Anne C. Brower

Histological Nature of the Cortical Irregularity of the Medial Posterior Distal Femoral Metaphysis in Children

Abstract The histological nature of the cortical irregularity of the medial posterior aspect of the distal femoral metaphysis is defined. This condition may simulate neoplastic bone in children. Although this irregularity does not show the typical radiographic picture of a benign cortical defect, histologically it is identical to that entity.

Selecting Radiology Resident Candidates

Radiology resident candidate selection has become a burdensome, subjective, and somewhat arbitrary process. Because the luxury of many well-qualified candidates exists, there is an obligation to select them as honestly, equitably, and objectively as possible. Two years were spent in revising and modifying the resident selection process to make it more uniform and more efficacious. An application scoring form was devised to extract uniform pertinent information from the original application form. Candidates could then be ranked according to a numerical score derived from the form. This allowed easy selection of top candidates to be interviewed. A new interviewing scoring form was developed to include desirable characteristics of resident candidate performance. This form was also devised in such a way as to be easily scored and to allow selection of the top 20 to 25 candidates. These candidates were then ranked by participating faculty members while reviewing their application score forms and their interview forms. Positions for the residency training program were offered according to the ranking. The usefulness of both new forms was evaluated and confirmed by correlating form scores with faculty ranking of academic performance of current residents in the training program.

Testing as a Teaching Tool

More than four years ago, the authors initiated testing as a means of obtaining data for evaluating residents. The testing process has evolved now and is used for its teaching value and as a means of objective resident self-evaluation. Testing is designed to provide 10 cases an hour, with characteristics allowing a single diagnosis as a unique answer. No history is provided because a common topic and anatomic area provide a context for each examination. Answers are given during the examination after each question, and discussion follows. All answers are written, and answer sheets are collected. Attendance is high. Test scores are routinely lower than in other forms of evaluation. Testing integrates all aspects of radiology training from cognitive through deductive, simulates written consultations, and provides a means of self-evaluation through rapid feedback. Testing is a viable form of teaching that blends self-evaluation with faculty and peer feedback.

Midline circular defect of the sternum.

A case of a midline circular defect of the sternum is presented. This may represent a localized fusion anomaly.

Rheumatoid nodulosis: another cuase of juxtarticular nodules.

A case of rheumatoid nodulosis and the difficulties encountered in its diagnosis are presented. A positive rheumatoid factor, biopsy proved involvement of the synovium and bone at the second metacarpophalangeal joint, and regression of nodules and mild arthritic symptoms with gold therapy, supported the diagnosis of a rheumatoid disease variant. The relationship of the disease to rheumatoid arthritis, gout, and xanthomatosis is discussed.

A Critical Appraisal of Radiographic Studies Employed in the Staging of Patients with Hodgkin's Disease

The relative merits of excretory urography, inferior vena cavography and lymphangiography performed in 55 patients with Hodgkins disease referred for staging and exploration were compared. The contribution of these studies to final staging appears limited. Radiographic review correctly changed clinical staging in only 10%, erroneously in 10%, and failed to detect additional disease in 16%. If extensive work-up in staging of Hodgkins disease must continue, inferior vena cavography should be the first study. Lymphangiography should be performed in patients with normal inferior vena cavagrams (IVC) but is unnecessary and potentially dangerous when the IVC is abnormal.

Case report 17

Figs. 1A and B. A grossly destructive lesion, with considerable new bone formation, involves the left orbit, with obliteration of most of its bony margins except the inferior border. A soft tissue mass is suggested because of the overlying hazy density. The lateral and inferior bony margins of the left fiontal sinus are also destroyed, with some opacification of both frontal sinuses, particularly the left. A metallic suture is present over the superior portion of the orbital area