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William C Torreggiani

Publications and source records attributed to William C Torreggiani.

At least 19 recordsLinked to original sources
PubMed2003

Pelvic bone asymmetry in 323 study participants receiving abdominal CT scans.

STUDY DESIGN: Retrospective review of all CT scans of pelvis and abdomen performed at our institution in October and November 2000. OBJECTIVE: To determine the prevalence and extent of radiographic pelvic asymmetry in a population of patients not preselected for having low back pain. SUMMARY OF BACKGROUND DATA: Pelvic asymmetry refers to asymmetric positioning of landmarks on the two sides of the pelvis and may have a structural or functional etiology. Pelvic asymmetry can be associated with the presence of true leg length discrepancy, lead to false diagnosis or inaccurate measurement of leg length discrepancy, or itself be independently associated with back pain. Although the prevalence of pelvic asymmetry has been reported in patients with back pain to be 24-91%, its prevalence in the general population is not known. METHODS: A total of 323 consecutive CT scans of the pelvis/abdomen were assessed for pelvic asymmetry by one of three examiners. Pelvic asymmetry was defined as an unequal distance from the iliac crests to the acetabuli bilaterally, measured on the anteroposterior scout view of the CT scan. Measurements made on 30 randomly selected scans by the three examiners were used to assess interrater reliability of the measurement method. RESULTS: Pelvic asymmetry ranged in magnitude from -11 mm to 7 mm [right pelvis (mm) - left pelvis (mm)]. Pelvic asymmetry was >5 mm in 17 of 323 (5.3%) and >10 mm in 2 of 323 (0.6%) of the subjects; 172 of 323 (53.3%) had a smaller right hemipelvis (mean asymmetry = -3.0 mm). A total of 95 of 323 (29.4%) had a smaller left hemipelvis (mean asymmetry = 2.1 mm). The intraclass correlation coefficient [ICC(2,1)] between the three observers was high (0.91). CONCLUSION: Pelvic asymmetry of >5 mm was uncommon, with a prevalence of approximately 5% in the population studied. CT scanography was found to be a practical and reliable method for the assessment of suspected pelvic asymmetry.

Adolescent↗
PubMed2003

Fibroid in the buttock: an unexpected diagnosis.

Uterine leiomyomas (fibroids) are very common lesions with well-described imaging features. We present an unusual case of a fibroid which presented in the buttock with atypical clinical and imaging features in a woman who had had a previous hysterectomy. Despite extensive imaging and biopsies, the diagnosis was not suspected until pathological evaluation of the resected mass. The differential diagnosis for such a lesion, and the imaging and pathological features of fibroids, including atypical and parasitic leiomyomas, are discussed.

Buttocks↗
PubMed2003

Comminuted fracture of the ulnar sesamoid of the metacarpophalangeal joint of the thumb: an uncommon injury.

Fracture of the ulnar sesamoid of the metacarpophalangeal joint of the thumb is rare. Injury may be caused as a result of hyperextension or, less frequently, direct trauma. A sesamoid may be incompletely ossified, making it difficult to diagnose the fracture on radiographs. Early recognition of this entity leads to appropriate management. The case of a 26-year-old man who sustained a hyperextension injury of the thumb is presented. Radiographs demonstrated a fracture of the ulnar sesamoid of the thumb metacarpophalangeal joint. The literature regarding this uncommon injury is discussed.

Accidental Falls↗
PubMed2003

Computed tomography of acute small bowel obstruction: pictorial essay.

In many patients, the diagnosis of SBO can often be made by a combination of clinical history, physical examination and plain radiographs. However, in many cases, the diagnosis of SBO may be difficult. Abdominal radiographs are limited in their ability to diagnose SBO and, more particularly, to identify a specific underlying cause. Although barium studies, ultrasonography and magnetic resonance imaging may all play a role in the evaluation of SBO, CT should be the examination of choice for most patients when the diagnosis and underlying cause of SBO is unclear. It may help differentiate pseudo-obstruction from true obstruction, and a specific underlying cause can often be determined. Signs of closed-loop obstruction, strangulation, perforation or infarction may be detected and allow for more timely and appropriate surgical management. We advocate the use of CT in any patient with SBO where the cause or diagnosis is unclear. We have attempted to demonstrate a range of clinical cases in our practice where CT played an invaluable role in the evaluation of our patients.

