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Biomedical subjects

A Saifuddin

Publications and source records attributed to A Saifuddin.

At least 73 records · Page 4Linked to original sources
PubMed1998

Non-communicating intramuscular ganglia.

Intramuscular ganglia are rare. Most of the previously reported cases were connected with an adjacent joint. We present the imaging findings in three patients who had intramuscular ganglia that were not connected with a joint. Magnetic resonance showed a septated, encapsulated mass that was isoor hypointense to muscle on T1-weighted and hyperintense on T2-weighted images. A post-contrast T1-weighted scan in one patient showed minimal capsular enhancement. Ultrasound performed in one case showed an encapsulated, anechoic mass.

Adult↗
PubMed1998

Effects on the vertebral end-plate of uncomplicated lumbar discography: an MRI study.

The study aimed to identify and characterise changes occurring in the vertebral end-plate on MRI following uncomplicated lumbar discography. MRI was performed immediately before and within 2 h after uncomplicated lumbar discography in 20 consecutive patients undergoing the study as a precursor to possible spinal fusion. Of these, seven patients underwent a further MRI study at a mean of 72 days after discography (range 19-183 days). The MRI scans were assessed for the presence of any changes in the end-plates prior to and following discography. End-plate changes were identified in eight patients (40%) prior to discography. No new changes in end-plate signal intensity (SI) were identified in either the immediate or delayed MRI studies. The study suggests that any changes occurring in the vertebral end-plate following discography should be considered due to infectious discitis. There is no support for the concept of chemical discitis, chemical irritation of bone or microfracture of subchondral trabeculae as a cause of pain at discography.

Adult↗
PubMed1998

An analysis of radiating pain at lumbar discography.

This study aimed to identify the morphological abnormalities of the intervertebral disc, as demonstrated by lumbar discography, that are associated with pain radiation to the hip, groin, buttock or lower limb. We carried out a retrospective review of 99 consecutive lumbar discogram reports. The association of disc degeneration, annular tears (partial or full thickness) and the level of disc injected was determined with respect to the presence and pattern of radiating pain. A total of 260 discs were injected, of which 179 were considered abnormal. Posterior annular tears were demonstrated in 84 discs, anterior annular tears in 15 discs and 45 discs had both anterior and posterior tears. A significant association was identified between isolated posterior tears and the production of concordant radiating pain (P = 0.0041). No difference was identified between partial thickness posterior tears and full thickness posterior tears associated with leak of contrast medium, with regard to radiating pain. Similarly, there was no significant association between disc level injected and the pattern of pain radiation. The results indicate that pain experienced in the buttock, hip, groin or lower limb can arise from the posterior annulus of the intervertebral disc without direct involvement of the nerve root.

Adult↗
PubMed1998

Vertebral end-plate (Modic) changes on lumbar spine MRI: correlation with pain reproduction at lumbar discography.

The vertebral end-plate has been identified as a possible source of discogenic low back pain. MRI demonstrates end-plate (Modic) changes in 20-50% of patients with low back pain. The aim of this study was to investigate the association between Modic changes on MRI and discogenic back pain on lumbar discography. The MRI studies and discograms of 58 patients with a clinical diagnosis of discogenic back pain were reviewed and the presence of a Modic change was correlated with pain reproduction at 152 disc levels. Twenty-three discs with adjacent Modic changes were injected, 21 of which were associated with pain reproduction. However, pain was also reproduced at 69 levels where no Modic change was seen. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for a Modic change as a marker of a painful disc were 23.3%, 96.8%, 91.3% and 46.5% respectively. Modic changes, therefore, appear to be a relatively specific but insensitive sign of a painful lumbar disc in patients with discogenic low back pain.

Adult↗
PubMed1998

Pictorial review: ultrasonography of primary bone tumours.

