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Biomedical subjects

J E Madewell

Publications and source records attributed to J E Madewell.

At least 19 recordsLinked to original sources
PubMed1991

The calcaneus: normal and abnormal.

The calcaneus is the largest tarsal bone. Many congenital and acquired disorders affect the bone. Primary disorders arise in the calcaneus itself, whereas secondary disorders arising in the neighboring soft tissues extend into and affect the calcaneus indirectly. Among the primary lesions, congenital, traumatic, infectious, hematologic, neoplastic, and other miscellaneous disorders constitute the majority, whereas various arthritides and soft-tissue neoplasms that arise adjacent to the bone constitute the important secondary calcaneal disorders. Radiographic features of many disorders of the calcaneus are disease-specific and thus diagnostic. This article describes a wide spectrum of calcaneal disorders and illustrates their salient radiographic features. This knowledge should facilitate radiographic diagnosis of various calcaneal disorders encountered in clinical practice.

Bone Diseases↗
PubMed1991

Diagnostic radiology peer review: a method inclusive of all interpreters of radiographic examinations regardless of specialty.

A proposed method of assessing the quality of diagnostic radiographic examinations includes peer review designed to evaluate physicians, including nonradiologists, involved in the performance and interpretation of such examinations. A pilot project evaluated this system with randomly selected Pennsylvania Blue Shield data files of 10 providers billing for chest radiography interpretations during the second quarter of 1989. Of the 98 chest radiographs reviewed blindly, all inadequately marked radiographs and incomplete written reports were produced by nonradiologists. Technical quality of images obtained by radiologists did not significantly differ from that of images obtained by nonradiologists (P = .189). All five interpretive errors that could have seriously affected the patient's health care were produced by nonradiologists (P = .019). Four of these serious errors were made by providers billing for fewer than 25 radiographs. While administrative and time cost limitations are obvious, this method of peer review encompasses all physicians billing for a particular radiographic service, irrespective of specialty.

Blue Cross Blue Shield Insurance Plans↗
PubMed1990

Fibrous lesions of bones.

A large variety of benign and malignant fibrous lesions occur in the skeleton. Many fibrous bone lesions have characteristic features on plain radiographs and are easy to diagnose; others may pose significant difficulty. Most often, an osteolytic defect is seen associated with a fibrous lesion in the affected bone, although a mixed and sclerotic fibrous bone lesion is not unusual. Many benign fibrous bone lesions are asymptomatic; others become clinically apparent because of associated pathologic fracture or deformity of the involved bone. Malignant fibrous lesions tend to be aggressive, with focal bone destruction and adjacent soft-tissue involvement. The authors describe many fibrous bone lesions with their salient clinical and radiographic features.

Bone Diseases↗
PubMed1990

Osteosarcomatosis.

A review of the 690 cases of osteosarcoma in the radiographic file of the Armed Forces Institute of Pathology revealed 29 cases of "osteosarcomatosis" (multiple skeletal sites of osteosarcoma). Fifteen of these patients were 18 years old and under and manifested rapidly appearing, usually symmetric, sclerotic metaphyseal lesions. The remaining 14 patients were more than 18 years old and had fewer, asymmetric sclerotic lesions. In most patients (28 of 29), a radiographically dominant skeletal tumor was seen. Pulmonary metastases occurred in the majority of patients and were detected at the same time as the bone lesions. These 29 patients were studied with regard to demographic data and skeletal distribution and radiographic appearance of their lesions. As a result of the findings, a metastatic origin from a primary dominant osteosarcoma is favored over a multifocal origin as the basis for osteosarcomatosis. Osteosarcomatosis is more commonly encountered in the mature skeleton than has been previously recognized.

Adolescent↗
PubMed1990

Parosteal osteogenic sarcoma arising in cranial bones: clinical and radiologic features in eight patients.

Parosteal osteogenic sarcoma is a distinct surface bone tumor with a better prognosis than conventional osteogenic sarcoma. We studied eight histologically proved cases of cranial parosteal osteogenic sarcoma. The tumors were identical in histologic appearance to parosteal osteosarcoma arising in long bones. Clinically, the tumor presented as a hard, painless, nodular scalp mass. The prevalence in women outnumbered that in men by 3:1, with most cases occurring between the second and third decades of life. Plain radiographs showed a rounded, sessile bone growth of variable size arising from the outer table of the skull. The tumor was heavily ossified centrally with variable margins and, at times, with radiating bony spicules at the periphery. No satellite bone nodules were noted in adjacent soft tissues. In three cases a fine radiolucent cleft was demonstrated between the tumor and the underlying outer table on the tangential radiographs or CT. After en bloc resection of the tumor, follow-ups for 20 years in one patient and 1 year in two patients showed no recurrence. Parosteal osteosarcoma of the skull is a rare low-grade tumor that usually arises from the outer table of the skull and has distinctive radiologic features that should distinguish it from other exophytic cranial bone neoplasms.

Adolescent↗
PubMed1989

Primary mucinous cystadenocarcinoma of the appendix with pseudomyxoma peritonei manifested as a splenic mass.

