Association between clinical signs assessed by manual segmental examination and findings of the lumbar facet joints on magnetic resonance scans in subjects with and without current low back pain: a prospective, single-blind study.

The relevance of magnetic resonance imaging (MRI) findings such as facet joint (FJ) effusion and edema in low back pain (LBP) is still unknown. Therefore, we prospectively evaluated the presence of these MRI findings in the lumbar spine (Th12-S1) and their association with pain evoked by manual segmental FJ provocation tests (spinal percussion, springing, and segmental rotation tests) in 75 subjects with current LBP (≥30 days in the past 3 months) compared with 75 sex- and age-matched control subjects. FJs were considered painful, if ≥ 1 provocation test triggered LBP.

Evidence of a third ADPKD locus is not supported by re-analysis of designated PKD3 families.

Mutations to PKD1 and PKD2 are associated with autosomal dominant polycystic kidney disease (ADPKD). The absence of apparent PKD1/PKD2 linkage in five published European or North American families with ADPKD suggested a third locus, designated PKD3. Here we re-evaluated these families by updating clinical information, re-sampling where possible, and mutation screening for PKD1/PKD2.

[A combined mediastinal and retroperitoneal cystic lymphangioma as a rare cause of recurrent pleural effusion].

We report on a 71-year-old female patient with spontaneous unilateral recurrent chylothoraces - at first glance with no apparent cause. After performing CT, MRI, lymphatic scintigraphy, and CT-guided biopsy, we were able to establish the diagnosis of a combined mediastinal and retroperitoneal cystic lymphangioma. Together with a review of the literature concerning cystic lymphangioma, we also discuss possible differential diagnoses of chylothoraces.

Syndrome of inadequate antidiuretic hormone secretion in pulmonary tuberculosis - a therapeutic challenge.

A forty-nine-year-old female patient with pulmonary tuberculosis developed syndrome of inadequate antidiuretic hormone secretion. Consequent restriction of fluid intake as a therapeutic measure was just as ineffective as a medication with tolvaptan which was performed later on. A probable explanation for the inefficacy of the aquaretic drug is an interaction of rifampicine and tolvaptan.

[Analysis of image acquisition, post-processing and documentation in adolescents with spine injuries - comparison before and after referral to a university hospital].

Purpose: Systematic evaluation of imaging situation and standards in acute spinal injuries of adolescents.

Materials And Methods: Retrospective analysis of imaging studies of transferred adolescents with spinal injuries and survey of transferring hospitals (TH) with respect to the availability of modalities and radiological expertise and post-processing and documentation of CT studies were performed. Repetitions of imaging studies and cumulative effective dose (CED) were noted.

[Dispensing with sedation in pediatric MR imaging of the brain: what is feasible?].

Purpose: Feasibility study to evaluate whether a diagnostic pediatric MRI scan of the brain can be performed without sedation by using BLADE sequences with rotating blade-like k-space covering.

Materials And Methods: Between 01/09 and 12/10 all children with a planned MRI of the brain were included. After age-dependent preparation of the child the MRI was acquired with a parent closely attending.

Interventional radiology at the meetings of the German Radiological Society from 1998 to 2008: evaluation of structural changes and radiation issues.

Objectives: Evaluation of structural changes and the weight given to radiation exposure of interventional radiology (IR) contributions at the Congress of the German Radiological Association from 1998 to 2008.

Methods: All IR abstracts were evaluated for type of contribution, design, imaging modality, and anatomic region. Weight given to radiation exposure was recorded as general statement, main topic and/or dose reduction.

Somatotroph pituitary adenoma with acromegaly and autosomal dominant polycystic kidney disease: SSTR5 polymorphism and PKD1 mutation.

A 39-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) presented with acromegaly and a pituitary macroadenoma. There was a family history of this renal disorder. She had undergone surgery for pituitary adenoma 6 years prior.

B9D1 is revealed as a novel Meckel syndrome (MKS) gene by targeted exon-enriched next-generation sequencing and deletion analysis.

Meckel syndrome (MKS) is an embryonic lethal, autosomal recessive disorder characterized by polycystic kidney disease, central nervous system defects, polydactyly and liver fibrosis. This disorder is thought to be associated with defects in primary cilia; therefore, it is classed as a ciliopathy. To date, six genes have been commonly associated with MKS (MKS1, TMEM67, TMEM216, CEP290, CC2D2A and RPGRIP1L).

Multidetector-CT angiography in pulmonary embolism-can image parameters predict clinical outcome?

Objective: To assess if pulmonary CT angiography (CTA) can predict outcome in patients with pulmonary embolism (PE).

Methods: Retrospective analysis of CTA studies of patients with PE and documentation of pulmonary artery (PA)/aorta ratio, right ventricular (RV)/left ventricular (LV) ratio, superior vena cava (SVC) diameter, pulmonary obstruction index (POI), ventricular septal bowing (VSB), venous contrast reflux (VCR), pulmonary infarction and pleural effusion. Furthermore, duration of total hospital stay, necessity for/duration of ICU therapy, necessity for mechanical ventilation and mortality were recorded.

[Prognostic pulmonary and thoracic findings in patients with unstable injuries of the thoracic spine].

Background: Instable fractures of the thoracic spine imply a substantial trauma to the chest. The aim of this study was to undertake a systematic analysis of the prognostic impact of CT findings of the chest wall, mediastinum, lungs, and pleural space on the mortality rate.

