继发性甲旁亢的锁骨骨吸收

１８例慢性肾衰继发性甲旁亢病人发现有锁骨骨吸收。发病部位包括锁骨内端、外端、外１／３下缘及内段下缘４个部位。其中锁骨内、外端骨吸收属软骨下骨吸收，内、外段下缘骨吸收属韧带下骨吸收。作者对锁骨骨吸收的Ｘ线表现及发病机制作了讨论。认为锁骨骨吸收是继发性甲旁亢的重要Ｘ线征象，对诊断肾性骨病具有重要的意义。     

骨冻伤平片X线分型与血管造影对照研究

笔者对５４例手足骨冻伤的Ｘ线平片与选择性锁骨下动脉血管造影结果进行了对照分析。提出了骨冻伤平片Ｘ线分型，即：Ｉ型：骨质疏松，大部分是活骨，为轻型骨冻伤；ＩＩ型：皮质下骨吸收，关节面呈条形相对密度增高伴周围骨的骨质疏松；ＩＩＩ型：骨破坏及坏死，为死骨吸收期。笔者认为，Ｘ线平片与血管造影综合检查对冻伤后早期骨变化能作出较为明确的诊断，而且对治疗选择和预后评估都有一定的意义。     

骨冻伤平片X线分型与血管造影对研究

笔者对５４例手足骨冻伤的Ｘ线平片与选择性锁骨下动脉血管造影结果进行了对照分析。提出了骨冻伤平片Ｘ线分型，即：Ⅰ型：骨质疏松，大部分是活骨，为轻型骨冻伤；Ⅱ型：皮质下骨吸收，关节面呈条形相对密度增高伴周围骨的骨质疏松；Ⅲ型：骨破坏及坏死，为死骨吸收期。笔者认为，Ｘ线平片与血管造影综合检查对冻伤后早期骨变化能作出较为明确的诊断，而且对治疗选择和预后评估都有一定的意义。     

继发性甲旁亢甲粗隆骨膜下骨吸收的X线观察

笔者采用指骨Ｘ线直接放大摄影来观察３０例甲粗隆的Ｘ线解剖和２４例肾性骨病甲粗隆骨膜下骨吸收的Ｘ线征象。认为甲粗降骨膜下骨吸收是肾性骨病继发性甲状旁腺机能亢进（甲旁亢）早期最敏感的Ｘ线征象。     

蛇毒所致肢端骨溶解X线分析（附10例报告）

蛇毒所致肢端骨溶解Ｘ线分析（附１０例报告）张吉才肢端指（趾）骨溶骨症不是独立疾病而是一种Ｘ线征象，主要表现为肢端指（趾）骨骨质吸收、破坏及残缺，可由多种病因引起。蛇毒所致肢端骨溶解报告甚少，本文报告４例并结合文献资料６例共１０例一并复习，并对其成因、...     

骨纤维异常增殖症：附120例报告

笔者报告了１２０例经病理证实的骨纤维异常增殖症（简称骨纤）。其中单骨型９８例（占８１．７％），多骨型２２例（占１８．３％），后者包括５例Ａｌｂｒｉｇｈｔ综合征。从Ｘ线表现上可分为囊肿型（８３灶）、弥漫型（１４０灶）、丝瓜瓤型（８灶）、虫噬型（３灶）和纤维骨瘤样改变（４灶）五种类型。四肢长骨６３例病变的Ｘ线病理观察发现胚骨和其他四肢长骨病灶内的骨小梁周围均有程度不同的成骨细胞镶边和骨小梁周边的板层转化现象，两者的出现率无明显差异（Ｐ＞０．０５）。笔者重点讨论了骨纤和骨化性纤维瘤的异同，发现两者尤其在病理上没有原则的区别，因而认为所谓的骨化性纤维瘤就是骨纤。     

马杜拉足的临床X线表现(附33例报告)

