Gout: radiographic findings mimicking infection.

OBJECTIVE: To describe radiographic features of gout that may mimic infection. DESIGN AND PATIENTS: We report five patients with acute bacterial gout who presented with clinical as well as radiological findings mimicking acute bacterial septic arthritis or osteomyelitis. Three patients had delay in the appropriate treatment with the final diagnosis being established after needle aspiration and identification of urate crystals under polarized light microscopy. Two patients underwent digit amputation for not responding to antibiotic treatment and had histological findings confirming the diagnosis of gout. CONCLUSION: It is important for the radiologist to be aware of the radiological manifestations of acute gout that can resemble infection in order to avoid inappropriate diagnosis and delay in adequate treatment. The definitive diagnosis should rely on needle aspiration and a specific search for urate crystals.

Amyloidosis of the shoulder in patients on chronic hemodialysis: sonographic findings.

OBJECTIVE: The purpose of this study was to determine the sonographic findings of amyloidosis in shoulders of patients on chronic hemodialysis. SUBJECTS AND METHODS: Sonograms were obtained for 19 shoulders of 11 patients on chronic hemodialysis with clinical findings suggestive of amyloidosis. Five patients had biopsy-proven amyloidosis, and one patient had positive shoulder joint fluid aspirate. The thicknesses of the following structures were measured: the rotator cuff, the subacromial-subdeltoid bursa, and the long head of the biceps tendon and its synovial sheath. The presence of intra- or periarticular masses or nodules, hyperechoic areas, bony erosions, and calcifications was specifically assessed. Shoulder sonograms from dialysis patients were compared with normal sonograms obtained for 20 asymptomatic shoulders of patients without renal disease. RESULTS: The mean rotator cuff thickness in the patients with amyloidosis was significantly greater than that in the normal group (p < .0001). Ten shoulders of six patients with amyloidosis but none of the control subjects had a rotator cuff thickness greater than 7 mm. The synovial sheath of the long head of the biceps tendon was thickened in 10 shoulders of patients with amyloidosis and in one normal shoulder. The subacromial-subdeltoid bursa was thickened in seven shoulders of patients with amyloidosis but not in any shoulders in the control group. Eight shoulder sonograms from dialysis patients showed intra- or periarticular nodules. CONCLUSION: Sonographic findings associated with amyloidosis of the shoulder include thickening of the rotator cuff, the synovial sheath of the long head of the biceps tendon, and the subacromial-subdeltoid bursa and the presence of nodules within or around the joint. Shoulder sonography may be useful as a noninvasive technique for the diagnosis of dialysis-related amyloidosis in the proper clinical setting.

[Compulsory internship in diagnostic radiology in the 5th year of medicine at the University of Montreal]. / Pasantía obligatoria de radiología diagnóstica en el quinto año medicina de la Universidad de Montreal.

Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students.

Pasantia obligatoria de radiologia diagnostica en el quinto ano de medicina de la Universidad de Montreal. / Required internship in diagnostic radiology in the fifth year of medicine at the Universidad de Montreal

Debido a los problemas metodologicos y de organizacion y evaluacion que confrontaban los departamentos de radiologias de los hospitales universitarios afiliados a la Universidad de Montreal, los estudiantes de medicina y la propia Universidad, en relacion con una pasantia optativa en radiologia que se ofrecia en el quinto ano de medicina, se constituyo un comite para reorganizar el plan de estudios. En este conciso articulo los autores describen esta y otras medidas tomadas por la Universidad para vencer los obstaculos mencionados. El interes fundamental del comite era reestructurar la pasantia, que se hizo obligatoria, a fin de que el futuro medico estuviera bien preparado para utilizar los recursos de la radiologia diagnostica y la medicina nuclear. Con ese fin, el comite formulo los objetivos, el contenido y el sistema de evaluacion que habrian de emplearse en esos cursos, asi como los medios pedagogicos. Los 25 modulos de autoaprendizaje que se concibieron, unidos a la observacion e interpretacion practica de sesiones radiologicas, fueron de gran utilidad para resolver los problemas iniciales y resultaron especialmente interesantes para los estudiantes

Pasantía obligatoria de radiología diagnóstica en el quinto año medicina de la Universidad de Montreal / Compulsory internship in diagnostic radiology in the 5th year of medicine at the University of Montreal

Problems of methodology, organization, and evaluation confronting the radiology departments of the university hospitals affiliated with the University of Montreal, the medical students, and the University itself in connection with an elective internship in radiology offered in the fifth year of medicine, resulted in the formation of a committee to reorganize the course of study. In this concise article the authors describe this and other measures taken by the University to solve these problems. The committees' main purpose was to restructure the internship which was made compulsory so that future physicians would be prepared to draw on the resources of diagnostic radiology and nuclear medicine. To this end, the committee formulated the objectives, content, evaluation system, and pedagogical methods to be used in those courses. The 25 self-teaching modules, together with the observation and practical interpretation of radiology sessions, proved highly useful in solving the initial problems, and were of particular interest to the students (Au)

Undergraduate radiology clerkship: the Universite de Montreal program.

At the Université de Montréal, a four-week rotation in radiology is part of the core curriculum for students in their fifth and final year of medicine. The objective of this undergraduate radiology clerkship is to prepare the future physician to use efficiently the resources of radiology and nuclear medicine in patient care. Specific goals and methods used to achieve them are described and analysed.

Metaphyseal dysplasia with maxillary hypoplasia and brachydactyly.

We report the familial occurrence in a French Canadian family of metaphyseal dysplasia associated to short stature and previously undescribed facial and acral anomalies. Facial manifestations include beaked nose, short philtrum, thin lips, maxillary hypoplasia, dystrophic yellowish teeth. Acral changes include bilateral shortness of metacarpal 5 and/or 2nd middle phalanx of fingers 2 and 5. Dermatoglyphics show low TRC, distal or absent axial triradius, absent triradius C, and radial loop on digit 4. The syndrome appears to be an autosomal dominant trait.