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At least 109 records · Page 6Linked to original sources

Evaluation of hemoptysis in patients with a normal chest roentgenogram.

Hemoptysis is a common presenting complaint in patients with pulmonary disease. Although controversial, many clinicians suggest that all patients with hemoptysis should be evaluated with bronchoscopy to exclude the presence of a serious pathologic condition. We reviewed records for an 18-month period, during which 113 patients had hemoptysis as their principal complaint. In all, 26 of the 113 patients had normal chest roentgenograms. All underwent bronchoscopy as part of their evaluations. Results of bronchoscopy in these patients neither altered therapeutic decisions nor led to diagnoses of specific pathologic processes. We conclude that close observation of patients with normal chest roentgenograms who have hemoptysis may be an acceptable clinical approach.

Hemoptysis↗

Routine chest roentgenograms and electrocardiograms. Usefulness in the hypertensive workup.

We reviewed the records of all patients entering the hypertension Clinic in 1974. One hundred sixteen met the criteria for hypertension and had a routine chest roentgenogram and/or ECG obtained for the evaluation of hypertension, Routine chest films and ECGs led to therapeutic or diagnostic interventions in only two instances, were not useful as baseline examinations, were never used for prognostic purposes, and not once influenced hypertensive management. We conclude that the value of routine chest roentgenograms and ECGs cannot be defended on the basis of their contribution to the workup of hypertension.

Electrocardiography↗

A useful sign in differentiation of p-a from a-p chest roentgenogram.

Differentiation of antero-posterior (a-p) from postero-anterior (p-a) projections of chest roentgenograms is practical with ease and reliability by connecting the two outermost points of the junction of the first and second ribs on the plain film and observing its relation to the superior margin of the lung apex and inferior border of the posterior part of the second rib. Greater than 92 percent accuracy was obtained when this criterion was used to evaluate 500 p-a and 500 a-p chest roentgenogram, regarding the standard technical datas.

Humans↗

The chest roentgenogram in sporadic cases of Legionnaires' disease.

We reviewed chest roentgenograms from 17 persons with confirmed Legionnaires' disease. None of the cases was associated with known outbreaks. Pulmonary infiltrates, usually extensive, were present in all cases. The predominant radiological pattern of both on initial roentgenograms and those from the peak of illness was distal air space disease, usually in a segmental or lobar distribution. The lower lobes were involved most frequently. Pleural effusion and volume loss were infrequent. Radiological findings progressed rapidly and often cleared rapidly, although slow clearing was also seen in some cases. Legionnaires' disease should be included in the radiological differential diagnosis of segmental or lobar pneumonia.

Adult↗

[A case of giant bulla which ruptured and disappeared on chest roentgenogram].

We experienced a case of progressive giant bulla which ruptured and disappeared on chest roentgenogram. The patient was a 60-year-old male who had been treated with home oxygen therapy for chronic pulmonary emphysema. One year after initiating home oxygen, emphysematous bulla occurred and expanded to become giant bulla which occupied 3/4 of the right hemithorax. Although we attempted to persuade him to undergo surgery for bullectomy, he refused. While being followed as an outpatient, sudden right anterior chest pain occurred, and dyspnea was markedly alleviated at the same time. Chest roentgenogram revealed right pneumothorax and pleural effusion, and the giant bulla subsequently receded. The patient has been stable for the approximately one year period since, without evidence of recurrence. It is rare for giant bullae to cause a pneumothorax. In addition, there are no previous reports in the literature with a clinical course such as that experienced by our patient.

Humans↗

[A case of angiosarcoma presenting as ill-defined opacities on chest roentgenogram and hemothorax].

