Our findings are noteworthy and the first attempt to compare vertebral fracture risk in women of different ethnicities on the African continent. A similar vertebral fracture risk between black and white women in South Africa must be considered at present to ensure appropriate evaluation in all subjects who present with clinical risk factors for osteoporosis, regardless of ethnicity.
The value of magnetic resonance imaging (MRI) in the early diagnosis of avascular necrosis (AVN) of the hip in SLE was investigated. Twenty females with severe SLE were studied prospectively. Each underwent 6-monthly X-rays, technetium -99m (Tc-99m) pyrophosphate bone scans and MRI of the hips over a 3-yr period. AVN was diagnosed in five hips of three patients (15%) during the study period. It was confirmed histologically in three hips of two patients who underwent core decompression. Radiological evidence of AVN was present in two patients at diagnosis. One patient developed progressive radiological changes despite core decompression. Bone scintigraphy was abnormal at some stage in all three patients with AVN however failed to detect the early ischaemic stage of AVN. MRI was the most reliable investigation and was able to detect asymptomatic AVN prior to the appearance of radiological or scintigraphic abnormalities.
During an analysis of a group of 40 rugby players who had sustained cervical spinal cord injury, 9 players were identified who had sustained only transient paralysis. These players showed no radiologic evidence of any injury to the cervical spine. We did a retrospective analysis of the clinical and radiological findings in this group of rugby players. The cervical spine radiographs were analyzed for evidence of spinal stenosis, congenital anomalies, and degenerative disk disease. Using the ratio method of assessment for spinal stenosis, we found spinal canal narrowing maximally at C-3 and C-4 in five of the nine players. In the remaining four players, one showed evidence of osteoarthritic change at two levels while another had congenital fusion of two vertebral bodies. In two players, no radiologic evidence of any abnormality was detected. The mechanism of transient disturbance of the spinal cord function after trauma is discussed here.
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