Custom, spray coated receive coils for magnetic resonance imaging.

We have developed a process for fabricating patient specific Magnetic Resonance Imaging (MRI) Radio-frequency (RF) receive coil arrays using additive manufacturing. Our process involves spray deposition of silver nanoparticle inks and dielectric materials onto 3D printed substrates to form high-quality resonant circuits. In this paper, we describe the material selection and characterization, process optimization, and design and testing of a prototype 4-channel neck array for carotid imaging. We show that sprayed polystyrene can form a low loss dielectric layer in a parallel plate capacitor. We also demonstrate that by using sprayed silver nanoparticle ink as conductive traces, our devices are still dominated by sample noise, rather than material losses. These results are critical for maintaining high Signal-to-Noise-Ratio (SNR) in clinical settings. Finally, our prototype patient specific coil array exhibits higher SNR (5 × in the periphery, 1.4 × in the center) than a commercially available array designed to fit the majority of subjects when tested on our custom neck phantom. 3D printed substrates ensure an optimum fit to complex body parts, improve diagnostic image quality, and enable reproducible placement on subjects.

The spine in sickle cell disease.

Bone changes in sickle cell disease occur due to marrow hyperplasia, tissue ischaemia and infarction due to vaso-occlusion. Between 1982 and 1991 thirty four patients were treated in the Orthopaedic and Neurosurgery Departments of the Kind Fahd University Hospital, Al-Khobar, with spinal complications due to sickle cell disease. There were 21 males and 13 females aged between 4 and 28 years (mean 17.4 years). Structural changes in the vertebral bodies due to marrow hyperplasia occurred in 44% of the patients. Avascular necrosis leading to collapse of the vertebral bodies was seen in 9 (27%) patients. Infective spondylitis was the most serious complication seen in 8 (24%) patients; the majority needed anterolateral decompression and bone grafting. The spine is often affected in sickle cell disease and aggressive treatment with close follow-up is required to avoid disabling complications.

The scud missile disaster in Al-Khobar, Saudi Arabia, 1991: the orthopaedic experience.

The orthopaedic experience of the scud missile disaster in Al-Khobar, Saudi Arabia during the Gulf war is reviewed. This was by far the most severe of 70 scud attacks. The majority of casualties had 'orthopaedic' injuries, fractures and soft tissue lacerations of the extremities and the back. Our experience confirmed the importance of the principles of planning triage beforehand and open wound treatment with secondary suture. Repeated ward rounds with reassessment of the patients proved beneficial. The ready availability of hospital beds in high-risk situations of regional war highly facilitated the management of mass casualties.

McMurray's test tested.

We studied the validity of McMurray's test for a torn meniscus in 93 patients. The clinical test results were compared with arthroscopic and/or arthrotomy findings as reference. The clinical test had a sensitivity of 58.5%, a specificity of 93.4%, and the predictive value of a positive result was 82.6%. The test therefore seems to be of limited value in current clinical practice.

Weight and height of Saudi children six to 16 years from the eastern province.

Measurements of weight and height of 21,638 Saudi boys and girls ages six to 16 years from the Eastern Province were taken. It was observed that the occurrence age of children could only be made out in Hegira years, as age is recorded by parents and at schools by the Hegira calendar. Age is a crucial factor in studies such as this and for valid comparison with any international reference standard, the latter must be adapted to the Hegira calendar year. Curves for weight and height percentiles for age have been constructed and compared with the Hegira adaptation of the NCHS growth standard.

The role of computerised tomography in the management of spinal tuberculosis.

Computerised axial tomography of the spine has been carried out in 56 patients with spinal tuberculosis; the extent of the bone and soft tissue involvement, spinal canal encroachment and neural compression were demonstrated. This accurate information made it possible to lay down guide lines for conservative and surgical management.

Congenital brachial palsy in the eastern province of Saudi Arabia.

