"Fibrous dysplasia" of the skull with complete unilateral cranial nerve involvement. Case report.

A 40-year-old man with a slowly progressive unilateral sclerotic process of the base of the skull developed complete involvement of all cranial nerves on the right. Roentgenograms of the skull are interpreted as fibrous dysplasia, but pathological confirmation is lacking.

[Use of physical therapy in the prevention and treatment of decubitus ulcer]. / Sull'impiego della terapia fisica nella prevenzione e nel trattamento delle prevenzione e nel trattamento delle ulcere da decubito.

The causes of bedsores and their complications are described, along with the preventive and surgical, medical and physiotherapeutic measures used in their treatment. Personal experience with an association of drugs and physiotherapy in 21 cases is reported and the modalities employed are described in detail. The advantages offered by the association in the way of simplicity and satisfacory results are explained.

Magnetic resonance imaging evaluation of bone marrow changes in obstructive sleep apnoea syndrome in adults.

PURPOSE: The aim of this study was to evaluate bone marrow reconversion in patients with obstructive sleep apnoea syndrome (OSAS) by means of magnetic resonance imaging (MRI). To our knowledge, no explicit correlation between OSAS and such parameter has been documented in the literature. MATERIALS AND METHODS: During a 35-month period, 33 patients with a clinical diagnosis of OSAS, obese but without restrictive or obstructive ventilatory defects, were evaluated with MRI during wakefulness in all patients with T1-, PD- and T2-weighted sequences in the sagittal and axial plane within 1 week after polysomnography. RESULTS: MRI showed bone marrow reconversion in 33.3% of patients. Patients with bone marrow reconversion showed higher mean haematocrit (HT) values, lower mean nocturnal oxyhaemoglobin saturation, higher percentage of sleep time with oxygen saturation (SaO2) <90%, lower nadir, as well as greater neck adiposity and soft-palate lengthening compared with patients without bone marrow reconversion. Furthermore, in patients with bone marrow reconversion, haematocrit (HT) was negatively correlated with daytime arterial oxygen partial pressure (PaO2) and positively with arterial carbon dioxide partial pressure (PaCO2). CONCLUSIONS: In patients with OSAS, bone marrow reconversion is probably correlated with the severity of nocturnal desaturation. As bone marrow reconversion is, for unknown reasons, greater in adults younger than 40 years, MRI evidence of bone marrow reconversion could be useful in young individuals for the early diagnosis of sleep-disordered breathing and prevention of associated cardiovascular diseases.

Neonatal death dwarfism--a new form.

A new type of neonatal death dwarfism is reported. Although it resembles superficially the metatropic dysplasia group of diseases it has some distinctive radiographic features which help to delineate it as a separate entity.

[Radiological findings in traumatic lesions of the achilles tendon (author's transl)]. / Il contributo radiologico nella patologia traumatica del tendine di Achille.

Xeroradiography fits particularly well in the study of the soft tissues and given better results than traditional radiographs. Traumatic pathology of the Achille's tendon has been studied. Usually the lateral projection both of the affected and the unaffected sides is enough. In some cases xeroradiographs are made with the foot both in hyperflexion and in hyperextension. Cases with partial or complete fracture of the Achille's tendon are described as well as cases with nodular tendinitis or tendinosis, as a sequela of traumatic lesions of the tendon. Finally the findings of the surgical reconstruction of the tendon are discribed.

Role of telethermography and arthrography in rheumatoid wrist.

After briefly reviewing some of the problems relating to an early identification of synovial pathology, the authors have pointed out the actual role of telethermography and arthrography, resulting from their diagnostic experience. The two techniques were applied to a group of 40 patients affected with rheumatoid arthritis and were found to be particularly helpful: (i) either providing quite early information (telethermography); or (ii) allowing an exact topographic definition of synovial and tendinous sheath involvement (opaque arthrography), or eventually (iii) supplying a manageable means to follow their development with.

[Fibrous dysplasia of the skull. Radiologic diagnosis]. / La displasia fibrosa del cranio. Diagnosi radiologica.

The authors examined 11 patients with fibrous dysplasia of the skull pointing out its radiologic features and preferential sites. Conventional radiology, CT and MR imaging were used. As for conventional radiology, tangential scans which of great value to depict the most typical morphologic patterns. Lesions of the skull base were most frequent in the sphenoid (7 of 11 cases), where 5 of 7 exhibited a sclerotic pattern. Bone changes in the skull vault were: mixed (3 cases), pagetoid (2 cases), "ground glass" (1 case) and lytic (1 case): none of these cases was of the sclerotic type. A typical feature of vault lesions was the widening of diploic space associated with expansion of the outer bone and integrity of the inner bone. Radiologic findings, often associated with suggestive clinical manifestations, always allowed a diagnostic hypothesis; histopathologic confirmation was needed only in a few cases (4 of 11 patients).

