Biomedical subjects
Publications and source records attributed to K R Kattan.
The radiographic image of a normal bone has a continuous radiopaque boundary of variable thickness and a relatively radiolucent interior. Normally, the endosteal edge of this boundary line is well defined. However, this edge may be obscured in diseases that induce medullary new bone formation. The use of this sign for the early detection of medullary sclerosis is demonstrated by specific examples.
The most common cause of RUL atelectasis in adults is neoplasm obstructing the RUL bronchus. Scarring of the lobe following chronic infection comes next. Other causes of obstruction, whether central or peripheral, are less common. The only direct sign of atelectasis is approximation of the fissures. All other signs are indirect. Increased density of the collapsed lobe is the most noticeable indirect sign. In the absence of adhesions the RUL is fixed at the hilum only. Therefore, it may take any one of the different shapes. Usually it is not difficult to recognize the dense shrunken lobe. Otherwise, we will have to depend on the other indirect signs, namely, displacement of mediastinal structures, elevation of the right hemidiaphragm, juxtaphrenic peak, elevation of hilum, "disappearance" of RUL artery, changes in position of of vascular (and bronchial) markings, and displacement of granuloma (if present).
More than 100 years ago Lasegue wrote, "Rheumatic fever licks at the joint but bites at the heart." This truth may be expanded to include nearly every joint ailment on one hand, and nearly every organ system on the other hand. In connective tissue disorders, bleeding diasthesias and metabolic and endocrine disorders, the joint manifestations are only one part of the total picture. This article shows a few examples of cardiopulmonary, gastrointestinal, and other manifestations. A few examples of iatrogenic complications are also described. The list of the examples described in this article is far from complete.
A variety of metallic objects may be seen on x-ray films of the head, facial structures, neck or chest. Among them are subperiosteal and endosseous implants, used to replace missing or damaged portions of the maxilla or mandible and to anchor dental prostheses. Wires, condylar head and neck replacements, surgical clips and silver amalgam may also be seen.
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Different devices are seen on chest roentgenograms everyday. The gamut of metallic density shadows include sutures, surgical clips, staples, cardiac valve prosthesis, wires, and plates. Tubes and catheters are recognized when metallic wires or barium are incorporated in their walls. The number of devices is ever growing and with them complications grow. The radiologist may be the first to detect these complications. This article endeavors to review briefly a small number of these devices and their complications. References are provided for the avid reader.
Despite CT and NMR, plain radiography still plays a major role in the diagnosis of mediastinal disease. In this article, the value and limitations of conventional techniques in the diagnosis of some unusual lesions of the lower mediastinum are demonstrated.
The chest radiograph may contain a wealth of information concerning the patient's condition and habits. Moreover, looking at the neck and chest wall and below the diaphragm is an integral part of reading the chest radiograph. A few pitfalls are also described in this article.
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The spinous process (SP) is often neglected in the radiologic examination of the spine. Proper coning decreases scattered radiation to the SP's in the lateral view. Lateral zonography (thick cut tomography) is occasionally needed in the thoracic region. In the anteroposterior view paying attention to alignment of the SP's and the distance between them will help in the diagnosis of fracture and/or dislocation. Examination of the spinolaminal line (i.e. the line joining the base of the SP's) on the lateral view is also important in looking for the alignment of the vertebra in trauma. Local absence of indistinctiveness of the spinolaminal line may be recognized in spina bifida or when an osteolytic process involves the cortex in this area. The SP itself is involved, with or without the remainder of the vertebra, in metastatic or primary carcinoma, in trauma, rheumatoid arthritis and Paget's disease and in primary benign tumors.
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