Spontaneous tension pneumopericardium complicating staphylococcal pneumonia.

The authors describe a patient with spontaneous pneumopericardium complicating staphylococcal pneumonia and empyema that resulted in cardiac tamponade. Spontaneous pneumopericardium is an unusual disorder. The causes and clinical findings of pneumopericardium are reviewed, as are the radiographic features that differentiate this condition from pneumomediastinum. Early recognition of pneumopericardium is important, because emergent pericardiocentesis may be required if there is clinical evidence of tamponade.

Edward B. D. Neuhauser Lecture. Paleoradiology of the prehistoric Australian aborigines.

Prehistoric populations suffered the rigors of everyday survival as hunter-gatherers, and some of the individuals had osseous manifestations as a result both of these stresses and of aging. Paleomedical scientists usually seek out osseous abnormalities found in skeletal remains, thus stressing the morbidity of a population [4]. In so doing, they portray those populations as less healthy than their own. This may not necessarily be the case. Specimens without signs of injury should be considered as evidence of the population's vitality; bones with evidence of injury that has healed during life should be considered as evidence of debility; and bones with evidence of conditions that are occupational in origin should be considered as evidence of social, economic, and ecological environmental conditions [4]. This is more useful than singling out specimens with abnormalities as signs of the population's morbidity [4]. This is confirmed by the majority of bones appearing osteologically healthy, except for the characteristic findings of biomechanical wear and tear arising from acquiring food and from combat (osteoarthritis, fractures). Although a number of children may have been infected by the treponematoses, which were manifested by cutaneous lesions, only a small percentage of children actually experienced osseous infection. Also, bone metastases were extremely rare.

Magnetic resonance imaging of the wrist.

Magnetic resonance imaging is one of the newest diagnostic techniques for evaluating the complex anatomy of the wrist. It is the only diagnostic modality that can directly depict abnormalities within the ligaments of the wrist and the TFC complex. Pathologic processes involving bone and soft tissue can also be demonstrated.

Fractures of the pelvis.

Imaging plays an important role in the evaluation of pelvic fractures. The indications, use, advantages, and limitations of conventional radiography, computed tomography, three-dimensional computed tomography, and radionuclide scanning of pelvic fractures are presented. The mechanisms of injury and radiographic features of the various types of pelvic fractures are discussed.

Advances in spinal imaging.

Considerable technical advances in spinal imaging have been made that have greatly aided diagnosis, surgical planning, treatment, and posttreatment follow-up of patients with spinal disorders. This article presents an update on the recent advances in magnetic resonance, digital, and radionuclide imaging techniques, three-dimensional computed tomography, and sonography of the spine.

The use of magnetic resonance imaging in the evaluation of bone and soft-tissue tumors.

We believe that MR imaging should follow plain films in the imaging analysis of soft-tissue tumors and bone tumors suspected of malignancy. MR imaging is primarily useful in tumor staging, although it may aid in diagnosis and the detection of recurrent or residual disease. Gd-DTPA and MR spectroscopy are currently being evaluated in many medical centers; their utility in the work-up and management of tumors of bone and soft tissue has yet to be determined.

Spondyloarthropathy of the cervical spine in long-term hemodialysis.

Changes stimulating osteomyelitis have recently been described in patients undergoing long-term hemodialysis. These consist of disk-space narrowing and irregularity of adjacent end plates. However, the characteristic prevertebral mass and clinical evidence of infection are often absent. In the appropriate clinical situation, although plain radiography and computed tomography have been helpful, magnetic resonance imaging may be more definitive in excluding infection and may obviate biopsy. The authors' imaging experience with five patients with this entity forms the basis of this report.

Red-yellow marrow conversion: its effect on the location of some solitary bone lesions.

The location of red marrow related bone lesions is dependent upon the distribution of red marrow. It is altered by the normal conversion of red marrow to yellow (fat) marrow and by the reconversion of yellow marrow to red marrow caused by marrow infiltrating disorders or marrow stress disorders.

Periarticular calcifications in association with intra-articular corticosteroid injections.

The authors report on three patients who received intra-articular corticosteroid injections (IACI) in the small joints of their hands for the symptomatic relief of local inflammation. In these cases radiographs showed that among the complications of IACI are periarticular soft-tissue calcifications. Evidence suggests that these calcifications are composed of hydroxyapatite crystals, which may themselves produce inflammatory arthritis.

Wrist arthrography.

Wrist arthrography can be helpful in the evaluation of the chronically painful wrist and, more specifically, in visualization of the integrity of the triangular fibrocartilage and interosseous ligaments. To be meaningful, arthrographic findings, i.e., compartment communication, synovial irregularity, tendon sheath and lymphatic visualization, loose bodies, and cartilage abnormalities, must be correlated with clinical history and physical examination.

Giant cell tumor of tarsal bones. Report of three cases and review of the literature.

Thirty-five cases of giant cell tumor (GCT) have been reported involving tarsal bones. Most occurred in the talus and calcaneus. We are adding three cases.

Elbow abnormalities in renal osteodystrophy.

Nine patients with renal osteodystrophy demonstrated characteristic abnormalities about the elbow consisting of subtendinous bone resorption at the sites of insertion and origin of muscles. The most striking abnormalities occurred at the insertion of the anconeus muscle, at the proximal extensor surface of the ulna, and along the posterior olecranon at the site of insertion of the triceps tendon. In three patients, the changes about the elbows were the most prominent features of hyperparathyroidism.

Radiographic evaluation of solitary bone lesions.

Diagnosis of solitary bone lesions through the use of plain film requires a careful evaluation of several diagnostic variables, the recognition and association of different radiographic signs, and an analytic approach to diagnosis. Diagnostic principles are discussed that can aid the physician in arriving at a correct diagnosis or in narrowing the diagnostic possibilities.