Radiology
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To reduce the risk of accidental needle-stick injury during fine-needle aspiration biopsy, a syringe to be used in such procedures was modified. In five cases, a small hole, punctured in the barrel of a syringe above the level to which the plunger is routinely retracted, allowed the syringe to fill with air. The specimen was expressed onto a slide without the necessity of removing and reattaching the needle. This modification reduces the need to handle contaminated needles.
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The authors describe magnetic resonance (MR) imaging findings of acute traumatic dislocation of the patella. ⋯ Constant findings at MR imaging were (a) contusion of the lateral femoral condyle, (b) tear of the medial retinaculum, and (c) joint effusion.
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Stellate ganglion blockade, typically performed by using palpable osseous landmarks, is an accepted method in the diagnosis and treatment of sympathetically maintained pain and other conditions. The authors present the results of stellate ganglion injection performed with computed tomographic (CT) guidance. Thirteen CT-guided procedures were performed in seven patients. ⋯ The ipsilateral hand temperature changes and the differences between the ipsilateral and contralateral hand temperature changes exceeded 1.5 degrees C in every case. Five patients preferred the CT-guided procedure over the conventional technique, and two patients noted no substantial difference between the approaches. With the CT-guided technique, a highly effective sympathetic block is achieved with a substantially reduced volume of anesthetic compared with the conventional approach.
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Changes in imaging sinonasal inflammatory disease have paralleled changes in the treatment of chronic sinusitis. As functional endoscopic sinus surgery has become a more widespread technique, coronal computed tomography (CT) has become the primary imaging modality, replacing plain radiography. Knowledge of the plethora of sinonasal anatomic variations and the inherent surgical implications is critical to the interpretation of the CT scans and to the safe performance of endoscopic surgery. Currently, the role of magnetic resonance imaging is restricted to the evaluation of complicated sinusitis, intraorbital and intracranial manifestations of aggressive sinusitis, and sinonasal neoplasms.
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This study was done to evaluate the diagnostic accuracy of bedside chest radiography for pneumonia, adult respiratory distress syndrome (ARDS), or both in patients receiving mechanical ventilation. The series consisted of 40 patients; diagnostic accuracy was defined as the area under the receiver operating characteristic curve. Overall diagnostic accuracy for ARDS was 0.84. ⋯ The authors conclude that chest radiography is of limited value for the diagnosis of pneumonia in patients receiving mechanical ventilation. The high false-negative and false-positive ratings for pneumonia resulted in a low diagnostic accuracy. The high diagnostic accuracy for ARDS was primarily due to the well-defined radiographic appearance of ARDS and few false-positive ratings.