Method: All multiple injury patients with instable fractures of the thoracic spine and initial CT scans treated in our clinic from April 2004 to May 2007 were eligible.

Efficacy of CT-guided biopsies of the spine in patients with spondylitis--an analysis of 164 procedures.

Objective: To evaluate efficacy of CT-guided spinal biopsy (CTSB) in patients with spondylitis considering patient characteristics, technical issues, antibiotic therapy, histopathological, and microbiological findings.

Materials And Methods: All CTSB procedures performed between 1995 and 2009 in patients with proven spondylitis were re-evaluated. Patient sex and age, antibiotic treatment, biopsy approach, number of specimens, length of needle path, laboratory results (CRP, WBC), and histopathological/microbiological findings were documented and compared to the final diagnosis of spondylitis.

Germline PKHD1 mutations are protective against colorectal cancer.

The autosomal recessive polycystic kidney disease (ARPKD) gene, PKHD1, has been implicated in the genesis or growth of colorectal adenocarcinoma, as a high level of somatic mutations was found in colorectal tumor tissue. To determine whether carriers of a single PKHD1 mutation are at increased risk of colorectal carcinoma, we assessed the prevalence of the commonest European mutation, T36M. First, we assayed a European cohort of ARPKD patients and found T36M was responsible for 13.

[Osteoporotic vertebral fractures in the elderly: are conventional radiographs useful? - clinical and radiographic results after kyphoplasty].

Aim: In a retrospective study we examined the reliability of conventional radiographs to detect osteoporotic vertebral fractures. Furthermore, we analysed clinical and radiological results 4 weeks and one year after balloon kyphoplasty.

Material And Methods: Between April 2007 and December 2008, 68 patients with 77 vertebral fractures were allocated to kyphoplasty.

Cumulative effective dose associated with radiography and CT of adolescents with spinal injuries.

Objective: The purpose of this study was to analyze the quantity and distribution of cumulative effective doses in diagnostic imaging of adolescents with spinal injuries.

Material And Methods: At a level 1 trauma center from July 2003 through June 2009, imaging procedures during initial evaluation and hospitalization and after discharge of all patients 10-20 years old with spinal fractures were retrospectively analyzed. The cumulative effective doses for all imaging studies were calculated, and the doses to patients with spinal injuries who had multiple traumatic injuries were compared with the doses to patients with spinal injuries but without multiple injuries.

[Paraganglioma--a rare cause of mediastinal lesions].

A 73-year-old female patient was admitted to our clinic for further clarification of a suspicious mediastinal lesion. Endosonographically, we performed a fine-needle aspiration biopsy. Clinical and radiological findings as well as cytology hardened the suspicion of a paraganglioma as being the cause of the mediastinal lesion.

Therapeutic mTOR inhibition in autosomal dominant polycystic kidney disease: What is the appropriate serum level?

Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease, and sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, has been shown to significantly retard cyst expansion in animal models. The optimal therapeutic dose of sirolimus is not yet defined. Here, we report the history of a previously unknown ADPKD deceased donor whose kidneys were engrafted in two different recipients.

Growth plate fractures of the distal tibia: is CT imaging necessary?

Purpose: Comparison of conventional radiographs (CR) of distal tibial growth plate fractures [Salter-Harris (SH) fracture types I-V/triplane fractures I-III] with computed tomography (CT) as the reference standard and assessment of diagnostic benefit of CT imaging in the affected patients.

Materials And Methods: We retrospectively evaluated all growth plate injuries of the distal tibia with complete pre-therapeutic imaging material (CR and CT including MPR) obtained between August 2001 and December 2006. The imaging material was randomised and presented to two radiologists.

Incompletely penetrant PKD1 alleles mimic the renal manifestations of ARPKD.

Autosomal dominant polycystic kidney disease (ADPKD), caused by mutation in PKD1 or PKD2, is usually an adult-onset disorder but can rarely manifest as a neonatal disease within a family characterized by otherwise typical ADPKD. Coinheritance of a hypomorphic PKD1 allele in trans with an inactivating PKD1 allele is one mechanism that can cause early onset ADPKD. Here, we describe two pedigrees without a history of cystic kidney disease that each contain two patients with onset of massive PKD in utero.

Multidetector computed tomography-spectrum of blunt chest wall and lung injuries in polytraumatized patients.

Accidental injuries are the leading cause of death in the 15 to 44-year-old age group. Blunt chest trauma is often encountered in these patients and is associated with a mortality of up to 25%. Although conventional radiography still plays an important role in the initial emergency room setting, for follow-up in the intensive care unit, multidetector computed tomography has established itself as the standard imaging method for the evaluation of chest trauma patients.

MRI in lipid-lowering agent-associated myopathy: a retrospective review of 21 cases.

Objective: The objective of our study was to identify disease-specific patterns of myopathic changes in patients with lipid-lowering agent (LLA)-associated myopathy using a dedicated MRI protocol.

Materials And Methods: Axial T1- and T2-weighted STIR images were obtained for the detection of lipomatosis and edema, respectively, of the thighs and legs. Information about patient age, sex, duration of dyslipidemia and of medication use, latency of symptom onset, maximum creatine kinase (CK) level, presence of myalgia and muscle weakness, and LLA or LLAs used was collected.