Proximal tibial physis fracture and popliteal artery injury

A case of fracture about the proximal tibial physis with associated popliteal artery injury is presented. These fractures are not common, but their complications can be disastrous. The radiologist should draw attention to the possibility of vascular injury when these fractures are recognized.

Comparison of AP supine vs PA upright methods of chest roentgenography in infants and young children

Various arguments have been advanced for preferring either the AP recumbent projection or the PA upright projection in chest roentgenography of infants and young children. One prominent argument for PA projection is that it shows less magnification.In a search of the literature, no study could be identified that statistically compares the cardiothoracic ratios in a series of patients with simultaneous PA upright and AP supine chest roentgenograms. This study addresses that point and also examines other factors in the two different projections.A survey of pediatric radiology departments in the United States shows an overall preference for the AP supine projection by a factor of 2:1. Statistical analysis of the two methods in this study demonstrates no significant difference in the cardiothoracic ratios. All other factors considered, the authors are of the opinion that the AP supine projection is more desirable in the infant and young child.

Multiple exostotic hypochondroplasia: syndrome of combined hypochondroplasia and multiple exostoses

This is a report of a family with major focus on the daughter who was of short stature. The mother had hypochondroplasia and the father had multiple exostoses. The daughter's skeletal roentgenograms show features of both hypochondroplasia and multiple exostoses. The roentgenographic, clinical and genetic aspects of these skeletal dysplasias are reviewed and hypochondroplasia is contrasted with achondroplasia. The genetic and counseling implications of the association of hypochondroplasia and multiple exostoses are discussed.

Late-onset Bochdalek's hernia with obstruction: radiographic spectrum of presentation

Three patients with late-onset Bochdalek's hernia are presented. All three had obstruction of the herniated bowel and, in two patients, this was complicated by strangulation and necrosis. The spectrum of roentgenographic manifestation included obvious findings of bowel in the chest in one patient; in another, the findings simulated pneumonia associated with reflex bowel ileus in the abdomen. The third patient had a massive pleural effusion, with what appeared to be associated bowel ileus. In spite of the misleading presentation it is imperative that the correct diagnosis be made early since the incidence of strangulation and severe morbidity is high.