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Spiral CT with three-dimensional and multiplanar reconstruction in the diagnosis of anterior chest wall joint and bone disorders.

Twenty-seven patients with symptoms or clinical findings suggesting joint or bone disorders of the anterior chest wall (ACW) were evaluated by spiral CT with 3-dimensional (3-D) and multiplanar reconstructions. Preceding conventional ACW tomography was performed in 10 patients. ACW joint and bone changes were visualized more adequately by coronal 2-D reconstructions based on spiral CT than by conventional tomography. In addition, nonossified costal cartilages and soft tissues lesions were demonstrated. 3-D reconstructions sometimes added information, especially in patients with fracture and dislocation.

Adolescent↗

Traumatic rupture of the ascending aorta and aortic valve following blunt chest trauma.

Traumatic rupture of the aorta at the level of the isthmus is a well-recognized injury following blunt chest trauma. By contrast, rupture of the ascending aorta and of the aortic valve in a road traffic accident is rare and does not appear to have been previously reported. The occurrence of such an injury in a 56-year-old man involved in a road traffic accident is reported. The diagnosis was made preoperatively following aortography and successful surgical correction involved aortic valve replacement with resection and grafting of the damaged area of the ascending aorta. The probable mechanisms involved in the production of this unusual injury are discussed.

Accidents, Traffic↗

Scintigraphic findings in ankylosing spondylitis.

A prospective study of bone scintigraphic findings has been carried out in 63 patients, firmly diagnosed as having ankylosing spondylitis. In addition to abnormal uptake of the radiotracer at the sacroiliac joints, a peripheral arthropathy has been a common finding, particularly in the proximal joints, occurring in up to 50% of patients. Increased uptake of radiotracer in the spine has also been found both diffusely and focally. Focal increases have been noted at the apophyseal joints in 40% of patients and in three patients with a sterile intervertebral diskitis, an unusual complication of this disease only diagnosed in two patients after bone scintigraphy.

Evaluation Studies as Topic↗

Prospective study of anterior chest wall involvement in ankylosing spondylitis and psoriatic arthritis.

A prospective study of anterior chest wall involvement was conducted in 50 ankylosing spondylitis patients and 50 psoriatic arthritis patients in the absence of palmoplantar pustulosis. All patients underwent a physical examination, tomograms, and a radionuclide bone scan. Magnetic resonance imaging with gadolinium was done in some cases. Half the patients in both groups had anterior chest wall involvement. Enthesitis was the mechanism of the lesions. The manubriosternal symphysis and sternocostoclavicular joints were the most common sites of involvement, although other entheses in the region were affected in some patients.

Adolescent↗

An unusual case of multiple mesosternal foramina.

We present an unusual example of multiple mesosternal foramina (MMF). The alignment of the paired defects is unlike any previously described. Although single sternal defects are often encountered, paired defects are quite uncommon. This is the first documented example of bilateral paired defects in the sternum.

Adult↗