It is with great pleasure and, much interest that I accepted to write the foreword to this book by Paul Doury, Yves Dirheimer, and Serge Pattin on the subject of "algodystrophy." First, because I know the extent of their personal experience, from which they have selected the best for this book. Second, because it seemed to me that their detailed analysis of the numerous works on the subject, works which have been published all over the world and which provide diverse physiopathologic interpretations, would provide a comprehensive study meeting a real need. Algodystrophy, to adopt the term used by the authors, merits rheumatolog ists' careful attention. It is indeed a frequent condition and, as is now well known, occurs in the most varied etiologic circumstances; it is not solely posttraumatic, a notion on which diagnosis had long been based. This variable etiology suggests the complexity of algodystrophy's pathogenic mechanism."

These exercises are meant for students and practitioners who wish to familiarize themselves with the normal and pathologieal computerized tomographie radioanatomy of the abdomen. The iconography is suffieiently characteristic to be read without the help of clinical or biological data. It comprises both normal and pathologie findings. Analysis of scans is comprised of two steps. The first part consists of the detailed study of normal scans, whieh serve as a reference. For this, eight main slice levels have been considered necessary and sufficient: neces sary since a certain number of slices are indispensable for the exploration of the abdomen; sufficient because a larger number of slices would risk rendering memorization difficult. The second part involves a study of the pathologie findings, organ by organ. Acknowledgements. Appreciation is extended to all those who have helped in realizing this study and, more particularly, to our friends and colleagues, J. L. DIETEMANN, C. Roy, J. L. BURGUET, M. VOUGE, and J. W. SOUITER. We would also like to thank Dr. J. WIECZOREK for his friendly assistance and advice in the planning and presentation of figures and schemata. 1 Technical Note Computerized tomography of the abdomen begins with an initial image called "scout view". This numbered radio graph of the abdomen is an analogous representation of the information and allows the location of the eight selected slice levels; these are represented by horizontallines. The slices are 10 mm thick and are taken at intervals of 2.5 cm.

Like my first book of exercises in radiological diagnosis con- cerning the vertebrae in adults, the first part of this book consists of an atlas of images ready for immanent reading. The images are numbered, each number corresponding to a case. The second part comprises the corresponding comments, critical interpretations, and drawings (using the same num- bers as the corresponding radiographs in the first part). I hope that this second booklet will be as appreciated as was the first, which was published in four languages (Radio- diagnosis of the Vertebrae in Adults. Springer, Berlin Hei- delberg New York 1983). My own documentation having proved deficient in some fields, I had recourse to the didactic collections oimy collea- gues, friends, and students. Special thanks are due to Prof. J. F. Bonneville, and to Drs. J. L. Dietemann, Y. Dirheimer, J. C. Dosch, and J. Vignaud. AUGUSTE WACKENHEIM VII Contents Introduction ...1 Part One: Iconography 5 Part Two: Commentary with Corresponding Schemata. 107 References . . 189 Subject Index 191 IX Introduction The analysis or the reading of an X-ray picture proceeds from struc- turalistic rules, such as the immanence, the synchronism, the significa- tion (signifiant and signifie of a sign), first from the semeiologic and then from the semantic point of view. In a simpler way, one can say that it is necessary to distinguish the signifiant, the signiGBPie, the comment, the interpretation, and the radiobioclinical confrontation. The signifiant or character is a normal or pathological "characteris- tic" part of the image.

This volume is the latest in the series Exercises in Radio logical Diagnosis, launched by the Strasbourg School of Radio logy. Further volumes on the facial bones, senology, and abdominal tomography are in preparation. Jean-Louis Dietemann has over a decade's experience of radiodiagnosis of the skull, and has already proven his talents as a teacher with his earlier books on the sella turcica and on carotid angiography. The present volume will assuredly be a great success and will enhance the series. Professor A. W ACKENHEIM Hospices Civils de Strasbourg Centre Hospitalier Regional Service de Radiologie I Strasbourg v Contents Part One: Iconography . . . . . . . . . . . . .. . . 1 . Part Two: Commentary with Corresponding Schemata. 85 References . . 165 Subject Index 167 VII Part One Iconography 1 1 a b 3 2 a b 4 3 4 5 6 6 a b 7 7 8 8 a b 9 9 10 10 11 a b 11 12 13 a b 13 a b 14 b 15 16 17 16 17 20 18 21 a b 19 22 a b 20 21 24 a b 22 b 23 26 27 24 a 25 26 29 27 31 32 28 33 34 29 35 36 30 37 a b 31 38 39 32 40 41 33 42 43 34 44 a b 35 44 c 45 a 36 45 b ~----~------~~ c 37 46 47 38 48 49 39 50 a b 40 41 52 53 a 42 53 b 54 a 43 54 b 55 44 56

It was with great pleasure that I accepted Professor Wackenheim's invitation to write the preface of this most interesting monograph. During the international course on neuroradiology in Obernai, organized by Professor Wackenheim in 1978, an entire day was devoted to discussions about various aspects of stenosis of the lumbar vertebral canal. As Professor Wackenheim and his group, in particular Dr. E. Babin, had thorough. ly studied this field, it was an excellent occasion for the exchange of views through personal contact. Their support of basic views such as attributing the cause of stenosis to a developmental disturbance of growth of the neural element - the vertebral arc- and spontaneous agreement about essentials in classification and nomenclature facili tated this exchange. Reading the present monograph made me think back to 1949 when I wrote my first publication on stenosis of the lumbar vertebral canal in a French volume that com memorated my teacher in neurosurgery, Professor Clovis Vincent. During the following years it was impossible to publish a more detailed paper on the subject in international journals since their editorial boards did not believe in its occurrence. My first English papers were published in the Journal of Bone and Joint Surgery (1954, 1955), but it was only during the 1970s that this form of stenosis became more universally recog nized."