Computed tomographic findings of intracranial gliosis

Summary The clinical and computed tomographic (CT) findings in eight patients with pathological evidence of cerebral gliosis are analyzed. CT findings do not permit differentiation of gliosis from other neoplastic and non-neoplastic conditions.     

Bilateral asymmetric hip dislocation: case report and literature review

Simultaneous anterior and posterior hip dislocation is an unusual injury. A unique case is presented, consisting of bilateral asymmetric hip dislocation with associated femoral head, femoral shaft, and acetabular fractures resulting from a motorcycle collision. The mechanisms of injury, management, role of imaging, and complications of this injury complex are discussed, with a review of the relevant literature.     

Computed tomography for anterior sacral and intracorporal meningoceles

Summary Two cases of recurrent anterior spinal meningocele are presented. Both cases were studied by CT. One of them was also investigated by ultrasonography. The value of these methods in the diagnosis of anterior spinal meningoceles is discussed.     

Computed tomography arthrography in traumatic hip dislocation

The newer diagnostic modalities such as computed tomography and magnetic resonance imaging are becoming increasingly used in the evaluation of joint trauma. The combination of computed tomography and arthrography can also be of significant diagnostic value in certain specific situations. In our case report, we describe its use in post-traumatic recurrent hip dislocation and its value, not only in depicting a posterior capsular tear, but also in the diagnosis of an internal joint derangement which may contribute to incongruous reduction of the hip joint.     

髋关节后脱位合并髋臼骨折的手术治疗

目的 探讨手术治疗髋关节后脱位合并髋臼骨折的临床结果及其影响因素.方法 对2000年3月-2006年3月收治的髋关节后脱位合并髋臼骨折患者52例进行回顾性分析.所有患者均于入院后急诊在全身麻醉下行手法复位骨牵引术,对其中41例行骨折切开复位钢板螺钉内固定术,术后X线片及随访X线片均按Matta标准评价,功能结果按Merle d'Aubigne标准评价.结果 41例手术患者中,33例获得1～7年随访,平均随访时间3.1年.术后X线评价:解剖复位27例(82 %),复位欠佳5例(15 %),复位差1例(3 %).功能评价优18例(55 %),良8例(24 %),中3例(9 %),差4例(12 %),总优良率为79 %.结论 早期关节复位、提高骨折复位质量和减少围术期并发症是提高临床效果的关键.     

MRI在婴幼儿先天性髋关节脱位中的应用

目的 探讨MRI在婴幼儿先天性髋脱位的应用价值,为临床提供合理的检查依据.方法 搜集47例3岁以内未经治疗的先天性髋关节脱位患儿行MR髋扫描,全部脱位髋按照Ogden和Dunn的标准分为3类.除Ⅲ型脱位髋外全部髋依照Fisher等描述的方法测量骨性髋臼指数(BAI)和软骨性髋臼指数(CAI)以及骨性髋臼商(BAQ)和软骨性髋臼商(CAQ).结果 正常髋、脱位髋、Ⅰ型脱位髋、Ⅱ型脱位髋的BAI分别是(25.24±3.70) °、(38.12±4.07)°、(35.59±2.86)°、(39.64±3.97)°;CAI分别是(8.49±2.15)°、(17.25±2.41)°、(15.85±2.00)°、(18.08±2.26)°;BAQ分别是0.199±0.026、0.126±0.028、0.131±0.028、0.124±0.028;CAQ分别是0.195±0.027、0.120±0.027、0.120±0.023、0.121±0.030.Ⅱ型脱位髋的BAI、CAI与Ⅰ型脱位髋相比呈升高变化,BAQ、CAQ呈减低变化.经统计分析,测量的 BAI和BAQ分别与CAI和CAQ呈线性相关(r值分别为0.876和0.706).MRI提示CDH主要改变为骨性髋臼失去正常的圆形轮廓,髋臼软骨增生外移.结论 MRI是临床评价婴幼儿髋关节骨、软骨结构和重要软组织的有效方法,是诊断和指导CDH治疗的良好手段.     

Computed tomographic ventriculography: a clinicoradiological study of 31 cases

We present 31 patients whose diagnoses were established by the aid of computed tomographic ventriculography. The indications for and diagnostic value of this method are reviewed.     

