Biomedical subjects

Deborah M Forrester

Publications and source records attributed to Deborah M Forrester.

6 recordsLinked to original sources

PubMed2004

Infectious spondylitis.

Infection of the spine is a rare but serious cause of back pain. Conventional radiographs remain the initial screening procedure. Typically two adjacent vertebral bodies and the intervening disk space are affected. Early in the course of the disease, radiographs may be normal or nondiagnostic. Magnetic resonance imaging or radionuclide bone scan will establish pathology centered in the vertebral body. Because of the ability to image soft tissues, magnetic resonance imaging is particularly helpful in detecting paravertebral and extradural abscesses. Four other conditions may mimic infectious spondylitis: degenerative disk disease associated with Modic type 1 changes, pseudoarthrosis in ankylosing spondylitis, dialysis spondyloarthropathy, and neuropathic spondyloarthropathy. Advanced imaging studies in combination with radiographs and clinical information are essential in determining the correct diagnosis.

Bacterial Infections↗

PubMed2004

Infliximab treatment of Familial Mediterranean fever and its effect on secondary AA amyloidosis.

We describe a patient with a long history of familial Mediterranean fever who developed proteinuria as a result of secondary AA amyloidosis. In this patient, the inflammatory process, including recurrent attacks of arthritis, abdominal pain, nephrotic syndrome secondary to amyloidosis, and high sedimentation rate, was rapidly suppressed by treatment with infliximab and there was remarkable improvement of the proteinuria.Because TNF-alpha is a proinflammatory cytokine that plays a major role in FMF and secondary amyloid, it is an appropriate target for therapy. Our case is the first case of reactive systemic amyloidosis secondary to familial Mediterranean fever, which responded favorably to infliximab.

Journal Article↗

PubMed2003

Imaging of amyloid arthropathy.

Amyloidosis is a disease complex caused by the extracellular deposition of an insoluble protein called amyloid. Amyloid arthropathy results from localized amyloid deposition in and around the joints. This article discusses the types of amyloidosis associated with amyloid arthropathy and presents their characteristic imaging findings.

Amyloidosis↗

PubMed2003

Inflammatory arthritis secondary to metastatic gastric cancer.

Metastatic spread of malignancy to the joints is rare and only a few cases of solid tumors have been reported. We describe a patient with inflammatory arthritis of the knee and ankle secondary to metastatic gastric adenocarcinoma to the joints and bone diagnosed by synovianalysis. Arthritis secondary to metastatic cancer is a poor prognostic sign. The diagnosis is based on a strong clinical suspicion, magnetic resonance imaging, and joint fluid cytology or synovial biopsy.

Adenocarcinoma↗

PubMedDate not supplied

The early diagnosis of sacroiliac joint infections in children.

UNLABELLED: We retrospectively reviewed the medical records and imaging studies of 15 children with infections of the sacroiliac joint to determine the usefulness of specific examinations and studies to aid in the early diagnosis of this condition. The clinical presentation, physical examination findings, pertinent laboratory data, and imaging studies were reviewed. Thirteen patients (87%) were febrile at the time of presentation. One patient presented in septic shock requiring intubation and critical care management. Tenderness to palpation over the sacroiliac joint was present in all 9 patients who had this examination performed, and the flexion abduction external rotation test was positive in 10 of 12 patients (83%) who had this test done. Laboratory indicators of infection were elevated in most patients, and 6 patients (46%) had positive blood cultures, most commonly growing Staphylococcus aureus. Initial conventional radiographs were negative in all but 1 patient. Radionuclide 99-m-technetium bone scans were positive in 7 of 10 patients (70%), and magnetic resonance imaging studies were ultimately positive in 13 of 14 patients (93%). However, within the first 6 days after the onset of symptoms, only 5 of 8 bone scans (63%) and 5 of 9 magnetic resonance imaging studies (57%) were consistent with infection. We conclude that while diagnostic imaging studies are ultimately helpful in confirming the diagnosis of sacroiliac joint infections in children, studies made within 6 days of the onset of symptoms may not always confirm the diagnosis. The early diagnosis of this condition is best made on the basis of clinical and laboratory findings. LEVEL OF EVIDENCE: Therapeutic Study, level IV (Case series [no, or historical control group]).

Adolescent↗

PubMedDate not supplied

Imaging of intraarticular masses.

Intraarticular masses can be classified as noninfectious synovial proliferative processes (lipoma arborescens, synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis), infectious granulomatous diseases (tuberculous arthritis, coccidioidomycosis arthritis), deposition diseases (gout, amyloid arthropathy), vascular malformations (synovial hemangioma, arteriovenous malformations), malignancies (synovial chondrosarcoma, synovial sarcoma, synovial metastases), and miscellaneous (cyclops lesion). Knowledge of articular anatomy aids the radiologist in localizing masses to the joint space. Some joints have complex anatomy with contiguous or adjacent bursae, recesses, and tendinous connections from which masses may originate or into which masses may extend. Many of the diseases causing intraarticular masses have specific imaging characteristics, especially on magnetic resonance images, and knowledge of these characteristics will allow for a more confident diagnosis.

Adult↗