[Subacromial impingement syndrome and rotator cuff tear. Ultrasonography of 140 cases]. / Sindrome da conflitto sotto-acromiale e lesioni della cuffia dei rotatori. Esperienza ecografica in 140 casi.

We investigated the role of rotator cuff impingement in causing tears of supraspinatus and biceps tendons and the comparative reliability of plain radiography and sonography (US). One hundred forty patients with symptoms referrable to the rotator cuff were examined with plain radiography and US of the shoulder. US findings were correlated with MR or double contrast arthrography results in 10 patients and 39 patients were submitted to surgery (acromionplasty). Radiographic studies were performed first and diagnosed rotator cuff impingement (63 patients) caused by abnormal acromial margins or size (23 patients), by acromioclavicular joint protrusion (17 patients), by anterior acromial osteophytosis (10 patients), or by massive periarthritic calcifications (13 patients). In the same 140 patients. US showed normal cuffs in 46 cases, tendonitis in 34, calcific tendonitis in 13, partial-thickness cuff tears in 13, full-thickness cuff tears in 20 and biceps tendon tears in 14 cases. Six of 13 partial tears were studied with MRI, with 4 true positives and 2 false positives. US diagnosis was confirmed by arthrography in 4 complete tears. Twenty-nine of 39 patients undergoing acromionplasty were examined only with plain radiography and US. US accurately diagnosed all 20 massive full-thickness tears, with no false positives nor false negatives (US versus surgery and arthrography). Eleven true positives, 2 false positives and no false negative were observed in 13 partial-thickness cuff tears (US versus surgery and MRI). These findings suggest that rotator cuff US and plain radiography are easily performed, reproducible routine examinations to study the whole rotator cuff and the acromioclavicular joint in the many patients who need an accurate, safe, painless, rapid and cost-effective differential diagnosis, leaving it up to the surgeon to consider MRI or arthrography. Rotator cuff impingement tendonitis, overuse or calcific tendonitis, partial-thickness cuff tears and full-thickness tears ranging from light to severe cause similar shoulder pain and weakness on arm raising. The differential diagnosis must distinguish all these common causes of shoulder dysfunction and cuff problems from other conditions. We conclude that US and plain radiography are accurate routine tests of rotator cuff integrity and rotator cuff impingement.

[A new digital radiology system. The technical considerations and clinical experience]. / Un nuovo sistema di radiologia digitale. Considerazioni tecniche ed esperienza clinica.

The authors report their experience with a new digital X-ray film processing system, particularly used in the diagnosis of breast, chest, joint and bone pathologic conditions. The technical features of the system are described, and the results are reported which appear as the most significant in mammography, with better visualization of both microcalcifications and small detail images. The above results are due to the possibility of broad contrast variations and of processing basal X-ray images. The possibility is also stressed of improving the diagnostic value of a technically incorrect radiograph, especially if overexposed, with subsequent dose saving.

[Urography with non-ionic contrast media. Multicenter experience on the optimization of the technic]. / Urografia con mezzi di contrasto non ionici. Esperienza multicentrica sulla ottimizzazione della tecnica.

The authors report the results of a multicentric experience based on 1200 urograms performed with nonionic contrast medium. The global diagnostic reliability is evaluated, together with the specific reliability for kidneys, ureters, and bladder, according to the various pathologies. The eventual need of radiographs of completion is showed. In searching for an optimization of the technique for nonionic contrast medium, a panoramic radiograph performed 10' after the end of the injection is pointed out as the key-moment of the test, being extremely rich in information, so as to help defining the most appropriate technique to continue the examination. For its excellent tolerability and high reliability, the nonionic contrast medium is recommended also in routine IVP, not only in risk patients.

[Ureteral duplication and anomalous symptomatology. Presentation of a case]. / Duplicità ureterale a sintomatologia anomala. Presentazione di un caso.

The authors report a case of unilateral ureteral duplication with extravesical ureteral orifice evaluated with sonography and confirmed by surgery. The peculiarity of the case is founded on the anomalous clinical findings with poorly significant uroculture and the apparent discrepancy between sonographic and urographic finding. The important rule of sonographic evaluation in early diagnosis of kidney malformations is confirmed.