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Biomedical subjects

G Morvan

Publications and source records attributed to G Morvan.

At least 19 recordsLinked to original sources
PubMed2005

[Percutaneous treatment of a gas containing epidural pseudocyst: an uncommon cause of sciatica].

Gas containing epidural pseudocyst is a rare cause of lumbar radicular compression. We present the case of a 42 year old woman presenting with right L5 radicular pain. CT showed vacuum phenomenon and a gas containing epidural pseudocyst compressing the right L5 root. Resolution of radicular pain occurred following CT guided aspiration and steroid injection. The patient remained asymptomatic at one year follow-up.

Cysts↗
PubMed2005

[Superficial US of superficial bones].

Although bones are not well imaged by US this imaging modality can be helpful in the assessment of bone surface and can be complementary to standard radiographs. A focal irregularity of the hyperechoic cortical line indicates a fracture, a cortical avulsion, a local bulging of the cortex or a foreign body related or not to previous surgery. Subperiosteal collections either purulent or hemorrhagic are easily detected and can be aspirated under US guidance if an infection is suspected. US also allows diagnosis of epiphyseal fractures when involving the distal epiphysis of the metatarsals, radial head, humeral head (Hill-Sachs fracture) growing cartilages... US examination of joints can detect osteophytes and marginal erosions (allowing early diagnosis of rheumatoid arthritis together with visualization of hyperaemic pannus and joint effusion) Cortical continuity in a location where in normal conditions a joint space is found indicates a synostosis. In children US, by directly visualizing the cartilaginous component of the non ossified bones, allows detection and serial follow-up of many congenital malformation (pes equinus...). US may be obtained in all patients where standard radiographs are not diagnostic because of it is efficient, non-invasive and relatively inexpensive.

Bone Diseases↗
PubMed2005

[Dynamic ultrasonography].

The ability to perform dynamic evaluation is a great advantage of ultrasound especially for musculoskeletal evaluation. Different manoeuvres are routinely used. The importance of the mobility of a structure or an articulation, but also the grade of compression of the lesion, can provide useful diagnostic information. For ligaments, the tension of each band is important and mobilisation is often able to depict some conflicts between the tendons and others structures. Muscle contraction is also an important element for making the diagnosis and, similar to a Valsalva manoeuvre for the diagnosis of a hernia. Interventional procedures are also facilitated by this dynamic evaluation. On the other hand, this great advantage requires the presence of a physician during the examination.

Adult↗
PubMed2003

[Anomalous insertion of the pectoralis minor muscle: ultrasound findings].

PURPOSE: With anomalous insertion of the pectoralis minor muscle, its distal fibers pass over the coracoid process instead of inserting on it, following sometimes a trajectory very similar to that of the coracohumeral ligament. The aim of this prospective study was to evaluate the frequency of detection of this anomalous insertion by ultrasonography. MATERIALS AND METHODS: Ultrasound demonstrated the abnormal insertion of the pectoralis minor muscle by directly visualizing its fibers slipping over the coracoid process during external and internal rotation of the humerus. Three hundred and three individuals underwent ultrasound of the shoulders (64,7% female, mean age of 45 years), for a total of six hundred and six shoulders; 30% (183/606) were symptomatic. RESULTS: An abnormal insertion was demonstrated in 9,57% of the examined shoulders (58/606), with a statistically significant predominance on the left side (12,2%) compared to the right side (6,9%), and of women (12,2%) compared to men (4,7%). CONCLUSION: Ultrasound demonstrated an abnormal insertion of the pectoralis minor muscle in 9,57% of 606 examined shoulders. There was a female and left side predominance and no significant correlation with symptoms.

Female↗
PubMed2002

[Evaluation of spinal alignment disorders in adults].

Evaluation of the alignment of the spine in the frontal and sagittal planes is an important part in the work up of many disorders of the spine. This type of study requires only frontal and lateral 30 x 90cm radiographs performed in the standing position and including spine, pelvis and proximal femurs. The relationship between spine, pelvis and lower limbs is stressed.

