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J E Gonyo

Publications and source records attributed to J E Gonyo.

3 recordsLinked to original sources

Typhlitis in adults.

Although described initially in children, typhlitis is an important clinical condition that may also occur in adults with hematologic malignancy or, less commonly, aplastic anemia. We describe 6 adult patients with typhlitis and review the salient features of this condition. In typhlitis, a necrotizing process of multifactorial origin involves the right colon alone or the right colon and other areas of the intestine as well. Secondary colonization of mucosal ulcers by colonic flora commonly leads to septicemia and pyrexia. Typhlitis may be associated with a variety of clinical and radiographic findings. However, a high index of suspicion and certain constellations of clinical and radiographic findings may lead to an accurate presumptive diagnosis of typhlitis, followed by the institution of appropriate therapy. Notwithstanding, the short-term prognosis for typhlitis remains poor.

Adolescent↗

Detection of femoral head avascular necrosis in adults by SPECT.

Twenty-one adult patients with the clinical diagnosis of avascular necrosis (AVN) of the femoral head were examined with radionuclide angiography, planar bone scintigraphy, and single photon emission computed tomography (SPECT). A final diagnosis of AVN was established for 15 symptomatic patients with a total of 20 involved hips. SPECT and planar bone scintigraphy were considered positive for AVN only if a photopenic bony defect could be identified. Using SPECT bone scintigraphy, 12 of 15 symptomatic patients and 17 of 20 involved hips (sensitivity of 0.85) were correctly identified, whereas with planar imaging only eight of 15 patients and 11 of 20 involved hips were detected. There were no false-positive diagnoses on SPECT or planar bone scintigraphy. In addition, hyperemia in the region of the proximal femoral metaphysis was demonstrated in six of 20 involved hips. It is concluded that by identifying a photopenic defect that is not evident on planar views, SPECT can contribute to the diagnosis of AVN of the femoral head. In addition, metaphyseal hyperemia appears to be a promising new scintigraphic sign of AVN worthy of further investigation.

Adult↗