John A. Campbell

Roentgen differentiation of the oculodentodigital syndrome and the Hallermann-Streiff syndrome in infancy.

An excellent recent publication has catalogued more than 100 syndromes affecting chiefly the head and neck (7). These sign and symptom complexes occur infrequently, but as a group they represent an important segment of medicine. Their recognition and correct diagnosis are important, particularly for the prognostic and possible genetic implications. In addition, clear delineation of a disease entity and its clinical spectrum is a requisite for serious consideration of etiology. Because of the similarity in facial appearance of some patients with different syndromes, confusion has developed which has tended to retard progress in correctly categorizing several disease entities. This communication is designed to emphasize the role of roentgen analysis as a complement to the clinical diagnosis of these rare syndromes, features of which, particularly in infancy, may appear to be limited largely to the head. Two cases, one of the oculodentodigital syndrome, the other of the Hallermann-Streiff syndrome, will be r...

Roentgenology of the Median Cleft Face Syndrome

In our continuing study of median craniofacial anomalies, we have found it convenient to subdivide cases on the basis of the interorbital distance. Orbital hypotelorism in combination with a proboscis or with a flat nose and median cleft lip reliably predict a brain that has failed to divide into cerebral hemispheres (holoprosencephaly) (3). The close correlation between face and brain in these patients prompted us to study the median facial anomalies associated with orbital hypertelorism (1). This communication reiterates the results of that study with emphasis on the roentgen characteristics. Classification and Roentgen Description Orbital hypertelorism occurs repeatedly with six other median facial anomalies: (a) low “V”-shaped frontal hairline, (b) cranium bifidum occultum frontalis, (c) primary telecanthus (lateral displacement of the medial canthi relative to the pupils), (d) median cleft nose, (e) median cleft prolabium2 and premaxilla,3 (f) median cleft secondary palate. In addition to these abnor...

Evaluation of Right Atrial Size

The accurate determination of specific chamber size is an integral part of the radiographic examination of the heart and great vessels. The left atrium and right ventricle can be evaluated with a high degree of accuracy by the utilization of well known and valid criteria. The posterior border of the left atrium is in juxtaposition to the esophagus, and enlargement of that chamber displaces the barium-filled esophagus posteriorly and to the right. This finding is best demonstrated in the lateral and right anterior oblique views. Enlargement of the right ventricle rotates the heart in a clockwise direction. On the postero-anterior view, the apex is usually elevated. Because the right ventricle is an anterior chamber, enlargement is well demonstrated in the right anterior oblique and lateral views as increased convexity of the anterior cardiac border and a decrease in the retrosternal space. Classically, the left ventricle enlarges posteriorly, downward, and to the left, as shown in the postero-anterior, lat...

Square-Frame Sixteen-Millimeter Cineradiography

Cine cameras, both 16- and 35-mm. size, record their images in a rectangular frame, the height measuring the shortest diameter (Fig. 1, A). As cine-radiographic images are circular in shape, it is apparent that the maximum diameter which may be recorded is restricted to the height of the rectangular frame. In order to obtain a reasonable compromise, it is frequently necessary to overframe the image (Fig. 1, B). This may result in a loss of as much as 50 per cent of the vertical dimension of the image, whether on 16-or 35-mm. film. After subtracting the space utilized by side perforations, the useful frame size of 16-mm. film is 7 1/2 × 11 mm., and 18 × 26 mm. for 35-mm. film. Some gain in the width of the frame may be achieved through the use of single perforated 16-mm. film by utilizing the unperforated edge. However, while this adds approximately 2 mm. to the width of the frame it obviously is of no great value in cineradiography as it does not extend the critical vertical diameter of the conventional f...

Factors Determining Film Exposure in Cineradiography

In the practical application of cineradiography, the radiologist needs a reliable and speedy determination of proper film exposure. Failure to achieve this greatly hampers the full realization of the clinical potential of this method of studying dynamic motion and restricts the extension of its usefulness to other areas of diagnostic roentgenology. As with spot-film radiography, some type of phototiming would be a desirable means of assuring correct film density for any combination of emulsion speed, framing rate, object density, and radiation exposure factors. Unfortunately, phototiming as we know it in conventional radiography cannot be readily achieved without a radical change in commercially available cine cameras. The compact design of these cameras does not provide sufficient space for the insertion of even a small conventional photocell into the area of the filming aperture. It is conceivable that a tiny selenium (cadmium sulfite) type photosensitive crystal could be placed in the camera, but this ...

Exposure Control in Cineradiography

Just as phototiming enhances the usefulness of spot-filming by eliminating exposure error, some means of assuring proper film density is a prerequisite for the broader clinical application of cineradiography. In the past, manual control of milliamperage by a millivolt monitor of the image tube current (Philips Co.) and a pre-read microammeter measuring the phototube current of a brightness-stabilizing circuit (Westinghouse) were used to establish correct cine film exposures in this work. Later, improved brightness stabilizers were employed in an attempt to maintain constant light levels for recording anatomical areas of varying opacity. While these devices, if properly used, permit one to achieve satisfactory film exposures, they are tedious to adjust, and the task of obtaining reproducible results under all conditions of cine operation requires a rather complicated procedure on the part of the radiologist. There is need for a simple-to-operate device which will assure constant film density at all film sp...