Mid-foot disassociation in rheumatoid arthritis.

The mid-foot is commonly involved in rheumatoid arthritis with subchondral sclerosis and erosions at the talonavicular joint. There may be a mid-foot disassociation whereby the hindfoot is usually subluxed. Occasionally the forefoot may be subluxed with mid-foot disassociation. In long-standing cases of rheumatoid arthritis there is a loss of the normal plantar arch.

Pseudoarthrosis in ankylosing spondylitis.

Pseudoarthrosis of the spine in ankylosing spondylitis consists of a fracture through the intervertebral disc and neural arch. There is vertebral body end-plate destruction with adjacent bony sclerosis.

"Hook" erosions in Jaccoud's arthropathy.

Jaccoud's aethropathy is a non-erosive deforming arthritis seen in rheumatic fever, systemic lupus crythematosis and ankylosing spondylitis. "Hook" erosions may occur on the radial palmar aspect of the metacarpal heads and can be differentiated from the marginal erosions of rheumatoid arthritis.

Urologic complications in renal homotransplantation.

Nineteen urologic complications developed in 161 renal transplant patients, 14 of whom developed cutaneous fistulae. The majority of complications occurred at the ureterovesical and ureteropelvic areas. Pelvic and vesical abnormalities were uncommon. Twelve patients with cutaneous fistulae were treated conservatively. The mortality rate in our series was 47%.

Knee joint bursal abnormalities in rheumatoid arthritis.

Twenty-five patients with rheumatoid arthritis presented with knee joint bursal abnormalities. Nineteen patients presented with symptoms simulating thrombophlebitis. Sixteen had a rupture of the posterior joint capsule without a communicating semimembranosus-gastrocnemius bursa (S-G), with extension ventrally between the soleus and gastrocnemius muscles or between the skin and muscle. Nine had an enlarged S-G bursa with or without rupture. Two patients had additional cephalad ruptures: one from the posterior compartment and the other one from the suprapatellar bursa.

Persistent primitive sciatic artery.

Angiography revealed persistence of the primitive sciatic artery in two cases. In one, the artery supplied a large arteriovenous malformation, and the profunda femoris artery was absent. In the other, there were associated findings of neurofibromatosis, decreased left lower limb lymphatic vessels, a left subinguinal lymphocele, and absent external iliac and femoral arteries.

Early acute rejection in renal homotransplantation. Angiographic-pathologic correlation.

Early acute rejection occurs between two and ten days after renal homotransplantation and has been recognized in eight of 156 renal transplants. Four of the eight patients developed spontaneous renal rupture unrelated to biopsies. Pathologically, there was acute passive congestion with areas of tubular necrosis, venous thrombi and perivenous lymphoplasia. Glomerular and arterial immunogenic injury was slight. Radiologically, the kidneys were enlarged with stretching of the interlobar and segmental arteries, decreased peripheral filling and a homogeneous nephrogram. Renal vein filling defects were a frequent feature.

Blunt trauma to the main hepatic artery.

Two patients are presented who sustained common hepatic artery injuries secondary to blunt trauma. One patient had a laceration and thrombosis of the proximal hepatic artery while the second patient developed a false aneurysm with dissection which necessitated ligation of the hepatic artery.

Intrarenal arterial collateral circulation.

In three cases of intrarenal arterial collateral circulation the collateral channels developed between interlobar arteries in diseased kidneys. Probably these originated in hypertrophied spiral vessels that had arisen from the interlobar arteries in the area of the minor calyces. This form of collateral circulation will undoubtedly be recognized more frequently with the increased use of magnification radiography.

Arteriovenous malformation of the stomach.

A patient with chronic anemia is presented who radiologically showed prominent rugae of the stomach. Angiography demonstrated an arteriovenous malformation with a large feeding artery and prominent draining veins.

Early acute rejection of renal homografts: a characteristic clinical syndrome.

Seven of 74 patients with early functioning cadaveric renal homografts developed acute oliguric renal failure after the second but before the ninth day post-transplantation. The syndrome characteristically begins with an abrupt and simultaneous decrease in creatinine clearance, urine volume and urine sodium concentration. After a variable period and despite a reduction in immunosuppressive therapy, a diuretic phase ensues and renal function is restored. Complications associated with the syndrome include groin hematoma, pulmonary edema and renal rupture with shock. Renal rupture does not require nephrectomy: if the hemorrhage is controlled, the transplanted organ will resume function. Angiographic studies show normal nephrograms, stretched arterial vasculature and filling defects in the veins. Percutaneous renal biopsy shows interstitial edema and hemorrhage, venous congestion and tubular necrosis. Evidence is presented to support the hypothesis that this is a form of rejection occurring as the result of injury to the renal venous system.