A Note on the Spectrum of Doubly Ionized Scandium by Smith S.

By Smith S.

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What is the diagnosis? 3. What other radiological investigations may be used to confirm the diagnosis? 4. What is the treatment? 5. Which three nerves must be preserved when surgery is undertaken for this condition? 29 02 Pages 25-74 15 21/11/01 11:12 am Page 30 (Black plate) Answers Radiology for Surgeons 1. The X-ray demonstrates a fairly well-defined moderately large calcific density projected under the body of the mandible. 2. Diagnosis: submandibular salivary gland calculus. 3. • Occlusal film: may demonstrate a calculus in Wharton’s duct.

Neurological: • Weakness and wasting of the small muscles of the hand from T1 nerve root compression. • Sensory changes along the medial border of the hand and forearm. 4. Differential diagnosis: • In the neck and arm: cervical spondylosis, cervical disc protrusion, Pancoast tumour, progressive muscular atrophy, syringomyelia, osteoarthritis of the shoulder, axillary vein thrombosis. • In the elbow: ulnar nerve neuritis. • In the wrist: carpal tunnel compression. • Other arterial conditions: atherosclerosis of the subclavian artery, Buerger’s disease, Takayasu’s disease.

What are the secondary complications of head injuries? 25 02 Pages 25-74 13 21/11/01 11:12 am Page 26 (Black plate) Answers Radiology for Surgeons 1. • There is a biconvex area of increased attenuation overlying the left temporal region. A further ill-defined area of high attenuation is seen within the parenchyma of the right temporal lobe. • Diagnosis: left extradural haematoma with right contra coup injury. 2. Typical history: a cricketer is struck on the side of the head by the ball, loses consciousness for a few seconds and then makes an apparent full recovery.

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