PubMed Health⌕ Search

Biomedical subjects

D B Finlay

Publications and source records attributed to D B Finlay.

At least 37 records · Page 2Linked to original sources
PubMed1994

Ultrasonography of the tibialis posterior tendon in rheumatoid arthritis.

This work was carried out to assess the frequency of frank rupture of the tibialis posterior tendon (TPT) in RA and to determine if other pathology in the tendon can be correlated with foot deformity. Clinical, radiographic and ultrasonographic signs of TPT pathology were assessed bilaterally in 28 patients with RA and hindfoot involvement. The degree of hindfoot pain, the single-heel-rise test and the tibiocalcaneal angle were assessed clinically. The talometatarsal angle was measured on lateral weight-bearing radiographs. Tendon continuity and thickness were noted on sonography, both in the study group and in a control group of 14 patients. The TPT was significantly thinner in those rheumatoid patients with an abnormal single-heel-rise test when compared to those patients with a normal test (P < 0.001) and to the control group (P < 0.001). The mean thickness in patients with an abnormal test was 1.6 mm, in patients with a normal test it was 2.3 mm and in the controls it was 1.9 mm. In the rheumatoid group thinning of the tendon was significantly correlated (r = -0.33, P < 0.05) with heel valgus as assessed by the tibiocalcaneal angle. It was also significantly correlated (r = 0.31, P < 0.05) with pes planus as assessed by the talometatarsal angle. Only one case of frank rupture of the TPT was identified. There were also significant correlations between TPT thickness and patient age, disease duration and steroid therapy, such that tendon attenuation was associated with increasing age, longer disease and steroid usage. There was no association between TPT thickness and the degree of hindfoot pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

An audit of paediatric technetium-99m methylene diphosphonate bone scans.

Eighty-nine Technetium-99m-MDP scans performed between January 1987 and June 1990 at the Leicester Royal Infirmary were reviewed with regard to the indication, patient outcome and value of the scans in the patients' management. The significant finding was the value of a normal scan in the management of children with chronic pain.

Acute Disease↗
PubMed1994

Knee effusions, radiology and acute knee trauma.

Sixty patients with acute knee trauma were examined radiographically at presentation and subsequently examined under anaesthetic, when arthroscopy was performed. The aim was to assess whether a normal radiograph at presentation excluded significant knee pathology. Nine patients with significant pathology (25%) had normal radiographs at presentation.

Acute Disease↗
PubMed1993

Recurrent anterior glenohumeral joint dislocation and torsion of the humerus.

Two computerized axial tomographic sections, one taken just below the coracoid process and the other about 2.5 cm proximal to the interepicondylar line, were used to determine glenoid version and humeral torsion in 19 patients with recurrent anterior glenohumeral joint dislocation and in 23 controls. Analysis of interobserver variation revealed the method to be reliable. There was no difference in glenoid version between the two groups. However, humeral torsion was greater in patients (153 degrees) than in controls (144 degrees). It appears that increased humeral torsion may predispose to glenohumeral joint dislocation.

Adolescent↗
PubMed1993

A deep lateral femoral notch as a sign of acutely torn anterior cruciate ligament.

Anterior cruciate ligament (ACL) tears are frequently associated with abnormalities of the lateral femoral condyle as shown by magnetic resonance imaging. The mechanism of injury has been described as due to bone compression during knee trauma. This may lead to compression of the lateral condylopatellar notch (sulcus). It has been suggested that detection of a deep notch on the plain lateral radiograph is a useful indirect sign of ACL tear. Depth of this notch was measured in 34 consecutive prospective patients assessed as having acute ACL tear clinically and proven at arthroscopy. In no patient was the notch deep, suggesting that this is not a useful sign in acute tears of the anterior cruciate ligament.

Acute Disease↗
PubMed1993

An audit of comparative views in elbow trauma in children.

A comparative radiograph of the contralateral elbow was obtained in only 30 (2.5%) of children examined after elbow trauma. Interpretation by junior clinical staff was changed in only three children (0.25%). Radiological review of the ipsilateral elbow alone altered diagnosis in six (20%) of the 30 children referred for comparative views and agreed with the final clinical diagnosis in 29 (97%). Comparative views were requested by inexperienced clinical staff in 28 (95%) of cases and were unnecessary in all patients. A senior radiological or clinical opinion would have resolved problems at interpretation.

Elbow Joint↗
PubMed1992

The importance of clinical details when reporting accident and emergency radiographs.

The effect of clinical information on the accuracy of reporting accident and emergency (A&E) radiographs was studied in two A&E officers and five radiologists involved in their daily reporting. Each was shown 50 sets of radiographs, 30 subtle fractures and 20 controls. In one half the clinical history and precise localization was provided, and in the other half no such information was given. After an interval of 6 months the radiographs were viewed again with the amount of information reversed. The observers were asked to determine the presence of injury, describe its site, and indicate how sure they were of their diagnosis. Correct diagnosis was improved from 72.3 per cent to 80.3 per cent overall, and from 68.1 per cent to 81.4 per cent in the fracture group. All observers improved their performance with clinical details. The results confirm that accurate clinical details improve injury location.

Accidents↗
PubMed1992

Do elderly patients with hip pain following trauma require hospital admission?

