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J L Drapé

Publications and source records attributed to J L Drapé.

At least 19 recordsLinked to original sources
PubMed2003

[Imaging of the painful cervical spine].

Neck pain can occur in several circumstances: traumatic, spontaneous, associated or not with motion, with or without head or upper limb irradiations. Each case requires appropriate clinical examination and radiographs. CT and MRI can be used to obtain additional information. Myelography and arteriography are exceptionally used. Cervical discography and facet joint arthrography are used therapeutically. After a brief anatomical review, normal and pathological patterns will be reviewed using radiographs. Each circumstance is studied: traumatic, degenerative, inflammatory and tumoral. It is emphasized that discogenic cervico-brachial neuralgia usually has a favorable spontaneous outcome. A special chapter is dedicated to calcifying and ossifying diseases of the cervical spine. Cervico-occipital neuralgia is also discussed.

Adolescent↗
PubMed2001

Value of the bell test and the hyperextension test for diagnosis in sciatica associated with disc herniation: comparison with Lasègue's sign and the crossed Lasègue's sign.

OBJECTIVES: To evaluate the reliability, sensitivity, specificity and positive (PPV) and negative (NPV) predictive values for the diagnosis of sciatica associated with disc herniation of the bell test (BT) and the hyperextension test (HT). METHODS: According to magnetic resonance imaging, computed tomography scanning or myelography findings, patients were classified as having sciatica associated with disc herniation (group A) or sciatica without disc herniation or sciatica of other mechanical origin (group B). Four clinical manoeuvres [bell test (BT), hyperextension test (HT), Lasègue's sign (LS) and the crossed Lasègue's sign (CL)] were tested by three investigators. Intra- and interobserver reliabilities were calculated using the kappa correlation coefficient or the intraclass correlation coefficient (ICC). The sensitivity, specificity, PPV and NPV of the four manoeuvres were calculated. Stepwise logistic regression analysis was performed to determine the best set of variables predicting sciatica caused by disc herniation. RESULTS: Seventy-eight patients (43 in group A, 35 in group B; 33 males) with a mean age of 50+/-16 yr were included. Interobserver reliabilities ranged from 0.58 to 0.64 for the BT, 0.35 to 0.50 for the HT, 0.27 to 0.47 for LS and 0.43 to 0.72 for CL. LS had the best sensitivity (0.77-0.83) and CL the best specificity (0.74-0.89), while PPV and NPV were equivalent for the four manoeuvres (0.55-0.75 for PPV and 0.45-0.59 for NPV). The best PPV was observed for the association of HT with CL (0.67-0.85). Stepwise logistic regression analysis did not allow us to propose a set of variables predicting sciatica caused by disc herniation. CONCLUSION: This study suggests that clinical values of the BT and HT are of interest, and are similar to those of LS and CL.

Adolescent↗
PubMed2001

Hemangiomas of the fingers: MR imaging evaluation.

PURPOSE: To report the magnetic resonance (MR) imaging features of finger hemangiomas. MATERIALS AND METHODS: Sixteen patients clinically suspected of having hemangioma of the finger underwent 1.5-T MR imaging with a customized local gradient coil. The location, size, margins, signal intensity, and enhancement patterns of the lesions were noted. In accordance with the literature on MR imaging of deep hemangiomas, the authors' findings could be divided into those with typical features-that is, high signal intensity at T1- and T2-weighted imaging, lobulated appearance, strong enhancement, and heterogeneous pattern with flow void artifacts-and those with atypical features. The reference standard was surgery (n = 12) or clinical outcome (n = 4). RESULTS: One posttraumatic hematoma was excluded. Most lesions were in the fingertip (n = 10), with involvement of the nail bed and/or the pulp (n = 5). Hemangiomas were classified as typical in ten cases and atypical in five. The mean size of typical lesions was larger than that of atypical lesions. The unique imaging features of atypical hemangiomas included a masslike appearance, which was either homogeneous with diffuse enhancement-suggestive of hypervascularity (n = 2)-or heterogeneous with poor enhancement (n = 3). CONCLUSION: MR imaging characteristics of finger hemangiomas can be classified as typical or atypical. Knowledge of both patterns can be helpful in the distinction of soft-tissue abnormalities at this location.

