RESUMEN
UNLABELLED: Mallet finger is a flexion deformity of the distal interphalangeal joint (DIPJ) caused by a disruption of the extensor mechanism. The deformity can b e caused by active trauma, minor trauma or other conditions like rheumatoid arthritis or osteoarthritis. AIM: To describe the sonographic findings in mallet finger. METHOD: We performed sonographic examination on thirty patients with traumatic mallet finger, on thirty control patients where we examined the same finger in the opposite hand (,) and thirty patients with rheumatoid arthritis or osteoarthritis and flexion deformity. RESULTS: We found four criteria for traumatic mallet finger which included: discontinuity of the extensor tendon with partial or complete tear, avulsion fracture, no real time movements of the extensor tendon, and fluid in the region of insertion of the extensor tendon. CONCLUSION: Sonographic examination of patients with traumatic mallet finger is an important diagnostic tool and can differentiate between traumatic mallet finger and flexion deformity of rheumatoid arthritis or osteoarthritis.
Asunto(s)
Dedos/diagnóstico por imagen , Deformidades Adquiridas de la Mano/diagnóstico por imagen , Anciano , Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico por imagen , Diagnóstico Diferencial , Articulaciones de los Dedos/diagnóstico por imagen , Lateralidad Funcional , Humanos , Persona de Mediana Edad , Osteoartritis/complicaciones , Osteoartritis/diagnóstico por imagen , Ultrasonografía , Heridas y LesionesRESUMEN
AIM: Sinus X-rays are still frequently used in the evaluation of paranasal sinusitis. Many radiology departments nowadays provide the referring doctors with a single Waters' projection. Our purpose was to evaluate the diagnostic accuracy of a single Waters' view vs high resolution computed tomography (CT) in the diagnosis of paranasal sinusitis. SUBJECTS AND METHODS: A total of 134 patients with suspected paranasal sinusitis underwent a Waters' view X-ray and high resolution CT on the same day. The radiographs were evaluated independently by nine experienced radiologists, who observed each sinus separately. Sensitivity, specificity, accuracy, positive and negative predictive values were calculated for each sinus and for each observer, using the CT findings as a 'gold standard'. RESULTS: The weighted mean sensitivity for diagnosis of any abnormality in the maxillary sinus was 67.7%, specificity 87.6%, accuracy 78.6%, positive predictive value 82.5% and negative predictive value 76.9%. For this sinus the variation between observers was small, however, the sensitivity for diagnosis of any disease in the frontal and ethmoid sinuses varied widely between observers (range 1.9-54.0% and 0-58.9%, respectively). The sensitivity for the sphenoid sinus was very low (range 0-3.8%), even in radiographs which seemed to demonstrate it well. CONCLUSION: The Waters' view has its limits in the diagnosis of sinusitis of the maxillary sinuses and its contribution for diagnosing lesions in the remaining sinuses is very poor. Whenever access to CT is available, a low dose high-resolution CT study of the paranasal sinuses is highly recommended.Konen, E. (2000). Clinical Radiology55, 856-860.