Unusual radiologic signs of bone echinococcosis in children]

The authors report 2 cases of 2 children aging 11 and 12-years-old presenting hydatitosis in the upper extremity of 2 long bones femur and tibia. In 2 cases, radiological appearances were atypical. In the femur, plain radiographs revealed multiple lucencies, irregular, located in the superior extremity with a periostal reaction. The CT scan confirmed these data and showed a cortical rupture, extension to soft tissue with contrast enhancement. In the tibia, plain radiographys showed delimitated lucencies, confluent with a rim condensation in the proximal epiphyseal-metaphyseal area. Echography and CT are helpful when radiological appearances are unusual.     

Early radiographic signs of tracheal rupture

Early diagnosis and repair of tracheal rupture are necessary to prevent acute tension pneumothorax, airway obstruction, and chronic tracheal stenosis. Few reliable radiographic signs of tracheal rupture have been proposed. We diagnosed seven cases of tracheal rupture, two related to blunt trauma and five resulting from tracheal intubation. Early radiographic signs included orientation of the distal portion of the endotracheal tube to the right relative to the lumen of the trachea with an overdistended endotracheal balloon cuff, migration of the balloon toward the endotracheal tube tip, and pneumomediastinum and subcutaneous emphysema. In four cases, the overdistended balloon with distal migration preceded the pneumomediastinum by several hours. An overdistended balloon in a patient after tracheal intubation or blunt chest trauma should suggest tracheal rupture.     

The radiographic signs of fatty liver.

Ninteen cases of radiographically visible fatty liver are presented. The four radiographic signs are muscle-fat interface, fat-water interface, a visible hollow viscus wall, and blurring of the medial margin of the right properitoneal fat stripe. The last sign, the authors believe, is the earliest radiographic change in developing fatty liver. In one case, isolated glycogen synthetase deficiency was the cause of fatty liver; this finding, to the authors' knowledge, has not previously been described. The value of the chest radiograph in diagnosing fatty liver is stressed.     

强直性髋关节炎平片与MRI分析

目的：分析强直性髋关节炎骨盆骨质疏松的细微结构和骨坏死的病理性征象。方法：收集北亚骨科医院强直性脊柱炎患者100例，其中8例行MR成像检查。分析髋部骨质疏松的特殊性和骨坏死征象以及关节软骨破坏程度。结果：髋部多发区域性骨小梁丢失、减少发生率最高85％，骶髂关节侵蚀破坏或骨性强直为100％，股骨头灶性骨坏死，吸收后表现单囊或多囊状破坏或有小死骨34％，关节破坏狭窄54％，股骨头关节软骨边缘滑膜骨化突出33％，耻骨联合吸收或硬化24％，坐骨结节骨化43％。结论：强直性髋关节炎主要表现为区域性迁移骨疏松和股骨头多发灶性骨坏死。     

Aluminum bone disease in children: radiographic features from diagnosis to resolution

Two children with chronic renal failure developed aluminum intoxication as a result of long-term ingestion of aluminum hydroxide for the control of hyperphosphatemia. In each child, bone biopsy confirmed severe osteomalacia, the absence of features of hyperparathyroid bone disease, and massive aluminum deposition at the bone-osteoid junction. Radiographs during the period of aluminum intoxication demonstrated osteopenia, pathologic fractures, fraying of the metaphyses of the long bones, and widening of the physis. When aluminum hydroxide therapy was discontinued (each patient) and aluminum was removed with chelation therapy (one patient), radiographs demonstrated a distinctly unusual pattern of healing. Calcification of the long bones began at the most recently formed osteoid and then proceeded toward the diaphysis. This unusual healing pattern created lucent defects and a transient "bone within a bone" appearance, which resolved with further healing.     

Fractures of the hook of hamate: radiographic signs

Isolated fractures of the hamulus, formerly considered rare, are being seen more frequently. Many of these injuries are sports related, particularly in golf, tennis, racquetball and baseball players. Failure to make an early diagnosis can result in severe pain and sometimes incapacitating disability. We studied the clinical and radiological findings in 12 patients who had fracture of the hook of the hamate. We propose three radiographic signs of fracture that are readily seen on routine PA projections: "absence" of the hook of the hamate; "sclerosis" of the hook; and lack of cortical density, i.e., a barely visible outline, of the hamulus.     

