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PubMed1982

Radiology of postnatal skeletal development. V. Distal humerus.

Thirty-one pairs of distal humeri were obtained from human cadavers ranging in age from full-term neonates to fourteen years. These were studied morphologically and roentgenographically. Specimen roentgenography using air/cartilage interfacing demonstrated both osseous and cartilaginous components of the epiphyses. These roentgenographic aspects of development are discussed and illustrated to provide a basis reference index. The supracondylar region is characterized by a fossa which initially is in both metaphysis and epiphysis, but migrates to the metaphysis completely within the first year. On either side of the fossa are osseous columns, which contrast with the broad metaphyseal bone above the columns. Within the fossa, anteriorly and posteriorly, are fat pads which may be elevated by intraarticular hematoma or reactive joint fluid. The physeal contour initially is transverse and smooth. Lappet formation progressively demarcates the epicondylar physeal regions, with the medial one becoming a functionally, but not histologically separate region. The capitellum is the first region to develop a secondary ossification center. This progressively expands into the trochlear portion of the epiphysis, a factor which predisposes to lateral condyle fracture propagation across the trochlear articular surface. The trochlea characteristically ossifies by multiple foci which fuse over time, often creating an irregular appearance to the developing ossification center. Epicondylar ossification tends to be from solitary foci. The lateral epicondylar center fuses with the capitellar center, whereas the medial epicondyle tends to be functionally separate entity throughout development and does not normally fuse to the trochlear ossification center.

Adolescent↗
PubMed1986

Generalized soft tissue calcification in children and adolescents with end stage renal failure.

Sixteen children and adolescents undergoing regular haemodialysis treatment were studied for the occurrence of metastatic calcifications. By the use of diphosphonate bone-scanning, roentgenography of the chest and skull and ocular slit lamp examination, generalized visceral calcification was diagnosed in two patients. No relationship between visceral calcification and biochemical, radiological or histological abnormalities of renal osteodystrophy was found. Our study demonstrates that visceral calcification also occurs in children with chronic renal failure and may be detected by scintigraphy.

Adolescent↗
PubMed1993

Osseous lesions associated with anterior cruciate ligament injuries. Assessment by magnetic resonance imaging at various periods after injuries.

In 56 patients with anterior cruciate ligament (ACL) rupture, we retrospectively examined osseous lesions secondary to the rupture using magnetic resonance imaging (MRI). Depending on the time from their ligamentous injury to the performance of MRI, the patients were divided into three groups: the acute group (less than 1 month, n = 20), the subacute group (between 1 and 12 months, n = 16), and the chronic group (12 months or more, n = 20). Occult osseous lesions which were not detected by roentgenography were revealed by MRI in 14 patients in the acute group (70.0%), 5 in the subacute group (31.3%), and 1 in the chronic group (5%). The detection rate of osseous lesions by MRI was significantly higher in the acute group than in the other groups (P < 0.001). Osseous lesions were always detected in the same locations of the lateral compartment of the knee joint. When examined by arthroscopy, these lesions were often found to be accompanied by articular cartilage injuries. In the acute group, osseous lesions were visible in the high signal intensity area of T2-weighted images and in the low signal intensity area of proton density images. They were interpreted as representing hemorrhage and edema within the bone marrow. In the subacute and chronic groups, the osseous lesions were smaller, and their signal intensity on T2-weighted images was lower than that in the acute group, probably reflecting the ongoing resorption of the hemorrhage and healing of the lesions. These results suggest that osseous lesions develop following injury to the ACL.

Adolescent↗
PubMed1993

Measurement of acetabular angle using ultrasound.

We have developed a method of measuring the acetabular angle by using ultrasound. Normal acetabular roofs are delineated as curvilinial hyperechoic lines on the screen, whereas in displastic hips the outlines of the acetabular roofs are shallower and more vertical. The values of 150 acetabular angles of 75 babies measured by ultrasound were in reasonably good agreement with those derived from roentgenography. This is a safe, handy, and effective for measuring the acetabular angle.

