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F Priolo

Publications and source records attributed to F Priolo.

At least 19 recordsLinked to original sources
PubMed1998

The current role of radiography in the assessment of skeletal tumors and tumor-like lesions.

Radiography offers more information than any other imaging modality in the study of bone lesions and remains the cornerstone for the differential diagnosis of skeletal tumors and tumor-like lesions thanks to its higher specificity in detecting tumor morphologic hallmarks. the radiographic features that help the radiologist make the diagnosis of a bone tumor or tumor-like lesion, or at least narrow the diagnostic possibilities, include patterns of bone destruction (geographic, moth-eaten and permeated), lesion margins (from sclerotic rim to ill-defined margin), internal characteristics of the lesion (non-matrix producing tumors, non-mineralized matrix producing tumors, mineralized matrix producing tumors), type of host bone response (medullary or periosteal), location (femur, tibia, humerus, etc.), site (metaphysis, diaphysis or epiphysis), and position (central, eccentric or periosteal) of the lesion in the skeletal system and in the individual bone, soft tissue involvement, and single or multiple lesion nature. Patterns of bone destruction, margins, and reactive changes in the host bone clearly depict the growth rate of a bone lesion, that is its biologic activity; the matrix of the lesion, as well as lesion location, site and position may allow a specific diagnosis. This general information coupled with clinical information helps define whether the lesion is neoplastic or non-neoplastic, benign or malignant, primary or metastatic, and will help further direct the subsequent work-up. CT may be indicated for the optimal assessment of tumor matrix especially in complex anatomical sites, such as the spine, pelvis and hindfoot. The main role of MRI lies in local tumor staging, especially for planning limb-salving resections. Biopsy is the definitive diagnostic procedure and should be carried out only after the appropriate diagnostic and staging tests. Whenever a bone lesion is suspected, clinical-radiologic pathologic correlation is essential to make a more accurate diagnosis and to improve patient care.

Biopsy↗
PubMed1998

Skeletal benign bone-forming lesions.

The imaging features of benign osseous lesions of the bone are often characteristic and suggestive of a specific diagnosis. This is particularly true for skeletal benign bone-forming lesions such as enostosis, osteoma, osteoid osteoma and osteoblastoma. Enostosis or bone island is an incidental finding in the axial skeleton (pelvis, spine, ribs) of asymptomatic patients; it appears as a small (0.2-2 cm) round to oval sclerotic area with irregular, radiating ('thorny') spicules peripherally. Osteoma is a benign slow-growth tumor and usually an incidental finding in cranial sinuses, vault and mandible, and presenting as a homogeneous, sharply defined bone mass arising from bone surface; its signs and symptoms are rare and depend on the tumor size and location--e.g. sinusitis, headache, exophthalmos, diplopia. Osteoid osteoma is a painful highly vascularized benign tumor usually affecting the long bone diaphysis cortex of young patients; it generally appears as a small radiolucent nidus with or without central calcification and surrounding bone sclerosis on radiographs, and as a 'hot' spot on scintigraphy. CT is the method of choice for the definite location of the nidus especially in sites of complex anatomy, such as the spine, pelvis and hindfoot. Osteoblastoma is a rare tumor, histologically similar to osteoid osteoma but with a significantly different clinical potential because of the possibilities of postoperative recurrence, of its locally aggressive behavior or, rarer still, malignant transformation; the spine and long bones are affected in more than half the cases. Its radiologic appearance is not always distinctive and usually characterized by a lytic lesion with varying bone production and expansile behavior; CT and MRI are required for the diagnosis of spinal osteoblastomas. When a bone-producing tumor or tumor-like lesion is suspected but no specific diagnosis can be made, the knowledge of the range of the imaging findings of these lesions will allow a suitably ordered differential diagnosis. Radiography is the single most effective imaging method in this respect. CT is required for the tumors in complex anatomical sites, such as the spine, pelvis and hindfoot, as well as for the optimal assessment of the tumor matrix. MRI is specifically required to study the lesion effect on the spinal canal.

Bone Diseases↗
PubMed1997

Clinical trials in rheumatoid arthritis: methodological suggestions for assessing radiographs arising from the GRISAR Study. Gruppo Reumatologi Italiani Studio Artrite Reumatoide.

