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Biomedical subjects

H M Kroon

Publications and source records attributed to H M Kroon.

At least 55 records · Page 3Linked to original sources
PubMed1992

Epi- and metaphyseal changes in children caused by administration of bisphosphonates.

Nitrogen-containing bisphosphonates (NCBs) are potent inhibitors of bone resorption and are used in the treatment of adults with various skeletal disorders. Little is known about their effects on the growing skeleton. The authors retrospectively studied the skeletal radiographs obtained in nine children before, during, and after NCB administration. Bandlike metaphyseal sclerosis and concentric epi- and apophyseal sclerosis developed in all patients. The extent of sclerosis depended on the duration of treatment and was related to local, and probably general, skeletal growth activity. In the maturing spine, NCBs caused a "picture-frame" or "bone-within-bone" appearance, depending on continuation or cessation of administration. In addition, metaphyseal undertubulation of long bones was noted in five patients. After discontinuation of bisphosphonate treatment and/or closure of the growth plates, the degree of sclerosis decreased, and sclerosis tended to disappear, indicating that this is a reversible phenomenon.

Adolescent↗
PubMed1990

Magnetic resonance imaging of the shoulder in patients with rheumatoid arthritis.

To evaluate the ability of magnetic resonance imaging (MRI) to detect shoulder abnormalities 18 patients (36 shoulders) with rheumatoid arthritis (RA) and shoulder complaints were studied. Osseous abnormalities of the glenoid and humeral head were readily detected with MRI. The imaging planes used were not suitable for the evaluation of acromioclavicular joint involvement. Magnetic resonance imaging depicted soft tissue abnormalities that were not clearly visualised by plain film radiography, such as involvement of rotator cuff tendons and subacromial bursae, joint effusion, and muscular atrophy. Magnetic resonance imaging appears to be a sensitive method for evaluation of glenohumeral joint changes in patients with RA.

Adult↗
PubMed1990

Osteoblastoma: clinical and radiologic findings in 98 new cases.

The data on 98 new patients with osteoblastoma were studied. The clinical features of pain, scoliosis, and neurologic deficit were largely consistent with those in previous reports. Osteoblastoma is usually a lytic lesion originating in the medulla of bones with matrix ossification and mild surrounding sclerosis. Osteoblastoma of the spine demonstrated better tumor delineation in the vertebrae, and a bony rim on the soft-tissue side was seen less frequently than previously observed. Osteoblastoma of the talus frequently appears as a blister on the surface of the bone and is accompanied by osteoporosis. In the hands and feet, the radiographic appearance is often very similar to that of aneurysmal bone cyst and giant cell tumor. In the skull it strongly resembles a button sequestrum of bone. The origin and extent of the tumor, the presence of matrix mineralization, and tumor delineation depicted as a thin bony shell are often better appreciated on computed tomographic (CT) scans. In addition, CT can demonstrate both edema and atrophy of the surrounding soft tissues. At magnetic resonance (MR) imaging, osteoblastoma demonstrates signal intensities similar to those of other bone neoplasms. In addition to the advantages offered by CT, MR imaging can help differentiate tumor tissue from accompanying edema.

Adolescent↗
PubMed1989

Arthropathy in von Willebrand's disease.

A 62-year-old woman with severe von Willebrand's disease and a long history of joint complaints is presented. Her history, the progressive radiological findings, the demonstration of haemarthrosis and a literature review support the view that some patients with von Willebrand's disease can suffer from an incapacitating arthropathy akin to that seen in haemophilia.

Female↗
PubMed1988

Cortical bone metastases.

The data on 26 patients with solitary metastatic lesions arising in cortical bone were studied. Nineteen patients were over 50 years of age. In 19 patients, the cortical metastasis was the first indication of the presence of a primary malignant condition. In seven cases, cortical metastases developed in patients with a known primary tumor. The primary tumors involved were eight renal cell carcinomas, six bronchogenic carcinomas, two carcinomas of the gastrointestinal tract, one osteosarcoma, one neuroblastoma, one melanoma, one hepatoma, one carcinoma of the breast, and one thyroid carcinoma. In four cases, the primary tumor remained unknown. A metastatic origin should be considered in the differential diagnosis of an osteolytic lesion arising in the cortex of a long bone, especially in older patients and in patients with a known primary malignant condition. The cortical bone metastases encountered in this study did not originate solely from bronchogenic carcinoma, as has been reported by other authors. Cortical metastases are probably less rare than has been hitherto assumed.

Adult↗
PubMed1988

Spinal chordoma: radiologic features in 14 cases.

The radiologic appearance of chordoma of the cervical (three patients), thoracic (four patients), and lumbar spine (seven patients) was studied. Eleven patients were over 50 years old and presented with long-standing back pain. All were examined with conventional radiographs; three cases also had CT examinations. In thirteen patients, the tumor originated in the vertebral body and, in one patient, in the posterior element of a vertebra. In nine (64%) of the 14 cases, osteosclerosis was a prominent feature. In the remaining five cases (36%), the bone lesion was purely osteolytic. Involvement of the intervertebral disk was found in three patients; in two of these the tumor extended to an adjacent vertebra. In nine patients, a soft-tissue mass was a distinctive additional feature. A sclerotic and/or osteolytic lesion in a vertebral body with a large, paraspinal soft-tissue mass in an older patient with long-standing back pain should raise the possibility of a chordoma.