Adult↗
PubMed2002

[Imaging of lumbar stenosis].

The spinal canal is a type of articulated pipe, with rigid rings articulated by joints. It can be divided into a central part, which contains the dural sac, and lateral parts, which contain the nerve roots. The role of imaging is to detect the presence and characterize the nature, level, and severity of stenotic lesions and their impact on neural elements. Stenoses can be constitutional or acquired and involve the central and/or lateral canal. Constitutional stenoses affect both rigid and soft segments whereas acquired stenoses affect mainly the mobile segments. Signs of constitutional stenoses at conventional radiography, CT and MRI will be described. Acquired stenoses are multi-factorial in etiology and more difficult to evaluate. Intra-spinal soft tissues and dynamic factors, poorly assessed at CT and MRI (static imaging), play a major role in this type of stenoses. Currently, only myelography with dynamic evaluation is able to demonstrate the importance of these factors or degree of dynamic stenosis. The lateral canal is divided in three parts: two mobile segments (disco-articular interval, and intervertebral foramen) on each side of a fixed bony segment (lateral recess). The different types of stenoses involving these segments and best imaging technique to demonstrate their presence are described.

Humans↗
PubMed2001

Ultrasound of the ankle.

Because of their size and superficial location the ankle tendons can be well evaluated with ultrasound (US). The excellent definition of the modern high frequency probes allows us to consider US the technique of first choice in their assessment. Basic US appearances correlate well with the MRI findings. Since US can diagnose most tendon disorders including tendinopathies, tears, dislocations and enthesopathies MRI is less often utilized. US can easily depict the main ankle ligaments. The basic US appearance of ligament tears is well known. US can be considered an inexpensive and accurate technique in the evaluation of ankle sprains.

Ankle↗
PubMed2001

[Foot and ankle imaging: what is the best modality].

There are numerous foot and ankle's pathologies and also numerous imaging technics. In fact, it often appears an inadequacy between the suspected pathology and the diagnostic tool used for its study. Aims. Know the qualities and the faults of each foot and ankle imaging technic. Know the best way of using these technics, according to the clinical problem, of a medical and economic point of view, in main skeletal pathologies, mechanical arthropathies of the hindfoot, tendonopathies, infections, and forefoot diseases.

Ankle Injuries↗
PubMed2000

[Ultrasonography of tendons and ligaments of foot and ankle].

UNLABELLED: The main ligaments and tendons of the ankle and the hind-foot can now be studied by US. This simple and safe technic constitutes a more and more reliable alternative to MRI and CT scan. AIMS: Know the normal US appearance of the tendons and ligaments of the ankle and the hind-foot, and how to study them with US. Know their main usual pathological appearance.

Ankle Joint↗
PubMed1999

Time dependence of iopamidol and iodixanol in arthrography of the knee.

PURPOSE: The safety and diagnostic efficacy of iodixanol (Visipaque) 270 mg I/ml was compared to that of iopamidol (Iopamiron) 300 mg I/ml in knee arthrography. MATERIAL AND METHODS: This trial was a bi-center double-blind trial including 128 patients (iodixanol/iopamidol 64/64 patients). Efficacy was evaluated by blinded grading of the diagnostic quality of the p.a. images taken 0, 12 and 25 min after contrast administration by the examining radiologist and later at a consensus evaluation by two experienced skeletal radiologists. Adverse events were recorded. RESULTS: No patient experienced any adverse event. The proportion of better images at both 12 and 25 min after injection was higher in the iodixanol group compared to the iopamidol group both by the examining radiologist and at the consensus evaluation. CONCLUSION: In the knee joint iodixanol is a safe contrast medium. The contrast effect of iodixanol lasted longer than that of iopamidol, which can be important when performing arthrography, especially CT arthrography, where the time between puncture and examination can be prolonged.