A 74-year old male was referred to the Tokai University Hospital for evaluation of abnormal opacities on a chest roentgenogram. Laboratory tests demonstrated leukocytosis, elevated ESR and CRP, elevated LDH, and hypoxemia. The chest roentgenogram demonstrated several ill-defined nodular infiltrates on the bilateral upper lung fields. In addition, a CT scan revealed bilateral pleural effusion which was found bloody on diagnostic thoracocentesis. Administration of antibiotics failed to improve lung infiltration or laboratory data. The patient died of respiratory failure on the 23rd hospital day. At autopsy, multiple ill-defined nodules, which were associated with alveolar hemorrhage, were scattered in the lungs bilaterally. Both hematoxylin-eosin and silver staining showed atypical cells of a vasoformative nature. Factor VIII related-antigen in the tumor cells was confirmed by the peroxidase-antiperoxidase method. These findings were consistent with angiosarcoma. The tumor foci were demonstrated in the lungs, pleura, kidneys, bone marrow, adrenal glands, and the gastrointestinal tract. The primary site of angiosarcoma, however, was not identified. Angiosarcoma, either primary or metastatic to the lungs, should be included in the differential diagnosis of multiple ill-defined nodular opacities associated with hemothorax.

Aged↗

Lacerations involving glass. The role of routine roentgenograms.

OBJECTIVE: To determine, when evaluating a laceration caused by glass, whether seeing that the bottom of the wound is free of glass eliminates the possibility that glass is present in the wound. RESEARCH DESIGN: Prospective patient series. SETTING: Two pediatric emergency departments. PARTICIPANTS: 226 children with lacerations due to glass occurring in a period of 21 months. SELECTION PROCEDURES: Consecutive sample. INTERVENTIONS: Before obtaining a roentgenogram, the triage nurse or the managing physician visually inspected each wound and recorded whether the bottom of the wound was seen, if glass was seen in the wound, and the length and depth of the wound. Further treatment of the wound was at the discretion of the managing physician. MEASUREMENTS/MAIN RESULTS: Glass was seen in the wounds of 10 children on initial inspection. Of the remaining 216 injuries, glass was contained in 12 (21.4%) of the 56 lacerations when the bottom of the wound was not visualized, and in 11 (6.9%) of the 160 lacerations when the bottom of the wound was visualized. There was a significant association between the depth of the wound and an inability to see the bottom of the wound, and deeper wounds were significantly more likely to contain glass. All but one of the lacerations containing glass had a depth of at least 0.5 cm. CONCLUSIONS: In the population studied, seeing that the bottom of the laceration was free of glass reduced, but did not eliminate, the possibility that glass was present in the wound. In addition, superficial lacerations (less than 0.5 cm) rarely contained undetected glass fragments. We recommended that further investigation concerning the mechanism of injury, the depth of the wound, and the type of glass involved is needed before physicians abandon routine roentgenography for lacerations due to glass.

Child↗

Pituitary apoplexy. The importance of skull roentgenograms and computerized tomography in diagnosis.

In two patients with pituitary apoplexy, computerized tomograms demonstrated a suprasellar mass that, after infusion with contrast medium, showed a peripheral ring-like enhancement consistent with a pituitary adenoma with central necrosis. In patients with symptoms or signs suggesting subarachnoid hemorrhage or meningitis, the finding of an enlarged sella turcica on plain skull roentgenograms should raise the possibility of pituitary apoplexy. This diagnosis may be rapidly and safely confirmed by computerized tomography.

Adult↗

Sex determination from chest plate roentgenograms.

Precise sexing--97% to 99% accuracy--of adult chest plates is possible when highly predictive costal cartilage ossification patterns are combined with four simple metric determinations. More than 1100 chest plate roentgenograms were evaluated for ossification pattern, fourth rib width, corpus width, sternal length and sternal area in an adult decedent population. An elementary, empirically obtained algorithm using the patternings and measurements, along with simple derivations (sternal length and area indices) was developed and then applied in chest plate sexing. This technique is not only easy, rapid and inexpensive, but it also results in a permanent and easily stored record.

Adult↗

A comparative study of the patello-femoral joint on axial roentgenogram, axial arthrogram, and computed tomography following arthrography.

