This paper deals with chest trauma, both blunt and penetrative. The emphasis is on the significance of various manifestations of trauma and the indications for further radiologic study.

Aortic Rupture↗

PubMed1991

MR imaging in fibromatosis: results in 26 patients with pathologic correlation.

Fibromatoses are a diverse group of soft-tissue lesions that have been inconsistently categorized and treated. The purpose of our study was to establish the range of appearances of fibromatoses on MR images and perform a pathologic correlation to explain the variable signal-intensity patterns. During a 3-year period, 26 patients with deep fibromatoses were examined with MR. The MR images were evaluated for signal-intensity characteristics, and findings were correlated retrospectively with the pathologic diagnoses. The results showed that the MR appearance of fibromatoses is similar to that of other soft-tissue lesions, and the signal intensities vary greatly from lesion to lesion and within lesions themselves. The fibromatoses were either hyperintense, isointense, hypointense, or of mixed signal intensity relative to adjacent skeletal muscle. The hypointense areas appear to be zones of hypocellularity and dense collagen deposition. Microscopically all of the lesions invaded adjacent structures, but the MR appearances of the margins varied and were judged to be well demarcated (n = 14), intermediate (n = 5), or poorly demarcated (n = 6). Our experience shows that fibromatoses have a variable MR appearance no different from that of other soft-tissue lesions, and this variability reflects the composition and cellularity of the lesions.

Adult↗

PubMed1984

The "mucous plug syndrome". A pulmonary embolism mimic.

Reported are ten instances of major bronchial obstruction by mucous plugs in eight patients during which the clinical features resembled pulmonary embolism. Perfusion lung studies showed significantly diminished perfusion of the involved portions of the lungs. The chest radiographs generally did not, however, reflect the severity of the airway obstruction and in some instances were completely normal. The ventilation studies indicated the extent and severity of the obstruction and matched with the perfusion scans. Pulmonary arteriograms were performed in three patients and gave direct evidence of focally diminished lung perfusion without embolism. The physiologic mechanisms underlying the condition are discussed.

Adult↗

PubMed1984

Mucous plugging simulating pulmonary embolism in patients with quadriplegia.

Two quadriplegic patients suddenly lost consciousness and were found to have an elevated alveolar-arteriolar oxygen gradient. Their chest x-ray films were normal. Perfusion scintiscans of their lungs showed large areas with markedly reduced or absent perfusion. Ventilation scintiscans demonstrated absent or decreased ventilation to the hypoperfused areas, suggesting mucous plugging. In quadriplegic subjects who have an ineffective cough, acute mucous plugging can produce the sudden onset of hypoxia with essentially normal chest x-ray films, thus mimicking acute pulmonary embolism.

Adult↗

PubMed1982

The pulmonary manifestations of lymphomatoid granulomatosis.

The pulmonary manifestations of 5 biopsy-proved cases of lymphomatoid granulomatosis are discussed. Two patients had diffuse reticulonodular infiltration of the lungs, thought to represent infiltrates of lymphomatoid granulomatosis. Three had nodular densities of varying size and distribution, with radiologically normal intervening lung, and biopsy suggested that these represented infarcts; the actual infiltrates of lymphomatoid granulomatosis were below the limits of resolution of the chest radiograph.

Adult↗

PubMed1981

Congenital absence of the pulmonary valve.

Congenital absence of the pulmonary valve (CAPV) is a rare anomaly usually associated with ventricular septal defect or Fallot's tetralogy. CAPV may be rapidly fatal in infancy because of severe disturbance of pulmonary ventilation resulting from bronchial compression by massively dilated pulmonary arteries. Other cases may be relatively benign. Our group of five cases with CAPV ranged from the severe to one case in which there was documented closure of a patent ductus arteriosus and a ventricular septal defect, leaving the CAPV as an apparently isolated, well-tolerated lesion. Plain chest radiographs play a major part in the diagnosis of CAPV since they almost invariably give some indication od the aneurysmal dilatation of the pulmonary arteries. On angiography, dilated main pulmonary arteries are shown giving rise to branches of normal or even diminished caliber.

Angiography↗

PubMed1981

The preauricular sulcus.

The preauricular sulcus of the iliac bone has been described by some as a characteristic of the female pelvis. The author investigated this possibility in a review of the pelvic radiographs of 100 men and 200 women. The results indicate that the preauricular sulcus is indeed a female characteristic which may be observed in approximately 25% of women.

Adolescent↗

PubMed1979

Peritendinitis calcarea of flexor carpi ulnaris.

Calcific tendinitis of the flexor carpi ulnaris presents a characteristic radiographic appearance of amorphous calcification near the pisiform. This calcification frequently is associated with acute symptoms and may be related to certain occupations and hobbies. Knowledge of the pertinent anatomic and radiographic criteria permits accurate diagnosis.

Calcinosis↗

PubMed1978

Gangrene of the lung: successful medical management of three patients.

Three patients with massive pulmonary gangrene who have survived without recourse to surgery are presented. In 2 cases, anaerobic organisms were suspected as being the causative pathogens although this was not proved. With resolution the radiological appearances of the involved lobe varied from no more than segmental to almost complete loss of the whole lobe.

Adult↗

PubMed1974