MRI examination of the glenohumeral joint after traumatic primary anterior dislocation

Primary traumatic anterior dislocation of the shoulder in young patients has a high recurrency rate. There are varying opinions on the pathology behind the recurrences. The aim of this study was to describe the MRI characteristics of the acute lesion, and at 6-month follow-up. Thirty patients aged 18–30 years with primary traumatic anterior dislocation of the shoulder were randomized into two groups. One group was treated with acute arthroscopic lavage within 10 days. The control group was treated with traditional non-operative therapy. All patients underwent acute MRI within 10 days and before the arthroscopic lavage, and again at the 6-month follow-up, for evaluation of the lesions. The acute MRI verified Hill-Sachs lesions in all patients. At the 6-month follow-up MRI, there was no change in the size of the Hill-Sachs lesion. This was also the case with the six patients in the control group with recurrent dislocations during the first 6 months. Twenty-nine patients (97%) had joint effusion at the acute MRI, which was very useful for evaluation of the soft tissue pathology. The glenohumeral ligaments were detached in 20/30 patients (66%), and the labrum in 22/30 patients (70%). A capsulolabral detachment classified as a Baker 3 lesion was seen in 16/30 (53%) of the patients, including all six patients with recurrent dislocation. At the 6-month control, only 3/30 (10%) of the patients had joint effusion for adequate evaluation of the labrum and ligamentous pathology. A Hill-Sachs lesion was found in 100% of the patients after primary dislocation, and recurrent dislocations did not change the size of the lesion. The study supports the opinion that this lesion is overlooked in the clinical situation. The joint effusion at the acute MRI was of utmost importance for evaluation of the soft tissue pathology. The 6-month MRI control was therefore considered inconclusive when evaluating capsulolabral lesions, due to lack of effusion. MRI arthrography with contrast administration would have been very helpful at the 6-month examination.     

全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎

目的：探讨全髋关节置换治疗髋臼骨折脱位术后创伤性关节炎（ traumatic ostcoarthritis,TOA）的临床疗效。方法选择2009年3月～2013年3月我院收治的髋臼骨折脱位术后并发创伤性关节炎行全髋关节置换术的患者27例为研究对象,男性16例,女性11例;年龄32～57岁,平均（45．2±8．7）岁。对其临床资料进行回顾性分析,并于术前和术后分别评定髋关节功能,评价手术疗效。结果27例患者均顺利完成手术,所有患者术后切口均Ⅰ期愈合;术后Harris评分为76～92分,其中80分以上的患者25例,优良率达到92．6％,平均（89．1±5．78）分,与术前的（45．3±5．86）分相比,存在显著差异（P＜0．05）;关节屈曲、内收、外展、外旋及内旋与术前对比差异均有统计学意义（ P＜0．05）,髋关节功能得到明显改善。结论髋臼骨折脱位术后易并发创伤性关节炎（TOA）,采用全髋关节置换术治疗具有术后并发症少、髋部功能改善明显、临床效果好、患者满意度高等优点,值得临床推广应用。     

全髋关节置换术后早期脱位原因分析及预防

目的：探讨全髋关节置换术后6个月内脱位原因及有效预防方法。方法：对320例全髋关节置换术患者，进行侧卧外展试验和放射学测量，分析术后早期脱位原因。结果：在320例全髋关节置换术后6个月共发生脱位15例，脱位率4．7％，其中翻修手术26例，发生脱位3例，脱位率11．5％，两者有显著差异（P〈0．01）。侧卧外展试验阳性患者132例，脱位8例，脱位率6．06％，试验阴性患者188例，脱位7例，脱位率3．72％，两者有统计学差异（P〈0．05）。测量术后X片臼杯安放位置在安全区内共285例，发生脱位7例，脱位率2．8％，在安全区外共35例，发生脱位8例，脱位率22．9％，两者有显著差异（P〈0．01）。使用具有防脱位高边的髋臼假体患者240例，发生脱位者8例，脱位率3．33％，使用普通髋臼假体患者80例，发生脱位7例，脱位率8．75％，两者有统计学差异（P〈0．05）。经后外侧入路手术患者160例，发生脱位9例，脱位率5．62％，经后外侧入路并保留修复关节囊患者160例，发生脱位6例，脱位率3．75％，两者有统计学差异（P〈0．05）。不同年龄、体重、性别的患者术后脱位率无显著差异。结论：全髋关节置换术后脱位与假体的放置位置、组织肌力平衡、手术是否保留修复关节囊、假体设计和是否翻修等因素有关，而与年龄、性别、体重等因素无关。精确假体置入、术后完善的护理可有效降低脱位发生率。     

Ischemic necrosis of the contralateral hip as a possible complication of untreated congenital hip dislocation

A five-year-old girl with untreated congenital hip dislocation and contralateral ischemic necrosis is described. The ischemic necrosis may have resulted from abnormal stress loading due to the abnormal contralateral hip.     

