Mollusca collected by Agassiz trawl from the 2016 SO-AntEco (JR15005) expedition to the South Orkney Islands, Antarctica - data

Background

This dataset contributes to the knowledge of macro- and megafaunal Mollusca associated with a range of benthic habitat types in the South Orkney Islands, Antarctica, an exceptionally diverse region of the Southern Ocean. The information presented is derived from Agassiz trawl samples collected on the archipelago's shelf plateau and slope, within and outside of the South Orkney Islands Southern Shelf Marine Protected Area (SOISS MPA). Sampling was conducted in the framework of the British Antarctic Survey/SCAR "South Orkneys - State of the Antarctic Ecosystem" (SO-AntEco) project aboard RRS James Clark Ross during expedition JR15005 in Austral summer 2016. This dataset is published by the British Antarctic Survey under the licence CC-BY 4.0. We would appreciate it if you could follow the guidelines from the SCAR Data Policy (SCAR 2023) when using the data. If you have any questions regarding this dataset, do not hesitate to contact us via the contact information provided in the metadata or via data-biodiversity-aq@naturalsciences.be. Issues with the dataset can be reported at https://github.com/biodiversity-aq/data-publication/. This dataset is part of the Biodiversity, Evolution and Adaptation Project of the Environmental Change and Evolution Program of the British Antarctic Survey. The cruise report of the expedition is available at https://www.bodc.ac.uk/resources/inventories/cruise_inventory/reports/jr15005.pdf.

New information

We report occurrences of Mollusca from individual samples taken with a 2 m-wide Agassiz trawl (AGT) in the framework of the February - March 2016 research expedition JR15005 of RRS James Clark Ross to the SOISS MPA and adjacent shelf and slope areas. Of 78 successful AGT deployments, 44 trawls at depths ranging from 235-2194 m yielded living Mollusca, totalling 2276 individuals, 67 morphospecies and 163 distributional records. One hundred and fifteen empty shells were also collected and recorded in the dataset. Three morphospecies (one Bivalvia and two Gastropoda) were sampled exclusively as empty shells, yielding a total of 70 morphospecies and 2391 specimens represented in the dataset. All specimens were preserved in 96% undenatured ethanol and are stored as vouchers in the collections of the British Antarctic Survey (BAS), Cambridge, United Kingdom. The publication of this dataset aims at increasing the knowledge on the biodiversity, abundance and geographical and bathymetric distribution of larger-sized epi- and shallow infaunal Mollusca of the South Orkney Islands.

Animal survival strategies in Neoproterozoic ice worlds

The timing of the first appearance of animals is of crucial importance for understanding the evolution of life on Earth. Although the fossil record places the earliest metazoans at 572-602 Ma, molecular clock studies suggest a far earlier origination, as far back as ~850 Ma. The difference in these dates would place the rise of animal life into a time period punctuated by multiple colossal, potentially global, glacial events. Although the two schools of thought debate the limitations of each other's methods, little time has been dedicated to how animal life might have survived if it did arise before or during these global glacial periods. The history of recent polar biota shows that organisms have found ways of persisting on and around the ice of the Antarctic continent throughout the Last Glacial Maximum (33-14 Ka), with some endemic species present before the breakup of Gondwana (180-23 Ma). Here we discuss the survival strategies and habitats of modern polar marine organisms in environments analogous to those that could have existed during Neoproterozoic glaciations. We discuss how, despite the apparent harshness of many ice covered, sub-zero, Antarctic marine habitats, animal life thrives on, in and under the ice. Ice dominated systems and processes make some local environments more habitable through water circulation, oxygenation, terrigenous nutrient input and novel habitats. We consider how the physical conditions of Neoproterozoic glaciations would likely have dramatically impacted conditions for potential life in the shallows and erased any possible fossil evidence from the continental shelves. The recent glacial cycle has driven the evolution of Antarctica's unique fauna by acting as a "diversity pump," and the same could be true for the late Proterozoic and the evolution of animal life on Earth, and the existence of life elsewhere in the universe on icy worlds or moons.

