Traumatic injuries of the diaphragm are a known consequence of severe trauma, usually of the blunt type. Its incidence is increasing due to the rise in number and severity of accidents, especially car accidents. Diagnosing a traumatic diaphragmatic rupture is still a challenge for both radiologists and surgeons, with a delayed diagnosis in more than half of cases, with the consequent development of latent hernia. This hernia may manifest with symptoms varying from unspecific to bowel strangulation. We present the case of a patient with colonic obstruction secondary to a traumatic diaphragmatic hernia, with previous history of a penetrating thoracoabdominal trauma seven years before. Radiologic methods and signs for the diagnosis of this pathology are reviewed.

Variability in measurement of acetabular index Developmental dysplasia of the hip (DDH) is a spectrum of diseases ranging from frank dislocation of the hip to mild acetabular dysplasia. DDH screening for detection is performed routinely in our country using pelvic x-ray at 3 months of age. The radiographic measured acetabular index is used to evaluate the dysplastic hip, at initial presentation and during follow-up. Objective: Evaluation of the intra-and inter-observer variability, among medical professionals, when measuring acetabular index. Methods: Four reviewers (a children orthopedic surgeon, a general practitioner, a pediatrician and a radiologist) performed acetabular index measurement in 100 radiographs (200 hips), on three occasions, separated each by one month (600 total measurements). An independent observer evaluated the measurement reproducibility. The intra-class correlation coefficient to determine significant differences was used. Results: The intra-observer variability was less than the inter-observer variability. The intra-observer variability was similar among the different assessors, ± 1.5 degrees. The inter-observer variability was ± 3.4 degrees. Conclusions: A high concordance among measurements was reported, evidencing a high reproducibility of the acetabular index; this index is a reliable method for the diagnosis and follow-up of acetabular dysplasia.

Introducción La radiosinovectomía (o radiosinoviortesis) es una técnica que se ha empleado desde la década de los '50 (1) para el tratamiento de sinovitis resistente a tratamiento sistémico en artropatías inflamatorias como la artritis reumatoide y en artropatía hemofílica. Consiste en una forma local de radioterapia basada en la inyección intraarticular de un radiofármaco emisor de partículas beta en forma de suspensión coloidal (2). Tiene una tasa de éxito similar a la de la sinovectomía quirúrgica, con las ventajas de ser un procedimiento ambulatorio mínimamente invasivo, que requiere un menor tiempo de recuperación y que puede ser repetido (3). Es especialmente útil en la artropatía hemofílica; la sinovectomía quirúrgica es un procedimiento complejo en estos pacientes, quienes requieren hospitalización prolongada y reemplazo de factores de la coagulación (4). La solución coloidal de renio-186 es la indicada actualmente para el tratamiento en articulaciones de mediano tamaño, como la cadera, tobillo, hombro y muñeca, dado que la profundidad de penetración de la emisión beta es la suficiente para la irradiación adecuada de la membrana sinovial, pero sin afectar el hueso subcondral (3). Ultrasound-guided wrist radiosynovectomy: Case report and topic review Abstract: Radiosynovectomy is a local form of radiotherapy used as second-line treatment in the management of inflammatory and non-inflammatory arthropathies with unsatisfactory response to local or systemic corticosteroid therapy. Its efficacy is similar to that of surgical synovectomy, with the advantages of being a low-cost and minimally-invasive treatment that requires a shorter recovery time. Its efficacy is greater in the treatment of inflammatory arthritis characterized by synovitis, such as rheumatoid arthritis and juvenile chronic arthritis with mono/ oligoarticular involvement, especially in upper extremity joints. A number of isotopes can be used in colloidal suspensions. Rhenium-186-sulphide colloid is currently indicated for the treatment of medium-sized joints. The ultrasound-guided injection is suitable for small joints, such as wrist. For proper and safe use and administration of this technique the collaboration of a trained and experienced radiologist is critical to successful treatment.

No abstract