Necrotizing soft tissue infections of the body wall: Computed tomographic evaluation

The spectrum of soft tissue infection ranges from cellulitis to uncommon, but potentially fatal, diseases like necrotizing fasciitis and myonecrosis. The severity and extent of infection can be difficult to assess by physical examination alone. Computed tomography can accurately define the location and extent of infection as well as aid in its characterization. This information is critical in guiding surgical intervention in necrotizing soft tissue infections, which have a high mortality rate and require early recognition and aggressive surgical debridement. The presence of soft tissue gas or the involvement of deep fascia is highly suggestive of severe necrotizing soft tissue infection. We describe the computed tomographic appearance of three cases of necrotizing infection involving the fascia and muscles of the body wall.     

全髋关节置换术后脱位21例临床分析

目的分析全髋关节置换术后脱位的影响因素,探讨术中如何准确置人髋关节假体以减少髋关节脱位。方法分析我科2005年1月—2012年12月全髋关节置换术后脱位病例的影响因素。结果本组病人脱位发生率为1．3％。女性占脱位人数的比例为62％,男性占38％。早期脱位占脱位人数的比例为90％,晚期脱位占10％。前方脱位占脱位人数的比例为19％,后方脱位占81％。假体位置不良占脱位人数的比例为52％,精神神经功能不全者占29％,术后活动范围过度者占脱位人数的比例为19％。结论患者因素、术者因素及髋关节假体因素都对人工髋关节置换术后脱位产生影响,术中准确置人髋关节假体是影响髋关节脱位的关键因素。     

Computed tomographic diagnosis of posttraumatic primary adrenal insufficiency

Acute, primary adrenal insufficiency in the posttrauma patient is a rare but lifethreatening condition that frequently is unrecognized. Abdominal computed tomographic imaging is useful in establishing its diagnosis.     

发育性髋脱位的影像学研究进展

发育性髋脱位是一种常见的小儿骨科疾病。临床表现较隐匿,影像学检查对其诊断有重要价值。本文对X线、造影、超声、CT、MRI等影像检查方法对发育性髋脱位的诊断应用进行综述,探讨各种方法的优缺点及对发育性髋脱位的诊断价值。     

Computed tomographic sinography in orthopedic radiology

Twenty-one computed tomographic (CT) and 17 conventional sinographies were performed on 17 patients with lesions in the musculoskeletal system. The CT sinography was superior to the conventional examination in all cases, giving detailed information on the relationship between the sinuses and neighboring soft tissue and skeletal structures. CT sinography is recommended as the primary method for examination of musculoskeletal sinuses.     

Acute small bowel ischemia: spectrum of computed tomographic findings

Acute small bowel ischemia is an important clinical entity with significant morbidity and mortality. Since the clinical presentation is often nonspecific, abdominal computed tomography (CT) is frequently obtained for the evaluation of patients with equivocal or unsuspected intestinal ischemia. In this article, the direct and ancillary CT findings of acute small bowel ischemia are reviewed. Although the individual CT manifestations are rarely specific, awareness of the spectrum of CT findings of small intestinal ischemia can help to suggest the diagnosis and direct appropriate management.     

Chronic septic arthritis of the adult hip: computed tomographic features

Abnormalities on computed tomography (CT) are described in 12 adults in whom septic arthritis of the hip was diagnosed. Presenting symptoms varied, as did CT findings. Soft tissue abnormalities ranged from intra-articular effusion to large abscess formation, and bone changes ranged from minimal erosion of articular surfaces to gross destruction of the proximal femur and acetabulum. CT can be helpful in the evaluation of septic arthritis of the hip because of its superior demonstration of soft tissue detail. An accurate diagnosis can be established in unsuspected cases and can be confirmed when clinical indicators are vague.     

Bilateral ectopic pheochromocytomas: Computed tomographic and sonographic correlation

We describe a case of clinically unsuspected bilateral ectopic pheochromocytomas in a young woman. The bilateral retroperitoneal masses were located in the lower sympathetic ganglia at the level of the organ of Zuckerkandl. Computed tomography (CT) accurately identified the location and vascular characteristics of these neoplasms and provided access for percutaneous biopsy. Sonographic correlation is also presented.     

Computed tomographic appearances of sternocostoclavicular hyperostosis

Computed tomographical analysis of sternocostoclavicular hyperostosis was performed in 27 patients. In the earliest stage hyperostosis occurred around the cartilaginous portion of the first ribs. The sternoclavicular joint space was preserved even in the late stage III of the disorder. These findings suggest that sternocostoclavicular hyperostosis develops around the costal cartilage including periosteum, perichondrium, and the ligamentous structures, and that the sternoclavicular joint is not primarily involved. It is also suggested that perichondritis and periostitis play important roles in the etiology of this disorder.