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Bijoy J Thomas

Publications and source records attributed to Bijoy J Thomas.

6 recordsLinked to original sources
PubMed2006

Incidence and MR imaging features of fractures of the anterior process of calcaneus in a consecutive patient population with ankle and foot symptoms.

OBJECTIVE: To determine the incidence, appearances and associated injuries of fractures affecting the anterior process of calcaneus from a general population with foot and ankle symptoms. DESIGN AND PATIENTS: A retrospective review of foot and ankle MR imaging procedures was performed for detection of cases with a fracture affecting the anterior process of calcaneus over a four year period. Radiographs, MR imaging studies, radiology reports, medical records, and operative notes were reviewed. Imaging analysis included fracture pattern, displacement, associated fractures, and presence of tendon and ligamentous injuries. RESULTS: The incidence of anterior process of calcaneus fracture on MR imaging was 0.5% (14/2577). Fractures were more common in female subjects (71%, 10/14). Fracture orientation was predominantly vertical (93%, 13/14). No comminuted fractures were seen and only three fractures were displaced. Three of the eight MR imaging evident fractures of anterior process of calcaneus were seen on radiographs. Associated fractures of the talus (n=5), navicular bone (n=3), cuboid (n=2), and calcaneal body (n=1) were noted. Associated injuries to the anterior talofibular ligament (n=3) and tears of the peroneus brevis (n=3) and peroneus longus (n=1) tendons were present. All fractures were treated non-operatively. Two patients had subtalar joint steroid injection for symptomatic relief. CONCLUSIONS: Fractures of the anterior process of the calcaneus are uncommon in MR examinations of a general population of patients with foot and ankle symptoms. Although anterior process of calcaneus fractures are rare, there was a moderately high incidence of associated bone and soft-tissue injuries.

Adolescent↗
PubMed2006

MR imaging of rectus femoris origin injuries.

OBJECTIVE: To describe the MR imaging findings of acute and chronic rectus femoris origin (RFO) injuries. MATERIALS AND METHODS: A retrospective review of pelvic and hip MR imaging procedures was performed over a 4-year period for detection of cases with injuries to the RFO. Subjects were classified as having either acute or chronic symptoms. MR imaging studies, radiographs, CT scans, radiology reports, medical records, and operative notes were reviewed. Imaging analysis was directed to assess injuries affecting the direct and indirect heads of the RFO. Concurrent osseous, cartilaginous and musculotendinous injuries were tabulated. RESULTS: The incidence of RFO injuries on MR imaging was 0.5% (17/3160). With the exception of one case of anterior inferior iliac spine apophysis avulsion and partial tear of the direct head of RFO, all subjects had indirect head of RFO injuries (acute injury 8/9, chronic injury 8/8). Partial tear of the direct head of RFO was less frequently seen (acute injury 3/9, chronic injury 2/8). Partial tears of the conjoint tendon were least frequent (acute 1/9, chronic 2/8). No full-thickness tears of the RFO were noted. Associated labral tears were seen in only one case, with no other concomitant abnormality of the articular cartilage or surrounding soft tissues. All RFO injuries were treated non-operatively. CONCLUSION: Injuries of the RFO are uncommon on MR examinations of pelvis/hips and may occur in a sequence progressing from indirect head injury to involvement of direct head and conjoint tendon in more severe cases.

Acute Disease↗
PubMed2005

Increased intramyocellular lipid accumulation in HIV-infected women with fat redistribution.

The human immunodeficiency virus (HIV)-lipodystrophy syndrome is associated with fat redistribution and metabolic abnormalities, including insulin resistance. Increased intramyocellular lipid (IMCL) concentrations are thought to contribute to insulin resistance, being linked to metabolic and body composition variables. We examined 46 women: HIV infected with fat redistribution (n = 25), and age- and body mass index-matched HIV-negative controls (n = 21). IMCL was measured by 1H-magnetic resonance spectroscopy, and body composition was assessed with computed tomography, dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging. Plasma lipid profile and markers of glucose homeostasis were obtained. IMCL was significantly increased in tibialis anterior [135.0 +/- 11.5 vs. 85.1 +/- 13.2 institutional units (IU); P = 0.007] and soleus [643.7 +/- 61.0 vs. 443.6 +/- 47.2 IU, P = 0.017] of HIV-infected subjects compared with controls. Among HIV-infected subjects, calf subcutaneous fat area (17.8 +/- 2.3 vs. 35.0 +/- 2.5 cm2, P < 0.0001) and extremity fat by DEXA (11.8 +/- 1.1 vs. 15.6 +/- 1.2 kg, P = 0.024) were reduced, whereas visceral abdominal fat (125.2 +/- 11.3 vs. 74.4 +/- 12.3 cm2, P = 0.004), triglycerides (131.1 +/- 11.0 vs. 66.3 +/- 12.3 mg/dl, P = 0.0003), and fasting insulin (10.8 +/- 0.9 vs. 7.0 +/- 0.9 microIU/ml, P = 0.004) were increased compared with control subjects. Triglycerides (r = 0.39, P = 0.05) and extremity fat as percentage of whole body fat by DEXA (r = -0.51, P = 0.01) correlated significantly with IMCL in the HIV but not the control group. Extremity fat (beta = -633.53, P = 0.03) remained significantly associated with IMCL among HIV-infected patients, controlling for visceral abdominal fat, abdominal subcutaneous fat, and antiretroviral medications in a regression model. These data demonstrate increased IMCL in HIV-infected women with a mixed lipodystrophy pattern, being most significantly associated with reduced extremity fat. Further studies are necessary to determine the relationship between extremity fat loss and increased IMCL in HIV-infected women.