We present our experience with the use of ultrasonography in the assessment of suspected primary or recurrent bone tumours of the appendicular skeleton and pelvis in 73 patients. Ultrasound can effectively assess the extraosseous component of malignant and aggressive benign lesions and those tumours arising from the surface of the bone. Periosteal reaction, cortical destruction, pathological fracture, matrix mineralization, fluid-fluid levels and involvement of the neurovascular bundle are all identified. Despite this, we could not identify any advantage of ultrasound compared to plain radiography or magnetic resonance imaging in diagnosis and local staging. However, ultrasound was found to be of great value in guiding percutaneous needle biopsy.

Adolescent↗
PubMed1998

The radiological investigation of lumbar spondylolysis.

Lumbar spondylolysis represents a stress fracture of the pars interarticularis and occurs most commonly at the L5 level. Pars defects can be imaged with plain radiography, bone scintigraphy, computed tomography (CT) and magnetic resonance imaging (MRI). Plain radiographic projections of particular value include the coned lateral view of the lumbosacral junction, which displays the majority of defects, and the anteroposterior view with 30 degrees cranial angulation. The value of oblique radiography is unproven. Planar bone scintigraphy (PBS) is more sensitive than radiography and single photon emission computed tomography (SPECT) more sensitive and specific than PBS. Both these techniques, however, are less specific than radiography and CT. CT, when performed with a reverse gantry angle and thin sections, is the investigation of choice for identifying radiographically occult lyses. Conventional lumbar spine MRI techniques are valuable for demonstrating normality of the pars, but may be associated with a high false positive rate for the diagnosis of pars defects.

Humans↗
PubMed1998

Reporting requirements for skeletal digital radiography: comparison of soft-copy and hard-copy presentation.

PURPOSE: To assess diagnostic performance and reader preference when reporting results from digital hard-copy and two soft-copy formats of skeletal digital radiography. MATERIALS AND METHODS: The data comprised hand radiographs of patients undergoing renal dialysis. Normal hand radiographs obtained in trauma patients were assessed as control images. One hundred fifteen images acquired with a photostimulable-phosphor computed radiography system were analyzed. Image selection and initial assessment were by consensus of two experienced radiologists, who graded the radiographic changes of hyperparathyroidism with the Ritz scoring system. The images were then presented to four readers in three formats: hard-copy output and soft-copy presentations at 2K2 and 1K2 resolutions. These readers scored pathologic change and image preference. The results were analyzed with the receiver operating characteristic technique. RESULTS: There was a significant improvement in diagnostic performance for both soft-copy formats relative to the hard-copy format (P < .001). No significant difference in diagnostic performance was found between the two soft-copy formats. There was a significant preference for both soft-copy formats relative to the hard-copy format (P < .01), with the 2K2 soft-copy images preferred to the 1K2 images (P < .01). CONCLUSION: Soft-copy reporting can provide superior diagnostic performance even for images viewed at a modest (1K2) resolution. The lack of difference between the two soft-copy formats has important economic implications with respect to departmental hardware requirements.

Bone and Bones↗
PubMed1998

Orientation of lumbar pars defects: implications for radiological detection and surgical management.

Lateral oblique radiographs are considered important for the identification of spondylolytic lesions, but these projections will give a clear view only when the radiological beam is in the plane of the defect. We studied the variation in orientation of spondylolytic lesions on CT scans of 34 patients with 69 defects. There was a wide variation of angle: only 32% of defects were orientated within 15 degrees of the 45 degrees lateral oblique plane. Lateral oblique radiographs should not be considered as the definitive investigation for spondylolysis. We suggest that CT scans with reverse gantry angle are now more appropriate than oblique radiography for the assessment of spondylolysis. Variation in the angle of the defect may also need consideration when direct repair is being planned.

Adolescent↗
PubMed1997

The value of lumbar spine MRI in the assessment of the pars interarticularis.

