Transition from Film to Electronic Media in the First-Year Medical School Gross Anatomy Lab

For the benefit of the first-year gross anatomy students, we digitized and published on a Web site images that had been collected over a 30-year period. We provided a CD-ROM (compact disk, read-only media) containing the image set in higher quality format to students and faculty. We supplemented basic images with hot topics such as CT angiography, virtual colonography, computer-aided diagnosis, and 3D post-processing. Full motion video and moving JPEG (Joint Photo Expert Group) animations were integrated into the atlas. On the post course questionnaire medical students reported that the images on CD-ROM were helpful during the course and for review prior to examinations. Faculty and medical students used the CD-ROM for problem-based learning sections and facilitator training. The images were clear and easily projected during review sessions and were useful for the small group sessions, where they served as examples of normal anatomy.     

Chemical shift imaging of mannitol in acute cerebral ischemia. Case report

The effectiveness of mannitol for the treatment of cerebral edema after stroke has long been debated, and the diffusion of mannitol through a disrupted blood-brain barrier has been the focus of many contradictory studies. The authors present a unique case in which chemical shift imaging was used to demonstrate the accumulation of mannitol in an area of stroke underlying a subdural hematoma in a patient with end-stage renal disease being treated with hemodialysis. A metabolite map for the xenobiotic mannitol was created from the data and demonstrated the accumulation of mannitol when hemodialysis was interrupted prematurely. Metabolite maps were also used to show removal of the mannitol with the reestablishment of hemodialysis. It is concluded that mannitol can accumulate in an area of infarction, and that chemical shift imaging can be used to illustrate this process.     

CT of small bowel obstruction secondary to a cocaine-filled condom

Drug smuggling is prevalent in our society. It is now frequently seen in the emergency room as an acute life-threatening emergency. The following case describes one such patient with an emphasis on the CT findings in these cases. Electronic Publication     

Magnetic resonance imaging of maternal diseases causing acute abdominal pain during pregnancy: a pictorial review

Evaluation of acute abdominal pain in a pregnant patient is a clinical challenge. In these patients, magnetic resonance imaging (MRI) can allow a systematic cross-sectional evaluation of the entire abdomen and can provide clinically useful information in a short enough time for emergent diagnosis. This pictorial essay demonstrates MRI findings of various maternal diseases that can present as acute abdominal pain in pregnant patients. Familiarity with these findings is important for the radiologist to make an accurate and prompt diagnosis.     

Blastomycosis of the lumbar spine: case report and review of the literature, with emphasis on diagnostic laboratory tools and management

We report on the conservative and surgical management of a patient with blastomycosis of the lumbar spine, causing severe and crippling deformity. The diagnosis was made through biopsy. Curative removal, reconstruction and realignment of the spine were achieved. Imaging modalities were highlighted, with a detailed discussion of the histology and conservative and surgical management. We emphasize the importance of early, aggressive treatment of blastomycosis to prevent deformity and disability, and to enable identification of the best management of a destructive lesion with deformity. This case demonstrates that empirical treatment should not be used in cases of unusual sinus and abscess locations. Specific diagnosis and early treatment are indicated to prevent dreadful complications and spinal deformity resulting from blastomycosis. Aggressive antifungal therapy can cure the disease but does not control complications related to deformity. The latter can only be addressed by surgical reconstruction. We review the literature of surgical treatment, focusing on abscess drainage, bone fusion and posterior instrumentation in the absence of addressing the deformity component. Received: 19 November 1997 Revised: 6 February 1998 Accepted: 16 April 1998     

Prospective analysis of uncomplicated bone bruises in the pediatric knee

To determine the incidence of uncomplicated knee bone contusions in pediatric patients. MRI studies were obtained using either high-field (1.5 T) or mid-field strength magnets (0.2–0.3 T), identifying 48 pediatric patients suitable for study. Contusion location, size, and any ligamentous or meniscal injuries were recorded. Exclusionary criteria did not include plain film findings, the interval between injury to imaging, or history of patellar dislocation [Fulkerson (2002) 30:447–456]. Uncomplicated bone bruises were those occurring in the absence of other internal derangements of the knee, such as meniscal and ligament tears. Consensus imaging findings by two reviewing radiologists revealed a 25% incidence of uncomplicated bruises (12/48 patients). These bone bruises involved the lateral and medial knee compartments 56 and 44% of the time, respectively. Bruises of the lateral compartment were larger (2.4 cm) than those found in the medial compartment (1.8 cm). Given the high incidence of symptomatic but uncomplicated contusions identified in this study of a pediatric population, we suggest appropriate joint rest and follow-up without other intervention as a primary course of treatment.