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Biomedical subjects

D Resnick

Publications and source records attributed to D Resnick.

At least 55 records · Page 3Linked to original sources
PubMed1990

Detection of thoracolumbar vertebral body destruction with lateral spine radiography. Part II: Clinical investigation with computed tomography.

Conventional radiography in the lateral projection was used to evaluate 25 osteolytic lesions involving vertebral bodies of the thoracolumbar spine. Destruction was calculated as percentages of the maximum transverse diameter and volume of the vertebral body as measured by computed tomography (CT) and the effect of size of lesion on detection was evaluated. Areas (Az) under the receiver-operating characteristic (ROC) curves and the significance of differences were determined from the observations of four radiologists. The mean difference between areas under the ROC curve for lesions involving 32% to 60% of the transverse diameter and for larger lesions of 61% to 93% was 0.12 and significant (P less than 0.05). The effect of the presence of localized loss of vertebral body density, sclerotic bone tissue surrounding the lesion and cortical destruction was evaluated in a second session, in films with lesions the observers scored 4 (probably abnormal) or 5 (definitely abnormal). Cortical destruction was reported to be helpful for detection in 35% of lesions, sclerotic bone surrounding the lesions was helpful in 30%, and a qualitative local decrease in bone density was noted in all lesions. In comparison with the results obtained for the same four observers with experimentally produced lesions in our previous cadaveric study, the clinical lesions of comparable size were not as readily detected. The ROC area for the largest group of clinical lesions (61% to 93%, Az = 0.83 +/- 0.07) was not significantly different from that for a group of smaller cadaveric lesions (41% to 60%, Az = 0.83 +/- 0.05). The smaller clinical lesions (32% to 60%, Az = 0.71 +/- 0.08) were similar in detectability to the experimental lesions of relative diameter 26% to 40% (Az = 0.74 +/- 0.15). Caution should be exercised in the interpretation of conventional radiographs in the lateral projection if there is suspicion of vertebral body destruction.

Adult↗
PubMed1990

The calcar femorale. An anatomic, radiologic, and surgical correlative study.

In order to define the anatomy of the calcar femorale, a radiologic and surgical study was done on ten paired cadaver femurs. After radiography and computed tomographic (CT) scans, the specimens were subjected to medullary reaming by an experienced orthopedist, simulating total hip arthroplasty procedures. The imaging studies were repeated and compared with the prereaming studies. The calcar femorale was dissected from surrounding medullary bone, and sections of this structure were examined histologically. The calcar femorale is a condensation of cancellous bone. It is not affected by the reaming procedure but may play a role in guiding the reamer. This structure is separate from the calcar area described in relation to bone resorption after hip arthroplasty.

Cadaver↗
PubMed1990

Dual-energy radiographic absorptiometry of the lumbar spine: clinical experience with two different systems.

Dual-energy radiographic absorptiometry (DRA) of the lumbar spine was performed in 222 subjects (aged 17-92 years) of both sexes with use of two different systems. In a sub-group of 21 patients, results were compared with those obtained by means of dual-photon absorptiometry (DPA) of the lumbar spine. There was a high correlation among the results obtained with three instruments (r = .9, P less than .0001), and interconversion factors were calculated. Data conversion based on these regression equations may be useful for comparing results from one laboratory to another.

Absorptiometry, Photon↗
PubMed1990

Osteophytosis of the knee: anatomic, radiologic, and pathologic investigation.

Although the radiologic manifestations of degenerative disease of the knee have been investigated, the distribution of marginal and central osteophytes has not been defined. This study included (a) 50 consecutive patients with osteoarthritis of the knee in whom routine and specialized projections were obtained prospectively, (b) 25 patients with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease whose knee radiographs were retrospectively reviewed, and (c) four cadaveric knees that were dissected to assess pertinent anatomy. In this study the importance of the tunnel view in the evaluation of osteoarthritis and CPPD crystal deposition disease is demonstrated, the distribution of and the relationship between marginal and central osteophytes are discussed, and two new radiologic signs are described. As both marginal and central osteophytes may simulate intraarticular bodies, the recognition of these outgrowths is of clinical importance.

Calcium Pyrophosphate↗
PubMed1990

Demonstration of the scapholunate space with radiography.

The importance of radiographic evaluation of the scapholunate space, which should not be wider than 2 mm, has been well established in cases of wrist injury. Unfortunately, the assessment of this space is not accurately determined with routine posteroanterior (PA) radiographs, because the scaphoid and lunate bones often overlap. Moreover, the exact portion of the scapholunate space that should be measured has never been clearly defined. Nine wrists with a scapholunate space no wider than 2 mm and without chondrocalcinosis were studied by means of plain routine views and special projections, transaxial and coronal computed tomographic scans, and dissection to determine the precise orientation and anatomy of this space. A PA radiograph with 10 degrees of tube angulation from the ulna toward the radius best demonstrated the scapholunate space. This space should be measured at the level of the midportion of the flat lateral facet of the scaphoid.

