Myelodysplastic syndrome and sagittal sinus thrombosis.

After a 5-day illness beginning with severe headache, a 46-year-old man with myelodysplastic syndrome died of complications from cerebral venous thrombosis. Considering the underlying hematologic abnormality, multiple therapies, and potential for leukemic transformation, we suggest that patients with myelodysplastic syndrome may be at increased risk for developing cerebral venous thrombosis.

Diffuse lung calcifications following fat emboli and adult respiratory distress syndromes: CT findings.

We present a case of diffuse lung calcifications that developed following fat emboli and adult respiratory distress syndrome. Computed tomography (CT) showed the majority of the calcifications to be within branches of the pulmonary arteries. High-resolution CT findings helped to characterize associated lung parenchymal changes.

CT of crack cocaine ingestion.

The imaging findings of a crack cocaine "body stuffer" are presented along with findings from in vitro experimentation with crack cocaine. It has been shown previously that contrast enhanced radiographic examinations can often outline the vessel in which ingested cocaine is contained; our work demonstrates that the crack cocaine itself may be visualized with CT performed without intravenous or oral contrast material. Due to the cost of CT, however, it is indicated only when clinically warranted to guide treatment. Positive identification of ingested crack cocaine by CT might prove helpful for both medical and legal indications.

Radiographic clues to fractures of the unossified medial humeral condyle in young children.

A fracture involving the trochlear ossification center as well as the medial epicondyle is a more serious injury than simple avulsion of the medial epicondyle. This diagnosis may be difficult in young children before the secondary centers are ossified. Radiographic clues to this injury in a young child are localized soft tissue swelling over the medial aspect of the elbow accompanied by a metaphyseal flake and/or a positive fat pad sign. In the older child, separation of the ossified medial epicondyle with a positive fat pad sign suggests a more complex injury.

Computed tomography for metastatic lesions of the osseous pelvis.

Significant metastatic lesions of the osseous pelvis can be easily missed by conventional x-ray studies. Although the radionuclide bone scan is the method of choice for detection of metastatic lesions of the osseous pelvis, computed tomography should be used as a complementary study in certain patients.

Radionuclide bone scan as an aid in localizing lesions for bone biopsy.

Two cases are cited as examples of the usefulness of bone scan-guided bone biopsies, using a lead marker for lesion localization, especially when the lesions are otherwise difficult to localize. This technique is quite useful in evaluating new solitary bone lesions in patients with a known primary malignancy.

Bladder base impressions in women: "female prostate".

Bladder base impressions due to prostate hypertrophy are a common urographic finding in older males. A similar appearance may be occasionally seen in females and presents a more difficult diagnostic problem. Sixteen such cases of bladder base defects in females at two institutions were identified. The impressions were caused by symphysis pubis asymmetry, postoperative change, urethral diverticulum, levator ani impression, or "urethral syndrome." Vaginal fibromyoma, ectopic ureterocele, and intramural bladder neoplasm can also cause this defect, although no such cases were found in this series.

Tarsal pseudo-coalition--a positional artifact.

Pseudo-coalition of the talocalcaneal joint is a positional artifact which is created by either slight abduction or inversion of the foot on the lateral radiograph. This apparent bony bridge is due to overlap of normal structures on opposite sides of the hindfoot. It may be distinguished from a true coalition by the following features: 1) it disappears in a truly lateral radiograph, 2) there is no associated talar spur, and 3) there are no clinical findings of spastic flat foot. In addition, the true medial talocalcaneal bridge requires special views for its demonstration and cannot be seen in a lateral radiograph.

Pseudosubluxation of the axis in young adults.

Pseudosubluxation or anterior slippage of the axis on C-3 is a well recognized physiologic phenomenon in children. Because of a downward shifting of the apex of flexion of the cervical spine that occurs at about age 10, this physiologic offset of C-2 has been thought unlikely to occur in older individuals. However, a review of a series of flexion and extension cervical spine films showed six such cases in the 14- to 21-year age range.

Bone mass in lifetime tennis athletes.

The effects of physical exercise on the status of bone mineralization for a population of lifetime athletes were investigated. The bone mineral content of the radii of experienced male tennis players was measured. The bone mass of the radius of the playing arm (mean, 1.37 g/cm) was greater than that of the nonplaying arm (mean, 1.23 g/cm) in all but one person. The results were compared with data for a nonathletic (normal) population. The quantity of bone mineral present in the playing arms of the athletic population was greater than that of the dominant arms of nonathletes, which suggests that playing tennis during a lifetime may produce a localized increase in bone mineralization that is greater than that found in nonathletes.