[Dynamic radiographs of the wrist].
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Biomedical subjects
Publications and source records attributed to A Chevrot.
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Arthrography of the hip was performed in outpatients on 25 children aged 5 to 14 years, using a supra-trochanteric latero-external puncture approach. Data obtained supplied anatomical details indispensable for the decision to operate or not, particularly in certain congenital dislocations or in Legg-Perthes-Calvé disease. The examination findings were useful not only for analyzing articular cartilages, limbus and chondro-articular surfaces in abduction and adduction but also for evaluating anteversion of bony and cartilaginous acetabula using an axial projection. The scanner provides comparable data with respect to the latter feature, but access is still more difficult.
We conducted a prospective study of the rheumatological manifestations in 20 patients with adrenal failure: 15 women and 5 men with a mean age of 56. Osteo-articular pathology was observed in 19 of the 20 cases (95%). The painful manifestations presented as arthralgia, myalgia or episodes of peri-arthritis; they were associated with active phases of the endocrine disease in 9 cases (45%). The radiological features of these patients were compared with those of age and sex matched controls who were hospitalized for other rheumatological conditions. 11 patients had radiologically visible tendinous calcifications (TC); 6 patients had 3 or more TC. The 20 patients had a total of 31 TC, which was significantly different from the controls. A related finding was calcification of the cartilages of the ears in 4 out of 10 patients (40%). Hypercalcaemia was detected in 5 cases (25%), accompanying episodes of decompensation of the adrenal failure. The pathogenesis of the tendinous calcifications is not clear. Mineralocorticoid treatment can not be considered to be a major aetiological factor for CT, calcification of the ears nor the pain, as its use was very constant. Thus, tendinous calcifications, which have rarely been reported to date, could explain a large part of the painful manifestations of adrenal failure.
A radiological technique is described based on the study of antero-posterior and lateral views of the hip. Mathematical calculations by trigonometry make it possible to deduce the degree of anteversion of the acetabular cup. The necessary tables are given.
The authors draw attention to the normal radiological appearances and the minor complication which may affect a cemented total hip replacement. Knowledge of these appearances enables the radiologist to define his attitude to the patient as well as his remarks on the case.
A trigonometric method for studying the anteversion of the acetabular portion of Charnley's prosthesis involves the use of standing anteroposterior and lateral pelvic films. Although a statistical analysis of results has not been conducted, the method was proved to be valid in thirty or so Charnley type total hip replacements, confirmation being supplied by operative findings when repeat surgery became necessary.
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Opacification of collateral pathways other than the central channels is very rare in lumbar epidural venography. Two cases of opacification of the inferior mesenteric vein following extravasation of contrast medium at the tip of the lateral sacral vein catheter are reported. One case is presented in which filling of normal parametrial venous plexuses and the left ovarian vein occurred as a consequence of incompetent or absent valves in the internal iliac vein. The literature containing comparable collateral flow patterns in disease is reviewed. The significance of the phlebographic features in our cases is discussed.
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Congenital afibrinemia is a rare disease, transmitted by an autosomal recessive mode, and due to deficient fibrinogen. Osseous involvement is exceptional, since only 2 cases have been reported. We describe a third case. The roentgenographic features are well limited radiolucent lesions, arising in the medullary space, and slightly expanding. These lesions are related to fibrous cysts, resulting from intraosseous hemorrhages. Spontaneous resolution may occur: the absence of fibrin deposits and blood clot probably favours resorption.
A method for radiological examination of the supporting areas of the anterior part of the foot employs a horizontal beam external total 3/4 projection as a complement to clinical and podoscopic investigations. This radiograph, which cannot effectively assess the condition of the talometatarsal joint, more clearly visualized on a Guntz film, can however provide more precise information on the state of the plantar pad and the level of the anterior bone pillars. These are normally disposed at an equal distance of approximately 10 mm from the ground. In cases with localised anomalies in the supporting areas, either from increased or decreased pressure, the corresponding modifications in the metatarsal heads are apparently more clearly visible in the Guntz film. The projection proposed enables study of anterior supporting areas when dorsal extension of the toes is impossible (hallux rigidus, metatarsophalyngeal arthrodesis). Finally, study of these films supplies data on the posterior bone pillars, the calcaneum, and styloid of the 5th metatarsal, which, together with the anterior supports, form the seven bone pillars of the foot. For the internal arch and the crown of the astralgus vault, the film shows the head of the astralgus, the tarsal sinus, and the posterior subastralgus joint.
The authors report on 4 cases of aseptic osteonecrosis of the vertebral matter in adult. The relatively rare localisation is the lot of elderly patients. It may follow cobalt therapy or corticotherapy and seems to be brought about by osteoporosis, hypertriglyceridemia and, perhaps, malignant lymphoidal proliferation. Histological confirmation of osteonecrosis was available in one case. The radiological aspect is characterised by settling, with heterogenic osteo-condensation and gaseous dissection of the vertebral matter. A double vertebral localisation is possible, and scintigraphical hyperfixation is common. The course is slowly favourable, with a symptomatic treatment.
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Results of experiments conducted in dogs are reported, in which the first few centimetres of the ureter were replaced by a prosthesis in silicone elastomer, the upper extremity being intubated by a trans-renal approach into the lower calyx and the upper extremity into the iliolumbar ureter. The one case of failure among the 6 dogs studied was due to a pyonephrosis from a technical error. In the 5 surviving dogs, the by-pass has remained permeable and there is no sign of incrustation. Control I.V.U. examinations after periods ranging from 26 months to 3 years showed normal function. This procedure has now been used in two human cases with good results.
The authors report 6 cases of isolated "ivory" vertebra which were confirmed as being due to Paget's disease after trocar biopsy. They analyse the radiological characteristics and find evidence of constant involvement of the posterior arch which shows the classical signs of Paget's disease: bone condensation, increase in size and cortico-medullary de-differentiation.
The authors report three cases of bone tumours, two in the scapula and one in the pelvis, which simulated chondrosarcoma on radiological examination. After biopsy it was concluded that they were metastases secondary to carcinoma of the bladder in one case and of unknown origin in the other two.