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Biomedical subjects

E Libson

Publications and source records attributed to E Libson.

At least 73 records · Page 4Linked to original sources

Significance of bone scintigraphy in symptomatic spondylolysis.

In a prospective study, the authors evaluated the usefulness of bone scintigraphy in the work-up of young military personnel with lumbar spondylolysis and persistent low back pain. Ten out of 23 spondylolytic individuals with a recent history of low back pain had positive scintigrams, and none of a group of painless spondylolytic individuals had positive scans. We believe these results indicate that bone scintigraphy is of value in determining whether a spondylolysis in a young individual can be attributed to recent physical exertion or a specific recent traumatic incident.

Adult↗

Oblique lumbar spine radiographs: importance in young patients.

Spondylolysis is a direct precursor of spondylolisthesis and can lead to crippling back pain. Of 1,743 patients surveyed, including 936 who were asymptomatic and 807 with back pain, 165 (including 91 who were asymptomatic and 74 with back pain) had spondylolysis, which was seen only on oblique lumbar views in 20% of cases. Because of the high false-negative rate of AP and lateral views, oblique views are essential in children and young adults. As spondylolysis is rare above L3, radiographs can be limited to L3-S1. Significantly less spondylolysis was seen in persons older than 30, with back pain usually caused by disk degeneration; thus routine oblique views could be safely omitted in older patients.

Adolescent↗

Bilateral symmetrical clavicular periosteal reactions in a child.

A case of bilateral symmetrical periosteal reactions of the lateral halves of the clavicles in a child with subacute sclerosing panencephalitis is presented. The appearances correspond with no previously recorded condition. The differential diagnosis most likely lies between aborted Salmonella osteomyelitis or a form fruste of subacute symmetrical osteomyelitis.

Child↗

Radiogrammetry of the metacarpal: a critical reappraisal.

The precise estimation of osteoporosis is hampered by the lack of a generally accepted method of evaluation. Measurement of the combined cortical thickness (CCT) of the centre point of the second metacarpal has been widely used for this purpose, but the wide normal variation found in population studies has reduced its value in the diagnosis of this condition in the individual. The factors leading this normal variability are discussed and the three centre metacarpals are compared with each other. It is concluded that simple CCT measurement is preferable to any of the indices so far devised, but that a single measurement of a given metacarpal is too imprecise to be of real value. If a single metacarpal is to be chosen, three measurements of the third metacarpal gives a coefficient of variation lower than those of the second or fourth, and an average of nine measurements of the three centre metacarpals produces a further useful reduction in variability.

Adult↗

Symptomatic and asymptomatic spondylolysis and spondylolisthesis in young adults.

The lumbar spine was examined radiologically for the presence of spondylolysis and spondylolisthesis in 936 asymptomatic soldiers prior to military placement and in 662 soldiers complaining of low back pain. The overall incidence of spondylolysis was 9.7% in both groups, but bilateral spondylolysis was more prone to be associated with symptoms than a unilateral defect. In the symptomatic group the incidence of spondylolisthesis was 5.3% but only 2.2% in the asymptomatic group. The defect was seen in the oblique views only in 18.7% of the cases of spondylolysis. The precise diagnosis is important for vocational counselling and military placement.

Adolescent↗

Calcified mucinous adenocarcinoma of the stomach--the CT appearances.

The CT appearances of calcified mucinous adenocarcinoma of the stomach have not been previously reported. This is a rare tumour with a high propensity to calcify, the calcifications typically are small and spiculated. A case is described where the condition was suspected in the plain films of the abdomen and confirmed by CT examination of the stomach.

Adenocarcinoma, Mucinous↗

Granulocytic sarcoma (chloroma) of bone: the CT appearance.

Granulocytic sarcoma (chloroma) is an unusual tumour usually seen in cases of myelogenous leukemia. The tumour is most commonly located in the skull, orbits and sinuses. Extracranial tumours occur mainly in the soft tissues of the body and bone involvement is uncommonly seen and is almost invariably lytic in nature. We describe the first case of CT demonstration of bone involvement by such a tumour. A mixed sclerotic and lytic pattern was seen.

Adult↗

CT appearance of primary pleural lymphoma.

We report a case of primary pleural lymphoma. The CT appearance was of hemorrhagic pleural effusion with thickened membranes. The CT evaluation of pleural disease is discussed.

Adult↗

Renal cell carcinoma metastatic to the ovary. Ultrasound and CT appearance.