Acetabulum↗
PubMed1985

Composite grafts of demineralized compact bone and marrow under systemic biosynthetic growth hormone treatment.

The influence of systemic treatment with biosynthetic human growth hormone on bone formation was studied, comparing rabbit radial bone defects grafted with demineralized autologous bone with contrallateral defects grafted with a composite including bone marrow. At 14 and 28 days after operation the bone-forming process was evaluated by roentgenography (planimetry included), and by scintigraphy after injection of 99mTc-labeled dicarboxypropane diphosphonate. At 28 days autoradiography was also performed. The roentgenographic and scintigraphic examinations revealed no difference between the grafted sides at either 14 or 28 days postoperatively. The elimination, after 14 days' growth hormone treatment, of a previously found difference between the marrow- and the nonmarrow-grafted sides might be an indication of accelerated osteogenesis at the beginning of the healing process.

Animals↗
PubMed1976

Prenatal diagnosis of osteogenesis imperfecta congenita by means of fetography.

By means of fetography, prenatal diagnosis of osteogenesis imperfecta congenita was performed on two pregnant women in the 34th week of gestation with familial histories of the disease. In 1 of the 2 cases, the fetogram revealed abnormal twisting of the torso, shortening, and severe angulation deformities of the extremities with callus formation and parchmentlike skull despite clear-cut outline of the scalp. On the basis of these findings, the fetus was diagnosed as osteogenesis imperfecta congenita and subsequently confirmed. Thus, the excellent fetal resolving power of fetography permitted successful prenatal diagnosis of the disease far more easily and precisely than plain roentgenography.

Adult↗
PubMed1989

Radial ray defect with vascular and vertebral anomalies.

A new case with combined intercalary radial ray defect, high origin of the radial and ulnar arteries, and anomalies of the thoracic vertebrae is presented. The diagnosis was based on roentgenography, arteriography, and electroneuromyography. The case was regarded as a thoracic outlet syndrome due to the first rib abnormality and was treated surgically.

Adult↗
PubMed1976

Evaluation of gastric ulcerations.

All gastric ulcers diagnosed during the period November, 1969-May, 1974, were prospectively evaluated by roentgenography, fiberoptic gastroscopy, directed biopsy, and brush cytology. Gastroscopy was performed routinely in patients with radiologic diagnosis of gastric ulcer or questionable findings, and in symptomatic individuals with negative roentgenograms. A total of 123/142 ulcers, 109 benign, 14 malignant, were available for complete follow-up. Gastroscopy was correct in 106 of 109 benign ulcers visualized. Roentgenoscopy demonstrated 91 of 109, of which 7 were incorrectly called carcinoma. Gross diagnosis was correct by gastroscopy in 11 of 14 malignant ulcers. Radiology visualized 6 of 14; gross diagnosis was correct in 1 of 6 (5 called benign). Directed gastroscopic biopsy was negative for malignant changes in all 109 benign and 3 of 14 malignant ulcers. Total complete gastroscopic diagnostic failures were 4 of 123, for an overall accuracy of 96.7%. Overall roentgenographic accuracy was 70.8%.

Biopsy↗
PubMed1982

[Results of thoracic vagotomy for stomal ulceration following Billroth I gastric resection (author's transl)].

Thoracic vagotomy is rarely considered today. This procedure is justified only in stomal ulcerations following partial gastrectomy. Since 1974, we have been using this operative method at the Chirurgische Universitätsklinik in Tübingen, Germany, routinely for all cases of stomal ulcerations following Billroth I gastric resection. In contrast to this in stomal ulcerations following Billroth II gastric resection, we perform a converting resection into Billroth I as the standard operation, since in this case control of the duodenal stump for retained antrum is mandatory. To date we have performed thoracic vagotomy in 24 patients. This approach compares well with the abdominal approach. There is a short operating time (average 70 min), a short hospital stay (average 15 days), a low complication rate, and nonexistent mortality. All ulcers, even giant ones penetrating into the pancreas, healed within 6 weeks postoperatively. None of the patients developed postvagotomy diarrhea. On follow-up examination 1.5--6.5 (mean = 4) years after surgery only three patients had a recurrent ulcer. All patients were examined pre- and postoperatively by roentgenography, endoscopy, gastric acid analysis, and serum gastrin evaluation. The Zollinger-Ellison syndrome was excluded in all cases. Because of our excellent results, we consider thoracic vagotomy a safe and successful operative method, which can be recommended as a routine procedure for stomal ulceration following Billroth I gastric resection.

