Journal of thoracic imaging
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Interstitial lung disease (ILD) is a frequent manifestation of rheumatoid arthritis (RA), and it has a close bearing on the prognosis of RA patients. Computed tomography (CT) has been shown to be excellent for the diagnosis of diffuse lung disease. In this study chest radiographs and high-resolution CT (HRCT) scans were obtained in 91 patients with RA to evaluate their ILD precisely. ⋯ HRCT was superior to chest radiographs for the detection of early interstitial changes. The histogram of HRCT values might be a useful adjunct to HRCT diagnosis by adding some degree of objectivity. HRCT is useful for the diagnosis of ILD in patients with RA.
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It is becoming increasingly clear that obstructive airway disease and early emphysema occur in some drug addicts who intravenously abuse drugs intended for oral use. We report four patients with such a history who had clinical, pathophysiologic, and radiologic evidence of severe obstructive airway disease with hyperinflation. ⋯ One patient had moderately severe emphysema at autopsy. The pathogenesis of this disease is uncertain but may involve synergism with cigarette smoke, direct toxic effects of the drug, or induced intravascular leukocyte sequestration causing proteolytic pulmonary injury.
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The article describes eight patients with enlarged internal mammary lymph nodes visualized on the frontal plain chest radiograph. Enlarged internal mammary lymph nodes cast shadows that initially may be mistaken for a mediastinal or pleural abnormality. Although the lateral film alone may suggest these nodes, the findings on the frontal film help lateralize the abnormality.
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Traumatic laceration of the pulmonary artery is rare and is associated with a high mortality rate. The article describes a patient with pulmonary artery laceration from blunt chest trauma who presented with tension pneumothorax. Potentially life-threatening intrathoracic bleeding was not apparent until the pneumothorax was decompressed.
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Magnetic resonance (MR) imaging has become the method of choice for evaluating patients with brachial plexopathy. The multiplanar capability of MR imaging and its superior ability to differentiate nerves from vessels and surrounding soft tissues contribute to its success. The article describes the MR anatomy of the brachial plexus in the axial, coronal, and sagittal planes and reviews the MR characteristics of traumatic and nontraumatic etiologies of brachial plexopathy.