AJR. American journal of roentgenology
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AJR Am J Roentgenol · Apr 1994
ReviewProliferative and constrictive bronchiolitis: classification and radiologic features.
The small airways of the lung consist of the terminal bronchioles, respiratory bronchioles, and alveolar ducts. A recently introduced pathologic classification system divides bronchiolitis into proliferative and constrictive types. ⋯ Proliferative bronchiolitis is characterized by air-space opacification, whereas constrictive bronchiolitis tends to be associated with lobular areas of decreased attenuation and airway dilatation. The purpose of this essay is to illustrate the radiographic and CT features of these two varieties of bronchiolitis.
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AJR Am J Roentgenol · Apr 1994
Fracture of the spine in patients with ankylosis due to diffuse skeletal hyperostosis: clinical and imaging findings.
Only 12 patients with a fracture through a portion of the spine ankylosed by diffuse idiopathic skeletal hyperostosis have been reported. The purpose of this study was to determine the types of causative trauma, spinal sites at risk for fracture, complications mortality, diagnostic difficulties, and abnormalities identified only with special imaging studies in a group of 15 patients with this complication seen at our institution. ⋯ Trivial trauma was the most common cause of fracture in the spine ankylosed by diffuse idiopathic skeletal hyperostosis. The severity of spinal cord injury in our patients was greater than in previous reports. We suggest that this may be a function of the relatively long segments of ankylosed spine (average, 16 vertebrae) in our patients providing a long lever arm for any traumatic force to act on. Patients with shorter ankylosed segments had less severe cord injuries. Delay in diagnosis of a fracture through an area of ankylosed spine associated with diffuse idiopathic skeletal hyperostosis was common if no neurologic deficit was present, and led to permanent paraplegia in two of three patients. CT and MR studies were useful in determining the anatomic abnormalities present, but were performed only in a limited number of patients.
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AJR Am J Roentgenol · Apr 1994
ReviewCT of the lung in patients with pulmonary emphysema: diagnosis, quantification, and correlation with pathologic and physiologic findings.
Pulmonary emphysema is a pathologic diagnosis. However, the diagnosis can be made with relative certainty on the basis of clinical and radiologic criteria. ⋯ Additionally, features of other obstructive lung diseases may overlap. From the clinician's standpoint, the main value of differentiating between emphysema and other obstructive diseases of the airways (e.g., asthma and chronic bronchitis) is to (1) establish a prognosis and (2) guide the use of corticosteroid therapy by defining the degree of reversibility that can be expected in patients with limitation in air flow.
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AJR Am J Roentgenol · Apr 1994
Case ReportsLarge-bowel obstruction resulting from traumatic diaphragmatic hernia: imaging findings in four cases.
Large-bowel obstruction is most often due to primary carcinoma, diverticulitis, or volvulus. In populations of patients in which trauma is prevalent, however, an additional important consideration is traumatic diaphragmatic hernia. We describe the findings on plain radiographs and single-contrast enema in four adults who had vague complaints of abdominal pain days to months after an abdominal stab injury and large-bowel obstruction resulting from herniation of colon or omentum through the left hemidiaphragm. ⋯ Delayed herniation through a trauma-induced defect in the left hemidiaphragm can be an unsuspected cause of large-bowel obstruction. Abnormalities of the left hemidiaphragmatic contour on plain radiographs of the chest should suggest the diagnosis in patients who have abdominal pain, colonic dilatation, and a history of abdominal injury.
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Clinical differentiation of peritonsillar abscess from peritonsillar cellulitis can be difficult and often relies on blind needle aspiration of the tonsillar fossa to locate pus. The objective of this study was to establish a noninvasive and reliable sonographic technique for differentiating peritonsillar abscess from peritonsillar cellulitis in equivocal cases and to thereby avoid unnecessary needle aspiration. ⋯ These results show that enlarged tonsils can be visualized with transcutaneous sonography, but intraoral sonography is necessary to adequately define the heterogeneous or cystic nature of a peritonsillar abscess. Intraoral sonography is a useful, simple, and well-tolerated noninvasive technique that can be used to accurately differentiate peritonsillar abscess from peritonsillar cellulitis in clinically equivocal cases. This technique eliminates the need for blind needle aspiration of the tonsillar fossa before surgical drainage. Intraoral sonography also can be used to monitor patients' responses after treatment.