Shifting Perspectives in Polar Research: Global Lessons on the Barriers and Drivers for Securing Academic Careers in Natural Sciences

The polar regions provide valuable insights into the functioning of the Earth’s regulating systems. Conducting field research in such harsh and remote environments requires strong international cooperation, extended planning horizons, sizable budgets and long-term investment. Consequently, polar research is particularly vulnerable to societal and economic pressures during periods of austerity. The global financial crisis of 2008, and the ensuing decade of economic slowdown, have already adversely affected polar research, and the current COVID-19 pandemic has added further pressure. In this article we present the outcomes of a community survey that aimed to assess the main barriers and success factors identified by academic researchers at all career stages in response to these global crises. The survey results indicate that the primary barriers faced by polar early and mid-career researchers (EMCRs) act at institutional level, while mitigating factors are developed at individual and group levels. Later career scientists report pressure toward taking early retirement as a means of institutions saving money, reducing both academic leadership and the often unrecognized but vital mentor roles that many play. Gender and social inequalities are also perceived as important barriers. Reorganization of institutional operations and more effective strategies for long-term capacity building and retaining of talent, along with reduction in non-research duties shouldered by EMCRs, would make important contributions toward ensuring continued vitality and innovation in the polar research community.

Abundance data of benthic peracarid crustaceans from the South Atlantic and Southern Ocean

Peracarid data were collected in the Southern Ocean and South Atlantic Ocean. Sampling was performed during nine different expeditions on board of RRS James Clark Ross and RV Polarstern, using epibenthic sledges (EBS) at depth ranging between 160–6348 m at 109 locations. The correlation between environmental variables and peracarid abundance was investigated. Abundance data comprise a total of 128570 peracarids (52366 were amphipods, 28516 were cumaceans, 36142 isopods, 5676 mysidaceans and 5870 were tanaidaceans). The presented data are useful to investigate the composition and abundance patterns of peracarid orders at a wide depth range and spatial scale in the Southern Ocean. They can also be reused to compare their abundance with that of other taxa in broader ecological surveys.

Local Drivers of Change in Southern Ocean Ecosystems: Human Activities and Policy Implications

Local drivers are human activities or processes that occur in specific locations, and cause physical or ecological change at the local or regional scale. Here, we consider marine and land-derived pollution, non-indigenous species, tourism and other human visits, exploitation of marine resources, recovery of marine mammals, and coastal change as a result of ice loss, in terms of their historic and current extent, and their interactions with the Southern Ocean environment. We summarise projected increases or decreases in the influence of local drivers, and projected changes to their geographic range, concluding that the influence of non-indigenous species, fishing, and the recovery of marine mammals are predicted to increase in the future across the Southern Ocean. Local drivers can be managed regionally, and we identify existing governance frameworks as part of the Antarctic Treaty System and other instruments which may be employed to mitigate or limit their impacts on Southern Ocean ecosystems.

Acceptability of childhood screening: a systematic narrative review

Objectives

A systematic narrative literature review was undertaken to assess the acceptability of childhood screening interventions to identify factors to consider when planning or modifying childhood screening programs to maximize participation and uptake.

Study design

This is a systematic narrative literature review.

Methods

Electronic databases were searched (MEDLINE, EMBASE, PsycINFO via Ovid, CINAHL, and Cochrane Library) to identify primary research studies that assessed screening acceptability. Studies were categorized using an existing theoretical framework of acceptability consisting of seven constructs: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and self-efficacy. A protocol was developed and registered with PROSPERO (registration no. CRD42018099763)

Results

The search identified 4529 studies, and 46 studies met the inclusion criteria. Most studies involved neonatal screening. Programs identified included newborn blood spot screening (n = 22), neonatal hearing screening (n = 13), Duchenne muscular dystrophy screening (n = 4), cystic fibrosis screening (n = 3), screening for congenital heart defects (n = 2), and others (n = 2). Most studies assessed more than one construct of acceptability. The most common constructs identified were affective attitude (how a parent feels about the program) and intervention coherence (parental understanding of the program, and/or the potential consequences of a confirmed diagnosis).

Conclusions

The main acceptability component identified related to parental knowledge and understanding of the screening process, the testing procedure(s), and consent. The emotional impact of childhood screening mostly explored maternal anxiety. Further studies are needed to examine the acceptability of childhood screening across the wider family unit. When planning new (or refining existing) childhood screening programs, it is important to assess acceptability before implementation. This should include assessment of important issues such as information needs, timing of information, and when and where the screening should occur.

Benthic ecosystem cascade effects in Antarctica using Bayesian network inference

Antarctic sea-floor communities are unique, and more closely resemble those of the Palaeozoic than equivalent contemporary habitats. However, comparatively little is known about the processes that structure these communities or how they might respond to anthropogenic change. In order to investigate likely consequences of a decline or removal of key taxa on community dynamics we use Bayesian network inference to reconstruct ecological networks and infer changes of taxon removal. Here we show that sponges have the greatest influence on the dynamics of the Antarctic benthos. When we removed sponges from the network, the abundances of all major taxa reduced by a mean of 42%, significantly more than changes of substrate. To our knowledge, this study is the first to demonstrate the cascade effects of removing key ecosystem structuring organisms from statistical analyses of Antarctica data and demonstrates the importance of considering the community dynamics when planning ecosystem management.

