Compression Fractures in the Setting of Diffuse Idiopathic Skeletal Hyperostosis

Compression fractures are the most common vertebral fractures. They involve the anterior column of the spine, and are considered stable fractures due to the presence of intact posterior ligaments that aid in resisting further collapse and deformity. They are thus often managed conservatively. We describe a series of 3 cases that were initially diagnosed as compression fractures and managed conservatively. With the abundance of compression fractures and increase in preference for conservative management of compression fractures, it is of utmost importance to recognize the possibility of other spinal co-pathologies, especially that of hyperostosis of the spine, both by clinical judgment as well as radiological analysis before embarking on conservative management, should there be under-treatment and development of complications that could have otherwise been avoided, as in the cases presented in this series.

Tromboembolismo pulmonar sin infarto diagnosticado en una radiografía de tórax / Pulmonary thromboembolism without infarction diagnosed by chest roentgenography

Se presenta un paciente del sexo masculino de 23 años de edad, asintomático, con antecedentes patológicos personales de tromboflebitis migratriz en estudio. Se le realizó radiografía de tórax, en la cual se observó imagen hipertransparente basal derecha (signo de Westermark) con vasos escasos a ese nivel e hilio ipsilateral de mayor tamaño, lo que hizo sospechar tromboembolismo pulmonar sin infarto. Se realizó angiotomografía pulmonar, comprobándose dicho diagnóstico al encontrar amputada la arteria segmentaria basal lateral derecha. La radiografía de tórax tiene baja sensibilidad y especificidad para la confirmación de tromboembolismo pulmonar; no obstante, no se debe olvidar que sigue siendo el examen por el que se inicia el estudio, porque resulta el método menos costoso, disponible en todas las instituciones de salud, que permite descartar otras afecciones capaces de simularlo, y en algunos casos, como este, permite incluso, hacer el diagnóstico.

A male 23-year-old asymptomatic patient presents with a personal history of migratory thrombophlebitis under study. Chest roentgenography showed a right basal hypertransparent image (Westermark sign) with scarce vessels at that level and a larger ipsilateral hilum, which raised the suspicion of pulmonary thromboembolism without infarction. The diagnosis was confirmed when pulmonary angiotomography showed that the right lateral basal segmental artery was amputated. Chest roentgenography has low sensitivity and specificity for the confirmation of pulmonary thromboembolism. However, it should be remembered that it continues to be the first test performed in the examination, due to its low cost and its availability in all health care centers, allowing to rule out other conditions which could simulate pulmonary thromboembolism, and in some cases, such as this one, even making it possible to reach a diagnosis.

Role of Routine Chest Roentgenography in Patients with Open Heart Operation

Three hundred and seventy four random patients admitted to the postoperative intensive care unit (lCU) underwent postoperative clinical positioning of endotracheal tube(ET), nasogastric tube, central venous catheter and laboratory arterial blood gas (ABG) assessment. Chest roentgenography was done for all the admitted patients and the findings reviewed. Thirteen (3.47%) patients required intervention because of abnormalities detected on chest roentgenography. None of the pathologic conditions detected was life threatening. Chest roentgenography on admission to the cardiovascular ICU should be done only if the surgery has been performed for cardiac trauma, re-exploration, and also if clinical and laboratory assessment indicate the possibility of underlying pathologic conditions that can only be confirmed by chest roentgenography.

Mammographic diagnosis of breast cancer / 第三军医大学学报

Objective To explore the imaging features of breast cancer by molybdenum target roentgenography in order to improve the diagnostic level. Methods The mammographic features of 68 cases with breast cancer confirmed surgically and pathologically were studied retrospectively. Results Masses with high density, spicule signs and lobulate margins were found in 61, 43 and 32 cases, respectively. Calcification was found in 29 cases (42 6%), in which only 7 cases of calcification without mass were found. Conclusion The masses and calcification are the main radiological features in breast cancer. The consciousness of comprehensive examination should be emphasized in the diagnosis of breast cancer.

