Radiographic findings in herpetic esophagitis.

The authors report a case of classic esophagitis simulating candidiasis radiographically. Endoscopy provided pathological conformation of herpes infection, showing typical multinucleated cells with intranuclear inclusion bodies.     

艾滋病合并念珠菌性食管炎的X线表现

目的探讨AIDS患者合并念珠菌食管炎的影像学表现。方法10例临床证实的AIDS患者均经食管钡餐与食管镜检查。结果10例食管钡餐检查阳性患者表现的黏膜粗糙，呈结节样网格状与食道镜检查吻合。结论比较食管钡餐造影及食管镜检查，均可较好显示AIDS食管念珠菌感染，同时，结合实验室检查可定性诊断。     

Radiographic findings in patients with clinical Tietze syndrome

Thirteen patients with similar painful tender swelling in the region of the sternocostal joint (SCJ) are reported. X-ray tomography revealed changes which might explain the swelling in 11 patients. Three patients had anatomical variants of the sternum. One of these and a further two patients had marginal osteophytes at the affected SCJ, as signs of osteoarthrosis. Six patients with psoriasis, pustulosis palmoplantaris, or psoriasis in the family had past or present arthritis of the involved SCJ or the manubriosternal joint. Tomography was found to be a useful confirmatory examination in patients with clinical Tietze syndrome.     

Radiographic findings in restrained hip joints associated with ACL rupture

Although decreased hip range of motion has been detected in many soccer players with noncontact anterior cruciate ligament (ACL), it is not clear whether it is associated with bone spurs, capsular soft tissue stiffness or both. Our aim was to investigate abnormal radiographic findings in soccer players with limited hip range of motion and noncontact ACL injury. Fifty consecutive male soccer players with restricted hip range of motion and noncontact ACL injury were subjected to radiographic examination to identify bone changes that could be associated with decreased hip range of motion. Of 50 patients, 56% revealed abnormal radiographic findings: pericapsular calcifications or acetabular rim osteophytes (24%), femoral neck deformity (10%), femoral neck and acetabular rim disorders (18%), neck groove caused by impingement (4%). Radiographic evaluation of those individuals showed a high number of bone abnormalities around the hip joint. This was considered to be an important finding to guide a decision-making process between three different approaches: changing the type of sports practiced, undergoing a more restrictive surgery (such as a double-bundle intra-articular reconstruction or an intra plus extra technique) or the onset of a hip-stretching program in addition to the conventional ACL rehabilitation protocol. In this last option, ACL-operated patients without radiographic hip abnormalities may have better outcomes for their decreased hip range of motion when submitted to a stretching program targeting the prevention of rotational overload on the reconstructed intra-articular grafts. The decision-making process concerning soccer players with ACL ruptures should take into consideration the amount of motion-limiting abnormalities around the hip joint.     

Exercise testing in the presence of complete heart block

A 28-yr-old female presented for preoperative evaluation. The resting ECG revealed sinus arrhythmia with complete heart block with a junctional escape rhythm and a ventricular rate of 43 bpm. The patient was in no apparent distress, and resting blood pressure was 80/50 mm Hg. Physical examination was largely unremarkable, with the exception of a soft, nontender, movable abdominal mass. The patient complained of mild dyspnea with stair climbing, but she was otherwise asymptomatic. Although high-grade atrioventricular (AV) block is considered a relative contraindication for exercise testing, this patient was referred for an exercise ECG stress test to assist in determining whether a electronic pacemaker or other therapy was necessary. A symptom-limited maximal ECG treadmill test was performed using the Bruce protocol. The resting HR before the test was 47 bpm, and resting blood pressure was 70/50 mm Hg. Beginning with the first stage of the test, sinus rhythm with a first-degree AV block was observed. The patient achieved 10.2 METs, with an HRpeak of 122 bpm and a peak blood pressure of 122/70 mm Hg. No ectopy was noted during exercise, no ST segment changes occurred during exercise or recovery, and the patient remained asymptomatic. The test was terminated because of the patient's inability to keep pace with the treadmill. On the basis of these results, no medical therapy or electronic pacemaker was recommended at this time, and the patient was permitted to undergo surgery for uterine fibroid tumors. This case illustrates that although complete heart block is a relative contraindication to exercise testing in some patients, the benefits of testing outweigh the risks.     

Radiographic findings in ovarian teratomas in children.

Twenty-one infants and children with ovarian teratomas are reported. Calcification or ossification occurred in 68%, a higher figure than quoted in prior series. Teeth were recognized in 29% of these. A lucent fat-containing mass was appreciated in only two patients. In younger children the tumor was more frequently abdominal rather than pelvic. In two patients the tumor was malignant. A patient with an amputated freely mobile teratoma is reported in detail and the differential diagnosis of mobile abdominal calcifications discussed.     