目的：探讨马杜拉足的临床Ｘ线表现以及与化脓性骨髓炎的区别。方法：收集马杜拉足３３例，分析其临床Ｘ线表现，对比左右两足在骨受累类型、分布以及Ｘ线表现上的差异。结果：临床特征有青年好发（２８．６岁），慢性病程（４５月），足部软组织肿胀和疼痛（２９例），皮肤糜烂、溃疡及反复流脓（１６例）。Ｘ线特征有跖骨和楔骨最常受累，以多骨受累为主，主要征象为骨质破坏（２８例）、软组织肿胀（２２例）、骨质硬化（１５例）、骨膜反应（８例）、骨干增粗和皮质增厚（７例），上述表现常合并存在。左足多骨受累多见，右足单骨受累多见，但左右两足之间在Ｘ线表现上无明显差异。结论：虽然马杜拉足的Ｘ线表现与慢性化脓性骨髓炎相似，但它们各有其不同的特征     

肌肉海绵状血管瘤诱发骨质改变的X线表现

本文报告了９６例肌肉海绵状血管瘤诱发骨质改变的分析结果。其Ｘ线表现主要为：（１）骨外形改变：骨胳受压、变形、发育不良。（２）骨质增生：骨膜增生、皮质增厚、骨髓腔增生硬化。（３）骨质吸收：骨质疏松、骨髓腔囊性缺损。同时，对各种Ｘ线征象的发生机理作了探讨。简要的讨论了有关疾病的鉴别诊断。     

滑膜骨软骨瘤病X线诊断（附61例报告）

滑膜骨软骨瘤病Ｘ线诊断（附６１例报告）高士伟，王学庆，孙家永滑膜骨软骨瘤病为发生于关节囊、滑囊及腱鞘滑膜的良性病变，笔者搜集６１例，３０例经手术与病理证实。现着重Ｘ线诊断探讨如下。一、一般资料：作者单位：２７６００３山东省临沂地区医院放射科６１例中男...     

距骨咀临床X线意义的初步探讨（附12例分析）

距骨咀临床Ｘ线意义的初步探讨（附１２例分析）刘布克徐春福距骨咀属距骨的发育变异［１］，不多见而常被忽视，其临床Ｘ线意义尚未有关报告。我们对７５０例踝关节Ｘ线片观察，仅见１２例（１．６％），并发现其中１０例（８３．３％）有临床症状、体征。本文据所搜集资...     

Bone metastasis revealing a primary prostate cancer

Spiculated reactive periosteal bone is usually found in cases of primary malignant bone tumors; rarely in secondary bone lesions. The authors report a case of bone tumor of the clavicle in a 62 year-old patient with "sunburst " periosteal reaction on radiographs. The metastatic nature of this lesion from an unknown prostate carcinoma was confirmed by immunohistochemical studies of the clavicle biopsy. Tumorectomy was performed and the patient's status is stable with a follow-up of 10 months.     

Numerous sites of increased uptake shown on bone scintigraphy in a case of adult T-cell leukemia

Bone scintigraphy was performed in a 69-year-old male patient with adult T-cell leukemia suffering from right lower limb pain. Numerous sites of increased uptake were seen in the skull, left clavicle, bilateral humeri, bilateral radii and right femur and tibia. Bone radiographs showed multiple osteolytic lesions, most of which corresponded to the abnormal deposits on the bone scans with 740 MBq of^99mTc-hydroxymethylene diphosphonate. This pattern is rarely reported, but bone involvement of adult T-cell leukemia is not uncommon. Bone involvement was remarkable on the appendicular skeleton when compared with common metastatic bone tumors. Bone scintigraphy may be useful in detecting bone involvement in adult T-cell leukemia.     

The apical oblique view of the clavicle: its usefulness in neonatal and childhood trauma

We analyzed clavicular radiographs of 26 patients with a history of trauma. The apical oblique projection of the clavicle was obtained with the injured side of the patient angled 45° towards the X-ray tube and a 20° cephalad angulation of the X-ray beam. This view proved to be more informative than the routine apical anteroposterior projection. It is especially effective in detecting nondisplaced fractures of the middle third of the clavicle in neonates and children. To verify our findings, we obtained apical anteroposterior and oblique radiographs of a specimen adult clavicle. On the oblique view with 20° cephalad angulation of the X-ray beam, the measurements of the projected lengths of the anatomical specimen, especially those of the middle portion of the clavicle, were very close to the corresponding anatomical lengths.     

