Radiology

Martel, William; Braunstein, Ethan M.; Borlaza, Gil; Good, Armin E.; Griffin, Phillip E.

doi: 10.1148/132.1.1pmid: 451180

The radiologic manifestations of Reiter disease in 56 patients are described. Although the findings are often nonspecific, certain features are distinctive, particularly when present in combination. These include subtle periosteal bone apposition at bony prominences, the infrequency of regional panarthritis and hip and shoulder involvement, the tendency for destructive arthritis to be confined to small joints, particularly in the feet, and a typically “discontinuous” spondylitis characterized by eccentric, laterally positioned vertebral hyperostoses which tend to bridge around the contiguous disk. Attention is drawn to similar hyperostoses which occur above the true sacroiliac joints. The significance of these features, particularly in terms of differential diagnosis, is discussed. Index terms Arthritis Hyperostosis Joints Reiter syndrome Spine, ankylosis, arthritits (Skeletal system, Reiter syndrome, 40.730)

Palayew, Max J.

doi: 10.1148/132.1.11pmid: 451182

While recognizing the importance of the posterior tracheal band as described previously, the author wishes to emphasize the separate characteristics of the tracheo-esophageal stripe and emphasize its importance as a sign of air in the esophagus as well as possible underlying esophageal pathology. Any such band or stripe measuring 3 mm or more in the cervical or thoracic region should be viewed with some suspicion. Index terms (Chest contents, fundamental observation, 60.910) Esophagus, 71.920 Trachea, 671.920

Miller, William B.; Murphy, William A.; Gilula, Louis A.

doi: 10.1148/132.1.15pmid: 451190

Upon review, 25 cases of Brodie abscess demonstrated a radiological spectrum not previously appreciated. One third of the lesions were diaphyseal in location, and 50% had associated cortical thickening, while 40% showed a stimulated periosteal reaction, and 20% contained sequestra. The variable radiological appearance was underscored by the fact that the preoperative diagnosis was other than osteomyelitis in half the cases. A diverse nomenclature has proliferated to describe and catalogue bone abscess formation. Although the radiological spectrum is broad, the unanimity of clinical presentation, pathological findings, and response to surgical excision supports the concept of a single entity with variable expression. Index terms Abscess Bones, infection (Skeletal system, osteomyelitis, 40.210) (Skeletal system, Brodie's abscess, 40).213)

Huang, Tsung-Yao; Cho, Shao-Ru

doi: 10.1148/132.1.25pmid: 451215

The unusual occurrence of nontraumatic torsion of the lung following pneumonia is presented. A bronchogram was important in confirming diagnosis. The patient was successfully treated with antibiotics and surgical manipulation. A brief explanation of the torsion is suggested. Index terms Lungs, abnormalities Pneumonia, complications and sequelae (Chest, complication of trauma, 60430)

Adler, Jonathan

doi: 10.1148/132.1.27pmid: 451216

A case of rare venous calcifications involving cavernous transformation of the portal vein and spontaneous splenocaval shunt is presented. Findings were obtained with plain abdominal radiography, computed tomography, and angiography. Inflammation of the portal vein with subsequent occlusion could account for splenomegaly and hypertrophy of the splenic artery and vein with atheromatous calcifications due to turbulence and sclerosis. Angiography is essential prior to surgical intervention in order to select the appropriate shunt. Index terms Abdomen, calcification Computed tomography, abdomen Portal vein Veins, splenic (Gl system, calcification, 70.810) (Gl system, vascular calcification, including aneurysm, 70.813) (Portal vein, splenic vein, aneurysm, 957.730) (Portal vein, splenic vein, cavernous transformation, 957.752)