Adipose Tissue↗
PubMed2005

Intramyocellular lipid quantification: repeatability with 1H MR spectroscopy.

PURPOSE: To prospectively determine the repeatability and variability of tibialis anterior intramyocellular lipid (IMCL) quantifications performed by using 1.5-T hydrogen 1 (1H) magnetic resonance (MR) spectroscopy in healthy subjects. MATERIALS AND METHODS: Institutional review board approval and written informed consent were obtained for this Health Insurance Portability and Accountability Act-compliant study. The authors examined the anterior tibial muscles of 27 healthy subjects aged 19-48 years (12 men, 15 women; mean age, 25 years) by using single-voxel short-echo-time point-resolved 1H MR spectroscopy. During a first visit, the subjects underwent 1H MR spectroscopy before and after being repositioned in the magnet bore, with voxels carefully placed on the basis of osseous landmarks. Measurements were repeated after a mean interval of 12 days. All spectra were fitted by using Java-based MR user interface (jMRUI) and LCModel software, and lipid peaks were scaled to the unsuppressed water peak (at 4.7 ppm) and the total creatine peak (at approximately 3.0 ppm). A one-way random-effects variance components model was used to determine intraday and intervisit coefficients of variation (CVs). A power analysis was performed to determine the detectable percentage change in lipid measurements for two subject sample sizes. RESULTS: Measurements of the IMCL methylene protons peak at a resonance of 1.3 ppm scaled to the unsuppressed water peak (IMCL(W)) that were obtained by using jMRUI software yielded the lowest CVs overall (intraday and intervisit CVs, 13.4% and 14.4%, respectively). The random-effects variance components model revealed that nonbiologic factors (equipment and repositioning) accounted for 50% of the total variability in IMCL quantifications. Power analysis for a sample size of 20 subjects revealed that changes in IMCL(W) of greater than 15% could be confidently detected between 1H MR spectroscopic measurements obtained on different days. CONCLUSION: 1H MR spectroscopy is feasible for repeatable quantification of IMCL concentrations in longitudinal studies of muscle metabolism.

Adult↗
PubMed2005

Automated computer-assisted categorization of radiology reports.

OBJECTIVE: The objective of our study was to create and validate an automated computerized method for the categorization of narrative text radiograph reports. MATERIALS AND METHODS: Using commercially available software with embedded Boolean logic, we created a text search algorithm to categorize reports of radiography examinations into "fracture,"normal," and "neither normal nor fracture." The algorithm was refined and optimized through repeated testing on 512 consecutive ankle radiography reports from a single clinical imaging center. The final algorithm was applied on a different set of 750 consecutive radiography reports of the spine and extremities produced at three different clinical imaging sites and interpreted by 44 different radiologists. Expert reviewers assessed the accuracy of the final classification. The chi-square test or Fisher's exact test was performed to determine the reproducibility of results across different clinical imaging sites. RESULTS: The computerized classification was highly accurate for the classification of radiography reports into "normal" (specificity, 91.6%; sensitivity, 91.3%), "neither normal nor fracture"(sensitivity, 87.8%; specificity, 94.9%), and "fracture"(sensitivity, 94.1%; specificity, 98.1%) categories. This performance showed no significant difference across the three sites (p >0.05). CONCLUSION: Computerized categorization of narrative-text radiography reports is highly sensitive and specific and can be used to classify reports from different imaging sites generated by different radiologists. This method can be an extremely powerful tool in future cost-effectiveness studies, health care policy studies, operations assessments, and quality control.

Algorithms↗