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Biomedical subjects

J L Brasseur

Publications and source records attributed to J L Brasseur.

16 recordsLinked to original sources

Extensor carpi ulnaris injuries in tennis players: a study of 28 cases.

Pain on the ulnar side of the wrist is common among elite tennis players. Ten years of experience has allowed identification of a pathology involving the extensor carpi ulnaris (ECU) tendon. On the basis of 28 clinical cases seen over the last five years, three clinical patterns are described: (a) acute instability of the ECU; (b) tendinopathy; (c) ECU rupture. Each of these clinical entities requires a different therapeutic approach. A review of the relevant anatomy is provided.

Adolescent↗

[Dynamic ultrasonography].

The ability to perform dynamic evaluation is a great advantage of ultrasound especially for musculoskeletal evaluation. Different manoeuvres are routinely used. The importance of the mobility of a structure or an articulation, but also the grade of compression of the lesion, can provide useful diagnostic information. For ligaments, the tension of each band is important and mobilisation is often able to depict some conflicts between the tendons and others structures. Muscle contraction is also an important element for making the diagnosis and, similar to a Valsalva manoeuvre for the diagnosis of a hernia. Interventional procedures are also facilitated by this dynamic evaluation. On the other hand, this great advantage requires the presence of a physician during the examination.

Adult↗

Sonoanatomy of the ulnar nerve in the cubital tunnel: a multicentre study by the GEL.

The objective is to determine the normal appearance of the ulnar nerve on a posterior axial sonogram section of the elbow through the medial epicondyle and the humeroulnar joint space. Ultrasound evaluation was carried out on 400 elbows with measurement of the ulnar nerve cross-sectional area and ulnar nerve-cortex distance, as well as recording of apparent ulnar nerve division. Factors that significantly influenced the study variables were sought by statistical analysis. Mean cross-sectional area of the ulnar nerve at the elbow was 7.9 +/- 3.1 mm2 overall. Values were lower in females than in males and increased between 40 and 60 years of age. The ulnar nerve-cortex distance was 0.8 +/- 0.4 mm and varied widely across individuals. Apparent ulnar nerve division at the elbow was noted in about one-fifth of individuals, with no difference between females and males or between the right and left elbows. When present, apparent division was often bilateral and was not associated with changes in cross-sectional area or in distance from the medial epicondyle cortex. This study provides normative data on ulnar nerve sonoanatomy at the elbow and establishes that apparent ulnar nerve division at the elbow is a normal variant.

Adult↗

Epithelioid sarcoma mimicking abscess: review of the MRI appearances.

A case of epithelioid sarcoma involving the soft tissues of the ankle is presented. The tumor was a hemorrhagic, fluid-filled, multiloculated lesion with inflammatory changes in the surrounding planes. Tuberculous abscess was diagnosed on the basis of the clinical picture, ultrasound and MRI findings. Surgical exploration of the ankle mass was carried out because of lack of local healing while the patient's general and pulmonary status improved on antituberculosis treatment. This was an unusual case of epithelioid sarcoma mimicking a multilocular abscess.

Abscess↗

MR arthrography of the hip: normal intra-articular structures and common disorders.

This pictorial review illustrates the anatomical features of normal intra-articular components of the hip and their common disorders on MR arthrography. On T1-weighted MR arthrograms, the normal contrast-filled joint cavity shows a homogeneous high signal intensity. Normal acetabular labrum appears as a well-delineated triangle showing a low signal intensity, surrounded by contrast material in the perilabral recess. Intra-articular paramagnetic contrast outlines labral tears, loose bodies, communicating labral cysts and cartilage lesions (traumatic tears, focal defects, degenerative fissures and thinning), and improves their detection. Overall, MR arthrography enables accurate detection and staging of hip intra-articular structure abnormalities.

Hip Joint↗

[Accurate use of imaging in ankle sprain].

Imaging ankle trauma has two goals: to evaluate bone lesions and to appreciate the capsulo-ligamentous tears. Concerning bone lesions, Ottawa's criteria specify the clinical characteristics to perform radiography in the emergency conditions. These recommendations negate the need for nearly 30% of unnecessary radiographs initially performed. Four views of the tarsis have been selected: anteroposterior, lateral, internal rotation, external oblique. Immediate screening of the ligament is very accurately performed with ultrasound, which depicts the number of bundle concerned and the extent of the lesions. This requires an experienced operator and a high quality sonograph. Stress radiography should not be performed anymore as sensitivity is around 50%. Arthrography and CT arthrography are very accurate when performed immediately but are more expensive. This report highlights the complementary role of radiography and ultrasound to evaluate ankle sprain.

