Picture quizPicture quizG H RoditiG H Roditi1Department of Radiology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G31 2ER, UK Search for more papers by this authorPublished Online:13 Feb 2014https://doi.org/10.1259/imaging/17004493SectionsPDF/EPUBFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail About"Picture quiz." Imaging, 16(3), pp. 285–286 Previous article Next article FiguresReferencesRelatedDetails Volume 16, Issue 3August 2004Pages: 205-vi © The British Institute of Radiology History Published onlineFebruary 13,2014 Metrics Download PDF

The hip is afflicted by different conditions according to age. MRI has an important role in detection of occult fractures. Trochanteric bursitis is a common cause of pain in the middle aged and elderly. Avascular necrosis is characterized by the “double line” sign on MRI. With transient osteoporosis the subchondral region is typically intact. Synovial proliferative disorders occur in young to middle aged adults. The snapping hip may have intrinsic or extrinsic causes.

Complex modern healthcare delivery depends on appropriate access to currently relevant data, which implies interoperability of computer systems at a national scale.There is a growing expectation that relevant records will be multimedia records that include or reference images, waveforms and other large information objects as stored in PACS.The Integrating the Healthcare Enterprise (IHE) initiative has implemented a methodology to enable users and suppliers in the medical imaging domain to work together to implement interoperable systems using subsets of existing standards.IHE provisions can form the basis for an important part of the patient record stored in electronic form.

Screening: Interpreting screening mammograms is difficult; radiologists must maintain specificity while reading films with a very low incidence of cancer. Estimates suggest sensitivity is no higher than 75%.CAD: Commercial systems are now available that prompt radiologists to look at suspicious regions. Such systems achieve high sensitivity but at low specificity.Evaluations: Evaluations of these CAD systems reveal that they do well at detecting microcalcifications but less well at detecting masses.Impact on decision-making: The low specificity of the computer prompts seems to hinder their capacity to influence radiologists' decision-making.Prospective trials: Only one prospective trial has been carried out of a CAD system for mammography. A replication of this trial in a UK setting is awaited.

CT remains the investigation of choice for suspected acute intracranial haemorrhage. Non-invasive angiographic techniques such as MR angiography (MRA) and CT angiography (CTA) are improving rapidly and are likely to replace conventional angiography for the diagnosis of vascular intracranial lesions. Normal CT does not exclude subarachnoid haemorrhage and, in appropriate clinical circumstances, lumbar puncture is necessary for exclusion of diagnosis. In ruptured aneurysms, endovascular treatment has significantly reduced morbidity and mortality compared with surgery at 1 year. Colour duplex ultrasound is usually the first line investigation for diagnosis of extracranial atherosclerotic disease, and concordance with MRA and/or CTA obviates the need for conventional angiography. Although MRI is excellent for demonstration of venous sinus thrombosis, caution is need when interpreting the MR venogram.

Multiple choice questionnaireMultiple-choice questionnaire: generalA M Connors and S P BlakeA M Connors1Department of Radiology, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK and 2Department of Radiology, South Infirmary, Old Blackrock Road, Cork, IrelandSearch for more papers by this author and S P Blake1Department of Radiology, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK and 2Department of Radiology, South Infirmary, Old Blackrock Road, Cork, IrelandSearch for more papers by this authorPublished Online:28 Jan 2014https://doi.org/10.1259/img.14.5.140428SectionsPDF/EPUBFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail About Previous article FiguresReferencesRelatedDetails Volume 14, Issue 5October 2002Pages: 355-437 © The British Institute of Radiology History Published onlineJanuary 28,2014 Metrics Download PDF

From the very early days of Carrel’s experimental attempts at transplantation in the 1900s resulting in the Nobel Prize of 1912 [1], to the unimmunosuppressed allografting of the 1950s and the slightly more successful outcome of twin-totwin transplants [2], the road to what we now regard as an almost routine and successful operation was indeed paved with multiple pitfalls, leaving some groups, at the time, to wonder whether further work in this area was justified. It was not until a better understanding of tissue rejection and the introduction of azathioprine and steroid in 1963 [3], and more specifically Cyclosporin A by Calne in the 1970s [4], that the door to progress was fully opened. Improvements in surgical technique, newer, more effective and less toxic anti-rejection therapy, the routine use of ultrasound in the 1970s and Doppler a decade later, and the development of interventional radiology have all combined in a synergistic manner to make this the successful operation and clinical outcome, we now take so much for granted. Without the fortitude and dedication of these early pioneers however, it is unlikely that any of these advances would have ever been achieved. Much of the work described below is largely as a result of those early informative years.

Heart, lung, and heart-lung transplantation is performed for end-stage congenital or acquired disease in children and adults. The major short- and long-term complications are infection and rejection. CT imaging plays a major role contributing to the diagnosis of many early and late complications. Plain chest films still provide a contributory role in continued surveillance. All grades of rejection in both heart and lung transplants require biopsy for tissue diagnosis, irrespective of imaging findings.

High resolution ultrasound can clearly depict the course of major nerves and their internal structure. Ultrasound is useful in identifying the site and cause of nerve entrapment syndromes. Ultrasound is an accurate technique for diagnosing Morton's neuroma and nerve sheath tumours. The potential role of ultrasound in neuropathies and trauma has not been clearly defined.

Musculoskeletal manifestations of HIV disease include aseptic inflammation, infection, neoplasia and therapy-related side effects. Lymphoma and pyomyositis are usually encountered when the CD4 count is markedly reduced. There is increased incidence of immune-mediated connective tissue disease in HIV infection. Infection may arise in the superficial soft tissues, muscles, joints and marrow cavity. Kaposi's sarcoma and non-Hodgkin's lymphoma are the commonest neoplastic conditions. Plain radiography, ultrasound, CT and MRI all have a role to play in patient assessment and management.