ABSTRACT
The authors present a case of "surfer's myelopathy," a rarely described syndrome characterized by nontraumatic paraparesis/paraplegia in novice surfers and theorized to result from spinal cord ischemia secondary to surfing-related positional hyperextension. Imaging and clinical course of the youngest known affected individual are discussed, including evidence of acute spinal cord infarction on diffusion-weighted magnetic resonance imaging, a finding not previously described in the literature.
Subject(s)
Diffusion Magnetic Resonance Imaging/methods , Spinal Cord Ischemia/diagnosis , Sports , Adolescent , Diagnosis, Differential , Female , Humans , Spinal Cord Ischemia/etiology , Spinal Cord Ischemia/rehabilitation , SyndromeABSTRACT
U.S. Navy Asbestos Medical Surveillance Program B-reading reports were analyzed for variability in identifying pneumoconiosis in 278,944 chest radiographs done from 1990 to 2004 using commercial database and statistical software. Reported presence of pneumoconiosis by 33 B-readers ranged from 1.85 to 32.28%. The reported presence of parenchymal abnormalities ranged from 0.11 to 15.07%; increased profusion (to 1/0 or greater) of small parenchymal opacities ranged from 0.10 to 17.70%; presence of large opacities ranged from 0.00 to 0.67%; and presence of pleural abnormalities ranged from 1.08 to 23.93%. Ranges appear to be decreasing slightly as rates of abnormal findings are diminishing. Differences between U.S. East Coast, West Coast, and midcontinent were not statistically significant.
Subject(s)
Asbestos/toxicity , Military Personnel , Naval Medicine , Occupational Health , Pneumoconiosis/diagnostic imaging , Population Surveillance , Databases as Topic , Humans , Pneumoconiosis/epidemiology , Pneumoconiosis/etiology , Radiography , Risk Factors , Time Factors , United States/epidemiologyABSTRACT
OBJECTIVE: To study the impact of variability among B-readers on clinical occupational medicine. METHODS: A total of 419,770 B-reading reports from February 1980 to May 2004 in the US Navy Asbestos Medical Surveillance Program were analyzed for changes in category from the previous B-reading on each individual worker. RESULTS: Over 7% of films were categorized as worse (ie, read as going from negative to positive), and over 6% were categorized as better. When profusion categories were reported as different from the previous reading (over 6% of the time), they were more frequently read as 2 or more minor categories worse or better. CONCLUSIONS: Changes from previous B-readings are common, and may have clinical and other implications, which are discussed. B-readings should not be used as the sole basis for determining the presence or absence of pneumoconiosis.
