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Biomedical subjects

D Resnick

Publications and source records attributed to D Resnick.

At least 73 records · Page 4Linked to original sources
PubMed1990

Magnetic resonance imaging of the knee.

MRI has been in widespread clinical use since 1985 and in this short time has dramatically altered musculoskeletal imaging. The technology continues to become increasingly sophisticated; as both clinicians and radiologists become more familiar with its possibilities, further elucidation of pathologic processes affecting the knee will occur. In addition, advanced computer software has allowed a decrease in imaging time, which will allow a decrease in cost of this once-expensive technique. At this time, in many centers, MRI has essentially replaced arthrography for evaluation of disorders of the knee. The advantages of MRI include its inherent contrast sensitivity that allows visualization of a wide variety of tissues, multiplanar capabilities, lack of ionizing radiation, noninvasiveness, rapidity of imaging, and acceptability to patients.

Bone Marrow↗
PubMed1990

Innovative approaches to noninvasive bone densitometry.

In conclusion, this review has endeavored to familiarize the practicing radiologist with some of the newer approaches to noninvasive bone densitometry that are currently being explored as potential improvements over existing techniques. Three-dimensional volumetric CT is a practical means of measuring bone density in the proximal femur, owing to the widespread availability of the necessary scanning equipment, and affords enhanced prediction of biomechanical parameters in the spine and hip, but suffers from limitations similar to those of conventional quantitative CT. Dual-energy projection radiography offers significant potential advantages over dual-photon absorptiometry from the standpoint of precision, radiation dose, image quality, and examination time, but remains to be thoroughly tested. Compton scattering appears to be a viable alternative to single-photon absorptiometry for bone density determinations in the peripheral skeleton. Neutron and proton activation analysis are unlikely to achieve widespread application, owing to their cyclotron-dependent nature, although the former will probably remain the optimal means for determining total body calcium. Experience with scanning-slit fluorography and magnetic resonance as applied to noninvasive bone densitometry is currently too limited to permit prediction of their ultimate role in this respect. As a final point, it should be noted that major incentives for mobilization of bone densitometric equipment currently exist: on Earth, as a means of facilitating patient access and saving money via joint ventures, and in space for monitoring the adverse effects of weightlessness on skeletal mass and the ability to function following return to a gravity environment.

Bone Density↗
PubMed1990

Current and innovative methods for noninvasive bone densitometry.

This article summarizes a variety of noninvasive techniques for measuring bone density in the clinical setting. Although dual-energy x-ray absorptiometry and quantitative computed tomography are currently the most widely used methods, older techniques such as radiogrammetry and single-photon absorptiometry continue to have research applications, and experimental approaches such as compton scattering and proton activation analysis may be important in the future. The evaluation of bone mass measurement underscores continuing progress in our understanding of bone metabolism and biomechanics, and has provided valuable insight into improvements in the therapy of osteoporosis and other forms of metabolic bone disease.

Absorptiometry, Photon↗
PubMed1990

Advanced imaging of the wrist.

Abnormalities of the wrist present a difficult diagnostic challenge requiring thorough evaluation of both osseous and soft-tissue structures. Advanced techniques such as scintigraphy, computed tomography, three-phase arthrography, and, most recently, magnetic resonance imaging have added greatly to our understanding of wrist pathology. This article discusses the application of these techniques in imaging the wrist.

Arthrography↗
PubMed1989

Computed tomography of rheumatologic disorders.

Diseases of the spine and peripheral joints can be diagnosed noninvasively by this revolutionary imaging modality. CT has retrospectively demonstrated superiority over myelography and other imaging techniques in delineating various pathologic conditions--e.g., trauma, neoplasm, and infection--as well as arthropathy. Specific technical approaches are described in detail.

Age Factors↗
PubMed1989

Inflammatory disorders of the vertebral column: seronegative spondyloarthropathies, adult-onset rheumatoid arthritis, and juvenile chronic arthritis.

