[Osteochondrosis dissecans of the elbow joint]. / Die Osteochondrosis dissecans des Ellenbogengelenks.

Thirty-one elbow joints in 29 patients (28 males, only 1 female), operated on for osteochondritis dissecans, were available for follow-up after an average of 10 years. The mean age at diagnosis was 24.4 years, but 11 patients were younger than 20. In 23 out of 29 patients the right elbow was involved, including 2 cases with bilateral involvement. In 20 cases removing the free bodies was the only surgical procedure performed, but in 2 cases it was combined with resection of the radial head. At follow-up, only one-third of the patients had no complaints. Nevertheless, daily activity was not restricted for any of the cases. Degenerative arthritic changes were found in only a few cases. These results are illustrated by means of three typical cases, which are compared with six similar cases in the international literature.

[Ultrasound examination of the scrotum]. / Ultralydskanning af scrotum.

Eighty-five patients who underwent ultrasound examination of the scrotum for scrotal disorders were reviewed. The predictive value of a positive test after ultrasound was better than after clinical examinations in almost every scrotal disease. Forty-five patients underwent operations, and six had malignant tumours of the testicle. Two of these were discovered by ultrasonography, although there were no suspicion of malignancy on clinical examination. Among the non-operated patients, nine patients had epididymitis, but four of these were not diagnosed by ultrasound. Ultrasound examination of the scrotum is recommended in patients presenting with scrotal symptoms.

Maternal-serum-alphafetoprotein screening for fetal malformations in 28 062 pregnancies. A four-year experience from a low-risk area.

From 1st March, 1980 and up to 29th February 1984 a multicenter serum alpha-fetoprotein (S-AFP) screening project was carried out for the detection of severe fetal malformations. S-AFP was determined by a radio-immunoassay in 28 062 pregnant women between the 16th and 20th week of gestation. Patients with elevated S-AFP values, e.g. above 95 percentile, were examined further with a second S-AFP and by ultrasound scan. 244 amniocenteses (0.9%) were carried out to detect 62 malformations (21 anencephalies, 14 spina bifidas, 2 encephaloceles, 7 omphaloceles, 5 gastroschises, 4 chromosome abnormalities and 9 other malformations). Fifteen of the 16 cases of spina bifida could not be verified by ultrasound scan, whereas all other malformations except chromosome abnormalities were confirmed by ultrasonography. Two cases of spina bifida and one case of skin-covered encephalocele had normal S-AFP concentrations and were therefore not detected. There were no definitive false-positives, e.g. therapeutic abortion of a normal fetus. Our conclusion is that a nationwide S-AFP screening should be recommended.

Ultrasound scanning for monitoring childhood hydronephrosis.

Ultrasound scanning of the kidneys in four children with radiologically proven hydronephrosis was undertaken with a new modification: scanning before and after copious intake of fluid. The anteroposterior diameter of the renal pelvis was used as an index of the hydronephrosis. Alterations in the dilatation were followed over a long period. Good agreement with simultaneous IVP was found. Improvement in the degree of hydronephrosis was apparent by reduction and disappearance of the dilatation of the pelvis during fasting as assessed by ultrasonic scanning, although pronounced dilatation was still observed after copious intake of fluid and at IVP. The results indicate that ultrasound scanning is a valuable supplement in the urological evaluation in children and that it can reduce significantly the number of radiological investigations required.