[The contribution of computerized tomography to synovial pathology]. / Apport de la tomodensitométrie dans la pathologie synoviale.

The authors have developed a technique of CT arthroscan which, by the use of a gas or opaque contrast medium, is able to demonstrate the synovial structures of the knee, the shoulder and the hip. Among the essential indications, they include the demonstration of neoplasia of the synovium and the evaluation of the pannus in rheumatoid arthritis. Their secondary indications include the demonstration of fluid effusions in the hip, the precise evaluation of hyperostotic lesions in the same joint, the detection of ossification phenomena in the capsule of the inter-apophyseal joints in ankylosing spondylitis and, in some cases, following negative or doubtful arthrography for the detection of synovial plica. They also recall the usefulness or the arthroscan in the diagnosis of lesions of the labrum glenoidale.

Gunshot wounds to the spine as evaluated by CT-scanning. Two illustrative case reports.

Two patients with gunshot wounds to the thoracic and lumbar spine were evaluated by A-P and lateral CT-scoutviews followed by axial CT-investigation. The combination of both CT modes is the investigative technique of choice for this type of injuries to assess the presence and topography of bone damage, metallic foreign bodies and associated intracanalar, paravertebral and intra-abdominal soft tissue lesions causing only minimal mobilization to the patient.

A sign of lumbar disk herniation recognizable on lateral CT generated digital radiograms.

Computed tomography is a very sensitive and fairly specific imaging mode for diagnosing herniated disks in patients with low back pain and radiculopathy. We describe a new CT sign associated with posterior disk herniation that consists of a bony defect on the lower posterior angle of the proximal vertebral body and endplate shown on CT generated digital radiograms. This finding, by no means constant, is encountered frequently enough to be described as a sign of posterior disk protrusion. It often occurs concomitantly with posterior avulsion of a bone fragment probably related to avascular bone necrosis of the posterior inferior angle of the endplate.

Computed tomography of acute spinal epidural hematoma associated with cervical root avulsion.

A case of acute spinal epidural hematoma associated with post-traumatic cervical root avulsion is described. Surgical management of this condition depends to a large extent on its early recognition as well as accurate information about its site and extent. Computed tomography is the investigative procedure of choice to evaluate this entity.

Epidural venous stasis in spinal stenosis. CT appearance.

Computed tomography permits reliable demonstration of the spinal canal and its contents. Measurements of the sagittal diameter of the bony canal do not take into consideration size, shape and state of intraspinal soft tissue structures, i.e. the thecal sac and its own contents, epidural fat and blood circulation pattern. Three particularly illustrative cases were selected in which obvious epidural venous engorgement was visualized in association with spinal stenosis. The authors think that epidural venous stasis occurring in segmental spinal stenosis is a CT sign of clinically significant narrowing of the neural canal. Accurate recognition of the type of lumbar stenosis together with epidural blood flow alterations permits a better understanding of the existing lesions. Thus, a more precise and specific surgical approach is possible.

CT in a case of intracranial penetration of a pencil. A case report.

A case is reported of an unusual foreign body, a pencil, penetrating the right temporal lobe through the squamous temporal bone in a fall. Wood has low attenuation coefficients, so that the appropriate CT examination includes multiple window settings to permit accurate assessment of bone fragment displacement as well as recognition of detached wood splinters. CT scanning and early surgery are important steps in the management of these injuries to reduce significantly the overall mortality as well as immediate and long term complications. The necessity for meticulous surgical technique when removing the foreign body is stressed as retained wood can not easily be visualized against the hypodense background due to postoperative changes.

Blood-fluid levels in multiloculated cystic brain metastasis of a hypernephroma. A case report.

A case of brain metastatic hypernephroma presenting as multiloculated blood-fluid levels is described and the mechanism of their formation discussed.

Intracerebral extravasation of contrast medium after head injury.

A case of intracerebral extravasation of contrast medium is reported. In cases of head injury this occurrence is rare and is manifested by persistent images on both frontal and lateral views of the angiogram. This indicates severe cerebral trauma with active hemorrhage and the prognosis is generally bad. A possible mechanism seems to be contrecoup.

The superficial recurrent ophthalmic artery supplying an occipital arteriovenous dural malformation.

Brief comment is made about a rare large arterial supply to an occipital arteriovenous intradural malformation.

[Acro-osteosclerosis in the course of sarcoidosis (author's transl)]. / Acro-ostéosclérose au cours de la maladie de Besnier-Boeck-Schaumann

The authors report two cases of acro-osteosclerosis occurring during sarcoidosis. Condensation lesions involve above all the distal and proximal phalanges of the hands. Comparison of these cases with those in the literature indicates that these particular types of bone changes in association with sarcoidosis are more common than indicated in the studies of Jüngling (occurrence estimated at 54% of subjects suffering from sarcoidosis with bone localisations). This acro-osteosclerosis is however not specific to sarcoidosis. It is seen in patients suffering from rheumatoid arthritis, Hodgkin's disease and other haematological disorders. It has also been seen in normal individuals in X-rays taken at the time of a traumatic accident.