Radiology
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A patient with a Kay-Shiley mitral prosthesis had abnormal intermittent systolic tilting of the prosthetic disc by cinefluoroscopy. Echocardiography revealed an abnormal "atrial emptying index" consistent with mitral obstruction. ⋯ At surgery, there was no prosthetic orifice obstruction. It was concluded that the atrial emptying index may be abnormally low in prosthetic mitral regurgitation without stenosis.
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An initial liver/spleen scan performed on a patient with blunt abdominal trauma was negative 3 days following the accident. A follow-up scan 7 days later showed definite evidence of splenic rupture, proved surgically. The authors conclude that, in such cases, spleen scans may be negative initially because of delayed splenic ruptures.
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Radiographic demonstration of three cases of lipohemarthrosis of the elbow is discussed. Lipohemarthrosis is superior to posterior fat pad as a more specific sign of elbow trauma because posterior fat pad merely indicates increased intra-articular pressure while lipohemarthrosis is due only to intracapsular fracture or cartilage and/or ligament injury. Little fat accumulated in the anterior compartment of the joint can be demonstrated by horizontal-beam technique and lipohemarthrosis may conceivably be observed before posterior fat pad is displaced dorsally. With horizontal-beam technique, the patient is more comfortable and it seems unnecessary to irradiate the other elbow.
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Configurations of 50 normal lumbar canals at each vertebral level were assessed and the dimensions of the canal at these levels measured. The appearances of the contents of the canal and their absorption values were carefully analyzed in the lumbar, cervical, and thoracic regions. Of 75 scans of patients with specific spinal symptoms, 38 showed abnormalities representing 19 pathological entities. The appearances of these lesions on scans are compared with normal scans, and the usefulness of CT scans in assessing lesions of the bone and within the canal is discussed.