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Biomedical subjects

A G Björkengren

Publications and source records attributed to A G Björkengren.

8 recordsLinked to original sources
PubMed1992

Rheumatologic and skeletal changes in acromegaly.

The anabolic functions of growth hormone (GH) and insulin-like growth factor-I (IGF-I) in cartilage and bone metabolism are important in the normal physiology of these tissues. The effects of chronic elevation of GH and IGF-I levels on bony structures produce the typical physical changes associated with acromegaly, whereas the effects on cartilage result in arthropathy, which is usually degenerative. This article presents an overview of the physiologic roles of GH and IGF-I in cartilage and bone metabolism, the clinical features of the degenerative arthropathy and other rheumatologic syndromes associated with acromegaly, effects of acromegaly on bone and mineral metabolism, and an unusual bone disease that is occasionally associated with acromegaly, the McCune-Albright syndrome.

Acromegaly↗
PubMed1990

Spontaneous osteonecrosis of the knee: value of MR imaging in determining prognosis.

Sixteen patients with early and late stages of spontaneous osteonecrosis of the knee were studied to evaluate if MR imaging can be used to determine the prognosis of the disease. All patients had sequential conventional radiographs and clinical examinations, one or more 99mTc-methylene diphosphonate bone scintigrams, and an MR examination. The duration of the disease at the time of the MR examination ranged from 1 to 58 months (mean, 18 months). A relationship was identified between the pattern of bone marrow alteration noted on long TR/TE MR sequences and the scintigraphic stage and clinical course of the disease. The dimensions of the osteonecrotic region could be identified as well or better on the short TR/TE MR images than on the radiographs in all patients. MR imaging also afforded evaluation of the hyaline cartilage overlying the osteonecrotic lesion, revealing secondary osteoarthrosis in seven patients. We conclude that MR imaging in patients with spontaneous osteonecrosis of the knee may provide information of value for determining the prognosis of the disease.

Adult↗
PubMed1990

MR imaging of the knee in acute rheumatoid arthritis: synovial uptake of gadolinium-DOTA.

In patients with rheumatoid arthritis, the presence of acute synovial inflammation is an indication of the activity of the disease. It is an important finding because it often influences therapeutic decisions. However, acute synovitis may be difficult to detect by clinical examination, especially if a joint effusion also is present. As gadolinium tetra-azacyclododecane tetraacetic acid (Gd-DOTA) can be expected to accumulate in areas of acute inflammation, we studied the value of Gd-DOTA-enhanced MR to determine the presence of acute synovitis. Nine patients with current knee symptoms underwent MR examination of the knee. Short and long TR/TE MR images were obtained with a 0.3-T magnet before and immediately after IV administration of Gd-DOTA. A 15-min delayed short TR/TE image also was obtained. Of eight patients with moderate to severe clinical evidence of acute synovitis, six had marked increase and two had moderate increase in signal intensity from synovial tissue on the short TR/TE image obtained immediately after administration of contrast material. In the ninth patient, who had minimal synovitis clinically, the signal from the synovium did not change after administration of contrast material. No difference was seen between the enhancement pattern on the immediate and the 15-min delayed images. These results suggest that Gd-DOTA is taken up by inflamed synovium and that Gd-DOTA-enhanced MR scans may be useful in detecting acute synovitis in patients with rheumatoid arthritis.

Adult↗
PubMed1988

Patterns of femoral head migration in osteoarthritis of the hip: a reappraisal with CT and pathologic correlation.

Although medial, superior, and axial patterns of migration of the femoral head in osteoarthritis of the hip have been well described, it is not clear what anatomic and biomechanical factors determine the direction of migration. The authors studied 22 patients with bilateral (11 patients) or unilateral (11 patients) osteoarthritis by means of conventional radiography and computed tomography (CT) to define any relationships between migration in the coronal plane and that in the transverse plane and to determine whether femoral anteversion, acetabular anteversion, femoral neck-shaft angle, or acetabular inclination were related to particular migration patterns. Anterior migration was evident in 14 of the 19 hips with a superior migration pattern, whereas posterior migration was present in five of the seven hips with a medial migration pattern. In the remainder of cases, no migration in the transverse plane was present. Femoral anteversion as determined with CT, femoral neck-shaft angle, angle of acetabular inclination, and acetabular anteversion angle in this relatively small sample were all found to be within normal limits and appeared to have no influence on the occurrence of a specific pattern of femoral head migration.

Aged↗
PubMed1987

Carpal alterations in adult-onset Still disease, juvenile chronic arthritis, and adult-onset rheumatoid arthritis: comparative study.

A specific pattern of pericapitate involvement of the wrist has been described in the rheumatologic literature as characteristic of adult-onset Still disease (AOSD), a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the potential diagnostic value of carpal radiography in suspected cases of AOSD, a retrospective blinded analysis of 48 patients (16 each with AOSD, juvenile chronic arthritis, and adult-onset rheumatoid arthritis) was performed. Pericapitate articular alterations without radiocarpal involvement were found to be distinctly unusual among patients with rheumatoid arthritis but frequent in the setting of AOSD. In juvenile chronic arthritis severe pericapitate involvement also occurs frequently but is more likely to be associated with interosseous fusion and severe pancompartmental disease.

Adult↗
PubMed1987

Enteropathic arthropathies.

Musculoskeletal disease occurs in association with inflammatory bowel disorders including Crohn's disease and ulcerative colitis, as well as with Whipple's disease; with enteritis caused by Salmonella, Shigella, and Yersinia; and also following intestinal bypass surgery. Extraintestinal causes of musculoskeletal alterations include Laennec's and biliary cirrhosis and pancreatitis. Three types of musculoskeletal abnormalities are recognized in patients with inflammatory bowel diseases: peripheral joint arthritis, sacroiliitis and spondylitis identical to ankylosing spondylitis, and rarely, miscellaneous changes such as digital clubbing and hypertrophic osteoarthropathy.

Arthritis, Infectious↗