Adult↗
PubMed1977

Statistical analysis of factors affecting survival after glioblastoma multiforme.

Statistical evaluation of 71 cases (adults) of histologically confirmed supratentorial surgically treated glioblastoma multiforme seen during the period 1958 to 1973 revealed that the state of calcification as determined by roentgenography and the histological appearance of the neoplasm appeared to have a relationship with the postoperative period of survival. Postoperative adjuvant treatment, location of the neoplasm, duration of preoperative symptoms, patient's age at onset, preoperative condition, and cystic formation in the neoplasm also appeared to have a relationship, although it was slight.

Adult↗
PubMed1988

Delayed recognition of vascular complications caused by central venous catheters.

Three patients are described in whom vascular complications occurred after placement of central venous catheters. Inappropriate catheter length and site of cannulation, catheter movement, and unsuitable catheter material can lead to complications. Guidelines for cannulation of central veins are defined, and recommendations for chest roentgenography, which could result in early recognition of catheter misplacement, are provided.

Adult↗
PubMed1982

[Short-term induction and cyclic maintenance therapy in inoperable small cell bronchial cancer].

Since July 1978 one hundred and three consecutive patients with unresectable small cell bronchogenic carcinoma were treated with a combination of doxorubicin, cyclophosphamide and vincristine (ACO). In limited disease patients (64) the second chemotherapy course was followed by prophylactic cranial irradiation, the fourth by irradiation towards primary disease sites. Complete responders were randomised to either receive etoposide or no further maintenance therapy. Objective responses were reached in 88/100 evaluable patients, with 72% of complete remissions in limited-stage disease and 33% in extensive disease, respectively. The actuarial median survival time for limited disease patients was 15.8 months compared to 9.3 months in extensive disease (p less than 0.005). 29 of the 100 patients remain still alive, 4 for more than 24 months without disease recurrence. The survival advantage of patients reaching complete remissions relative to those who did not is highly significant (p less than 0.001). Acute gastrointestinal and hematological side effects were common, with possibly three drug-related deaths from infections during transient granulocytopenia (mean nadir: 600-900 cells/mm3). The present induction regimen using only four courses of chemotherapy produces high complete remission rates on roentgenography and bronchoscopy and improved survival in the majority of patients. Thus far any effectiveness of etoposide-maintenance therapy following ACO could not be substantiated.

Adult↗
PubMed1984

Anatomical relationship between the medial head of the gastrocnemius and the occurrence of a dystrophic bony lacuna.

A bony lesion with identical radiological features was seen in the medial part of the distal femoral metaphysis in five patients who practised cross-country motorcycling. These findings suggested that the cause of the lesions was of muscular origin. The nature and physiopathogenesis of the lesions were studied by roentgenography, computerized tomography and analysis of anatomical specimens. The results of these procedures were compared to observations made peroperatively. The lesion was identified as a specific, dystrophic bony lacuna resulting from the action of the medial head of the gastrocnemius (caput mediale m. gastrocnemii). In certain conditions this powerful biarticular muscle induces multiple microtrauma via traction on the structures of its tendinous insertion, especially the underlying bone, thus leading to bony avulsion. It is shown in this study that the bone-tendon-muscle complex forms a veritable biomechanical unit.

Adult↗
PubMed1991

Hepatobiliary anomalies associated with polysplenia syndrome.

