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Biomedical subjects

J Freyschmidt

Publications and source records attributed to J Freyschmidt.

At least 37 records · Page 2Linked to original sources
PubMed1996

Percutaneous bone biopsy, techniques and indications.

In the first part of this article we discuss some special technical aspects of percutaneous bone biopsy (PBB). But our main intention is to illuminate the critical indication of PBB against the background of the diagnostic and clinical utility. Reliable indications for PBB are: lytic metastases, solitary lytic lesions in a patient with known primary tumour and infection. Sclerotic metastases and vertebral compressions, on the other hand, have a lower diagnostic utility. Negative biopsies must be interpreted carefully and repeated if considered to be nonrepresentative The indication for percutaneous biopsy of primary bone tumours remains doubtful. Most of them require open biopsy.

Adult↗
PubMed1996

[Spiral computerized tomography of acute abdominal aortic aneurysm with optimal 3-D image reconstruction].

43 of 46 consecutive patients with suspected rupture of abdominal aortic aneurysm could be examined by spiral CT. Rupture of an abdominal vessel was found in 18 patients and proved by surgery. Size and extent of the aneurysm, rupture, dissection and vascular occlusion were demonstrated quickly and precisely by spiral CT, planning of surgical intervention could be optimized. Using spiral CT unnecessary explorative laparotomies could be avoided in 25 patients. In addition spiral CT offers the possibility of multiplanar reconstruction images with spatial visualisation of the vascular system. In 8 patients DSA offered no advantage in comparison with 3-D reconstruction images. Spiral CT meets all requirements for quick and reliable diagnosis in suspected rupture of abdominal vessels. Other imaging modalities like digital subtraction angiography are not necessary for evaluation of abdominal aortic aneurysms.

Aged↗
PubMed1995

[Experimental studies of the visualization of the vertebral body spongiosa by high-resolution computed tomography].

AIM: To show the accuracy and the lower limit of visualisation of cancellous bone in high-resolution computed tomography (HR-CT). METHODS: 18 native human lumbar vertebrae were placed in a water phantom and examined by HR-CT. The scans were compared with contact radiographs of correlating thin bone sections by morphologic criteria. RESULTS AND CONCLUSION: The measured lower limit of visualisation of cancellous bone structures is clearly worse than expected from the measurements of spatial resolution with standard phantoms used for HR-CT (0.6 versus 0.4 mm). True and exact imaging of normal cancellous bone cannot be achieved even by modern HR-CT. Noise creates structures mimicking cancellous bone.

Adult↗
PubMed1995

[Synovial lesions of the upper ankle joint].

The ankle is a typical synovial joint. It is affected by systemic as well as locally limited synovial processes. Looking at oligo- and polyarticular diseases it is affected by Reiter's Syndrome and Rheumatoid Arthritis in young patients. In middle aged people Crystal Synovitides dominate the picture and in old age Gout and tumorous lesions are seen. Looking at monarticular inflammatory processes one has to think of tuberculosis first. Crystal-induced monarthropathies such as hemochromatosis can also start at the ankle. In this review we describe the possible inflammatory diseases of the talocrural joint and present a diagnostic algorithm.

Ankle Joint↗
PubMed1994

Pustulotic arthroosteitis: spectrum of bone lesions with palmoplantar pustulosis.

PURPOSE: To discuss the association of palmoplantar pustulosis (PPP) with sternocostoclavicular hyperostosis (SCCH) and other infection- or tumor-simulating bone lesions. MATERIALS AND METHODS: From 1989 to 1992, 25 patients (11 men and 14 women, aged 19-69 years [mean, 42 years]) with pustulotic arthroosteitis (PAO) and SCCH were seen. Findings were accumulated to determine the concomitant findings of other bone lesions. RESULTS: Thirteen patients with skeletal lesions had proved PPP. Eleven of these patients also had SCCH, four had sacroiliitis, six had spondylitis, and six had tumorlike manifestations in the appendicular skeleton. In another 12 patients with SCCH, none had proved PPP but four had psoriasis. Fifteen of 25 patients with SCCH had skin disease. Seven of the 25 patients had only one site of bone involvement (six had SCCH and one had spondylitis); all other patients (including the six with tumor-simulating extraaxial lesions) had more than one skeletal site of bone involvement. CONCLUSION: Because radiologists play the key role in the diagnosis of PAO, awareness of the possibility of benign disease is necessary to obviate certain diagnostic or therapeutic procedures.

