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Biomedical subjects

G Greenway

Publications and source records attributed to G Greenway.

At least 19 recordsLinked to original sources
PubMed1998

Osteochondral defect of the glenoid fossa: cross-sectional imaging features.

PURPOSE: To evaluate the cross-sectional imaging features of osteochondral defects (OCDs) of the glenoid fossa and to elicit a more detailed analysis of the trauma, if any, that may cause this injury. MATERIALS AND METHODS: Eight patients (seven male patients, one female patient; age range, 15-42 years; mean age, 27 years) with an OCD in the glenoid fossa were identified. Conventional computed tomography (CT), CT arthrography, or magnetic resonance (MR) imaging was performed. Surgical correlation was available in six patients. RESULTS: Six patients had a history of anterior dislocation or subluxation, one patient had an acromioclavicular joint separation, and one patient had chronic pain. Seven patients had anterior labral tears, and four had a redundant capsular insertion. A glenoid OCD appeared as either a multiloculated cyst in the subchondral bone mimicking a subchondral cyst (six patients) or a single osteochondral fragment (two patients). The lesion ranged from 8 mm to 2.0 cm in diameter. Three patients had an intraarticular body. Surgery confirmed an OCD in six of six patients. CONCLUSION: A glenoid OCD occurs most often as a result of acute trauma and has a high association with instability, labral tear, and intraarticular bodies.

Adolescent↗
PubMed1998

Evidence of the subperiosteal origin of osteoid osteomas in tubular bones: analysis by CT and MR imaging.

OBJECTIVE: A large series of patients with pathologically proven osteoid osteoma of tubular bones was reviewed to determine the frequency of a subperiosteal site of origin. MATERIALS AND METHODS: Thirty-eight cases that were included met two criteria: the tumor was located in a tubular bone, and the lesion had been evaluated by CT scanning or MR imaging, or both. The location of the osteoid osteoma was categorized as intracortical, sub-periosteal, endosteal, or medullary. RESULTS: Among the 38 cases, 19 were imaged with CT scanning, 14 with MR imaging, and five with both techniques. The most common affected sites were the femur (n = 13), tibia (n = 15), and humerus (n = 4). Among these 38 cases, 18 were intracortical, two were intramedullary, and 18 were subperiosteal. CONCLUSION: Osteoid osteomas occurring in a subperiosteal or surface location are not rare. Indeed, many osteoid osteomas arising in a tubular bone possibly originate in a subperiosteal site and later appear as an intracortical lesion. This site of origin appears to relate principally to continual remodeling of bone with subperiosteal deposition and endosteal erosion.

Adult↗
PubMed1992

Osteoma of soft parts.

Osteomas of soft tissue are rare tumors. All previously reported cases occurred in the head, usually in the posterior tongue. We present two patients with soft-tissue osteomas in the thigh. Both masses were densely ossified and consisted of mature trabecular bone on computed tomography and magnetic resonance examination. Increased uptake of bone-seeking radiopharmaceutical was found on scintigraphy. Histologically, mature lamellar bone was seen with small amounts of cartilage seen in the periphery. Symptoms of mass effect which resolved following surgery were noted. We believe that this previously unrecognized soft-tissue appendicular neoplasm lies at the end of a spectrum of post-traumatic ossifying lesions which includes soft-tissue chondromas and osteochondromas, as well as myositis ossificans.

Aged↗
PubMed1990

Fibrous dysplasia: magnetic resonance imaging appearance at 1.5 tesla.

Fibrous dysplasia has been described in a small number of cases in the literature as showing low signal intensity on T1- and T2-weighted magnetic resonance images. We reviewed magnetic resonance scans of 13 patients with fibrous dysplasia to determine if there might be a characteristic appearance. All lesions had sharply defined borders and were of intermediate signal intensity on T1-weighted images. With T2 weighting, six lesions (46%) showed high signal intensity, four (31%) showed persistent intermediate signal intensity, and three (23%) showed mixed intermediate and high signal intensity. Ten lesions (77%) had inhomogeneous signal intensity and three (23%) had homogeneous signal intensity. We concluded that fibrous dysplasia does not have a characteristic appearance on magnetic resonance imaging. However, magnetic resonance may be helpful in establishing the diagnosis of fibrous dysplasia if low to intermediate signal intensity is seen on both T1- and T2-weighted images. This situation occurred in 54% of our cases, whereas the other 46% had nonspecific signal characteristics indistinguishable from many other bone lesions.

Adult↗
PubMed1989

Intraosseous fat necrosis associated with acute pancreatitis: MR imaging.

