Summary Two cases of lymphangiosarcoma occurring in an œdematous arm following radical mastectomy for carcinoma of the breast are described. The 35 previously reported cases are reviewed. Lymphœdema appears to be the only established aetiological agent. The diagnosis of this tumour may well be mistaken for that of a primary breast carcinoma; only an adequate biopsy can differentiate the two tumours. Radical radiotherapy or radical amputation is thought to be the best method of treatment.
Summary The clinical aspects of osteomyelitis variolosa are briefly reviewed. Substantial reasons for considering this disorder to be due to a virus are put forward. The evolution of the radiographic changes in bones and joints is described. The most noteworthy lesion specific to this virus infection is a metaphysitis causing growth disturbances which may result in bizarre deformities as the child gets older.
The diagnosis of acute calcific periarthritis is traditionally confirmed from a radiograph demonstrating periarticular calcifications in the affected area. Care must be taken when using ultrasound as the presentation of periarticular calcification is easily mistaken for a cortical avulsion fracture, requiring a radiograph to distinguish between the 2 differential diagnoses. We present the correlated ultrasound and radiographic findings of the hand of a 37-year-old man who was suffering from a dull ache in his thumb followed by acute severe pain 1 week later, and make the diagnosis of acute calcific periarthritis of the first metacarpophalangeal joint.
Summary A brief description is given of cystic disease of the renal pyramids (‘sponge kidney’). A short series of patients (all of whom were females) is recorded. The condition may be demonstrated by excretion urography, but the retrograde pyelogram is usually normal. Frequently small calculi develop in the cysts. The symptoms are mild and are usually suggestive of a mild urinary infection. The prognosis is excellent. Cystic disease of the pyramids must be distinguished from the chronic form of renal papillary necrosis.
Since the death of Chief Opechankanough >350 years ago, the myasthenia gravis (MG) community has gained extensive knowledge about MG and how to treat it. This review highlights key milestones in the history of treatment and discusses the current "golden age" of clinical trials. Although originally thought by many clinicians to be a disorder of hysteria and fluctuating weakness without observable cause, MG is one the most understood autoimmune neurologic disorders. However, studying it in clinical trials has been challenging due to the fluctuating nature of the medical condition which impacts MG clinical outcomes. Clinical trials must also account for the possibility of a placebo effect. Because MG is a rare incurable autoimmune disorder, it limits the number of potential patients available to participate in clinical trials. In the last 15 years, however, significant progress has been made with MG randomized clinical trials, resulting in a new drug (eculizumab) for physicians' treatment repertoire and an old technique (thymectomy) confirmed effective for MG. Some of the therapies (eg, thymectomy, corticosteroids, plasma exchange, and intravenous immunoglobulin [IVIg]) have survived the test of time. Others (eg, eculizumab and neonatal Fc receptor inhibitor) are novel and hold promise.
Summary Radiographs of 88 patients with acute pancreatitis have been reviewed. Plain films of the abdomen are of little help in making a positive diagnosis of pancreatitis. A cholecystogram during the first two weeks of the illness is always abnormal. Barium-meal examination can be done in the X-ray department or at the patient's bedside using portable apparatus. It may be of assistance in diagnosis both of pancreatitis and of its complications, and in following the progress of a pseudopancreatic cyst. Per-operative pancreatography is simple, probably not very safe, and does not yield as much information as had been hoped.
The successful use of urografin in hysterography is reported and the technique discussed. Whilst it is not claimed that urografin is the ideal contrast medium, it has in our experience proved to be the most satisfactory medium yet used.
Summary The meniscus sign was originally described by Carman as a sign of ulcerating gastric carcinoma. Inaccurate descriptions of the sign are given in a number of text-books and as a result simple ulcers may be mistakenly diagnosed as malignant. Five cases are reported as examples of the sign, and for comparison with them radiographs are reproduced of four simple ulcers showing an appearance which is often confused with the meniscus sign. Carman's sign, although uncommon, has been found by the present authors to be a reliable index of malignancy.
The results of treatment of a series of 87 cases of ankylosing spondylitis are assessed. A simple method, classifying the stage of the disease and the degree of improvement, is proffered so that a standard of efficiency of treatment may be apparent.
Summary A case of pulmonary metastasis presenting as multiple cavities is described together with a review of the literature and a discussion of the radiological features. The method of formation of the cavitary shadows is considered.
A case of œsophageal moniliasis in an adult is presented, and the radiological findings are described.
A total of 181 hysterosalpingograms was performed using these different opaque media.
Summary Urografin 60 per cent did not appear to be responsible for any significant change in the blood-pressure, pulse-rate, and respiratory-rate of the patients investigated by that contrast medium. Similar findings for hypaque were recorded by Roberts (1957). The side-reactions of a number of cases investigated with hypaque and urografin were recorded; 27 out of 103 cases investigated with urografin had a reaction, 23 of these being mild; 23 out of 98 cases investigated with hypaque had a reaction, 20 being mild. An attempt at the assessment of the diagnostic properties of the media, though subject to observer error, has been made. No significant difference between the two media was shown. Hypaque is easier to administer intravenously.
Eighteen cases of synovial sarcoma are described showing radiological evidence of bone involvement. They were chosen from a total series of sixty-five synovial sarcomas. Detailed descriptions of the X-ray appearances are given. Cases showing pressure atrophy of bone without other changes were not included. A classification into broad groups is suggested.
Five cases of mediastinal bronchogenic cyst have been recorded, their radiological appearances described, and their possible modes of origin discussed. It is believed that an accurate diagnosis of these lesions can be made from careful study of their features as seen in the routine radiographs of the chest.
RADIOGRAPHY as an aid to the diagnosis of nasopharyngeal incompetence is not new. Veau and Maisonny-Borel (1943) recommended fluoroscopy to ascertain those patients who were unlikely to benefit in the U.S.A. and this country, utilizing X rays in the study of the palate and the surrounding structures. In the past, the results of surgery have been assessed by the direct examination of the soft palate
There is a description of 6 cases of metastatic carcinoma simulating primary growths in the paranasal sinuses. In addition metastases occurred to the sinuses in 2 other cases where there was a known primary. A review of the literature is given.