We have reported a case of pseudomyxoma peritonei manifested as a splenic mass in a 38-year-old woman. Upon reviewing previously reported cases of pseudomyxoma peritonei with visceral involvement or extension above the diaphragm, we conclude that such spread of the disease does not significantly alter the prognosis. Furthermore, our findings support the concept that pseudomyxoma peritonei represents the implantation of malignant cells rather than metaplastic transformation of mesothelial cells.

Adenocarcinoma, Mucinous↗
PubMed1989

The clavicle: normal and abnormal.

The clavicle is an unusual long bone with many unique embryologic features. It is often involved in congenital and acquired disorders. Traumatic, inflammatory, neoplastic, metabolic and many other miscellaneous lesions may also affect the bone. Because of its ligamentous attachments and the presence of articulations at both ends, the clavicle can also be involved in arthritic diseases. This article illustrates the radiographic manifestations of many of the disorders of the clavicle that are commonly encountered in clinical practice.

Bone Diseases↗
PubMed1989

The many faces of neuroblastoma.

Neuroblastoma is a common tumor in childhood. It arises in the adrenal gland or in various extraadrenal primary sites of the sympathetic chain. Clinically, it may present as an abdominal mass or as disseminated metastatic disease. We studied 52 patients with neuroblastoma, and the typical and unusual radiographic features of the disease are presented.

Adrenal Gland Neoplasms↗
PubMed1989

Bladder diseases and imaging methods.

New and exciting diagnostic modalities which substantially change the evaluation of the urinary bladder have become available in the last decade. This is a review of the principles involved in and the advantages of diagnostic imaging using the modalities available to study the urinary bladder in a modern radiologic facility. It emphasizes the values of the different modalities in specific disease states. Excretory urography, cystography, and voiding cystourethrography were the mainstay of the evaluation of bladder pathology. These modalities are still good screening methods under certain circumstances but are relatively limited in comprehensive assessment of the bladder. Bladder studies using radionuclides, such as nuclear cystography, still have a space in the long-term follow-up of pediatric patients due to their relative low radiation dose. Since the addition of ultrasonography, computed tomography, and more recently, magnetic resonance imaging to the radiologist's armamentarium of imaging modalities, there has been a tremendous improvement not only in the demonstration of bladder abnormalities, but also in the staging of bladder neoplasms. The relative merits of these past and present imaging modalities are illustrated. Their appropriate contributions to improved quality of care of patients with bladder disease are also discussed.

Humans↗
PubMed1988

Expansile bone lesions of the vertebra.

Vertebral expansion may be caused by both benign and malignant disease processes. Recognition of such lesions on radiographs facilitates accurate diagnosis in many cases.

Bone Cysts↗
PubMed1987

Osteomyelitis, acute and chronic.

In certain patient populations, osteomyelitis is a significant clinical problem. The judicious use of plain film radiographs and radionuclide bone imaging by the imaging consultant has a critical role in the early detection and diagnosis of osteomyelitis. This complementary imaging approach produces the highest and greatest accuracy in the documentation of skeletal infections. Inadvertent delay in the initiation of appropriate therapy can be obviated utilizing these imaging techniques and undue morbidity averted.

Acute Disease↗
PubMed1979

The collar button ulcer. A radiologic-pathologic correlation.

The collar button-shaped ulcer is a distinctive radiographic manifestation of inflammatory disease of the GI tract. Its hallmark is mucosal ulceration with undermining submucosal extension limited by the relatively resistant underlying muscle wall. Such a process is commonly associated with ulcerative colitis where it may be seen diffusely in advanced stages of the acute disease. Occasionally, however, it may be seen in any ulcerating inflammatory disease. In the more aggressive transmural diseases, it is likely to be a localized and transient phenomenon. The same pathophysiological mechanism gives rise to the common appearance of benign ulceration anywhere in the GI tract and, particularly, in the undermined gastric ulcer.

Amebiasis↗
PubMed1979

Metastatic transitional cell carcinoma from the bladder: radiographic manifestions.

Metastases from transitional cell carcinoma of the bladder are not widely appreciated radiographically, although they are commonly found at autopsy. Radiographic evidence of metastatic disease was reviewed in 51 patients. Sites included lung, 28; bone, 24; mediastinum, eight; liver, eight; brain, three; urethra, one; abdominal nodes, one; and extradural space, two. The patterns of lung metastases consisted of solitary nodules, multiple nodules, sigmental infiltrates, pulmonary edema, and a Pancoast tumor. A sarcoidlike pattern with hilar and interstitial disease was also seen. One patient had a malignant pleural effusion. Mediastinal lymph node enlargement was isolated or associated with lung involvement. Bone metastases demonstrated either an osteoblastic or a mixed osteolytic-osteoblastic pattern in 47% of the instances. Ivory vertebrae were identified in three patients. Because of the significance of identifying metastatic disease before any extensive curative bladder surgery, we recommend at least a preoperative chest radiograph, a bone scan, and a liver scan.

Adult↗