The aim of this study is to assess the ability of conventional lumbar spine magnetic resonance imaging (MRI) to demonstrate the pars interarticularis. The right and left L4 and L5 pars in 50 patients undergoing lumbar spine MRI for low back pain, with or without radiculopathy, were assessed and classified into four types. Based on their appearance, 59 (29.5%) were classified as normal (Type 1), 59 (29.5%) as hypointense (Type 2), 53 (26.5%) could not be demonstrated (Type 3) and 29 (14.5%) were thought to have defects (Type 4). The gold standard was set by the consensus opinion of two consultant musculoskeletal radiologists on the available plain radiographs of the lumbar spine. MRI was found to have a sensitivity of 57% to 86%, specificity of 81% to 82%, positive predictive value of 14% to 18% and negative predictive value of 97% to 99% for the diagnosis of a pars defect.

Adolescent↗
PubMed1997

Defining the use of gadolinium enhanced MRI in the assessment of the postoperative lumbar spine.

A retrospective study of case notes and magnetic resonance imaging (MRI) examinations was performed to assess the value of gadolinium enhanced MRI in the investigation of persistent back pain following lumbar spine surgery in patients who have not had a discectomy for disc herniation. Gadolinium enhancement is commonly used during MRI of patients with persistent back pain following surgery and epidural scar is frequently identified in patients who have had a previous discectomy. However the value of gadolinium enhancement in patients without previous discectomy had not been addressed. One hundred sets of case notes were examined and 24 patients with an accurate history of previous lumbar spine surgery without discectomy were identified. The nature of surgery and the MRI findings were correlated in these patients. Epidural enhancement was identified at seven sites in six patients (engorged epidural venous plexus, three; enhancement adjacent to degenerate discs, two; enhancement adjacent to facets, two). In no case was epidural scarring involving nerve roots identified. We conclude that routine gadolinium enhancement is unnecessary in patients without a history of discectomy for disc herniation.

Aged↗
PubMed1997

Sagittal vertebral body fractures: magnetic resonance imaging features.

Isolated sagittal vertebral body fractures are rare and the plain radiographic diagnosis may be difficult. We report two cases, confirmed by CT, and describe the subtle MRI features which comprised increased signal intensity only on the midline sagittal T2 weighted images. In one case, the information from MRI significantly altered the patient's management by leading to a change from surgical to conservative treatment.

Adult↗
PubMed1997

Radiological and clinical recurrence of giant-cell tumour of bone after the use of cement.

We have reviewed 13 operations on 11 patients using curettage and polymethylmethacrylate cement for giant-cell tumour of bone (GCT) to assess the value of radiology in the early detection of recurrence. There were four recurrences, the most specific radiological sign on plain radiography was lysis of 5 mm or more at the cement-bone interface. This preceded clinical signs by a mean of four months and was identified at a mean of 3.75 months after operation. There was not always a complete sclerotic margin around the cement, but when it was present, there was never evidence of recurrence. MRI was helpful in assessing cases with evidence of recurrence. Frequent surveillance with plain radiography should continue for one year after operation irrespective of clinical signs of recurrence. When the appearance of the plain radiographs suggests recurrence, MRI should be performed and followed by image-guided needle biopsy.

Adult↗
PubMed1996

Variations in morphology of the lumbosacral junction on sagittal MRI: correlation with plain radiography.