Adolescent↗
PubMed2000

[Imaging strategies in common low back pain].

Imaging strategy varies according to the background of acute or persistent low back pain. In case of acute low back pain with associated symptoms of a cauda equina syndrome or any atypical clinical signs PA and lateral radiographs of the lumbar spine are required. An additional MRI examination is often necessary, even with negative radiographs. In the other cases, radiographs are only obtained when the low back pain persists longer than 7 weeks. Secondary, MRI may be performed in case of worsening and persistence of the clinical symptoms or if a specific low back pain is suspected. In case of chronic low back pain, with a severe socio-professional impact or a planed invasive treatment, plain films of the lumbar spine must be obtained, eventually with additional MRI examination.

Acute Disease↗
PubMed1999

Study of the joint space of the hip on supine and weight-bearing digital radiographs.

AIM: To compare hip joint space on supine and weight-bearing anteroposterior digital radiographs. MATERIALS AND METHODS: Fifty anteroposterior views of the hip in 25 patients were taken in supine and weight-bearing positions on a fluoroscopic unit. Two observers in a double-blind study assessed the width of the joint space on an Easy Vision unit with an indirect method of measurement (metric index). RESULTS: Inter-observer and intra-observer variabilities of the metric index were less than 4.1%. There was no significant difference of the metric index of the hip (P>0.05), between supine and weight-bearing positions. CONCLUSION: There is no significant difference of the width of the joint space of the hip between supine and weight-bearing anteroposterior radiographs. Measuring joint space loss in osteoarthritis of the hip with anteroposterior views should be done with radiographs of the hip in the supine position to improve image quality.

Adult↗
PubMed1999

A glomus tumour with four recurrences.

A case of a glomus tumour of the distal segment of the ring finger, with four apparent recurrences in an 8-year period, is described. The patient was treated by two different surgeons (two and three times respectively) and obtained pain free intervals of between 4 and 11 months before recurrence. Histological examination confirmed the diagnosis of a glomus tumour in all five procedures. The location of the glomus tumour was defined preoperatively by high resolution MR imaging.

Adult↗
PubMed1999

[Radio-anatomy of the knee].

The authors review the radiologic anatomy of the knee joint with particular points of interest such as the cruciate ligaments, the menisci, and the articular cartilage. All imaging modalities are shown with special attention regarding MR imaging.

Anterior Cruciate Ligament↗
PubMed1999

[Pain in the internal knee compartment].

The anatomical classification of the traumatic or non traumatic lesion gives a mnemotechnical list which assists in the etiological search for pain of the inner aspect of the knee: skin, sub cutaneous tissue, medial lateral ligament, meniscus, cartilage, sub chondral bone, cruciate ligaments. Each mean of imaging detect specific lesions according to its technical capabilities: standard X Ray film, arthrography, CT scanner, MRI, bone scintigraphy, and echography. In practice, strategy is adapted to the clinical presentation, traumatic or non traumatic. In emergency situations, one is looking for bone, ligamentous, and meniscus lesions. Without acute traumatism, one can discover ligamentous tear sequellae (Pelligrini Stieda's ossifications), transient osteoporosis (algodystrophy), degenerative lesions (arthrosis) of the inner compartment. Always remember "close to the knee", it is necessary to check for more serious infectious or tumoral pathology. If standard plain films remain the first means of examination, and are still useful, MRI is becoming increasingly necessary for a complete anatomical evaluation.

Diagnosis, Differential↗
PubMed1998

Closed ruptures of the flexor digitorum tendons: MRI evaluation.