Management of nystagmus in children: a review of the literature and current practice in UK specialist services

Nystagmus is an eye movement disorder characterised by abnormal, involuntary rhythmic oscillations of one or both eyes, initiated by a slow phase. It is not uncommon in the UK and regularly seen in paediatric ophthalmology and adult general/strabismus clinics. In some cases, it occurs in isolation, and in others, it occurs as part of a multisystem disorder, severe visual impairment or neurological disorder. Similarly, in some cases, visual acuity can be normal and in others can be severely degraded. Furthermore, the impact on vision goes well beyond static acuity alone, is rarely measured and may vary on a minute-to-minute, day-to-day or month-to-month basis. For these reasons, management of children with nystagmus in the UK is varied, and patients report hugely different experiences and investigations. In this review, we hope to shine a light on the current management of children with nystagmus across five specialist centres in the UK in order to present, for the first time, a consensus on investigation and clinical management.

A new Southern Ocean species in the remarkable and rare amphipod family Podosiridae (Crustacea: Amphipoda) questions existing systematic hypotheses

The amphipod family Podosiridae is unusual in that it combines morphological elements of the disparate families Podoceridae and Eusiridae. Here, we describe a new species in the family from specimens collected from the Southern Ocean in the vicinity of the South Orkney Islands and South Shetland Islands. We present mitochondrial (COI and 16S) and nuclear (18S) nucleic acid sequences for this and a congeneric species and use these to investigate the phylogenetic placement of Podosiridae within the Amphipoda. Our results do not provide evidence for a close relationship between Podosiridae and Podoceridae or Eusiridae, suggesting that the superficial similarity between these families is the result of morphological convergence. Instead, it is likely that Podosiridae are more closely related to families within Amphilochidira, such as Stenothoidae. Definitive placement of Podosiridae in the Amphipoda awaits further specimen collection, additional nucleotide data (including sequences from the Hyperiopsidae and the Vitjazianidae) and a more directed analysis of relationships within this portion of the amphipod phylogeny.

On the ecological relevance of landscape mapping and its application in the spatial planning of very large marine protected areas

In recent years very large marine protected areas (VLMPAs) have become the dominant form of spatial protection in the marine environment. Whilst seen as a holistic and geopolitically achievable approach to conservation, there is currently a mismatch between the size of VLMPAs, and the data available to underpin their establishment and inform on their management. Habitat mapping has increasingly been adopted as a means of addressing paucity in biological data, through use of environmental proxies to estimate species and community distribution. Small-scale studies have demonstrated environmental-biological links in marine systems. Such links, however, are rarely demonstrated across larger spatial scales in the benthic environment. As such, the utility of habitat mapping as an effective approach to the ecosystem-based management of VLMPAs remains, thus far, largely undetermined. The aim of this study was to assess the ecological relevance of broadscale landscape mapping. Specifically we test the relationship between broad-scale marine landscapes and the structure of their benthic faunal communities. We focussed our work at the sub-Antarctic island of South Georgia, site of one of the largest MPAs in the world. We demonstrate a statistically significant relationship between environmentally derived landscape mapping clusters, and the composition of presence-only species data from the region. To demonstrate this relationship required specific re-sampling of historical species occurrence data to balance biological rarity, biological cosmopolitism, range-restricted sampling and fine-scale heterogeneity between sampling stations. The relationship reveals a distinct biological signature in the faunal composition of individual landscapes, attributing ecological relevance to South Georgia's environmentally derived marine landscape map. We argue therefore, that landscape mapping represents an effective framework for ensuring representative protection of habitats in management plans. Such scientific underpinning of marine spatial planning is critical in balancing the needs of multiple stakeholders whilst maximising conservation payoff.

Microplastics in the Antarctic marine system: An emerging area of research

It was thought that the Southern Ocean was relatively free of microplastic contamination; however, recent studies and citizen science projects in the Southern Ocean have reported microplastics in deep-sea sediments and surface waters. Here we reviewed available information on microplastics (including macroplastics as a source of microplastics) in the Southern Ocean. We estimated primary microplastic concentrations from personal care products and laundry, and identified potential sources and routes of transmission into the region. Estimates showed the levels of microplastic pollution released into the region from ships and scientific research stations were likely to be negligible at the scale of the Southern Ocean, but may be significant on a local scale. This was demonstrated by the detection of the first microplastics in shallow benthic sediments close to a number of research stations on King George Island. Furthermore, our predictions of primary microplastic concentrations from local sources were five orders of magnitude lower than levels reported in published sampling surveys (assuming an even dispersal at the ocean surface). Sea surface transfer from lower latitudes may contribute, at an as yet unknown level, to Southern Ocean plastic concentrations. Acknowledging the lack of data describing microplastic origins, concentrations, distribution and impacts in the Southern Ocean, we highlight the urgent need for research, and call for routine, standardised monitoring in the Antarctic marine system.

