Pneumothorax, Pneumomediastinum and Pneumopericardium: A Pictorial Review

Pneumothorax, pneumomediastinum and pneumopericardium usually develop during emergency situations and these conditions may result in cardiopulmonary compromise, so an early and accurate diagnosis is seen as crucial for proper treatment. For diagnosis of pneumothorax, pneumomediastinum and pneumopericardium, chest radiography is a primary modality and CT can help for diagnosing them earlier and detecting associated abnormalities. The purpose of this pictorial essay is to describe the pathophysiology, various radiographic signs and diagnostic pitfalls of pneumothorax, pneumomediastinum and peumopericardium on chest radiographs that are correlated with CTs, and to aid the physician in the radiographic diagnosis.

Multiple Thymoma in a Patient with Myasthenia Gravis: Case Report

A thymoma often occurs in patients with myasthenia gravis, but the development of multiple thymoma is very rare. The authors report the radiologic and pathologic findings of multiple invasive thymoma in a 59-year-old male with myasthenia gravis.

MR Findings of Transient Synovitis of the Hip

PURPOSE: To evaluate the MR findings of transient synovitis of the hip in children. MATERIALS AND METHODS: Between 1993 and 1997, MR imaging was performed in 30 children(male:female=22:8) in whom transient synovitis had been clinically diagnosed. In 20 of these 30 patients, Gd-en-hanced study was also performed. The signal intensity of bone marrow of the femur, the synovial enhancement pattern and the amount of hip joint effusion in affected hips were evaluated; the last-mentioned was determined using the volume measurement method. RESULTS: In 29 patients(97 %), no abnormal signal intensity was seen in bone marrow of the femur in affected hips. Gd-enhanced MR imaging revealed synovial enhancement of affected hip joints, as follows: minimal en-hancement in eight patients(40 %), moderate enhancement in eight(40 %), and strong enhancement in four( 20%). No abnormal enhancement was demonstrated in bone marrow of the femur or adjacent soft tissue. The mean amount of joint effusion of affected hips was 2.7 +/- 1.7(range, 0.2 -18.9)ml; statistically, this was much greater than that of contralateral hip (p<0.01). CONCLUSION: The MR findings of transient synovitis of the hip in children were normal bone marrow signal intensity of the femoral head, moderate or strong synovial enhancement, and asymmetric hip joint effusion.

A case of intraabdominal abscess cured by transrectal catheter drainage / 대한내과학회지

Intraabdominal abscess, resulting from primary intraperitoneal disease such as appendicitis, diverticulitis or as a complication of surgery, remains a serious problem with high mortality if not treated early and adequately. In the case of acute bowel perforation, surgery is the treatment of choice, but radiologically guided percutaneous drainage is very effective for the subacute and localized abscess within the peritoneal cavity. However, perirectal abscesses located deep within the pelvis are unapproachable percutaneously because of interposed structures such as the urinary bladder, loops of bowel. Transrectal drainage overcomes these limitations. We present here a case of perirectal abscess treated successfully and safe with transrectal catheter drainge.

A Childhood Case of Nephrotic Syndrome Complicated with Cerebral Venous Sinus Thrombosis Followed by Left Popliteal Artery Thrombosis

We report a 10-year-old male with steroid-responsive nephrotic syndrome which was complicated by cerebral venous sinus thrombosis including superior sagittal sinus and left popliteal artery thrombosis following 5 months later. At each thrombotic episode, he suffered from relapse of massive proteinuria with hypovolemic crisis, and from hemoconcentration with dehydration due to vomiting or diarrhea. Brain MR angiography confirmed thromboses of superior sagittal sinus, straight sinus, vein of Galen and occipital sinus. Diagnosis of left popliteal artery thrombosis was made according to the clinical observations including pulseless left dorsalis pedis artery, pain and coldness of left lower leg, and reperfusion injury of calf muscle after heparinization. Each thrombotic episode was successfully managed with heparinization, oral warfarin therapy and fresh frozen plasma for the antithrombin III replacement.

Measurement of Necrotic Portion in Legg-Clave-Perthes Disease: Comparison of MRI Volume Measurement Method andCatterall Classification

PURPOSE: The purpose of this study was to evaluate the extent of necrosis of the femoral head inLegg-Clave-Perthes (LCP) disease. This involved the use of MRI, followed by volume measurement and the use of theCatterall classification system; the difference between the grade obtained using each of these approaches was thendetermined. MATERIALS AND METHODS: We retrospectively reviewed 28 hip-joint MR images on which a diagnosis of LCPdisease had been based. According to the necrotic portion of femoral head, and on the basis of the catterallclassification, LCP was graded 1 to 4, as follows: Grade I=0~ <25%; II=2 5~ <50%; III=50~ <75; IV=75-100%. Using atransparent paper on which 1mm squares had been drawn, the necrotic area of each MR image was measured; thefollowing equation was then used to calculate the volume of the necrotic portion: volume=necrotic area x slicethickness. On the basis of this measurement, each femoral head was graded and the results were compared with thoseobtained using the Catterall classification. RESULTS: In 24 joints(85.7%), grades according to the Catterallclassification and MRI volume measurement were not the same. As compared with the volume measurement method, useof the Catterall classification led to grade overestimation in 18 joints (64.3%) and underestimation in six(21.4%). CONCLUSION: The grade according to the Catterall classification was different from that obtained usingthe volume measurement method. This study thus indicates the need for a new system of classifying LCP diseasebased on the volume measurement method and using MR imaging.