[The contribution of CT scanning in spinal pathology].
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Biomedical subjects
Publications and source records attributed to R Potvliege.
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A case of lethal, subacute monocytic leukaemia is described in which the development of multiple sclerotic bone lesions, resembling metastases, was due to secondary myeloid metaplasia. The spectrum of leukaemic involvement of the skeleton is discussed with emphasis on sclerotic bone lesions. The differential diagnosis of other focal areas of bone sclerosis is considered.
One hundred fifty-six anatomical specimens of cervical vertebrae and 55 C1 and 53 C2 vertebrae were examined for the presence of an accessory costotransverse foramen. We also reviewed 60 cervical spine computed tomographic (CT) scans. The variations of the costotransverse and accessory foramen are discussed. The frequency of the latter is 19% in the anatomical specimens and 45% in CT scans. The local anatomy and the excellent visualization on axial transverse CT are stressed.
The authors describe an unusual case of unilateral, nonfusion of the neural arch of the sixth cervical vertebra, documented with conventional X-ray examination and computed tomography. A brief review of other forms of congenital clefts is given and correlated with embryological findings.
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This article describes a case of osteopathia striata with cranial sclerosis. The patient also has multiple sclerosis. The symptomatology includes a right sided conduction deafness and a left maxillar nerve deficit, which were both attributed to the bone disorder. The authors review the literature of this rare genetic syndrome and pay special attention to the neurological manifestations. These mainly consist of hearing loss, mental subnormality and occasionally the involvement of other cranial nerves. The bone scan in their patient shows hyperactivity in the left skull base region. This finding provides further evidence that, at least in some instances, the bone disorder has a progressive course.
Computed tomography (CT) of the knee was performed in 160 patients following double-contrast arthrography. Seventy-five synovial folds on the medial wall of the knee joint were found, and 63 of these plicae could be considered mediopatellar plicae. In 10 of the 63 cases, long, thick mediopatellar plicae were found, which could lead to a mechanical internal derangement. Twelve synovial folds did not conform to the classic description of a mediopatellar plica. These folds probably represent synovial tissue reaction, since they were most commonly seen in patients who had undergone meniscectomy.
A prospective study of the diagnostic yield of ultrasound (US) and ERCP was made on a continuous series of 424 patients. Technical failures were slightly more frequent with US (11%) than with ERCP (8%), while US proved more accurate than ERCP in the diagnosis of focal hepatic disease--94% of correct diagnosis versus 41% (n = 17). In diffuse hepatic disease (n = 63) the accuracy of both methods was the same--87% of correct diagnosis with US, 83% with ERCP. US had better performances (91%), while ERCP was more accurate in the diagnosis of common duct lithiasis or tumour (98% for ERCP, 36% for US). Although ERCP has a better diagnostic yield for pancreatic diseases (92% to 100% of correct diagnosis according to the lesions) associate complications, such as pseudo-cysts, abscess formation and extravasations are better demonstrated by US (95% of correct diagnosis versus 73%). The two methods thus prove to be complementary.
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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.
Sixty seven patients with pain in the knee were studied. A compound tomography (CT) score indicating chondromalacia was devised, based on the results of CT after arthrography. This score takes account of the regularity, the congruity, and the imbibition of contrast material. Thus the patients could be divided into four groups: those who definitely have chondromalacia (++), probably (+), probably not (+/-), and definitely not (-). These results were compared with the clinical diagnosis based on clinical signs, arthroscopy, or operation. Eighteen patients had clinically proved chondromalacia, CT scored 14++, 3+ and 1+/-. Twenty nine patients had no chondromalacia, CT scored 19-, 8+/-, and 2+. Twenty patients had an uncertain clinical diagnosis. Arthrography was less accurate in detecting chondromalacia.
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