OBJECTIVES: The three x ray assessors of the GRISAR study (blinded to treatment) gave consensual erosion and damage scores to the baseline and 12 month radiographs of 284 rheumatoid arthritis (RA) patients using three different methods: single readings (blinded as to patient and chronological sequence of the x rays), paired readings (blinded as to sequence), and chronologically ordered paired readings. The aim was to evaluate which of these reading procedures is the most appropriate for clinical trials. METHODS: The progression of the scores obtained using each procedure was compared by means of descriptive statistics, principal components analysis, and intra-patient correlation coefficients of pairs of methods. Bootstrap estimates of the variance of the difference in the means of two equally sized random samples were calculated to evaluate the power of the statistical analysis performed to assess the possible treatment effect for both paired and chronological reading methods. RESULTS: (a) The standard deviations of the paired and chronological readings were similar, but that of the single readings was higher. (b) The knowledge that two x rays were of the same patient accounted for a sizeable proportion of the between method variability. (c) Agreement was satisfactory between the paired and chronological methods for both scores but, between them and the single readings, it was modest for erosions and poor for damage. (d) The bootstrap estimate of the variance of the difference was smaller for the paired than the chronological method, possibly giving it greater power to test treatment effect. CONCLUSIONS: These results suggested that paired readings were the most suitable for evaluating the progression of joint damage in the GRISAR study.

Arthritis, Rheumatoid↗
PubMed1997

Lumbosacral junction injury associated with unstable pelvic fracture: classification and diagnosis.

PURPOSE: To determine the types and prevalence of lumbosacral junction injuries associated with an unstable pelvic fracture and to assess the diagnostic value of conventional radiographic and computed tomographic (CT) findings. MATERIALS AND METHODS: Anteroposterior, inlet, and outlet radiographs and CT scans in 97 patients with pelvic disruption were retrospectively reviewed. RESULTS: Unstable pelvic fractures were seen on radiographs in 73 patients, 42 of whom had a sacral fracture. Fourteen of these 42 patients had an associated L5-S1 facet joint injury (three extraarticular, nine articular, and two complex). In three of these 14 patients, the L-5 body was laterally bent by more than 10 degrees, with asymmetric L5-S1 intervertebral space. The diagnosis in nine of the 14 patients with an associated lumbosacral junction injury was rendered on the basis of CT findings only. CONCLUSION: Lumbosacral junction injury must be considered in patients with an unstable pelvic fracture, especially in those with an associated sacral fracture. CT is necessary because these conditions may be overlooked on radiographs, although outlet radiographs are better than CT scans for depicting the possibly associated L5-S1 intervertebral disk lesion.

Adolescent↗
PubMed1997

Radiographic changes in the feet of patients with early rheumatoid arthritis. GRISAR (Gruppo Reumatologi Italiani Studio Artrite Reumatoide)

OBJECTIVE: To assess the value of radiographs of the feet of patients with early rheumatoid arthritis (RA) in the evaluation of RA classification and outcome. METHODS: Within a multicenter therapeutic trial, baseline and 12 month radiographs of the hands, wrists, and feet of 284 patients with early RA (< or = 4 years; mean 1.4; median 0.6) were scored according to a modified Larsen-Dale method by an independent radiological reading committee, blinded to the treatment, clinical, and laboratory data. RESULTS: Thirty-two patients (11%) had only foot erosions at baseline. Twelve month progression in the eroded joint count was more frequent in the patients with foot erosions than in those without (63% CI 55 divided by 71 vs 42% CI 35 divided by 50). CONCLUSION: Foot radiographs facilitate the identification of patients with early erosive RA. Foot involvement is indicative of more aggressive disease. Assessment of foot radiographs allows the most adequate therapeutic strategy to be adopted.

Adolescent↗
PubMed1996

Slow progression of joint damage in early rheumatoid arthritis treated with cyclosporin A.

OBJECTIVE: To evaluate the ability of low-dose cyclosporin A (CsA) to control radiologic disease progression, and to assess the clinical efficacy and tolerability of CsA, compared with conventional disease-modifying antirheumatic drugs (DMARDs), in patients with early active rheumatoid arthritis (RA). METHODS: In this long-term, multicenter, prospective, open, blinded end point, randomized trial, 361 consenting patients with early (<4 years since diagnosis) active RA were enrolled. Of the eligible patients, 167 were treated with CsA at 3 mg/kg/day, and 173 with DMARDs. The decision to use conventional antirheumatic drugs as controls was based on the fact that joint erosion could be expected to occur after 1 year regardless of the type of DMARD being used. The possibility of switching therapies in both groups was intended to keep the largest possible number of patients in the study. RESULTS: Blinded evaluation of hand and foot radiographs after 12 months of treatment showed that CsA led to a significant (P < 0.001) delay in the mean +/- SD progression in the eroded joint count (1.3 +/- 3.1 versus 2.4 +/- 3.0 for the control group) and in the joint damage score (3.6 +/- 8.9 versus 6.9 +/- 9.1 for the control group), both measured by the Larsen-Dale method. When only the patients without erosion at baseline were considered (37 in the CsA-treated group and 54 in the control group), erosion appeared in only 10.8% of the CsA-treated patients, but in 51.8% of the controls (P = 0.00005). Low-dose CsA was as effective as traditional DMARDs in controlling clinical symptoms. Maintenance on the initially prescribed treatment regimen ("survival on treatment") was also better at 12 months with CsA than with DMARDs (89.2% versus 77.5%; P = 0.002). The tolerability of CsA was acceptable. CONCLUSION: These 12-month results suggest that low-dose CsA decreases the rate of further joint damage in previously involved joints as well as the rate of new joint involvement in previously uninvolved joints, in patients with early RA.

