ABSTRACT
The last 100 patients to have wrist arthrography at our institution had, in addition to the standard radiocarpal joint injection, injections into the distal radioulnar joint and midcarpal joint. Seventy-seven of the 100 patients had abnormal arthrograms. In 29 cases abnormalities not identified by the radiocarpal joint injection were demonstrated either by the distal radioulnar joint or the midcarpal joint injection. In 38 patients abnormalities shown by radiocarpal joint injection were not demonstrable by the other two injections. Seven detachments of the triangular fibrocartilage complex from the ulnar styloid could be demonstrated only by the distal radioulnar joint injection. The midcarpal joint injection was far more useful than the radiocarpal joint injection in the evaluation of radiocarpal joint-midcarpal joint communications. All three injections appear to be necessary for a complete arthrographic evaluation.
Subject(s)
Arthrography , Contrast Media/administration & dosage , Injections, Intra-Articular , Wrist Joint/diagnostic imaging , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Wrist Joint/abnormalitiesABSTRACT
Outpatient pediatric orthopedic records were reviewed retrospectively in an attempt to identify all patients with congenital spine and urinary tract anomalies. All patients with a positive intravenous pyelogram (IVP) were asked to return for ultrasonographic evaluation. Urinary tract abnormalities were identified in seven (26%) of the 27 patients with documented IVPs. An additional patient was later added to the series, making a total of seven patients who returned for an ultrasonogram, which was then compared with the IVP. Observations and a review of the literature suggest that ultrasonography combined with urinalysis and serum creatinine is the screening protocol of choice in this patient population.
Subject(s)
Spine/abnormalities , Ultrasonography , Urinary Tract Infections/diagnosis , Humans , Urinary Tract Infections/complications , UrographyABSTRACT
Symptoms in the competitive athlete frequently are assumed to be related to overuse. A limited number of these patients will have orthopedic problems not related to their activity. This article outlines specific examples of bone tumors, infections, and metabolic causes of pain in the athlete.
Subject(s)
Athletic Injuries/diagnostic imaging , Pain/etiology , Adolescent , Adult , Athletic Injuries/physiopathology , Bone Diseases/diagnostic imaging , Bone Diseases/physiopathology , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/physiopathology , Diagnosis, Differential , Female , Humans , Joint Diseases/diagnostic imaging , Joint Diseases/physiopathology , Male , Middle Aged , Sprains and Strains/diagnostic imaging , Sprains and Strains/physiopathology , Tomography, X-Ray ComputedABSTRACT
Arthrography of the wrist was performed on 50 consecutive patients with obscure post-traumatic wrist pain by injecting contrast separately into the radiocarpal joint, midcarpal compartment, and distal radioulnar joint. When distal radioulnar joint and midcarpal compartment injections were added to the standard radiocarpal injection, many significant unsuspected abnormalities were identified. Of the 25 triangular fibrocartilage complex abnormalities identified, six (24%) were found only with the distal radioulnar joint injection. Of the 29 abnormal communications between the midcarpal compartment and the radiocarpal joint, ten (35%) were found only with the midcarpal injection. Similarly, five of 29 (17%) of the abnormal radiocarpal-midcarpal communications would have been missed if a midcarpal injection alone had been performed. These findings indicate that separate injections into the radiocarpal joint, midcarpal compartment, and distal radioulnar joint are needed to identify a large number of abnormalities not seen with injections into one compartment alone.