OBJECTIVE: To assess the MRI findings in cases of closed rupture of the flexor digitorum tendons (FDT). PATIENTS AND DESIGN: Ten patients with a clinical suspicion of rupture of FDT underwent MRI before surgery. None of the patients presented a skin injury. Fingers were imaged using axial T1-weighted SE sequences, three-dimensional GE images, and curved reconstructions. RESULTS: Twelve FDT had surgical confirmation of rupture. Flexor digitorum profundus (FDP) and flexor pollicis longus (FPL) tendons were more frequently ruptured (n=8) than flexor digitorum superficialis (FDS) tendons (n=4). MR images accurately depicted the level of the rupture. The gap between the tendon ends (mean 45 mm, range 21-70 mm) was assessed best with curved reconstructions and was well correlated with the surgical findings. The proximal end mainly retracted into the palm or the carpal tunnel (n=8), and less frequently into the digital canal (n=4). In two cases, the proximal end curled up in the palm, clinically simulating a rupture of a lumbrical muscle in one case. MRI also showed the appearance of the adjacent tendons. CONCLUSION: MRI accurately depicted the level of rupture and the gap between the tendon ends, which assisted the surgical choice between suture, graft or tendon transfer.

Adult↗
PubMed1998

Quantitative MR imaging evaluation of chondropathy in osteoarthritic knees.

PURPOSE: To determine the validity and the reliability of T1-weighted three-dimensional gradient-echo magnetic resonance (MR) imaging for quantification of articular cartilage abnormalities of osteoarthritic knees. MATERIALS AND METHODS: Forty-three patients (mean age, 63 years) with knee osteoarthritis (American College of Rheumatology criteria) of the medial tibiofemoral compartment underwent a prospective, cross-sectional study. Knees were examined with a T1-weighted three-dimensional gradient-echo sequence (1.4-mm contiguous sections), with use of a 0.2-T dedicated MR unit, before arthroscopic exploration. The tibiofemoral articular cartilage abnormalities were quantified blindly on both the MR and arthroscopic images with the French Society of Arthroscopy (SFA) score (0-100) and grading scheme (five grades). RESULTS: There was a statistically significant correlation between the SFA-arthroscopic score and the SFA-MR score (r = .83) and between the SFA-arthroscopic grade and the SFA-MR grade (weighted kappa = 0.84). The deepest cartilage lesions graded with arthroscopy and MR imaging showed correlation in the medial femoral condyle (weighted kappa = 0.83) and in the medial tibial plateau (weighted kappa = 0.84). The intraobserver reliability of the SFA-MR score was higher (r = .94) than the interobserver reliability (r = .80). CONCLUSION: Quantification of chondropathy with MR imaging is feasible and well correlated with anatomic cartilage breakdown.

Aged↗
PubMed1998

[MRI and articular cartilage].

Although plain films are fundamental for routine imaging of degenerative chondral lesions, MRI is a promising tool of investigation for the articular cartilage. Its modalities are still imprecise and debated, but, because of its noninvasiveness, it is destined to be preferred over arthroCT. The small size of the cartilage requires thin slices of less than 3-mm thick. The various features of normal cartilage images must be well known. They depend on acquisition parameters, zonal structure of the cartilage and numerous artifacts (partial volume average, chemical shift, magnetic susceptibility, truncation, "magic angle"). Fast SE images provide a good compromise between contrast and the signal-to-noise ratio. T2-weighted images take advantage of an arthrographic effect in case of joint effusion. 3D GE images allow a more accurate evaluation with 1-mm thick slices. In all sequences, adding of a fat-suppression presaturation increases contrast between the cartilage and the surrounding structures. The diagnostic accuracies of the different sequences and of MR arthrography are discussed. Quantitative measurements of cartilage thickness and volume remain the topic of clinical research.

Arthrography↗
PubMed1997

[Imaging].

The panoply of imaging techniques useful in podology is essentially limited to X-rays. Standard "standing" and "lying" X-rays furnish most of the required information. Arthrography is sometimes performed, in particular for trauma or tumour of the ankle. CT scan and MRI make a decisive contribution in difficult cases, notably in fractures and in small fractures without displacement. The two latter techniques are useful in tendon, ligament and muscular disorders, where echography is also informative. Rigorous analysis of radiographies and a good knowledge of foot disorders make these imaging techniques efficacious.

Adult↗
PubMed1996

Standard and high resolution magnetic resonance imaging of glomus tumors of toes and fingertips.