Adult↗
PubMed1996

Is the control of disease progression within our grasp? Review of the GRISAR study. (Gruppo Reumatologi Italiani Studio Artrite Reumatoide).

A prospective, open, multicentre, randomized study with a blinded radiological end-point was started in 1991. The aim of the study was to assess whether cyclosporin A (CyA) controls ongoing anatomical damage in active early rheumatoid arthritis (RA) better than conventional disease-modifying anti-rheumatic drugs (DMARDs) as used in everyday clinical practice. A total of 340 consenting patients with early RA (mean duration 1.4 yr) were recruited; 167 were randomized to CyA 3mg/kg per day and 173 to DMARDs. Hand, wrist and foot X-rays were blindly scored by a central committee of three radiologists using the Larsen-Dale method. Any side-effects were carefully recorded. The control of clinical symptoms was similar in both groups. Radiological evaluation of 284 patients (141 on CyA; 143 on DMARDs) after 12 months showed a significant decrease in the mean progression in the eroded joint count (1.3 +/- 3.1 vs 2.4 +/- 3.0, P < 0.001). There was also better maintenance on treatment with CyA than in the group treated with DMARDs (89.2 vs 77.5%, respectively; P = 0.002). CyA seems to offer greater control of ongoing anatomical joint damage in early RA than conventional DMARDs after 12 months.

Adult↗
PubMed1995

[A syndrome caused by separating rags in textile industry: a new clinical entity?].

A group of 104 workers were examined. They were employed in selecting rags and separating the lining from wollen fabrics to be used again as thread waste in the textile industry. The aim of the study was to point out tendon and joint related disorders of the upper limb due to repetitive and forced movements. Twenty-eight (26.9%) workers complained of hand and wrist echography and thermography. In 19 patients (67.8%) clinical carpal tunnel syndrome was diagnosed. Eight workers (28.5%) had Dupuytren's contracture. Swelling of the fingers was found in 23 (82.1%). 14.2% and 28.5% of the workers showed respectively acro-osteolysis and acrosclerosis. The textile industry of Prato shows peculiar characters: the workers employed in selecting rags out a manual job which causes soft tissues and skeletal disorders in a great number of them. The acro-osteolytic and acrosclerotic changes of the fingers seem alike the bone disorders of chronic inflammatory rheumatic diseases as seronegative spondyloarthritis.

Carpal Tunnel Syndrome↗
PubMed1992

[Pelvic fractures].

Pelvic fractures, although accounting for only 2-3% of all traumatic skeletal lesions, are extremely important due to the frequent sequelae and complications that can cause the death of the patient. Moreover, their incidence is increasing due to road accidents, sport and work injuries. X-ray examinations, if correctly performed, allow the degree of residual stability of the pelvic ring to be assessed; they allow both the recognition of the mechanisms of injury and the evaluation of bone lesions. The X-ray examination can provide the orthopedist all the necessary information for the correct treatment planning, employing an external setting or, when the lesion is unstable, an open-field setting. The authors, after considering the major types of pelvic ring fractures, classified on the basis of the mechanisms of injury, suggest the best radiologic protocol, in their opinion, for the pelvic fractures whose diagnosis is based on X-ray examinations. In these cases, CT is less useful than in the study of acetabular fractures; it rarely provides additional information and thus remains a supplemental exam to X-rays.

Fractures, Bone↗
PubMed1984

[Variability of the radiologic characteristics of osteoid osteoma].

The authors have studied the anatomical-radiographic correlations in 55 patients with osteoid osteoma. On the basis of the results gathered we feel able to state that the variability of radiologic features of osteoid osteoma (nidus surrounded by a zone of sclerosis) depends on the site of the lesion and on the advanced stage of the neoplastic tissue.

Adolescent↗