Biomedical subjects
Publications and source records attributed to J O Aaron.
Magnetic resonance imaging has proven to be useful in the diagnosis of spinal cord pathology. Little has been written in the literature concerning magnetic resonance imaging of acute transverse myelitis. A case of magnetic resonance imaging of acute transverse myelitis in a young man with known systemic lupus erythematosus is presented along with a review of the radiographic approach to transverse myelitis.
Lower extremity radiculopathy usually originates from abnormal changes in the spinal canal, such as herniated nucleus pulposus, degenerative spinal stenosis, or spondylolisthesis. Multiple cases have been reported in which lower extremity neurologic symptoms were associated with a vascular abnormality in the abdomen or pelvis. Femoral and obturator neuropathies and lumbosacral radiculopathies have been described as presenting signs of complicated aortic and iliac aneurysms. We present an unusual case of a nonruptured aortoiliac aneurysm with erosion into the spinal canal and neuroforamina which presented as a lumbosacral radiculopathy secondary to direct compression of nerve roots. The unsuspected presence of a major vascular structure in an atypical location could have catastrophic consequences in the fact of instrumentation. In patients with known or suspected aortoiliac aneurysms, CT or MRI evaluation of the spine should be performed as the initial diagnostic evaluation of new radicular pain.
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Imaging of the upper extremities can be challenging and rewarding. Newer imaging modalities, including MRI and CT, have greatly expanded the ability of the radiologist to define soft-tissue abnormalities in the wrist, especially triangular fibrocartilage tears and carpal and radioulnar instability. MRI of the shoulder has almost replaced the arthrogram for diagnosing rotator cuff tears. The plain film, however, remains the mainstay of bone imaging and is the most efficacious first step in the diagnostic work-up. The radionuclide scan, although nonspecific, may provide a map for the radiologist to locate occult lesions. Dialogue between the surgeon and radiologist is essential to effective upper extremity evaluations. The radiologist can maximize his or her effectiveness by performing a brief history and physical examination of the patient.
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Fat density in the cavernous sinus on computed tomography (CT) is described in 6 out of 16 (37.5%) patients with Cushing disease. This finding may aid in making a specific diagnosis in patients with a pituitary mass. It was not seen in 30 random CT studies of the sella; however, parasellar fat was incidentally noted in one patient with acromegaly.
One hundred and two patients, who were being evaluated for carotid artery disease, were prospectively studied for complications occurring as a result of intravenous digital subtraction angiography (DSA). We recorded the type, number, and outcome of complications and reviewed the amount of contrast material used, along with the patient's age and medical history for possible correlation with increased complications. There were 55 total complications or side effects involving 37 patients. Central nervous system (CNS) complications included six major-transient and one major-permanent complication. Systemic complications included 20 major-transient and two major-permanent events. The patient's age and the amount of contrast material used did not appear to be significant risk factors. Complications in our series were significantly higher than previous DSA reports and published data on conventional angiography studies. Many of our patients were in a relatively high risk group, including 74 patients who had multisystem disease and 30 who had histories of angina.