After arthrography 71 young patients with pain in the knee had a computed tomography (CT) examination. The form of the patella is classified according to the method of Wiberg [12] and on CT 50% of them do not correspond to the type described on the axial roentgenogram. The position of the patella can be examined on CT with a relaxed knee in 15 degrees of flexion. The patellar cartilage is easier to assess on CT: congruity, regularity, imbibition of contrast material and thickness are studied.

Adolescent↗

Neonatal polycythemia and chest roentgenograms.

Chest roentgenograms of 34 newborns with a hematocrit of 75 or more at the age of 12 hours were studied. An analysis was made of the findings during the first four days of life and the results were compared with those of 18 newborns with a hematocrit of 65 or less. The cardiothoracic ratio (CTR) was found to be greater in the polycythemic infants than in the non-polycythemic infants, and greatest of all in infants with symptomatic polycythemia. Prominent pulmonary vascularity and pulmonary hyperaeration were seen more often in polycythemic newborns than in non-polycythemic infants. Eleven infants in the polycythemic group and three in the non-polycythemic group had some symptoms or signs.

Cardiomegaly↗

The effect of chemotherapy on osteosarcoma of the extremities as apparent from conventional roentgenograms.

The introduction of chemotherapy has greatly changed the treatment of osteosarcoma. During the preoperative phase the tumor response to chemotherapy can be assessed in various ways. This paper discusses the clinical, histological and radiological response to preoperative chemotherapy in three patients. Changes in conventional roentgenograms following chemotherapy can reflect the effect of chemotherapy on the primary tumor. This can be important in planning further chemotherapy or surgery.

Adolescent↗

Clinical utility of chest roentgenograms.

Because chest roentgenograms are the most common radiological procedure, they represent a considerable use of resources. Because the usefulness of chest radiography is frequently disputed, it is mandatory to investigate whether or not this use of resources can be defended in terms of clinical utility. The current study was performed as an outcome analysis to assess the clinical utility of chest radiography for monitoring patients in general practice (GP). One year of chest radiography referrals from a municipality practice, comprising a total of 55 patients, were prospectively studied. Prior to the referrals, questionnaires were filled in with indications and expected results. After the examination, the radiological results were assessed regarding clinical utility. All 55 patients were carefully monitored by the same GP. The most frequent reason for referral was infectious disease. Only in 5 patients was the radiology report without value. In the 29 patients with a negative report, it was considered of value. In 7 of these 29 patients the ongoing treatment was altered. The subjective value of the radiology reports were considered to be high. The clinical utility was good, both when receiving positive and negative answers. Of special interest was the negative answers as 7 patients actually changed treatment. The clinical utility was considered high enough to justify the costs. Good access to radiology for GPs is both cost-saving and cost-effective.

Aged↗

Lateral lumbar spine roentgenograms: potential role in complications of lumbar disc surgery.

Penetration into the abdominal cavity with injury to visceral, vascular, or neural structures is a potentially life-threatening complication of lumbar disc exploration. In this report, we used reconstructed computed tomographic measurements of the L3-L4, L4-L5, and L5-S1 intervertebral discs to show that lateral spine roentgenograms contain an unavoidable magnification error that makes accurate measurement of minimal depth to penetration impossible. This magnification error may mislead the unwary surgeon into an overestimation of actual disc size. Moreover, the "safe distances" that have been published for the avoidance of penetration at the L3-L4, L4-L5, and L5-S1 intervertebral levels would have been excessive for 22.2%, 19.4%, and 8.3%, respectively, of the 26 patients in our study.

Female↗

Clinical features and roentgenograms of symbrachydactyly.

Müller and Blauth have suggested that short webbed fingers, atypical cleft hand and acheiria develop as morphological variants of symbrachydactyly. The clinical features and roentgenograms of our 76 patients were analysed. The common features of all types of symbrachydactyly were that all cases were unilateral, various degrees of bone hypoplasia existed in the affected limbs, and in every grade there were some cases with pectoral muscle absence. There seems to be a successive process of formation of atypical cleft hand. Monodactyly and peromelia occur as a result of more severe reduction occurring in the central finger rays of symbrachydactyly of short finger type.

Female↗