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Biomedical subjects

H J Griffiths

Publications and source records attributed to H J Griffiths.

At least 37 records · Page 2Linked to original sources
PubMed1995

Hyperextension strain or "whiplash" injuries to the cervical spine.

PURPOSE: To define "whiplash" radiologically. MATERIAL AND METHODS: A full cervical spine radiographic series (including flexion and extension views) was reviewed in 40 patients with clinically proven "whiplash" injuries and compared to the radiographs in 105 normal controls. The level and degree of kinking or kyphosis, subluxation, and the difference in the amount of fanning between spinous processes on flexion and extension films were measured in each patient. RESULTS: Localized kinking greater than 10 degrees and over 12 mm of fanning, often occurring at the level below the kinking or kyphosis, occurred mainly in the group of whiplash patients (sensitivity 81%, specificity 76%, accuracy 80%). CONCLUSIONS: Localized kinking greater than 10 degrees and fanning greater than 12 mm are useful measurements by which to separate patients with true whiplash injuries from those with minor ligamentous tears. Flexion and extension views are essential to help define whiplash and other ligamentous injuries of the cervical spine.

Adult↗
PubMed1995

Radiographic evaluation of the complications of long bone allografts.

PURPOSE: To study the long-term results of long bone allografts in patients with benign and malignant bone tumors. MATERIAL AND METHODS: Forty patients for whom full clinical and radiological information was held were investigated in order to assess the overall incidence of complications including fractures, nonunion, hardware problems, infections, and bone resorption. RESULTS: There were four deaths; four more patients had distant metastases and one patient had a recurrent chondrosarcoma. Seventeen patients (42%) had either no complications (nine patients) or only minor ones (eight patients). Eleven patients (27%) sustained fractures of either their allograft (eight patients) or of their hardware (three patients). Hardware problems occurred in nine patients (22.5%), six of whom had serious problems requiring revision. The majority of the fractures and hardware problems occurred in younger male patients (82%). Infection occurred in five patients (12.5%), two of whom required revision, while two cases were superficial. Dissolution of the allograft occurred in 12 patients (30%), 7 of whom required removal of the allograft. Ten of these 12 patients were female. CONCLUSION: The long-term survival of long bone allografts is not as good as generally reported if an adequate follow-up time period is used. Most of the fractures and hardware problems occurred in the younger active male patients, whose activities should probably be curtailed. Resorption of the allograft is another serious complication which appears to occur mainly in female patients and could possibly be controlled by chemotherapy.

Adult↗
PubMed1995

Radiologic case study. Multicentric reticulohistiocytosis.

MRH is somewhat similar to, and probably occasionally mistaken for, psoriatic arthritis, Reiter's syndrome, or less frequently, rheumatoid arthritis. However, several important features distinguish MRH from the other arthritides. Rheumatoid arthritis more commonly involves the metacarpophalangeal joints, while MRH ordinarily affects the distal interphalangeal and proximal interphalangeal joints. Furthermore, MRH rarely exhibits the degree of articular osteopenia that is the hallmark of rheumatoid disease. While psoriatic arthritis and Reiter's often affect the DIP joints, they rarely display the symmetry of MRH. In addition, MRH does not demonstrate the periosteal new bone formation that is seen in both psoriatic arthritis and Reiter's syndrome. Hence, the diagnosis of MRH may be made with reasonable confidence on the radiologic findings alone, even before the cutaneous nodules appear, which can then be biopsied to confirm the diagnosis.

Adult↗
PubMed1995

Cyclops lesion.

Postoperative impingement of the knee following ACL reconstruction does occur. MRI can be useful in the diagnosis of the patient who is not recovering as quickly as expected following surgical reconstruction. MRI allows the assessment of 1) tunnel position and alignment, 2) graft integrity, 3) the menisci for possible re-tear or extension of previous tears, and 4) joint for scar tissue and cartilaginous bodies either loose or fixed.

Adult↗
PubMed1995

Total hip replacement and other orthopedic hip procedures.

The history of total hip replacement including that of the Girdlestone procedure and resurfacing procedures is discussed. An overview of total hip replacement and its indications and complications forms the bulk of this section. Also, the use of porous-coated prostheses and endoprostheses as well as pins and plates is discussed and illustrated.

Bone Cements↗
PubMed1995

The radiology of bone allografts.

Bone allograft surgery provides an attractive and effective solution to many orthopedic problems. Nevertheless, the entire process is technically demanding and associated with many potential complications of which infection is one of the most difficult to treat. Many advances have been made in the procurement and use of bone allografts, and further investigation should expand the applications of allograft surgery and continue to diminish the incidence of complications.

Bone Transplantation↗
PubMed1995

Orthopedic complications.

This overview of the complications encountered in orthopedic cases focuses on, among other things, complications of spinal surgery. The incidence of infection in spinal instrumentation and other orthopedic procedures is discussed and followed by a review of the complications of total joint replacement. Finally, a few words on the radiologist's responsibility for the reporting of orthopedic complications are given.

Humans↗
PubMed1994

Diagnosis of breast implant rupture: imaging findings and relative efficacies of imaging techniques.

