Patellar tendinitis demonstrates a consistent spectrum of changes at MR imaging that can aid understanding of the origin and treatment of damage.

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We describe our experience with fluoroscopically guided percutaneous gastrostomy, assessing in particular the functional performance of inserted tubes. We also examine the ability of radiological investigations to detect intraperitoneal gastrostomy leakage after the procedure. A functioning gastrostomy tube was established and maintained for as long as was required in 34 (89.5%) of 38 patients referred during a 21-month period. This necessitated further gastrostomy tube placements in 13 patients. On average, inserted gastrostomy tubes functioned for 10.75 weeks and during the review period a total of 34 malfunctioning tubes required replacement or removal. This was most commonly due to tube dislodgement, blockage, or intraperitoneal leakage. We found increasing pneumoperitoneum on sequential postprocedure erect chest films a reliable sign in the diagnosis of the latter complication. In conclusion, while we have been disappointed with aspects of individual tube function, our satisfactory overall functional success rate indicates that percutaneous gastrostomy is an effective method for establishing and maintaining enteral feeding. We also propose a protocol for the management of suspected intraperitoneal leakage based on the findings on postprocedure erect chest films.

No abstract

This report compares the presentations and outcome of pneumothorax in 11 patients aged over 65 with 15 patients aged 20-35 years. Information was retrospectively collected from the charts regarding modes of presentation and the course of the illness. A questionnaire was sent to the general practitioners of the older group asking about the long-term outcome relating to functional status. Older patients were more likely than younger to present primarily with dyspnoea. The classical symptom of acute onset of pleuritic chest pain was present in ten of the 15 younger patients but in only two of the older patients. There were also statistically significant associations of the elderly patients with the following: radiological evidence of pre-existing lung disease; absence of pleuritic chest pain on admission; atypical or absent pain; a major delay from symptom onset to presentation; the diagnosis being clinically missed prior to chest radiography; and prolonged hospitalization. Nine of the 11 elderly patients were eventually independent at home.