Arthrography of the plica syndrome and its significance.

The plica is a synovial fold inside the knee joint that may become symptomatic if for any reason the fold is converted into a bowstring. In 42 patients with chronic knee problems, arthrograms of the knee were obtained with evidence of the plica syndrome. Twenty-four were asymptomatic, 18 symptomatic, and of these 16 were excised. After a mean follow-up period of 3 years, 10 of the symptomatic patients were free of symptoms, while eight were unchanged or worse. The plica syndrome is not common, and careful assessment must be made by exclusion with clinical examination, double-contrast arthrography, and arthroscopy.

Increased uptake of radio labelled white blood cells into abdomen of uremics on peritoneal dialysis.

Peritonitis and exit-site tunnel infection are frequent causes of CAPD drop out. We studied 9 patients, 8 treated by CAPD and 1 by IPD. These patients underwent sonographic and scintigraphic study of the abdomen. All scintigraphic examinations showed a visceral uptake. In two cases, sub-clinical bowel inflammation, demonstrated by scintigraphic study, preceded a gram negative peritonitis. The scintigraphic study with radiolabelled white blood cells may be useful in identifying chronic aseptic inflammations and some bowel and exit-site conditions which are possible risk factors in some cases of peritonitis.

[Skeletal changes in non-Hodgkin lymphoma]. / Le alterazioni scheletriche nei linfomi non-Hodgkin.

140 patients affected by non-Hodgkin lymphoma (NHL) are performed by the A. Skeletal involvement of metastatic nature is observed in 14 of these (10%). Only the aggressive lymphomas have radiographic bone disseminations. At beginning of disease no patient has interested by bone changes. The most frequent roentgenographic finding observed by the A. include high incidence of osteolityc lesions: in particularly, pattern so called "permeative" is present in 35.6% of cases. Osteosclerotic and mixed manifestations were much less commonly observed (7,2% respectively). Periosteal reactions is not observed in any cases. The value of roentgen skeletal investigation in diagnosis, staging and therapy of NHL is discussed by the A.

[Comparative diagnostic value of echography and oral radiologic examination of the gallbladder in relation to surgical findings]. / Valore diagnostico comparato dell'ecografia e dell'esame radiologico per os della colecisti al vaglio chirurgico.

For nearly 60 years, since it was introduced by Graham and Cole (1924), oral cholecystography (OCG) has been used as the imaging technique of choice in investigation of gallbladder disorders. Recently, the future of OCG has come into doubt, principally as a result of ultrasonography, with the advent of high-resolution real-time scanning. Stones are seen as echoes within the lumen of the gallbladder and are associated with an acoustic shadow, findings which are highly specific. On this basis, to evaluate the accuracy of ultrasonography in detecting cholelithiasis, the A. have performed by real-time cholecystosonography 60 patients with not diagnostic OCG in a group of 546 patients affected by gallbladder diseases. Our results have confirmed that sonography revealed 4 normal gallbladders, 51 gallstones and 1 primary gallbladder cancer, with 5 cases of false positive. The true false negative rate has been difficult to determine, as surgery is usually not performed after a negative study. The accuracy of cholecystosonography for gallstone diagnosis was found to be 88,1% for all three Crade's categories.

[Value and limits of echography and abdominal lymphography in malignant lymphomas]. / Valori e limiti dell'ecografia e della linfografia addominale nei linfomi maligni.

Diagnostic results obtained by echography and lymphography in the study of abdominal lymphoglandular involvement in patients with lymphomas are compared. The data indicate that while lymphography is more revealing, the two examinations should be used together in staging. Echography, on the other hand, should be used for long-term surveillance, once the lymphographic contrast medium has been absorbed.

[Hemoptysis in a patient with post-obstructive pneumonia due to a broncholith]. / Emottisi in un paziente con polmonite post-ostruttiva da broncolita.

A case of a 51-year-old man admitted to the hospital for hemoptysis after a three-week history of fever and cough is presented. The chest x-ray film revealed consolidation in the left upper lobe. Because microbiologic studies of the bronchial lavage showed the grew of Pseudomonas aeruginosa, the patient was treated with piperacilline and pefloxacin. Haemoptysis and abnormal temperature was persistent for several days. Revaluation of the chest x-ray permitted to discover a little calcified nodule of 1 mm diameter. CT scan of the thorax confirmed the consolidation of the left upper lobe and the little calcification. A second fiberoptic bronchoscopy was performed in 10th day, using a bronchoscope with a smaller diameter; it was possible to observe the occlusion of the subsegment bronchus LB 1&2 due to a mobile protruding mass. The mass was gentle removed by the use of alligator bioptic forceps; it presented as a grey, hard, 2 mm diameter body with irregular surface like a "floating mine". On microscopical examination of the mass, aspergillus hyphae appeared as broad septate filaments. Culture of the samples were negative. Haemoptysis and fever stopped after FOB. Chest x-ray in 19th day was negative: consolidation and calcification were absent.