Radiographic findings in the chest of patients following cardiac transplantation

The postoperative chest radiographic findings in 38 patients undergoing orthotopic (37 patients) and heterotopic (1 patient) cardiac transplantation were evaluated. Findings were correlated with those of echocardiograms, sputum and blood cultures, and lung and heart biopsies. The radiographic manifestations in the chest of these patients are classified in the following three main categories: (1) Newly formed cardiac silhouette findings due to the transplanted heart itself, i.e., changes in size and shape of the new heart and pericardial effusion resulting from the placement of a smaller heart in a larger pericardial sac. (2) Infectious complications due to bacteria, fungal, and other opportunistic agents secondary to immunosuppressive therapy, and (3) Usual postoperative complications following thoracotomy and open-heart surgery.     

Radiographic findings in a canine model of mucopolysaccharidosis I. Changes associated with bone marrow transplantation

Eight dogs with mucopolysaccharidosis I (MPS I) were studied and their radiographic lesions compared with those reported in human MPS I. Three of the dogs received bone marrow transplants from unaffected littermates at 5 months of age. These dogs, and two affected control littermates were radiographed at 3, 6, 9, 12, 15, 18 and 20 months post-transplantation to evaluate the effects in chondro-osseous tissues. Although bone marrow transplantation did not alleviate all radiographically detectable changes, there was delayed onset of some lesions and reduced severity of most lesions in the dogs receiving transplants. Those lesions most closely associated with clinical lameness or gait abnormalities in untreated canine MPS I were most improved (or eliminated), and this was reflected in marked clinical improvement.     

Radiographic findings in 20 patients with Hantavirus pulmonary syndrome correlated with clinical outcome.

OBJECTIVE: Hantavirus is a rare rodent-borne pathogen responsible for the Hantavirus pulmonary syndrome. The objective of this study was to review the clinical and radiographic findings of patients presenting with Hantavirus pulmonary syndrome in northern Alberta, Canada. MATERIALS AND METHODS: We retrospectively reviewed the cases of 20 patients who presented with Hantavirus pulmonary syndrome from 1989 to 1999. RESULTS: Two patterns of presentation were identified. One group (13/20 patients) presented with fulminant clinical and radiographic findings and required intensive care support. Six (46%) of the 13 died within a few days of presentation. Some presented in respiratory failure with bilateral parenchymal infiltrates or a rapid progression from mild bilateral interstitial changes to bilateral interstitial and alveolar infiltrates with pleural effusions. The radiographic findings paralleled these clinical symptoms. The second group (7/20) consisted of patients whose clinical course was more limited, as were their corresponding radiographic findings. These patients had a limited hospital stay, and only minimal changes were identified on radiographs. None of the second group of patients died. CONCLUSION: Clearly, in our study, the patients with Hantavirus pulmonary syndrome presented as two groups: those with the fulminant form of the illness and those with the limited type. Of the patients we studied, the group with the fulminant form presented with severe clinical symptoms and radiographic signs of pulmonary disease and had a 46% mortality rate. The group with the limited form presented with mild clinical symptoms and minimal radiographic changes and had no mortalities.     

Radiographic findings in the hands in patients with systemic lupus erythematosus

Hand radiographs of 59 patients with systemic lupus erythematosus (SLE) were examined. Thirty-four revealed radiographic abnormalities, most commonly periarticular soft-tissue swelling or demineralization. Alignment abnormalities, acral sclerosis, avascular necrosis, soft-tissue calcification and terminal tuft resorption were also seen. All patients with periarticular calcification or terminal tuft resorption had Raynaud's phenomenon. Clinical indicators of disease activity (including low serum complement levels) did not correlate with the presence or severity of radiographic abnormalities. Patients with abnormal radiographs generally were older at the time of diagnosis than those with normal studies.     

Painful gleno-humeral joint instability in athletes. Radiographic findings

Instability of the glenohumeral joint is a common cause of chronic shoulder pain and disability in athletes using repetitive arm movements in elevation and external rotation. A series of 29 athletes with persistent shoulder discomfort for transient subluxation was evaluated with plain radiography and tomography in right axillary projection. The purpose was to detect abnormalities in the osseous glenoid rim. Twenty-six patients (89.6% of all cases studied) had various degrees of skeletal damage, including 18 fractures (69.2%) of the anterior rim, 2 (7.6%) of the posterior rim, and 6 cases (23.07%) of local degenerative changes; 3 cases were negative for skeletal damages. The result of this study demonstrate conventional radiography to be useful in the diagnostic assessment of shoulder pain in athletes, where similar problems must be promptly detected and not ignored.