MRI characteristics of systemic mastocytosis of the lumbosacral spine.
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Biomedical subjects
Publications and source records attributed to R B Harrison.
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We present a case of diffuse lung calcifications that developed following fat emboli and adult respiratory distress syndrome. Computed tomography (CT) showed the majority of the calcifications to be within branches of the pulmonary arteries. High-resolution CT findings helped to characterize associated lung parenchymal changes.
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A fracture involving the trochlear ossification center as well as the medial epicondyle is a more serious injury than simple avulsion of the medial epicondyle. This diagnosis may be difficult in young children before the secondary centers are ossified. Radiographic clues to this injury in a young child are localized soft tissue swelling over the medial aspect of the elbow accompanied by a metaphyseal flake and/or a positive fat pad sign. In the older child, separation of the ossified medial epicondyle with a positive fat pad sign suggests a more complex injury.
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Two cases are cited as examples of the usefulness of bone scan-guided bone biopsies, using a lead marker for lesion localization, especially when the lesions are otherwise difficult to localize. This technique is quite useful in evaluating new solitary bone lesions in patients with a known primary malignancy.
Significant metastatic lesions of the osseous pelvis can be easily missed by conventional x-ray studies. Although the radionuclide bone scan is the method of choice for detection of metastatic lesions of the osseous pelvis, computed tomography should be used as a complementary study in certain patients.
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Bladder base impressions due to prostate hypertrophy are a common urographic finding in older males. A similar appearance may be occasionally seen in females and presents a more difficult diagnostic problem. Sixteen such cases of bladder base defects in females at two institutions were identified. The impressions were caused by symphysis pubis asymmetry, postoperative change, urethral diverticulum, levator ani impression, or "urethral syndrome." Vaginal fibromyoma, ectopic ureterocele, and intramural bladder neoplasm can also cause this defect, although no such cases were found in this series.
The effects of physical exercise on the status of bone mineralization for a population of lifetime athletes were investigated. The bone mineral content of the radii of experienced male tennis players was measured. The bone mass of the radius of the playing arm (mean, 1.37 g/cm) was greater than that of the nonplaying arm (mean, 1.23 g/cm) in all but one person. The results were compared with data for a nonathletic (normal) population. The quantity of bone mineral present in the playing arms of the athletic population was greater than that of the dominant arms of nonathletes, which suggests that playing tennis during a lifetime may produce a localized increase in bone mineralization that is greater than that found in nonathletes.
Defects or clefts may be seen in the growing epiphysis and are usually observed just before puberty. The basal epiphysis of the proximal phalanx of the great toe is the most common site but similar defects have been observed in a number of other epiphyses. At least some of these defects develop within a single normal appearing epiphysis and are not associated with signs or symptoms suggestive of fracture. The mechanism of formation of these defects is not clear. The defects probably close spontaneously sometime around late puberty.
A small spur seen at the edge of an open epiphyseal line indicates the presence of an open epiphysis when this is not clear radiographically. In addition, the spur should not be mistaken for an avulsion fracture.
A case is presented in which an irregular pattern of extravasation of contrast medium was observed during excretory urography. This proved to be extravasation into the necrotic center of a neoplasm. The differential diagnosis of extravasation during excretory urography is discussed.
The left renal vein frequently demonstrates a marked variation in caliber between the part distal to the aorta and the part directly in front of the aorta. This is well seen on both computed tomography (CT) and sonography. This variation in caliber or distention is believed to be secondary to a "nutcracker " effect formed by the aorta posteriorly and the superior mesenteric artery anteriorly. The third part of the duodenum may also add to the pincer effect on the left renal vein. A series of 72 patients was examined for this variation and the relation of the caliber of the left renal vein to the anatomy of the aorta, superior vena cava, and duodenum. These patients were also evaluated for any possible relation between the presence of a distended left renal vein and a varicocele.