A description and explanation of an unexpected echographic appearance in a patient who had sustained an abdominal shotgun wound is presented. In the B-scans, a trail of dense continuous echoes, simulating a comet tail, is seen distal to each lead pellet. This comet tail appearance is shown to be a type of reverberation artifact. The effect of object size, shape, composition, and orientation on the appearance of this artifact is demonstrated.
Sternal dehiscence is a recognized complication of median sternotomy in 2.5-4.8% of patients. The authors describe the prognostic significance of a lucent midsternal stripe which was seen in 12 patients over a two-year period. Sternal dehiscence requiring surgical revision developed in 4, and radiological suspicion preceded clinical evidence of dehiscence in 3 of them. A review of 100 consecutive median sternotomies revealed that sternal dehiscence did not develop in any patient who did not have a midsternal stripe. It is suggested that this may be a useful tool in identifying those patients who are at high risk of the development of sternal dehiscence.
Two hundred patients with suspected deep venous thrombosis had thermography performed prior to ascending phlebography. Diagnostic agreement was obtained in 79%. Published diagnostic thermographic criteria were used; it was not possible to diagnose consistently limited or early thrombosis, especially in the calf muscle veins. Venous insufficiency produced the majority of false positives.
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