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At least 55 records · Page 3Linked to original sources
PubMed1994

The value of routine chest roentgenograms on admission for rehabilitation after traumatic spinal cord injury.

The value of routine chest roentgenograms has come under increasing scrutiny in the medical literature. In this retrospective study we investigated the value of routine chest radiographs obtained on admission to a rehabilitation unit after an acute spinal cord injury. The charts of all patients admitted for rehabilitation after a traumatic spinal cord injury during a 1-year period were reviewed and 79 patients fulfilled criteria for inclusion into the study. Of the 79 patients, 12 had findings on routine admission films, 9 of which were felt to be significant (11.4%). All 9 patients with abnormal admission films had experienced cardiopulmonary complications during their acute hospitalization (P < 0.001). Fourteen patients with normal chest roentgenograms on admission had repeat films performed during their rehabilitation stay, 4 of which were abnormal. All 4 had experienced cardiopulmonary complications during their acute hospitalizations (P < 0.01). Our findings would support the selective use of admission chest roentgenograms in spinal cord-injured patients with clinical indications or a history of cardiopulmonary complications during their acute care stay.

Adult↗
PubMed1988

Spinal pedicle fixation: reliability and validity of roentgenogram-based assessment and surgical factors on successful screw placement.

The increased popularity of pedicle fixation prompted research to address two issues: the reliability and validity of roentgenograms as a technique for evaluating the success of pedicle fixation, and the effects of surgical factors on successful fixation. Thus, does approach--the point and angle of screw insertion, surgeon experience, practice, level of the spine involved, and screw size--effect success of pedicle fixation? Eight fresh thoracolumbar spines were harvested and cleaned of all soft tissues. Two surgeons, one more experienced in pedicle fixation than the other, used two pedicle fixation approaches (Weinstein and Roy-Camille) on both the left and right sides at levels T11-S1 of each specimen. All screws were placed under anteroposterior (AP) and lateral c-arm control. For specimens 1 to 3, 5.5 mm screws were used at T11-L1, and 7.0 mm screws at L2-S1. Unacceptable failure rates at L2 and L3 for the first three specimens resulted in a change of instrumentation for the remaining specimens, with 5.5 mm screws used at T11-L3 and 7.0 mm screws at L4-S1. When surgeons completed the fixations for a specimen, AP and lateral roentgenograms were taken and both surgeons independently evaluated the films to assess the success of each fixation. Failure was defined as evidence of any cortical perforation on any side of the pedicle in or outside of the spinal canal. After completing the roentgenogram evaluation, the specimen was transected in the midline, and the success of each pedicle fixation was evaluated by visual/tactile inspection. There were no disagreements between surgeons on the visual/tactile evaluations of the specimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Bone Screws↗
PubMed1991

Clinical validation of functional flexion-extension roentgenograms of the lumbar spine.

The purpose of this study was to determine the clinical validity of functional flexion-extension roentgenograms of the lumbar spine in a defined patient population. One hundred and one adults with low-back pain or functional disorders underwent passive functional flexion-extension examinations. Their roentgenograms were analyzed using a computer-assisted method to determine segmental motion parameters such as rotation and translation of the lumbar vertebrae. The patient population was broken down into five groups with similar pathologies or physical conditions, and their motion parameters compared to a normal population and to each other. It was found that all of the patient groups exhibited significantly hypomobile motion, spread equally among all levels, in comparison to the normal population, except for the group of high-performance athletes, who had significant hypermobility. The uniform spread of hypomobility limits the ability to distinguish with any confidence between the four pathologic groups by their motion. Thus, we believe that the analysis of the segmental motion of the lumbar spine using passive flexion-extension roentgenograms does not aid in differentiating the underlying pathologic condition of patients with low-back pain, and that no useful information can be derived form this procedure, especially in relation to the need for surgical intervention.

Adult↗
PubMed1980

Correlation of pulmonary function with the chest roentgenogram in chronic airway obstruction.

To evaluate the correlation of various roentgenographic indices with airway obstruction, the chest roentgenograms of 189 patients were independently examined (without knowledge of their clinical status or measured pulmonary function) by a pulmonary physician and by a chest radiologist. For most indices, there was a close correlation in the measured results between the 2 observers; the exception was assessment of areas of hyperlucency. Airflow obstruction was best correlated with the level of the right dome of the diaphragm. When this level was at or below the anterior end of the seventh rib, airflow obstruction was almost invariably present (specificity greater than 97%); however, the sensitivity of this index was low (range, 31 to 42%). There was a significant correlation with other roentgenographic indices; however, curvature of the diaphragm and retrosternal space were not as good over-all indices of airflow obstruction as was the level of the right dome of the diaphragm. When the retrosternal space was greater 4.4 cm or the transverse diameter of the heart was less than 11.5 cm, airflow obstruction was almost invariably present; but the sensitivity of these indices was low. In contrast, the presence and extent of areas of hyperlucency were poorly correlated with airflow obstruction. Parahilar bronchi were visualized in less than 50% of the chest roentgenograms by either observer; the ratio of wall thickness to diameter of these bronchi was not well correlated with the degree of airflow obstruction. The results indicate that a good assessment of the presence or absence of airflow obstruction can be made from various features of the chest roentgenogram.