A series of 123 elderly patients (mean age 77.8 years) were identified who presented to the accident and emergency department following trauma, who complained of hip pain but had a 'normal' hip radiograph. These patients were followed up by a scrutiny of hospital admissions, 'phone contact with their general practitioner or nursing home or postal questionnaire. At the time of review, which ranged from 3 to 12 months, 13 patients had died. Of the remaining patients, five had sustained a fracture but only three had sustained a hip fracture. Of patients reviewed, 20 per cent had been admitted to hospital with other problems. Hip pain following trauma may be a better predictor of morbidity and mortality than of an occult hip fracture.

Accidental Falls↗
PubMed1992

Scintigraphic abnormalities in patients with painful hip replacements treated conservatively.

A retrospective review of the scintigraphic appearances of 98 painful hip replacements was made. 16 patients (16%) underwent revision surgery whereas in the remaining 82 hips (84%), symptoms settled with conservative management. 73 of these (89%) had at least one area of increased activity on delayed diphosphonate scintigraphy with 27% having increased activity in three or more areas around the femoral component. Hips with increased activity at the lesser trochanter and tip were less likely to undergo spontaneous resolution of symptoms. Uncemented prostheses were more likely to have multiple areas of increased activity. Abnormalities in dynamic bone scintigraphy and gallium studies were also seen in patients whose symptoms resolved without surgery. Whereas a normal bone scintigram indicates that loosening or infection is most unlikely, the presence of increased activity does not necessarily indicate a need for revision surgery, even when multiple areas are present. A period of conservative management should be considered before operative intervention is undertaken.

Diphosphonates↗
PubMed1991

Technical report: oxygen saturation monitoring during sedation for chemonucleolysis.

Pulse oximetry is widely used during anaesthetic practice to monitor heart rate and oxygenation and has been recommended as a monitor when sedative techniques are used. We monitored 25 patients receiving sedation for chemonucleolysis and showed that 17 became hypoxaemic at some stage of the procedure, none of whom had clinically detectable signs of respiratory depression. We recommend that monitoring with pulse oximetry is used in all patients receiving sedation for radiological procedures and that all radiologists administering sedation be trained in airway management.

Adult↗
PubMed1990

The prognostic significance of radiologically detected knee joint effusions in the absence of associated fracture.

The significance of radiologically detected knee joint effusion as a marker of soft tissue injury following trauma is uncertain. In this study 100 patients presenting to the casualty department following acute injury, with effusions but no fracture, were assessed. Of those available for follow-up, 20% required further investigation and 11% proceeded to surgery for significant soft tissue injury. It is concluded that radiologically detected knee joint effusions are a useful marker for underlying soft tissue injury.

Adolescent↗
PubMed1989

Disruption of the radiocapitellar line in the normal elbow.

Disruption of the radiocapitellar line (RCL) can be a useful sign in injured elbows in children. Although originally described only in the true lateral projection, it has become generally accepted to apply the sign to any radiographic projection. However, it is not clear how to draw the line in the anteroposterior projection when there is prominent bowing of the radial shaft. Five cases are presented where the RCL, when drawn on radiographs of uninjured elbows, either did not pass through the capitellum (one case) or only passed tangential to it (four cases). In these cases, the elbow was not in the standard anteroposterior or lateral position. Radiologists and clinicians involved in trauma should be aware that radiographic positioning and normal bowing of the radial shaft can affect the validity of this sign and that it is best applied only to the true lateral projection as originally described.

Child, Preschool↗
PubMed1989

Pre-operative evaluation for uncemented hip arthroplasty. The role of computerised tomography.

We have studied the role of computerised axial tomography in the assessment of the acetabulum before an uncemented Mittelmeier arthroplasty was performed in 20 patients. In the absence of gross anatomical abnormality, computerised tomography did not provide additional information, but in eight patients it was useful in determining adequacy of acetabular depth, anterior acetabular cover, and thickness of the anterior and posterior walls. In these patients, the CT scans provided information which was not available from plain radiographs and greatly assisted in pre-operative planning.

Acetabulum↗
PubMed1989

Patterns of union in fractures of the waist of the scaphoid.

Eighty-two of 85 patients who had sustained a fracture of the waist of the scaphoid in 1985 were reviewed more than one year after injury. The incidence of nonunion, defined as a clear gap at the fracture site one year after injury, was 12.3%. This was much higher than expected. Most of the patients with nonunion had symptoms and had appreciable restriction of wrist movement. In a further 25% of the patients at review, the site of the fracture could be easily identified although it appeared to have healed. These patients were older and more of them were women. Three-quarters of these patients had symptoms but their wrist movement was essentially normal.

Adolescent↗
PubMed1988

The suspected fracture of the scaphoid: a rational approach to diagnosis.

It has been the policy of the accident and emergency department in Leicester to treat all clinically suspected fractures of the carpal scaphoid in plaster for 2 weeks, even after negative radiology. A preliminary audit of policy revealed that 150 wrists had been immobilized in plaster during a 6-month period and yet only eight fractures of the scaphoid were identified in this group. In order to reduce the degree of 'overkill' a new policy was introduced for the management of the clinically suspected, radiologically negative fracture of the scaphoid and results were assessed prospectively. The new policy was based on resting all such injuries in broad arm slings until review by a more senior member of staff was possible, always within 1 week. Results indicate that it is easier to make a definitive soft tissue diagnosis a few days after such injuries and, therefore, the number of plasters applied dropped substantially. Not all fractures of the scaphoid were apparent on initial radiographs, but despite this it was possible to treat all such injuries appropriately on the strength of their clinical signs when reviewed. The new scheme of management is recommended for general use in accident and emergency departments on the strength of a prospective study of 111 patients with pain after injury, tenderness and swelling in the anatomical snuffbox.

Adolescent↗