Computerized blood flow analysis for decision making in the treatment of osteochondritis dissecans.

Patients presenting the radiologic appearance of osteochondritis dissecans (OCD) require a decision as to further treatment. This often requires an invasive procedure. The noninvasive technique of computerized blood flow analysis (CBFA) has been used in 13 patients with OCD. In clinically early disease (four patients), there is always decreased flow in the area distal to the OCD lesion. Patients with intermediate OCD (four patients) showed characteristics of healing reflected in increased flow to the OCD lesion. These patients were left under observation and underwent spontaneous healing. Patients who showed no increase in flow or had decreased flow in the area of involvement (four patients) were clinically found to be nonviable OCD and required surgical intervention. The technique of CBFA therefore holds promise for decision making in the management of this disease.

Dynamic bone scintigraphy in osteochondritis dissecans.

We report a retrospective study of eighteen patients with pain in the knee or ankle, eleven of whom had osteochondritis dissecans. In these patients the bone-flow time-activity curves were observed after an intravenous injection of a bolus of 99mTc MDP. The curves varied according to the severity of the clinical signs and symptoms. The diagnosis rate was 29% with static scintigraphy and this improved to 57% when dynamic flow studies were used. A positive pattern in the dynamic study together with radiographs and static scintigraphs raised the diagnosis rate to 100%; the sensitivity was 90%. These preliminary results show that dynamic bone scintigraphy holds promise as a technique for identification and management of this condition.

Computerized blood-flow analysis in osteochondritis dissecans.

A retrospective review of static images and computerized blood flow studies (CBFS) in patients with osteochondritis dissecans (OCD) suggests that CBFS maybe useful in following the clinical course of this disease.

Partial anomalous pulmonary venous drainage of the right lower lobe shown by CT scans.

A case is reported in which the diagnosis of partial anomalous pulmonary venous return was first suggested on computed tomographic (CT) scans. Abnormal pulmonary vessels could be seen on serial CT sections to drain into the superior vena cava. The diagnosis was confirmed at angiographic study.

Overview of computed tomography of the temporomandibular joint.

Computed tomography of the temporomandibular joint has been shown to be an accurate method of assessing the position of the disk. To date, we have examined over 500 patients with this modality and have found it also to be effective in the evaluation of other osseous and soft tissue abnormalities. An overview of temporomandibular joint pathology is presented, including the range of osteoarthritic changes from spur formation to complete fusion. Anterior dislocation, with and without reduction, and closed lock are demonstrated. A heretofore unreported phenomenon--posterior dislocation of the meniscus with open lock--is presented. Also shown is the computed tomography evaluation of splint therapy, which has not been dealt with in other publications.

A subtraction technique in conventional angiography.

A subtraction technique is described for conventional angiography by which a superimposed vessel can be removed, allowing exact visualization of the area in question. The method is easy, requires only standard subtraction apparatus, and obviates the need for additional contrast material injections.