Introduction: the presence of anti-CCP is an important prognostic tool for rheumatoid arthritis (RA), but its relationship with the activity of the disease and functional capacity is still being investigated. Objectives: to study the relationship between anti-CCP and the indices of disease activity, functional capacity and structural damage, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in stabilized RA. Methods: cross-sectional study of RA patients with one to 10 years of disease. The participants were subjected to clinical evaluation with anti-CCP screening. Disease activity was assessed by means of the Clinical Disease Activity Index (CDAI) and functional capacity by means of the Health Assessment Questionnaire (HAQ). CR was analyzed by the Sharp van der Heijde index (SmvH) and MRI by the Rheumatoid Arthritis Magnetic Resonance Image Scoring System (RAMRIS). Results: 56 patients were evaluated, with median (IIq) of 55 (47.5–60.0) years, 50 (89.3%) were female among whom 37 (66.1%) were positive for anti-CCP. The median (IIq) of CDAI, HAQ, SmvH and RAMRIS were 14.75 (5.42–24.97), 1.06 (0.28–1.75), 2 (0–8) and 15 (7–35), respectively. There was no association between anti-CCP and CDAI, HAQ, SmvH and RAMRIS. Conclusion: our results did not establish the association of anti-CCP with the severity of the disease. So far, we cannot corroborate the anti-CCP as a prognostic tool in RA established.

Vascular access in hemodialysis is one of the pillars of success of the program. Therefore, efforts should be directed firstly to achieve the greatest number of vascular accesses of the arteriovenous fistula type, and secondly to reduce complications related to access cannulation in order to functionally preserve the access. Several strategies have been described to improve this last aspect; this article describes the use of ultrasound to improve the probability of successful cannulation in cases considered difficult by the nursing team.

Focused Assessment with Sonography for Trauma (FAST) has been widely used and studied in blunt and penetrating trauma for the past 3 decades. Prior to FAST, invasive procedures such as diagnostic peritoneal lavage and exploratory laparotomy were commonly used to diagnose intra-abdominal injuries. Today, the FAST examination has evolved into a more comprehensive study of the abdomen, heart, thorax, inferior vena cava, among others, with many variations in technique, protocols and interpretation. Trauma management strategies such as laparotomy, endoscopy, computed tomography angiography, angiographic intervention, serial imaging and clinical observation have also changed over the years. This technique, at times, has managed to replace computed tomography and peritoneal lavage diagnosis, without producing delays in the surgical procedure. As such, the relationship between the patient’s clinical information and the results of the exam should be guided to guide therapeutic approaches in difficult to access settings such as intensive care units in war zones, rural or remote locations where other imaging methods are not available. This review will discuss the evolution of the FAST exam to its current status and evaluate its evolving role in the acute management of the trauma patient.

The temporomandibular joint (TMJ) is considered a bicondylar diarthrosis type joint. Imaging evaluation is a fundamental part of its assessment, which should include both bony and soft tissue characteristics and the relationship between them. Magnetic resonance imaging (MRI) represents the gold standard for the study of soft tissues; however, up to now, its main application continues to be the visualization of the articular disc. For this reason, the present article aimed to point out the information available in the literature regarding the visualization of the joint capsule in MRI and to evaluate it as an independent structure.

Gout is an arthritis characterized by the deposition of sodium monoacid crystals in the synovial membrane, articular cartilage, and periarticular tissues that leads to an inflamatory process. In most cases, the diagnosis is established by clinical criteria and analysis of the synovial fluid for MSU crystals. However, gout may manifest in atypical ways and make diagnosis difficult. In these situations, imaging studies play a fundamental role in helping to confirm the diagnosis or even exclude other differential diagnoses. Conventional radiography is still the most commonly used method in the follow-up of these patients, but it is a very insensitive test, because it only detects late changes. In recent years, advances in imaging methods have emerged in relation to gout. Ultrasound has proven to be a highly accurate test in the diagnosis of gout, identifying MSU deposits in articular cartilage and periarticular tissues, and detecting and characterizing tophi, tendinopathies, and tophi enthesopathies. Computed tomography is an excellent exam for the detection of bone erosions and evaluation of spinal involvement. Dual-energy computed tomography, a new method that provides information on the chemical composition of tissues, allows identification of MSU deposits with high accuracy. MRI can be useful in the evaluation of deep tissues not accessible by ultrasound. In addition to diagnosis, with the emergence of drugs that aim to reduce the tophaceous burden, imaging examinations become a useful tool in the follow-up treatment of gout patients.

Introduction: It is universally accepted that the posteroanterior skull radiograph shows a lower degree of distortion than other radiographic images, so that measurements on it are considered reliable. Objective: To determine the percentage of distortion in the different facial regions of the postero-anterior skull radiograph. Methods: Thirty human skulls with their jaws were divided by three horizontal and four vertical planes into fifteen quadrants; there were ten in the skull and five in the jaw. On each of them a steel wire was placed in vertical and horizontal positions and their length (actual measurement) was measured. Each set was X-rayed in posteroanterior projection and the length of the wires was measured in the image (radiographic measurement). Results: It was not possible to measure in the lateral quadrants of the skull. The horizontal measurement in the right and left lower intermediate quadrants of the skull and in the intermediate and lateral quadrants of both sides of the mandible is not reliable; in the median quadrant of the mandible it is minimized; in the right and left upper intermediate and median quadrants of the skull and in the median of the mandible it is magnified. Vertical measurements in all quadrants are reliable; in the right and left upper intermediate and left upper and middle quadrants of the skull and in the right and left middle and lateral quadrants of the mandible it is magnified; in the lower intermediate and upper and lower middle quadrants of the skull and median of the mandible it is minimized. The least distortion for both measurements occurs in the upper median quadrant of the skull. Percentages of distortion are reported for each quadrant. Conclusions: Distortion is present in the posteroanterior skull radiograph and varies from one region of the face to another.