Esophageal communication with mediastinal cysts: classification and incidence.
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Biomedical subjects
Publications and source records attributed to F M Hall.
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Surgeons are increasingly required to resect nonpalpable breast lesions only detected by mammography. Methods for preoperative localization of such lesions were reviewed with emphasis on invasive radiologic techniques using injection, needle, and wire markers. Invasive localization of nonpalpable breast lesions is a relatively simple procedure that should be available wherever breast biopsies and mammography are performed. Its precision and success relate to the radiologist's experience in marker placement and to close cooperation between the radiologist and surgeon.
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Normal menisci may show transient distortion during knee arthrography. This usually results from intermittent visualization of the meniscus out of direct profile to the x-ray beam. Similar transient distortion may result from actual buckling of an anatomically normal meniscus during stressful maneuvers in young individuals.
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We reviewed the radiographs of patients undergoing negative breast biopsies on the basis of false positive mammograms. In a small number of these patients, the radiologic error was attributable to the summation effect of superimposed focal areas of normal or dysplastic breast tissue giving the false impression of a mass. This summation effect more frequently results in an equivocal radiologic impression, often with a recommendation for short interval repeat mammograms, rather than an actual biopsy. This false positive mammographic appearance can often be suspected on the basis of a discrepancy in the appearance of the suspicious area on the standard lateral and craniocaudad views. In a prospective study we identified women in whom suspicious mammograms were felt to possibly relate to this superimposition effect, and in this small selected group of patients an additional oblique projection was obtained. The oblique view frequently enabled the initially equivocal abnormality to be definitely assessed.
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Peripheral separations of the posterior medial meniscus, diagnosed at arthrography, may not be recognized at arthroscopy, arthrotomy or even upon examination of the resected specimen. Arthrographic recognition of an oblique buckethandle meniscal tear may be difficult when the visualized outer fragment maintains a triangular appearance. Articular cartilage defects, out of profile to the x-ray beam, may be suspected at fluoroscopy and confirmed by additional views. There is an icreased incidence of chondromalacia in symptomatic postmeniscectomy knees. Degenerative meniscal changes without arthrographically recognized discrete tears are common, particularly in older individuals. Localized lack of definition of meniscal surfaces may be the only arthrographic finding. Resected specimens invariably show surface irregularities to be more extensive than suggested radiologivally, and frequently there are unsuspected associated horizontal cleavage tears. The clinical implications of degenerated menisci are controversial. A variety of normal synovial folds can simulate the anterior cruciate ligament.
A new sign for the diagnosis of lipohemarthrosis on vertical beam lateral knee radiographs depends upon visualization of the joint capsule due to the presence of fat lying both within and outside of the joint. Recognition of lipohemarthrosis on routine knee radiographs may aid in the diagnosis of subtle tibial plateau fractures.
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