Marc S. Lapayowker

Pigmented Villonodular Synovitis of the Temperomandibular Joint

Two cases of pigmented villonodular synovitis of the temperomandibular joint are reported. The diagnosis was not considered originally in either case and this entity has never been previously reported in this location. Smooth destruction of adjacent bone was encountered in both cases. Differential diagnosis including carcinoma of the external auditory canal and middle ear as well as other, less likely possibilities, are discussed.

Ultrasound determination of cerebrospinal fluid shunt patency: Technical note

A technique employing a Doppler ultrasound flowmeter in determining cerebrospinal fluid shunt patency is described. The technique has proven to be a valuable aid in the elevaluation of the patient in whom shunt function is in question.

Echocardiography in the Diagnosis of Pericardial Effusion

The diagnosis of pericardial effusion by reflected ultrasound, as described by Feigenbaum and his associates (1), promises to be a technic superior to presently used modalities with respect to safety and ease of performance and equivalent to them in accuracy. Differentiating a pericardial effusion from a large, dilated heart is a familiar problem to radiologists. Radioisotope scanning (2) as well as various radiographic procedures from simple decubitus films to angiocardiography and intravenous CO2 (3–5) are used to aid in this distinction. The latter has proved the most satisfactory in our hands and is virtually without morbidity. However, all these technics generally require in excess of thirty minutes. In addition, they involve the use of elaborate equipment and necessitate transport of the patient. These factors, plus positional requirements, prohibit examination of the very ill patient—often the one in whom correct diagnosis is most urgent. In contrast, echocardiograms can be obtained with commercial...

A Co-Operative Evaluation of Mammography in Seven Teaching Hospitals

The diagnostic criteria and radiographic technic of mammography were described in the American literature by Leborgne (1) in 1951 and Gershon-Cohen (2) in 1953. Prior to Egans report in 1960 (3), however, the examination was not performed as a routine in the majority of radiology departments in hospitals of the Philadelphia area. Many radiologists had attempted mammography only to abandon it after failing to achieve the accuracy of interpretation of published reports (4). Because of the unchanging death rate from breast cancer and the possibility of earlier accurate diagnosis suggested by Egan, a group of radiologists representing seven teaching hospitals2 in Philadelphia undertook in 1962, at the suggestion of Dr. Eugene P. Pendergrass, to study the value of mammography as a diagnostic tool. The primary purpose of the project was to determine the accuracy of mammography in diagnosis and its usefulness in the management of the breast patients of the physicians and surgeons practicing in the participating...

Angiography, Ultrasound, and Thermography in the Study of Peripheral Vascular Disease

Abstract A study of angiography, ultrasonography, and thermography which included 166 patients with suspected thrombophlebitis and 300 others with peripheral arterial disease showed that thermography aids in recognizing phlebitis and in assessing postoperative (but not preoperative) arterial disease. Although Doppler ultrasound cannot reliably detect thrombophlebitis, it permits highly accurate monitoring of peripheral arterial flow and is very helpful in programming arteriography and follow-up after arterial surgery. Both noninvasive techniques are well-suited for serial studies of peripheral vascular disease.

Thermography and ultrasound in detection and diagnosis of breast cancer

Although thermography has not proven to be of significant value in detecting early breast cancer as used in the National Breast Cancer Detection Program, it can represent a high risk indicator and can be useful in combination with other factors in reducing the number of women who should receive routine mammograms for screening purposes. In breast cancer patients, thermography has been shown to have prognostic value. “Cold” breast cancers have an increased survival as compared to those with increased infrared emission in some series. The use of diagnostic ultrasound to date has been generally limited to evaluation of breast cancer or masses found by either palpation or mammography. Recent improvements in technology with the use of multiple transducers, higher frequencies, through‐transmission techniques, and computerization have resulted in finding lesions greater than one centimeter in diameter. Lesions below this size and small calcifications have not so far been generally demonstrated successfully because of the limitation of ultrasound resolution.

Thermographic Diagnosis of Deep Venous Thrombosis

Two hundred patients with suspected deep venous thrombosis had thermography performed prior to ascending phlebography. Diagnostic agreement was obtained in 79%. Published diagnostic thermographic criteria were used; it was not possible to diagnose consistently limited or early thrombosis, especially in the calf muscle veins. Venous insufficiency produced the majority of false positives.

Thermography and oral inflammatory conditions

A brief review of the literature on the use of thermography in medicine and dentistry is presented. This is followed by the presentation of eleven case reports of the use of thermography in dental clinic patients with various oral inflammatory conditions. The results showed that in seven of the eleven cases the thermogram was able to delineate the involved from the noninvolved side. The findings were nonspecific, however, and in its current form thermography cannot be used alone for differential diagnosis.

Computer Diagnosis of Breast Thermograms

A computer-based technique was developed for the automated diagnosis of breast thermogram. Eighty-five thermograms were digitized and analyzed, and 23 parameters computed for each thermogram. A statistical decision program, based on a linear discriminant analysis technique, classified the thermograms into normal and abnormal categories. The accuracy of classification was evaluated by several techniques and found to be comparable to that of trained thermographers.

Arthrography in the diagnosis of calf pain.

Abstract A radiological differentiation was made between synovial rupture, giant cyst, and thrombophlebitis of the leg in 17 cases of calf pain. In Bakers cyst rupture, there was extravasation of contrast medium and/or air along soft-tissue planes, while an unruptured giant cyst was identified as a partially filled, sharply marginated, somewhat loculated collection. Rheumatoid arthritis was infrequent in these cases. A case of spontaneous rupture of a Bakers cyst without symptoms suggests that the chemical composition of the synovial fluid under pathological conditions such as rheumatoid arthritis may be more important in causing symptoms than the physical rupture of the synovia.