BACKGROUND: High-resolution magnetic resonance imaging (MRI) of subungual glomus tumors has been recently reported. OBJECTIVE: Our purpose was to compare high-resolution MRI and standard MRI for the diagnosis of 44 glomus tumors of the toes and fingertips. METHODS: Glomus tumors (11 cases) were first examined by MRI with a commercial surface coil (set 1). Thirty-three other glomus tumors and one tumor from set 1 were then examined with a high-resolution module designed for skin imaging (set 2). RESULTS: All 44 glomus tumors were identified with MRI. The limits of the tumors were detected in 54% of set 1 and 100% of set 2. A capsule was present in most cases, but was incomplete or absent in eight cases. Subtypes of glomus tumors were more easily differentiated in set 2. CONCLUSION: Standard MRI was adequate to detect glomus tumors, but high-resolution MRI assessed tumor characteristics more accurately.

Adolescent↗
PubMed1996

Median nerve suture in the distal part of the forearm. MRI evaluation.

The aim of the study was to assess MR images of median nerve suture in the distal part of the forearm on fresh cadavers and injured patients. The median nerve was dissected in the distal one-third of the forearm in four fresh cadaveric specimens, divided and repaired in three of them in two cases with 3/0 nylon (one with well-apposed edges and the other with a lateral gap) and, in the third specimen, with 9/0 nylon with well apposed edges. The course of the median nerve was then studied on MR imaging in different planes and the quality of the nerve repair was evaluated. A good correlation was found between the MR images and the type of nerve suture. These findings were applied in management of two clinical cases in whom reexploration and revision of the median nerve repair was carried out.

Adult↗
PubMed1996

The lunula: a magnetic resonance imagining approach to the subnail matrix area.

High-resolution sagittal magnetic resonance images depict an oval area in the dermis beneath the nail matrix that gives a particular signal. This study defines the magnetic resonance imaging characteristics of this area and examines its correlation with the lunula. A high-resolution surface gradient coil specially designed for skin imagining was used on a 1.5 T magnetic resonance unit. The subnail matrix (SNM) areas of 12 subjects had a significantly longer T2 relaxation time and a higher enhancement ratio after injection of gadolinium than did the nail bed dermis. The length of the SNM area distal to the free edge of the proximal nail fold was highly correlated with the length of the lunula (R = 0.98) in 30 fingers and 10 toes. The total length of the SNM area was somewhat correlated with the nail thickness (R = 0.86) in 30 fingers. The histology and microvascularization of the subungual tissue in 21 fingers showed that this SNM area had specific features: The area was composed of loose connective tissue without bundles, and the reticular and subdermal vascular networks had large regular meshes in this oval area. The lunula is shown to be linked to a well-defined area in the underlying dermis with a specific histology and microvascularization.

Adult↗
PubMed1996

Complications of flexor tendon repair in the hand: MR imaging assessment.

PURPOSE: To determine if magnetic resonance (MR) imaging enables differentiation of adhesions from tendon rupture after repair of digital flexor tendon injuries. MATERIALS AND METHODS: The reference group comprised eight tendon sutures with a good clinical outcome. Axial and sagittal spin-echo sequences and three-dimensional gradient-echo sequences with curved reconstructions were analyzed in 63 injured fingers. Reoperation was performed in 41 fingers. RESULTS: MR imaging depicted isolated peritendinous adhesions (n = 31), most often with a continuous, uniform tendon (sensitivity 91%, specificity 100%). There were two types of rupture: frank rupture (n = 140; sensitivity 100%, specificity 100%) or elongated callus (n = 18; sensitivity 100%, specificity 94%). Tendon gap was significantly longer in frank rupture (P = .0011). Thin fibrous continuity existed with elongated callus. Tenolysis was sufficient when the callus was short and mature with predominant new collagen fibers. Axial spin-echo sections were essential, as they showed the maturation of the callus. CONCLUSION: MR imaging may enable distinction among several complications that occur after repair of an injured digital flexor tendon.

Adolescent↗