Adolescent↗
PubMed1988

Generalized peliosis hepatis and cirrhosis after long-term use of oral contraceptives.

Peliosis hepatis, a condition characterized by the presence of blood-filled lacunar spaces in the liver, has been described primarily in patients on androgenic steroid medication and patients with tuberculosis. It has never been reported as a complication of the use of oral contraceptives, except in association with and localized in contraceptive-induced hepatic tumors. The present report concerns a 43-yr-old woman with generalized peliosis hepatis that developed during long-term use of oral contraceptives. Extensive examination did not reveal a hepatic tumor. Liver cirrhosis and portal hypertension developed, although the oral contraceptives had been withdrawn. She finally underwent successfully an orthotopic liver transplantation.

Adult↗
PubMed1987

Reduced morbidity from skeletal metastases in breast cancer patients during long-term bisphosphonate (APD) treatment.

131 patients with osteolytic metastases from breast cancer were randomised to receive long-term oral treatment with aminohydroxy-propylidene-bisphosphonate (APD), 300 mg daily (n = 70), or to act as controls (n = 61) in a multicentre trial. Specific antitumour therapy was at the discretion of the clinician and variable. An interim analysis was made after a median follow-up of 13 months in the APD group and 14 months in the controls. There was a significant reduction in pathological fractures and severe bone pain in the APD group, and hypercalcaemia was prevented. Consequently the necessity for radiotherapy for skeletal complications was more than halved; the number of systemic therapy changes was also reduced. Gastrointestinal side-effects of APD led to a drop-out of 8% of patients. Oral supportive APD therapy is simple and convenient, and significantly reduced skeletal morbidity in advanced breast cancer.

Adult↗
PubMed1986

Graft-versus-host disease of the gastrointestinal tract.

Forty-two gastrointestinal examinations performed in 24 patients with a history of bone marrow transplantation were analyzed retrospectively. All patients were clinically suspected of a graft-versus-host disease (GVHD) involving the alimentary tract. No specific abnormalities were found in the esophagus or the stomach. Radiographic features of a GVHD of the small bowel are: edema of mucosal folds in ileum and jejunum; effacement of folds towards the ileum; thickening of the bowel wall, and spasms and stenosis with prestenotic dilatation. In the active phase the bowel appears to be shortened. A short transit time was not a specific finding. Follow-up examinations showed partial regression of these findings. Radiological findings in the colon consisted of loss of haustration, thumbprinting, spasms and ulcerations.

Adolescent↗
PubMed1986

Radionuclide angiocardiography in the clinical evaluation of cardiac malpositions in situs solitus in adults.

A right-sided position of the heart in the chest in situs solitus is an abnormal feature easily discernible from a plain chest radiograph. This cardiac malposition may be due to cardiac displacement (dextroposition), which is usually a feature of lung disease, or a structural abnormality of the heart (dextrocardia). Because each condition has different clinical pathologic implications, it is important to distinguish them. Chest films, however, often provide no conclusive information. We performed radionuclide angiocardiography (RNA) in six adults with a cardiac malposition in situs solitus. It was found that morphologic data obtained from the serial images may distinguish dextroposition from dextrocardia. In addition, these images permitted us to diagnose congenitally corrected transposition, a cardiac anomaly which occurs with increased frequency in situs solitus with dextrocardia. Quantitative shunt detection performed during this procedure is helpful in the differential diagnosis of dextroposition and able to distinguish uncomplicated dextrocardia from dextrocardia associated with other cardiac abnormalities. RNA therefore is a valuable and easily performed method in the analysis of cardiac malpositions in adults.

Adolescent↗
PubMed1986

Ectopic calcification in hypophosphatasia.

The radiological findings in a 24 year old female with hypophosphatasia included frayed joint surfaces, intra- and peri-articular, and paravertebral calcification. These changes were compared to the usual radiographic findings in hypophosphatasia and prompted a family study. Excessive spinal osteophytosis and/or chondrocalcinosis was a relatively frequent finding in the relatives and it is suggested that these changes might indicate the heterozygous state.

Adolescent↗
PubMed1985

Congenitally corrected transposition in adults with left atrioventricular valve incompetence.

Congenitally corrected transposition of the great vessels (CCT) is usually detected in childhood owing to the presence of associated cardiac malformations. If such malformations are absent, the patient may remain asymptomatic until adulthood; such persons usually present with left atrioventricular valve incompetence and conduction disturbances. The chest radiograph may be the first clue to the diagnosis, demonstrating the typical cardiovascular silhouette produced by the convex left ascending aorta. The authors examined seven cases of CCT manifested in adulthood and found that in four of them the diagnosis was not apparent from the plain image because the ascending aorta instead followed a concave course. Hallmarks of this phenomenon are discussed, and two radiological signs are presented: the double mediastinal stripe and the straight left lower cardiac border.

Adult↗