PubMed Health⌕ Search

Biomedical subjects

D Resnick

Publications and source records attributed to D Resnick.

At least 361 records · Page 20Linked to original sources
PubMed1987

Potential contrast agents for MR arthrography: in vitro evaluation and practical observations.

In an attempt to identify an ideal contrast agent for MR arthrography, signal behavior as well as T1 and T2 values for articular cartilage, menisci, and ligaments were determined in knees from cadavers and normal volunteers. Comparison was made with similar data derived for intraarticular blood, varying concentrations of an albumin-saline solution (simulating synovial fluid) and Gd-DTPA, 0.9% saline, Renografin 60%, and air. Cadaveric specimens were imaged after intraarticular administration of each substance. A 500-microM volume of Gd-DTPA proved to be an ideal contrast agent for MR arthrography, exhibiting excellent contrast differences with articular structures on T1-weighted images. An albumin concentration of 12%, potentially occurring in severe inflammatory arthritis, also manifested adequate contrast to articular cartilage on T1-weighted images. Renografin and saline provided inadequate contrast on T1-weighted images, and saline necessitated the use of T2-weighted sequences. Air was not found to be an optimal contrast agent. Intraarticular blood exhibited insufficient contrast differences with articular cartilage during the acute hemorrhagic phase. Synovial fluid associated with severe arthritis as compared with fresh intraarticular hemorrhage may thus prove to be a better biological contrast agent for MR arthrography. Saline is currently recommended for use in arthrography, but Gd-DTPA offers significant advantages and should be safety-tested for potential clinical use.

Air↗
PubMed1987

Stress fractures of the distal tibia and calcaneus subsequent to acute fractures of the tibia and fibula.

Stress fractures (two in the calcaneus and four in the distal tibia) occurring distal to the site of a healing fracture of the tibia or fibula were discovered in five patients. Three of these fractures were identified radiographically at the time of their occurrence, and three were identified only after retrospective review of the radiographs of 74 patients with previous tibial or fibular fractures. Three of the patients were less than 10 years old. All five patients had disuse osteopenia and recently had begun weight-bearing. Four patients had healing of their acute fractures with angulation or displacement. Stress fractures can easily be overlooked on radiographic studies in this setting and may be a source of pain that mistakenly can be attributed to malunion or nonunion. Stress fractures should be considered in patients with fractures of the lower extremity, particularly those who experience new or persistent pain or discomfort.

Adolescent↗
PubMed1987

Radiographic evaluation of joints resurfaced with osteochondral shell allografts.

The radiographic features of 41 cadaveric osteochondral shell (low ratio of subchondral bone to articular cartilage) allografts placed in 24 patients for articular resurfacing as an alternative to arthroplasty are presented. Underlying causes of joint disease included ischemic necrosis (20 grafts), osteochondritis dissecans (nine), chondromalacia patellae (10), and posttraumatic osteochondral fracture with degenerative disease (two). Congruity with the adjacent native articular surface and the opposite side of the joint was evident on immediate postoperative radiographs in all patients, and proved to be critical to the ultimate success of the procedure. On follow-up radiographs over a period of 2-28 months, successful incorporation of the allograft was characterized by progressive loss of the relative increased density of the graft, in association with diminished lucency related to new bone formation at the graft-native bone interface, as well as maintained alignment. Graft failure was associated with positional changes including collapse, persistent increased density, and poorly defined fragmentation that occasionally simulated infection radiographically and resulted in intraarticular bodies. Resurfacing of diseased articulations with osteochondral shell allografts constitutes a potentially desirable alternative to total joint arthroplasty, particularly among younger patients. Consequently, an awareness of the expected radiographic alterations associated with graft incorporation and failure is important.

Adolescent↗
PubMed1987

Enteropathic arthropathies.

Musculoskeletal disease occurs in association with inflammatory bowel disorders including Crohn's disease and ulcerative colitis, as well as with Whipple's disease; with enteritis caused by Salmonella, Shigella, and Yersinia; and also following intestinal bypass surgery. Extraintestinal causes of musculoskeletal alterations include Laennec's and biliary cirrhosis and pancreatitis. Three types of musculoskeletal abnormalities are recognized in patients with inflammatory bowel diseases: peripheral joint arthritis, sacroiliitis and spondylitis identical to ankylosing spondylitis, and rarely, miscellaneous changes such as digital clubbing and hypertrophic osteoarthropathy.

Arthritis, Infectious↗
PubMed1987

Magnetic resonance imaging of the lumbar spinous processes and adjacent soft tissues: normal and pathologic appearances.

The spinous processes and intervening soft tissues of the lumbar region may be involved by degenerative, inflammatory, neoplastic, and traumatic processes resulting in low back pain. While conventional radiography and computed tomography have proven useful in the demonstration of abnormalities affecting the spinous processes, they are of limited utility in the evaluation of the intervening soft tissues, which are the predominant site of initial pathologic involvement. To explore the potential role of magnetic resonance imaging (MRI) in the assessment of the spinous processes and adjacent ligaments, a retrospective review of 55 consecutive examinations of the lumbar spine was performed. The normal and pathologic appearances of the region on both T1 and T2 weighted images were characterized, and the optimal imaging variables for demonstration of the spinous processes and adjacent soft tissues were determined with subsequent prospective application to new cases. Correlative examination of cadaveric sections and dried specimens was also performed to facilitate understanding of anatomical relationships visualized by MRI. Based upon the results of this investigation, MRI is the procedure of choice in the evaluation of disease processes affecting the spinous processes and intervening ligaments, primarily owing to the ability to image directly in the sagittal plane and its superior soft tissue contrast discrimination capability.

