[The hip: synovial osteochondromatosis, villonodular synovitis, synovial sarcoma].
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Biomedical subjects
Publications and source records attributed to B Rousselin.
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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.
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The results of extracorporeal shock wave lithotrity (Dornier lithotriptor) for 700 cases of urinary calculi have been reviewed and correlated with the radiological features of the calculi in order to define some predictive radiological criteria of effectiveness. The calculi were broken up in 74.5% of all cases, complete destruction (no residual fragment) was achieved in 34.5% and partial destruction in 40% of cases. The rate of failure (failure to break up or scatter the calculus) is 8.9%. Complications were observed in 2.6% of all cases, a second session of lithotrity or a surgical operation was required in 4.8% of cases (evolution lost to follow-up: 9.2%). The comparison of these results with the radiological data obtained before lithotrity allows distinguishing 2 categories of calculi: 1) Calculi with a favorable prognosis: single, smaller than 1 cm, pyelic, not very opaque and heterogeneous, located in normal-sized cavities; 2) calculi with a poor prognosis: multiple, larger than 2 cm, lower calyceal or ureteral, very opaque and homogeneous, located within dilated cavities.
Radiographs and clinical charts were reviewed in a series of 13 cases of primary neuroectodermal bone tumors, involving 9 males and 4 females, aged from 3 to 32 years (average: 15 years). The average delay between the onset and diagnosis was 5 months. Fever and other systemic symptoms were present in 6 cases; in 4 cases a fracture was the mode of presentation. Seven patients had metastases (4 involving bone) at the time of presentation. Only one patient is still alive after 5 years. In the 10 patients who died as a direct result of the tumor, death occured on average 8 months following diagnosis if metastases were present initially, and 36 months after the diagnosis otherwise. Tumors predominantly involved the leg (7 cases), the pelvis (2 cases), and the humerus (2 cases), the involvement being both diaphyseal and metaphyseal. The radiologic appearance is that of an aggressive, poorly demarcated tumor, with cortical destruction, periosteal reaction and soft tissue invasion. Comparison with Ewing sarcoma shows little radiologic or clinical difference, except for a poorer prognosis in neuroectodermal bone tumors. Both bone tumors may have a similar neuroectodermal origin, with Ewing sarcoma representing the undifferentiated variety.
Condensing pediculolaminar hypertrophy of mechanical origin is known as "Dahu's sign". Dahu's sign corresponds to hypertrophy of the vertebral hemi-arch found by CT scan and leads to suspicion of controlateral lysis of the isthmus. It is the CT scan equivalent of vertebral "anisocorism" by conventional radiology.
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