Hepatic hemangioma is frequently asymptomatic, and bleeding is rare, even in cases of large lesions. The authors report the case of a 31-year-old female patient presenting with acute abdominal pain, whose imaging studies have demonstrated hematoma in the left hepatic lobe associated with hemoperitoneum. The patient was submitted to left hepatectomy, with a final histopathological diagnosis of cavernous hemangioma.

Keywords: Hepatic hemangioma, Hemoperitoneum, Computed tomography, Acute abdomen

The authors report a rare case of frontal sinus pneumocele in a 26-year-old female patient assessed by computed tomography.

Keywords: Pneumocele; Frontal sinus; Computed tomography.

OBJECTIVE: To describe the main ultrasound findings of chikungunya fever in the ankle. MATERIALS AND METHODS: This was a cross-sectional observational study involving 52 patients referred to the Hospital Universitário Pedro Ernesto and presenting with clinical and biochemical evidence of chikungunya fever. The examinations were performed by a radiologist with more than 20 years of experience in ultrasound. RESULTS: The predominant gender was female (in 88.5%), and the mean age was 58.4 years. The majority (61.5%) of the patients came from the northern part of the city of Rio de Janeiro, and 46.2% were using corticosteroids to treat inflammatory symptoms. The most common alterations observed by ultrasound were joint effusion (in 69.2%), tenosynovitis (in 59.6%), cellulitis (in 46.2%), Kager's fat pad thickening (in 29.9%), myositis (of the soleus or flexor hallucis longus muscle) (in 17.3%), retrocalcaneal bursitis (in 5.8%), tendon ruptures (in 3.8%), and increased vascular flow on power Doppler (in 3.8%). CONCLUSION: Signs of synovitis and tenosynovitis were the main ultrasound findings in a predominantly female population with a mean age of 58.4 years. Further studies are needed in order to define the role of ultrasound in the follow-up of such patients.

Keywords: Chikungunya virus; Arboviruses; Ultrasonography; Synovitis; Tenosynovitis.

OBJECTIVE: To define diagnostic criteria for coronavirus disease 2019 (COVID-19) on computed tomography (CT); to study the correlation between CT and polymerase chain reaction (PCR) testing for infection with severe acute respiratory syndrome coronavirus 2; and to determine whether the extent of parenchymal involvement and the need for mechanical ventilation are associated with the CT findings and clinical characteristics of patients with COVID-19. MATERIALS AND METHODS: This was a retrospective study of 155 patients with COVID-19 treated between March and May 2020. We attempted to determine whether the CT findings correlated with age and clinical variables, as well as whether the need for mechanical ventilation correlated with the extent of the pulmonary involvement. RESULTS: On average, the patients with COVID-19 were older than were those without (mean age, 54.8 years vs. 45.5 years; p = 0.031). The most common CT finding (seen in 88.6%) was ground-glass opacity, which correlated significantly with a diagnosis of COVID-19 (p = 0.0001). The CT findings that correlated most strongly with the need for mechanical ventilation were parenchymal bands (p = 0.013), bronchial ectasia (p = 0.046), and peribronchovascular consolidations (p = 0.012). The presence of one or more comorbidities correlated significantly with more extensive parenchymal involvement (p = 0.023). For the diagnosis of COVID-19, CT had a sensitivity of 84.3%, a specificity of 36.7%, and an accuracy of 73.5% (p = 0.012 vs. PCR). CONCLUSION: The patterns of CT findings are useful for the diagnosis of COVID-19 and the evaluation of disease severity criteria. The presence of any comorbidity is associated with greater severity of COVID-19.

Keywords: Coronavirus infections/diagnostic imaging; Tomography, X-ray computed; Pneumonia, viral.