Necrosis of fatty bone marrow, caused by lipolytic enzymes, is a rare complication of several pancreatic disorders. A 44-year-old man with polyarthritis, subcutaneous nodules, and osteolysis associated with alcoholic pancreatitis underwent magnetic resonance (MR) imaging of the knees. In the marrow of the distal femur and proximal tibia, the images showed multiple foci of abnormal signal intensity compatible with the diagnosis of fat necrosis secondary to acute pancreatitis. Because MR imaging can depict abnormalities in fatty marrow that seem to precede necrosis, this modality may add early diagnostic information.

Acute Disease↗
PubMed1988

Chronic unreduced dislocations of the glenohumeral joint: imaging strategy and pathologic correlation.

Although the evaluation of acute or recurrent dislocations of the glenohumeral joint (GHJ) using routine radiography, specialized views, arthrography, and computed tomography (CT) has been extensively studied, methods of evaluation and osseous pathology of chronic unreduced GHJ dislocations are not well documented. In order to define such methods and pathology, we studied nine patients with chronic (greater than 6 months) unreduced anterior, posterior, superior, or central dislocations as well as one patient with a chronic rotator cuff injury; and seven scapular specimens, six with matching humeral specimens, with osseous abnormalities similar to those in the patients. We examined 15 additional scapular specimens with evidence of subluxation secondary to chronic rotator cuff injury. Standard, reformatted, and three-dimensional (3D) CT techniques were used to evaluate both the patients and the specimens. Our results indicate that characteristic alterations occur in the scapula and humeral head that are far more extensive than the classic Hill-Sachs, Bankart, and trough lesions. Such alterations occur at sites of osseous contact between the malpositioned humerus and scapula and are modified owing to prolonged adjustments made by the patients in an attempt to increase GHJ motion. Although routine radiography and specialized views are of some value, standard and 3D CT provide a more accurate analysis of the location and extent of the bone abnormalities and, as such, should be employed, particularly in the evaluation of patients in whom surgery is being considered.

Acute Disease↗
PubMed1987

Fluid-fluid levels in giant cell tumors of bone: report of two cases.

Fluid-fluid levels have been described in association with aneurysmal bone cysts, telangiectatic osteosarcoma, and a chondroblastoma. We report two cases of giant cell tumors of bone with fluid-fluid levels identified by computed tomography and, in one case, by magnetic resonance imaging. This finding has not previously been associated with giant cell tumors. The radiographic features of the fluid-fluid levels cannot be distinguished from those reported in other osseous neoplasms.

Adolescent↗
PubMed1986

Computerized tomography of proximal femoral trabecular patterns.

A comprehensive imaging and pathologic investigation utilizing patients and cadaver material was performed in order to identify the normal trabecular pattern of the proximal femur and to assess alterations in this pattern in various disorders. Patients and specimens were studied with computed tomography (CT), including three-dimensional CT image reconstruction in selected cases and plain film radiography. The CT imaging of the proximal femur provides insight into the dynamic state of bone in this region. Despite limited resolution, three-dimensional CT image reconstruction is capable of portraying the concentration and orientation of major trabeculae in the proximal femur. Increased trabecular spacing occurs in osteoporosis and is well depicted by CT. Proliferation and thickening of the most superior subchondral primary compressive trabeculae is an early sign of osteoarthritis. In the region of the calcar femorale, crossing trabeculae, similar to the appearance of an enchondroma or bone infarct, have been described in osteoporosis and osteoarthritis and probably represent unmasking of normally present reinforcing trabeculae. In ischemic necrosis, CT should be considered a useful modality for detection of early or mild alterations and may be valuable in treatment planning.

Cadaver↗
PubMed1986

Carpal tunnel syndrome with cystic bone lesions secondary to amyloidosis in chronic hemodialysis patients.

Carpal tunnel syndrome (CTS) is increasingly recognized in patients undergoing chronic hemodialysis. Although the etiology remains obscure, angioaccess-related vascular engorgement and edema, and ischemic neuropathy are two likely possibilities. Amyloidosis is a relatively rare cause of CTS and had previously been thought to occur almost exclusively in patients with multiple myeloma. We report seven patients on chronic hemodialysis who developed CTS and were shown to have amyloid deposition within the synovium. Amyloid was demonstrated by characteristic staining with Congo red on polarizing microscopy and confirmed by electron microscopy. Six patients also exhibited radiolucent carpal bone cysts which were histologically shown to be due to bone replacement by an amyloid-positive synovitis. The average age of the patient and time on dialysis were 59.1 and 7.9 years, respectively. Serum and urine immunoelectrophoresis and bone marrow aspirates showed no evidence for plasma cell dyscrasia in six patients, while one patient did manifest a monoclonal IgA spike. Autopsies in three patients and liver biopsy in another showed no other evidence for disseminated amyloid. These hemodialysis patients exhibited a unique syndrome of CTS, lytic lesions of the carpal bones, and amyloid deposition in the synovium and within the bone cysts.

