Skeletal manifestations of lysinuric protein intolerance. A follow-up study of 29 patients.

Lysinuric protein intolerance (LPI) is an autosomal recessive disease caused by defective transport of the cationic amino acids lysine, arginine, and ornithine at the cell membrane. About 80 patients with LPI have been described worldwide, almost half of them in Finland. The symptoms appear in early childhood as a failure to thrive, growth retardation, muscular hypotonia, and episodes of stupor after protein-rich meals.

Cortical thickness and trabecular pattern of the femoral neck as a measure of osteopenia.

The pelvic radiographs of 312 patients aged 18 to 92 years were reviewed to determine if the Singh index was valid or not. The cortical thickness of the lower part of the femoral calcar, the stress index (body weight, physical activity, and femoral neck angle), and the Singh Index (trabecular pattern of the femoral neck) were measured in each patient and correlated with each other and with the patient's age, sex, and dominant side. It was found that the Singh index correlates well with age but not with the cortical thickness or stress index.

F-18 fluorodeoxyglucose: its potential in differentiating between stress fracture and neoplasia.

F-18 fluorodeoxyglucose (FDG) accumulates into regions of enhanced glucose uptake and metabolism such as the brain, heart, and malignant tumors. The clinical usefulness of this positron-emitting radiopharmaceutical is illustrated in a case where the clinical picture and CT indicated a malignant bone lesion in the clavicle. Histologically a stress fracture was found secondary to chronic strain on the clavicle.

Bone scintigraphy in polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy.

Five patients with polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (PLO-SL) were investigated using bone scintigraphy. Abnormal findings were detected in hands, wrists, knees, ankles and feet of all five patients.

Juxta-articular erosions in reflex sympathetic dystrophy.

Thirty-one patients with documented reflex sympathetic dystrophy syndrome (RSDS) were reviewed for their radiographic changes. Juxta-articular and metaphyseal bone loss was found in the majority of the patients. Juxta-articular bone loss closely resembling erosions seen in rheumatoid arthritis was found in all the patients.

Hemiaplasia of the posterior atlantic arch with a low-lying posterior tubercle.

A case of hemiaplasia of the posterior arch of the atlas with an ossification in the region of the posterior tubercle is presented. The low position of the ossification compared to the contralateral posterior tubercle was concluded to be a part of the anomaly.

Stress response of the tibial cortex: a longitudinal radiographic study.

The influence of physical exercise on bone tissue was studied in a sample of 30 conscripts, who served in the coast commando battalion . A repeated roentgen examination of the lower legs was performed after 10, 20 and 40 weeks' service. In the anterior cortex of mid-diaphysis of the tibia a structural change in bone could be regularly observed.

Double-contrast examination of the stomach: 100mm fluorography vs. full-size radiography.

Full-size radiographs and 100mm fluorographic spot views taken with an image intensifier were compared during double-contrast examination of the stomach. Differences in image quality between the two modalities were small; there was also a small decrease in absorbed dose, since fluoroscopy comprised more than half of the total dose. The authors recommend that 100mm spot views be used routinely in double-contrast examination of the stomach.

Value of high contrast medium dose in brain CT.

Fifty-five patients with brain lesions were examined by computed tomography (CT) after two doses of contrast medium: a bolus injection of 65% meglumine diatrizoate, 1 ml/kg, and a bolus injection of 65% meglumine diatrizoate, 1.5 ml/kg, in combination with an infusion of 250 ml meglumine iodamide containing 110 mg I/ml. The studies were usually performed 2 days apart and were analyzed by three radiologists.

Radiologic bone changes of polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy.

More than 50 cases of polycystic lipomembranous osteodysplasia (PLO) with sclerosing leukoencephalopathy (SL) have been described in Finland, Sweden, Japan, and in the USA. Radiographic bone changes, including symmetrical cystic lesions in the small bones of the extremities and trabecular loss in the distal ends of the long tubular bones, represent primary abnormalities in the diagnosis of the disease. Neuropsychiatric symptoms, frontal syndrome, and pyramidal signs make the patients dangerous to themselves.