Melorheostosis: presentation of a case followed up for 24 years.

The case of a woman affected by Melorheostosis of the left arm, who was followed for 24 years, is presented. After a brief review of the main clinico-radiological features and the most likely pathogenetic theory, the authors point out the slow but inexorable progression of the alterations and their localization, which is strictly limited to the dermatome supplied by a spinal nerve.

Angiographic study of digital arteries in workers exposed to vinyl chloride.

Five patients exposed to vinyl chloride were studied by hand angiography and other non-invasive methods, including photoplethysmography, rheography, and thermography. Raynaud's phenomenon was present in all five subjects, while acro-osteolysis affected only one. Organic vascular lesions, such as narrowing, segmentary occlusions of digital arteries and bridge collaterals, were found in angiographic studies. Only one patient did not show clear segmentary occlusions, but his vessels were crooked and diffusely narrowed. Angiographic results appear to correlate well with the changes shown by non-invasive techniques.

[Congenital pseudarthrosis of the clavicle: roentgenographic appearance and discussion of the aetiological and pathogenetical theories [author's transl]. / La pseudo-artrosi congenita della clavicola:a aspetti radiologici e considerazioni etiopatogenetiche.

The authors briefly reviewed the anatomic and radiological pattern of the congenital pseudarthrosis of the clavicle, with the main aetiological and pathogenetical theories. They also report their personal experience about 2 patients, stressing the peculiarity of this affection compared with others similar in their radiological pattern. They underline the coexistence, in one of the two cases, of the Ehlers-Danlos syndrome, suggesting a single vascular aetiology and pathogenesis.

[Peritubal adhesions and hysterosalpingography]. / Aderenze peritubariche e isterosalpingografia.

Hysterosalpingography cannot directly show pelvic adhesions due to pelviperitonitis, salpingitis, perimetritis or parametritis. Nevertheless this method is able to evidence an eventual tubal involvement by adhesive tissue. Located pools of contrast medium around the tubae is a well known radiological sign, but not the only nor the most frequently one observed. If the adhesions include the proximal end of the tubae, the contrast pooling may be absent. This paper analyzes, in controlled series of patients with pelvic adhesions, all the hysterosalpingographic signs which can indicate an adhesive tubal involvement.

Does MURCS association represent an actual nonrandom complex of malformations?

The MURCS association was first suggested by Duncan in 1979 as a distinctive nonrandom association of congenital anomalies involving the Mullerian duct, the kidneys and the cervicothoracic spine. Two personal cases, highly resembling Duncan's description, are reported. In our opinion, they seem to support somehow the hypothesis that MURCS association should be considered as an autonomous pathological entity. The great phenotypical variability and the still unknown etiopathogenetic mechanism are particularly stressed.

Premature epiphyseal fusion and extramedullary hematopoiesis in thalassemia.

The main skeletal abnormalities in beta-thalassemia are widening of medullary spaces, rarefaction of bone trabeculae, thinning of cortical bone, and perpendicular periosteal spiculation. Premature epiphyseal fusion (PEF) and extramedullary hematopoiesis (EH) are found, though more rarely. The incidence of PEF and EH in 64 patients affected by beta-thalassemia is reported. The different incidence of such complications in thalassemia major and intermedia is reported, and a possible correlation with transfusion regimen is also considered.

Xeroradiography of tenomuscular traumatic pathologic conditions of the limbs.

Due to its intrinsic technical features xeroradiography is particularly suitable for the documentation of soft tissue abnormalities. Indications and advantages of the method in the posttraumatic alterations of the tenomuscular system of the limbs are discussed. Several examples of acute or chronic diseases are presented. The authors prefer this technique to the traditional films in view of the obtainable graphic results; a better demonstration of the tenomuscular structures is obtained. Often comparison with the contralateral side is necessary; the performance of "functional' xeroradiograms is essential, especially in smaller lesions. Xerography is a useful complement of clinical examinations for an early diagnosis of lesions, for detection of clinically doubtful lesions and for the follow-up after treatment.

An unusual kind of muscular and skeletal involvement in a heroin addict. A case report.

After a brief review of the infectious complications that frequently occur in heroin users, the authors report a case of chronic osteomyelitis affecting the ulnar diaphysis bilaterally. Musculo-cutaneous dystrophic lesions were also present and resulted in forced flexion of the distal phalanges of fingers 2-5. The most likely pathogenetic development discussed.

[Prone position in hysterosalpingography]. / Il decubito prono in isterosalpingografia.

The authors discuss the importance of prone hysterosalpingography to the aim of a careful tubal examination. Nearly all the complete or partial tubal obstructions, observed during supine hysterosalpingography, have been resolved by the simple prone position. The high percentage (91%) of successes, without pharmacological help, recommends the routine use of this simple method in all cases of doubtful tubal obstructions.