Computed tomography of ununited neurocentral synchondrosis in the cervical spine.

The authors describe an unusual case of unilateral, nonfusion of the neural arch of the sixth cervical vertebra, documented with conventional X-ray examination and computed tomography. A brief review of other forms of congenital clefts is given and correlated with embryological findings.

Monocytic leukaemia associated with myeloid metaplasia, resembling metastatic bone disease.

A case of lethal, subacute monocytic leukaemia is described in which the development of multiple sclerotic bone lesions, resembling metastases, was due to secondary myeloid metaplasia. The spectrum of leukaemic involvement of the skeleton is discussed with emphasis on sclerotic bone lesions. The differential diagnosis of other focal areas of bone sclerosis is considered.

Comparative study of ultrasound and ERCP in the diagnosis of hepatic, biliary and pancreatic diseases: a prospective study based on a continuous series of 424 patients.

A prospective study of the diagnostic yield of ultrasound (US) and ERCP was made on a continuous series of 424 patients. Technical failures were slightly more frequent with US (11%) than with ERCP (8%), while US proved more accurate than ERCP in the diagnosis of focal hepatic disease--94% of correct diagnosis versus 41% (n = 17). In diffuse hepatic disease (n = 63) the accuracy of both methods was the same--87% of correct diagnosis with US, 83% with ERCP. US had better performances (91%), while ERCP was more accurate in the diagnosis of common duct lithiasis or tumour (98% for ERCP, 36% for US). Although ERCP has a better diagnostic yield for pancreatic diseases (92% to 100% of correct diagnosis according to the lesions) associate complications, such as pseudo-cysts, abscess formation and extravasations are better demonstrated by US (95% of correct diagnosis versus 73%). The two methods thus prove to be complementary.

Osteopathia striata with cranial sclerosis. Report of a case and review of the literature.

This article describes a case of osteopathia striata with cranial sclerosis. The patient also has multiple sclerosis. The symptomatology includes a right sided conduction deafness and a left maxillar nerve deficit, which were both attributed to the bone disorder. The authors review the literature of this rare genetic syndrome and pay special attention to the neurological manifestations. These mainly consist of hearing loss, mental subnormality and occasionally the involvement of other cranial nerves. The bone scan in their patient shows hyperactivity in the left skull base region. This finding provides further evidence that, at least in some instances, the bone disorder has a progressive course.

The value of computed tomography scanning in chondromalacia patellae.

Sixty seven patients with pain in the knee were studied. A compound tomography (CT) score indicating chondromalacia was devised, based on the results of CT after arthrography. This score takes account of the regularity, the congruity, and the imbibition of contrast material. Thus the patients could be divided into four groups: those who definitely have chondromalacia (++), probably (+), probably not (+/-), and definitely not (-). These results were compared with the clinical diagnosis based on clinical signs, arthroscopy, or operation. Eighteen patients had clinically proved chondromalacia, CT scored 14++, 3+ and 1+/-. Twenty nine patients had no chondromalacia, CT scored 19-, 8+/-, and 2+. Twenty patients had an uncertain clinical diagnosis. Arthrography was less accurate in detecting chondromalacia.