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At least 1,261 records · Page 70Linked to original sources
PubMed1986

The cervical spine in hemophilia.

Fifty-three patients with known hemophilia A or B were retrospectively reviewed to determine the incidence of cervical spine involvement. Twenty-five were examined prospectively, including a detailed history and physical examination and cervical spine roentgenograms consisting of an AP and lateral flexion-extension series. All roentgenograms were reviewed by a board-certified radiologist. The mean age of patients in both groups was 25.4 years (range, eight to 54 years). In the retrospective review, no patients were noted to have complaints referable to the cervical spine, although five patients had prior trauma to the cervical spine. In the prospective study, 8 of 25 patients complained of intermittent neck discomfort and 9 of 25 had restricted lateral rotation and/or lateral flexion. No patient had radicular symptoms or objective neurologic deficits. Roentgenograms showed abnormalities in 13 of 25 patients. Ten patients (aged 19 to 54 years; mean, 32 years) showed cystic changes or endplate irregularity within one or more vertebral bodies. Two patients, aged 15 to 19 years, had an increased atlanto-dens interval of 5 mm (normal, 3 mm). No odontoid erosion was noted. No correlation was found between the severity of peripheral involvement and the cervical spine roentgenograms. Occult instability of the cervical spine is discussed, along with ramifications for patients with hemophilia.

Adolescent↗
PubMed1979

Risks of exposure to X-rays in patients undergoing long-term treatment for scoliosis.

Thirteen healthy teenage girls with idiopathic adolescent scoliosis were studied using multiple thermoluminescent dosimeters while undergoing standard diagnostic roentgenograms. Average organ doses for each anteroposterior and lateral examination were calculated for bone marrow, gastrointestinal tract, lungs, breast tissue, and gonads. Given an average of twenty-two roentgenograms over a three-year Milwaukee brace-treatment program, the increase in organ carcinogenic risk due to x-ray radiation ranged from 3.4 to fifteen per million (1.3 per cent to 7.5 per cent), except for breast tissue which increased from 140 to 290 per million (110 per cent). Using posteroanterior rather than anteroposterior exposures reduced the increased risk to 5.3 per million (3.8 per cent). The genetic risks of scoliosis roentgenographic studies were considered to be negligible, especially with gonadal shielding and infrequent roentgenograms made every three to four months. Good technique and judicious ordering of roentgenograms added significantly to the safety of the patient.

Bone Marrow↗
PubMed1983

[Tilting angle of the scapula].

The shoulder joint has the most freedom of range of motion in the human body. This joint is composed of the gleno-humeral joint, the acromio-clavicular joint, the sterno-clavicular joint and the scapulo-thoracic articulation. The scapula has a very important role in the scapulo-humeral rhythm in the shoulder motions, but the scapular position could be identified from the two roentgenograms from different distances in the same direction. Three points of the scapula were chosen to decide the plane of the scapula as below: A: The intersection of the vertebral border and the scapular spine, B: The inferior angle, C: The tuberos, infraarticularis. The two roentgenograms were taken using the distances of one and two meters from the X-ray tube to the X-ray film. The X-ray was concentrated on the point A of the scapula. Points B and C on each roentgenogram were measured by X-Y coordinates. The lengths of AB, BC and CA and the scapular angles (the medially tilting angle, the downward tilting angle and the upward rotation angle) were calculated by using specific equations. The lengths of AB, BC and CA and the medially tilting angle of 16 scapulae (dry bones) were measured by using a caliper, and those were calculated by roentgenograms. Each measurement was almost accurate the length of AB, BC and CA; r equal 0.965, the medially tilting angle; r equal 0.928). Then the scapular angles of a human body determined from the roentgenographic examination in the standing position. Also the shoulder was loaded with five kg at the forearm and the length were reconfirmed. The results were as below: The medially tiling angles were 42.7 degrees +/- 1.3 degrees (n equal 50) in the resting position (R.P.) and 47.5 degrees +/- 2.0 degrees (n equal 23) in the five kg loaded position (5 L.P.) among the males. Those angles were 45.5 degrees +/- 2.6 degrees (n equal 19, R.P.) and 49.5 degrees +/- 2.1 degrees (n equal 13, 5 L.P.) among the females. The downward tilting angles were 8.5 degrees +/- 1.6 degrees (R.P.) and 7.8 degrees +/- 2.0 degrees (5 L.P.) among the males and were 7.7 degrees +/- 2.6 degrees (R.P.) and 5.1 degrees +/- 4.8 degrees (5 L.P.) among the females. The upward rotation angle was 8.7 degrees +/- 0.9 degrees (R.P.) and was 5.6 degrees +/- 1.5 degrees (5 L.P.) among the males, and was 6.6 degrees +/- 1.8 degrees (R.P.) and was 4.4 degrees +/- 2.6 degrees (5 L.P.) among the females.

