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Biomedical subjects

A Chevrot

Publications and source records attributed to A Chevrot.

At least 37 records · Page 2Linked to original sources
PubMed1996

Epidural lipomatosis not induced by corticosteroid therapy. Three cases including one in a patient with primary Cushing's disease (review of the literature).

We report three cases of epidural lipomatosis including one in a patient with primary Cushing's disease. Our literature review found 16 additional cases of symptomatic epidural lipomatosis in patients who were not receiving corticosteroids. The presenting symptoms were nonspecific. The main clinical symptoms were nerve root pain, weakness of the lower limbs upon exertion, paraparesis or isolated back pain. Degenerative lesions were common and were sometimes the cause of the symptoms. Cases were evenly distributed between the thoracic and lumbar spine. Of the 18 patients, 14 were men and eight were older than 54 years. Three-fourths of patients were obese. Spinal cord or nerve root compression occurred in some instances. Modern imaging techniques (computed tomography and magnetic resonance imaging) can establish the diagnosis rapidly. In patients without neurologic compromise, surgery should be considered only if symptoms fail to respond to weight reduction. The rate of occurrence of epidural lipomatosis in patients with Cushing's disease is probably underestimated. Routine investigation by magnetic resonance imaging of Cushing's disease patients who have manifestations known to occur in epidural lipomatosis would allow to evaluate the role of increased production of endogenous corticosteroids in the occurrence of epidural lipomatosis.

Adrenal Cortex Hormones↗
PubMed1995

C1-2 arthrography.

OBJECTIVE: To describe the technique of C1-2 arthrography and recommend it as a suitable treatment for pain due to C1-2 abnormalities. MATERIALS AND METHODS: One hundred patients with the following conditions were studied: cervical pain or neuralgia without radiographic changes (group 1, n = 23), osteoarthritis (group 2, n = 37), rheumatoid arthritis (group 3, n = 23), ankylosing spondylarthritis (group 4, n = 5) and diverse conditions (group 5, n = 12). The technique consists of lateral puncture of the posterior aspect of the C1-2 joint with a 20-gauge needle under fluoroscopic control, arthrography using 1 ml contrast medium, and a 1-ml long-acting steroid injection subsequently. RESULTS: The articular cavity has an anterior and a posterior recess. Sometimes the posterior recess is large. In 18% of cases the contralateral joint also opacifies. CONCLUSIONS: C1-2 arthrography appears to be an efficient and safe technique for the treatment of upper cervical pain due to C1-2 articular disorders.

Adolescent↗
PubMed1995

[Limitations of ultrasonography in the detection of small cancers of the left kidney].

Renal ultrasound seems to be more difficult on the left than on the right side. In a retrospective analysis of 343 patients in whom a radical nephrectomy for renal tumor diagnosed by abdominal ultrasonography had been carried out, we analyzed the characteristics of these tumors. TNM classification was used. Right kidney tumors (n = 170) were smaller than the left ones (n = 172), 58 +/- 31.7 mm and 66.8 +/- 31.5 mm respectively, the difference being statistically significant (p = 0.01). Right kidney tumors of a less advanced stage (p < 0.05). Asymptomatic renal tumors were found more frequently on the right side (58.7%) than on the left (41.3%) (p = 0.03) and were smaller on the right (44 mm +/- 19.6 vs 54.5 mm +/- 27.2) (p = 0.04). In conclusion, Ultrasound exploration of the left kidney seems to be more difficult, mostly because the exploration of the right kidney is facilitated by the acoustic window of the liver.

Aged↗
PubMed1994

[Value and results of radioguided deep spinal biopsy].

MATERIAL AND METHODS. 76 percutaneous vertebral biopsies were performed with fluoroscopic guidance at the Radiology B Service, Hôpital Cochin in Paris, from November 1991 to March 1994. There were 12 cervical, 23 thoracic, 45 lumbar and sacral biopsies. There were 71 patients (28 women and 43 men), aged 22 to 88 years old (mean age 55.9). The needle used was either a trophine needle (Mazabraud) or a cutting needle (Surcut) or both. We have been doing vertebral percutaneous biopsies for 20 years in our radiology Service, and we published a review of 100 cases in 1983. The aim of this second review is to actualize the technique and the results. RESULTS. An accurate diagnosis was made in 80% of all cases. Diagnosis were: malignancy (34 cases), infection (21 cases), benign compression fracture (10 cases), miscellaneous (11 cases). There were two complications, one at the cervical spine (aggravation of a cervical cord compression) and one at the thoracic spine (pneumothorax). CONCLUSION. Percutaneous vertebral biopsy under fluoroscopic guidance is a safe and reliable method of obtaining a diagnosis in different spine lesions, avoiding thus, in most cases, a surgical procedure.