Stress-induced osteolysis of the clavicle

Osteolysis in the distal clavicle--manifested radiographically by erosions, resorption of the subchondral cortical bone, and an increased space between the acromion and clavicle--may occur in patients who experience repeated stress or microtrauma to the shoulder. This entity has a radiographic appearance similar to posttraumatic osteolysis of the clavicle. One patient with painful shoulders and typical osteolytic changes of the clavicles on radiographs is described, with three other cases reported.     

MR observations of postraumatic osteolysis of the distal clavicle after traumatic separation of the acromioclavicular joint

PURPOSE: The purpose of this work was to characterize the MR features of post-traumatic osteolysis of the distal clavicle in patients who have sustained a previous separation of the ipsilateral acromioclavicular (AC) joint. METHOD: We studied eight male patients (mean age 25 years) with intractable pain in the AC joint after sustaining a traumatic joint separation. With use of the Rockwood classification, the separations were classified as Type 1 in one patient, Type 2 in two patients, and Type 3 in five patients. The MR studies were evaluated for periarticular soft tissue swelling, cortical irregularity defined as thinning or absence of portions of the cortex in the acromial and clavicular articular surfaces, hypertrophic osseous changes, periostitis, bone marrow edema, periarticular cyst-like changes, and joint space widening exceeding 6 mm. Radiographs were evaluated independently of the MR studies. Osteolysis of the distal clavicle was confirmed pathologically in seven patients and with surgery in one patient. RESULTS: The incidence of osteolysis in patients who have had a previous AC joint separation was estimated to be approximately 6%. Observations on MRI included soft tissue swelling, bone marrow edema in the distal clavicle, and cortical irregularity associated with periarticular cyst-like erosions in eight patients, joint space widening in six patients, clavicular periostitis in three patients, and marrow edema in the cromion in five patients. Only one patient had osteophyte formation. Radiographic observations of periarticular soft tissue swelling, osteopenia of the distal clavicle, articular erosions, and joint space widening allowed diagnosis in only four patients prospectively. CONCLUSION: The MR features of posttraumatic osteolysis are characteristic of this process. We advocate the use of MRI in patients with chronic AC joint pain who have had a prior AC joint dislocation, particularly if follow-up radiographs are nonspecific, equivocal, or do not indicate the presence of secondary osteoarthritis.     

A rare cause of dyspnea due to chylothorax

We report the case of an 8-year-old boy who presented to the emergency department of another hospital and was referred to our pediatric intensive care unit with dyspnea and tachypnea of recent onset. The diagnosis of massive chylothorax with mediastinal shift was made on chest radiographs and CT scan. Initial investigations revealed no definite cause for the chylothorax. On later radiography and CT imaging with 3D surface rendering, a marked bone loss of the left ribs, clavicle, and shoulder joint was shown. The diagnosis of Gorham–Stout disease associated with chylothorax was suspected and histologically confirmed.     

Management of clavicle fractures

Fractures of the clavicle are relatively common injuries that can occur in patients of all ages. The history and physical examination remain the primary means of diagnosing this injury. Plain radiographs are helpful to confirm the diagnosis and to provide information regarding fracture classification, prognosis, and treatment options. The emphasis of this article is on the management of these injuries. Historically, only unstable distal clavicle fractures were treated operatively. However, recent well-conducted studies demonstrate that plate fixation of displaced midshaft clavicle fractures may result in improved functional outcome and a lower rate of malunion and non-union, compared with non-operative treatment. For clavicle fractures managed non-operatively, the sling-and-swathe or figure-of-eight splints remain appropriate options. Multiple factors should be considered when counseling an athlete on the appropriate time to return to sports participation after a clavicle fracture.     