Adult↗
PubMed1983

Caveat arthroscopos: extra-articular lesions of bone simulating intra-articular pathology of the knee.

In the period from 1977 to 1981, eleven patients with a primary bone neoplasm and one with a bone abscess, located in the shaft or distal end of the femur or the proximal part of the tibia, were referred to the Massachusetts General Hospital Orthopaedic Oncology Unit. All had had diagnostic or therapeutic arthroscopy. For one of the patients no roentgenograms had been made prior to arthroscopy. For another, roentgenograms had been made but were not repeated prior to the arthroscopy three months later. In six patients the lesions were clearly evident on the roentgenograms; they were not reported in four patients, while in two patients the lesions were not considered to be a contraindication to arthroscopy. Two lesions were located in the femoral shaft and one was in the popliteal space, but they had not been noted by the surgeon or radiologist. In four patients the lesion arising from the bone was biopsied through the arthroscope, introducing tumor cells into the joint and theoretically causing synovial seeding of the lesion. The problems raised by this study are obvious to all orthopaedic surgeons who perform arthroscopy. Any patient who is thought to have an intra-articular lesion must first be fully evaluated by history, physical examination, and, most importantly, appropriate biplane roentgenograms prior to the performance of any procedure. If a lesion arising from the bone is encountered during an arthroscopic procedure, the lesion must be biopsied not transsynovially, but through a separate extracapsular approach.

Adolescent↗
PubMed1995

[Pulmonary endometriosis with recurrent catamenial hemoptysis].

A 32-year-old woman with a history of dilation and curettage for missed abortion at 31 years old had sudden hemoptysis during menstruation on May 25, 1993. She had catamenial hemoptysis again, and was admitted to our hospital on July 21, 1993. After admission, catamenial hemoptysis occurred, and a nodular shadow was noted in the right S4 area on chest roentgenogram and computed tomogram. A few days after menstruation, hemoptysis and the abnormal shadow on chest roentgenogram disappeared. Pulmonary endometriosis was diagnosed by clinical course, past history, and chest roentgenographic findings. During the next menstruation, hemoptysis and a nodular shadow in the right S4 area on chest roentgenogram recurred, so transbronchial lung biopsy and laparoscopy were done. TBLB specimens revealed macrophages with phagocytosed hemosiderin, and laparoscopy revealed pelvic endometriosis. She was treated with buserelin acetate. Catamenial hemoptysis and the nodular shadow on the chest roentgenogram disappeared after treatment.

Adult↗
PubMed1994

[Manufacture and usage of a new rotatometer of spine].

The purposes of this research are to study the changes of some projective points of vertebrae on roentgenogram during consecutive axial rotation and to design and manufacture a new rotatometer of spine for clinical and research work. Using 2 anatomic specimens of normal spines, aged 10 and 17 years. We took anteroposterior roentgenograms for each vertebra during consecutive axial rotation from 0 th 90 degrees. Some projective points on the roentgenograms were selected. Changes of the projective points were measured. The data were analysed with the stepwise regression, linear fitting in a microcomputer. The rotatometer was designed and manufactured upon the linear regressional equation. The results showed that there was an excellent correlation between actual rotation of vertebra and changes of the projective points on anteroposterior roentgenograms. The distances between the center of vertebral pedicle and lateral edge on convex side of vertebra and rotation angle Q were the reliable references which express the actual axial rotation of vertebra. We thought that rotation angle Q was the mark which had advantages of definition, directness, precision and extended measurable range. The 3 sets of graduations were used to measure the segments of T3-6, T7-12 and L1-4 neuromuscular scoliosis, some congenital scoliosis and axial rotation of spine without certain causes in adolescents. Quantitative measurement of scoliotic rotation is very important for determinating and selecting schemes of operations on scoliosis. It is also helpful to predict prognosis of scoliosis and evaluate the results of corrective operations on spinal deformity.

Adolescent↗
PubMedDate not supplied

Bilious vomiting during the first week of life.

