Harold G. Jacobson

Dense bone — Too much bone: Radiological considerations and differential diagnosis

In conclusion, the attempt has been made to demonstrate that three major forms of new bone formation exist: reactive, neoplastic and the newborn or relative skeletal sclerosis in congenital (developmental) disorders. A classification of skeletal disorders has been presented and four major groups have been selected from the nine categories in this classification. These are: congenital-developmental, metabolic and endocrine, benign neoplasms and malignant neoplasms. In all four categories a large group of entities which may present with new bone (sclerosis) are listed and are discussed in some, but limited, detail. A number of these entities in each of the four categories are illustrated.

Angiographic differentiation of thoracic aneurysms and neoplasms

The distinction between nondissecting aneuryms of the thoracic aorta and thoracic neoplasms may be difficult. The aortographic findings associated with aneurysms may be subtle. However, when the aortogram is properly performed and interpreted and the findings correlated with the plain chest roentgenograms the distinction between aneurysms and neoplasms may be made consistently. The thoracic aortogram should be filmed in at least 2 projections and abdominal aortography and ultrasonography should be performed. With aneurysms the aortographic signs include widening (often slight) of the aortic lumen, thickening of the aortic wall, small ulcer-like collections of contrast and non-filling of regional intercostal arteries. With neoplasms none of these radiological features is to be anticipated, while the aorta will be normal, displaced or narrowed.

Changes in the style of references and the structure of abstracts of papers

The editors have proposed and the editorial committee has accepted certain moves to bring Skeletal Radiology in line with an increasing number of distinguished scientific journals. It is considered that such uniformity of structure can only prove of benefit. Beginning in 1994, we shall be changing to the Vancouver system for referencing of papers. During 1994, all newly submitted papers will be expected to have this format, which has the advantage for authors of gradually becoming the standard for scientific journals; hence the reference numbering of a paper does not need to be altered if submitted to most other journals. Because a number of our papers are in preparation, it is likely that this journal will, in the second half of 1994, contain papers in each style. By the first edition of 1995, all papers published in Skeletal Radiology will have adopted the Vancouver system. Secondly, in line with a growing number of other journals, we shall be requiring the introduction of a simple structured form of abstract, for the convenience of the readership. These abstracts will contain four sections: Objective, Design, Patients, Results and conclusions. Such a change does not signify that the abstracts should be any longer than at present; in fact the concise form is likely to be not only clearer but, in many cases, probably shorter. Details of both these changes are to be found in the revised Instructions to authors on the page opposite. As Editors of this journal we believe that these changes are timely and will enhance the value of the published articles for both authors and readers.

Fractures and dislocations around the adult knee

HE KNEE JOINT has evolved into a highly specialized structure in the human, surpassing that of all lower animals in its complexity. The cause lies in the excessive functional demands made on the human knee as a result of man’s erect posture. Weight-bearing, walking, running, and the ability to extend the knee completely are physiologic functions that subject the human knee to considerably more stress than in four-legged mammals. The knee, the largest joint in the body, is in a vulnerable position for direct trauma and unusual torsional and bending stresses. The security of the knee depends mostly on the powerful ligaments that bind the osseous components together, as well as on the muscles that surround it. Increasing participation in various sports activities has subjected more and more individuals to greater stress and severe injury of the knees than ever before.