Clinical radiology
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Case Reports
Ultrasonic and comparative angiographic appearances of a spontaneous aorto-caval fistula.
A 71-year-old man with an atherosclerotic abdominal aortic aneurysm developed a spontaneous aorto-caval fistula. The ultrasound appearances showing a direct fistulous communication between the inferior vena cava and the aorta are presented and these are correlated with the angiographic appearances.
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Elevation of the fat pads around the elbow joint is a well recognised radiological sign of a joint effusion which may be due to trauma or other inflammatory process. There are occasions when plain radiographs fail to demonstrate this sign. ⋯ The normal ultrasonic appearances are described. Ultrasound examination may be useful in patients where plain radiographs have failed to demonstrate the position of the fat pads.
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Two cases are reported in which accidental inhalation of barium contrast medium occurred owing to disordered swallowing in elderly women. In each case there was a pulmonary inflammatory reaction followed within a few hours by death. Experimental and clinical reports of barium inhalation are reviewed and the hazard of aspiration of high density barium preparations in elderly and debilitated patients with dysphagia is emphasised. It is concluded that particular care should be taken in the radiological examination of such patients, and a suggested method for performing a contrast swallow in those who are liable to aspirate is described.
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This study describes high field magnetic resonance imaging (MRI), in 55 patients with suspected metastatic spinal cord compression. MRI, principally using T1-weighted sagittal surface coil images, showed evidence of cord compression in 29 patients, and intramedullary masses in three patients. ⋯ Comparison with conventional myelography was possible in 21 patients and MRI was superior or equivalent to myelography in 18 patients and inferior in three patients. MRI is the method of choice for the investigation of patients with suspected metastatic spinal cord compression.
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A retrospective study of the wrist radiographs of 1453 patients presenting with acute wrist trauma was undertaken in order to assess the value of soft tissue signs. A total of 773 radiographs which were judged to be normal were used to evaluate the normal pronator quadratus fat stripe. The distance of the normal pronator fat stripe from the radius was shown to be significantly lower in females than in males and increased with age. ⋯ Although most fractures were associated with some soft tissue abnormality, certain fractures, especially greenstick fractures in children, had normal soft tissue planes. Only 4% of the wrists examined had soft tissue abnormalities with no visible fracture. The presence of soft tissue signs should therefore be considered with suspicion when evaluating wrist radiographs in trauma, but the absence of signs does not necessarily exclude a fracture.