Abduction Arthro-Fluoroscopy in Adhesive Capsulitis of the Shoulder.

This technical note describes a method of diagnosing adhesive capsulitis of the shoulder based on the real-time study of abduction movement under fluoroscopy control after opacification of the joint cavity with contrast media. This movement passively or actively shows a limitation of the abduction, a scapulohumeral block, or a weak or even an absence of rolling of the humeral head in the glenoid cavity, transforming the abduction into a shoulder elevation.

Application of the Canadian C-Spine rule and nexus low criteria and results of cervical spine radiography in emergency condition.

INTRODUCTION: The Canadian C Spine Rule (CCR) and the National Emergency X-Radiography Utilization Study (Nexus) low criteria are well accepted as guide to help physician in case of cervical blunt trauma. METHODS: We aimed to evaluate retrospectively the application of these recommendations in our emergency department. Secondly we analyzed the quality of cervical spine radiography (CSR) in an emergency setting. RESULTS: 281 patients with cervical blunt trauma were analyzed retrospectively. The CCR and the NEXUS rules were respected in 91.2% and 96.8% of cases respectively. No lesions were found in 96.4% of patient. A lesion was present in 1.1% of patient and suspected in 2.5% of patient. The quality of CSR was adequate in only 37.7% of patient. The poor quality of CSR was due either to the lack of C7 vertebrae visualization in 64.6% or other lower vertebrae in 28%. Other causes included the absence of open mouth view (8%), the absence C1 vertebrae visualization (3.4%), artifact in 2.3% and the absence of lateral view in 0.6% of patient. CONCLUSION: CCR and NEXUS are widely used in our emergency department. The high rate of inadequate CSR reinforces the debate about it's utility in emergency condition.

Evaluation of the stimulating effect of a low dose of secretin compared to the standard dose on the exocrine pancreas with MRCP: preliminary results in normal subjects (MRCP quantification of secretin stimulation).

BACKGROUND: Secretin administration during MRCP improves depiction of pancreatic ducts and allows assessment of pancreatic exocrine secretions. However, secretin increases the cost of secretin-enhanced MRCP (S-MRCP). The aim of this study was to quantify using MRCP the stimulating effect of 0.3 CU/kg of secretin and to compare it to the standard dose (1 CU/kg). METHODS: Ten healthy volunteers underwent four S-MRCP (two for each dose). Pancreatic exocrine secretions were quantified by pancreatic flow output (PFO) and total excreted volume (TEV), derived from a linear regression between MR calculated pancreatic exocrine volumes and time. Two readers analysed individually all sets of images. RESULTS: A linear increase of pancreatic exocrine volumes was observed after administration of both doses of secretin. Intra-individual and inter-observer differences were not statistically significant (P > 0.05). The mean PFO and TEV, given for reader 1 only, were, respectively, 6.9 +/- 1.5 mL/min and 103 +/- 26 mL for the standard dose and 6.1 +/- 1.2 mL/min and 84 +/- 19 mL for the dose of 0.3 CU/kg. Differences between PFO and TEV obtained with the two doses of secretin were statistically significant for both readers (P < 0.05). CONCLUSIONS: MRCP is a non-invasive, reproducible tool that allows quantification of pancreatic exocrine secretions during secretin stimulation. PFO and TEV calculated with the low dose were still in the range of previously reported reference values. The administration of 0.3 CU/kg of secretin can reduce significantly the cost of S-MRCP.

Hypoxemia after pneumothorax exsufflation: a case report.

We describe a 36-year-old patient who was admitted to the emergency ward for acute dyspnea due to a spontaneous pneumothorax. He was successfully drained but shortly after presented a severe hypoxemia due to pulmonary oedema secondary to pulmonary re-expansion. The physiopathology behind this complication is still unknown. We will try to describe this complication and its predictive factors.