Sex determination using anthropometric dimensions of the clavicle in Iranian population

ObjectiveSometimes only skeletal remains are available for forensic identification. Therefore, sex determination using human skeletal remains is one of the most important components in forensic identification. Different levels of accuracy for sex determination using clavicle have been reported in various studies, and on the other hand, anthropometric dimensions of different bones are unique in each race and geographical region. This study was carried out to assess the accuracy of this bone for sex determination in Iranian population. Based on the results of this research, by using the anthropometric dimensions of the clavicle bone, gender can be estimated with a high accuracy.Materials and methodsThis research was carried out on 120 Iranian cadavers. Maximum of length and midshaft circumference of clavicle was measured. SPSS (Version 13.5) was used for statistical analysis.ResultsThe mean of maximum of the length and the midshaft circumference of clavicle was larger in men (P < 0.001). Using claviclular anthropometric parameters, we could determine sex with 73.3%–88.3% accuracy.ConclusionThe results of this research indicate that sex can be determined using clavicle dimensions with relatively high accuracy, when only the clavicle bone is available due to explosion, plane crashes, mutilated bodies, etc.     

Arthroscopic acromioclavicular joint resection. An anatomical study

Distal clavicle resection has been an effective procedure for treatment of acromioclavicular arthritis. The conventional open surgical technique involves deltoid detachment and reattachment, which may cause postoperative weakness and requires protection during the postoperative period to allow for healing. Arthroscopic acromioclavicular joint resection has the theoretical advantages of no deltoid disruption and a shorter rehabilitation period. The purpose of this study was to compare open versus arthroscopic acromioclavicular joint resection in a laboratory setting. The goals of acromioclavicular joint resection in this study were to remove 5 mm of the medial acromion and 10 mm of the distal clavicle. Acromioclavicular joint resections were performed on 10 cadaver shoulders (5 open resections and 5 arthroscopic resections). Open resection was successful at 10 of 15 distal clavicle locations and 14 of 15 medial acromial locations. Arthroscopic resection was successful at 14 of 15 distal clavicle locations and 10 of 15 medial acromial locations. The combined bone resection averaged 14.8 mm (+/- 1.99 mm) for the open technique and 14.8 mm (+/- 2.58 mm) for the arthroscopic technique. The combined bone resection was 1.5 cm or more in all of the measured locations for the open technique and in 14 of 15 measure locations for the arthroscopic technique. There was no statistically significant difference between the two groups. In the laboratory setting, acromioclavicular joint resection was performed effectively and predictably with arthroscopic instruments. Arthroscopic bone resection was comparable to open bone resection.     

Distales Klavikulaödem

PURPOSE: Distal clavicle marrow edema: frequency, MRI in the early stage and macroscopic correlation to the bone marrow distribution and to evaluate frequency and diagnostic criteria of a posttraumatic clavicula disorder with an edema pattern on MRI. An additional macroscopic study of the clavicle should elucidate anatomic peculiarities which could explain the reaction of the distal clavicle. MATERIAL AND METHODS: 285 MRI of traumatized patients were analyzed for edema pattern of the distal clavicle. Pattern A edema within the clavicle and the acromion was distinguished from pattern B edema within the clavicle only. Dissection in 20 cadavers should reveal vascular peculiarities and the bone marrow distribution within clavicle and acromion or vascular peculiarities. RESULTS: In 38 patients (13,3%) we found edema within the distal clavicle. Pattern A was found in 28 (9,8%) and pattern B in 10 patients (3,5%). Pattern A was usually associated with swelling of the AC joint (27 out of 28). Other injuries were not evident. 18 cadavers showed hematopoietic marrow within the distal clavicle and fatty marrow within the acromion. CONCLUSION: The distal clavicle can frequently react with edema pattern after trauma without evidence for another injury. Distinguish in cases with and cases without synovitis of the AC joint could have impact on therapy. A peculiar vascular supply of the distal clavicle could not be found.