The evolutionary origins of the southern ocean Philobryid bivalves: hidden biodiversity, ancient persistence

Philobryids (Bivalvia: Arcoida) are one of the most speciose marine bivalve families in the Southern Ocean and are common throughout the Southern Hemisphere. Considering this diversity and their brooding reproductive mode (limiting long-distance dispersal), this family may have been present in the Southern Ocean since its inception. However Philobrya and Adacnarca appear only in the Quaternary fossil record of the Antarctic, suggesting a much more recent incursion. Molecular dating provides an independent means of measuring the time of origin and radiation of this poorly known group. Here we present the first combined molecular and morphological investigation of the Philobryidae in the Southern Ocean. Two nuclear loci (18S and 28S) were amplified from 35 Southern Ocean Adacnarca and Philobrya specimens, with a combined sequence length of 2,282 base pairs (bp). Adacnarca specimens (A. nitens and A. limopsoides) were resolved as a strongly supported monophyletic group. Genus Philobrya fell into two strongly supported groups ('sublaevis' and 'magellanica/wandelensis'), paraphyletic with Adacnarca. The A. nitens species complex is identified as at least seven morpho-species through morphological and genetic analysis of taxon clustering. Phylogenetic analyses resolve Philobryidae as a strongly supported monophyletic clade and sister taxon to the Limopsidae, as anticipated by their classification into the superfamily Limopsoidea. Bayesian relaxed clock analyses of divergence times suggest that genus Adacnarca radiated in the Southern Ocean from the Early Paleogene, while P. sublaevis and P. wandelensis clades radiated in the late Miocene, following the formation of the Antarctic Circumpolar Current.

Ross Sea Mollusca from the Latitudinal Gradient Program: R/V Italica 2004 Rauschert dredge samples

Information regarding the molluscs in this dataset is based on the Rauschert dredge samples collected during the Latitudinal Gradient Program (LGP) on board the R/V “Italica” in the Ross Sea (Antarctica) in the austral summer 2004. A total of 18 epibenthic dredge deployments/samplings have been performed at four different locations at depths ranging from 84 to 515m by using a Rauschert dredge with a mesh size of 500μm. In total 8,359 specimens have been collected belonging to a total of 161 species. Considering this dataset in terms of occurrences, it corresponds to 505 discrete distributional records (incidence data). Of these, in order of abundance, 5,965 specimens were Gastropoda (accounting for 113 species), 1,323 were Bivalvia (accounting for 36 species), 949 were Aplacophora (accounting for 7 species), 74 specimens were Scaphopoda (3 species), 38 were Monoplacophora (1 species) and, finally, 10 specimens were Polyplacophora (1 species). This data set represents the first large-scale survey of benthic micro-molluscs for the area and provides important information about the distribution of several species, which have been seldom or never recorded before in the Ross Sea. All vouchers are permanently stored at the Italian National Antarctic Museum (MNA), Section of Genoa, enabling future comparison and crosschecking. This material is also currently under study, from a molecular point of view, by the barcoding project “BAMBi” (PNRA 2010/A1.10).

Antarctic crabs: invasion or endurance?

Recent scientific interest following the "discovery" of lithodid crabs around Antarctica has centred on a hypothesis that these crabs might be poised to invade the Antarctic shelf if the recent warming trend continues, potentially decimating its native fauna. This "invasion hypothesis" suggests that decapod crabs were driven out of Antarctica 40-15 million years ago and are only now returning as "warm" enough habitats become available. The hypothesis is based on a geographically and spatially poor fossil record of a different group of crabs (Brachyura), and examination of relatively few Recent lithodid samples from the Antarctic slope. In this paper, we examine the existing lithodid fossil record and present the distribution and biogeographic patterns derived from over 16,000 records of Recent Southern Hemisphere crabs and lobsters. Globally, the lithodid fossil record consists of only two known specimens, neither of which comes from the Antarctic. Recent records show that 22 species of crabs and lobsters have been reported from the Southern Ocean, with 12 species found south of 60 °S. All are restricted to waters warmer than 0 °C, with their Antarctic distribution limited to the areas of seafloor dominated by Circumpolar Deep Water (CDW). Currently, CDW extends further and shallower onto the West Antarctic shelf than the known distribution ranges of most lithodid species examined. Geological evidence suggests that West Antarctic shelf could have been available for colonisation during the last 9,000 years. Distribution patterns, species richness, and levels of endemism all suggest that, rather than becoming extinct and recently re-invading from outside Antarctica, the lithodid crabs have likely persisted, and even radiated, on or near to Antarctic slope. We conclude there is no evidence for a modern-day "crab invasion". We recommend a repeated targeted lithodid sampling program along the West Antarctic shelf to fully test the validity of the "invasion hypothesis".