The clinical features of 57 patients (31 males, 26 females) with congenital brachial palsy seen at the King Fahd Hospital of the University over a 5-year period are described. Delivery was difficult in 32 (56%), 20 (35%) were large babies (birth weight greater than 3,600 g), and 20 deliveries required either forceps or vacuum extraction. The presentation at delivery was vertex in 45, breech in five, and shoulder in four. Associated injuries or features, encountered in 14 cases, were fractures of the clavicle and humerus (six cases each), and skull fracture and Horner's syndrome in one patient each. The right and left sides were involved in 31 and 24 cases, respectively, and both sides in only two cases. All the muscle groups of the affected limb were most commonly involved (40%), and hand muscles alone were affected in only one patient. Although 60% of the cases presented late to the hospital, functional recovery was observed in 63%. The major predisposing factors identified in this study were technically difficult deliveries, large infants, and breech or shoulder presentation with assisted delivery. It is suggested that early identification of these factors and improvement in obstetric care of both the mothers and babies during delivery would reduce the incidence and severity of this disability.

Tuberculosis of the arch of the atlas. Case report.

This rare case of tuberculosis of the arch of atlas illustrates the potential difficulties in making a clinical diagnosis of tuberculosis of the upper cervical spine. Plain roentgenograms may not demonstrate an early lesion of the neural arch, and CT is a valuable adjunct. The use of a halo vest proved a successful alternative to operation in conferring stability to the spine during healing.

Squamous cell carcinoma in chronic osteomyelitis. Report of a case and review of the literature.

Malignant change at the site of a chronic osteomyelitis, a rare condition, is reported in a 45-year-old man, along with a review of the literature. This patient with a 30-year history of chronic osteomyelitis of the right femur and an intermittently discharging sinus had a large abscess in the lower thigh. The abscess was drained, and an ulcer developed at the mouth of the sinus tract. Soon afterward, he sustained a pathologic fracture through the lower femur. Biopsy specimens of the ulcer showed a well-differentiated squamous carcinoma. An amputation was performed at the level of the proximal 10 cm of the femur. The patient remains well 18 months later with no clinical or radiologic evidence of metastases. Changes in character of a previously innocuous osteomyelitis sinus tract should arouse suspicion of neoplastic transformation. Biopsy of various depths of the sinus tract, including the bone marrow, is essential. Early amputation for squamous cell carcinoma is indicated and offers a good prognosis.

Malignant bone tumours, experience at King Fahd University Hospital Al-Khobar, Saudi Arabia.

Reports show striking regional and ethnic variations in the incidence and pattern of certain malignancies in the Middle East. In view of this, a study of 19 cases of malignant tumours of the bone seen at King Fahd University Hospital during the period 1981-1983 was carried out. Of these eight were primary and eleven secondary tumours. Lymphoma and Ewing's sarcoma formed 50% of the primary tumours. Breast and lungs were the chief sources of secondary deposits in the bone.

Iliofemoral thrombosis in a case of chicken pox.

A case of iliofemoral thrombosis possibly related to chicken pox infection is reported. Treated with rest and anti-coagulants, the patient made a satisfactory recovery.

Deep vein thrombosis in a jogger.

Deep vein thrombosis is rare in young and healthy athletes. A case of venous thrombosis is reported in a young, physically fit jogger.

The treatment of isolated fractures of the ulnar shaft in adults.

This study of 254 cases of isolated fractures of the ulnar shaft in adults is the largest series to date. The methods of treatment employed are analysed. Conservative treatment and the indications for, and technique of operation are discussed. A plan of management is proposed for these fractures.

Non-union of the isolated fracture of the ulnar shaft in adults.

Twenty-one cases of non-union of the isolated fracture of the shaft of the ulna were reviewed. The factors which have been shown to predispose to non-union include the site of the fracture, its initial displacement, comminution, the presence of multiple injuries and early mobilization. The use of rigid fixation and the delay of one week in operation reduced the incidence of non-union in those internally fixed. No evidence was found that internal fixation reduced the incidence of delay in union, compared with closed treatment. Fourteen of the fractures later united. Plating the fracture of internal fixation with bone grafting secured union in 11 out of 12 cases. These were the only satisfactory methods of treatment.