Radiologic Findings in Adults with Seronegative Spondyloarthropathies: Distinguishing the chronic arthropathies in adulthood.

Radiographic features of the four most common entities encountered in adult seronegative spondyloarthropathies are described and illustrated. The presence, pattern, and usual distribution of the peripheral and axial inflammatory changes are reviewed with pertinent clinical data. A combination of clinical observations, laboratory parameters, and careful roentgenographic evaluation of some inflammatory abnormalities usually leads to an early and precise diagnosis; however, evolution of the disease is at times necessary.

Radiologic Findings in Children with Seronegative Spondyloarthropathies: Distinguishing the chronic arthropathies of childhood.

Radiologic findings in the seronegative spondyloarthropathies are described and illustrated, and the presence, pattern, and usual distribution of peripheral and axial arthritis are discussed. Enthesitis and a family history are often present. Although some features are relatively specific, such as associated psoriatic nail or skin changes, inflammatory bowel disease, or eye and urogenital inflammation, it is difficult to distinguish the different spondyloarthropathies from one another and from juvenile rheumatoid arthritis.

Destructive spondyloarthropathy in short term chronic ambulatory peritoneal dialysis and hemodialysis.

Of the many rheumatic manifestations of kidney failure treated by longterm dialysis, a destructive spondyloarthropathy has recently been recognized. We performed a survey of our small, relatively short term (3-year average) dialysis population of 45 patients to establish a prevalence figure and establish a data base to assess risk factors. Destructive spondyloarthropathy was seen in 4 of 34 patients receiving hemodialysis and in 2 patients receiving chronic ambulatory peritoneal dialysis (CAPD). Age of the patient (p less than 0.09) and duration of dialysis (p less than 0.05) seem to be associated risk factors. Although it may be coincidental, radiological and biochemical hyperparathyroidism can be clearly dissociated from destructive spondyloarthropathy. The very peculiar quasiconstant, asymptomatic and early cervical localization of destructive spondyloarthropathy suggests a local mechanical factor accentuated by crystal and/or amyloid deposition disease which may become overwhelming as survival is prolonged.

[Radiological demonstration of an intradural epidermoid cyst rupture]. / Démonstration radiologique d'un kyste épidermoïde intradural rupture.

We report an unusual lumbar intradural epidermoid cyst found in an eight-year-old boy. At the age of 11 months, the child had one lumbar puncture to exclude possible meningitis, but seven years later he was experiencing pain. Lumbar myelography showed three intradural lesions, two of which were mobile in the subarachnoid space. Surgery revealed the presence of a single epidermoid ruptured cyst with free detached subarachnoid fragments, the dissemination of which had not caused aseptic meningitis.

Cricoarytenoiditis: CT assessment in rheumatoid arthritis.

The cricoarytenoid (CA) joint is a true diarthrodial joint that can be affected by rheumatoid disease. Its strategic location in the airway anatomy makes its evaluation of clinical importance. Direct fiberoptic laryngoscopy (DFL) and high-resolution computerized tomography (HRCT) were used to assess the larynx in 32 rheumatoid patients. Abnormalities were seen in 75% of patients at endoscopic examination. HRCT studies showed abnormalities in 72%. Erosion-luxation of the CA joint and surrounding soft-tissue swelling can be demonstrated on HRCT scans. A radiologic grading of the rheumatoid larynx is proposed, stressing that accurate evaluation of the larynx should be part of the diagnostic evaluation of every rheumatoid arthritic patient, given the high frequency of occurrence of rheumatoid laryngitis.

Cricoarytenoiditis in rheumatoid arthritis: comparison of fibrolaryngoscopic and high resolution computerized tomographic findings.

Cricoarytenoid involvement in rheumatoid arthritis has been assessed in 32 patients by combining clinical evaluation, direct fiberoptic laryngoscopy (DFL), and high resolution computerized tomography (CT). Symptoms were inconstant, variable, and rarely prominent. Absence of symptoms does not exclude an involvement. One case presented as an acute respiratory distress. The study showed an unexpected frequency of involvement with 75% of abnormal DFL and 72% of abnormal CT. Semiology of laryngoscopy and CT are described.

Computerized arthrotomography in recurring shoulder dislocations and subluxations.

A prospective study of 14 patients demonstrated the value of computerized arthrotomography in the unstable shoulder. This technique allows the visualization of soft-tissue and bone anomalies that cannot be detected otherwise.

The plica syndrome. A syndrome of controversy.

A plica is a synovial fold inside the knee joint that may become symptomatic following trauma. The authors diagnosed and excised 20 symptomatic plicae; after a mean follow-up period of 20 months 13 patients were free of symptoms, while six were unchanged or worse. Plica syndrome is not common, and careful assessment must be made to exclude other causes of pathologic knee conditions. The treatment of choice consists of excision of the entire plica to prevent recurrence of the symptoms.