Carpal Bones↗
PubMed1990

Cauda equina syndrome complicating ankylosing spondylitis.

The cauda equina syndrome is an uncommon and poorly understood complication of ankylosing spondylitis. The clinical and radiologic findings in five patients with this syndrome are described. Typical findings include cutaneous sensory impairment of the lower limbs and perineum with sphincter disturbances. Motor impairment occurs less frequently, and associated pain is an inconstant feature. Enlargement of the caudal sac and dorsal arachnoid diverticula that erode the lamina and spinous processes are characteristic myelographic and computed tomographic findings. The pathogenesis of the cauda equina syndrome in ankylosing spondylitis remains unknown but may be due to demyelination, post-irradiation ischemia, or compression from spinal arachnoiditis.

Adult↗
PubMed1990

Rheumatoid knee: role of gadopentetate-enhanced MR imaging.

Physical examination is often insufficient in distinguishing between joint effusion and inflamed synovium in the knee joints of patients with rheumatoid arthritis. The authors prospectively evaluated the role of intravenously administered gadopentetate dimeglumine in distinguishing between these two conditions. Fourteen patients with classic rheumatoid arthritis were examined first by a rheumatologist and then by means of magnetic resonance (MR) imaging with T1- and T2-weighted sequences. T1-weighted images were also obtained following the intravenous administration of gadopentetate dimeglumine. T1-weighted images obtained prior to contrast material administration demonstrated an identical low-intensity signal from both effusion and inflamed synovium, and T2-weighted images demonstrated increased signal intensity in both cases. Intravenous administration of gadopentetate dimeglumine allowed distinction between effusion and abnormal synovium, with the effusion remaining of low signal intensity and the synovium demonstrating enhancement and increased signal intensity. The authors conclude that the use of gadopentetate allows distinction between synovial thickening and joint effusion in the knee, which may affect treatment decisions.

Adult↗
PubMed1990

Scapholunate advanced collapse: a common wrist abnormality in calcium pyrophosphate dihydrate crystal deposition disease.

Scapholunate advanced collapse (SLAC) is a pattern of wrist malalignment that has been attributed to posttraumatic or spontaneous osteoarthritis of the wrist. Its features, however, also have been observed in patients with idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. To determine the frequency and characteristics of SLAC in this disease, the authors reviewed wrist radiographs in 168 well-documented cases of this disorder. Forty-four of the cases (26%) revealed wrist abnormalities typical of SLAC. Associated findings included bilateral involvement (63%); calcification in or near the triangular fibrocartilage (70%); scapholunate widening or dissociation (70%); and arthropathies of the trapezioscaphoid (57%), metacarpophalangeal (second through fifth) (52%), first carpometacarpal (40%), and radiolunate (14%) joints. Results strongly suggest that CPPD crystal deposition disease is one of the major causes of SLAC. Furthermore, radiolunate arthropathy was found in 14% of the patients with SLAC and CPPD crystal deposition disease, which is different from other observations.

Aged↗
PubMed1990

Is MR better than arthrography for evaluating the ligaments of the wrist? In vitro study.

The purpose of this study was to determine the relative merits of MR imaging and three-compartment digital arthrography in the assessment of carpal ligaments in vitro. We performed MR imaging and arthrography in 10 normal wrists of fresh cadavers ranging in age from 48 to 71 years, and compared the appearance of the interosseous ligaments and triangular fibrocartilage complex with findings on anatomic sections of the joints. In six of the specimens, relatively T1-weighted MR images, 800/20 (TR/TE), preceded three-compartment digital arthrography performed with standard contrast material. In the other four specimens, arthrography, using an MR solution of iodinated contrast material mixed with cupric sulfate and gelatin, was performed before MR imaging. This was done to mimic the intraarticular fluid that might be seen in an injured wrist. MR allowed accurate assessment of the triangular fibrocartilage complex and scapholunate ligament in eight of 10 cases. Consistent MR visualization of the lunotriquetral ligament was difficult. Three-compartment digital arthrography allowed accurate assessment of the triangular fibrocartilage complex and scapholunate and lunotriquetral ligaments in all 10 cases. We concluded that MR is useful but inferior to arthrography in the evaluation of interosseous ligaments and the triangular fibrocartilage complex.

Aged↗
PubMed1990

Insufficiency fracture of the sternum caused by osteopenia: plain film findings in seven patients.

