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Biomedical subjects

A Cerase

Publications and source records attributed to A Cerase.

29 records · Page 2Linked to original sources
PubMed1997

Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis.

PURPOSE: To determine the types and prevalence of lumbosacral junction injuries associated with an unstable pelvic fracture and to assess the diagnostic value of conventional radiographic and computed tomographic (CT) findings. MATERIALS AND METHODS: Anteroposterior, inlet, and outlet radiographs and CT scans in 97 patients with pelvic disruption were retrospectively reviewed. RESULTS: Unstable pelvic fractures were seen on radiographs in 73 patients, 42 of whom had a sacral fracture. Fourteen of these 42 patients had an associated L5-S1 facet joint injury (three extraarticular, nine articular, and two complex). In three of these 14 patients, the L-5 body was laterally bent by more than 10 degrees, with asymmetric L5-S1 intervertebral space. The diagnosis in nine of the 14 patients with an associated lumbosacral junction injury was rendered on the basis of CT findings only. CONCLUSION: Lumbosacral junction injury must be considered in patients with an unstable pelvic fracture, especially in those with an associated sacral fracture. CT is necessary because these conditions may be overlooked on radiographs, although outlet radiographs are better than CT scans for depicting the possibly associated L5-S1 intervertebral disk lesion.

Adolescent↗
PubMed1997

Radiographic changes in the feet of patients with early rheumatoid arthritis. GRISAR (Gruppo Reumatologi Italiani Studio Artrite Reumatoide)

OBJECTIVE: To assess the value of radiographs of the feet of patients with early rheumatoid arthritis (RA) in the evaluation of RA classification and outcome. METHODS: Within a multicenter therapeutic trial, baseline and 12 month radiographs of the hands, wrists, and feet of 284 patients with early RA (< or = 4 years; mean 1.4; median 0.6) were scored according to a modified Larsen-Dale method by an independent radiological reading committee, blinded to the treatment, clinical, and laboratory data. RESULTS: Thirty-two patients (11%) had only foot erosions at baseline. Twelve month progression in the eroded joint count was more frequent in the patients with foot erosions than in those without (63% CI 55 divided by 71 vs 42% CI 35 divided by 50). CONCLUSION: Foot radiographs facilitate the identification of patients with early erosive RA. Foot involvement is indicative of more aggressive disease. Assessment of foot radiographs allows the most adequate therapeutic strategy to be adopted.

Adolescent↗
PubMedDate not supplied

Postoperative lumbar spine.

The differentiation between normal sequelae and complications of any surgical treatment of the lumbar spine is of the utmost importance. Clinical and radiological diagnosis is often difficult. Certainly the introduction of computed tomography (CT) and magnetic resonance imaging (MRI) has improved and refined the diagnostic possibilities, however not all problems have been resolved. For example, the frequent resort in vertebral surgery to metal implants which may limit or even prevent the interpretation of CT or MR images, should be kept in mind. The main types of surgical procedures involving the lumbar spine are briefly reviewed, focusing on CT and MRI appearance of normal sequelae of early or late complications and the recurrence of the lesion that necessitated the first procedure.

Diskectomy↗
PubMedDate not supplied

Neoplasms of the basal ganglia.

Neoplasms of the basal ganglia are deep-seated and this markedly impacts on therapy, especially with respect to the surgical approach. However, neoplasms purely involving the basal ganglia are rare: more frequently, basal ganglia are secondarily involved by tumors originating in the cerebral hemispheres, the ventricles and the pineal or suprasellar regions. Following an anatomical and epidemiologic overview, most frequent CT and MR imaging findings of pediatric neoplasms of basal ganglia are described.

Adolescent↗
PubMedDate not supplied

The radiological assessment of rheumatoid arthritis.

Antirheumatic therapy has changed from a rather conservative approach towards more aggressive early intervention. Objective measures of the course and outcome of rheumatoid arthritis are essential to understand the disease process and evaluate the therapeutic response. Radiological evaluation fulfils many of the criteria of objectivity: the films provide a permanent record and can be evaluated serially and repeatedly; the changes do not fluctuate with disease activity; and good technique and correct timing can keep the radiation load to a very acceptable level. Consequently, therapies can be evaluated on the basis of their efficacy on radiological progression. In clinical practice, a visual qualitative assessment is usually sufficient, but for therapeutic trials or studies of disease progression in certain patient groups, quantitative methods are needed. A number of different evaluation systems have been introduced, but none of these have gained universal acceptance. No ideal evaluation method (which should be rapid, easy to use and have a good level of reproducibility) has yet been found. Here we make provisional recommendations on the conduct of future therapeutic trials to maximise the likelihood that they will give conclusive results using radiographic outcome assessments.

