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Nótese la presencia de una fuga de cemento desde el cuerpo de la quinta vértebra lumbar hacia la vena ilíaca común derecha (flecha larga); esta fuga probablemente sea la responsable de la embolia de cemento a las arterias pulmonares. B y C) Imágenes axial (B) y coronal (C) de la TC (proyección de máxima intensidad) en las que se visualizan múltiples defectos de repleción lineales de muy alta densidad (flechas) en la luz de las arterias pulmonares principales que representan embolias de material de cementación.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Gorospe Sarasúa, Paola Arrieta, Deisy Barrios-Barreto, Carlos de la Puente-Bujido" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" ] 1 => array:2 [ "nombre" => "Paola" "apellidos" => "Arrieta" ] 2 => array:2 [ "nombre" => "Deisy" "apellidos" => "Barrios-Barreto" ] 3 => array:2 [ "nombre" => "Carlos" "apellidos" => "de la Puente-Bujido" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574318301230" "doi" => "10.1016/j.reumae.2018.09.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301230?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X17301365?idApp=UINPBA00004M" "url" => "/1699258X/0000001500000005/v1_201910230648/S1699258X17301365/v1_201910230648/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173574318301229" "issn" => "21735743" "doi" => "10.1016/j.reumae.2018.09.005" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "1070" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2019;15:e55-e56" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Tophaceous Gout of the Shoulder Joint" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e55" "paginaFinal" => "e56" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Afectación del hombro en la gota tofácea" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 943 "Ancho" => 2500 "Tamanyo" => 165670 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Hands with multiple tophi. (1) Simple X-ray of right shoulder in anteroposterior projection. In the clavicle region of the right acromioclavicular joint a punched-out eccentric bony erosion is observed, formed by the replacement of the bone by a less dense tophus (1). Due to the slow, benign growth the bone reacts forming a sclerotic “ring” which surrounds the tophus and even overlaps the anatomical limits of the bone forming a raised edge (→). The change in the glenohumeral joint is mainly apparent in plain X-ray due to the occupation of the subacromiodeltoid bursa (2).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana María Tierra Rodriguez, Lucía Pantoja Zarza, Pelayo Brañanova López, Carolina Diez Morrondo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana María" "apellidos" => "Tierra Rodriguez" ] 1 => array:2 [ "nombre" => "Lucía" "apellidos" => "Pantoja Zarza" ] 2 => array:2 [ "nombre" => "Pelayo" "apellidos" => "Brañanova López" ] 3 => array:2 [ "nombre" => "Carolina" "apellidos" => "Diez Morrondo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X17301298" "doi" => "10.1016/j.reuma.2017.05.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X17301298?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301229?idApp=UINPBA00004M" "url" => "/21735743/0000001500000005/v1_201910260908/S2173574318301229/v1_201910260908/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173574318301242" "issn" => "21735743" "doi" => "10.1016/j.reumae.2018.09.007" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "1076" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2019;15:e51-e52" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5 "HTML" => 5 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Diagnosis of Relapsing Polychondritis in a Patient With Chronic Cough and Without Nasal or Auricular Chondritis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e51" "paginaFinal" => "e52" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Diagnóstico de policondritis recidivante en una paciente con tos crónica y sin condritis nasal ni auricular" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1702 "Ancho" => 1005 "Tamanyo" => 189125 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) CT axial view where a noticeable thickening of the tracheal walls (arrows) may be observed, together with highly significant reduction in their lumens. (B) CT axial view (lung imaging window) where major circumferential thickening of the walls of both main bronchi may also be observed, together with serious reduction in their lumen quality (arrows).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Gorospe Sarasúa, Deisy Barrios-Barreto, Ismael Said-Criado, Carlos de la Puente-Bujidos" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" ] 1 => array:2 [ "nombre" => "Deisy" "apellidos" => "Barrios-Barreto" ] 2 => array:2 [ "nombre" => "Ismael" "apellidos" => "Said-Criado" ] 3 => array:2 [ "nombre" => "Carlos" "apellidos" => "de la Puente-Bujidos" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X17301377" "doi" => "10.1016/j.reuma.2017.06.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X17301377?