Late haemodynamic response to metrizamide and ioxaglate in canine renal angiography. Preliminary report.

The renal blood flow as examined in six dogs for 2 h after contrast agent injection into the renal artery using the dye dilution method. After injection of an ionic contrast agent (iodamide) there was an initial vasodilatation and later constriction, but the blood flow was back to normal after 10-15 min. Ioxaglate caused a similar initial response, but after a relatively large dose the blood flow remained below normal for 2 h.

Achilles tendon thickness in hypercholesterolaemia.

The maximum thickness of the achilles tendon was measured by radiographic technique in twenty-six hypercholesterolaemic patients and thirty-four controls. There were thirteen patients with diagnostic criteria of familial hypercholesterolaemia. All achilles tendons except one of the familial hypercholesterolaemic patients were thicker than normal, but in the non familial hypercholesterolaemic group the thickness of achilles tendons was within normal limits.

Estimating rate of growth in bone lesions: observer performance and error.

In an experimental study of reader experience in identifying the variables essential to grading bone neoplasms, reader error is measured against book grade, a human consensus of the presence or absence of key variables. The average accuracy for classifying focal lesions into slow or fast categories is 83.4% for 890 readings as compared with average diagnostic accuracy of 53.

Determining growth rates of focal lesions of bone from radiographs.

Rate of growth divides focal lesions of bone into two classes which are largely mutually exclusive. Not all focal lesions require biopsy, and grading is especially helpful in deciding which should be biopsied and which may be safely followed. The statistical proof and logic of grading as an expression of growth rate are presented with a set of rules establishing each of the five grades in the presence of bone destruction.

Accuracy of 100 mm x 100 mm mirror optic camera technique as compared to normal chest radiography technique.

Full size and 100 mm x 100 mm mirror optic camera (photofluorographic) chest films of 121 patients were read by a team of four radiologists. Altogether 2781 diagnostic statements were reported, 968 of which were of primary importance, and only these statements were analysed. Error rates with the standard technique varied between 16 and 31% and with the 100 mm x 100 mm technique between 21 and 38%.

Computerised tomography of the pancreas with acute pancreatitis.

Twenty patients with clinically diagnosed or suspected pancreatitis were examined with computerised tomography. Five pseudocysts and one pancreatic abscess were found as a complication of the disease. Computerised tomography is a non-invasive method of diagnosis in acute pancreatitis and is especially valuable in diagnosing the complications of the disease.

Finger joint swelling: correlation with age, gender, and manual labor.

A soft tissue immersion radiography technique was used to study changes in 4,648 finger joints of 166 patients free from signs of inflammatory joint disease. An age-specific correlation was found for joint swelling, joint space narrowing, joint margin spurs, and intraarticular loose bodies. The distal interphalangeal joints were more commonly swollen in women, and the proximal interphalangeal and metacarpophalangeal joints more commonly swollen in manual laborers.

Computer aided diagnosis of bone tumors.

Four radiologists, three of whom having no special expertise in bone tumor radiology, analysed 177 bone tumors. One of the radiologists, using a computer aided bone tumor program, performed significantly better than the other two at a comparable level of training and was able to compete successfully with the fourth radiologist experienced in bone diagnosis. The results validate the assumption that computer aided diagnostic programs may improve the diagnostic accuracy of radiologists having limited experience with the problem at hand.

Direct measurement of the effect of film miniaturization on diagnostic accuracy.

A method for directly measuring the reduction in diagnostic accuracy incurred by altering original radiographs was applied to evaluate a 35 mm film system. A total of 4,290 readings of 2,145 proved cases were collected. Analysis of the results indicate that the 35 mm system reduced diagnostic accuracy by about 2.

[Clinical test of the Delcomat miniaturisation system (author's transl)].

A series of 1720 roentgen examinations consisting of 5178 roentgen films were copied with the Delcomat (de Oude Delft) copying apparatus. The copies were re-examined after some months, and the diagnoses were compared with the original ones made of normal size films. The diagnostic accuracy was in most examinations not significantly reduced.