OBJECTIVE: The purpose of this study was to compare the efficacies of mammography, sonography, CT, and MR imaging in the detection of breast implant rupture and to analyze the imaging findings. SUBJECTS AND METHODS: Thirty-two women with 63 silicone breast implants participated in the study. All but one had signs and symptoms suggestive of rupture, and all had requested that their implants be removed before they were enrolled in this imaging study. All patients had film-screen mammography, sonography, CT, and MR imaging. Twenty-two ruptures were found at surgery; 21 were intracapsular and one was extracapsular. The relative efficacies of the imaging studies were determined, and the imaging findings were compared with the surgical results. RESULTS: Of the 32 women with 63 implants, mammographic sensitivity for detecting implant rupture was only 23% but the specificity was 98%. Sonography had a higher sensitivity (59%), but its specificity was significantly lower (79%). CT had a sensitivity of 82% and a specificity of 88%. MR was the only imaging technique that consistently provided evidence that enabled the evaluation of intracapsular and extracapsular ruptures. The sensitivity and specificity of MR imaging were 95% and 93%, respectively. CONCLUSION: Our results show that MR imaging is more sensitive and specific for the detection of breast implant rupture than is mammography, CT, or sonography.

Adult↗
PubMed1994

Staging of musculoskeletal tumors.

Staging of musculoskeletal neoplasms is important for planning chemotherapy and surgical procedures. Accurate staging has increased in importance with advancements in limb salvage procedures. This article outlines concepts, techniques, and potential problems with staging of neoplasms. It is important to remember that biopsy should be preformed after consultation with an orthopedic surgeon specialized in tumor surgery.

Adolescent↗
PubMed1993

Magnetic resonance imaging of the nose with surface coils: a new technique to evaluate functional and aesthetic problems.

Determining the preoperative functional and aesthetic anatomy has been of critical importance to surgeons planning nasal procedures. Beyond skilled clinical examination, few objective studies exist to aid the surgeon. Magnetic resonance imaging (MRI) represents a potentially excellent method for precise anatomic imaging of the nose. Unlike computed tomography (CT) and conventional x-rays, MRI involves no radiation. Similar to CT, however, MRI can provide computer-enhanced three-dimensional and quantitative airway data. Full-head MRI has proven sensitivity in evaluation of tumors of the brain and sinuses and is the imaging modality of choice for many soft-tissue tumors. Due to the relatively high cost of conventional full-head MRI scanning ($600 to $1200 per scan), MRI of the nose utilizing full head scanning technique has been limited. The recent development of small field of view surface coils has enabled higher-resolution nasal scans at a fraction of the scanner time and cost ($200 to $500) of conventional MRI scans. We have developed a protocol utilizing a small field of view coil which results in reproducible high-resolution nasal scans requiring less than 6 minutes of scanner time. This protocol has been used in both the diagnosis and follow-up of patients with traumatic and congenital nasal and septal deformities. Image resolution obtained using the protocol is significantly better than with conventional coils. This technique is excellent for both diagnosing and documenting nasal anatomy and pathology.

Humans↗
PubMed1993

The use of MRI in the diagnosis of benign and malignant bone and soft tissue tumours.

Two hundred and thirty four suspected primary bone and soft tissue tumours were investigated using plain films and MRI. The MR appearance of 200 of these tumours was assessed with respect to the intensity of the lesion, the homogeneity of the tumour, the presence or absence of a capsule or lobulation, whether the tumour was whorled or not and whether it contained either fluid or blood. Apart from benign lipomas and some malignant myxoid liposarcomas, however, it seemed virtually impossible to tell one tumour from another and in many cases to differentiate a benign lesion from a malignant tumour using MRI alone. We recommend that the workup of a suspected soft tissue tumour should be initially by MR scanning and that the workup of a suspected malignant bone tumour should be plain films followed by an MRI scan.

Adult↗
PubMed1993

Scanning electron-microscopic and magnetic resonance-imaging studies of injuries to the patellofemoral joint after acute transarticular loading.

To examine the effects of transarticular loading on articular cartilage and subchondral bone, we used a canine model that we had developed previously, in which a standardized load of approximately 2000 newtons is delivered across the patellofemoral joint. The purpose of the study was to define and describe the initial changes, as seen on histopathological and magnetic resonance-imaging studies, that occur in the early stages after injury to the joint by transarticular loading. Scanning electron microscopy was used to define the extent and characteristics of the fractures produced in the subchondral bone of four patellae that were examined on the day of loading. We found multiple, extensive fractures through the zone of calcified cartilage and the subchondral bone, frequently with step-off displacement, and with little or no change in the gross appearance of the articular cartilage. Specimens from four patellae were examined histologically two weeks after loading, and the observed changes were correlated with those that had been demonstrated by scanning electron microscopy. Fractures through the zone of calcified cartilage and the subchondral bone, with step-off displacement, were prominent. Clefts were present in the surface of the articular cartilage and, in some areas, there was a focal loss of proteoglycan from the extracellular matrix, as indicated by the complete absence of staining with safranin O. Six dogs were examined one year after loading. There was healing of the subchondral fractures and restoration of proteoglycan in the extracellular matrix. However, superficial clefts and fissures were still present in the articular cartilage. Sequential magnetic resonance-imaging studies were also carried out on these six dogs, at two, eight, sixteen, thirty-six, and fifty-two weeks after loading. Two weeks after loading, all knees had soft-tissue swelling, effusion, and a decreased marrow signal in the medullary cavity of the patella. The decreased marrow signal and effusion were still present eight weeks after the impact, and then the findings gradually returned to normal. One year after loading, it was found that the histopathological changes had not been progressive; in fact, they had been ameliorated and, to some extent, reversed by repair processes. The early, severe magnetic resonance-imaging changes had also been reversed, so that this study demonstrated normal findings by one year after loading.

Animals↗