Computed radiography in neonatal intensive care.

The Authors report their experience in the employment of a computerized digital radiographic system in Neonatal Intensive Care. The analog screen-film system is replaced by photosensitive imaging plates, scanned after X-ray exposure by a laser that releases the digital image, which can then be manipulated on computer work-stations. In a period of twelve months about 200 chest-abdomen X-ray examinations in Neonatal Intensive Care have been performed using this method with good technical and diagnostic results. The use of digital radiography in the neonatal area is of high interest: this system produces good quality images, there is a reduction in radiation dose and 'retakes', the system allows selective enhancement of different structures and their magnification.

[Use of grids in mammography]. / L'impiego delle griglie in mammografia.

The authors report their experience in grid mammography in 265 patients. Image quality of grid mammograms was compared with conventional film-screen combination mammograms. The superior image quality of grid mammography, especially in large size breasts, was demonstrated. On the other hand the images obtained using grid fixed and Potter resulted almost alike.

[Xeroradiography in the study of the "diabetic foot"]. / La xeroradiografia nello studio del "piede diabetico".

42 patients, 25 males and 17 females, affected by diabetic osteoarthropathy of the foot were examined by the authors by means of xeroradiography. The radiographic findings, already reported in literature, as Charcot's joint and mutilating osteopathy, are better shown by xeroradiography, which allows to appreciate soft tissues, joints and vessels pathologic conditions much better than plain films. Moreover, the edge contrast enhancement and great contrast scale of xeroradiography allow to reproduce in a single image all the structures of the foot, as tarsal metatarsal and falangeal bones (especially in dorso-plantar projection) with optimal reproduction of single foot components and their skeletal structure.

[Xeroradiography in the study of dysmetabolic arthropathies]. / La xeroradiografia nello studio delle artropatie dismetaboliche.

70 patients affected by methabolic joint diseases are reviewed. Xeroradiography has been performed in hand, foot and knee for studying soft tissue and bone lesions in 12 subjects affected by chronic gout and 5 by CPPD. Results show that xeroradiography is more effective than X-ray films in outlining soft tissue masses, especially little dystrophic meniscal calcifications, and initial lesions in bone.

[Direct magnification in mammography with a 0.3 millimeter focus]. / L'ingrandimento diretto in mammografia con fuoco da 0.3 millimetri.

The authors emphasize the value of mammography with a 0.3 millimetres microfocus-tube with a magnification system. This technique is limited to those large lesions increasing "twilight effect". For a better study of all breast's lesions the use of fine microfocus-tubes is suggested, as it results also from the latest literature.

[Double-contrast arthrography of the knee in traumatic capsular-ligamentous lesions. A critical review]. / L'artrografia a doppio mezzo di contrasto del ginocchio nelle lesioni traumatiche capsulo-legamentose. Revisione critica.

The authors conducted a statistical study and a critical review on a series of 1,300 patients examined with double-contrast fluoroscopically guided knee arthrography using a simple examination technique. Arthrographic diagnoses were subsequently compared with arthrotomic (500 patients), arthroscopic (350 patients), and clinical (450 patients) diagnoses. The critical review pointed out the high diagnostic accuracy (90%) and the good sensitivity (87%) of arthrographic examination in patients affected with pathologic conditions of the cruciate ligaments. In collateral ligament diseases and in capsular ruptures arthrographic sensitivity was not as high but still acceptable (74%). Capsular tears and medial collateral ligament tears can be identified when contrast medium is seen leaking from the knee joint. Cruciate ligament tears may be partial or complete: if a tear is partial the synovial surface of the cruciate ligament cannot be identified the cruciate ligament is wavy, lumpy, or focally thin, while in complete tears the synovial surface of the cruciate ligament cannot be identified either entirely or partially.

Diagnostic potential of double contrast arthrography of the knee with the digital technique.

Experience with digital radiography applied to double contrast arthrography of the knee performed with a photostimulable phosphor plate is reported. The image processing technique used to improve the digital image is described, and some theoretical considerations are discussed. A preliminary comparison is also made between arthrographic images obtained with conventional screen-film systems and the digital system, especially in respect of the image quality and visualization of the soft tissue structures least well demonstrated with conventional arthrography.

[The acromegalic hand. Diagnostic value of various radiographic measurement indices]. / La mano acromegalica. Validità diagnostica dei vari indici di misura radiografici.

The first classic description of so-called "spade hand" in acromegaly dates from 1886 and is reported by Marie [22]. The hand radiograph is easily diagnostic, when gross abnormalities are present. Sometimes, however, it may be difficult to distinguish the appearances of the milder case from the normal, only by X-ray. The aim of this paper is to define the position of several hand measurements (sesamoid index, tufting, joint space thickness, hand length, metacarpal index, soft tissue measurements at index finger) and to compare these indices in relation to the detection of disease in radiological diagnosis. Hand measurements were made in 100 normal controls and in 19 cases of acromegaly, of whom hand radiograph and xerograph were performed and also compared each others.