MediAI

Edited by ScholarGen MediAI Team Executive Clinical Summary A patient with severe transfusion-dependent β-thalassemia major presented with bilateral ankle pain, swelling, and restricted joint motion after years of regular transfusion therapy and iron chelation. Laboratory testing showed a hemoglobin level of 8.3 g/dL, with an MCV of 81.3 and an RDW of 26.7%. The patient had required regular red blood cell transfusions since infancy and iron chelation since childhood. The right tibia and fibula radiograph demonstrated a characteristic combination of expanded medullary cavities, cortical thinning, and coarse trabecular architecture . In the clinical setting of severe β-thalassemia major, this pattern strongly supports marrow hyperplasia (marrow expansion) related to chronic ineffective erythropoiesis. The imaging finding, however, should not be interpreted in isolation. Skeletal complications in β-thalassemia are multifactorial. Marrow expansion may coexist with osteopenia, osteoporosis...

  How pelvic abscess, entero-ovarian fistula, rectosigmoid stenosis, and Apple Core morphology can reveal an occult colorectal malignancy. Edited by ScholarGen MediAI Team Executive Clinical Summary A woman in her early 40s presented with approximately one month of progressively worsening abdominal pain, nausea, vomiting, and fever. Two months earlier, she had been treated for pelvic inflammatory disease associated with a tubo-ovarian abscess. Contrast-enhanced CT initially appeared to support a gynecologic diagnosis. A multiloculated gas-fluid collection with peripheral rim enhancement was present in association with the right ovary, compatible with a tubo-ovarian abscess. However, the adjacent rectosigmoid colon was abnormal: bowel-wall thickening was present, and gas appeared to pass through a suspected defect in the bowel wall toward the pelvic collection. The critical diagnostic question was therefore not simply whether an abscess was present, but why the abscess had developed...