Adolescent↗
PubMed1987

Radiography of the hyperextended lumbar spine: an effective technique for the demonstration of discal vacuum phenomena.

A prospective evaluation of dynamic lateral lumbar spine radiographs in the erect position in 52 symptomatic patients over the age of 50 years revealed vacuum phenomena in intervertebral discs in 46%. Their frequency was greatest at the L5-S1 spinal level and decreased progressively at higher lumbar levels. Analysis of the dependency of discal vacuum phenomena on spinal position during radiography revealed that hyperextension detected all such phenomena; radiography in the neutral position detected 73% of vacuum phenomena, whereas that obtained with the spine flexed revealed 20% of vacuum phenomena. Our results indicate that lateral radiographs of the hyperextended lumbar spine are useful in the differential diagnosis of intervertebral osteochondrosis (degenerative disease of the nucleus pulposus) and infection.

Aged↗
PubMed1987

Computed tomography of the spine: an update and review.

Computed tomography (CT) has proven to be an important diagnostic imaging technique for the evaluation of a variety of spinal disorders. The method is useful for identifying and characterizing acute fractures in traumatized patients and can accurately quantify spinal canal encroachment. Intervertebral disc disease and facet joint osteoarthritis are readily demonstrated by CT in both the cervical and lumbar regions. The technique can reliably distinguish between infection and neoplastic disease in the spine and is helpful for the guidance of percutaneous biopsy. A variety of congenital and developmental vertebral abnormalities, including dysraphic states, spondylolysis, and spinal stenosis, are optimally assessed using CT. Quantitative CT affords selective analysis of trabecular bone in the spine and has proven useful for the detection and follow-up of osteoporosis as well as other forms of metabolic bone disease. Most recently, the application of multiplanar reformation and three-dimensional image reconstruction has enhanced presentation of diagnostic information contained on cross-sectional images.

Humans↗
PubMed1987

New concepts in bone grafting.

The authors review the diagnostic and surgical imaging aspects of a number of recent bone grafting procedures in the orthopaedic management of various osseous and articular disorders. They discuss several innovative new approaches to bone grafting as well as the use of a variety of bone grafting substitute materials. They discuss the three types of bone graft available for orthopaedic reconstruction; autograft, allograft or homograft and xenograft or heterograft. They stress that an awareness of the radiographic features of each of the various bone grafting techniques is important to the physician dealing with musculoskeletal disorders in determining the results of his efforts.

Bone Transplantation↗
PubMed1987

The architecture of the proximal femur: an imaging analysis.

The proximal femur is a dynamic region whose internal architecture reflects the biomechanical demands of weight-bearing. It is composed of two major trabecular systems arranged along the lines of compressive and tensile stresses. Adaptive alterations in these trabeculae occur in a variety of disorders, including osteoporosis, osteoarthritis, and ischemic necrosis. Plain film radiography and computed tomography (CT) have been utilized to study these changes and provide insight into the pathophysiology of these disorders. Analysis of the order of resorption of trabeculae in osteoporosis, the proliferation of trabeculae in osteoarthritis, and the reparative changes in ischemic necrosis often allows accurate assessment of the severity of involvement and can give valuable information to aid treatment planning.

Femoral Neck Fractures↗
PubMed1987

Knee dysfunction secondary to dislocation of the fabella.

The fabella, a sesamoid bone in the lateral head of the gastrocnemius muscle occurring in 10% to 30% of individuals, is rarely considered a possible cause of knee dysfunction. When noted, the fabella is occasionally mistaken radiographically for an intraarticular ossified fragment; however, symptomatic conditions of the fabella have been well documented in the literature. This is a report of symptomatic dislocation of an enlarged fabella in a 37-year-old man. In a review of the literature of various lesions of the fabella, disability related to dislocation seems not to have been previously reported.

Adult↗
PubMed1987

The diabetic foot.

Disorders of the foot are a common and disabling problem among diabetic patients. Often the most difficult problem radiographically is to differentiate infection from neuropathic change. This article reviews the radiographic features and imaging approach to patients with diabetic foot disorders, with specific reference to both conventional and advanced imaging modalities.

Angiography↗
PubMed1986

Distal interphalangeal joint involvement in rheumatoid arthritis.

Sixty-two patients with seropositive rheumatoid arthritis (RA) were evaluated radiographically for distal interphalangeal (DIP) joint involvement and were compared with 50 age- and sex-matched control subjects. The frequency of DIP erosions was 37% in the patients versus 14% in the controls; these erosions were mild and were not related to disease duration. Erosions elsewhere in the hand and wrist were of all degrees of severity and were related in part to disease duration. Osteophytes occurred frequently in both the RA group (71%) and the control group (60%). However, joint space narrowing occurred more frequently in RA patients (77%) than in the controls (46%) (P less than 0.009). The findings from this study suggest that in RA patients, DIP erosions occur frequently, do not occur in isolation, and are not simply a marker for severe global erosive disease in the hand and wrist. The high frequency of osteophytosis and joint space narrowing in both groups probably represents the overlap of osteoarthritis and RA that occurs in many patients.

Arthritis, Rheumatoid↗
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↗