Biomedical subjects
C Sloth
Publications and source records attributed to C Sloth.
The apical oblique radiograph in examination of acute shoulder trauma.
One-hundred and twenty-five patients with acuta trauma to the shoulder were radiographed using anteroposterior and transthoracic views supplemented by an apical oblique projection with the patient seated in posterior oblique position, central beam directed 45 degrees caudad. The two standard views were evaluated prior to the apical oblique view. In 15.2% of the patients lesions were seen only in the apical oblique view, which also provided better examinations in 23.2% of all patients. Mainly dislocations of joints and fractures (in particular posterior glenohumeral dislocations), glenoid fractures, Hill-Sachs lesions and soft tissue calcifications were revealed in this view. Its routine use in acute trauma radiography is recommended.
Diagnosis of fracture of the carpal scaphoid with 4 oblique projections.
Two hundred and nine consecutive patients who suffered acute trauma had their carpal scaphoids examined by a radiographic method comprising 4 oblique projections with 1.4 x magnification. The method proved to be extremely sensitive in the primary diagnosis of scaphoid fracture, as none of 111 patients with normal primary examinations, but persistent soreness, proved to have fractures on control radiographs. A treatment less rigoristic than the traditional plaster cast is suggested when no fracture is shown on primary radiographs obtained by this method.
The role of carbon dioxide and atmospheric air in double-contrast barium enema.
BACKGROUND: Patient discomfort 0-24 h after double-contrast barium enema (DCBE) was investigated in two ways. METHODS: In part 1, 139 patients, not previously informed, were contacted by telephone to assess symptom rates without bias. In part 2, designed as a prospective randomized double-blind trial, the effect of carbon dioxide (CO2) as an insufflating gas was compared with conventional atmospheric air (AA). RESULTS: Part 1: 10% experienced severe abdominal pain, and 18% severe abdominal distention. Part 2: Low discomfort rates were found for both severe pain (7% for AA vs. 2% for CO2) and severe distention (13% for AA vs. 8% for CO2); the differences were not significant. In both parts of the study, female patients with a history of abdominal discomfort of "colon irritable" type were significantly overrepresented in the severely symptomatic groups. Equal numbers of patients experiencing severe abdominal distention for the first time were found in both the AA and CO2 groups, ruling out AA as the sole cause of these symptoms. CONCLUSION: Abdominal post-DCBE discomfort seems to be less frequent than previously reported and is not effectively eliminated by CO2. We still find the use of AA in DCBEs justified.
Radiographic examination of the acute shoulder.
Since 1988 the routine shoulder examination at our department has consisted of the anteroposterior projection (AP), the transthoracic projection (TT) and the apical oblique projection (AO). To save discomfort to the patients - including unnecessary X-rays - as well as time and money, we wanted to see, whether one of the projections could be omitted from the primary examination without losing diagnostic information. Retrospectively, 125 acute shoulder examinations were reevaluated - each projection separately - and the findings from the three radiographs of each shoulder compared. In 47 patients the examinations were normal. The remaining 78 patients had a total of 112 lesions. The AO alone showed 17 of 112 lesions (15%) of which eight were isolated lesions. The AO together with the AP presented 111 of 112 lesions, and with a supplementary TT obtained in case of fracture, no lesions were overlooked. Based on this present material and the literature, we recommend that the routine radiographic examination of the acute shoulder includes the AO and the AP, to be supplemented with the TT - or another lateral projection - in case of humeral fracture.