Roentgen diagnosis of ascaris in the gastro-intestinal tract

1 The roentgen diagnosis of ascariasis in the gastro-intestinal tract is not meant entirely to supplant the microscopic examination2. The roentgen examination of the gastro-intestinal tract furnishes an invaluable aid or for the proper management of cases presenting typical and even frank gastro-intestinal pathological conditions3. Because of the high incidence of ascariasis in the Philippines, the X-ray examination of the gastro-intestinal tract may prove to be a valuable aid in the diagnosis of vague gastro-intestinal disturbances4. Roentgen diagnosis of ascariaris in the gastro-intestinal tract may be positive in the instances where feces examination is negative. This contradiction may occur: (a) when there are not adult worms present; (b) when the ascaris present are males only5. The X-ray findings, if positive, give also the worms situation in the gastro-intestinal tract. Such a locating could not be furnished by the feces examination alone6. Because of the insufficient amount of contrast substance which can be ingested by children the result of roentgen examination is not so satisfactory with them as with adults. (Summary)

Otitis media: a clinical, bacteriological and roentgenological study

1. The above study confirmed the popular notion that the definite management of otitis media is determined mostly by the clinical findings and observation of a given case2. That bacteriological and X-ray surveys are important adjuncts in the management of otitis media3. That a normal functioning Eustachian tube is essential in the care of chronic otorrhea so that the upper respiratory tract should be free from abnormalities4. That despite the availability of antimicrobial agents against otitis media, it is still a major problem in the out-patient section of our Army Hospitals5. Surgical intervention is a frequent procedure in the over all management of otitis media despite the use of the drug of choice because of the neglect in the care of most cases seen before coming to the dispensary. (Summary and conclusions)

Abdominal complications of Ascaris lumbricoides among Filipino children

Three hundred cases of abdominal emergencies due to ascaris infection because of the presence of ascaris in the vomitus and or stools, severe abdominal pain with tenderness, palpable masses and positive signs in the roentgenograms were studied. Of the cases presented only 3 were operated on mainly on the basis of clinical and radiologic findings of complete obstruction. Conservative management is still our treatment of choice. Roentgen examination is considered as the most helpful diagnostic procedure. (Summary)

A Diagnostic Significance of Simple X-ray Examination for Children's Flatfoot in Footprint

OBJECTIVE: The purpose of this study was to evaluate the difference for each variable on plain radiologic study of the foot between weighted and non-weighted routine plain anterior-posterior and lateral views in flatfoot children diagnosed by Harris mat footprint. METHOD: Both feet of thirty-four children over two-year old, who had been diagnosed as flatfooted by modified Rose' classification using Harris mat footprint were included. We studied plain roentgenogram images, including anterior-posterior and lateral views, in both standing (weighted) and sitting (non weighted) position of the feet of the patients. We measured the following variables; arch height (AH), calcaneal pitch (CP), talocalcaneal angles from lateral view (TCALA) and anterior-posterior view (TCAAP), talo-first metatarsal angles from the lateral (TFML) and anterior-posterior view (TFMA). RESULTS: Each variable revealed no significant difference between boys and girls (p>0.05); neither was there any significant difference noted in each parameter between the right and left feet (p>0.05). All the variables of plain foot roentgenogram on weighted state were significantly different from the data of non-weighted state, except TCAAP (p<0.05). CP was the only parameter which showed significant difference according to severity of flatfoot by modified Rose'classification. CONCLUSION: Because most of the flatfoot in childhood is hypermobile type, it is necessary to take plain radiologic studies of the feet both in weighted and non weighted state and to compare both data of each variable. In addition, it is prefer to use plain radiologic study of foot both in weighted and non weighted state with footprint as the screening method of pediatric flatfoot lesions.

Roentgenographic Study of the Upper Airway in Patients with Obstructive Sleep Apnea Syndrome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Using sophisticated imaging techniques, such as x-ray cephalometry, computed tomography, and magnetic resonance imaging, we found obstructive sleep apnea patients to have smaller upper airways than nonapneic individuals. The purpose of this study was to examine whether a simple test, such as routine roentgenographic views of the upper airway, is useful in identifying anatomic narrowing of the airway in patients with sleep apnea. MATERIALS AND METHODS: We carried out a prospective study of a group of 30 patients (28 male and 2 female subjects) referred for evaluation of heavy snoring and possible obstructive sleep apnea. All patients had full nocturnal polysomnography and the lateral views of their airways were used to measure the pharyngeal diameters at three sites along the airway. All measurements were performed with the patients positioned both upright and supine. RESULTS: We observed that obstructive sleep apnea patients maintained significantly lower the retropalatal distance in the supine position than in the upright position. CONCLUSION: We concluded that routine roentgenographic measurements of upper airway diameters are useful screening methods for patients suspected of having sleep apnea.