A variety of inflammatory disorders may involve the spine and sacroiliac joint. Of these, the seronegative spondyloarthropathies (consisting principally of ankylosing spondylitis, psoriasis, Reiter's syndrome, and certain intestinal diseases), adult-onset rheumatoid arthritis, and juvenile chronic arthritis are particularly important. The imaging abnormalities accompanying these disorders, supplemented with some clinical and pathologic data, are the subject of this review.

Arthritis, Juvenile↗
PubMed1989

Quantitative dual-energy radiographic absorptiometry of the lumbar spine: in vivo comparison with dual-photon absorptiometry.

Quantitative dual-energy radiographic absorptiometry (DRA) and dual-photon absorptiometry (DPA) were compared to determine the best means of assessing bone density. Both methods were used to evaluate the lumbar spine in 107 women (aged 35-84 years [mean, 64 years]) referred for evaluation of osteoporosis risk. High correlation was documented between measurements derived by the two techniques, with a .95 linear regression coefficient for the total spine density measurement. Age-related regression equations were similar in slope but manifested different intercepts. Bone mineral density values derived with DRA were consistently lower than those obtained with DPA (conversion equation: DPA density = [1.067 X DRA density] + 0.163). Besides the inherent imperfections of each system, it was found that inaccurate identification of intervertebral spaces on the low-resolution DPA images introduced errors in patient data. DRA may replace DPA as the dedicated projectional densitometric procedure of choice for technical reasons, but at present a conversion equation must be used to compare DRA data to DPA data.

Adult↗
PubMed1989

Axial bone density in rheumatoid arthritis: comparison of dual-energy projection radiography and dual-photon absorptiometry.

The usefulness of dual-energy projection radiography (DEPR) in the evaluation of rheumatoid arthritis was compared with that of dual-photon absorptiometry (DPA). Bone density measurements of the lumbar spine and the proximal femur were obtained with DPA in 75 patients (45 women and 30 men). For comparison, the bone density of the lumbar spine was measured with DEPR in a subset of 52 patients (33 women and 19 men). High correlation was documented between DEPR and DPA measurements of the lumbar spine. No significant relationship between bone density and age was observed, in contrast to the known relationship in healthy subjects regardless of sex, site of measurement, or measurement technique. Bone density values in the spine and the proximal femur were significantly reduced for both sexes as compared with matched normative data. Interlevel variation in lumbar vertebral density as measured with DEPR was not significantly different in patients with rheumatoid arthritis as compared with control subjects. Significant correlation between bone density determination and body weight, as well as duration of menopause, was noted, whereas duration of disease, functional status, and cumulative corticosteroid dose were not predictive. Rheumatoid arthritis did not appear to influence the relationship between DEPR and DPA measurements of the spine, and neither method nor site of measurement exhibited a consistent advantage in discriminating patients with rheumatoid arthritis from healthy control subjects.

Absorptiometry, Photon↗
PubMed1989

Osteosclerosis of the phalanges in Werner syndrome.

Werner syndrome is an autosomal-recessive disease characterized by premature aging, shortness of stature, scleroderma-like skin changes, endocrine abnormalities, and cataracts. Although radiographic findings have been well documented, the presence of distinctive osteosclerotic changes in the phalanges of the hands and feet has not been emphasized in previous publications. The authors' review of radiographs of both hands in nine patients and of both feet in six patients with Werner syndrome documented the frequent occurrence of phalangeal sclerosis related predominantly to endosteal thickening. In the hand, sclerosis was present in every patient, was generally symmetric in distribution, predominated in the distal phalanges, and demonstrated an ulnar predilection. Similar changes in the phalanges of the feet were demonstrated in only two patients. The presence of osteosclerosis in the phalanges of the hand alone or both the hand and foot, when combined with osteoporosis and periarticular calcification, suggests the diagnosis of Werner syndrome.

Adult↗
PubMed1989

Diffuse idiopathic skeletal hyperostosis: diagnostic significance of radiographic abnormalities of the pelvis.