Arthrography↗
PubMed1999

[Radio-anatomy markers and applications of current imaging of the ankle and back of the foot].

The only aim of this work is to emphasize some anatomic and pathologic particularities of the constitutional elements of the ankle and the hind-foot, and their application in the actual imaging of this region. The characteristics of talus, calcaneus, navicular bone, talo-crural, sub-talar, medio-tarsal and tarso-metatarsal joints, calcaneus tendon, plantar aponevrosis, medial and lateral tendon of the ankle are successively detailed.

Ankle Injuries↗
PubMed1998

[Fractures of the ischium after laminoarthrectomy. Retrospective study of a series of 31 patients].

PURPOSE OF THE STUDY: Pars interarticularis fracture is one possible source of pain after laminoarthrectomy. The purposes of this study were: to describe the pars defect, to determine its causes and to analyse its consequences on the functional final result. MATERIAL AND METHOD: 31 patients operated for disc herniation or degenerative lumbar stenosis were retrospectively studied. Clinical symptoms were evaluated before and 3 months after initial surgery, at the time of postlaminectomy radiological examination and at last follow-up according to Beaujon rating scale. Radiological evaluation included: description of the pars defect on plain radiographs and CT imaging, calculation of the amount of bone just above the inferior articular process that was resected, analysis of the postoperative stability of the spine both on static and dynamic radiographs. Any remaining disc herniation or stenosis were also noted. RESULTS: 39 pars interarticularis fractures were disclosed. These fractures were identified as a linear luency on plain radiographs or on reformed CT imaging view. Asymmetric widening of the facet joint space just below the pars defect was easier to observe and was present in 66 per cent of the cases on plain radiographs and in 79 per cent on CT imaging. After initial surgery 12 slipping appeared. In all of these cases pars fracture was bilateral at the same level or associated to a complete unilateral facetectomy at the same level. The amount of bone resected just above the inferior facet process was 66 per cent in average, range from 45 to 84 per cent. All the patients complained for low back pain and/or leg pain. In 62 per cent of cases symptoms occurred within one year after surgery, at an average onset of 7.6 months postlaminectomy. 27 patients were reported Revision surgery was in all cases a posterolateral fusion with or without instrumentation; new decompression was performed in 15 cases. At last follow-up, according to our classification, results were very good in 9 cases, good in 15 cases and fair in the remaining 3 cases. Improvement rate obtained after the initial surgery was 75 per cent in average, it was 59 per cent after revision surgery, difference was statistically significant. CONCLUSION: Pars interarticularis fractures may be a source of postlaminectomy pain. They appear to be caused primarily by an excessive resection (more than one half) of the bone immediately superior to the inferior articular process at the level of the laminectomy. These results suggest that caution in resection of this bone or additional posterolateral fusion in case of large resection of pars interarticularis, can avoid the problem. Asymmetric widening of the joint space just below the defect seems to be the key to this diagnosis in the postoperative lumbar laminectomy patient with persistent or recurrent pain.

Adult↗
PubMed1997

[The medial collateral ligament of the knee].

Injuries of the medial collateral ligament (MCL) of the knee are easily diagnosed on clinical grounds. These lesions are generally treated conservatively. Radiological examinations are generally unhelpful. However, injuries of the MCL may be associated with those of many other ligaments of the knee in the case of complex strain of the knee so that the clinical diagnosis may be challenging; in some cases, surgical repair of associated lesions is indicated. In these cases of multiple ligamentous injuries, a radiological study of ligamentous abnormalities may be of interest. The anatomical background and the different radiological findings including those of X-rays, US, arthrography and MRI, obtained in patients with injuries of the MCL, are described; radiological differentiation of ruptures of the MCL with or without knee instability is emphasized.

Arthrography↗
PubMed1996

[L5-S1 herniated disk migrated to the anterior part of the right sacral wing with compression of the right lumbosacral roots].