A New Method for Measurement of Femoral Anteversion: A Comparative Study with Other Roentgenographic Methods / 대한정형외과학회잡지

The authors designed a new biplanar method of measuring femoral anteversion, which may be considered a modified Magilligan's method. In addition to true A-P view, a true lateral view is taken, instead of trans-cervical lateral view in the Magilligan's technique. Acute angles(α and r) between the long axis of the femoral shaft and the femoral neck on both the A-P and lateral films are measured. The true angle (r1) of anteversion is calculated by substituting the values of tan(90-α) and tan (90-r) for the trigonometric formula tan r1 = tan(90-α)/tan(90-r). The measurement by the Magilligan's and the author's methods and the conventional CT method were compared with direct measurement for their accuracy in 20 sdult dried femora. Also correlativity among these three methods were analyzed clinically in 40 femora of 20 children. Following results were obtained, 1. Compared with the direct measurement, the Magilligan's, suthor's methods and CT method deviated an average of + 6.050 degrees, + 3.600 degrees and −1.150 degrees, respectively, all three being statistically accurate(p>0.05). The values for the latter two were closer to that of direct measurement. However, there was no statistical difference between the two. 2. The Magilligan's method overestimated in 95% and underestimated in 5% of the cases, and there was over-or under- estimation of less than 5 degrees in 20% and less than 10 degrees in 95%. The author's method overestimated in 70% and underestimated in 0% of the cases, and there was over-or under-estimation of less than 5 degrees in 55% and less than 10 degrees in 100%. The CT method overestimsted in 30% and underestimated in 60% of the cases, and there was over-or under-estimation of less than 5 degrees in 95 and less than 10 degrees in 100%. Both Magilligan's and autor's methods tended to overestimate and the CT method tended to underestimate(p<0.05). 3. The correlation coefficients among the Magilligan's and author's methods, the Magilligan's and CT methods, and author's and CT methods were 0.830, 0.592, 0.478 respectively, in clinical aspects. It is concluded that author's new method of biplanar measurement of femoral anteversion is more accurate than the Magilligan's method, while it is not less accurate than the conventional CT method.

Quantitative Analysis of Bone Density on Roentgenography in Korean / 대한정형외과학회잡지

The bone is the dynamic living tissue which is always maintained bone mineral content by bone resorption and formation. It has been well known that the bone mineral content is decreased very slowly with aging. It is very difficult to diagnose the osteopenia because it is almost subclinical. Another important problem in the osteopenia is the fracture occurring spontaneously. The quantitative method of bone mineral mass provide an information to diagnose the osteopenia and predict the risk of spontaneous fracture. Various methods have been used to access the degree of bone atrophy but have not been routinely available for clinical application in the hospital. The microdensitometric method is a noninvasive, easy, accurate, and objective one to monitor the degree of changes in the skeletal mass quantitatively. So, we measured the 7 indices at the middle site of the 2nd metacarpal bone with a microdensitometer and computer on an X-ray film of the hands and studied the correlations between the age and indices of those under 30 and over 30 yrs old in healthy and fracture groups. The results were obtained as follows : 1. There was a significant high correlation between age and indices in healthy and fracture groups. 2. The measurement of age by microdensitometric method was highly correlated with the chronological age. 3. Comparing both groups, There was a significant correlation of D (P<0.001), MCI(P<0.01), and d (P<0.01) over 30 yrs in male and GSmin (P<0.001) and ΣGS/D (P<0.01) over 30 yrs in female. 4. In fracture group, 1) The index of bone width(D) was slightly larger than in the healthy group. 2) The metacarpal index(MCI) was lower than in the healthy group. 3) The index of medulla width(d) was wider than in the healthy group. 4) The density index of cortex(GSmax) was smaller than in the healthy group. 5) The density index of cortex and medulla(GSmin) was smaller than in the healthy group. 6) There was no considerable difference in ΣGS/D between healthy and fracture groups. 7) The densitometric pattern was more aggrevated than in the healthy group.