John H. Juhl

Roentgenographic Variations in the Normal Cervical Spine

The cervical spine with its relatively wide range of motion is peculiarly susceptible to indirect injury caused by sudden forces of acceleration or deceleration. This type of trauma, commonly termed whiplash injury, is a frequent result of automobile accidents. The mechanism of injury is sudden forcible flexion or extension of the neck, followed by less violent oscillations of flexion and extension. The human head is relatively large and heavy in proportion to the cervical spine and its supporting muscular and ligamentous structures. This undoubtedly contributes to the development of cervical injury (5). Many cases are complicated by the factor of potential compensation for personal injury and occur under circumstances which make it extremely difficult to evaluate the extent of disability. This fact has led to a number of studies of the roentgen changes in the cervical spine following trauma of the “whiplash” type. It is generally accepted that the normal cervical curve is convex anteriorly in the neutral...

Roentgenographic Findings in Fanconi's Anemia

Atriad of severe refractory hypoplastic anemia with pancytopenia, brown pigmentation of the skin, and multiple congenital anomalies was first described by Fanconi (9) in 1927. He reported three siblings who presented this triad which is now known as Fanconis syndrome or Fanconis hypoplastic anemia. The condition is rare, about 90 cases having been reported up to 1960, according to Nilsson and others (1–11, 14–17, 19–21, 23). Its distribution is world-wide; it has been reported throughout Europe and the United States as well as in Japan, Turkey, South Africa, and South America. There is no racial or geographic preponderance. The disease is somewhat more common in males than in females in a ratio of approximately 2 to 1. The purposes of this report are to present the clinical and roentgenographic findings in 14 cases, with case histories of 4 of them, to review briefly the clinical manifestations, particularly as they relate to roentgenographic findings, and to discuss the roentgenographic diagnosis of th...

Radiological Findings in Congenital and Acquired Occlusions of the Foramina of Magendie and Luschka

Hydrocephalus secondary to occlusion of the outlets of the fourth ventricle was initially described by Dandy and Blackfan in 1914 (15). In 1921 Dandy (16) described the surgical and pathological findings in the two major types of occlusion of these foramina; congenital and acquired (post-traumatic or postinfectious) and set forth the roentgenographic findings in the latter (basilar adhesive arachnoiditis). Taggart and Walker (45) have done the most extensive work on the congenital variety to date. Because of the distinctive radiographic, clinical, and pathological findings, Benda (3) in 1954 referred to the congenital type as the Dandy-Walker syndrome. Since several cases of basilar arachnoiditis and postsurgical cyst formation have been reported as examples of the Dandy-Walker syndrome (12, 19, 20, 42, 46), it is the purpose of this paper to attempt to clarify the differentiation of congenital occlusion of the foramina of the fourth ventricle (Dandy-Walker syndrome) from acquired occlusion (basilar adhes...

Radiological findings in lissencephaly (congenital agyria).

Lissencephaly is a rare congenital malformation of the central nervous system characterized by a failure in development of the cerebral sulci and gyri (agyria). The term itself means smooth brain (21). Absence of gyri is normal in the human fetus under four months of age, but the persistence of agyria after this age indicates an arrest in the brain development. Its etiology is unknown; there is no definite evidence to suggest a causative environmental agent, and no chromosomal abnormalities have been recorded or were found in the two cases to be presented. This does not rule out a genetic basis, which must be considered in view of the two cases in one family reported by Miller (15). The clinical findings in lissencephaly include microcephaly, decerebrate posture, unresponsiveness to the environment, severe motor retardation, seizures before the age of one year, failure to thrive, associated congenital anomalies, recurrent infection, and early death (7). Of special interest has been the observation of char...

Pulmonary Adenomatosis: Further Roentgen Observations

There continues to be disagreement as to the place of pulmonary adenomatosis in the classification of neoplasms, the correct nomenclature to be employed, the origin of the basic cell, and even the existence of the condition as a separate entity. Nevertheless, reports on the disease have been appearing with increasing frequency, and further information regarding its nature, clinical course, incidence, and related features has been accumulating. Our discussion will be concerned mainly with the clinical and roentgenologic aspects based on personal observation of 8 cases (4 reported previously and 4 new ones), together with a review of some of the pertinent information to be found in the literature. In 1945, Paul and Ritchie (7) reported 4 cases of pulmonary adenomatosis and discussed the general features of this relatively uncommon disease in so far as they were then known. At that time the condition had been of interest mainly to pathologists, since the diagnosis had not been made during life (except in 1 c...