Braver, John M.; Paul, Robert E.; Philipps, Ervin; Bloom, Stephen

doi: 10.1148/132.1.29pmid: 451217

Linear peptic ulcerations are not uncommon lesions of the stomach and duodenum and can be demonstrated by upper gastrointestinal series. This is facilitated by the double contrast technique, but they may also be appreciated via compression methods. The criteria found helpful to establish the presence of a linear ulcer include: ( a ) contour deformity; ( b ) niche projection; ( c ) fuzzy line; and ( d ) folds radiating to a line (crater). Routine use of these criteria with the double-contrast method enabled the authors to diagnose 42 linear ulcers. Index terms Duodenum, radiography Gastrointestinal tract, radiography Peptic ulcer Stomach, radiography (Gastrointestinal system, ulcer disease, 70.250) (Gastrointestinal system, single niche, 70.251)

Moffa, Robert E.; Peltier, George L.; Jewell, William R.

doi: 10.1148/132.1.33pmid: 451218

Gastric bypass is now the operation of choice for surgical management of morbid obesity. Prompt and accurate radiological diagnosis in the early postoperative period is critical for proper management of suspected gastrojejunal anastomotic leakage, abscess formation, and acute distension of the excluded stomach and afferent loop. Inadequate weight loss may indicate an increase in the gastric pouch and anastomosis or dehiscence of the staple line. Gastric and jejunal ulceration and anastomotic narrowing also require radiological and endoscopic evaluation. Index terms Intestines, surgery Obesity Stomach, surgery (Gl system, postoperative with internal anastomosis, 70.435) Surgery, complications

Tegtmeyer, Charles J.; McCue, Frank C.; Higgins, Stanley M.; Ball, Donald W.

doi: 10.1148/132.1.37pmid: 582211

Single and double contrast arthrographic techniques were compared in 951 patients with suspected meniscal injuries. Exploratory surgery of the knee was performed in 384 of these patients and good clinical follow-up was obtained in 135 patients. In the latter two groups of patients, the single contrast technique was 97% accurate in assessing the medial meniscus and 96% accurate in assessing the lateral meniscus. Double contrast arthrography was 97% accurate in assessing the medial meniscus and 93% accurate in assessing the lateral meniscus. Numerical differences in the results from the two techniques were not statistically significant. Therefore both techniques can be considered equally effective diagnostically. Index terms Arthrography, technique Knee, arthrography Knee, injury (Knee, arthrography, 45. 122)

Clark, Robert A.; Wyatt, George M.; Colley, David P.

doi: 10.1148/132.1.43pmid: 451219

Thirty-one cases of renal vein thrombosis (RVT) were reviewed retrospectively for clinical, laboratory, and radiographic findings. An underlying renal disorder was present in 28 cases, absent in only 3. This supports other evidence that RVT is usually a complication of renal disease rather than a primary event, and that nephrotic syndrome may be due to renal disease rather than RVT. The findings also confirmed the large spectrum of urographic appearances in RVT, and were used as a basis for developing specific and liberal indications for renal venography. Index terms Thrombosis, renal (GU system, venous disorder, 80,750) (Other GU structure, renal vein thrombosis, 89.751) (Renal veins, thrombosis, 966.751)

Freeny, Patrick C.; Mennemeyer, Ralph; Reiley Kidd, C.; Bush, William H.

doi: 10.1148/132.1.51pmid: 377379

Visceral transcatheter occlusive therapy was performed with isobutyl 2-cyanoacrylate (Bucrylate) in 14 patients. Of 10 .patients who subsequently died, postmortem examination in 6, performed 2–196 days post-embolization, showed only a mild histiocytic foreign body giant cell reaction to Bucrylate. The reaction was confined to the vessel lumina and did not involve the vessel walls or contiguous parenchymal tissues. Clinical and radiographic follow-up in the other 4 patients (range = 30–180 days) showed no evidence of untoward reaction to Bucrylate. No ischemic or inflammatory complications were observed in any of the peripheral organs. Index terms Embolism, therapeutic, 9.129 Gastrointestinal tract, hemorrhage (Vessel of Gl system, bleeding, 95.710)