Airway Resistance↗
PubMed1985

Role of fiberoptic bronchoscopy in patients with hemoptysis and a normal chest roentgenogram.

We reviewed the charts of 48 consecutive patients who had fiberoptic bronchoscopy performed in the evaluation of hemoptysis with a normal chest roentgenogram. Fiberoptic bronchoscopy provided a diagnosis other than endobronchial inflammation in only four patients--benign fibromuscular polyp in one patient, Mycobacterium tuberculosis in 1 patient, and carcinoma in two others. A literature review revealed an overall 3 percent incidence of bronchogenic carcinoma in patients with hemoptysis and normal findings on chest roentgenogram. Other than abnormal findings on chest roentgenogram, risk factors for carcinoma in patients with hemoptysis include: (1) age greater than 40; (2) significant smoking history; and (3) duration of hemoptysis for longer than one week. We concluded that in patients with hemoptysis and normal chest x-ray film findings, routine fiberoptic bronchoscopy may not always be indicated to rule out malignancy.

Adult↗
PubMed2002

[Method for measuring dental roots by roentgenograms for making experimental models].

Two methods were used for measuring the true size of abutment teeth roots for making experimental models. One method was based on the use of intraoral contact roentgenograms made with a Russian 5D-2 x-ray diagnostic dental device and the other on the use of roentgenograms made with parallel beam bundles from a longer distance using an x-ray diagnostic dental device with a more potent x-ray tube, Evolution-300 (Italy) on a Kodak x-ray film (USA) Ultra-speed-58, 3.1[symbol: see text]4.1 cm. The results obtained by the latter method are more accurate, the difference from the true size being no more than 0.5 mm. However intraoral contact roentgenograms give the results close to the true size of abutment teeth roots, for example, for one of the mandibular premolars; however a correction coefficient should be used.

Dental Abutments↗
PubMed1992

Correlation between knee roentgenogram changes and clinical symptoms in osteoarthritis.

The main purpose of this study was to analyze the relationship between clinical symptoms and roentgenographic changes in patients with incipient osteoarthritis of the knees (OA). One hundred and sixty-two patients (126 women, 36 men, mean age 59 years) with established osteoarthritis of the knee were examined. Patients performed subjective self-assessment using Lequesne's questionnaire (index of severity for OA of the knee) and had frontal and lateral roentgenograms of both knees. Validity of the indices as reflections of individual symptoms was documented. A statistically significant correlation was found between clinical and patient indices (r = 0.327, p < 0.0001) as well as a very weak correlation between the clinical and roentgenogram indices (r = 0.196, p = 0.286). However, there was no correlation between the patient index and roentgenogram index (r = 0.065, p = 0.47). For the assessment of severity and progression of the disease, items reflecting acute irritation (swelling, effusion, increased joint temperature, pain during passive motion) were more reliable than items reflecting chronicity (muscular atrophy, decreased range of motion, crepitus). This study confirmed that Lequesne's questionnaire is a suitable tool for assessing subjective symptoms as well as for generating a condensed measure of disease severity. In addition, sclerosis, narrowing and osteophytes were proved to be important features characterizing the OA process.

Female↗
PubMed1991

[CT diagnosis in primary lung cancer (a correlative study of roentgenogram CT, surgical and pathological findings)].

A correlative study of roentgenogram, CT, surgical and pathological findings was investigated on 40 cases with primary lung cancer to evaluate differences between x-ray and CT of the chest in imaging pathological changes of lung cancer. The study revealed that CT was more sensitive than roentgenogram in showing lobulation, speculate and internal structure of SPN or masses, hilar and mediastinal adenopathy, invasion to neighbouring tissues and soft tissues of chest wall and abnormal pattern of the bronchus in cross section. Abnormal findings in CT was 67.4% higher than that in roentgenogram, CT provided more information in diagnosis of primary lung cancer. Some limitations of CT in diagnosis of primary lung cancer were also discussed.

Adenocarcinoma↗
PubMed1989

[Clinical investigation of pulmonary dirofilariasis with unusual abnormalities on chest roentgenograms].

