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case_images: Sinus and chest CT scan. (A) Axial sinus CT scan demonstrated thickened mucous membranes in the bilateral maxillary and ethmoid sinuses (orange arrows), indicating sinus involvement. (B and C) Axial chest CT (Brilliance iCT; Philips Healthcare, Cleveland, Ohio, USA) scans revealed tracheal wall thickening (~5 mm) with tracheal lumen narrowing, with the narrowest portion measuring ~4-5 mm (red circles). (D) Axial chest CT scan indicated the narrowest points of the right (1-2 mm, orange arrow) and left main bronchi (1-2 mm, blue arrow). (E) Axial chest CT scan depicted narrowing of the right middle bronchus to about 1 mm (orange arrow) and the left upper lobe bronchus to ~2 mm (blue arrow). (F) Axial chest CT scan showed the left lower lobe bronchus narrowed to about 2 mm (orange arrow).
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case_images: Thickening of tracheal and bronchial walls with homogeneous enhancement; narrowing of the tracheal and bilateral main bronchial lumens. The narrowest tracheal lumen measured ~4 mm; the narrowest bronchiole lumen ~2 mm (Figure 1B-F).
case_images: Bronchoscopic findings. (A) The glottis exhibited mild mucosal irregularities without significant obstruction. (B and C) The trachea showed concentric narrowing, with the cartilage rings absent, indicating severe airway involvement. (D) The carina of the trachea demonstrated both mucosal hypertrophy and atrophy, suggesting advanced inflammatory damage. (E) The right main bronchus revealed mucosal thickening and slight narrowing of the lumen. (F) The right middle bronchus showed marked mucosal thickening with luminal narrowing. (G) The left main bronchus presented with significant mucosal thickening and narrowing, similar to the right bronchus. (H) The trachea during the expiratory phase displayed generalized inflammation and mucosal edema, resulting in a narrowed airway passage.
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case_images: Bronchoscopy (BF-F260; Olympus Medical Systems, Tokyo, Japan): Tracheal lumen narrowing, loss of cartilaginous rings, mucosal hypertrophy/atrophy, thickening of left and right lobe mucosa, widened left upper lobe and middle bronchial ridge (Figure 2).
case_images: Pelvic magnetic resonance imaging. (A-D) Pretreatment MRI images showing left hip arthritis/synovitis, joint capsule, and surrounding soft tissue swelling. The images revealed: (A) Axial T1-weighted image displayed joint effusion and abnormal signal in the glenoid labrum. (B) Axial T2-weighted image showed increased fluid within the joint, indicating active inflammation. (C) Coronal T2-weighted fat-saturated image demonstrated narrowing of the joint space and poor continuity of the round ligament of the femoral head. (D) Coronal T2-weighted fat-saturated image highlighted patchy high signal intensity in the left femoral head and acetabulum, along with swelling of the surrounding soft tissues. (E) Follow-up MRI, 3 months posttreatment, showed a reduction in joint cavity fluid and less pronounced joint space narrowing compared to previous imaging, indicating improvement in the inflammatory process.
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case_images: MRI showed improved left hip OA/synovitis (Figure 3E).