Diversity and distribution patterns in high southern latitude sponges

Sponges play a key role in Antarctic marine benthic community structure and dynamics and are often a dominant component of many Southern Ocean benthic communities. Understanding the drivers of sponge distribution in Antarctica enables us to understand many of general benthic biodiversity patterns in the region. The sponges of the Antarctic and neighbouring oceanographic regions were assessed for species richness and biogeographic patterns using over 8,800 distribution records. Species-rich regions include the Antarctic Peninsula, South Shetland Islands, South Georgia, Eastern Weddell Sea, Kerguelen Plateau, Falkland Islands and north New Zealand. Sampling intensity varied greatly within the study area, with sampling hotspots found at the Antarctic Peninsula, South Georgia, north New Zealand and Tierra del Fuego, with limited sampling in the Bellingshausen and Amundsen seas in the Southern Ocean. In contrast to previous studies we found that eurybathy and circumpolar distributions are important but not dominant characteristics in Antarctic sponges. Overall Antarctic sponge species endemism is ∼43%, with a higher level for the class Hexactinellida (68%). Endemism levels are lower than previous estimates, but still indicate the importance of the Polar Front in isolating the Southern Ocean fauna. Nineteen distinct sponge distribution patterns were found, ranging from regional endemics to cosmopolitan species. A single, distinct Antarctic demosponge fauna is found to encompass all areas within the Polar Front, and the sub-Antarctic regions of the Kerguelen Plateau and Macquarie Island. Biogeographical analyses indicate stronger faunal links between Antarctica and South America, with little evidence of links between Antarctica and South Africa, Southern Australia or New Zealand. We conclude that the biogeographic and species distribution patterns observed are largely driven by the Antarctic Circumpolar Current and the timing of past continent connectivity.

Highly diverse, poorly studied and uniquely threatened by climate change: an assessment of marine biodiversity on South Georgia's continental shelf

We attempt to quantify how significant the polar archipelago of South Georgia is as a source of regional and global marine biodiversity. We evaluate numbers of rare, endemic and range-edge species and how the faunal structure of South Georgia may respond to some of the fastest warming waters on the planet. Biodiversity data was collated from a comprehensive review of reports, papers and databases, collectively representing over 125 years of polar exploration. Classification of each specimen was recorded to species level and fully geo-referenced by depth, latitude and longitude. This information was integrated with physical data layers (e.g. temperature, salinity and flow) providing a visualisation of South Georgia's biogeography across spatial, temporal and taxonomic scales, placing it in the wider context of the Southern Hemisphere. This study marks the first attempt to map the biogeography of an archipelago south of the Polar Front. Through it we identify the South Georgian shelf as the most speciose region of the Southern Ocean recorded to date. Marine biodiversity was recorded as rich across taxonomic levels with 17,732 records yielding 1,445 species from 436 families, 51 classes and 22 phyla. Most species recorded were rare, with 35% recorded only once and 86% recorded <10 times. Its marine fauna is marked by the cumulative dominance of endemic and range-edge species, potentially at their thermal tolerance limits. Consequently, our data suggests the ecological implications of environmental change to the South Georgian marine ecosystem could be severe. If sea temperatures continue to rise, we suggest that changes will include depth profile shifts of some fauna towards cooler Antarctic Winter Water (90-150 m), the loss of some range-edge species from regional waters, and the wholesale extinction at a global scale of some of South Georgia's endemic species.

Diffuse lymphangiomatosis of bone

Two cases of lymphangiomatosis of bone, a very rare systemic condition characterized by both skeletal and parenchymal lesions, are presented. The skeletal changes have an appearance similar to haemangiomas in the spine, and soap-bubbly lesions in the flat bones. One case carried the diagnosis of eosinophilic granuloma for 18 years. The findings on MRI, which have not been previously well-established, are discussed.