Antirheumatic Agents↗
PubMedDate not supplied

[Integrated role of computerized tomography and magnetic resonance imaging in identifying the early changes in rheumatoid arthritis of the craniocervical junction].

Any cervical spine segment may be affected by rheumatoid arthritis, but destructive changes are most prominent at the craniocervical junction. Cervical involvement is a devastating complication of the disease, because of the risk of a range of neurological complications (paresthesia, cervical myelopathy, vertebro-basilar insufficiency), and even sudden death from medullary compression. However, the incidence of both cervical rheumatoid arthritis and its neurological complications are still debated, being respectively reported in 17-86% and 11-70% of the patients, according to the variability in neurological and radiologic classification systems adopted by the authors. To assess the incidence of cervical rheumatoid arthritis and the integrated role of different imaging techniques in its diagnosis, 38 consecutive patients (29 women and 9 men) with rheumatoid arthritis according to the American Rheumatism Association criteria were examined. The average age was 60 years (range: 27-70 years) with a mean disease duration of 6.6 years (range: 6 months-25 years). All the patients underwent conventional radiography of the cervical spine, unenhanced Computed Tomography (CT) of the craniocervical junction and unenhanced and Gadolinium-enhanced Magnetic Resonance Imaging (MRI) of the cervical spine. Cervical spine involvement was demonstrated in 25/38 (66%) patients 20 women and 5 men, with an average age of 57 years and a mean disease duration of 8.5 years. In 13 of them (mean disease duration: 12.7 years), the diagnosis was made with radiography which showed atlantoaxial and subaxial subluxations and/or erosions. Of the 12 patients with negative conventional radiography (mean disease duration: 2.5 years), 4 were identified with both CT and MRI (synovial pannus and erosions). 3 with MRI only (joint effusion/hypervascularized synovial pannus), and 5 exhibited questionable CT findings which were clarified only by MR demonstration of inflammatory tissue contiguous to suspicious irregularities of the cortical bone of the odontoid process. 52% (13/25) of cervical rheumatoid arthritis patients were identified with plain radiographs, 68% (17/25) with CT and 100% (25/25) with MRI. Our preliminary data show that a specific tool for the diagnosis is recommended even in the early disease phases since rheumatoid arthritis commonly affects the craniocervical junction. Studying the craniocervical region is clinically difficult, and diagnostic imaging assessment is essential. Conventional radiography allowed to detect more than half the patients with cervical rheumatoid arthritis, but only in advanced disease stages. On the contrary, MRI had the unique potential of direct and detailed synovial visualization, thus permitting the diagnosis of cervical involvement even in the early phases of the inflammatory process, when CT findings were still negative or questionable.

Adult↗
PubMedDate not supplied

Diagnostic imaging of musculoskeletal tuberculosis.

In the last decade an increase in the incidence of tuberculosis has been observed, due in part to the growing number of AIDS-patients. Musculoskeletal involvement is observed in 1-3% of tuberculosis cases. Aim of this article is to describe the diagnostic imaging of musculoskeletal tuberculosis and in particular the diagnostic potentialities of conventional radiology, CT and MRI. The role of MRI in the early identification of vertebral infectious process, in the determination of its locoregional extension and sometimes in its characterization, is underlined. In peripheral osteoarticular tuberculosis both CT and MRI do not supply additional diagnostic information as compared to conventional radiology; the tuberculous process is of difficult differentiation from other degenerative, inflammatory or neoplastic processes; in any case very careful attention is mandatory to establish an early diagnosis.

Adult↗
PubMedDate not supplied

Diagnostic imaging of neurotuberculosis.

Neurotuberculosis is represented by different and possibly concomitant forms, of which the most frequent are tuberculous meningitis and parenchymal tuberculosis followed by cerebral miliary tuberculosis and the extremely rare tuberculous abscesses. Tuberculous meningitis is characterized by the presence of inflammatory meningeal exudate involving meningeal surfaces and CSF spaces with involvement of relative vascular and nervous structures. Most frequent complications are parenchymal infarction, hydrocephalus and mycotic aneurysms. Inflammatory meningeal exudate shows intense contrast enhancement. Parenchymal tuberculosis may directly involve the cerebral and/or medullary parenchyma as areas of cerebritis/myelitis with solid nodular lesions (tuberculomas) with a central area of caseating necrosis. Tuberculomas are characterized by intense nodular or ring enhancement.

Diagnostic Imaging↗