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  • 1
    ISSN: 1438-1435
    Keywords: Tomography, x-ray computed ; Mandible, injuries ; Facial injury ; Computed tomography, helical
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 36-year-old man was brought to the emergency department after being assaulted. A mandible series showed a nondisplaced fracture through the angle of the mandible extending through the left third molar tooth. Axial slices from a nonhelical computed tomographic (CT) examination of the head as well as a helical CT examination of the mandible failed to demonstrate the fracture. The fracture was well shown, however, on sagittal CT reformations. Although CT is generally regarded as more sensitive than plain radiography for the detection of fractures, fractures may be overlooked by CT if examination in only one plane is performed.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1438-1435
    Keywords: Diaphragmatic rupture ; Blunt abdominal trauma ; Magnetic resonance imaging ; Plain radiographs ; Computed tomography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Two patients are reported with rupture of the right and left hemidiaphragms, respectively, after blunt abdominal trauma. The diagnosis in both cases was suggested by plain radiographs and computed tomography but was confirmed by magnetic resonance imaging. The magnetic resonance scan in both cases clearly showed the diaphragmatic injury and herniation of abdominal contents into the chest.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1438-1435
    Keywords: Thoracic spine fracture ; Portable chest radiograph ; Paraspinal hematoma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Early detection of thoracic spine fracture in the often unconscious multiple trauma patient is of utmost importance. Failure to recognize thoracic spine fracture early could result in neurologic injury during certain radiologic and therapeutic procedures that may be indicated for other injuries. In most trauma centers, the initial evaluation of the multiple trauma patient includes a portable chest radiograph, which may show signs of thoracic injury. To determine the value of the initial portable chest radiograph in the detection of thoracic spine fracture, 34 cases of multiple trauma patients with proven thoracic spine fractures were studied. The initial portable chest radiograph was reviewed for signs of thoracic fracture and compared with the findings on plain bone radiographs and computed tomographic scans and with the patient's medical record. Of the 34 cases, radiologic signs of fracture were initially reported in 18 patients (53%). On re-review, positive signs of fracture were seen in 27 patients (79%). The authors conclude that the initial portable chest radiograph in the multiple trauma patient must be carefully studied for subtle signs of thoracic spine fracture. The most frequent chest radiographic findings were paraspinal hematoma, decreased vertebral body height, and lateral translation of vertebral bodies. Apical pleural cap, increased interpediculate distance, increased interspinous distance (“empty vertebral body sign”), and rib disarticulation were also noted.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1438-1435
    Keywords: Computed tomography ; Pneumatosis intestinalis ; Volvulus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An 80-year-old man presented with progressive left-sided abdominal pain and distention. His abdominal plain radiograph revealed a focally dilated, redundant loop of sigmoid colon, having a mottled appearance. A computed tomographic (CT) scan with soft tissue settings showed no evidence of pneumatosis; however, with lung window settings [mean, —600 Hounsfield units (HU); width, 1000 HU], intramural pockets of air were seen in the bowel wall. The pneumatosis was presumed secondary to recurrent sigmoid volvulus. The utility of CT lung windows to evaluate the gastrointestinal tract in patients with acute abdominal conditions cannot be overemphasized.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1438-1435
    Keywords: Computed tomography ; Appendix ; Appendicitis ; Helical
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Our objective was to describe a new, helical computed tomographic (CT) technique for evaluating appendicitis, the focused appendix CT (FACT), and report preliminary experience with its use. Thirty-five consecutive patients were selected on the basis of clinical suspicion for appendicitis. Patients received oral and colon contrast media but not intravenous contrast medium before CT scanning. A thinsection, contiguous helical scan limited to the lower abdomen and upper pelvis was performed. Each scan was interpreted as positive or negative for appendicitis, and any alternative pathology was noted, if present. Seventeen patients had a final diagnosis of appendicitis at surgery and pathology, and 18 patients had appendicitis excluded at clinical follow-up for at least 3 months (17 patients) or at surgeryand pathology (1 patient). FACT interpretations were correct in all cases. Alternative pathology was noted in 13 of the 18 cases (72%) interpreted as negative for appendicitis.
    Type of Medium: Electronic Resource
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