Diverticulosis of the fallopian tubes

Diverticulosis of the fallopian tubes is uncommon, but is 9 times as common in Negro women of Jamaican origin as in Caucasian women living in Bristol. 58 examples were encountered in 918 hysterosalpingograms done in Kingston, Jamaica (426) and in Bristol (492) from 1968-1972. In 41 cases (71 per cent) diverticulosis was bilateral. There are several possible predisposing causes, of which infection, including tuberculosis, is the most important. The radiological appearances are distinctive, but, with the possible exception of tuberculosis, do not give any indication of cause. Infertility was the commonest clinical association of diverticulosis. Among infertile patients, hydrosalpinx and tubal obstruction were slightly commmoner in the presence of diverticulosis and the significance of this is discussed. Ectopic pregnancy is the most important associated condition and diverticulosis predisposes to its occurence. Hysterosalpingography is indicated following ectopic pregnancy to show whether there is diverticulosis to the contralateral tube, as this may influence prognosis and management (AU)

Radiological changes in elderly patients with sickle cell anaemia

The survival of a relatively large group of patients with SS disease beyond the age of 40 years in Jamaica has enabled a number of studies defining the charcteristics of this group. These are important because this group may reflect extremes of pathological change consequent on the long duration of the sickling process. The present paper describes the pattern of bone involvement in patients over the age of 40 years as detected by skeletal surveys of the skull, lumbar spine, pelvis, shoulders, hands, femurs, tibia, fibulae and chest. Radiologial evidence of bone marrow expansion was common and included widening of the marrow cavities, large nutrient foramino, osteoporosis, and coarsencing of the remaining trabecular pattern. Calcified medullary infarction in long bones, which has been considered rare in SS disease, was common in this group. Changes consistent with avascular necrosis of the femoral and humeral heads occurred and were often unsuspected clinically, especially with humeral involvement. Factors leading to these changes are discussed (AU)

Haemoglobin SC disease in Jamaica

A skeletal survey was carried out on 84 cases of haemoglobin SC disease. The radiological features noted were increased translucency of bone, abnormal trabecular pattern, medullary expansion, wide vascular channels in phalanges, and radiological evidence of infarction, both medullary and cortical. The frequency of bone lesions thus demonstrated increased with age. The most characteristic lesions in this region were those of vascular necrosis; contributing factors such as the high haemoglobin level characteristic of the condition are discussed. An interesting feature was the lack of correlation betweeen clinical severity and degree of radiological change. (AU)

Homozygous sickle cell disease in Jamaica

An analysis of the radiological appearances in a skeletal survey of 61 patients in Jamaica with homozygous sickle cell disease is presented. Evidence of bone-marrow expansion was present in all age groups. Bone infarction was shown to become increasingly common with age. Bone infarction was commonest in the femoral and humeral heads. (AU)

Sickle cell beta thalassaemia in Jamaica

An analysis of the radiological appearances in a skeletal survey of 48 patients in Jamaica with sickle cell beta thalassaemia is presented. The appearances are similar to those in homozygous sickle cell disease and SC disease and a confident distinction between the conditions on radiological grounds alone is likely. (AU)

Intralobar pulmonary sequestration in association with bilateral systemic arterialization of the lungs

Over 250 cases of intralobar pulmonary sequestration have now been reported (Ranniger and Valvassori, 1964). The diagnosis which may be suscepted on the clinical, plain radiograph and bronchographic findings, depends on the angiographic or operative demonstration of an aberrant systemic arterial supply to the affected segment. The preoperative angiographic visualization of this pulmonary systemic arterialization arising from the thoracic or abdominal aorta either as a single large vessel (McDowell, Robb, and Indyk, 1955) or as multiple small arteries (Turk and Lindskog, 1961) to a large extent eliminates the operative hazards (Harris and Lewis, 1940). This paper reports an unusual case of pulmonary intralobar sequestration in association with bilateral aberrant systemic arteries. The angiographic and operative findings suggest that this may be a case of bilateral pulmonary sequestration (Summary)

Radiological changes associated with leg ulcers in the tropics

The radiological changes associated with four distinct types of leg ulceration common in the tropics are reviewed. Only mild changes occurred in the tropical phagedenic group, but more marked radiological abnormalities occurred in the three chronic groups. The frequency and pattern of the periosteal reaction is the most useful guide to radiological differentiation of these groups. (AU)

Arterio-venous fistulae - abstract

Arterio-venous fistulae which may be physiological or pathological are communications between arteries and veins without traversing a capillary network. Twenty-five pathological arterio-venous fistulae have been investigated arteriographically in the University Hospital of the West Indies during the past decade. Congenital lesions were twice as frequent as the acquired arterio-venous fistula. This series shows that acquire arterio venous fistulae are readily amenable to surgery and early radiographic demonstration particularly in the traumatic mesenteric and aorto-caval fistula can be life saving. The congenital fistulae are sub-divided into three groups on the basis of the arteriographic features which correlate well with the histolgy. Surgical intervention in these lesions is hazardous and is usually only undertaken in the peripheral fistulae. Pre- and post-operative angiograms are essential for obtaining satisfactory results in these cases. Differentiation between the acquired and congenital arterio-venous fistulae is possible on clinical histological and arteriographic criteria. Eight of these arterio-fistulae showed unusual anatomicopathological features (AU)

Carotid artery fibromuscular dysplasia and its association with hypertension and intracranial aneurysms

The findings in three cases of fibromuscular dysplasia of the internal carotid artery are discussed in this paper. In one case several intracranial aneurysms were found and two of the three cases where hypertensive. The importance of these association is stressed and the differential diagnosis of arterial fibromuscular dysplasia is also briefly discussed (AU)