Adult↗
PubMed1994

[MRI of the knee. Value of delayed sequences after intravenous injection of gadolinium].

A prospective study of delayed sequences after intravenous injection of gadolinium for knee MRI shows the similar results as from the literature: enhancement of synovial fluid after 30 minutes. Sixteen patients were studied mainly with gradient echo. This phenomenon improves the visualisation of the intraarticular structures like meniscus, cruciate ligaments, or cartilage. This study leads to use this technique in case of difficulties like postoperative intraarticular lesions.

Cartilage, Articular↗
PubMed1993

[Chemolysis of intravertebral disk hernia and spinal syndrome].

The authors report a 31 year old patient who underwent L5-S1 chemonucleolysis. The prenucleolysis discogram disclosed intravertebral discal displacement. Severe spinal symptoms and development of geodes in the endplates adjacent to the treated disk occurred after the procedure. This case suggests that intraosseous discal displacement may be a risk factor for postchymopapain nucleolysis discitis and may contraindicate chemonucleolysis.

Adult↗
PubMed1992

[Sub-acromio-deltoid bursography].

Subacromio-deltoid bursography may be diagnostic and/or therapeutic. As a diagnostic procedure, it opacifies the bursa, which may be more or less fused. It visualises the superior surface of the cuff, which may be fissured and it demonstrates exaggerated impression of the acromio-coracoid ligament. It is only indicated when arthrography of the shoulder is normal. As a therapeutic procedure, it constitutes a more sensitive test than Neer's test. When it is negative, the diagnosis of anterior conflict is doubtful. The addition of a corticosteroid prolongs the therapeutic effect and facilitates rehabilitation.

Acromioclavicular Joint↗
PubMed1992

[X-ray guided puncture-aspiration of refractory calcifications of the shoulder].

Calcifying periarthritis of the shoulder may have either an acute or a chronic course. In both cases, direct puncture of the calcification shortens the natural history and facilitates and accelerates resorption in 50% of cases. The addition of a small amount of corticosteroid relieves the painful syndrome, with 80% good and very good results. The use of low doses of corticosteroid is particularly important in diabetics, patients with peptic ulcer and sportsmen. The puncture technique and the necessary precautions are described.

Adrenal Cortex Hormones↗
PubMed1992

Imaging of degenerative disk diseases.

This review provides a new understanding of the areas of disk anatomy, degeneration, herniation, and lumbar canal stenosis. It discusses new findings on calcified disks, disk imaging, intraspinal synovial cysts and even intraspinal pigmented villonodular synovitis. Special attention has been given to percutaneous therapeutic procedures and the postoperative spine.

Discitis↗
PubMed1992

Magnetic resonance imaging assessment of sacroiliac joint involvement in Gaucher's disease.

A young woman with Gaucher's disease experienced acute pain in her right sacroiliac (SI) joint. Although pelvic radiographs and computed tomographic scan showed no significant change in the right SI joint, magnetic resonance imaging demonstrated an area of high signal intensity in the iliac part of the right SI joint, and a periosseous collection of blood. This skeletal location is rarely reported in Gaucher's disease; the mechanism of bone crisis is still controversial and our case suggests the occurrence of a bone infarct.

Adult↗
PubMed1991

[Radiologic anatomy of the wrist].

Wrist imaging still relies first on plain X-Ray films, MRI allows excellent appreciation of the sculture of bones, ligaments, tendons and even nerves. C.T. is essentially useful in traumatology, while Wrist arthrography can be useful for detection of small ligament lesions.

Humans↗
PubMed1991

[A criterion of validity of the x-ray computed tomographic measurement of femoral neck anteversion].

A wrong patient's position on the CT scan table may lead to mistakes in the measurement of femoral neck anteversion. We present an experimental demonstration using a wood manufactured femur model. If the slices are performed with flexion of the thigh, the measurement is lower than the true value. Thus, to check the measurement on the picture of added slices, it is necessary to have a superimposition of the pictures of the upper part and the lower part of the femur. Otherwise, the measure is wrong and the mistake depends of the direction of the shifting: --if the lower part of the femur is higher, the anteversion measure is lower than expected. --if the lower part of the femur is lower, the anteversion measure is higher.

Femur Neck↗
PubMed1990

[Anulography].

Despite new imaging modalities such as MRI, the discography remains useful, particularly as the first step of chemonucleolysis. The anulography corresponds to a technical error due to the wrong position of the needle during the procedure. We have noticed 32 anulographies on 1226 discographies done in our department, between 1985 and 1989. The anulography exhibits a typical pattern that must be diagnosed; if not, that can lead to a diagnosis mistake or a wrong therapeutic attitude. The needle of discography must then be repositioned.

Adult↗