AJR. American journal of roentgenology
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AJR Am J Roentgenol · Sep 1985
Assessment of the radial head-capitellum view and the dorsal fat-pad sign in acute elbow trauma.
The radial head-capitellum (RHC) view was assessed in a prospective study of 130 patients with acute elbow trauma in whom 35 fractures were identified. The RHC view demonstrated only 16 of the 32 fractures available for review, including one fracture that was not seen on routine projections. ⋯ Routine use of the RHC projection is not justified in all cases of elbow trauma. It may be added in cases in which no fracture has been identified but clinical suspicion remains high or displaced fat pads are seen on the routine projections.
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AJR Am J Roentgenol · May 1985
Case ReportsCT evaluation of tarsometatarsal fracture-dislocation injuries.
Fracture-dislocation in the tarsometatarsal region (Lisfranc) may be subtle and difficult to recognize on standard radiographic projections. Computed tomography (CT) was used to study the normal anatomy of the forefoot and to evaluate three patients with suspected tarsometatarsal fracture dislocation. The advantages of CT in the evaluation of forefoot trauma are emphasized.
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Three patients had hydropneumothoraces in which the air-fluid interfaces were tilted from the horizontal. One was examined fluoroscopically, and the interface "seesawed" synchronously with the heartbeat. Displacement of the fluid by cardiac pulsation is the most likely usual cause of tilted air-fluid interfaces in the chest.
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A prospective evaluation for occult pneumothorax was performed in 25 consecutive patients with serious head trauma by combining a limited chest CT examination with the emergency head CT examination. Of 21 pneumothoraces present in 15 patients, 11 (52%) were found only by chest CT and were not identified clinically or by supine chest radiograph. Because of pending therapeutic measures, chest tubes were placed in nine of the 11 occult pneumothoraces, regardless of the volume. Chest CT proved itself as the most sensitive method for detection of occult pneumothorax, permitting early chest tube placement to prevent transition to a tension pneumothorax during subsequent mechanical ventilation or emergency surgery under general anesthesia.