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C Pineda

Publications and source records attributed to C Pineda.

At least 37 records · Page 2Linked to original sources
PubMed1991

New clinical and radiographic features of the seronegative spondyloarthropathies.

This article reviews new data supporting the hypothesis that the clinical spectrum of the seronegative spondyloarthropathies is wider than previously realized. It describes the literature in general and specific reports on the prevalence and clinical features of seronegative spondyloarthropathies in a number of different populations from America and Asia. Undifferentiated or unclassified spondyloarthropathies are now recognized more frequently. There is an extensive analysis of new proposals for nomenclature and criteria for classification that need to be validated. The normal appearance and biomechanics of the sacroiliac joints as well as new imaging techniques to approach them in several diseases are also discussed. Clinical, radiographic, and histopathologic findings in spinal disease and further observations on gut inflammation and intestinal permeability are also presented here. A long list of clinical associations of the seronegative spondyloarthropathies is also given.

Humans↗
PubMed1991

Takayasu's arteritis in children.

We reviewed the clinical features of 26 children with Takayasu's arteritis. In contrast to what is often seen in adults, in this age group inflammation of different systems is a conspicuous feature. Eighty five percent of cases had arterial hypertension. The high incidence of arthritis and heart failure provoked confusion with rheumatic fever. There was a high frequency of positive purified protein derivative (73%) and lymphadenopathy (38%) with a histological picture of caseating granulomas, suggesting a link between Takayasu's arteritis and an atypical mycobacterial infection. No improvement of the arterial obstruction was observed with corticosteroid therapy. Takayasu's arteritis in children presents as an aggressive often lethal disease. The mortality rate was 35% over an observation period of 5 years.

Adolescent↗
PubMed1990

The spectrum of soft tissue and skeletal abnormalities of hypertrophic osteoarthropathy.

We review our radiographic experience with hypertrophic osteoarthropathy. Soft tissue abnormalities such as finger clubbing, "elephant feet" and cutis verticis gyrata are well appreciated by plain radiography. Hypertrophic osteoarthropathy is characterized by a bone remodeling process at the tip of the digits. In older patients it is manifested as tuftal hypertrophy whereas in younger individuals acroosteolysis takes place. Radiographic signs of inflammatory arthropathy are conspicuously absent. Periosteal proliferation is an orderly evolving process in 3 dimensions: in the number of affected bones, in the area of involvement of a given bone and in the shape of periostitis.

Adult↗
PubMed1989

Digital clubbing: a numerical assessment of the deformity.

We describe a simple method that defines with numbers the drumstick deformity of the digits. We measured 2 circumferences on each of the 10 fingers at the nail bed (NB) and at the distal interphalangeal joint (DIP), the sum of the 10 ratios NB:DIP was termed Digital Index. Intraobserver variation of the Digital Index was small, with a Pearson's correlation coefficient of R = 0.979; interobserver variation was also not significant (R = 0.999). Making use of this Digital Index, we studied 22 patients with digital clubbing associated with cyanotic congenital heart disease and 66 healthy controls. Digital Index clearly separated patients from controls, 10.73 +/- 0.32 vs 9.33 +/- 0.27 (means +/- SD). The Index was independent of age or sex. Patients with hypertrophic osteoarthropathy had significantly higher indices than patients with clubbing alone.

Adolescent↗
PubMed1988

Primary hypertrophic osteoarthropathy.

We describe seven patients with primary HOA and review 125 cases reported in the English, French, and German literature. The salient clinical features of primary HOA are: a bimodal distribution of disease onset with one peak during the first year of life and the other at age 15, a male predominance (nine to one), uncommon benign joint effusion, and a variety of skin abnormalities resulting from cutaneous hypertrophy or glandular dysfunction. We concluded that HOA is not a synovial disease. It is suggested that synovial effusions, when present, are perhaps a sympathetic reaction to the neighboring periostitis. Proposed diagnostic criteria for HOA, including digital clubbing and radiographic periostitis, appear 86% sensitive. The clinical features, age of onset, and sex distribution suggest that a genetically controlled growth promoting factor, different from growth hormone, plays a role in the pathogenesis of this syndrome.

Adolescent↗
PubMed1986

Computerized tomography of proximal femoral trabecular patterns.

A comprehensive imaging and pathologic investigation utilizing patients and cadaver material was performed in order to identify the normal trabecular pattern of the proximal femur and to assess alterations in this pattern in various disorders. Patients and specimens were studied with computed tomography (CT), including three-dimensional CT image reconstruction in selected cases and plain film radiography. The CT imaging of the proximal femur provides insight into the dynamic state of bone in this region. Despite limited resolution, three-dimensional CT image reconstruction is capable of portraying the concentration and orientation of major trabeculae in the proximal femur. Increased trabecular spacing occurs in osteoporosis and is well depicted by CT. Proliferation and thickening of the most superior subchondral primary compressive trabeculae is an early sign of osteoarthritis. In the region of the calcar femorale, crossing trabeculae, similar to the appearance of an enchondroma or bone infarct, have been described in osteoporosis and osteoarthritis and probably represent unmasking of normally present reinforcing trabeculae. In ischemic necrosis, CT should be considered a useful modality for detection of early or mild alterations and may be valuable in treatment planning.

Cadaver↗
PubMed1986

Hand radiographic changes in patients with primary and secondary Sjögren's syndrome.

