CT appearances of chronically retained wooden intraorbital foreign bodies.

Identification of wooden intraorbital foreign bodies (WIOFB) is crucial for avoiding severe orbital infection. Despite careful clinical examination, WIOFB are often not recognised. We report the CT findings in chronically retained WIOFB. When not initially diagnosed, WIOFB create a granulomatous inflammatory foreign-body reaction. CT demonstrates the WIOFB as a linear dense structure surrounded by a soft-tissue mass with density similar to that of muscle, corresponding to the foreign-body reaction.

The sacroiliac joint: anatomical study in the coronal plane and MR correlation.

The current clinical imaging technique applied to the sacroiliac joint (SIJ) is coronal Computed Tomography (CT). The aims of this study were: 1) to section the cartilage, the ligaments of the SIJ, and their relations to adjacent organs, in a coronal plane; 2) to correlate anatomical and magnetic resonance (MR) sections; 3) to extend these data in vivo. A topographic dissection of a 52 year-old female specimen was performed to identify the various components, and spatial relationships of the SIJ. Another fresh frozen 50 year-old female cadaver was chosen on CT criteria of normality, and examined with a high resolution (HR) T1-weighted spin echo sequence, in a plane parallel to the ventral limit of the first two sacral vertebrae. This cadaver was then sliced with a sliding gauge device (slice thickness: 5 mm, and device thickness: 1 mm). The SIJ of a 28 year-old nulliparous volunteer, were examined in HR MR imaging, and with a faster sequence, for comparison with the post mortem data. The slice study was correlated with conventional dissection. The continuity and thickness of the auricular cartilage, the complex fascicles of proximal ventral and dorsal sacroiliac ligaments, and distant sacrotuberous and sacrospinous ligaments, were studied. In each plane, coronal HR MR imaging studies were correlated with anatomical sections. The clinical relevance of this comparison was to extend these data in vivo. The auricular cartilage and the ligaments of the SIJ are clearly analyzed by MR imaging, which could contribute to the study of sacroiliitis.

Unilateral diaphragmatic dysfunction in blunt chest trauma.

This study was undertaken to evaluate unilateral diaphragmatic dysfunction within ten days after blunt chest trauma. Thirty patients with unilateral chest injury, or predominantly one-sided injuries, were investigated in the supine position, under analgesia. Right and left hemidiaphragm displacement (DD) was measured, using digital subtraction radiography, during quiet and forced breathing. The diaphragmatic contribution to breathing was determined by rib cage and abdominal circumference measurement changes. In both breathing modes, DD of the injured side was lower than DD of the uninjured side (p less than 0.01, p less than 0.001). Six patients had complete diaphragmatic motionlessness. The inspired air volume due to diaphragmatic motion (Vab) was reduced when compared to normal subjects and Vab/VT ratio was always found to be less than 0.65. The degree of diaphragmatic dysfunction appeared related to injury location and is most severe in injuries of the lower chest which implies direct diaphragm muscle injury, although other mechanisms may be implicated. Diaphragmatic dysfunction can contribute to respiratory failure in these patients, and should be considered.

[Compression of the popliteal artery by a malignant fibrous histiocytoma simulating an aneurysm of the popliteal fossa]. / La compression de l'artère poplitée par un histiocytome fibreux malin simulant un anévrysme du creux poplité.

The authors report a case of severe intermittent claudication caused by a tumor mass in the popliteal fossa simulating an aneurysm. This proved to be a mesenchymatous tumor: malignant fibrous histiocytoma.

[Trapped popliteal arteries. Incidence, epidemiology, therapeutic considerations]. / Artères poplitées piégées. Incidence, épidémiologie, considérations thérapeutiques.

The trapped popliteal artery syndrome is an extrinsic dynamic compression of the vascular structures in the popliteal fossa by the surrounding fibromuscular structures. The condition mainly affects the popliteal artery resulting in atypical intermittent claudication because it often occurs in young and active patients. The arterial lesions are initially purely extrinsic and dynamic; sometimes they progress to thrombosis, embolism or aneurysm due to jet lesions. The diagnosis is obtained by radiology in the uncomplicated forms by showing compression or complete occlusion of the artery during contraction of the gastrocnemius and quadriceps muscles. Doppler studies of the posterior tibial artery may also demonstrate the condition during these manoeuvres. The epidemiological study was performed in 199 medical students and 80 athletes. A positional abolition of the posterior tibial artery was demonstrated in 39 students (19%) and 12 athletes (15%). The entrapment was commoner in females (24%) than males (13%). It was observed more frequently in dancers, cyclists and basket ball players: 12 control digitised intravenous angiographies were performed; the diagnosis was confirmed in 11 cases. Several anatomical anomalies of the popliteal fossa may give rise to this condition. The commonest is a deviation of the artery within the internal head of the gastronemius muscle; compression by the soleus or fibro muscular bands arising from the semi-tendinous or semi-membranous have been described. The treatment is surgical in very symptomatic or complicated cases; uncrossing the artery associated with venous grafting in cases of thrombosis are the procedures of choice.

