Myelography in the Assessment of Degenerative Lumbar Scoliosis and Its Influence on Surgical Management.

Objective: Myelography has been shown to highlight foraminal and lateral recess stenosis more readily than computed tomography (CT) or magnetic resonance imaging (MRI). It also has the advantage of providing dynamic assessment of stenosis in the loaded spine. The advent of weight-bearing MRI may go some way towards improving assessment of the loaded spine and is less invasive, however availability remains limited.

Ultrasound-guided intervention in the ankle and foot.

In this comprehensive review, we discuss the main interventions performed in the foot and ankle for Achilles tendinopathy, Morton's neuromas and Plantar fasciitis as well as techniques for intra-articular and peritendinous injections. We present the different imaging techniques and injectable agents that can be used in clinical practice, trying to help the reader decide the most appropriate way of managing the patient with a problem in the ankle and foot.

Septic arthritis of unilateral lumbar facet joint with contiguous abscess, without prior intervention.

A 40-year-old female patient presented with persistent severe back pain radiating to the right leg, abdominal pain and constipation. Other clinical symptoms included nausea, vomiting and high-grade fever. Clinical examination showed generalised abdominal and lower back tenderness.

Acute gastric volvulus: an uncommon complication of a hiatus hernia.

An 80-year-old male patient with a history of a hiatus hernia presented with acute abdominal pain and vomiting. CT of his abdomen revealed extraluminal free gas consistent with a perforation. He had a large hiatus hernia.

Calcific tendonitis of the tibialis posterior tendon at the navicular attachment.

Calcific tendinosis (tendonosis/tendonitis) is a condition which results from the deposition of calcium hydroxyapatite crystals in any tendon of the body. Calcific tendonitis usually presents with pain, which can be exacerbated by prolonged use of the affected tendon. We report a case of calcific tendinosis in the posterior tibialis tendon at the navicular insertion.

Sacral insufficiency fractures.

Purpose: To highlight difficulties in the diagnostic process and the validity of imaging techniques for sacral insufficiency fractures.

Methods: Records of 25 women aged 68 to 95 years with sacral insufficiency fractures were reviewed. Baseline blood biochemistry and haematology test results were obtained.

Multislice CT in imaging of trauma of the spine, pelvis and complex foot injuries.

Multislice CT (MSCT) has greatly enhanced the performance of CT scanners and has vastly improved imaging of musculoskeletal trauma. Fast, high resolution scanning is now possible. In our institution, MSCT is an essential part of the imaging of the traumatized patient.

Comminuted fracture of the ulnar sesamoid of the metacarpophalangeal joint of the thumb: an uncommon injury.

Fracture of the ulnar sesamoid of the metacarpophalangeal joint of the thumb is rare. Injury may be caused as a result of hyperextension or, less frequently, direct trauma. A sesamoid may be incompletely ossified, making it difficult to diagnose the fracture on radiographs.

Chronic contained leak of abdominal aortic aneurysm presenting as lumbar neuropathy.

Chronic contained rupture of aortic aneurysm is a rare event which can cause diagnostic difficulties. It can present as high lumbar neuropathy, hence, chronic contained rupture should be borne in mind while examining patients with back pain. Delayed diagnosis and delayed surgical repair of the ruptured aneurysm can compromise the final results.

Ultrasound imaging of forearm fractures in children: a viable alternative?

Objective: A pilot study to investigate whether ultrasonography can be reliably used to demonstrate uncomplicated greenstick and torus fractures in children.

Method: Children between the ages of 2 and 14 years with a high clinical suspicion of a non-articular, undisplaced forearm fracture were included. Ultrasound imaging of the injury was performed by a consultant radiologist who gave an immediate report.

A comparison of barium swallow and erect esophageal transit scintigraphy following balloon dilatation for achalasia.

We evaluated the relationship between radionuclide esophageal transit studies and barium swallow appearances in a group of patients following forceful balloon dilatation for the treatment of achalasia of the cardia. Paired erect radionuclide esophageal transit studies and erect barium swallows of a group of patients who had undergone pneumatic balloon dilatation for the treatment of achalasia were analyzed. Indices derived from the radionuclide transit study were the percentage of maximum activity remaining in the esophagus 30 s after swallowing a dilute volume of tracer (A30 s) and the percentage of retained activity remaining at 100 s after washout with a bolus of water (A100 s).

Magnetic resonance imaging of the lumbar spine: direct access for general practitioners.

At the Cardiff Royal Infirmary we have offered general practitioners (GPs) direct access for magnetic resonance imaging (MRI) of the lumbar spine for sciatica or suspected spinal claudication since January 1993. We compared referrals for MRI from GPs and hospital outpatient doctors, and assessed GP patient management following the scan report. No difference in the diagnostic rates for disc herniation and spinal stenosis were found.

Impact of MRI on a knee arthroscopy waiting list.

As part of a waiting list initiative, magnetic resonance imaging (MRI) scans were arranged for 69 patients waiting for knee arthroscopy. All patients had a clinical diagnosis of a meniscal tear. With 11 non-attenders, 58 scans were performed.

Bile duct stenting: a comparison of the One-Action Stent introduction system with the conventional delivery system.

Background And Study Aims: A "One-Action Stent Insertion System" (OASIS) for use with biliary stents has been produced, which is said to be easier to use than conventional insertion systems. The aim of this study was to assess whether there was any measurable difference in the technique in a comparison between the two methods.

Patients And Methods: A prospective study was carried out.

Percutaneous transluminal angioplasty of an innominate artery occlusion.

A middle-aged woman presented with recent-onset left hemiparesis and right subclavian steal syndrome. She was found to have an obstructed innominate artery. We successfully performed balloon angioplasty of the occluded innominate artery and encountered no complications during follow-up of currently 8 months.

Tuberculosis contact tracing: are the British Thoracic Society guidelines still appropriate?

The value of contact tracing in South Glamorgan for the period May 1987 to December 1989 was assessed. Tuberculosis was diagnosed in six (3.5%) of 170 close contacts.

Audit of a tuberculosis contact tracing clinic.

Objective: To determine the efficiency of tuberculosis contact tracing in South Glamorgan 1987-9.

Design: Review of records of contact tracing clinic and of data from the Mycobacterium Reference Unit. The clinic's practice was compared with 1983 British Thoracic Society's recommendations.