (tracheobronchial) fibrinonecrotic material (arrow) from the airway shown in A, with subocclusion of the bronchial lumen (*)

Featured as part of Airways (tracheobronchial) in the treatment section

Airways (tracheobronchial) Fibrinous or pseudomembranous bronchitis (arrow) with subocclusion of the airways (* indicates subocclusion of the airways by pseudomembranes)
Airways (tracheobronchial) Fibrinous or pseudomembranous bronchitis (arrow) with subocclusion of the airways (* indicates subocclusion of the airways by pseudomembranes)

Featured as part of Airways (tracheobronchial) in the treatment section

Airways (tracheobronchial) Bronchoscopic biopsy demonstrated septate hyphae with branching at 45o (methenamine silver stain ×400).
Airways (tracheobronchial) Bronchoscopic biopsy demonstrated septate hyphae with branching at 45o (methenamine silver stain ×400).

Featured as part of Airways (tracheobronchial) in the treatment section

Airways (tracheobronchial) Bronchoscopic manifestations of Aspergillus tracheobronchitis. (a) Type I. Inflammatory infiltration, mucosa hyperaemia and plaques of pseudomembrane formation in the lumen without obvious airway occlusion. (b) Type II. Deep ulceration of the read more...
Airways (tracheobronchial) Bronchoscopic manifestations of Aspergillus tracheobronchitis. (a) Type I. Inflammatory infiltration, mucosa hyperaemia and plaques of pseudomembrane formation in the lumen without obvious airway occlusion. (b) Type II. Deep ulceration of the read more...

Featured in Airways (tracheobronchial) in the treatment section

Wu N, Huang Y, Li Q, Bai C, Huang HD, Yao XP. Isolated invasive Aspergillus tracheobronchitis: a clinical study of 19 cases. Clin Microbiol Infect. 2010 Jun;16(6):689-95 Article

Airways (tracheobronchial) High resolution CT showing centrilobular nodular opacities and branching linear opacities (tree-in-bud appearance) (Al-Alawi 2007).
Airways (tracheobronchial) High resolution CT showing centrilobular nodular opacities and branching linear opacities (tree-in-bud appearance) (Al-Alawi 2007).

Featured as part of Airways (tracheobronchitis) in the treatment section

Al-Alawi A, Ryan F. Aspergillus Pseudomembranous Tracheobronchitis Complicating Treatment of COPD Exacerbations. Kuwait Med J. 2007;9(2):184-7 Article

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