Biomedical subjects

E Pacciani

Publications and source records attributed to E Pacciani.

10 recordsLinked to original sources

PubMed1996

[Clinico-radiologic correlations in common neck pain].

Patients with spontaneous neck pain, headache, dizziness and/or pain to the upper limbs are frequently observed. Common cervicodynia, due to the involvement of arthromuscular structures of the cervical spine, was diagnosed in the patients with these symptoms in the absence of trauma or neurologic signs. The authors investigated the clinical-radiologic correlation in a series of 130 symptomatic patients and considered it a metameric disorder. The frequent association of many radiographic signs at the same level often prevents single radiographic signs from being assessed individually; therefore, the authors selected some patients with just one radiographic change per functional unit, to assess its relationship with clinical symptoms. The patients underwent anteroposterior, lateral and functional (flexion-extension) radiographs of the cervical spine. Vertebral rotation, detected on antero-posterior views as a spinous process deviation, was the most frequent isolated sign (79/130 cases) per metameric level, with strong clinical correlation (70/79 cases). Vertebral rotation was probably due to unilateral muscular stiffness. Other single radiologic signs per functional unit with strong clinical correlation follow: atloaxial rotation (13/130 with clinical-radiologic agreement of 12/13), functional blockage (13/130 with clinical-radiologic agreement of 11/13), angular flexion (21/130 with clinical-radiologic agreement of 19/21) and overall disc space thinning (12/130 with clinical-radiologic agreement of 10/12). Atloaxial rotation is represented as an asymmetry of the spaces between the odontoid and the lateral masses of the atlas; functional blockage consists of insufficient or lacking physiological width of the occipito-atlantoid or interspinous space in functional tests. Angular flexion consists of a single flexion angle of the cervical spine in functional tests; two or more angles indicate normal flexion of the cervical spine. This study confirmed the poorer clinical impact of degenerative changes, mostly interapophyseal arthrosis, than of other radiologic signs. Interapophyseal arthrosis alone was isolated in single functional units in 46/130 patients, mostly at C7-D1, with clinical-radiologic agreement in 19/46 patients. Clinical-radiologic correlation proved the high diagnostic value of anteroposterior, lateral and functional radiographs of the cervical spine in common cervicodynia, which make them a valuable tool for the clinician.

Adolescent↗

PubMed1995

Associated dental anomalies in an Etruscan adolescent.

Three fragments of the upper jaw of an Etruscan adolescent of the 6th century B.C. discovered at the necropolis of Cancellone 1 (Magliano in Tuscany, Grosseto, Italy) were examined. A triad of associated dental anomalies was found: congenitally missing second premolars, "peg-shaped" permanent lateral incisors, and ectopic (palatal) eruption of a permanent canine. These findings provided the opportunity to discuss etiopathogenetic aspects of the associations among different types of tooth abnormalities.

Adolescent↗

PubMed1995

[Nonspecific osteomyelitis in childhood and adolescence. The contribution of imaging diagnosis].

Nonspecific osteomyelitis in children and adolescents can be diagnosed in patients 2 to 16 years old and may present as acute, subacute or chronic. During the last 9 years, 40 pediatric patients (aged 2 to 16 years) affected with extra-axial inflammatory bone lesions were examined. The series of cases was then reviewed. This work was aimed at investigating the role of various imaging modalities: conventional radiology (CR), bone scan with technetium-99 methylene diphosphonate (99mTc-MDP), scintigraphy with technetium-esamethylpropylenaminoxima labelled leukocytes (99mTc-HMPAO), computed tomography (CT) and magnetic resonance imaging (MRI) were used to detect the lesions, to make a differential diagnosis and to assess different disease stages. As for acute osteomyelitis (6 patients), CR showed a lytic lesion, periosteal new bone and soft tissue swelling in 4/6 patients; no abnormalities were demonstrated in the other two. Bone scan, CT and MRI depicted bone involvement. CT and MRI also showed inflammatory lesion spread to surrounding soft tissue. 99mTc-HMPAO scintigraphy was not performed in acute osteomyelitis, because of technical difficulties in performing the exam promptly; thus, the early diagnosis of lesion nature was made with bone biopsy. As for subacute osteomyelitis (23 patients), 99mTc-HMPAO scintigraphy was performed in 8/23 patients and proved to be a highly sensitive method, showing cell clusters and confirming the diagnosis of inflammatory lesion. MRI showed a focal area of intermediate-low signal intensity on T1-weighted sequences, with small focal intralesional areas of low intensity, a low-signal perifocal rim and diffusely low signal of surrounding bone marrow. T2-weighted images showed high signal intensity in both the abscess lesion and bone marrow, the latter probably due to edema. In 5 patients, a paramagnetic contrast agent (Gd-DTPA) was administered during MRI and showed inhomogeneous enhancement of both the inflammatory lesion and surrounding bone marrow. As for chronic osteomyelitis (7 patients), MRI was performed in 5/7 patients. In 4 patients the lesion appeared as a low-signal area on T1-weighted images while T2-weighted images showed an inhomogeneous high-signal area. In the same patients, 99mTc-HMPAO scintigraphy was always positive. In patient 5, the lesion was represented by a low-signal area on both T1 and T2-weighted images, while 99mTc-HMPAO was negative. Therefore, in chronic osteomyelitis, both MRI and 99mTc-HMPAO were useful in detecting both spinal and peripheral bone involvement, which was in some cases asymptomatic at first observation CR, CT (3/4) and MR (4/4) findings extra-axial localizations were similar to those in subacute-chronic forms.

Acute Disease↗

PubMed1994

Enamel hypoplasia and age at weaning in 19th-century Florence, Italy.

