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Abstract Background Bone infections such as chronic fungal erosive osteomyelitis are uncommon forms of bone infection. The endemic dimorphic fungus Coccidioides impact generally immunocompromised patients. These infections frequently have no symptoms and the clinical signs remain undetected, allowing the infection to worsen over weeks or months. Mycotic arthritis is one of the rarest clinical symptoms; it is hard to distinguish from other types of arthritis, which slows down the diagnosis procedure. Case presentation In order to demonstrate the beginning and progression of radiological abnormalities in a case of aggressive fungal osteomyelitis, we provide the case of a 31-year-old male patient here. The man showed signs of extensive bone erosion and inflammatory involvement in his right knee and right hallux phalanx, although he had no prior history of immunodeficiency. The infection resulting from Coccidioides Immitis in his right knee and in his hallux was the reason for the injuries. Conclusions While an acute, benign, and self-eradicating lung infection is the predominant presentation for most cases of coccidioidomycosis, a small percentage of patients experience a devastating extrapulmonary condition, which can include arthritis. The pathogenic mechanism of bone involvement is unknown, and it often remains untreated. Here, we discuss radiographic evidence of particular bone inflammation during the early phase and later phases of the disease, since management of this chronic condition remains a challenge. We propose that imaging may mimic osseous neoplasia in persistent fungal diseases, such as coccidioidomycosis.

Abstract Background We present the clinical, MRI and CT findings in a case of a new mitochondrial genome mutation (tRNA arginine gene), characterized by brain calcifications which are indicative of Kearns–Sayre syndrome (KSS). Some radiological features resembled those of Fahr’s disease (affecting the PDGFRB gene). Case presentation A 36-year-old male presented some typical clinical features of KSS, including onset before 20 years of age, pigmentary retinopathy, progressive external ophthalmoplegia and ptosis. However, the hallmark radiological finding of diffuse calcifications in the nuclear ganglia resembles some cases related to the PDGRFB mutation. Genetic investigation revealed a new mutation in the mitochondrial tRNA-arginine gene. Conclusions Brain calcifications are a common feature of mitochondrial diseases, but little is known about their pathophysiology. Here, we describe radiological similarities between a new mitochondrial DNA mutation and other genetic conditions, which are related to Fahr’s disease. These similarities could provide new insights into putative genotype–phenotype correlations.

Objectives. To assess the potential of CT for characterizing small renal tumors. Methods. 76 patients with