Biomedical subjects
Publications and source records attributed to J M Dumas.
An unusual patient with pyogenic spondylodiscitis and preservation of the disc space anteriorly is reported. The diagnosis of pyogenic spondylodiscitis may be difficult when there is underlying spinal disease. We emphasize the need for early systematic imaging studies and intervention in such patients, including careful evaluation of vertebral endplates on plain films, early use of radionuclide studies, and prompt needle aspiration.
In a prospective study conducted over a 12-month period, 30 patients underwent double-contrast arthrography of the knee followed by arthroscopic study. An 80% correlation rate was found between results. Arthrography had a higher rate of accuracy (93%) than arthroscopy (84%) and had a 7% false-positive and 0% false-negative rate. A commonly overlooked arthrographic sign--the triple-S or stuck sail sign--was 91% accurate in the prediction of meniscal tears. The complementary nature of the two examinations is discussed.
The specificity of the intraarticular facet block as a diagnostic test for facet joint disease is currently unknown. Capsular rupture with epidural and periarticular diffusion is probably responsible for many false positive findings. We found a comparatively low success rate of the procedure in 25 patients in whom maximal volumes were strictly controlled to avoid extravasation.
Our experience, in a group of 25 patients with chronic low back pain, shows that nuclear imaging of the spine with 99mTc-methylene diphosphonate is of no benefit in predicting the sites at which intraarticular facet blocks may be successful.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Osteoid osteoma in cancellous bone lacks the usual osteoblastic reaction that accompanies the classical cortical or juxtacortical osteoid osteoma. Familiarity with this type of presentation should instigate the appropriate diagnostic steps, including nuclear medicine studies using pin-hole collimation, and thin tomographic cuts.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.