Sternal insufficiency fractures, whether nonbuckling (displaced or nondisplaced) or buckling, are rare and have been described in elderly osteopenic patients with accentuated kyphosis of the thoracic spine. We retrospectively analyzed the radiographs and clinical records in seven osteopenic patients with sternal insufficiency fractures and correlated the type of insufficiency fracture with the presence and degree of dorsal kyphosis, as well as the presence of chest pain, soft-tissue mass, and osteolysis. We found that displaced or nondisplaced nonbuckling fractures (five patients) may be associated with chest pain localized to the sternum (three patients), and may be present with (three patients) or without (two patients) associated thoracic kyphosis. This type of insufficiency fracture also may be accompanied by a soft-tissue mass and osteolysis (three patients), findings simulating pathologic fractures. All buckling insufficiency fractures (two patients) were associated with thoracic kyphosis and were asymptomatic. Our findings suggest that sternal insufficiency fractures may occur with or without exaggerated dorsal kyphosis. The fractures are an uncommon complication of osteopenia and may resemble pathologic fractures when osteolysis and soft-tissue swelling are present.

Adult↗
PubMed1990

Jogging causes acute changes in the knee joint: an MR study in normal volunteers.

As MR imaging allows evaluation of soft-tissue structures not previously possible with imaging techniques, we undertook a preliminary study to evaluate the effects of a popular form of exercise (jogging) on the knee. The specific question prompting our investigation was, does repetitive impulse loading produced by jogging cause acute structural changes within the knee that are visible by MR imaging? The knees of 10 healthy subjects were examined on a 1.5-T MR system before and immediately after 30 min of continuous jogging. The same extremity was examined each time, and the imaging sequences and photographic technique (meniscal windows) were identical for both examinations. Effusions developed in five of 10 subjects after exercise. In addition, five of 10 subjects had subtle increased signal intensity within their menisci. These results suggest that jogging frequently leads to acute changes in the knee that are visible on MR imaging. The significance of these changes is unknown.

Acute Disease↗
PubMed1990

MR imaging of the temporomandibular joint: a cadaver study of the value of coronal images.

Recent studies comparing cryosectional anatomy of the temporomandibular joint (TMJ) to its MR appearance have shown that the assessment of disk displacement is inaccurate when based on the sagittal plane alone. This article describes the MR appearance of the normal and abnormal (positional and osseous changes) TMJ in the coronal plane and compares these findings with their cryosectional anatomy. Twenty-two TMJs from unselected frozen cadavers were embedded in paraffin. Coronal and sagittal MR imaging was performed; specimens were then cut in the same plane as the coronal images. Disk position by cryosection was normal in 14 cases and abnormal in eight cases. Coronal MR images alone correctly depicted the TMJ disk position in 17 cases (77%) (13 normal, four abnormal). Complementary sagittal images were necessary for diagnosing anterior displacement in two cases (9%). MR was inaccurate in three cases (14%) of severe degenerative joint disease. Bone condition was correctly diagnosed on the basis of coronal images alone in all cases. Our study shows that coronal MR imaging alone of the TMJ in cadavers accurately shows disk position in 77% of cases. Complementary sagittal images were of benefit in the diagnosis of an additional 9% with anterior displacement. Disk position was assessed inaccurately in either plane in patients with severe degenerative joint disease. For a full MR assessment of the TMJ for disk position and bone condition, we recommend imaging in both coronal and sagittal planes.

Cadaver↗
PubMed1990

MR arthrography of the shoulder: comparison with conventional MR imaging.

Twenty-three patients underwent both conventional MR imaging of the shoulder and MR shoulder arthrography for clinically suspected labral or rotator cuff abnormalities. Images obtained before and after contrast administration were studied independently, and without knowledge of clinical findings, by two radiologists for the presence of abnormalities of the glenoid labrum or rotator cuff. Results were correlated with surgical findings in all patients. Nine patients had surgically proved labral tears. MR arthrography detected all nine labral abnormalities, while six of the nine were missed on conventional MR imaging. Fourteen patients had surgically proved rotator cuff tears. MR arthrography detected 11 of the 14 tears and missed three partial tears on the bursal surface. Conventional MR imaging detected nine cuff tears and missed five tears; two of these were complete rotator cuff tears and three were partial tears of the undersurface of the rotator cuff. Our results suggest that MR arthrography enhances the accuracy of MR in the evaluation of the glenoid labrum and rotator cuff tendon.

Adolescent↗
PubMed1990

Magnetic resonance imaging of the shoulder.

MR imaging has proved to be of great value in the assessment of musculoskeletal imaging. Its superiority in evaluating knee and spine pathology is well established. Recent studies also have established an important role for MR imaging in the assessment of shoulder disorders. Multiplanar capabilities coupled with excellent contrast resolution that allows simultaneous delineation of osseous and soft-tissue structures make MR imaging a useful method for evaluating the complex anatomy of the shoulder.

Humans↗
PubMed1990

Pseudopseudarthrosis in a patient with ankylosing spondylitis.

There is a growing consensus that the mechanism leading to extensive discovertebral destruction (type III) in most patients with ankylosing spondylitis relates to fracture and subsequent pseudarthrosis. We introduced the term "pseudopseudarthrosis" to describe (in our case) the occurrence of abnormal motion between 2 fused spinal segments, resulting in extensive discovertebral destruction without fracture or pseudarthrosis.

Adult↗