Evidence map›Paper›PMID 40115709›Full record

ArticleCureus2025

The Value of the "Trident Sign" and Flow Cytometry in Suspecting Spinal Cord Sarcoidosis: A Case Report and a Flow Chart of Diagnostic Imaging in Longitudinally Extensive Transverse Myelitis (LETM).

Maurizio Giorelli, Sergio Altomare, Ruggiero Leone, Rosario F Balzano, Silvio Orlando, Pasquale Di Fazio, Leonardo Santo

Abstract readCase Reports
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Maurizio GiorelliOperative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, ITA.
Sergio AltomareOperative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, ITA.
Ruggiero LeoneOperative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, ITA.
Rosario F BalzanoOperative Unit of Radiology, "Dimiccoli" General Hospital, Barletta, ITA.
Silvio OrlandoOperative Unit of Thoracic Surgery, Mater Dei Hospital, Bari, ITA.
Pasquale Di FazioOperative Unit of Nuclear Medicine, "Dimiccoli" General Hospital, Barletta, ITA.
Leonardo SantoOperative Unit of Rheumatology, "Dimiccoli" General Hospital, Barletta, ITA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The diagnosis of sarcoidosis-related longitudinally extensive transverse myelitis (LETM) is challenging, requiring the exclusion of mimicking conditions along with histopathological confirmation of the diseases affecting the spinal cord. This report presents the case of a 68-year-old woman with complaints of low back pain and tingling dysesthesia in the limbs one month prior and finally developed paraparesis with the need for support from a third person for walking. Magnetic resonance imaging (MRI) of both the brain and spinal cord, total body computed tomography, lumbar puncture, flow cytometry of the cell sediment from cerebrospinal fluid (CSF), and whole-body 18-F-fluorodeoxyglucose positron emitting tomography (FDG-PET) assisted us to finalise the diagnosis. The presence of the "trident sign" in axial sequences of MRI is of exceptional value since it is a clue for sarcoidosis of the spinal cord. CSF flow cytometry may help clinicians to rule out lymphoma, and FDG-PET can help clinicians in identifying manifestations of sarcoidosis, which need to be biopsied so as to unveil the final diagnosis.

Indexed as

cytofluorometrylongitudinally extensive transverse myelitismagnetic resonance imagingneurosarcoidosisparaparesis

Identifiers

PMID40115709
PMCPMC11925211

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.