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Biomedical subjects

A H Newberg

Publications and source records attributed to A H Newberg.

18 recordsLinked to original sources
PubMed1992

Long-term results after Russe bone-grafting: the effect of malunion of the scaphoid.

Twenty-five patients had Russe anterior corticocancellous bone-grafting between 1973 and 1984 for twenty-six symptomatic established non-unions of the scaphoid. The mean duration of follow-up was eleven years (range, seven to eighteen years). Twenty-one (81 per cent) of the twenty-six scaphoid bones united. We developed two rating scales to evaluate the results of the operation. One scale, based on objective findings, included the radiographic appearance of the wrist, the range of motion, and strength; the other scale, based on subjective findings, comprised function, pain, perception of a decrease in performance because of limitation of motion or strength, and satisfaction. These scales were used to compare the objective and subjective results in patients who had a malunion of the scaphoid in which the lateral intrascaphoid angle was more than 45 degrees convex dorsally between the proximal and distal poles (a so-called flexion or humpback deformity, which results in extension of the proximal fragment of the scaphoid at the radiocarpal joint) with the results in patients who had no such deformity. The lateral intrascaphoid angle was more than 45 degrees in thirteen (50 per cent) of the twenty-six wrists. Although the difference in the objective results between the wrists that had a malunion and those that did not have a malunion was highly significant (p = 0.001), there was no significant difference in the subjective results between the two groups, including satisfaction of the patient (p = 0.39). Twenty-three patients (92 per cent) returned to full-time employment and twenty-two (88 per cent), to sports activities. Twenty-three patients (92 per cent) reported that they had pronounced relief of pain and that the procedure had improved their quality of life. The presence of this deformity of the scaphoid after bone-grafting for a symptomatic non-union was not predictive of a poor long-term subjective outcome.

Adolescent↗
PubMed1990

Computed tomography of joint injuries.

CT has become the imaging modality of choice in most acute and chronic injuries involving the articular surfaces. Today's technology allows high resolution, fast scanning, and rapid reformatting, all of which contribute to prompt orthopedic evaluation and decision making. Our orthopedic colleagues have come to rely on high-quality CT scans in order to evaluate calcaneal and tibial plateau fractures, stress fractures, osteochondritis dissecans, acute and chronic shoulder trauma, and problems of the painful wrist--especially the distal radioulnar joint.

Athletic Injuries↗
PubMed1988

The risk of abscess from sternoclavicular septic arthritis.

From a systematic review of the literature on septic arthritis and our own patient records we found that in a high percentage of cases (20% of those we reviewed) infection of the sternoclavicular joint leads to an abscess. This appears to be true regardless of the presence or absence of a history of intravenous drug abuse or underlying illness compromising the immune system, and regardless of the responsible organism. The predisposing factors must center on the joint itself. The risk from spread of infection should be considered in management of the uncommon but difficult clinical problem of sternoclavicular septic arthritis.

Abscess↗
PubMed1987

The radiographic evaluation of shoulder and elbow pain in the athlete.

This article presents the important anatomic features of the shoulder joint and the abnormalities to which the athlete is most susceptible leading to pain and disability. It also reviews the pertinent elbow anatomy and discusses the radiographic techniques currently employed in diagnosing elbow problems in the athlete, including tomography, arthrography, and computed tomography.

Athletic Injuries↗
PubMed1986

A comparative analysis of the interpretations of lumbar spinal radiographs by chiropractors and medical doctors.

Ninety-nine anteroposterior and lateral lumbar radiographs taken of men, 18 to 55 years of age, were randomly selected from participants in a population survey of low-back pain. Thirty-one (31%) had never had low-back pain; 44 (44%) had or were having mild low-back pain; and 24 (24%) had or were having severe low-back pain. Three chiropractors assessed 56 radiographic variables, which included determinations of disc space height, vertebral malalignments and subluxations, spondylosis, postural disturbances, relationships among pelvis and spine and other congenital or acquired abnormalities. Interobserver reliability measurements showed that 6 of the 56 variables analyzed produced a high interobserver reliability. Sixteen additional variables showed a fair interobserver reliability. Comparison of the observations made by the chiropractors and a radiologist showed minimal agreement except for disc space height assessments at L3-4 and L4-5. Few of the radiographic variables discriminated between the current or prior history of low-back and leg complaints, although a few variables (most notably disc space narrowing) were statistically associated with back or leg complaints (P = .025). The conclusion was reached that spinal radiographs, whether analyzed by measurements, by a radiologist, or by chiropractors, have minimal value in determining the presence or absence of low-back complaints and, in particular, have no value in epidemiologic studies.

Adult↗
PubMed1985

Digital subtraction arthrography.

The technology of digital subtraction image processing was applied as a substitute for conventional arthrographic subtraction techniques in the evaluation of 29 joints in 27 patients. There were 15 total hip replacements, one total knee replacement, eight wrists, three shoulders, and two ankles. Information regarding prosthetic component loosening and ligamentous disruption of carpal bone articulations could be determined with a high degree of accuracy when compared with information gained using conventional radiographic methods. Our results indicate that this method may be a suitable substitute for other arthrographic techniques.

Arthrography↗
PubMed1985

Complications of arthrography.

Arthrography is considered extremely safe since reactions to intraarticular contrast media are rare. We have only seen one severe complication in the performance of more than 2,000 arthrographic procedures. To determine the incidence of complications, a questionnaire was sent to 84 radiologists experienced in arthrography. The 57 respondents had performed more than 126,000 arthrographic procedures, and findings of the survey indicate no deaths, three cases of infection, and 61 cases of hives. Other acute reactions included hypotension, seizures, air embolism, and laryngeal edema. Related complications included sterile chemical synovitis, severe pain after the procedure, and vasovagal reactions.

