Multiple myeloma: evaluation by CT

Although patients who have multiple myeloma usually have straightforward clinical symptoms and corroborative radiographs, in some instances, these patients will present atypically, with symptoms suggesting active disease but radiographs that are normal or nonspecific. We reviewed the records of 32 patients who had documented multiple myeloma and had undergone CT examinations, assessing the value of those examinations. Although CT is not indicated in all patients who have multiple myeloma, it is especially useful in patients who have bone pain and normal or nonspecific radiographs. CT provided confirmatory information in all cases in which lesions were seen on radiographs. CT also frequently demonstrated a greater extent of disease than could be appreciated on the radiographs.     

Injuries of the cervical segment of the spinal cord in alcoholic intoxication. Preliminary report

The clinical documentation of 777 patients treated for traumatic injury of the cervical spinal cord has been analyzed. A comparison of consequences of accidents, neurologic and functional results of treatment in two groups of patients: admitted for treatment while being drunk and sober, has been presented. There were 246 intoxicated persons (32 per cent of the patients) in the analyzed group. An analysis of the data has indicated a smaller degree of spinal cord injury and better neurologic and functional results in patients that were not intoxicated by alcohol on admission. A statistic analysis (chi-square test)has shown that the quoted relationships have a high degree of probability. The authors have criticized incomplete documentation in previously used preliminary examination charts and have introduced a modified examination chart including data about the degree of a patient's sobriety.     

Supraacetabular insufficiency fractures

Insufficiency fractures in the supraacetabular region were identified in five women, aged 55-83 years. Factors contributing to the diminished resistance of their bones included postmenopausal osteoporosis, steroid therapy, radiation therapy, and rheumatoid arthritis. The supraacetabular fractures were seen on routine radiographs as hazy bands of sclerosis located immediately above and parallel to the acetabular roof. All five patients had additional fractures in the spine or pelvis. Supraacetabular insufficiency fractures may be an unsuspected cause of hip pain, especially in older women.