Three years following nephrectomy for renal cell carcinoma, a 54-year-old woman presented with symptoms secondary to ascites, and a large left adnexal mass. A large predominantly cystic, partially solid, septated mass with thick irregular margins was found on ultrasound and computed tomography scans. Pathological examination revealed renal cell carcinoma identical to the original tumor. The etiology and appearance of metastatic disease to the ovary are discussed.

Ascites↗

CT-guided aspiration core needle biopsy of gastrointestinal wall lesions.

PURPOSE: The purpose of this work was to examine the accuracy and safety of CT-guided core biopsy of gastrointestinal wall lesions. METHOD: We reviewed over 1,200 CT-guided abdominal core biopsy results from 1989 through 1998. Forty-five were from gastrointestinal wall lesions (16 gastric, 3 duodenal, 7 small intestine, and 19 colon). RESULTS: A definitive histologic diagnosis was obtained from the core biopsy in 41 patients (91%) without complication. The gastric lesion diagnoses were mesenchymal tumor of smooth muscle origin (eight), lymphoma (one), adenocarcinoma (three), and normal (one). Duodenal core biopsy diagnoses were inflammation (one) and normal (one). Small intestinal core biopsy diagnoses were non-Hodgkin lymphoma (four), metastatic leiomyosarcoma (one), carcinoma (one), and tuberculosis (one). Colon core biopsy diagnoses were carcinoma (11), lymphoma (2), actinomycosis (2), granulomatous inflammation (1), metastatic squamous cell carcinoma (1), chronic abscess (1), and mesenchymal tumor of smooth muscle origin (1). CONCLUSION: Percutaneous CT-guided core needle biopsy from gastrointestinal wall lesions is safe and accurate, especially in submucosal lesions, and should be considered in selected cases with negative endoscopic biopsy or in which endoscopic biopsy is not possible.

Biopsy, Needle↗

Scoliosis in young men with spondylolysis or spondylolisthesis. A comparative study in symptomatic and asymptomatic subjects.

While an increased incidence of scoliosis in symptomatic spondylolysis and spondylolisthesis has been established previously, a comparison of its occurrence in symptomatic and asymptomatic individuals has not been performed. The present study is a comparison of symptomatic and asymptomatic young men with analysis as to the incidence of scoliosis. Idiopathic scoliosis was not found and all cases were due to spasm scoliosis or olisthetic scoliosis with the spasm type being much more common. Scoliotic curves were divided into mild (0-9 degrees) and moderate (10-20 degrees). No case of a curve greater than 20 degrees was seen. Scoliosis incidence in asymptomatic individuals without a pars break was 6.65%. In the groups of: (1) asymptomatic unilateral spondylolysis, (2) asymptomatic bilateral spondylolysis, (3) symptomatic bilateral spondylolysis, and (4) asymptomatic spondylolisthesis the scoliosis incidence was similar, ranging from 13.3-23.8%. These figures are significantly higher than those seen in the asymptomatic subjects without a pars break, but they are in the same range as in symptomatic patients without a pars break, suggesting that muscle spasm is the principal cause of the scoliosis.

Adolescent↗

Acute osteolytic lesions following pancreatitis in a dialysis patient.

A 42-year-old man undergoing maintenance hemodialysis suffered an attack of acute pancreatitis. Convential treatment resulted in quick recovery. 10 days after its onset his hands and feet became swollen, hot, red and painful. Multiple intramedullary osteolytic lesions of the metatarsals, metacarpals and phalanges, with cortical destruction and a number of fractures were found. These lesions subsided over many weeks and did not recur. We believe that such acute osteolytic lesions following pancreatitis are not 'renal osteodystrophy' as such, but should be recognized as a possible complication in renal failure patients.

Acute Disease↗

Severe acute pancreatitis as the presenting symptom of primary sclerosing cholangitis: treatment by endoscopic insertion of a biliary stent.

Primary sclerosing cholangitis is a chronic, fibrosing, inflammatory condition of unknown origin of extra and intrahepatic bile ducts. Recurrent cholangitis and jaundice are the most frequent clinical manifestation in symptomatic patients. We report a patient with primary sclerosing cholangitis presented with recurrent attacks of acute pancreatitis. Such a combination was not reported till now in the literature. The acute pancreatitis was probably due to reflux of bile and sludge into the pancreatic duct due to stricture of the distal part of a common bile and pancreatic ducts. Endoscopic insertion of a biliary stent managed to prevent jaundice and recurrent pancreatitis.

Acute Disease↗