The report of a 29-year-old woman with polysplenia syndrome, Crohn's disease, and bilateral cataracts is presented. The patient was noted to have a right-sided stomach and small bowel, Crohn's ileitis, and a left-sided colon. Results of roentgenography of the chest and echocardiography were consistent with a diagnosis of hypoplasia of the inferior vena cava with azygos continuation. The patient underwent laparotomy with cholecystectomy, exploration of the common bile duct, and choledochoscopy for cholelithiasis, choledocholithiasis, and chronic cholecystitis. Laparotomy revealed a liver that had two lobes, each with the morphologic appearance of the left lobe. The gallbladder was centrally located. T-tube cholangiography revealed a quadruplication of the intrahepatic biliary ducts. To our knowledge, this patient is the only known adult with this syndrome in whom cholangiography demonstrated isomerism of the biliary tree. A review of the literature on this subject is given with emphasis on biliary anomalies.

Abnormalities, Multiple↗
PubMed1983

Esophageal involvement in epidermolysis bullosa dystrophica: clinical and roentgenographic manifestations.

Epidermolysis bullosa is a rare hereditary mechanobullous skin disorder. Four patients with esophageal involvement are reported. These cases and review of reported cases of epidermolysis bullosa dystrophica-recessive (EBD-R) showed distinct clinical and roentgenographie features of esophageal involvement: diffuse inflammatory changes, motility disorders, small blisters or bullae seen as constant nodular-filling defects, esophageal ulcers, scars, pseudodiverticula, transverse and circumferential webs, various size strictures, shortening of the esophagus with development of traction hiatal hernia and gastroesophageal reflux, perforation, and complete obstruction of the esophageal lumen. Dysphagia is reversible when caused by bullae or webs and permanent when due to cicatrizing strictures. The strictures may remain unchanged in size for many years despite variations in dysphagic symptoms.

Adolescent↗
PubMed1976

Postvagotomy unmasking of nontropical sprue.

Adult celiac disease which became clinically evident after exophagectomy and vagotomy is described. The diagnosis was suggested by small bowel roentgenography and confirmed by intestinal biopsy and response to a gluten-free diet. The possibility that vagotomy unmasks asymptomatic adult celiac disease is discussed.

Celiac Disease↗
PubMed2003

Pose estimation of artificial hip joint using a single radiographic projection.

Total hip joint arthroplasty is commonly used in cases of osteoarthritis and rheumatoid arthritis. A hip joint prosthesis consists of a cup and a stem. The relative pose (position and orientation) of the prosthesis, when the patient is standing naturally, is planned pre-operatively; however, there is no guarantee that the pre-operatively planned pose will be accurate. Prosthesis component malposition, which is inadequate positioning of the acetabular or femoral component, results in limited joint movement and a large prosthetic joint contact area, and this can cause dislocation of the femoral head from the cap. Because the range of motion after total hip joint arthroplasty is determined by the relative pose of the cup and the stem, it is important to know the relative pose after hip arthroplasty. Several pose estimation methods using single-plane fluoroscopy or conventional roentgenography have been proposed. Because a conventional radiograph system is commonly used at small cost, a method using conventional radiograms is desirable for use in a clinical setting. In this study, a pose estimation method using conventional radiography is proposed, and an in vitro experiment is performed to evaluate its accuracy. The rotational errors of the relative pose of the cup with respect to the stem were smaller than 2.3 degrees.

Hip Joint↗
PubMed1979

Nonobstructive coarctation.

Roentgenographic studies, including plain chest roentgenography, thoracic aortography, and coronary angiography, were performed in seven adult patients with nonobstructive coarctation, a congenital deformity of the upper thoracic aorta. The chest roentgenographic findings were compared with those of ten patients with obstructive coarctation studied during the same period. A great similarity was found in the morphology and associated lesions of these two conditions, which supports the idea that nonobstructive and obstructive coarctation are stages of the same disease. Patients with nonobstructive coarctation had a more prominent aortic arch, and the indentation in the thoracic aorta was higher than in patients with obstructive coarctation. In addition, patients with nonobstructive coarctation had no rib notching on plain chest roentgenograms. Angiographic evaluation in patients with nonobstructive disease demonstrated the anatomic lesion, the absence of collateral circulation, and the commonly associated anomalies of the aortic valve.

Adult↗