ABSTRACT
PURPOSE: To confirm the accuracy of the standard parameters of Chamberlain's line, McGregor's line, McRae's line, and Ranawat's line in the diagnosis of basilar impression in a normal Asian population using magnetic resonance imaging (MRI) scans of the craniocervical junction, and to evaluate the use of MRI in the initial diagnosis of basilar impression. METHODS: We retrospectively reviewed MRI scans of the craniocervical junction in 114 Thai patients (61 men and 53 women) aged 20 to 89 years to assess the lines of Chamberlain, McGregor, McRae, and Ranawat. Patients with injury, tumour, or metastasis in the craniocervial junction; congenital anomalies; or clinical symptoms and signs of basilar impression were excluded. RESULTS: 39 of the 114 patients had the odontoid tip extended above Chamberlain's line by 1 mm to 9 mm (mean, 2.89 mm). Only 7 men and 5 women had the tip of the odontoid process extended beyond the normal range of 5 mm. The mean distance of the odontoid tip extended past McGregor's line in male and female subjects was 0.33 mm (standard deviation [SD], 1.2 mm) and 0.17 mm (SD, 0.7 mm), respectively, markedly less than those reported previously, although one male patient's odontoid tip extended 8 mm above the McGregor's line. Regarding McRae's line, no patient had the odontoid tip extended above the foremen magnum. The mean Ranawat's line in male and female subjects was 15.75 mm (range, 12-19; SD, 1.71 mm) and 14.09 mm (range, 11-17; SD, 1.38 mm), respectively. CONCLUSION: After using MRI to confirm the standard parameters of basilar impression as previously formulated from lateral skull radiographs, we recommend using McRae's line and Ranawat's line in the initial screening for basilar impression for the Asian population. Chamberlain's line and McGregor's line are viable alternatives, but clinicians must be aware of the potential for false positives.
Subject(s)
Magnetic Resonance Imaging , Platybasia/diagnosis , Skull Base/abnormalities , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Reference Values , Retrospective Studies , Skull Base/anatomy & histology , ThailandABSTRACT
Excessive femoral and coxa valga have been reported to be major contributors leading to hip dislocation in patients with cerebral palsy (CP). Femoral torsion angle (FT) and neck-shaft angle (NSA) were measured by the radiographic technique described by Rippstein and Müller in 157 patients with CP (289 hips). Factors associated with the degree of FT and NSA were evaluated. The researchers explored the correlation between the two angles and hip pathology. A large database of measurements was constructed. Our findings suggest that age and ambulatory status are the main factors correlated with FT and NSA.
Subject(s)
Cerebral Palsy/pathology , Femur Neck/pathology , Femur/pathology , Adolescent , Adult , Bone Diseases/pathology , Cerebral Palsy/diagnostic imaging , Cerebral Palsy/epidemiology , Child , Cross-Sectional Studies , Female , Femur/diagnostic imaging , Femur Neck/diagnostic imaging , Hemiplegia/pathology , Humans , Male , Osteotomy , Radiography , Retrospective Studies , Torsion AbnormalityABSTRACT
Eighty-six children with cerebral palsy (CP) born as a product of twin pregnancies were studied. Data regarding their co-twins were also gathered. The authors' findings suggest that (1) monozygotic twins have a higher risk of CP than dizygotic twins, (2) twin order at birth does not seem to be a relevant factor in the etiology of CP, (3) mothers less than 24 or more than 34 years of age had the highest incidence of children with CP as a product of a twin pregnancy, and (4) the data do not support a genetic basis for the disease.
Subject(s)
Cerebral Palsy/genetics , Diseases in Twins/genetics , Birth Order , Cerebral Palsy/etiology , Female , Humans , Infant, Newborn , Male , Maternal Age , Neurologic Examination , Risk Factors , Twins, Dizygotic/genetics , Twins, Monozygotic/geneticsSubject(s)
Bone Diseases, Developmental/etiology , Meningitis, Meningococcal/complications , Purpura/complications , Amputation, Surgical , Bone Diseases, Developmental/diagnostic imaging , Bone Diseases, Developmental/surgery , Child , Child, Preschool , Debridement , Female , Humans , Infant , Ischemia/etiology , Ischemia/surgery , Male , Purpura/surgery , Radiography , Skin TransplantationABSTRACT
A review of the recent orthopaedic literature reveals little information on the endocrinopathic associations of polyostotic fibrous dysplasia. This article illustrates the need for endocrinologic evaluations at both initial diagnosis and at follow-up examinations. Two patients with polyostotic fibrous dysplasia and acromegaly are presented. In both cases, diagnosis was made by endocrinologic and radiographic evaluations, including computed tomography (CT) scan of the skull. One patient had pituitary macroadenoma, and the other had pituitary microadenoma. Irradiation therapy was performed successfully in both patients without any complications.
Subject(s)
Acromegaly/complications , Fibrous Dysplasia, Polyostotic/complications , Acromegaly/diagnosis , Adult , Fibrous Dysplasia, Polyostotic/blood , Fibrous Dysplasia, Polyostotic/diagnosis , Hormones/blood , Humans , Male , Pituitary-Adrenal Function TestsABSTRACT
We have been using real-time ultrasonographic examination at Srinagarind Hospital since 1988, chiefly for confirming the diagnosis of subluxated and dislocated hips. We have also studied the click sensation, which is usually detected during Barlow and Ortolani tests in normal neonates. This article presents the significance, possible causes, and any correlation of the click sensation with congenital dislocation of the hip resulting from our study using real-time ultrasonography. No demonstrable subluxation or dislocation was found while the click sensation was created during the study.
