Encapsulated epidural catheter. CT findings.

A case where an encapsulated permanent epidural catheter for continuous analgesia caused pressure on the dural sac is presented. The clinical findings and postmyelographic computerised tomography (CT) imitated an epidural metastasis, until an epidurography via the epidural catheter revealed its true nature.

Diagnosis of fracture of the carpal scaphoid with 4 oblique projections.

Two hundred and nine consecutive patients who suffered acute trauma had their carpal scaphoids examined by a radiographic method comprising 4 oblique projections with 1.4 x magnification. The method proved to be extremely sensitive in the primary diagnosis of scaphoid fracture, as none of 111 patients with normal primary examinations, but persistent soreness, proved to have fractures on control radiographs. A treatment less rigoristic than the traditional plaster cast is suggested when no fracture is shown on primary radiographs obtained by this method.

The apical oblique radiograph in examination of acute shoulder trauma.

One-hundred and twenty-five patients with acuta trauma to the shoulder were radiographed using anteroposterior and transthoracic views supplemented by an apical oblique projection with the patient seated in posterior oblique position, central beam directed 45 degrees caudad. The two standard views were evaluated prior to the apical oblique view. In 15.2% of the patients lesions were seen only in the apical oblique view, which also provided better examinations in 23.2% of all patients. Mainly dislocations of joints and fractures (in particular posterior glenohumeral dislocations), glenoid fractures, Hill-Sachs lesions and soft tissue calcifications were revealed in this view. Its routine use in acute trauma radiography is recommended.