Ankle Injuries↗

[Normal and pathological MRI aspects of the posterolateral corner of the knee].

The purpose of the study is to compare normal PLC anatomy and its MRI appearance, with the various lesions observed in MRI, from the simple popliteus tendinous contusion to the complete PLC rupture. For this specific work on PLC lesions, we selected 61 examinations among the traumatic knees explored during the last 3 years. Surgical correlation is obtained for the 61 patients. MRI examinations are performed on a 0.5 T. unit with gradient echo T1, T1 and T1 GD-DOTA IV. Normal PLC anatomy is compared to the dissection of 4 anatomic subjects. Normal MRI slices are evaluated with this reference analysis. The principle anatomical structures of the PLC include the lateral collateral ligament, the popliteus tendon, the arcuate ligament, the fabello fibular ligament, the posterolateral condylar capsule, and the posterior horn of the lateral meniscus. Surgical findings confirm PLC lesion for 58 patients with 3 false positive. Diagnosis of these lesions is important because chronical posterolateral laxity is secondary to the destabilisation of lateral condyle. Unrecognised and untreated posterolateral instability may result in failure of ACL reconstruction. When clinical tests are doubtful or complex, or the examination very painful, MRI evaluates completely the traumatic knee and particularly the PLC.

Humans↗

Ultrasono-anatomy of the ankle ligaments.

The ligaments of the ankle are superficial and easily accessible at ultrasonography. Surprisingly, the reliability of this technique has never been proven. With this goal in mind, ten ankles were subjected to a ultrasono-anatomic comparison. The five principle ligamentous fascicles (three on the lateral side and two on the medial side) measured at ultrasonography and the values verified after dissection. This study shows that the ligaments of the ankle are analyzed with ultrasonography and that the measures done are valid and have a precision of 2 mm for the anterior fascicle and the lateral fascicle of the lateral ligamentous plane Due to its simplicity and its low price, ultrasonography appears to be an important method in evaluating the ligaments and the degree of seriousness of ankle sprains.

Ankle Joint↗

[Cystic lymphangioma of the duodenum revealed by digestive hemorrhage and associated with exudative enteropathy].

Cystic lymphangioma is a rare and benign congenital lesion of the lymphatic system, which can become manifest at any age. Intra-abdominal cysts are found in less than 10% of cases and mesenteric involvement is the most common. The case of a patient with intra-abdominal cystic lymphangioma that involved the liver, the spleen, the kidney and the small intestine, and complicated by gastrointestinal bleeding and protein losing enteropathy is reported herein. Despite severe gastro-intestinal manifestations, spontaneous outcome was favorable. This observation suggests that a) duodenal cystic lymphangioma must be considered as a cause of gastrointestinal bleeding and of protein losing enteropathy, b) conservative treatment can be proposed.

Aged↗

[The sign of the fibular head. An indication of torsion?].

The head of the fibula is posteriorly located on a lateral view of the knee. This location varies according to the rotation of the limb when the knee is positioned for the radiograph. Our study shows that the location of fibular head is an indirect sign of torsion disorder of the inferior limb.

Adolescent↗

[Ligament pathology of the ankle joint].

Recent advances in ultrasound technology and the development of high-resolution ultrasound transducers have enabled detailed depiction of superficial musculoskeletal structures. The advantages of ultrasound include wide availability and dynamic evaluation. The main disadvantage is the uneasiness of performing ultrasonography, especially for foot and ankle. In addition, diagnostic accuracy requires time, knowledge, and meticulous attention to technical parameters. Ultrasound can be used to evaluate joints, ligaments, tendons, plantar fascias, fore-foot diseases and to look for foreign bodies. Power Doppler can be used to evaluate blood flow. The standardisation of the procedure and the production of normal reference images seem to guarantee a global increase in quality of the sonographic examinations. The diagnostic and therapeutic impact is very important regarding the low cost of this technique, especially in ankle sprain.

Ankle Injuries↗

[Ultrasound of acute disorders of the shoulder].

Acute pain of the shoulder, with or without associated injury shows specific features that enable differentiation from chronic lesions. Osteo-articular injuries, tendinous lesions, bursitis and moving calcification may produce acute pain. Examination of the acromio-clavicular joint is also essential as acromial lesions are often overlooked in emergency radiology. Along with X-ray radiography, sonography, if adequately performed, is able to determine the etiology of acute pain and to establish lesion staging.

Acromioclavicular Joint↗