From Nov. 1988 to Nov. 1991, forty-five newborns, who were admitted due to bilious vomiting within the first 7 days of life followed prospectively. Twenty-three (51.1%) required surgical intervention, and the remaining twenty-two (48.9%) had nonsurgical conditions. Clinical findings of green vomitus, abdominal distension, lethargy, irritability and abdominal tenderness are more likely to indicate the need for surgery. But the onset of vomiting and time of first stool passage are not helpful in detecting the need for surgery situation. Initial routine plain abdominal roentgenogram is helpful in distinguishing infants with surgical or nonsurgical problems. Sixteen infants with normal plain abdominal roentgenograms had nonsurgical conditions. Specific findings on the plain abdominal roentgenogram were noted in 23 infants, and 19 (82.6%) of these needed surgical intervention. Contrast studies were indicated for those without signs of complete obstruction, perforation or peritonitis, but the plain abdominal roentgenogram was abnormal and clinical condition did not improved.

Bile↗
PubMed1994

Early identification and isolation of inpatients at high risk for tuberculosis.

BACKGROUND: Although it has been recommended that all patients suspected of having tuberculosis be placed in isolation, the feasibility of this recommendation has not been investigated. METHODS: Forty-three patients with pulmonary tuberculosis were compared with 43 control subjects. The control subjects had submitted expectorated sputum, and were culture negative. Variables included chest roentgenogram results, and risk factors used by the Centers for Disease Control and Prevention (Atlanta, Ga) to identify patients at increased risk for tuberculosis. RESULTS: Potential control subjects outnumbered patients by 92:1. Although a positive tuberculin skin test, foreign birth, and weight loss were more common in the patients, 86% of the control subjects had at least one risk factor for tuberculosis. Chest roentgenograms consistent with tuberculosis (cavities or apical or nodular infiltrates) were found in 86% of the patients, but in only 16% of the control subjects (odds ratio, 31.7; 95% confidence interval, 8.6 to 127.7). The positive and negative predictive values of a consistent chest roentgenogram were 6% and 99.8%, respectively. The sensitivity of testing a single sputum specimen was 81%, yet almost half of the control subjects had only one specimen submitted. Of the inpatient cases, 58% were not identified on admission with a median delay of 13 days before isolation. CONCLUSIONS: Isolating all the patients at the time sputum is submitted for testing is not practical and would have resulted in a 92-fold overuse of isolation rooms. The chest roentgenogram was of great value in identifying patients who did not require isolation and was the best available means of identifying inpatients at high risk for active pulmonary tuberculosis.

Adult↗
PubMed1993

The medical approach for calcaneal fractures.

A practical classification of calcaneus fractures based on standard heel roentgenograms and Brodén's views is presented. Diagnosis is made from these roentgenograms, even though many believe that more sophisticated studies are needed. In fact, only the Brodén's and lateral views are needed for diagnosis. What one needs to know is the type of fracture present, whether it is a tongue or joint depression-type fracture, and the width of the fragment. The necessary information is easily determined from these roentgenograms. Once these facts are known, a plan of approach can be made. The medial approach is an indirect method of reduction as one might use for the tibia or femur fracture. Experience has shown that the longitudinal threaded pin is an excellent method of stabilization. It is quick and effective. It has eliminated the need for exposure of the neurovascular bundle. Minimal metal is implanted, and a smaller incision is used. Most common calcaneal fractures can be reduced well from the medial side. A few may need lateral reduction also, but this is simplified if the nonarticular components of the fracture are reduced first by the medial approach technique. The results of the medial approach technique have been much better in the last 12 years. This is attributed to the classification, the knowledgeable interpretation of the roentgenograms, and use of the threaded longitudinal pin for fixation.

Calcaneus↗
PubMed1997

Femoral insertion of the ACL. Radiographic quadrant method.