Calcaneal fractures in diabetic patients

We would like to present 23 calcaneal fractures in 22 patients of whom 21 had type I diabetes mellitus. There appear to be three basic fracture types: (1) a superiorly displaced extra-articular avulsion fracture of the posterior calcaneus (or Iowa fracture), which occurred in 12 patients (five men, seven women); (2) a mid-calcaneal compression fracture in six patients (four men, two women), and (3) a cleavage or "wedge" type fracture in four patients extending from the calcaneal tubercle (one man, 3 women). All four of this last group of patients had a history of a chronic penetrating ulcer, and this is noteworthy since only one other patient out of the remaining 18 in groups 1 and 2 had a similar history. Most patients had decreased bone mineralization: 15 patients were on long-term, high-dose steroids, and 18 patients had either poor renal function or complete renal failure (11 of 12). Fourteen patients had received either renal or pancreas transplants. Eight patients were on restricted weight bearing prior to their fractures. We believe that diabetic patients are more prone to calcaneal fractures than the general population, and early diagnosis is imperative, followed by early treatment to prevent significant bony deformity.

Effects of capsular contracture on ultrasonic screening for silicone gel breast implant rupture

Unlike computed tomography and magnetic resonance imaging, ultrasound is an inexpensive test of potential use in detecting silicone gel breast implant (SBI) rupture. However, periprosthetic capsular contracture can make ultrasonic diagnosis of rupture difficult because the contracture-related radial folds inside the SBI can lead to a false-positive diagnosis of rupture. This study was conducted to determine the effects of capsular contracture on the ability of ultrasound to diagnose SBI rupture. Preoperative ultrasonic results of 122 SBIs were compared with surgical findings at the time of implant removal. The sensitivity and negative predictive values of ultrasound were lower in the presence of a contracted capsule (41.2% vs. 68.7%, p = 0.062; and 58.3% vs. 79.6%, p = 0.056 respectively). Ultrasound should be considered reliable in diagnosing SBI rupture only in the absence of a contracted capsule.

The use of MR imaging in the assessment and clinical management of stress reactions of bone in high-performance athletes

Based on experience, the authors believe that MR imaging is a useful tool in the assessment and management of stress fractures and stress phenomenum of bone. The use of standard, graded MR evaluation aides the assessment of a repetitive stress injury to bone by allowing a more accurate diagnosis of bone injury. This more accurate assessment has predictive value in estimating the duration of disability. The use of a standard, graded MR evaluation aides the management of repetitive stress injuries to bone by defining a low grade of stress fracture (i.e., grade 1 and 2) injuries and a high grade of stress fracture (i.e., grade 3 and 4). This grading system has implications in the management of stress fractures, allowing more individualized treatment for the elite athlete.

The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in two large American Midwest metropolitan hospital populations

OBJECTIVE

There are no published large-scale studies of the overall prevalence of diffuse idiopathic skeletal hyperostosis (DISH) and it has been proposed that the prevalence is greater than previously reported. We thus decided to review chest radiographs in a population of patients over 50 years of age seen at two large but differing metropolitan hospitals in a major American Mid-west city.

DESIGN AND PATIENTS

The posterior-anterior and lateral chest radiographs of 1363 patients were reviewed for evidence of DISH at the University of Minnesota Hospital and Clinic. There were 500 consecutive inpatient admissions, 540 consecutive patients who attended the outpatient clinics and 326 patients collected from our film archive. A population of 1001 patients seen at Hennepin County Medical Center was also studied. It was possible to subclassify this latter group with respect to race.

RESULTS AND CONCLUSION

Using strict criteria, i.e., four or more levels involved, the overall prevalence of DISH in the male population over age 50 years was 25% and in the female population over age 50 years was 15%. This prevalence climbed to 28% in males over 80 years and to over 35% in males over age 70 years. In females over 80 years, the prevalence was found to be 26%. Although our population base was small, DISH was found to be less common in the black, Native-American and Asian populations. The prevalence of DISH was also found to be far lower in a similar white population with osteoporosis. The overall prevalence of DISH was higher than expected in a predominantly white population over age 50 years with a lesser incidence in the black, Native-American and Asian populations, suggesting a genetic origin of the condition.

Use of MRI in evaluating postoperative changes in patients with bone and soft tissue tumors

We reviewed the clinical, surgical and magnetic resonance imaging (MRI) findings in 80 patients who underwent resection of primary benign or malignant bone or soft tissue tumors. There were 18 benign and 62 malignant tumors. Although 31 patients were originally thought to have recurrence, on review only 20 patients were considered to have recurred. Of these, three were found only to have postoperative changes at surgery. Seventeen patients actually had recurrence of tumor. We believe that the presence of an actual mass lesion on MRI is the cornerstone for the correct diagnosis of recurrent tumor.

The biomechanics of gravity-dependent traction of the lumbar spine

STUDY DESIGN

This study evaluated the biomechanical responses evoked by the use of a gravity-dependent, self-operated traction device. These responses were determined by radiographs and were correlated with the body weight of the patient who was supported by a seat strap.