The authors recently encountered three cases of pulmonary dirofilariasis with unusual abnormalities on chest roentgenograms. In case 1, with right upper and lower lobe masses and right pleural effusion, the right lower lobe mass and pleural effusion spontaneously disappeared one month after admission. In case 2, chest roentgenograms and chest CT scanning revealed a small mass with cavity formation. In case 3, with a right lower lobe mass and pleural effusion, steroid therapy resulted in disappearance of the mass and a remarkable reduction of pleural effusion. Human pulmonary dirofilariasis is a rare disease. In Japan, only 32, including our cases, have been reported in the literature of pulmonary dirofilariasis with unusual abnormalities on chest roentgenograms. The literature was reviewed.

Aged↗
PubMed1978

The bitewing roentgenogram and its diagnostic importance.

The role of the bitewing roentgenogram in dentistry is reviewed, including the roentgenographic techniques used, accessories for stabilisation of the film, and execution of the roentgenograph. Common errors in application of the technique are listed. The literature on the bitewing roentgenogram is surveyed and the conclusion stated that this roentgenographic technique is a diagnostic instrument that has no substitute for the purpose of detecting incipient interproximal carious lesions and periodontal diseases in the early stages of affecting the alveolar bone. No dental examination can provide complete diagnosis without bitewing roentgenograms.

Child↗
PubMed1989

The role of standard roentgenograms in the evaluation of instability of pelvic ring disruption.

Anteroposterior pelvic roentgenograms of 154 patients with pelvic ring disruptions were evaluated to assess their value in the determination of pelvic instability. Three different categories of stability were roentgenographically recognizable: (1) stable, characterized by impacted vertical fracture of the sacrum, nondisplaced fracture of the posterior sacroiliac complex, and/or subtle fractures of the upper sacrum evidenced by asymmetry of the sacral arcuate lines; (2) unstable, characterized by hemipelvic cephalad displacement exceeding 0.5 cm, sacroiliac joint diastasis exceeding 1 cm and/or sacral or iliac diastatic fracture exceeding 0.5 cm; and (3) indeterminate (that is, suspicious but not diagnostic of pelvic instability), characterized by cephalad hemipelvic displacement of less than 0.5 cm, sacroiliac joint diastasis less than 1 cm, and/or diastatic fracture of the sacrum or ilium of less than 0.5 cm. Correlation of the standard roentgenographic, computed tomographic, and clinical orthopedic examinations revealed that pelvic stability was accurately evaluated on the standard pelvic roentgenograms in 88% of cases. Disruptions were stable in 70%, unstable in 18%, and suspect in 12% of patients, for whom adjunct roentgenographic and clinical examinations were required. Determination of pelvic stability in the manner described allows immediate identification of patients with a stable or unstable pelvic injury, as well as identification of those with indeterminate stability requiring further clinical or roentgenologic evaluation. Immediate recognition of pelvic instability on standard pelvic roentgenograms obviates the need for additional diagnostic studies that unnecessarily delay the institution of emergency therapeutic measures designed to control associated hemorrhage.

Adult↗
PubMed1986

The need for chest roentgenograms in adults with acute respiratory illness. Clinical predictors.

The predictive values of several clinical variables for the presence or absence of pneumonia in adults with acute respiratory complaints were studied. Patients with congestive heart failure were excluded. Of 464 patients who received a chest roentgenogram, 129 (27.8%) had pneumonia. None of the symptoms, signs, or laboratory findings evaluated could reliably predict the presence of pneumonia. The absence of abnormal auscultatory findings on lung examination, however, excluded pneumonia with greater than 95% certainty. Among the 106 patients who presented with acute asthma, only two (1.9%) had pneumonia. Among the 33 patients with underlying organic brain syndrome, 25 (75.8%) had pneumonia. Incorporating these findings into a diagnostic strategy for ordering chest roentgenograms could have reduced the number of roentgenograms obtained by 54% and spared 72% of patients without pneumonia unnecessary radiation exposure.

Acute Disease↗
PubMed1985

Cardiorespiratory disease associated with Hallermann-Streiff syndrome: analysis of craniofacial morphology by cephalometric roentgenograms.