Acute Disease↗
PubMed2002

Ollier's disease in association with adjacent fibromatosis.

Ollier's disease (enchondromatosis) is a nonhereditary disorder of mesodermal dysplasia. It is characterized by the presence of multiple enchondromas that typically affect the metaphyseal ends of bones. The association of Ollier's disease with adjacent fibromatosis has, to our knowledge, not been previously described. We report a case of Ollier's disease in association with soft tissue fibromatosis adjacent to the involved upper arm.

Adult↗
PubMed2002

Bilateral lipoma arborescens associated with early osteoarthritis.

Lipoma arborescens is a rare disease that has generally been considered to be unilateral. We report a case of bilateral disease in a patient with associated marked premature osteoarthritis of the knees. We postulate a possible association between these two conditions and explain a possible underlying mechanism. We suggest that lipoma arborescens be considered as a rare underlying cause of young patients with bilateral premature osteoarthritis, and recommend MRI as the definitive imaging modality.

Adult↗
PubMed2002

Unenhanced helical CT in the investigation of acute flank pain.

Unenhanced helical CT has emerged as the imaging technique of choice for the investigation of patients presenting with acute flank pain and suspected nephroureteric stone disease. There are several signs identifiable on unenhanced CT that support a diagnosis of stone disease. However, there are many pitfalls, that may confound a correct diagnosis. Some of the common pitfalls, together with methods to avoid such occurrences, will be discussed. A review of some of the common alternative diagnoses that may mimic the symptoms of nephroureteric stone disease is illustrated.

Acute Disease↗
PubMed2002

Intra-abdominal free fluid without solid organ injury in blunt abdominal trauma: an indication for laparotomy.

BACKGROUND: The optimal management of patients sustaining blunt abdominal trauma (BAT), in whom intra-abdominal free fluid but no solid organ injury is found on imaging, remains unclear. The purpose of this study was to determine the incidence and significance of this finding. METHODS: All patients presenting with suspected BAT to a provincial trauma center over a 30-month period were reviewed. A screening focused abdominal sonogram for trauma scan was obtained in every case. Stable patients with positive or indeterminate scans underwent computed tomographic scanning. Those with free fluid but without visible solid organ injury were studied. Radiologic interpretation, clinical management, and operative findings were analyzed. RESULTS: Twenty-eight of 1,367 patients (2%) met inclusion criteria. Twenty-one patients (75%) underwent exploratory laparotomy, which for 16 (76%) was therapeutic: bowel injuries were found in 10 patients, mesentery injuries in 6, and injuries to solid organs in 3. In five patients, laparotomy was nontherapeutic. Those with more than a trace of free fluid were significantly more likely to have a therapeutic procedure. Seven patients (25%) were observed, of whom two failed nonoperative management and underwent therapeutic laparotomies within 24 hours of admission for missed colon, splenic, and hepatic injuries. The presence of abdominal seat belt bruising or a Chance-type fracture in the study patients was associated with a 90% and 100% therapeutic laparotomy rate, respectively. Computed tomographic scan findings were variable and were not able to predict injury severity or need for surgery. CONCLUSION: The finding of more than trace amounts of free fluid in the absence of solid organ injury in BAT is often associated with clinically significant visceral injury. Early laparotomy is recommended for these patients.

Abdominal Injuries↗
PubMed2002

Dermatofibrosarcoma protuberans: MR imaging features.

OBJECTIVE: The objective of our study was to describe the MR imaging features of 10 cases of histologically confirmed dermatofibrosarcoma protuberans. CONCLUSION: MR imaging is useful in identifying the extent and location of dermatofibrosarcoma protuberans. Although most cases of this tumor are superficial and well defined, we have shown three cases in which the tumor was in a deep location and one case in which the tumor was ill defined in appearance. Knowledge of the variable MR imaging appearances of these tumors may aid in the diagnosis of difficult or atypical cases.

Adult↗