OBJECTIVES

To examine the biomechanical effectiveness of the LTX 3000 Lumbar Rehabilitation System.

SUMMARY OF BACKGROUND DATA

The LTX 3000 Lumbar Rehabilitation System (Spinal Designs International, Minneapolis, MN) was used to administer the lumbar fraction. No previous study has been conducted on this device.

METHODS

For each of the 14 healthy male patients (age range, 19-69 years), lumbar lengthening, alterations in spinal curvature, and thoracic spine movement were assessed using radiographs taken: 1) before traction; 2) at 2, 10, and 15 minutes after the onset of traction; and 3) 2 minutes after traction was completed. Strain on the buttocks-supporting seat strap was recorded continuously during study sessions.

RESULTS

The entire patient pool displayed an average maximal lumbar lengthening of 6.39 +/- 4.21 mm. The amount of lumbar lengthening was influenced by the degree of thoracic immobilization and by the amount of prior LTX 3000 (Spinal Designs International) use. Significant curvature reduction was observed during and after traction for the entire patient pool. Strain measurements correlated well with the measured response in the radiographs.

CONCLUSIONS

Proper use of the LTX 3000 (Spinal Designs International) induces significant lumbar lengthening and curvature reduction in healthy patients. Measurements of body weight supported by the seat strap could help determine if thoracic immobilization has been achieved and if the patient is responding to the lumbar unloading.

"Incisura" of the ascending aorta and vascular pedicle width in the cardiac transplant patient

BACKGROUND

The purpose of this study was to evaluate three findings in cardiac transplant patients: the appearance, etiology, and incidence of "incisura" (a characteristic indentation) of the ascending aorta; the vascular pedicle width, which usually appears enlarged on standard chest radiographs; and clearing of the retrosternal clear space.

MATERIAL

Two hundred sixty-one cardiac transplantations were performed at the University of Minnesota before December 31, 1992. The appearance, etiology, and incidence of an incisura were studied; the vascular pedicle width was measured; and the rate of clearing of the retrosternal clear space was determined.

RESULTS

Forty-six percent of the patients whose ascending aorta could be visualized on the lateral chest radiogram showed an incisura. Approximately one third of the patients showed continued opacification of the retrosternal space postoperatively. The width of the vascular pedicle in this series of cardiac transplant patients measured 60.9 +/- 22.8 mm (standard deviation, 11.4 mm), in comparison to a normal of 48 +/- 5.0 mm.

CONCLUSIONS

An incisura of the ascending aorta and the widened vascular pedicle are normal postoperative chest radiographic findings in cardiac transplant patients and should not be misconstrued as abnormalities.

Lipoblastoma of the foot

Lipoblastoma is an uncommon benign lipomatous soft tissue mass of childhood, occurring most commonly in children less than 3 years of age. We present a case of lipoblastoma occurring in the foot of a 14-year-old boy and review the literature. The appearance of the mass on magnetic resonance imaging (MRI) is illustrated and is correlated with the findings at gross and microscopic pathological examination. A lobulated architecture, the presence of adipose tissue, thin nonenhancing septa, peripheral lobules of more immature and therefore less specific tissue, and a peripheral pseudocapsule were evident on MRI and at pathological examination.

Cyclops lesion

Postoperative impingement of the knee following ACL reconstruction does occur. MRI can be useful in the diagnosis of the patient who is not recovering as quickly as expected following surgical reconstruction. MRI allows the assessment of 1) tunnel position and alignment, 2) graft integrity, 3) the menisci for possible re-tear or extension of previous tears, and 4) joint for scar tissue and cartilaginous bodies either loose or fixed.

Hyperextension strain or "whiplash" injuries to the cervical spine

PURPOSE

To define "whiplash" radiologically.

MATERIAL AND METHODS

A full cervical spine radiographic series (including flexion and extension views) was reviewed in 40 patients with clinically proven "whiplash" injuries and compared to the radiographs in 105 normal controls. The level and degree of kinking or kyphosis, subluxation, and the difference in the amount of fanning between spinous processes on flexion and extension films were measured in each patient.

RESULTS

Localized kinking greater than 10 degrees and over 12 mm of fanning, often occurring at the level below the kinking or kyphosis, occurred mainly in the group of whiplash patients (sensitivity 81%, specificity 76%, accuracy 80%).

CONCLUSIONS

Localized kinking greater than 10 degrees and fanning greater than 12 mm are useful measurements by which to separate patients with true whiplash injuries from those with minor ligamentous tears. Flexion and extension views are essential to help define whiplash and other ligamentous injuries of the cervical spine.