The optimal femoral insertion or footprint for an anterior cruciate ligament (ACL) graft is the anatomic site. This study was designed to determine the radiographic localization of the femoral insertion of the ACL on a lateral roentgenogram using a quadrant method. Ten human cadaveric knees with intact ACL were dissected. The most anterior, posterior, proximal, and distal borders of the femoral insertion of the ACL were marked with K-wires that were shortened at the bone level of the intercondylar fossa. A roentgenogram was obtained in the strictly lateral position. The end of the K-wires determined the projection of the femoral ACL insertion on the lateral roentgenogram. The center of the radiographically marked area was defined as point K, then four distances were measured on the lateral roentgenogram: distance t (representing the total sagittal diameter of the lateral condyle measured along Blumensaat's line), distance h (representing the maximum intercondylar notch height), distance a (representing the distance of point K from the most dorsal subchondral contour of the lateral femoral condyle), and distance b (representing the distance of point K from Blumensaat's line). Distance a is a partial distance of t and distance b is a partial distance of h, and distances a and b are expressed as length ratios of t and h. The center of the femoral insertion of the ACL was located at 24.8% of the distance t measured from the most posterior contour of the lateral femoral condyle and at 28.5% of the height h measured from Blumensaat's line. Based on these results, the ACL can be found just inferior to the most superoposterior quadrant, which means in anatomic terms it is localized from the dorsal border of the condyle at approximately a quarter of the whole sagittal diameter of the condyle and from the roof of the notch at approximately a quarter of the notch height. By using this radiographic quadrant method combined with fluoroscopic control during surgery, we were able to reinsert the ACL at its anatomic insertion site. This method is independent of variation in knee size or film-focus distance, easy to handle, and reproducible.

Anterior Cruciate Ligament↗
PubMed1977

Scintigraphic findings in stress fractures.

Forty-two patients suspected of having stress fractures were evaluated by serial roentgenograms and by one total-body scan with detailed views of suspicious areas. Stress fracture was the ultimate clinical diagnosis in twenty-one patients, and in fifteen of them the roentgenograms were normal while the scintigram was positive. The false negative rate for the roentgenograms was 71 per cent. In eleven of the fifteen patients, the roentgenograms eventually became positive. There were five positive scintigrams from causes other than stress fracture, giving a false positive rate for scintigraphy of 24 per cent. The bones with stress fractures included the metatarsals, calcaneus, tibia, femur, and fibula.

Adult↗
PubMed1987

Reducing roentgenography use. Can patient expectations be altered?

Many roentgenographic tests, including lumbar spine roentgenograms, may be overutilized. We examined the psychological, functional, and financial consequences of omitting spine films for patients with back pain with little risk of underlying systemic illness. Patients were randomized to receive immediate roentgenograms (n = 49) or a brief educational intervention, with roentgenography only for failure to improve (n = 52). After three weeks, 73% of the roentgenography group believed "everyone with back pain should have an x-ray," vs 44% of the education group. After three months, although 31% in the education group had received roentgenograms, overall radiology charges were still far less than those of the roentgenography group. No serious diagnoses were missed, and symptom resolution, functional improvement, and satisfaction were similar for the two groups. Thus, eliminating or delaying spine films need not cause anxiety, dissatisfaction, or dysfunction. This strategy may modify future expectations of roentgenography use and reduce health care costs.

Adult↗
PubMed1991

Hemoptysis. Indications for bronchoscopy.

Indications for bronchoscopy in patients with hemoptysis and a normal or nonlocalizing chest roentgenogram continue to be controversial. We reviewed the records for 119 bronchoscopies performed for hemoptysis in patients with a normal (n = 75) or nonlocalizing (n = 44) chest roentgenogram. Bronchogenic carcinoma was identified in 2.5% of the bronchoscopies. Additional neoplasms were found in another 2.5%. The presence of nonlocalizing abnormalities was not associated with an increase in either the rate of bronchogenic carcinoma or in the diagnostic yield (specific anatomic diagnosis or bleeding site identified) at bronchoscopy when compared with patients with normal chest roentgenograms. The factors of male sex, age more than 40 years, and a more than 40 pack-year smoking history appear useful in identifying patients in whom the yield of bronchoscopy is likely to be high.

Adolescent↗
PubMed1982

Osteomyelitis of the mandible. An initial feature in late-onset osteopetrosis.

Osteopetrosis is a rare disease that may be seen with numerous disorders referable to the head and neck. It occurs in both a malignant and a benign form. The benign form is consistent with a long life span and, when clinically manifest, often does so as osteomyelitis of the mandible. An awareness of this association greatly simplifies diagnosis through standard osseous roentgenograms. The findings of osteopetrosis so characteristic on standard osseous roentgenograms may be inapparent if only mandibular roentgenograms are obtained.

Humans↗
PubMed1987

Mandibular fractures. Their effect on growth and dentition.

