Distal biceps tendon injury: MR imaging diagnosis.

PURPOSE: To review the authors' experience with magnetic resonance (MR) imaging of patients with suspected injury of the distal biceps tendon. MATERIALS AND METHODS: Twenty-one patients with clinically suspected injury of the distal biceps tendon were evaluated with MR imaging. Surgical correlation was performed in 15 patients, and long-term clinical follow-up was performed in the remaining six cases. RESULTS: Twelve complete biceps tears, four partial tears, one brachialis rupture, and one ganglion were identified. Axial MR images were more valuable than sagittal images in accurately grading distal biceps tendon injury preoperatively. There was 100% agreement between MR imaging and surgical findings. MR imaging findings led to changes in clinical treatment plans in eight patients (38%). CONCLUSION: MR imaging is useful in the evaluation of patients with suspected distal biceps tendon injury. In particular, axial MR images of the distal biceps insertion are important for accurate grading of the injury.

Pattern recognition of the pulmonary manifestations of AIDS on CT scans.

More than 50% of patients with acquired immunodeficiency syndrome (AIDS) develop pulmonary disease during the course of their illness. The authors reviewed 96 computed tomographic (CT) scans of patients with AIDS in an attempt to describe disease entities by the patterns seen on the scans. Such patterns included isolated ground-glass and interstitial infiltrates, which are suggestive of Pneumocystis carinii pneumonia (PCP). If pleural effusions or parenchymal nodules are also present, AIDS-related lymphoma (ARL) or Kaposi sarcoma (KS) is more likely. Although diffuse alveolar infiltrates are most commonly present in PCP, a segmental alveolar infiltrate is suggestive of a bacterial pneumonia, especially when associated with cavitation or ipsilateral pleural effusion. Well-defined nodules are typical for ARL, whereas ill-defined nodules are more commonly suggestive of KS. Accompanying adenopathy or effusion with nodules further suggests ARL. Different combinations of parenchymal, nodular, and pleural abnormalities may be suggestive for additional diagnoses, including Mycobacterium tuberculosis, M avium-intracellulare, and Cryptococcus neoformans infections and human immunodeficiency virus adenopathy. The authors believe that a specific pattern of involvement can help suggest a likely diagnosis in many instances.