A sample representing a population of the Florence district of middle 19th century was studied to determine the age of occurrence of enamel hypoplasias. The age interval most affected was that between 1.5 and 3.5 years. Historical sources on weaning habits of 19th-century Italian populations indicate a weaning period between 12 and 18 months. This is in agreement with the data on enamel defects, showing that children of post-weaning age are more subject to stress. Wide "grooves", with prolonged duration, are concentrated between 2 and 2.5 years, whereas "lines" occur primarily between 2.5 and 3 years. We suggest that this distribution could reflect the gradual introduction of dietary supplements until weaning is complete.

Age Factors↗

PubMed1994

[Static-dynamic computerized tomography in the diagnosis of traumatic lesions of alar ligaments. Preliminary results].

The patients affected with cervical injuries often complain of cervical pain, headache and dizziness even when no bone fractures are detected. Such patients are likely to have a post-traumatic injury of the cervical ligaments. Twenty-five symptomatic patients (19 women and 6 men) were examined with upper spine CT and functional CT scans (right and left rotation) to detect ligament injuries and hypermotility of the craniocervical junction, both related to traumatic events. Eleven patients showed no alterations, while unilateral densitometric alterations of the alar ligaments were observed in 14 cases and thought to be related to trauma. On axial CT scans, the normal alar ligaments were identified as paramedian, quadrangular soft-tissue structures at the apex of the dens epistrophei and right above it. In 14 patients with alar ligament injuries, CT showed incomplete ligament interruption and thinning in 12 cases and its total absence on all images in 2 cases. The laterodental space in the affected side was hypodense due to fat tissue replacement. Of 14 patients with alar ligament injuries, only 14 patients with alar ligament injuries, only 4 exhibited rotatory hypermotility at C0-C1 and C1-C2. The low frequency of rotatory hypermotility is probably due to the high rate of incomplete alar ligament injuries as well as to cervical muscle stiffness, which is marked in some subjects. In conclusion, static and functional CT of the upper spine is not only useful to predict trauma outcome, but also allows the detection of the alar ligaments, of their morphodensitometric changes and of the segmental instability of the craniocervical junction.

Adolescent↗

PubMed1989

"Orthodontistry" and dental occlusion in Etruscans.

Specimens dating back to the VIII Century B.C. indicate Etruscans may have been the first people to employ orthodontic bands to improve tooth alignment. A survey of dental occlusion in Etruscan cranial remains, however, shows very good typical occlusion and almost no crowding. Thus, these people do not represent the earliest development of epidemiologically high prevalence of malocclusion, a feature instead reserved for the later industrial world.

Ethnicity↗

PubMed1986

The radiological diagnosis of spinal stenosis in the lumbar canal.

Based on a study of 132 patients suffering from lumbar spinal stenosis, the authors propose a simple classification aimed at providing the surgeon with the maximum essential information on which to plan surgery. This is based on an analysis of standard radiographic and radiculographic findings, and stresses the importance of diagnosing the correct type and level of the stenosis. Certain physiopathological aspects of the subarachnoid space which have a bearing on the use of contrast radiography are also discussed.

Female↗

PubMedDate not supplied

Symptomatic cervicogenic headache.

Cervicogenic headache is a little-known clinical condition whose true importance has only recently been recognized. A number of causes may lie at the basis of the onset of headache (symptomatic cervicogenic headache). However, despite exhaustive attempts, sometimes it is not possible to identify a clear cause responsible for the onset of the syndrome (primitive cervicogenic headache). The genesis of symptomatic cervicogenic headaches sometimes may be easy to identify as a result of a close, pre-existing, cause-effect relationship (i.e. trauma). On other occasions it may be much more laborious to pinpoint the pathology responsible for headache (some cranio-cervical anomalies, etc.). Clinically, it is necessary to perform a thorough preliminary clinical and anamnestic evaluation which can orient subsequent investigations to achieve a diagnosis in the least time possible with the minimum discomfort to the patient and his relatives, not to mention lower costs for society.

Arthritis, Rheumatoid↗

PubMedDate not supplied

[Osteoid osteoma and osteoblastoma of the vertebrae].

Five cases of osteoid osteoma and five cases of osteoblastoma of the spine are reported. All the patients underwent surgery and the radiographic diagnosis was always histologically confirmed. Conventional radiographic technique using tomography constantly permitted the diagnosis. Computed tomography was primarily useful for spatial localization of the lesion. The authors evaluate the radiographic findings of the two lesions discussing the symptoms which are suspected for these pathologic conditions. Bone scintigraphy must precede radiological examination.

Humans↗

PubMedDate not supplied

Diagnostic imaging of the early slipped capital femoral epiphysis.

INTRODUCTION: Early slipped capital femoral epiphysis (ESCFE) can be treated surgically, with excellent results, if it is diagnosed in its initial stage; however, the rate of late or missed diagnoses remains surprisingly high. PURPOSE: We compared radiography, US and MR sensitivity in ESCFE diagnosis. MATERIAL AND METHODS: We examined 21 symptomatic overweight patients (15 boys and 6 girls) aged 9 to 15 years with anteroposterior radiographs; frog leg images were not acquired in 3 cases only. US was performed in 19 cases and the images acquired with 5-7.5 MHz probes on the sagittal plane parallel to the femoral neck. MRI was performed in 9 cases, with coronal and sagittal T1 SE and T2* GE images. RESULTS: Our sensitivity rates were 66% for anteroposterior radiography (6 false negatives), 80% for combined anteroposterior and frog leg images (3 false negatives), 95% for US (1 false negative) and 88% for MRI (1 false negative). DISCUSSION AND CONCLUSION: We believe that US is the method of choice in ESCFE diagnosis; if it is negative, but pain persists, MRI should be performed.

Adolescent↗