Posterior apophyseal ring fracture (PARF) of the lumbar spine is an uncommon injury thought usually to occur in adolescence. We analysed CT findings in 20 cases (19 patients), whose age ranged from 16 to 45 years (average 30 years). The PARF could be divided into two distinct groups on the basis of the shape and location of the fracture and the defect of the vertebral rim. In group 1 (2 cases), PARF involved the central aspect of the inferior vertebral rim and bone fragments were large and broad-based. In group 2, PARF were located at the posterolateral margin of the superior vertebral rim and bone fragments were small and focal. The great majority of previously reported cases belonged to our group 1. A pathogenesis for each group is suggested.
We performed a study to determine whether clinical history gives a positive or negative influence on X-ray film interpretation. One hundred and nine patient's radiograms, consisting of 55 normal and 54 abnormal cases (136 abnormalities), were interpreted twice by three pairs of residents in radiology and a pair of qualified radiologists, without clinical history first and with clinical history next. The interpreters recorded diagnosis and confidence level of normal or abnormal findings on a six-point scale. Analysis of receiver operating characteristic (ROC) curves showed that knowledge of clinical history improved diagnostic accuracy. Residents, especially beginners, should be advised to obtain clinical history whenever they read radiograms.
The air meniscus sign occurs in a number of lung conditions, including infection, benign and malignant tumors, and hematoma. Sclerosing hemangioma does not appear to have been implicated previously in this connection. Two such cases are described. Possible mechanisms of air meniscus formation and its diagnostic value in sclerosing hemangioma are discussed.
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