[The assessment of the value of ultrasound and magnetic resonance imaging in diagnosing hand joint arthritis]. / Ocena przydatnosci ultrasonografii i rezonansu magnetycznego w diagnostyce zapalenia stawów rak.

The main imaging investigation used in diagnosing rheumatoid arthritis is radiography of the hands and feet. It allows visualisation of bone erosions--typical of the disease. However, bone erosions occur during the later stages of the rheumatoid arthritis and are preceded by synovitis. The aims of the study were to use ultrasound (US) and magnetic resonance imaging (MRI) in examining joints in patients suffering from chronic arthritis, and also to assess the value of these methods in diagnostics. In 61 patients with chronic arthritis (39 with rheumatoid arthritis--RA, and 22 with another etiology arthritis), plain radiography, US and MRI of the hands was performed. MRI and US were more sensitivity in visualisation of bone erosions than plain radiography. Both methods showed synovitis in all patients with RA. In detecting bone erosions in the hand joints MRI and US are more sensitive methods than plain radiography. Both methods detect synovitis and tenosynovitis. Inflammatory changes shown using the MRI and US are more intensive in RA than in patients suffering from another etiology arthritis.

MRI evaluation of pathological changes taking place in the hand in patients with rheumatoid arthritis.

The aim of this study was to use magnetic resonance imaging (MRI) to evaluate the pathological changes taking place in the hands of patients with rheumatoid arthritis (RA), and to attempt to characterize early and persistent changes. 42 patients were examined, including 31 women and 11 men in age from 23 to 75, the duration of illness ranged from 1 month to 27 years (average 7.1 years). The MRI examination was performed using a 1,5 T Magnetom 63 SP whole body system. The SE sequence was used in T1-weighted (TR600, TE15) and fat-suppressed images (A-250, TR1155, TE22), obtained with 3 mm scans, matrix 256 x 512. A knee coil was used. In 30 patients erosion was detected on the joint surfaces of the bones, including 7 patients whose erosion was not visible in plain ordinary x-ray photos. In 31 patients bone marrow edema was detectable, including 6 patients in whom advanced pathological changes were absent. In all patients signs were discovered of thickening of the synovial membrane with (30 of 42) or without (12 of 42) the presence of pannus. Periarticular effusion was observed in all patients, and in 6 patients it occurred together with bone marrow edema. Tendonitis was visible in 25 patients who were in an advanced stage of the disease. For 7 patients, the MR examinations prompted an upgrading of the diagnosed phase of rheumatoid arthritis to a more advanced stage, due to the detection of erosion. In patients with a less advanced stage of the disease, MR examination revealed 11 more joints with pathological changes (periarticular effusion) than were detected by ordinary physical examination. Magnetic Resonance Imaging seems to be the examination of choice in patients with rheumatoid arthritis at an unclear or early stage.

[Aphasia without alexia after surgical treatment of aneurysm of the right middle cerebral artery--incomplete lateralization of verbal functions?]. / Afazja bez aleksji po operacji tetniaka prawej tetnicy srodkowej mózgu--niepelna lateralizacja funkcji werbalnych?

The authors present a case of aphatic disorders after surgical treatment of the right middle cerebral artery aneurysm. A prominent dissociation of verbal function was noticed.