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301242?idApp=UINPBA00004M" "url" => "/21735743/0000001500000005/v1_201910260908/S2173574318301242/v1_201910260908/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Asymptomatic Bilateral Central Pulmonary Embolism Following Multiple Cement Vertebroplasties" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e53" "paginaFinal" => "e54" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Luis Gorospe Sarasúa, Paola Arrieta, Deisy Barrios-Barreto, Carlos de la Puente-Bujido" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Luis" "apellidos" => "Gorospe Sarasúa" "email" => array:1 [ 0 => "luisgorospe@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Paola" "apellidos" => "Arrieta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Deisy" "apellidos" => "Barrios-Barreto" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Carlos" "apellidos" => "de la Puente-Bujido" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Embolismo pulmonar central bilateral asintomático por cemento tras vertebroplastia múltiple" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1083 "Ancho" => 1400 "Tamanyo" => 125747 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) CT sagittal view where one may observe the cement material in the 5 vertebral bodies (short arrows). Note the presence of a cement leakage from the fifth vertebra towards the right common iliac vein (long arrow); this leakage is probably responsible for the cement emboli in the pulmonary arteries. (B and C) Axial (B) and coronal (C) images of CT (maximum intensity projection) with very high density lineal repletion defected (arrows) in the lumen of the main pulmonary arteries and which represent the cement material.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of an 84-year old patient with a personal history of auricular fibrillation and colorectal adenocarcinoma who underwent a vertebroplasty of 5 lumbar vertebrae due to painful osteoporotic fractures. The patient recovered from this procedure with no serious complications and was discharged on the same day as the multiple vertebroplasties were performed. Three months after the vertebroplasty (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A), due to the patient's oncological history, a follow-up CT scan was performed which showed multiple acrylic cement emboli in both main pulmonary arteries, extending to the lobar arteries of both lungs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and <span class="elsevierStyleSmallCaps">C</span>). Due to the absence of any symptoms and the fact that the patient took anticoagulant drugs for his auricular fibrillation a conservative treatment approach was taken for the cement emboli (CE), with the patient remaining stable and with no dyspnoea or chest pain.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Radiologic demonstration of CE is increasingly common due to the progressive ageing of the population, for whom vertebroplasty with cement has become a relatively safe form of treatment and to the increasingly high use of CT scans. Although initially the rate of CE was described as being under 5% and affected almost exclusively the peripheral pulmonary arteries,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> the latest reviews have shown that this phenomenon affects 23% of patients who have undergone vertebroplasty and that it may involve more central arteries<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a> (as in our case).</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Liabilities</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of people and animals</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that for this research no experimentation has been carried out on human beings or animals.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Data confidentiality</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors declare that they have adhered to the protocol of their centre of work on the publication of patient data.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical Liabilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of Interests" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-05-15" "fechaAceptado" => "2017-06-10" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gorospe Sarasúa L, Arrieta P, Barrios-Barreto D, de la Puente-Bujido C. Embolismo pulmonar central bilateral asintomático por cemento tras vertebroplastia múltiple. Reumatol Clin. 2019;15:e53–e54.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1083 "Ancho" => 1400 "Tamanyo" => 125747 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) CT sagittal view where one may observe the cement material in the 5 vertebral bodies (short arrows). Note the presence of a cement leakage from the fifth vertebra towards the right common iliac vein (long arrow); this leakage is probably responsible for the cement emboli in the pulmonary arteries. (B and C) Axial (B) and coronal (C) images of CT (maximum intensity projection) with very high density lineal repletion defected (arrows) in the lumen of the main pulmonary arteries and which represent the cement material.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:2 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multiple pulmonary embolisms caused by acrylic cement after vertebroplasty" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Fornell-Pérez" 1 => "J.M. Santana-Montesdeoca" 2 => "P. Junquera-Rionda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2010.04.007" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2010" "volumen" => "46" "paginaInicial" => "493" "paginaFinal" => "494" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20675028" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0020" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonthrombotic pulmonary artery embolism: imaging findings and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Unal" 1 => "S. Balci" 2 => "Z. Atceken" 3 => "E. Akpinar" 4 => "O.M. Ariyurek" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2016" "volumen" => "8" "paginaInicial" => "1" "paginaFinal" => "12" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001500000005/v1_201910260908/S2173574318301230/v1_201910260908/en/main.assets" "Apartado" => array:4 [ "identificador" => "5795" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Clinical Rheumatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001500000005/v1_201910260908/S2173574318301230/v1_201910260908/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574318301230?idApp=UINPBA00004M" ]
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