Retrospective evaluation of the osseous pelvis in 93 patients with severe diffuse idiopathic skeletal hyperostosis (DISH) revealed 14 locations of radiographic abnormalities. Two osteoradiologists independently studied these sites for abnormalities in a prospective, blinded fashion in 103 patients over the age of 45 years. Lateral radiographs of the thoracolumbar spine were quantitatively and qualitatively evaluated to determine whether DISH, spondylosis deformans, or a normal spine was present. Statistical analysis was performed for evaluation of interobserver reliability, the relationship between pelvic and spinal abnormalities, and the significance and predictive values of pelvic abnormalities for DISH versus non-DISH and DISH versus spondylosis deformans. Although significantly higher frequencies and greater extents of radiographic abnormalities at 10 of 14 pelvic locations were noted for DISH compared with non-DISH, this number decreased to four of 14 locations when compared with spondylosis deformans. The alterations in three of these four pelvic sites consisted of ossification of ligaments. These changes appear to be good indicators of the presence of spinal DISH and support the concept that DISH is an entity separate from spondylosis deformans.

Adult↗
PubMed1989

Intraosseous fat necrosis associated with acute pancreatitis: MR imaging.

Necrosis of fatty bone marrow, caused by lipolytic enzymes, is a rare complication of several pancreatic disorders. A 44-year-old man with polyarthritis, subcutaneous nodules, and osteolysis associated with alcoholic pancreatitis underwent magnetic resonance (MR) imaging of the knees. In the marrow of the distal femur and proximal tibia, the images showed multiple foci of abnormal signal intensity compatible with the diagnosis of fat necrosis secondary to acute pancreatitis. Because MR imaging can depict abnormalities in fatty marrow that seem to precede necrosis, this modality may add early diagnostic information.

Acute Disease↗
PubMed1989

Diagnostic imaging of lower extremity trauma.

Traumatic injuries to the lower extremity are a common occurrence in today's society and may result in significant morbidity and mortality if not appropriately treated. Adequate radiographic evaluation is crucial to the assessment of these injuries. This article reviews the radiographic features and imaging approaches to the commonly encountered injuries of the lower extremity.

Femoral Fractures↗
PubMed1989

Diagnostic imaging of tarsal and metatarsal stress fractures. Part I.

As the preoccupation with physical fitness grows in this country, the problem of "stress fracture" has become more clinically significant. Reliable techniques for imaging the musculoskeletal system have also continued to grow, allowing the clinician to better diagnose and manage this condition. However, the radiographic findings of stress fracture are sometimes difficult to interpret. This review compares plain radiography, scintigraphy, CT, and MRI in the imaging of stress fractures.

Ankle Injuries↗
PubMed1989

Arthrography of the post-traumatic knee, shoulder, and wrist. Current status and future trends.

The current status of arthrography of the wrist, knee, and shoulder has been discussed with particular emphasis given to those conditions seen in patients following acute or chronic trauma. Cross-sectional techniques that impact on the current usage of arthrography of these joints also were discussed. Wrist arthrography remains the standard procedure for the evaluation of ligamentous abnormalities about the wrist. MR imaging is unlikely to make a large impact in this area until improvements in technique and surface coil technology allow routine visualization of the very small, but important, interosseous ligaments. MR imaging of the knee will likely replace arthrography except in those cases in which cost considerations or availability prevent its implementation. MR imaging undoubtedly will continue to contribute to the evaluation of shoulder abnormalities, but whether or not it will completely replace standard arthrography and CT arthrography depends upon the results of future studies.

Humans↗
PubMed1989

Fatigue fracture of the sacrum: a case report.

We report a patient with a stress fracture in the sacrum. This may be a cause of hip or back pain. In contrast to typically bilateral insufficiency fractures, fatigue fractures are usually unilateral and the appearances are not diagnostic on scintigraphy. As the plain film findings may be subtle and overlooked, computed tomography is more specific in delineating a sclerotic vertical fracture parallel to the sacroiliac joint. Recognition of the characteristic radiographic pattern in sacral fatigue fractures can avoid incorrect diagnosis and unnecessary tests or treatment.

Adult↗