Peribursal fat plane of the shoulder: anatomic study and clinical experience

A comprehensive anatomic and radiographic analysis of the peribursal fat plane in 12 cadavers confirmed that the fat plane seen on radiographs represents extrasynovial fat lining the subacromial bursa and documented the anatomic relations of the bursa. A three-part retrospective clinical evaluation of rotator cuff tears, calcific tendinitis, and rheumatoid arthritis was performed. Two osteoradiologists blindly graded the appearance of the peribursal fat plane with the shoulder in external versus internal rotation in 21 patients with arthrographically intact rotator cuffs and 21 patients with disrupted rotator cuffs. The peribursal fat plane was seen better with disrupted rotator cuffs. The peribursal fat plane was seen better with the shoulder in internal rotation and was seen in 60% of control subjects but only 21% of patients with rotator cuff tears. Partial or complete obliteration of this fat plane is a sensitive (79%) but less specific (60%) indicator of rotator cuff tears. Obliteration of the peribursal fat plane by inflammatory processes in adjacent tissues, including calcific tendinitis and rheumatoid arthritis, occurred with a high frequency.     

Computed tomography in obstetrics and gynecology.

Computed tomography (CT) has become essential in the diagnostic evaluation of the female pelvic. CT allows accurate delineation of neoplastic and inflammatory processes and provides an effective means of guiding percutaneous needle biopsy of masses and aspiration/drainage of fluid collections. In the pregnant woman, pelvimetry and excretory urography can be performed using the CT scout view with a radiation dose significantly lower than with conventional x-ray techniques. This paper covers the clinically relevant technical considerations involved in performing CT on women and follows with an overview of normal female pelvic anatomy and frequently encountered pathologic conditions.     

Rupture of the posterior tibial tendon: CT and surgical findings

Computed tomography (CT) was performed in 42 patients with 49 clinically suspected tears of the posterior tibial tendon. Twenty-eight of the 49 suspected tears were subsequently surgically explored and repaired. Three patterns of tendon abnormalities were recognized on CT scans: type I-intact, hypertrophied, heterogeneous tendon; type II-attenuated tendon; and type III-absence of a portion of a tendon. Types I and II correlated with partial rupture seen during surgery, and type III correlated with complete rupture of the tendon. CT findings were accurate in 96% of the patients who underwent surgery. In four cases (14%), tendon rupture was seen on CT scans, but the extent of the injury was underestimated and the rupture was misclassified. Reactive periostitis of the distal tibia was seen in 71% of diseased tendons and may represent an important factor in the diagnosis of tendon rupture.     

Craniofacial screening profile: quick screening for congenital malformations.

The correct identification of syndromes and other congenital malformations at an early age is critical for the child, family and care providers. Most specialists who conduct large screenings of young children are not adequately trained to recognize signs and symptoms that should lead to appropriate referral to the clinical geneticist and/or diagnostic team. A systematic approach for recognizing important signs is presented here; a Craniofacial Screening Profile. Following a brief training program, the Profile was validated by 39 speech-language pathologists in screening 3,539 kindergarten and first grade children. The results were excellent (specificity was 99.6%), demonstrating that with limited training, specialists can effectively screen for important signs and symptoms of a major group of syndromes and other congenital malformations.     

Early Teenage Substance Use as a Predictor of Educational-Vocational Failure

The authors report on the relationship of early adolescent substance use (up to the time of the 16th birthday) to educational-vocational performance in the early adulthood of 612 African-American urban subjects. Voluminous prospective data were available on the behavior, test performance, and families of 612 urban African-American subjects, from birth up to 7 years of age. Scarcer prospective data were available for school performance during later years of school. Control variables were derived from these data to determine the amount of variance in each dependent educational-vocational outcome variable that was accounted for, independently of the amount of variance accounted for by early substance use. (American Journal on Addictions 1994; 3:325–336)