Arthrography↗
PubMed1985

Bone scanning in the assessment of patellar viability following knee replacement.

In an attempt to diagnose avascular necrosis (AVN) of the patella, a potential complication of the surgical procedure, 99mTc-MDP bone scanning was performed pre- and postoperation in 37 patients treated by 41 total knee arthroplasties. The normal immediate postoperative scan should demonstrate increased radionuclide uptake in the patella when compared to preoperative scans. Decreased uptake was seen in four cases in the early postoperative period. This latter group was believed to be at risk for osteonecrosis and stress fracture of the patella. For this reason, prophylactic restriction of activity was instituted, with subsequent return of normal radionuclide uptake in the patella. Bone scanning provides an effective method of early diagnosis of patients at risk for the development of AVN and secondary patellar fractures following total knee arthroplasty.

Adult↗
PubMed1985

Diseases of the hip. A comparative study of Japanese Oriental and American white patients.

Pelvic radiographs of 200 consecutive Japanese Oriental patients who were admitted for hip surgery at the Hospital of Kobe University in Japan were compared with those of 199 consecutive American white patients who were admitted for the same purpose to a New England hospital over a similar four and a half-year period between 1972 and 1976. One hundred and fifty-three Japanese Oriental and 157 American white patients had either primary or secondary osteoarthritis. The remainder had other types of hip pathology, such as avascular necrosis, rheumatoid arthritis, and ankylosing spondylitis. The radiographs of five Japanese Oriental and seven American white patients showed evidence of previous Legg-Calvé-Perthes disease, coxa vara, or slipped capital femoral epiphysis. With only two exceptions, the osteoarthritis in the remainder of the Japanese Oriental patients was secondary, caused by antecedent congenital hip disease: twenty-eight had one or two congenitally dislocated hips, ninety-two had acetabular dysplasia, and twenty-six had superolateral osteoarthritis. In contrast, only nine of the American white patients clearly had a diagnosis of acetabular dysplasia, and twenty-six had superolateral osteoarthritis. Twenty-one American white men had a femoral head-tilt deformity. Among the Americans, the largest group (sixty-five patients) had superomedial osteoarthritis. Nine had non-rheumatoid protrusio acetabuli and twenty had axillary or concentric osteoarthritic involvement. The majority of American white patients, therefore, had a type of osteoarthritis that was not seen in the Japanese Oriental patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Aspiration of the retrocalcaneal bursa.

We aspirated the retrocalcaneal bursa in cadavers to determine the characteristics of bursal fluid. A small amount of clear, viscous fluid was constantly present in the bursa. Leucocyte count was low, and the mucin clot test was good. With the same technique we aspirated the retrocalcaneal bursae of 4 patients. Three had Reiter's syndrome; the bursal fluid was inflammatory, and symptoms promptly resolved after local corticosteroid injection. The fourth patient presented with heel pain; intracellular, positively birefringent crystals were present in the aspirate, consistent with the diagnosis of pseudogout.

Achilles Tendon↗
PubMed1981

Familial infantile cortical hyperostosis: an update.

In 1961, the senior author reported 11 members of one family with infantile cortical hyperostosis. Since then, 10 new cases have occurred in this family resulting in a total of 21 cases. The incidence of infantile cortical hyperostosis in this family is as common today as it was two generations ago, and there has been no diminution in the incidence. Several patients with minimal or no clinical symptoms would have gone unrecognized had it not been for the family history of the disorder. On the basis of this study, infantile cortical hyperostosis is inherited as an autosomal dominant with variable penetrance.

Follow-Up Studies↗
PubMed1979

Rheumatic syndromes in endocrine disease.

It is not widely appreciated that endocrine disease may present primarily as rheumatic syndromes, sometimes spectacular in onset, more commonly insidious and subtle, making their true recognition difficult. The underlying hormonal, biochemical, and metabolic events have understandable reflection in the structure and function of bone, joint, and muscle.

Acromegaly↗
PubMed1979

Osteochondral fractures of the dome of the talus.

Osteochondral fracture of the talar dome is an uncommon lesion occurring after ankle inversion and tearing of the lateral ligaments. This lesion can be overlooked if internal oblique radiographs are not obtained. The value of tomography is discussed. Symptoms may persist for many months if accurate radiographic diagnosis is delayed. Prompt arthrotomy is indicated to prevent post-traumatic arthritis of the ankle joint.

Adult↗
PubMed1978

Radiographic evaluation of tibial plateau fractures.

Thorough radiographic evaluation of tibial plateau fractures is necessary in order to determine the extent and type of injury. Routine anteroposterior and lateral radiographs should be supplemented by oblique and horizontal beam lateral views. Tomography most accurately delineates fracture anatomy and thus plays a key role in planning treatment; the surgical approach is determined by the tomographic localization of the fracture fragments. The radiologist's understanding of tibial plateau fractures aids the orthopedic surgeon in the management of these patients.

Adolescent↗
PubMed1978

Case report: an unusual stress fracture in a jogger.

Stress fractures of the proximal fibula are uncommon, but do occur in the distal fibula in long-distance runners. A case is presented of a 71-year-old jogger who presented with a 2-month history of left knee pain. Radiographs showed an apparent destructive lesion of the proximal fibula which resembled a malignant bone lesion. Excision revealed a healing fracture.

Aged↗
PubMed1976

Predicting tomographic levels for urography.

Based on a retrospective and prospective analysis of more than 200 consecutive patients undergoing excretory urography, the authors formulated a chart for determing optimum tomographic levels using the anteroposterior abdominal distance as a criterion. the renal contour was visualized satisfactorily in 93% of cases.

Humans↗