A case of a male, 29-year-old patient who, in a suicide attempt, has self-administered a 2 ml injection of metallic mercury into his left arm is reported. Radiological studies have shown the presence of several metallic spheres in the subcutaneous tissue of the olecranal fossa and along the veins of the left arm, with dissemination to lungs, heart, liver, spleen and brain.

Keywords: Embolism, Mercury, Radiology, Computed tomography

The authors report a case of a newborn term infant with horseshoe lung associated with supracardiac total anomalous pulmonary venous drainage; such association remains unreported in the Western literature.

Keywords: Horseshoe lung, Chest radiography, Computed tomography, Angiography

OBJECTIVE: To describe a technique for measuring gastric emptying in children. MATERIALS AND METHODS: Gastric emptying time was measured in 14 healthy volunteer children aged between 2 to 11. The children were asked to drink modified milk in proportion of 200 ml/m² of body surface. The antral area was measured before the injection of contrast media and at 60, 90, 120 and 150 minutes after the injection. RESULTS: The diet was well tolerated by most patients. In the majority (85%) of the children total gastric emptying occurred 150 minutes after the ingestion of the solution. CONCLUSION: Ultrasound is a safe and low cost alternative for the assessment of gastric emptying.

Keywords: Ultrasound, Gastric motility, Gastric emptying

OBJECTIVE: To compare the accuracy of high-resolution computed tomography (HRCT) with chest radiography in the diagnosis of interstitial lung disease in systemic sclerosis (SSc). MATERIALS AND METHODS: HRCT scans and chest radiographs in postero-anterior and lateral views were performed in 34 patients with systemic sclerosis, according to the American College of Rheumatology preliminary criteria for the diagnosis of SSc. The prevalence of radiological findings suggestive of interstitial lung disease in SSc seen on both imaging methods was compared. RESULTS: Interstitial disease was observed on HRCT images of 31 patients (91%) and in the chest radiographs of 16 patients (47%). The most frequent findings observed on HRCT were septal lines (74%), honeycombing (56%) and parenchymal bands (26%). Chest radiographs showed reticular areas of attenuation in 11 patients (32%) and parenchymal distortion in 12% of the patients. In 18 patients (53%) with normal chest radiographs HRCT showed septal lines in 55%, ground glass in 44%, honeycombing in 38.5% and cysts in 33%. CONCLUSION: HRCT is more sensitive than chest radiography in the evaluation of incipient interstitial lung involvement in patients with SSc and can provide a justification for immunosuppressive therapy in patients with early disease.

Keywords: Lung high-resolution computed tomography, Lung diseases, Systemic sclerosis

OBJECTIVE: A marked impact on the splanchnic circulation is seen in liver cirrhosis. Doppler ultrasonography (DUS) was performed in a group of patients with end-stage liver cirrhosis before, during and after orthotopic liver transplantation (OLT) in order to investigate the hemodynamic changes in portal vein flow velocity. MATERIALS AND METHODS: Fifty-four patients submitted to OLT and intraoperative DUS were prospectively studied from January 2002 to July 2003. Seventeen patients were excluded because of missing data due to either technical difficulties to obtain the measurements or early patient death. All 37 patients included in the analysis had liver cirrhosis mainly associated with hepatitis C virus infection and alcoholic disease. Patients were submitted to DUS just before OLT, intraoperatively after graft reperfusion, and in the postoperative period (1st and 7th postoperative days). Mean flow velocity was measured at main, right and left portal veins. Statistical analysis was performed using paired t test. Differences were significant when p < 0.05. RESULTS: The mean pre-OLT velocity in the portal vein was 16.0 cm/s. Intraoperative measurements obtained few minutes after graft reperfusion showed an increase in portal vein velocity to 84.09 cm/s. Portal flow velocity was 71.0 cm/s and 58.5 cm/s in the 1st and 7th postoperative days, respectively. Intraoperative and postoperative mean flow velocity in the portal vein was significantly higher than in pre-OLT period (p < 0.001). On the 7th postoperative day, the mean flow velocity in the portal vein decreased significantly compared to intraoperative values (p < 0.05). CONCLUSION: In liver transplantation, there is a significantly increase in mean flow velocity in the portal vein immediately after graft reperfusion when compared to pre-OLT data. Likewise, after this initial peak flow there is a significant and progressive decrease in mean flow velocity in the portal vein, which tends to normalize on the 7th postoperative day.

Keywords: Portal vein, Mean velocity, Transplantation, Hemodynamics

A choking patient was admitted with dyspnea, cyanosis, and loss of consciousness, which initially improved after suction of the airways. The patient presented worsening of the clinical parameters until the introduction of supportive treatment, after which she rapidly recovered. Chest x-ray taken on day of hospitalization showed bilateral diffuse alveolar filling pattern, and computed tomography showed ground glass areas. The aim of this paper is to show the radiological features of this syndrome.

Keywords: Mendelson syndrome, Chest x-ray, Computed tomography

The aim of this study is to compare helical computed tomography with imaging studies currently used to evaluate patients with acute low back pain. In addition, we briefly review the pathophysiology of urolithiasis. The literature published in the last 30 years was reviewed, and the following methods were discussed: plain abdominal radiographs, intravenous pielography, ultrasound of the urinary tract, and helical computed tomography. Helical computed tomography showed high sensitivity and specificity for detecting urolithiasis, virtually showing all stones, except in patients receiving indinavir. The accuracy of plain abdominal radiographs associated with ultrasound was similar to helical computed tomography, although the latter showed superiority as an isolated method. Data from literature suggest that whenever helical computed tomography is available, it is helpful in the evaluation of low back pain and also allows differential diagnosis between conditions that mimic the symptoms of urolithiasis.

Keywords: Plain abdominal radiographs, Helical computed tomography, Intravenous pielography, Low back pain, Ultrasound of the urinary tract, Urolithiasis

Knee pain is the most frequent symptom in osteoarthritis, a condition that is the leading cause of chronic disability in the elderly and one of the main sources of morbidity attributable to osteoarthritis in general. The causes of knee pain in individuals with osteoarthritis cannot be easily understood, and the knowledge of such causes is critical for determining future specific interventions. Bone attrition represents remodelling of the subchondral bone envelope in osteoarthritis, leading to a consequential change in bone shape and/or bone loss. However, bone attrition is not a feature that can be easily read, since it is hardly detected in the absence of clear defects of cortical bone integrity and because of overlap of bone structures at radiography. Bone attrition is associated not only with knee pain, but also with stiffness and disability. If attrition occurs prior to advanced osteoarthritis, this would suggest that changes in subchondral bone occur concurrently with cartilage loss and that treatments targeting cartilage loss alone are unlikely to be effective. Association with edemalike bone marrow lesions may be observed and constitute predictive factors for subchondral bone attrition. The present study was aimed at reviewing the literature, demonstrating the relevance of bone attrition and explaining how to diagnose this entity on imaging studies.

Keywords: Magnetic resonance imaging; Osteoarthritis; Knee pain; Bone attrition; Subchondral bone; Diagnosis.