ABSTRACT
We studied serial CT scans of 45 arthritic shoulders (34 rheumatoid, 11 osteoarthritic) and 19 normal shoulders, making measurements at three levels on axial images. The maximum anteroposterior diameter of the glenoid was increased in rheumatoid glenoids at the upper and middle levels by 6 mm and in osteoarthritic glenoids at all levels by 5 to 8 mm as compared with normal. In rheumatoid cases, nearly half the available surface of the glenoid was of unsupported bone, mainly posteriorly at the upper and middle levels. In osteoarthritic glenoids, the best supported bone was anterior at the upper level and central at the middle and lower levels. The depth of the rheumatoid glenoid was reduced by a mean of 6 mm at the upper and middle levels and by 3 mm at the lower level. This inclined the surface of the glenoid superiorly. The depth at the middle level in osteoarthritis was reduced by a mean of 5 mm, suggesting central protrusion. Osteoarthritic glenoids were retroverted by a mean of 12.5 degrees, but of rheumatoid glenoids two-thirds were retroverted (mean 15.1 degrees) and one-third anteverted (mean 8.2 degrees). Our findings have important implications for the planning and placement of the glenoid component of total shoulder replacements; CT can provide useful information.
Subject(s)
Arthritis, Rheumatoid/diagnostic imaging , Osteoarthritis/diagnostic imaging , Scapula/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedSubject(s)
Actinomycosis/etiology , Intrauterine Devices/adverse effects , Pelvic Inflammatory Disease/etiology , Actinomycosis/diagnostic imaging , Female , Humans , Middle Aged , Pelvic Inflammatory Disease/diagnostic imaging , Pelvic Inflammatory Disease/drug therapy , Pelvis/diagnostic imaging , Penicillins/therapeutic use , RadiographyABSTRACT
The intravenous urogram has long been the mainstay of urinary tract imaging in adult practice. It has been shown recently that in many clinical situations the routine use of intravenous urography is no longer justified and in some situations avoidance of adverse contrast reactions, reduced examination time and significant cost reduction. In order to assess the clinical and financial aspects of a change in practice in our department, a prospective study was undertaken over a total of 10 weeks when 328 patients who were referred for intravenous urography were also examined independently by ultrasound combined with the plain abdominal radiograph. The results were compared and in 81.4% of cases the two techniques yielded identical information. Ultrasound plus a plain abdominal radiograph provided more diagnostic information in a further 12.5% of cases, whilst intravenous urography was more informative in only 6.1%. The findings of the study are discussed by considering the main clinical groups and comparing the relative yields of ultrasound and urography. A scheme of routine urinary tract investigations using ultrasound and the plain abdominal radiograph is proposed. We estimate a 58% reduction in number of urographic examinations while retaining diagnostic accuracy. The financial and planning implications for our department are discussed.
Subject(s)
Ultrasonography , Urography , Urologic Diseases/diagnosis , Humans , Prospective Studies , Urologic Diseases/diagnostic imagingABSTRACT
Real time ultrasound is being increasingly used in the diagnosis of venous thrombosis. We have studied its role in six patients with jugular and/or subclavian vein thrombosis and conclude that ultrasound is a useful, non-invasive first line imaging technique and may negate the need for venography in this small but important group of patients.
Subject(s)
Jugular Veins/pathology , Neck/blood supply , Subclavian Vein/pathology , Thrombosis/diagnosis , Ultrasonography , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
In a series of 50 patients presenting with gastric or colonic neoplasms ultrasound scans of the liver were performed during the pre-operative assessment. The radiologist who performed the scan was informed that the patient had gastro-intestinal malignancy but was unaware of the clinical or biochemical findings that might suggest hepatic metastases. The ultrasound findings were then compared with the results of laparotomy, laparoscopy or the clinical course of the patient. The overall accuracy of ultrasound in this small series was 88%.
Subject(s)
Colonic Neoplasms/pathology , Liver Neoplasms/secondary , Stomach Neoplasms/pathology , Ultrasonography , Humans , Liver Neoplasms/diagnosis , Neoplasm Staging/methods , Preoperative CareABSTRACT
The accuracy of large volume selective arteriophlebography in demonstrating the main renal veins in 28 patients with renal carcinoma is presented. The diagnosis was shown to be correct at operation in 96% of examinations. It is suggested that the technique is valuable and safe and should form part of the routine pre-operative assessment of patients with renal carcinoma.