Biomedical subjects
Publications and source records attributed to F L'Huillier.
Wrist imaging still relies first on plain X-Ray films, MRI allows excellent appreciation of the sculture of bones, ligaments, tendons and even nerves. C.T. is essentially useful in traumatology, while Wrist arthrography can be useful for detection of small ligament lesions.
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Despite new imaging modalities such as MRI, the discography remains useful, particularly as the first step of chemonucleolysis. The anulography corresponds to a technical error due to the wrong position of the needle during the procedure. We have noticed 32 anulographies on 1226 discographies done in our department, between 1985 and 1989. The anulography exhibits a typical pattern that must be diagnosed; if not, that can lead to a diagnosis mistake or a wrong therapeutic attitude. The needle of discography must then be repositioned.
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The authors describe seven cases of pituitary adenoma with acute neurological symptoms (the so-called pituitary apoplexy), which were examined by magnetic resonance imaging (MRI). Four patients underwent surgery and the diagnosis of pituitary adenoma was histologically confirmed. In 3 patients, conservative treatment was decided and serial MRI examinations showed progressive decrease in size of the tumour, leading in one case to an empty sella. Computerized tomography (CT) was positive in all 7 cases, but less contributive than T1-weighted MRI images both for tumoral volume determination and detection of intratumoral haemorrhage. Although theoretical problems may arise concerning the diagnosis of acute intratumoral bleeding at an early stage, the authors emphasize the value of MRI in showing the extension of the tumor into the retroclival cistern and the cavernous sinus, especially when surgery is not performed in the acute period.
In the context of a particular case report, the authors recall that calcified discs may be responsible for root pain, hyperalgic sciatica or lumbago. In the present case, the pain responded to intra-discal injection of long-acting corticosteroids. The authors compare this case to 10 other personal cases and 16 cases reported in the literature.