Findings in 28 subjects having had childhood mandible fractures with long-term follow-up document asymmetric facial growth and dental abnormality in a high proportion. Facial growth abnormalities, five of which were moderate to severe, were detected by trained medical-dental examiners in 13 of the subjects (47%). Cephalometric abnormalities were detected in 18 (67%) of the 27 subjects so analyzed, with five (18%) meeting multiple roentgenographic criteria for abnormality. Frontal and lateral cephalometric abnormalities were found in nearly equal percentages among condylar-only, condylar-body, and noncondylar fracture groups, but abnormalities were most severe in association with the condylar injuries. The single best screening tool for facial abnormality was clinical examination. Frontal cephalometric roentgenograms correlated with clinical findings better than lateral cephalometric roentgenograms. However, roentgenograms alone had a 35% false-positive incidence of abnormality when correlated with the clinical-dental examination. Abnormalities of occlusion and dentition were seen in ten (36%) of the 28 subjects. Pterygoid muscle exercises following prolonged intermittent, nocturnal, intermaxillary fixation are discussed as a possible means to reduce the incidence of these abnormalities as the child matures.

Adolescent↗
PubMed1986

Green vomiting in the first 72 hours in normal infants.

From June 1980 to September 1984, forty-five newborns (weight greater than or equal to 2000 g), initially presumed normal, were seen with bilious vomiting in the first 72 hours and were prospectively followed up. Nine (20%) required surgical intervention, five (11%) had nonsurgical obstruction such as meconium plug or left microcolon, and the remaining 31 (69%) had idiopathic bilious vomiting. Infants with idiopathic bilious vomiting had a benign transient course and resumed feedings by 1 week of age; 30 of the 31 had normal or nonspecific findings on initial plain abdominal roentgenogram. Specific findings on the initial plain abdominal roentgenogram were noted in five infants, and four (80%) of these had a lesion requiring surgical intervention; 56% (5/9) of neonates with surgical lesions had normal or nonspecific findings on the plain abdominal roentgenograms. None developed bowel ischemia or midgut infarction secondary to a volvulus as they were identified by contrast studies shortly after the initial episode of bilious vomiting. Although the majority of "normal" neonates with bilious vomiting do not have a surgical lesion, this study indicates that 56% of surgical cases will be missed if contrast studies are not done.

Age Factors↗
PubMed1988

Roentgenographic features of common pediatric viral respiratory tract infections.

Viral infections of the respiratory tract in infants and children are common. Little has been reported on roentgenographic findings associated with infection caused by common viruses other than with respiratory syncytial virus. We studied chest roentgenograms from 128 previously healthy infants and children who were infected with respiratory syncytial virus, parainfluenza virus, influenza virus, or adenovirus. Four common roentgenographic findings were detected: parahilar peribronchial infiltrates, hyperexpansion, segmental or lobar atelectasis, and hilar adenopathy. Diffuse interstitial infiltrates and significant pleural fluid accumulations rarely occurred in our series. We confirmed the popular but not well-documented belief that other common respiratory viruses can be associated with roentgenographic findings similar to those caused by respiratory syncytial virus. However, respiratory syncytial virus infection is associated with more abnormal chest roentgenograms than any of the other viruses regardless of the clinical syndrome. Hilar adenopathy was more common in adenovirus infection. Young infants had significantly more abnormal chest roentgenograms, with more hyperexpansion and parahilar peribronchial infiltration than older children. We also found a significant correlation between lobar atelectasis and severity of the illness. In infants and children with viral infection of the lower respiratory tract, roentgenographic information can be a useful adjunct to clinical viral diagnosis.

Adenoviridae Infections↗
PubMed1984

Roentgenographic contrast studies in acute small-bowel obstruction.

Plain abdominal roentgenograms are usually adequate for the treatment of patients with small-bowel obstruction. There is a select group of patients who may benefit from a more precise diagnosis or by nonoperative therapy for whom contrast roentgenograms may be helpful. Contrast roentgenograms were performed in 68 (21%) of 327 patients who had nondiagnostic abdominal films, atypical histories or findings, or those in whom nonoperative resolution would be highly desirable. Sixty-eight percent of 48 contrast tracers gave useful information, whereas 75% of 24 contrast enemas were helpful. Contrast material passed through a site of obstruction in 34 patients, yet 13 (38%) still required an operation. Contrast material did not pass in 16 patients and only one avoided a surgical procedure. No difference was noted between barium sulfate or water-soluble contrast material or how it was administered.

Adult↗