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The aim of this study was to describe the radiographic appearances of femoral allografts in 29 total hip arthroplasty (THA) revision procedures among 21 patients. Each patient had evidence of severe bone loss in the proximal femur related to previous hip arthroplasty. Proximal femoral allografts and cortical strut allografts were used to supplement and reinforce the native femur. The radiographic appearances were reviewed over a mean follow-up period of 2.5 years. A definite pattern emerged as the graft proceeded to unite with the host bone. The earliest feature was haziness and blurring of the ends of the allograft, followed by rounding and tapering of the ends, several months later. Eventually, sclerosis and coarse trabeculation of the cortex was seen when the graft had incorporated. A minor degree of resorption occurred in all cases, most commonly beneath the cerclage wires binding the grafts to the host bone. Complications included infection, fracture of the allograft and the host femur, and resorption of the graft. There were 3 cases of complete non-union and 11 cases of partial union. A definite radiographic pattern is evident as allograft bone unites with host bone. Knowledge of this pattern is useful to assess progression towards bony unit. Le but de ce travail est de decrire les apparences radiographiques d'allogreffes femorales dans 29 cas d'arthroplasties totales de la hanche (ATH) chez 21 patients ayant subi une intervention corrective. Chacun des patients presentait une perte considerable de la masse osseuse du femur proximal due a la precedente arthroplastic. Afin de renforcer et de compenser le femur naturel on avait procede a des allogreffes femorales proximales et des allogreffes a etai cortical. Les apparences radiographiques ont ete etablis sur une periode moyenne de suivi medical de deux ans et demi. Un schema bien defini apparait a partir du moment ou la greffe commence a se souder a l'os recepteur. On observe d'abord l'apparition d'une tache trouble et voilee aux extremites de l'allogreffe suivi plusieurs mois plus tard d'un effacement aux extremites. Une fois la greffe prise, on remarque une sclerose et trabecule grossiere du corteux. Dans tous les cas observes il s'etait produit une resorption, en general au niveau des cerclages metalliques fixant la greffe a l'os recepteur. Parmi les autres complications il faut citer egalement l'infection, la fracture de l'allogreffe et du femur recepteur et la resorption de la greffe elle-meme Dans trois des cas la greffe ne s'etait pas faite et dans onze des cas elle n'etait que partielle. Il est ainsi possible d'observer au niveau radiographique le schema evolutif d'une allogreffe tandis qu'elle se soude a l'os recepteur. Il est utile de savoir reconnaitre cette evidence afin de pouvoir estimer la progression de la soudure des os.

Eighty malpractice claims were taken against the U.S. government alleging negligence and delay in the diagnosis of breast cancer in federal medical facilities during the period from 1980 to 1989. Medical records and claim documents were reviewed together with the opinions of expert witnesses, journal articles, and opinions of the Department of Legal Medicine of the Armed Forces Institute of Pathology. The radiology and pathology reports were reviewed. Of the 80 claims, 68 were closed; compensation amounts ranged from $6,000 to $1 million. There was no correlation between the length of delay in diagnosis and the amount of compensation paid. The reasons for delayed diagnosis are considered in detail, and recommendations are made in an attempt to minimize the number of such claims in the future.

Because of significant difficulties encountered in the manipulation of data from 99Tcm-DTPA and 99Tcm-mercaptoacetyltriglycine (MAG3) renogram studies, it was decided to try to improve the percentage dose of radioisotope injected and thus the number of counts obtained by using a minimum dose volume of 1 ml for all injections. This resulted in an improvement in the percentage dose injected. However, difficulties were still encountered in the younger children. 18.7% of children aged less than 3 months, received less than 50% of the injected dose, showing little or no improvement using the newer method. The difficulty of injecting small babies seems the most obvious reason. During the interpretation of the findings in paediatric radioisotope studies, it is important to remember that not all children may have received an adequate percentage dose to constitute a reliably diagnostic study.

We describe a case of dirofilariasis of the breast in a woman presenting with a breast lump. The mammogram and ultrasound appearances are described with histopathological correlation. The suspicion of a parasitic infection was raised by the presence of rod-like structures within a hypoechoic nodule on sonography, appearances that have not been previously described. The case illustrates an unusual diagnostic problem since it presented in a non-endemic area.

We report the ultrasound findings in a 28-day-old infant with encephalitis due to herpes simplex type 2. To date less than ten such cases have appeared in the world literature. Asymmetric ventricular dilatation was seen sonographically with widespread parenchymal hyperechoic areas which corresponded to areas of low attenuation on CT. Cranial ultrasound has a distinctive appearance which, if recognised, and suggested, can lead to an early definitive diagnosis.

A 5-year retrospective study (January 1981-December 1985) of 87 patients with a known diagnosis of MS who were admitted to the University College Hospital, Galway, Ireland, was carried out. The duration of disease relapse was correlated with the following meteorological factors prevailing about the period of relapse: (a) temperature--mean daily, absolute maximum, absolute minimum; (b) rainfall; (c) relative humidity, and (d) sunshine and global radiation. Highly significant positive correlations were found between relapse duration and temperature variables, total number of sunshine hours and global radiation. Negative correlations were found between relapse duration and both rainfall and relative humidity. Relapses were of longer duration in the middle months of the year.

A case is outlined of a patient presenting with a painful shoulder. Metastatic malignant melanoma was diagnosed. The sites of origin of melanotic lesions as well as metastatic sites are described. Both gross and radiological appearances of such lesion are not uniform, varying from osteolytic to osteoblastic forms. Treatment is for the most part ineffective. The outcome is rapid and invariably fatal.