Radiographic evaluation of the complications of long bone allografts

PURPOSE

To study the long-term results of long bone allografts in patients with benign and malignant bone tumors.

MATERIAL AND METHODS

Forty patients for whom full clinical and radiological information was held were investigated in order to assess the overall incidence of complications including fractures, nonunion, hardware problems, infections, and bone resorption.

RESULTS

There were four deaths; four more patients had distant metastases and one patient had a recurrent chondrosarcoma. Seventeen patients (42%) had either no complications (nine patients) or only minor ones (eight patients). Eleven patients (27%) sustained fractures of either their allograft (eight patients) or of their hardware (three patients). Hardware problems occurred in nine patients (22.5%), six of whom had serious problems requiring revision. The majority of the fractures and hardware problems occurred in younger male patients (82%). Infection occurred in five patients (12.5%), two of whom required revision, while two cases were superficial. Dissolution of the allograft occurred in 12 patients (30%), 7 of whom required removal of the allograft. Ten of these 12 patients were female.

CONCLUSION

The long-term survival of long bone allografts is not as good as generally reported if an adequate follow-up time period is used. Most of the fractures and hardware problems occurred in the younger active male patients, whose activities should probably be curtailed. Resorption of the allograft is another serious complication which appears to occur mainly in female patients and could possibly be controlled by chemotherapy.

Orthopedic complications

This overview of the complications encountered in orthopedic cases focuses on, among other things, complications of spinal surgery. The incidence of infection in spinal instrumentation and other orthopedic procedures is discussed and followed by a review of the complications of total joint replacement. Finally, a few words on the radiologist's responsibility for the reporting of orthopedic complications are given.

Total hip replacement and other orthopedic hip procedures

The history of total hip replacement including that of the Girdlestone procedure and resurfacing procedures is discussed. An overview of total hip replacement and its indications and complications forms the bulk of this section. Also, the use of porous-coated prostheses and endoprostheses as well as pins and plates is discussed and illustrated.

The radiology of bone allografts

Bone allograft surgery provides an attractive and effective solution to many orthopedic problems. Nevertheless, the entire process is technically demanding and associated with many potential complications of which infection is one of the most difficult to treat. Many advances have been made in the procurement and use of bone allografts, and further investigation should expand the applications of allograft surgery and continue to diminish the incidence of complications.

Radiologic case study. Multicentric reticulohistiocytosis

MRH is somewhat similar to, and probably occasionally mistaken for, psoriatic arthritis, Reiter's syndrome, or less frequently, rheumatoid arthritis. However, several important features distinguish MRH from the other arthritides. Rheumatoid arthritis more commonly involves the metacarpophalangeal joints, while MRH ordinarily affects the distal interphalangeal and proximal interphalangeal joints. Furthermore, MRH rarely exhibits the degree of articular osteopenia that is the hallmark of rheumatoid disease. While psoriatic arthritis and Reiter's often affect the DIP joints, they rarely display the symmetry of MRH. In addition, MRH does not demonstrate the periosteal new bone formation that is seen in both psoriatic arthritis and Reiter's syndrome. Hence, the diagnosis of MRH may be made with reasonable confidence on the radiologic findings alone, even before the cutaneous nodules appear, which can then be biopsied to confirm the diagnosis.

Diagnosis of breast implant rupture: imaging findings and relative efficacies of imaging techniques

OBJECTIVE

The purpose of this study was to compare the efficacies of mammography, sonography, CT, and MR imaging in the detection of breast implant rupture and to analyze the imaging findings.

SUBJECTS AND METHODS

Thirty-two women with 63 silicone breast implants participated in the study. All but one had signs and symptoms suggestive of rupture, and all had requested that their implants be removed before they were enrolled in this imaging study. All patients had film-screen mammography, sonography, CT, and MR imaging. Twenty-two ruptures were found at surgery; 21 were intracapsular and one was extracapsular. The relative efficacies of the imaging studies were determined, and the imaging findings were compared with the surgical results.

RESULTS

Of the 32 women with 63 implants, mammographic sensitivity for detecting implant rupture was only 23% but the specificity was 98%. Sonography had a higher sensitivity (59%), but its specificity was significantly lower (79%). CT had a sensitivity of 82% and a specificity of 88%. MR was the only imaging technique that consistently provided evidence that enabled the evaluation of intracapsular and extracapsular ruptures. The sensitivity and specificity of MR imaging were 95% and 93%, respectively.

CONCLUSION

Our results show that MR imaging is more sensitive and specific for the detection of breast implant rupture than is mammography, CT, or sonography.