The crowned dens syndrome. Evaluation with CT imaging.

Purpose: The purpose of this study was to verify the value of computed tomography (CT) in the diagnosis of the "crowned dens" syndrome, not only in crystal deposition diseases, but also in other rheumatic or nonrheumatic conditions.

Materials And Methods: Thirty-eight patients (15 men and 23 women; mean age 55 years; age range 35-79) with neck pain were examined and divided into two groups: (1) patients already identified as rheumatic and referred for further investigation of the atlantoaxial region; (2) patients with symptoms confined to the cervical spine, with inconclusive radiographic findings. Unenhanced CT of the cervical spine (Tomoscan SR 7000 Philips, Eindhoven, Netherlands) was performed in all patients.

Perception and reality in a case of suspected cervical fracture.

The case of a 36-year-old female, who following a road accident, had a cervical whiplash, is discussed. A radiographic examination of the affected region was performed at the Emergency Department. It showed a transverse radiolucent line at the basal odontoid process of the axis.

Correlation of multimodality imaging in Paget's disease of bone.

Purpose: The aim of this study is double: 1. to review the known and less known radiographic patterns of Paget's disease of bone, employing the most recent imaging techniques; 2. to propose a rationale algorithm for the diagnosis and management of the disease.

The value of computed tomography in the diagnosis of low back pain. A review of 2,012 cases.

Aim: The aim of this study was to establish the effective role of CT in the diagnosis of low back pain, and whether CT features correlate with clinical signs and symptoms.

Methods: Two thousand and twelve consecutive patients, of which 866 males and 1,146 females, aged 22 to 91 years, affected by generic painful back, have been studied in the period between January 2000 and October 2002. Volumetric CT of the lumbo-sacral column was performed on all the patients, employing a Philips Tomoscan SR 7000 (Eindhoven, The Netherlands).

Association between monoclonal gammopathy of undetermined significance (MGUS) and diffuse idiopathic skeletal hyperostosis (DISH).

Purpose: To determine whether an association exists between monoclonal gammopathy of undetermined significance (MGUS) and diffuse idiopathic skeletal hyperostosis (DISH).

Materials And Methods: Radiological studies of skeleton were performed in a series of 76 patients (51 males and 25 females) affected by MGUS, observed in a consecutive period of 36 months. They revealed hyperostotic lesions similar to those described in DISH.

[Metastatic bone disease. Strategies for imaging].

Skeletal metastases represent the most common malignant bone tumor. They occur mainly in adults and even more frequently in the elderly. The most common metastases in men are from prostate cancer (60%) and in women from breast cancer (70%).

Bronchial carcinoid tumors: clinical and radiological correlation.

Purpose: To evaluate the incidence of bronchial carcinoid tumor (BCT) in population affected by various lung tumors, retrospectively reviewed between 1986-2001, and to emphasize the radiographic patterns if they are characteristic.

Materials And Methods: In the above mentioned period, chest x-ray and CT were performed in 1110 patients, both male and female, affected by lung neoplasms.

Results: 20 patients were affected by BCT (16 males, and 13 females), aged between 26 and 75 years (mean age 57.

[Diagnostic imaging of bone metastases].

Purpose: To present an "algorithm" for detection and diagnosis of skeletal metastases, which may be applied differently in symptomatic and asymptomatic cancer patients.

Material And Methods: February to March 1999 we randomly selected and retrospectively reviewed the clinical charts of 100 cancer patients (70 women and 30 men; mean age: 63 years, range: 55-87). All the patients had been staged according to TNM criteria and had undergone conventional radiography and bone scan; when findings were equivocal, CT and MRI had been performed too.

[Non-hodgkin's lymphomas of extranodal localization. Strategies for imaging diagnosis].

Purpose: To evaluate the diagnostic workup proposed by the UICC (International Union against Cancer) Flow charts for diagnosis and staging of lymphomas in developed and developing countries (1998).

Material And Methods: Our series consists of 134 patients with early non-Hodgkin's lymphoma (NHL). The patients, 75 men (56%) and 59 women (44%), ranging in age 14-80 years (mean: 56.

Rheumatoid arthritis: sequences.

Objective: Rheumatoid arthritis (RA) is an autoimmune disorder of unknown etiology characterized by symmetric, erosive synovitis and sometimes multisystem involvement. It affects 1% of the adult population and exhibits a chronic fluctuating course which may result in progressive joint destruction, deformity, disability and premature death. We review the literature data relative to the peculiar pathologic features of the disease shown by diagnostic imaging techniques.

[Role of computerized tomography in the diagnosis of bone disease in multiple myeloma].

Purpose: To assess the role of CT in the diagnosis and management of multiple myeloma (MM) and to investigate if CT findings can influence the clinical approach, prognosis and treatment.

Study Design And Patients: We reviewed the findings relative to 273 MM patients submitted to CT June, 1994, to December, 1996. The patients were 143 men and 130 women (mean age: 65 years): 143 were stage I, 38 stage II and 92 stage III according to Durie and Salmon's clinical classification.

[Periodontal disease in patients with HIV infection. Radiographic study].

A painful and rapidly progressive form of periodontitis--involving both soft tissue and bone, with gingival bleeding and loss of teeth--was observed in HIV-patients in the mid-80's. Today, there are few reports regarding the real incidence of periodontitis in HIV populations: however, it seems not as high as first supposed on discovering the disease, and bacterial plaque is moderate, compared with "conventional" periodontitis. Since there are few radiologic studies, the Authors report on the clinical-radiographic patterns of periodontitis in 20 HIV patients, compared to 20 normal controls.