This paper analyzes the craniofacial morphology in a patient with typical Hallermann-Streiff syndrome (HSS) who developed symptomatic cardiorespiratory deficiency at the age of 48 years. The patient had obstructive sleep apnea (OSA), hypoxia, hypercarbia, pulmonary hypertension, tricuspid insufficiency, and right ventricular failure. Analysis of cephalometric roentgenograms, done 15 years earlier, revealed severe mandibular hypoplasia with marked underdevelopment of the ramus and body. The gonial angle was abnormally obtuse. The condylar and coronoid processes were reduced in size. The anteroposterior dimension of the upper airway was markedly narrowed. Cephalometric roentgenograms of six other HSS patients from our clinic were compared to those of the reference patient. Considerable variation in the features of the syndrome were noted. None of the other patients showed definitive airway obstruction. Comparison was also made with cephalometric roentgenograms of a patient with Treacher Collins syndrome and of a patient with progeria. The former showed airway obstruction associated with a deformed hypoplastic mandible; the latter had an unobstructed airway despite a small mandible because of associated hypoplasia of the maxilla and tongue. The HSS reference patient improved after oxygen therapy, diuretics, antibiotics, and relief of OSA. Patients with HSS, as well as those with Treacher Collins syndrome, appear to be at risk for the development of cardiopulmonary disease if they have obstructed airways. OSA has been shown to have developed in two patients with HSS. The resultant cardiopulmonary insufficiency of such patients may be preventable if airway obstruction can be relieved relatively early in life.

Adolescent↗
PubMed1982

Roentgenograms in primary care patients with acute low back pain: a cost-effectiveness analysis.

For patients visiting a primary care office practice for acute low back pain, we compared the benefits, risks, and costs of obtaining a roentgenogram of the lumbar spine routinely at the initial visit with performing a roentgenogram only if the patient's pain does not improve during and eight-week follow-up period. The cost-effectiveness analysis indicated that, to avert one day of physical suffering in a population of patients, the population would have to be subjected to the additional risk of 3,188 mrad of radiation and an additional cost of $2,072. While, in the individual case, circumstances might lead to a different conclusion, in general, the risks and costs of obtaining lumbar roentgenograms at the initial visit in patients with acute low back pain do not seem to justify the relatively small associated benefit.

Acute Disease↗
PubMed1983

Usefulness of screening chest roentgenograms in preoperative patients.

We proposed that clinical criteria could define a group of patients very unlikely to have abnormal preoperative chest roentgenograms. Nine hundred five surgical admissions were screened for the presence of clinical factors we thought would make those patients more likely to have abnormal preoperative chest roentgenograms. Of these, 368 had no risk factors. One patient (0.3%) of the 368 had an abnormal x-ray film, which did not affect the surgery. No material abnormalities were found in the remainder of the group without risk factors. Five hundred four patients had identifiable risk factors. Of these, 114 (22%) were found to have serious abnormalities on preoperative chest roentgenogram.

Adult↗
PubMed1982

Cough: diagnostic considerations with normal chest roentgenograms.

Cough is the second most frequent symptomatic reason given by patients visiting office-based physicians. The patient with cough and normal chest roentgenograms requires further evaluation in addition to a detailed history, careful general physical examination, meticulous otorhinolaryngology examination, and posterior-anterior and lateral chest roentgenograms. Additional studies may need to include bronchoscopy, paranasal sinus roentgenograms, pulmonary function tests (with possible inhalation challenge and exercise studies), biopsy of lung parenchyma, assessment for gastroesophageal reflux, esophogram, bronchography, echocardiography, and consideration of psychiatric factors.

Adult↗
PubMed1982

Correlation of ocular findings and plain skull roentgenogram in pituitary adenoma.

A review of the conditions of 44 consecutive patients diagnosed as having pituitary tumor is presented. In none of those with abnormal visual acuity, visual field defect, or extraocular muscle palsy was the plain skull roentgenogram normal. In all but one patient who had an abnormality on ocular examination), there was erosion of the clinoids on the plain lateral skull roentgenogram and, in that one patient, erosion was found on the side of the visual loss by the use of tomography. Based on these observations, we have stressed primarily the early use of simple plain skull roentgenograms in the evaluation of the conditions of patients with unexplained visual loss or extraocular movement palsy. We have also presented a scheme for evaluation of the conditions and the follow-up of patients suspected of having pituitary tumors.

Adenoma↗
PubMed1993

[An adult case of chickenpox with multiple nodular shadows on chest roentgenogram].

An adult case of chickenpox with a chest roentgenogram revealing multiple nodular shadows of 5 to 20 mm in diameter is reported. These shadows were different from those in previously reported varicella pneumonia cases especially with respect to size. Pulmonary function test showed disturbance in diffusion capacity, and bronchoalveolar lavage fluid analysis revealed a decreased CD4/CD8 ratio. Transbronchial lung biopsy showed mild alveolitis and focal exudation and hemorrhage into the alveolar space, which were thought to correspond to the relatively large nodules on the chest roentgenogram. These findings suggest that multiple nodular shadows on the chest roentgenogram may been seen in some patients with chickenpox.

Adult↗