Radiography: a review for the rehabilitation professional.

In the normal course of practice, rehabilitation professionals are not typically provided with x-rays or radiology reports. Hand therapists who obtain x-rays or reports will glean valuable information about the patient that might otherwise go unidentified. Unique details discovered from an x-ray can contribute to improved clinical treatment plans and functional outcomes. Radiography is the general term used to describe the commonly known imaging procedures of x-ray and fluoroscopy. The purposes of this article are to provide the reader with an overview of basic radiography terminology and provide information to help better understand the typical positions and views used in upper extremity radiography. With this knowledge, guidelines for reviewing x-rays will be presented and several examples of bony pathology revealed by x-rays will be presented along with several case studies.

Ventral polyradiculopathy with pediatric acute lymphocytic leukemia.

A 3-year-old girl with acute lymphocytic leukemia (ALL) in remission developed lower extremity paraparesis and areflexia 15 days after receiving intrathecal methotrexate, cytarabine, and hydrocortisone. Cerebrospinal fluid protein was 107 mg/dl. Compound muscle action potential amplitudes were reduced, F waves were absent, and sensory conduction studies were normal. Needle electromyography (EMG) revealed reduced motor unit potential recruitment. Magnetic resonance imaging (MRI) showed lumbosacral ventral root enhancement. She was treated with intravenous immunoglobulin and slowly recovered. Nerve conduction and EMG abnormalities correlated with MRI root enhancement, facilitated early diagnosis, and distinguished this from a myelopathy or distal polyneuropathy. These findings could represent selective ventral nerve root vulnerability to intrathecal chemotherapy. A selective autoimmune process cannot be excluded.