[Dynamic radiographs of the wrist].
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Biomedical subjects
Publications and source records attributed to F Gires.
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CT scan imaging findings are described in 22 patients with lumbar spine joint synovial cysts, of intraspinal development, provoking sciatica or lumbosciatica from nerve compression in spinal canal. Diagnosis was suggested by a mass at the posterior joint level, of variable density, sometimes with peripheral calcification, presenting a vacuum appearance on occasions, and with enhanced image with contrast. Differential diagnosis is from excluded hernia and postoperative fibrosis. Posterior intraarticular arthrography can confirm diagnosis and allow treatment with prolonged action corticoid infiltrations.
An unselected group of patients with rheumatoid affections presents radiologic evidence of a notch of acetabulum roof in about 20% of cases. The anatomic substratum of this variant is described and should be recognized to avoid a mistaken diagnosis of periarticular lacuna.
Lateral images were studied in the sitting and standing positions during a continuous series of 150 radiculographies, in patients presenting with a symptomatology suggestive of herniated disk or lumbar stenosis. In 67% of cases the dural sac was abnormally reduced at the level of the inter-somatic spaces, due to disk protrusion or intracanalar protrusion of posterior soft tissues. In 23% of cases, an absolute canalar stenosis with anterior-posterior decrease to less than 10 mn in the standing position existed. This was due in 65% of cases to an isolated or predominant posterior impression, the latter appearing in the standing position in only 55% of cases. Saccoradiculography is the only procedure allowing study of the dural cul-de-sac in the standing position. It should be carried out if a narrow lumbar canal is suspected clinically, even if investigations in the lying position, such as CT scan or MR imaging show normal canalar dimensions.
Normal and pathologic femoral heads have been studied by MRI at 1.5 Tesla. The study was centered upon avascular necrosis (53 lesions). Twenty normal subjects and three patients with algodystrophy were examined. The osteonecrosis patterns were established from known lesions. A low signal rim surrounds an upper polar zone of conserved (Type I) or decreased (Type II) signal. The lesions age correlates significantly with their type: amongst type I lesions, 6 are asymptomatic and the 21 others have a mean age of 5.5 months; Type II lesions have a mean age of 12.7 months. Fourteen lesions were not seen on plain radiographs and six were not detected by bone scan. The older lesions with femoral head deformation are better depicted by standard radiologic techniques. Conservatively MRI is the most efficient examination for recent avascular necrosis lesions.
Historical aspects and anatomophysiologic features of posterior lumbar vertebral joints are summarized and results of arthrography of 55 joints presented, together with a simple, original method for performing this examination. Normal anatomic appearances condition understanding of principal lesions encountered, particularly with respect to compression of adjacent nerve structures.
Findings on arthrography of posterior lumbar spine joints in 55 patients were compared with those reported in the literature. Two major degenerative lesions of these joints, diverticula and cysts, can provoke back pain and symptomatic nerve compression. Whereas diagnosis of a cyst is dependent mainly on computed tomography imaging, that of a diverticulum is ensured by arthrography, an investigation which also has a therapeutic aim since it allows infiltrations to be performed.