[Radiographic manifestations in teeth and jaws in chronic kidney insufficiency].

Forty-five patients affected with chronic renal failure (29 men and 16 women; mean age: 47.8 years), treated with hemodialysis for 4 to 245 months (mean: 66.9 months) were examined with panoramic and skeletal radiographs-the latter of the skull, hands, shoulders and clavicles, pelvis and spine.

[Diagnostic imaging of osteoid osteoma].

Conventional radiography, bone scintigraphy and Computed Tomography (CT) are the most useful tools to identify osteoid osteomas. We examined 26 patients (14 men and 12 women) with osteoid osteoma in different skeletal sites (13 femora, 3 tibiae, 3 hands, 2 peroneal bones, 2 humera, 2 spines and 1 talus) and compared the diagnostic yield of the above techniques. The fundamental radiographic findings in this benign bone lesion are the presence of a "nidus", with or without calcifications, perilesional sclerosis and periosteal new bone formation.

[Monoarthritis].

By definition, monoarticular arthritis means one-joint involvement, even though, in fact, such a condition is often an oligoarthritis because as many as two or three separate joints will be involved. Arthritis is often limited and may regress, so that it is frequently misdiagnosed. Sometimes, a monoarticular condition may be a polyarthritis onset (i.

Association between diffuse idiopathic skeletal hyperostosis and multiple myeloma.

Objective: To determine whether an association exists between multiple myeloma and diffuse idiopathic skeletal hyperostosis (DISH).

Design And Patients: Radiologic studies were performed over a 26-month period in a series of 97 consecutive patients with multiple myeloma (56 male and 41 female, aged 42-91 years).

Results: Both myelomatous bone lesions and hyperostosis similar to DISH were found in these patients.

[Significance and usefulness of SPECT with Tc-99m HMPAO in the diagnosis of hemicrania with aura].

It is generally agreed upon that the attacks of migraine with aura are indicative of abnormal cerebral perfusion, while the permanence of such perfusion abnormalities during the pain-free intervals of migraine remains debated. This study was aimed at assessing: 1) the presence of cerebral perfusion abnormalities also during the interictal phase and 2) the role of SPET with 99mTc HM-PAO to diagnose migraine. Twenty-eight patients (22 women and 6 men), diagnosed as having migraine with aura according to the International Headache Society (Headache Classification Committee criteria), were submitted to SPET studies, within 10 days of the last attack.

[Skeletal changes in the kidney transplant patient].

The skeletal status was investigated with noninvasive diagnostic procedures in 44 renal transplant patients (mean time since intervention: 5 to 195 months) treated with steroid and azathioprine (21 cases) or with steroid, azathioprine and cyclosporine (23 cases). 38.6% of the patients had reduced renal function (creatininemia: 1.

Platyspondyly in treated beta-thalassemia.

Flattening of the vertebral bodies with a platyspondyly appearance is described in 14 patients selected for evaluation of short stature from 106 patients affected by thalassemia major, who received an intensive transfusion regimen combined with continuous chelation therapy. The vertebral body height/width ratio was decreased at the level of all the investigated tracts, namely, cervical and/or dorsal and/or lumbar. The flattening of the vertebral bodies may be due to suppression of intramedullary hematopoiesis by a high transfusion regimen.

[Anomalies of the masticatory apparatus in beta-thalassemia. The present status after transfusion and iron-chelating therapy].

Fifty-four homozygous beta-thalassemic patients (26 men and 28 women) aged 7 to 24 years, who had been treated with high transfusion regimen (Hb levels = 9-10 g/dl) and chelation therapy (desferrioxamine, 35-50 mg/kg), underwent clinical and radiographic investigations. This study was aimed at assessing the clinical and radiographic changes in the stomatognathic system (teeth, mandible and maxilla, occlusion relationship and dental bases). All patients underwent orthopantomography and teleradiography of the skull, in the lateral view.

[The evolutionary effects of therapy on the skeletal lesions in beta-thalassemia].

Up to the mid-1960s, beta-thalassemia was treated with blood transfusions as frequent as needed to keep symptoms under control and to prevent transfusional hemosiderosis. In the following years, high transfusion regimens and iron chelation therapy with desferrioxamine were used. Because of these different treatment modalities, skeletal findings in thalassemia have markedly changed.

[Cephalometry and digital radiography. Technical note].

Conventional and digital lateral teleradiographs of the skull were performed on 6 consecutive patients (3 men and 3 women). The study was aimed at comparing the diagnostic capabilities of the two imaging techniques to measure points and angles, as derived from different cephalometric analyses (see text for details). These variables were analyzed by three different operators: for both techniques, 18 cephalometric tracings were made, including a total of 414 points and 36 angles.

[The temporo-mandibular joint in pathologic conditions: rheumatoid arthritis and seronegative spondyloarthritis].

Pain and dysfunction of the temporomandibular joint (TMJ) are major clinical problems, especially in arthritides and allied conditions. In the last 10 years, such new imaging methods as arthrography, CT and MRI have been developed, but many problems are still to be solved. This study was aimed at reporting the radiographic patterns of lesions in TMJ rheumatoid arthritis and seronegative spondyloarthropathies and at investigating the role of conventional radiology in the assessment of these disorders.