Adult↗
PubMed1994

[MRI diagnosis of bone tumors].

Diagnosis of bone tumours is still based on plain films and, if necessary, computed tomography because crucial morphologic criteria such as ossification of tumour matrix, patterns of bone destruction and formation of new bone are not clearly visualized by MRI. Only in a few cases is MRI helpful for characterization of bone lesions. Although MRI is of limited value for differential diagnosis of bone tumours, it may be very helpful for planning of biopsy or surgery by virtue of its ability to demonstrate tumour extent and soft tissue changes. For local staging and follow-up of primary bone tumours MRI is clearly the method of choice. MRI strategy should be coordinated with clinical requirements in order to ensure optimum evaluation of tumour extent, effectiveness of chemotherapy and detection of local recurrence.

Bone Neoplasms↗
PubMed1994

[Proton spin tomographic errors--overevaluation of a new method].

This case report represents an addendum to the article by B. Holland and J. Freyschmidt in the same issue of this journal. It demonstrates that premature use of magnetic resonance imaging (MRI) of an osteolytic lesion in the femur of a 53-year-old patient led to confusion with a false diagnosis (fibrous dysplasia) of great importance for the patient. Correct interpretation of the destruction pattern on plain film is of much greater diagnostic value than the MR images. In the case described the lesion would have been classified as a Lodwick grade II lesion. Statistically the first differential diagnosis of such a lesion in a 53-year-old man with a smoking history would be "metastasis of a lung carcinoma". The next diagnostic step should have been a plain film of the chest with demonstration of the primary tumor. Indiscriminate application of expensive methods like MRI or CT will never replace what we call the "diagnostic idea", based on the information from plain film, the history of the patient and statistical probabilities.

Adenocarcinoma↗
PubMed1993

[Percutaneous bone biopsy. Critical analysis of 153 patients].

The value of transcutaneous bone biopsy was critically examined in a retrospective study of 153 patients with various bone diseases. A comparison of the clinical, radiological and histological findings gave reliable results in approximately 82%. Specific results were worse in inflammatory processes than in those involving tumours. The results of biopsy were of particular interest where clinical and radiological examinations pointed to an isolated bone metastasis in cases of known and unknown primary tumours. The advantages of the method are discussed with regard to the patient's well-being and to cost.

Adolescent↗
PubMed1991

[The comparative measurement of the bone marrow dose in quantitative computed tomography (QCT), dual-photon radiography (DPX) and conventional x-rays of the LS].

One of the issues in the discussion on the best method for measuring the bone mineral content is the relevance of the applied dose. We used highly sensitive thermoluminescent dosimeters (TLD) to directly compare bone marrow doses in a human phantom. DPX gave a bone marrow dose in the lumbar spine of 4 mu Gy, in QCT the dose corrected to the same amount of irradiated marrow was about 1 mGy. This value is in the same range as conventional a.p. plus lateral view x-rays of the lumbar spine. Corrected to the total body dose, the QCT dose is as low as 10% of the yearly background irradiation. It should therefore be radiobiologically irrelevant.

Absorptiometry, Photon↗
PubMed1990

[The rare phenomenon of intraosseous gas collections (the so-called pneumatoceles].

We present two unusual cases of gas-filled cavities, the first in a 5th lumbar vertebra, the second in the subcortical area of the iliac bone close to the iliosacral joint. These accumulations of gas are evidently connected to vacuum phenomena in anatomically adjacent joints. They are characterised as pneumatoceles. Different mechanisms of these rare intraosseous gas accumulations are discussed.

Adult↗
PubMed1990

[Tumor-like bone lesions in sternocostoclavicular hyperostosis and palmoplantaris pustulosis].

We present two unusual cases of sternocostoclavicular hyperostosis (SCCH) in conjunction with palmoplantar pustulosis (PPP) and additional tumour like manifestations in a scapula and a femur respectively. The association of SCCH with complexes of signs and symptoms such as chronic multifocal osteomyelitis (CRMO), or other nosological entities such as seronegative spondylarthropathies, is discussed.

Adult↗