[Imaging diagnostics of the wrist: MRI and Arthrography/Arthro-CT]. / Bildgebende Diagnostik des Handgelenkes: MRT und Arthrographie/Arthro-CT.

PURPOSE: To evaluate the use of magnetic resonance imaging (MRI) compared with arthrography and arthro-CT (AG/ACT) in patients with wrist pain. METHODS: MRI and arthrography/arthro-CT (AG/ACT) of the wrist joint were retrospectively evaluated in 346 patients over a three-year period. Imaging findings were correlated to surgical results (n = 78) or clinical course in an at least 6-month follow-up. RESULTS: For tears of the triangular fibrocartilage, arthrography, arthro-CT, and MRI demonstrated a sensitivity and specificity of more than 0.96. Only the positive predictive value was superior for arthrography/arthro-CT (0.99 and 0.98, respectively) compared with MRI (0.94). Arthrography was superior for functional diagnosis of scapho-lunate ligament tears (n = 25). Ulno-lunate and ulno-triquetral ligament defects were demonstrated more exactly by arthrography. Traumatic osseous defects, particularly scaphoid fractures (n = 33) and avascular necrosis (n = 17), were better diagnosed using MRI. CONCLUSION: For suspected lesions of the triangular fibrocartilage complex, AG/ACT is slightly more reliable than MRI. However, MRI was found to be highly accurate in diagnosing TFC tears, and is superior to AG/ACT in detecting traumatic and vascular lesions of the wrist.

[Celiac disease and HLA in a hospital population of Uruguay]. / Enfermedad celíaca y HLA en una población hospitalaria del Uruguay.

Since the description of the association of HLA-B8 antigen with celiac disease, it has been confirmed by many authors. The incidence of HLA-B8 antigen is higher in adults and children when it is compared to apparently healthy controls. Some authors found a reduction on the incidence of HLA-B7 antigen and others suggested that a higher incidence of HLA-B12 antigen in patients HLA-B8 antigen negative, is associated with celiac disease. We studied 19 unrelated patients with celiac disease and 64 controls. Their ages range from 18 months to 18 years old, onset of the disease was during childhood. We determined twelve antigens of the HLA-A locus and thirteen antigens of the HLA-B locus. We used the NIH Microlymphocytotoxicity Technique. The degree of association was computed by the relative risk and the results were statistically evaluated by the X2. The statistically significant increase in frequency was shown only for HLA-A29 The results did not show neither the higher incidence for HLA-B8 found by other authors, nor the higher incidence for HLA-B12; however HLA-B7 was not detected in our patients. The final decision on the association of HLA-A29 antigen with celiac disease in our population will require examination of a broader panel of probands.

Enfermedad celiaca y HLA en una poblacion hospitalaria del Uruguay. / Celiac disease and HLA in an Uruguayan hospital population

Desde que fue descrita, la asociacion del antigeno HLA-B8 con la enfermedad celiaca ha sido confirmado por muchos autores. Estudiamos 19 pacientes, no emparentados, con enfermedad celiaca y 64 controles. Sus edades oscilaban entre 18 meses y 18 anos. El comienzo de la enfermedad fue durante la infancia. Se determinaron 12 antigenos de locus A y 13 del locus B, usando la tecnica NIH de microlinfotoxidad. El grado de asociacion fue computado por el riesgo relativo y los resultados fueron estadisticamente evaluados por el Chi 2.Se demonstro mayor frecuencia solo en la del HLA-A29. Nuestros resultados no muestran una mayor incidencia para el HLA-B8 encontrados por otros autores, ni una incidencia mayor para el HLA-B12, sin embargo el HLA-B7 no fue detectado en nuestros pacientes. La decision final de que el HLA-A29 se asocia a la enfermedad celiaca en nuestra poblacion requerira el analisis de una muestra mayor