Adult↗
PubMed1986

Plasma cell sclerosis of bone: a spectrum of disease.

We describe the clinical, radiographic, and pathologic manifestations of a group of disorders characterized by osteosclerosis in association with plasmacytic infiltration of bone marrow. These conditions include multiple myeloma, plasma cell granuloma, sternocostoclavicular hyperostosis, the POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes), and chronic symmetric plasma cell osteomyelitis of childhood. Although clinically unrelated in many respects, features shared by these diseases support the existence of a specific factor linking the plasma cell to local osteogenesis.

Adolescent↗
PubMed1986

Diagnosis of tarsal coalition with computed tomography.

The value of computed tomography in the diagnosis of tarsal coalition is reported in six patients, five with talocalcaneal coalition and one with calcaneonavicular coalition. The examination is technically easy to perform with the patient in the supine position and the knees flexed, and it allows simultaneous visualization of both sides. Because of these features and an ability to distinguish between bony and cartilaginous or fibrous fusion, computed tomography appears to be the method of choice for diagnosis of coalition involving talus and calcaneus. It is less useful in other types of coalition.

Adult↗
PubMed1985

Osteogenesis imperfecta with unusual skeletal lesions: report of three families.

Thirteen individuals with osteogenesis imperfecta (OI) from three families were evaluated. All examined persons with OI had multilocular radiolucent, radiopaque, or radiolucent-radiopaque lesions of the maxilla and mandible. In most patients, the lesions involved the tooth bearing areas, but in two, the rami also were involved. Teeth were normal. Radiologic findings in the extragnathic skeleton included marked coarseness of trabeculae and diffuse osteopenia. It is proposed that these patients represent yet another dominantly inherited OI syndrome.

Adolescent↗
PubMed1985

Synovial cysts of the hip joint and iliopsoas bursitis: a spectrum of imaging abnormalities.

Synovium-related soft tissue disease around the hip constitutes a spectrum ranging from isolated iliopsoas bursitis to pure articular synovial herniations without bursal involvement. The clinical, pathologic, and radiographic features of these entities are discussed as they pertain to the variety of underlying disorders which predispose to their occurrence. Nine case reports are utilized to illustrate the variable clinical and radiographic presentations which may be encountered. Based upon these cases as well as those in the literature, an imaging algorithm has been developed which should eliminate unnecessary studies and allow prompt and accurate diagnosis.

Adult↗
PubMed1982

Distal femoral cortical defects, irregularities, and excavations.

A review of available radiographic and pathologic material revealed evidence that two distinct anatomical variations may be found on the posteromedial aspect of the distal femur. One, the femoral cortical irregularity, is a common finding on clinical radiographs, shows a definite predilection for children and adolescents, and is closely located to the site of attachment of tendinous fibers of the adductor magnus muscle. It is almost certainly related to stress, and can be associated with a degree of periosteal proliferation that simulates malignancy. In a study of prehistoric adult femoral specimens, the second lesion, the femoral cortical excavation, was a frequent finding. However, it appears to be less common in clinical radiology. It occurs at the osseous site of attachment of the medial head of the gastrocnemius, which supports a stress-related pathogenesis. Its relationship to fibrous cortical defects is not clear.

Adolescent↗
PubMed1980

Heterotopic ossification in paraplegia: a possible disturbance of the paravertebral venous plexus.

The distribution of the heterotopic ossifications that complicate paraplegia and other neurological disorders is remarkably similar to that of the paravertebral venous plexus of Batson. Stasis within this system consequent to immobilization and spinal trauma, combined with demineralization of the skeleton, are postulated to be the main factors promoting precipitation of calcium salts in the soft tissues in these conditions.

Humans↗
PubMed1979

Dorsal defect of the patella (DDP): a characteristic radiographic lesion.

The dorsal defect of the patella (DDP) is a benign lesion with specific radiographic features. Seven cases of DDP are reviewed; all 7 lesions were identical in location and radiographic appearance. The characteristic lesion is round and lytic, with well-defined margins; it is located in the superolateral aspect of the patella adjacent to the subchondral bone. Arthrography reveals intact cartilage. DDP may occur in both sexes and may be bilateral. It is often found incidentally on radiographs ordered for acute trauma. Its etiology is not known. Differential diagnosis is also discussed.

Adolescent↗