Direct radiographic magnification in bone infections

An experimental model of bacterial osteomyelitis was used to investigate the correlation of direct radiographic magnification and histopathologic changes in the femora of rabbits. The histopathologic changes demonstrated a severe chronic state of osteomyelitis. The extent of radiographic changes was more clearly recognizable with direct radiological enlargement (up to 15-fold) than on normal radiographs: this applied to destruction of marrow and cortical bone, formation of sequestra, and (frequently) extraosseous extension. Histopathologic findings were in agreement with the changes revealed by direct radiographic enlargement.     

Repeatability and accuracy of a paralleling technique for radiographic evaluation of distal bone healing after impacted third molar surgery

Objectives

The purpose of this study was to investigate the repeatability and radiographic accuracy of an intraoral paralleling technique to evaluate periodontal bone healing on the distal surface of the second mandibular molar (2 Mm) after impacted third mandibular molar (3 Mm) surgical extraction.

Methods

In order to estimate the variation in different radiographs, three replicas were made, each from 2 Mm, totalling 69 radiographic radicular longitude (RRL) recordings. One operator performed the periapical radiographs in a standard manner, utilizing a modified posterior film holder for the radiographic technique of parallelism, applied on the posterior region with the X-ray beam focused on the centre of 2 Mm. These radiographic recordings of the same region were obtained on three different and separate occasions, over a 12 month evaluation period after surgical extraction of the impacted 3 Mm. The RRL variable was measured and recorded three times by the same operator, with side-by-side comparison of three posterior periapical radiographs, irrespective of when the assessments were performed.

Results

There were no statistically significant differences between the three replica recordings (p = 0.969). The correlations between the three sets of measurements were evaluated and found to be highly associated (intraclass correlation reliability coefficient = 0.90) and statistically significant (p≤0.05). The median and mean error of the radiographic technique evaluated was ±0.257 mm and ±0.347 mm, respectively.

Conclusions

The radiographic technique described permits standardization in periapical radiographs with a high repeatability and accuracy in posterior radiographic records (distal surface of 2 Mm) over a postoperative evaluation period of 12 months.     

乳腺癌X线征象与免疫组化标记物之间关系的研究进展

乳腺癌在我国是女性第二位常见的恶性肿瘤,并且发病率逐年递增,早期发现、早期诊断、早期治疗对提高生存率、降低病死率、改善预后非常重要,其中钼靶X线检查对早期乳腺癌敏感性较高,在全球范围内得到了广泛的应用。现今对乳腺癌的影像学研究已经发展到分子生物学和病理生理学领域,结合免疫组织化学方法测定的生物学标记物和基     

骨包虫病影像学表现及诊断

目的分析骨包虫病的X线、CT及MRI表现，探讨骨包虫病影像学特点。方法回顾性分析7例经手术病理证实的骨包虫病影像学资料。7例均摄常规正侧位X线平片，4例行CT扫描，3例行MR扫描。结果颅骨包虫1例，脊柱包虫3例，髂骨包虫1例，骶骨包虫1例，肋骨包虫1例。X线表现：囊状膨胀性骨破坏5例，其中单囊性改变2例，多囊性骨破坏3例；溶骨性破坏2例，边缘硬化5例，钙化1例，软组织肿块4例。CT表现：4例中囊性膨胀性骨破坏3例，病灶呈多囊性2例，单囊性1例；溶骨性破坏1例；边缘硬化3例，钙化2例，软组织肿块4例。MRI表现：3例均为脊柱病变，共累计7个椎体，单囊性改变1例，多囊性改变2例，软组织肿块3例。病灶在T1IW呈低信号，T2WI呈高信号，囊内容物呈高信号，簇集呈“葡萄串样”，椎体压缩楔形变。结论影像学检查对骨包虫病的诊断具有重要意义，联合应用X线平片、CT、MR检查并密切结合流行病学史能进一步提高对骨包虫病的诊断及鉴别诊断。     

一氧化氮与骨折愈合

一氧化氮(nitric oxide，NO)是一种高度弥散的自由基，是生物体内重要的第二信使和神经递质。NO在神经递质释放、血压调节、免疫排斥、炎症反应、细胞功能及信息传递等方面有着广泛的作用。近年来，NO在骨科领域的研究也取得一些成果，其中包括骨组织的发生、骨改建、骨代谢、骨关节炎等方面。