[Embryology, anomalies, dystrophy and pathology of the lower limbs arteries (author's transl)]. / Embryologie, anomalies, dystrophie et pathologie des artères des membres inférieurs.

The development in the embryo of the lower limbs arteries is made by means of the retrogression of the ischiatic artery, which is initially preponderant, and of the persistence in the popliteal pit of an anastomosis between the original ischiatic axis and the final femoral axis. The tibial arteries originate from one or the other of these axes. The attention is turned to the areas rendered fragile by the complexity of their forming and likely to provoke some topographic anomaly or some dystrophic disease: persistence of the ischiatic artery, trapped popliteal artery, gelatinous dystrophy, Leriche-Fontaine aneurysmal dystrophy, anterior tibial hypoplasia. The repetition of such problems which are non-existent at the upper limbs and are localized to the same arterial segments, especially to the popliteal artery, puts stress upon an eventual dysplasic pathogenesis originating from the embryo.

[Renal arteriovenous fistulae after nephrectomy: report of a case and review of the published literature (author's transl)]. / Les fistules artério-veineuses rénales après néphrectomie. Une observation personnelle. Revue de la littérature.

The authors review the principal etiological, pathogenic, clinical and radiological features of post-nephrectomy renal arteriovenous fistulae, basing their remarks on the personal observation and 46 cases reported in the published literature. Surgical treatment is essential and consists, preferentially, of resection of the aneurysmal sac with dissection and a separate ligature of the artery and the vein.

[A case of pulmonary distomiasis (author's transl)]. / Distomatose pulmonaire: une observation.

Pulmonary distomiasis due to Paragonimus westermani was discovered in a young 21-year-old patient from Thailand following several bouts of hemoptysis. The authors review the published literature and outline the principal characteristics of this affection, emphasizing the radiological appearances and the possible value of bronchial arteriography.

[Thrombosis of the left popliteal artery from hypertrophy of the gemellus muscle (author's transl)]. / Thrombose de l'artère poplitée gauche par hypertrophie des muscles jumeaux.

The authors report a case of thrombosis of the left popliteal artery in a man aged 20 years, secondary to repeated minimal trauma from contact with a hypertrophied internal gemellus muscle. A bifurcation abnormality was also present. They review the anatomical variations seen at the end of the femoro-popliteal trunk and define the clinical and angiographic characteristics of popliteal thrombosis due to adjoining muscle hypertrophy.

[Retroperitoneal haemangiopericytoma (author's transl)]. / Hémangiopércytome rétro-péritonéal. A propos d'un cas.

The author's present a case of left retroperitoneal haemangiopericytoma with a malignant potential. They emphasise the value of angiography in the assessment of this rare disorder.

[Case of giant intra-petrous and intra-cavernous internal carotid aneurysm in a child]. / Un cas d'anévrysme géant intra-pétreux et intra-caverneux de la carotide interne chez l'enfant

The authors report the case of an eight-year-old girl hospitalised for severe headache with paroxysmal left otalgia, vomiting, aprexia, paralysis of the left 6 th cranial nerve and slight left facial weakness. Left carotid arteriography revealed a very large aneurysm of the internal carotid, involving its entire intra-petrous and intra-cavernous course. Treatment consisted of ligation of the internal carotid in the neck. Postoperative angiographic studies showed complete exclusion of the aneurysm, and it was unecessary to carry out "trapping" by ligation of the supra-cavernous carotid, as had initially been envisaged. The postoperative course was uneventful : immediate disappearance of otalgia, secondary complete recovery of the oculo-motor involvement and facial paresis. The absence of any infections or traumatic past history, together with the young age of the patient, represent arguments in favour of the congenital origin of this intra-petrous carotid aneurysm.

[Post-traumatic pseudo-aneurysm of the anterior cerebral artery (author's transl)]. / Pseudo-anévrysme post-traumatique de la cérébrale antérieure

The authors report a case of post-traumatic pseudo-aneurysm of the pericallosal artery in an 11 year old child. The lesion was secondary to a perforating wound of the roof of the right orbit, the eye itself being undamaged.