OBJECTIVE: To identify on sagittal magnetic resonance imaging (MRI) scans of the lumbar spine the features that indicate the presence of a lumbosacral transitional vertebra (LSTV). DESIGN: One hundred consecutive sagittal T1-and T2-weighted MRI scans of the lumbar spine were reviewed and separated into four types depending upon the absence or presence of disc material between what was considered to be the uppermost sacral segment and the remainder of the sacrum, as follows: type 1: no disc material present; type 2: a small residual disc, not extending for the whole anteroposterior (AP) diameter of the sacrum; type 3: a well-formed disc extending for the whole AP diameter of the sacrum; type 4: a well-formed disc extending for the whole AP diameter of the sacrum with, in addition, an abnormal upper sagittal sacral outline. The corresponding plain radiographs of each patient were than reviewed and assessed for the presence of an LSTV. These were classified according to the method of Castellvi et al. PATIENTS: All patients had been referred for MRI of the lumbar spine, usually because of back pain with or without radiculopathy. There were 51 male and 49 female patients with a mean age of 42 years and an age range of 18-85 years. RESULTS AND CONCLUSIONS: With regard to sacral morphology on MRI, 30 patients had type 1, 42 patients type 2, 16 patients type 3 and 12 patients type 4 morphology. Fifteen patients had an LSTV. There was a good correlation between the presence of a fused LSTV and a type 4 MRI appearance, indicating that this type of LSTV can be identified on sagittal MRI scans.

Adolescent↗
PubMed1996

Gorham's disease of the spine.

Massive osteolysis is a rare condition and is very uncommon in the spine. The MRI appearance of Gorham's disease of the spine has not previously been reported. We present here a case of this condition with imaging details.

Child, Preschool↗
PubMed1996

Spinal osteoblastoma: relationship between paravertebral muscle abnormalities and scoliosis.

OBJECTIVE: To illustrate the variety of paravertebral muscle abnormalities as seen on computed tomography (CT) or magnetic resonance imaging (MRI) in association with spinal osteoblastomas and correlate the findings with the presence of scoliosis. DESIGN: In a retrospective study the clinical notes, plain radiographic, CT and/or MRI features were reviewed for the presence of scoliosis and paravertebral muscle abnormality (either inflammation or atrophy). PATIENTS: Twelve patients (7 male, 5 female) with a mean age of 17 years were studied. Three lesions occurred in the cervical spine, five in the thoracic spine and four in the lumbar spine. RESULTS AND CONCLUSIONS: Nine patients had scoliosis. All patients with a thoracic or lumbar lesion and scoliosis (n = 8) had an associated abnormality of the paravertebral muscles (usually atrophy with fatty replacement). One patient with a lumbar lesion and no scoliosis had normal paravertebral muscles. One patient with a cervical lesion had thoracic scoliosis but no muscle abnormality in the cervical region, while two patients with cervical lesions and no scoliosis showed muscle abnormalities. The results support the clinical hypothesis that scoliosis in patients with spinal osteoblastoma is due to paravertebral muscle spasm, although this would not appear to be the case for cervical lesions.

Adolescent↗
PubMed1996

The role of imaging in the diagnosis and management of thoracolumbar burst fractures: current concepts and a review of the literature.

The burst fracture of the spine was first described by Holdsworth in 1963 and redefined by Denis in 1983 as being a fracture of the anterior and middle columns of the spine with or without an associated posterior column fracture. This injury has received much attention in the literature as regards its radiological diagnosis and also its clinical management. The purpose of this article is to review the way that imaging has been used both to diagnose the injury and to guide management. Current concepts of the stability of this fracture are presented and our experience in the use of magnetic resonance imaging in deciding treatment options is discussed.

Humans↗
PubMed1996

Unusual imaging findings in association with spinal osteoblastoma.

This paper describes four patients with spinal osteoblastoma that had unusual imaging features. Two cases arose in the cervical spine and two in the thoracic spine. Three tumours were associated with diffuse sclerosis of the vertebral body (an 'ivory vertebra'). All of these lesions either arose in the vertebral body or extended into the body from the adjacent pedicle. Reactive sclerosis at multiple levels was seen in three cases (one involving adjacent vertebral bodies, two involving adjacent pedicles or laminae and one involving multiple ribs). Osteophyte formation was identified bridging the disc space on the concave side of a scoliosis in two cases. Another case had an unusual scintigraphic appearance with an area of linear activity adjacent to the tumour. The finding of an 'ivory vertebra' in a child or young adult should raise the possibility of osteoblastoma involving the vertebral body, especially if there is an associated scoliosis.

Adult↗