Unselected hand radiographs from 37 primary Sjögren's syndrome patients (pSS), 19 patients with rheumatoid arthritis (RA) and Sjögren's syndrome (secondary SS) and 29 patients with RA only were evaluated blind by osteoradiologists, using reference radiographs for scoring joint space narrowing and erosion at the proximal interphalangeal joints, the metacarpophalangeal joints and the wrists. A history of arthralgias and/or arthritis of the above joints was taken from the patients charts. It is shown that pSS patients suffer from transient episodes of arthralgias and/or arthritis, while both secondary SS and RA patients had a history of chronic arthritis of the small joints of the hand. Evaluation of the hand radiographs showed that pSS patients exhibited mild joint space narrowing but no erosions, whereas the other two groups of patients presented with more severe joint space narrowing and varying degrees of erosions. Finally, RA patients without SS had more advanced radiographic changes than secondary SS patients. Thus hand X-rays can be used in addition to the previously described clinical differences in the differentiation of primary and secondary SS.

Arthritis, Rheumatoid↗
PubMed1986

Diagnosis of tarsal coalition with computed tomography.

The value of computed tomography in the diagnosis of tarsal coalition is reported in six patients, five with talocalcaneal coalition and one with calcaneonavicular coalition. The examination is technically easy to perform with the patient in the supine position and the knees flexed, and it allows simultaneous visualization of both sides. Because of these features and an ability to distinguish between bony and cartilaginous or fibrous fusion, computed tomography appears to be the method of choice for diagnosis of coalition involving talus and calcaneus. It is less useful in other types of coalition.

Adult↗
PubMed1985

Widespread osteonecrosis of the foot in systemic lupus erythematosus: radiographic and gross pathologic correlation.

A patient with systemic lupus erythematosus required an amputation of the foot related to the presence of vascular disease and infection. Radiographs obtained prior to amputation revealed osteonecrosis in virtually every bone of the foot. Radiographic-pathologic correlation documented this widespread osseous involvement. Although ischemic necrosis of bone is a well-known feature of systemic lupus erythematosus, its localization in the small bones of the foot is rare.

Adult↗
PubMed1985

Plantar compartmental infection in the diabetic foot. The role of computed tomography.

This review discusses the role of computed tomography (CT) in the evaluation of extent of plantar soft tissue infection in the diabetic foot. CT abnormalities are correlated with conventional radiography, results of preoperative aspiration cultures, intraoperative assessment, and bone, gallium, and 111In-leukocyte scan findings. Plantar soft tissue disease respects compartmental boundaries in general, with transcompartmental spread possible along musculotendinous units that normally transgress the intervening fascial septae. CT correlates well with the extent of infection as determined by other modalities, but cannot precisely predict its proximal boundary due to gradual transition between unequivocally abnormal and normal tissue. CT may be useful in establishing an appropriate level for contemplated amputation and can detect extension of superficial diabetic foot infections at an earlier stage than existing clinical methods, potentially resulting in less extensive surgical procedures.

Bacterial Infections↗
PubMed1985

Osteoarthritis of the glenohumeral joint: a radiologic-pathologic study.

Cadaveric specimens and patient radiographs were examined in order to establish the pattern and the distribution of degenerative alterations of the glenohumeral joint. Characteristic osseous changes occur in response to alterations in the articular cartilage and rotator cuff. The extent of these changes is underestimated by plain-film radiography. A strong association was found between the changes of osteoarthritis (OA) and those related to deterioration of the rotator cuff. Idiopathic OA of the glenohumeral joint was discovered in 10 (20%) of 50 symptomatic patients age 60 years and over. Theories regarding the pathomechanics and interrelations between glenohumeral joint OA and rotator cuff deterioration are discussed.

Aged↗
PubMed1984

Vertebral involvement in calcium pyrophosphate dihydrate crystal deposition disease. Radiographic-pathological correlation.

The authors conducted a comprehensive radiographic and pathological investigation of more than 1,000 postmortem spinal specimens and documented many examples of calcium pyrophosphate dihydrate crystal deposition disease (CPPD/CDD) in a variety of vertebral structures, including not only the intervertebral disk but also the apophyseal and sacroiliac joints, posterior longitudinal ligament, interspinous and supraspinous ligaments, ligamentum flavum, interosseous sacroiliac ligament, transverse atlas ligament, and posterior median atlanto-axial joint. Such crystal accumulation supports previous reports of abnormal calcification and structural damage on radiographs of the axial skeleton in patients with CPPD/CDD and may explain not only the associated spinal symptoms and signs but also spinal stenosis, spondylolisthesis, and atlanto-axial subluxation.

Calcinosis↗
PubMed1984

Digital arthrography of the wrist: a radiographic-pathologic investigation.

An analysis of digital arthrography of the wrist was accomplished in 10 cadaveric specimens. In each case, images were obtained during a 30-sec period in which a small amount of contrast material was introduced into the radiocarpal compartment; films were reviewed with and without subtraction technique. Pathologic examination of the sectioned specimens documented the accuracy of this arthrographic method. The sequence of contrast opacification of the various compartments of the wrist and the location and size of the defects within ligamentous and cartilaginous structures were ideally seen with digital arthrography. A previously unemphasized pattern of communication, that between the midcarpal and pisiform-triquetral compartments, was seen in two instances. Digital wrist arthrography seems to represent an excellent method to evaluate the patient with suspected soft-tissue injury.

Fluoroscopy↗