Hairy cell leukemia affecting the hip joint.
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Biomedical subjects
Publications and source records attributed to B Ghelman.
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Abnormalities of the patellofemoral joint are one of the main problems in internal derangement of the knee. The role of different imaging modalities (plain radiographs, CT, CT/arthrograms, radionuclide scans, and MR imaging) is discussed in this article.
Double-contrast arthrography using gravity provides more detail than single-contrast techniques. With gravity, air rises to the uppermost portion of the joint and the positive contrast material settles. The cartilagenous articular surfaces and the synovial lining of the elbow are coated with contrast material and highlighted by the intra-articular air. Cartilagenous intra-articular bodies can be identified and located and the size of cartilagenous encapsulated osseous bodies can be confirmed. This method is faster to perform and easier to interpret than single-contrast studies, exposes the patient less than a tomographic examination, and is helpful before surgical exploration.
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Three new methods to assess the degree of anteversion or retroversion of the femoral component of a total hip prosthesis are described. Compared with previously described methods, the new methods make few physical demands on the recently operated patient. The only requirement is that the affected femur be held in a neutral position parallel to the x-ray table. The methods are relatively easy to perform and are accurate and objective.
Experience with double-contrast arthrography indicates it is superior to the single-contrast technique. First, the double-contrast study provides additional information on the width of rotator cuff tears and on degeneration in the tendons. This information is valuable in choosing surgical candidates and electing the best surgical incision. Second, the air-distended capsule permits visualization of the entire intra-articular portion of the biceps tendon. Third, improved visualization of the articular cartilages is important in evaluating patients with previous anterior shoulder dislocations or inflammatory arthritis.
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Double contrast shoulder arthrograms revealed rotator cuff abnormalities in 14 of 31 cases. Although both the single and double contrast methods provide a means of diagnosing complete tears of the cuff, or partial tears of its inferior surface, the double contrast study provides additional information regarding the width of the tear, the presence of degenerative changes in the cuff, and the condition of the articular cartilages.
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Unexplained pain following prosthetic replacement of the hip should be evaluated by a review of serial plain radiographs, hip aspiration and arthrography. The distinction between infection and loosening cannot be established on plain films. The preoperative diagnosis of infection and/or loosening should be attempted by hip aspiration and arthrography. Neither of the latter studies is definitive but in combination they correlate well with the surgical findings.
Avulsion injuries occurring near the symphisis pubis are related to the sites of origin of the adductor longus, adductor brevis, and gracilis muscles. Young athletes complain of pain near the symphisis which is increased by active adduction of the limb against resistance. Radiographic findings, similar to those found in infection and neoplasms, are mixed bone destruction and sclerosis on one side of the symphisis, frequently extending inferior pubic ramus.
Three cases of discoid medical menisci were diagnosed preoperatively by arthrography. Discoid mensiscus usually occurs on the lateral side of the knee; its pathogenesis is obscure.
Limbus vertebra results from an intrabody herniation of disc material. It can be mistaken for a fracture, infection, or tumor, resulting in unnecessary invasive diagnostic procedures. A case is presented in which the lesion was diagnosed by discography. Most radiologists are unfamiliar with discograms, yet they are useful because they opacify the anteriorly herniated portion of the nucleus pulposus.
An easy and reliable technique to inject the shoulder joint for arthrography is described. The technique utilizes a straight anteroposterior position of the patient and a directly vertical placement of the needle with the aid of fluoroscopy.
Sustentacular-talar tarsal coalitions can be difficult to detect radiographically. The sustentacular-talar articulation is a part of the talocalcaneonavicular joint. Thus, arthrography of this joint, combined with tangential views of the sustentaculotalar articulation (Harris views), provides a new and simple method to detect or exclude talocalcaneal tarsal coalitions.