The Dot in Circle Sign : Remembered and re explored

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-1112

Type:

Educational Exhibit

Keywords:

Extremities, Musculoskeletal bone, Musculoskeletal soft tissue, MR, CT, Conventional radiography, Diagnostic procedure, Imaging sequences, Abscess, Infection, Inflammation

Authors:

R. M. S. V. Vadapalli¹, K. R. Harsha Vardhana¹, A. S. Vadapalli², K. Pottala³; ¹Hyderabad/IN, ²Pune/IN, ³Secunderabad/IN

DOI:

10.1594/ecr2015/C-1112

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-1112

Fig. 2: Dot in Circle: Pathological correlates

Fig. 3: Fungal Granulomas with T2 hyper intense Matrix

Fig. 4: Clinical Images of Mycetoma feet

Fig. 5: Radiography of Mycetoma feet

Learning objectives

To explain the pathophysiologic basis of Dot in Circle Sign and discuss its Imaging correlates. To illustrate the Sign with Clinical examples. To discuss the MR Imaging findings in Mycetoma and Madura Foot

Background

The dot-in-circle sign is a recently described sign reflecting the unique pathological feature of mycetoma on MRI Madura foot. This condition can be caused by either filamentous actinobacteria (actinomycotic mycetoma) or true fungi (eumycotic mycetoma). Gill, who worked at a dispensary in the southern Indian province of Madura, first recognized mycetomas as a disease entity in 1842. Godfrey first documented a case of mycetoma in Madras, India. Native peoples of the province of Madura commonly called the disease Madura foot. In 1860, Carter, who established...

Findings and procedure details

The dot-in-circle sign is a recently described sign reflecting the unique pathological feature of mycetoma. It is seen as a tiny hypointense focus within high-intensity spherical lesions. This sign was proposed by Sarris et al.in 2003 on T2-weighted, STIR, and T1-weighted fat-saturated gadolinium enhanced images. Pathological Correlates of Dot in Circle Sign: The disease usually begins as a painless swelling or thickening of the skin and subcutaneous tissue. As the disease gradually progresses over months or years, the initial lesion enlarges and eventually becomes tumorous....

Conclusion

This exhibit is Pictorial essay of fungal inection of the foot and highlights the Use of ‘Dot in Circle sign’ for characterization of Mycetoma

Personal information

rammohan vadapalli [email protected]

References

1. Lewall DB, Ofole S, Bendl B. Mycetoma. Skeletal Radiol 1985; 14:257–262. 2. Abd El, Bagi ME. New radiographic classification of bone involvement in pedal mycetoma. AJR Am J Roentgenol 2003; 180:665–668. 3. Salamon ML, Lee JH, Pinney SJ. Madura foot (madurella mycetoma) presenting as a plantar fibroma: a case report. Foot Ankle Int 2006; 27:212–215. 4. Ispoglou SS, Zormpala A, Androulaki A, Sipsas NV. Madura foot due to Actinomadura madurae: imaging appearance. Clin Imaging 2003; 27:233–235. 5. Czechowski J, Nork M, Haas D, Lestringant...