PURPOSE OF THE STUDY: The goal of this study was to report an exceptional case of far lateral and anterior disc herniation at L5-S1 level. CASE REPORT: A 47 year-old man presented a right L5 radicular pain with motor deficit of tibialis anterior and extensor hallucis longus resisting to medical management. Standard X-rays showed a degenerative process of L5-S1 disc. The CT scan was at first considered as normal. The myelogram was normal. A second study of the CT scan showed an opacity next to the L5 right root in front of the sacral wing. A discography combined with CT scan was then performed showing the migrated herniated disc from L5-S1 to the anterior part of the right sacral wing in contact with L5 root. RESULTS: Surgery was performed by transperitoneal approach and needed a difficult dissection of hypogastric vessels. The herniated disc was found behind the L5 root. A L5-S1 disc excision and arthrodesis with iliac grafts were performed. The result has been very good with relief of the pain and recovery of the palsy within a month. CONCLUSION: The lecture of a CT scan should include the far extraforaminal zone if there is no compression in the spinal canal. Such an anterior migration of an herniated disc has not been already described as far as we know.

Diskectomy↗
PubMed1995

Chemonucleolysis: correlation of results with the size of the herniation and the dimensions of the spinal canal.

The aim of this study was to determine whether the results of chemonucleolysis are related to the size of the disc herniation and to the dimensions of the spinal canal. Short and long-term results (average follow-up 4 and a half years) of 148 patients were evaluated. Measurements made with a divider included the size of the disc herniation related to the sagittal diameter of the spinal canal at the discal level and the transverse interligamentous diameter at the level of the facet joints. The morphology of the lateral recess was also assessed. Measurements were initially made by five observers and were repeated eight times and on eight computed tomography (CT) scans in order to assess intra- and interobserver variability. Measurements of the entire series were then made by the two observers demonstrating a good intra- and interobserver reproducibility. Of the 148 patients 74% had an overall successful result. No significant difference was disclosed when comparing the various parameters of the clinical results with the size of the herniation. Similarly, a lack of correlation was also found between the clinical results and the dimensions of the spinal canal and of the lateral recess. In this series, the results were not significantly influenced by the size of the herniation or the morphology of the spinal canal.

Humans↗
PubMed1995

Traumatic atlantooccipital dislocation with survival: case report and review of the literature.

We present the case of a patient with traumatic atlantooccipital dislocation. The initial neurological examination showed no abnormalities. Dislocation was the result of rapid deceleration in a motor vehicle accident. The mechanism of injury was hyperextension/rotation, probably combined with a distraction force. Only a few cases of atlantooccipital dislocation without neurological involvement have been reported. Every report pointed out difficulties of initial diagnosis. Special attention should be directed toward the atlanto-odontoid-basion relationships as seen on lateral radiographs. Prompt recognition and surgical stabilization are essential to avoid further neurological injury.

Adult↗
PubMed1994

[What remains of arthrography?].

At the time of RMI, arthrography appears sometimes old-fashioned. However this exam, which knows a second youth in relation with the supply of CT-scan (arthro-CT) remains the gold-standard in the exploration of many pathologic situations: intra-articular foreign bodies, tears of glenoid or acetabular labrum, precise assessment of chondral or ligamentous lesions (especially of the ankle), sub-scapularis tendon tears, adhesive capsulitis, complications of prosthesis, appreciation of intra-articular position of the needle's tip before injection of a therapeutic drug. Arthrography, completed or not by CT-slices gives, in this indications, excellent spatial resolution images, easy to perform, to read, to understand and to transmit at the clinicians, with a reasonable cost and a minor risk. RMI is a more and more used alternative, especially for the study of meniscus and ligaments of the knee, and rotator's cuff of the shoulder. It's sure that, with the increase of the RMI image's quality, other common indications will slip towards this technique, but nevertheless at this time (and it seams to me, for a long time) arthrography and arthro-CT will remain an excellent diagnostic tool with a very competitive advantages/inconvenience ratio.

Arthrography↗