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[Differential diagnosis of pathological and pseudo-pathological shoulder. Clinico-ultrasonographic findings].

Clinical examination for rotator cuff tears is rarely conclusive and very difficult is the differential diagnosis with lesions of the axillary nerve. In a little hospital we chose to use first non invasive and cheaper tools for this diagnosis. 24 patients were first evaluated by a physiatric MD, and radiological and ultrasound studies were then performed. Ultrasonography (US) was done with a high frequency probe (7.5 MHz). More than 85% of our patients had, in this way a quick, cheap and non invasive diagnosis, and moreover a quick rehabilitation treatment. Only 3 patients were later studied invasively by arthrography or electromyography with needle, their treatment started later. In 3 patients US demonstrates a normal rotator cuff, and so a diagnosis of nervous lesion. Four patients had a complete large tear of the rotator cuff. In 14 patients US shows small or partial tear. Our non invasive diagnosis was quick, cheap and therapy started earlier with better final results.

Diagnosis, Differential↗

[Pathology of the placenta. XIII. Pathological anatomy of the placenta and placental insufficiency].

An account is given of morphological issues relating to placental insufficiency. Variable manifestations of placental insufficiency in foetuses and newborns are described in some detail. Reference is made to morphological clues useful in diagnosing causes of placental insufficiency. It proved to be particularly difficult to find quantitatively recordable parameters for such diagnosis, comparable to morphological indicators resulting from various placental measurements or from determination of exchange area and thickness measurement of placental basal membranes. Most of these quantitative methods, after all, would not even be applicable to routine examination. All the other diagnostic criteria of placental insufficiency are part of obstetrics (placental hormone production, measurement of uterus circulation and of intervillous space). In a more specialized section of this paper, reference is made to various pathologico-anatomic patterns of placental disorders and their specific relevance to placental insufficiency. Circulatory disorders (maternal side), placental inflammation, impaired maturation and obliterative endarteriitis were the most common findings in this order.

Female↗