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Biomedical subjects

D D Sauser

Publications and source records attributed to D D Sauser.

8 recordsLinked to original sources
PubMed1990

The causes of bone scintigram hot spots in fluoride-treated osteoporotic patients.

We previously described new bone formation in fluoride-treated osteoporotic patients. Since then, several investigators have contended that fluoride-induced "hot spots," as seen on bone scintigrams, represent stress fractures. To further evaluate this issue we analyzed scintigrams, radiographs, and quantitative computer tomography (CT) scans of the spine and femoral condyles from 129 patients, obtained before and during therapy. Hot spots, new or of increased intensity, were more than twice as common in the weight-bearing peripheral skeleton than in nonweight-bearing sites (p less than 0.001). The hot spots were usually diffuse, multiple, bilateral, and mostly seen early in therapy, a pattern quite different from that expected of stress fractures. Previously, we postulated that mechanical stress and fluoride act synergistically to stimulate new bone formation. If this hypothesis were correct, we would expect to see a greater increase in femoral condyle bone density in patients with hot spots. Consistent with this hypothesis, patients who developed hot spots in the knees had a greater increase in condylar density (22 +/- 2.5 vs. 9 +/- 3.3 mg/cc) than those without hot spots and stress fractures were not seen in either group. Additionally, patients with more than 5 hot spots in the peripheral skeleton had greater increases in spinal and condylar density than those with fewer than 5 hot spots. Finally, stress fractures were found in less than 2% of our patients. While we do not exclude the possibility that some additional patients may have had stress fractures, our data support the hypothesis that the great majority of hot spots seen on the scintigrams are the sites of new bone formation.

Adult↗
PubMed1990

Imaging of the elbow.

The imaging needs for diagnosis of abnormalities in and about the elbow are presently satisfied in most instances by plain film radiography. Arthrography with tomography and CT has enabled us to delineate the joint space and articular surfaces better. The sensitivity of radionuclide imaging allows early detection of disease processes but lacks specificity. The advantages of MR imaging in the musculoskeletal system should allow improved diagnostic imaging capability about the elbow as it has for other joints.

Diagnostic Imaging↗
PubMed1988

Adhesive capsulitis of the wrist: arthrographic diagnosis.

Persistent pain and decreased range of motion are disabling complications of wrist trauma. Between 1978 and 1986, in ten patients with persistent pain following trauma, arthrography depicted changes characteristic of adhesive capsulitis. Adhesive capsulitis has been described in the shoulder, hip, and ankle, but little mention has been made of this entity in other joints. Confirmation of this diagnosis requires arthrography, since there are no characteristic findings on plain radiographs. Typical arthrographic findings include decreased capacity, small volar and styloid recesses, and adhesions preventing complete opacification of the joint. The arthrographic diagnosis allows proper institution of appropriate therapy.

Adult↗
PubMed1988

Imaging of peripheral nerve lesions.

The imaging of peripheral nerve lesions remains limited to the radiographic demonstration of secondary skeletal lesions in birth trauma, reflex sympathetic dystrophy, neuropathic arthropathy, leprosy, and congenital indifference to pain. Nerve root avulsions can be imaged directly and the newer imaging modalities now allow delineation of lesions that previously could not be studied using conventional radiography. The ability of ultrasound, CT, and MRI to differentiate soft tissue structures makes it possible, in many instances, to study the primary abnormality in trauma, nerve entrapment syndromes, and tumors. With fractures, the possibility of trauma to adjacent nerves can only be inferred on the radiographs, while the role that peripheral nerve injury plays remains controversial in other entities, such as amputation with replantation. Imaging of peripheral nerve lesions remains in its infancy. With further refinement in the signal-to-noise ratio made possible by advances in MRI technology, we may be optimistic about future imaging of peripheral nerve pathology.

Arthropathy, Neurogenic↗
PubMed1988

Adhesive capsulitis of the wrist. Diagnosis and treatment.

Adhesive capsulitis occurs as a pathologic entity in the shoulder, hip, and ankle joints. Thickening and contracture of the wrist joint capsule were demonstrated on arthrograms performed on ten patients ranging in age from 20 to 82 years. The patients had pain and limited range of motion in the wrist. The findings included: (1) resistance to the injection of smaller than normal volumes of contrast material, (2) obliteration of recesses, and (3) extravasation of the contrast agent along the needle tract. Closed manipulation under general anesthesia of the wrist on four patients resulted in some improvement in range of motion. A distal ulna fracture in one older patient occurred as a complication of manipulation. Careful technique and judicious patient selection are of paramount importance.

Adult↗
PubMed1986

Hip changes in spastic cerebral palsy.

Radiographs of the hips of 69 patients with cerebral palsy were evaluated for the angle of Wiberg, acetabular angle, degree of subluxation, shape of the femoral head, and, when the appropriate studies had been performed, anteversion and neck-shaft angles. Abnormalities included various degrees of superior lateral subluxation or dislocation, dysplasia of the acetabulum associated with femoral head displacement, flattening of the medial and/or lateral portions of the femoral head, an increase in the anteversion angle, functional increase in the neck-shaft angle, and, in long-standing cases, secondary degenerative joint disease and pseudoarticulation. Neuromuscular imbalances and abnormal ambulation caused by cerebral palsy change the biomechanical forces on the hip and result in characteristic osseous changes. Recognition and proper treatment of these changes can significantly alter the clinical course of the disease.

Adolescent↗
PubMed1978

Discogenic vertebral sclerosis.

Narrowing of a disc space, sclerosis of the adjacent vertebral bodies, and irregularity of the vertebral end plates constitute a roentgen complex classically associated with infectious spondylitis. However, narrowing of a disc space may be the result of a herniated nucleus pulposus, and in some individuals the reactive sclerosis is sufficiently intense to resemble infection. Roentgenographic recognition of discogenic vertebral sclerosis may obviate the need for further evaluation and biopsy. Forty-four cases of discogenic vertebral sclerosis, nine with surgical proof and four developing after disc surgery, are presented. Roentgen signs helping to distinguish it from infection include: (i) rounded sclerosis most frequently in the anterior vertebral body (100%), (ii) central lucency in the sclerosis (77%), (iii) associated degenerative changes at the intervertebral disc, e.g. vacuum phenomena (44%), (iv) absence of a para-spinal mass and (v) maintenance of vertebral body height.

Adult↗