The Craniovertebral Region in Chronic Inflammatory Rheumatic by Yves Dirheimer

By Yves Dirheimer

Radiology, the youngest of the foremost scientific sciences, has gone through a unprecedented technical evolution because the discovery of X-rays. it all started with the improvement of the different sorts of tomography and the adoption of many distinction brokers, then proceeded speedily to serioscopy, subtraction of pictures, direct expansion, echography, thermography, and xerography. this present day, even prior to most of these recommendations have come into universal use, one other department of radiologic know-how has developed: automatic (axial) tomography. greater than simply an innovation, its real dimensions are unfore­ seeable. Radiology has turn into in below a century an integral adjunct to the perform of medication. the improvement of radiology as a speciality its technical advances, which diversified drastically from nation to nation. This speedy improvement led fast to subspecialization, even the very early improvement of radiotherapy and radiodiagnostics as separate entities. notwithstanding, the access of radiology into the college has preserved it a unmarried department of medication, averting the widespread tendency towards automobile­ nomy of the branches of a speciality. at the present time the fourth new release of radiologists is confronted with one other deci­ sion: no matter if to develop into technologists subjugated to their equipment, to develop into sub experts with a unmarried ability, or to stay medical professionals. the majority of this fourth iteration has rejected turning into an adjunct to a grasp approach and really has really expert in accordance with the hippocratic notion of drugs.

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4a). Type 2 shows the upper vertebra in a fixed position, while the lower vertebra shows both end-positions of the movement (Fig. 4 b). The movement diagram of the COil segment in the flexion-extension movement is constructed by superimposing the image of the atlas and tracing out the contours of the occiput. This is type 1. In type 2 the contours of the occiput are superimposed and those of the atlas traced out. B. Wackenheim's Method [381] Chamberlain's line is traced in the three positions; neutral, flexion, and extension.

Conclusion: definite osteomalacia on a probably overall rarefied bone. 45 Chapter 2 Articular Changes: Arthritis Classically, there are no radiological changes at the very onset of rheumatoid arthritis. At best, in the joints of the limbs, a slight widening of the articular interspace is visible, consistent with tumefaction of the soft parts and hypertrophy of the synovia. We have never observed these features in the atlanto-occipital or atlantoaxial joints. We shall deal separately (Part 5, Chapter 5) with the problem of the atlanto-odontoid joint.

Martel [225], Sweetnam [348], and Boyle [45] found bulbar disturbances to be the cause of some unexplained deaths in rheumatoid arthritis and in ankylosing spondylarthritis. Such cases with bulbar disturbances would particularly justify cervico-occipital arthrodesis after reduction and decompresSIOn. Disturbances in sphincter control are most often mild. Hence, they often pass unoticed but should be carefully looked for since they are valuable for the diagnosis. By depriving the bladder of central control, medullary lesions tend to manifest the purely reflex function with incontinence and sudden urination.

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