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Jacques Malghem

Publications and source records attributed to Jacques Malghem.

16 recordsLinked to original sources
PubMed2006

Cartilage lesions of the glenohumeral joint: diagnostic effectiveness of multidetector spiral CT arthrography and comparison with arthroscopy.

This study assessed the diagnostic effectiveness of multidetector spiral CT arthrography (MDCTa) in detecting hyaline cartilage abnormalities of the shoulder joint, with correlation to arthroscopy. Shoulder MDCTa images prospectively obtained in 22 consecutive patients (mean age, 50 years; age range, 23-74 years; 12 female, 10 male) were evaluated for glenohumeral cartilage lesions. Two musculoskeletal radiologists independently analysed the cartilage surfaces of the humeral head and of the glenoid fossa in nine anatomical surface areas. Observations of MDCTa were compared to arthroscopic findings. The sensitivity and specificity of MDCTa for grade 2 (substance loss <50%) or higher and grade 3 (substance loss >or=50%) or higher cartilage lesions, the Spearman correlation coefficient between arthrographic and arthroscopic grading, and K statistics for assessing Intra and Interobserver reproducibility were determined. At MDCTa, sensitivities and specificities ranged between 80% and 94% for the detection of grade 2 or higher cartilage lesions, and between 88% and 98% for the detection of grade 3 or higher cartilage lesions. Spearman correlation coefficients between MDCTa and arthroscopic grading of articular surfaces ranged between 0.532 and 0.651. Interobserver agreement was moderate for grading all articular surfaces (kappa = 0.457), but substantial to almost perfect for detecting lesions with substance loss (kappa, 0.618-0.876). In conclusion, MDCTa is accurate for the study of cartilage surface in the entire shoulder joint. This technique may beneficially impact patient's management by means of selecting the proper treatment approach.

Adult↗
PubMed2006

Multi-detector CT imaging in the postoperative orthopedic patient with metal hardware.

Multi-detector CT imaging (MDCT) becomes routine imaging modality in the assessment of the postoperative orthopedic patients with metallic instrumentation that degrades image quality at MR imaging. This article reviews the physical basis and CT appearance of such metal-related artifacts. It also addresses the clinical value of MDCT in postoperative orthopedic patients with emphasis on fracture healing, spinal fusion or arthrodesis, and joint replacement. MDCT imaging shows limitations in the assessment of the bone marrow cavity and of the soft tissues for which MR imaging remains the imaging modality of choice despite metal-related anatomic distortions and signal alteration.

Artifacts↗
PubMed2006

Chronic osteomyelitis of clavicle as primary manifestation of SAPHO syndrome in adolescents: report of four cases and long-term evolution.

Four cases of chronic osteomyelitis of clavicle as primary manifestation of synovitis, acne, pustulosis, hyperostosis, osteomyelitis (SAPHO) are reported in adolescents. In all cases a typical radiographical evolution had been observed with progressive slow migration of sclerotic area from medial to lateral side of clavicle. Long-term evolution was alternation of remission and exacerbation but none of the patients healed.

Acquired Hyperostosis Syndrome↗
PubMed2006

Correlation between baseline femoral neck marrow status and the development of femoral head osteonecrosis in corticosteroid-treated patients: a longitudinal study by MR imaging.

OBJECTIVE: To test the hypothesis that the development of corticosteroid (CS)-associated femoral head osteonecrosis (ON) is influenced by baseline femoral neck marrow status. PATIENTS AND METHODS: The population consisted of 20 untreated patients with a newly diagnosed rheumatic disease in whom a standardized CS regimen was planned. Before CS treatment, baseline femoral neck marrow status was determined by magnetic resonance (MR) imaging on T1-weighted images (proportion of surface area of femoral neck and intertrochanteric area occupied by fatty marrow; index of marrow conversion [IMC]) and on a quantitative MR sequence (bulk T1 values of femoral head and neck). The presence of ON was assessed by coronal T1-weighted MR images of the hips at 6 and 12 months. RESULTS: None of the patients suffered from ON at baseline. Four patients (20%) developed bilateral femoral head ON at 6 months. The mean percentage of fat marrow in the femoral neck before treatment was significantly higher in ON-positive than in ON-negative patients (p=0.0025). The mean baseline femoral neck IMC value, which parallels the degree of red to yellow marrow conversion, was higher in ON-positive than in ON-negative patients (p=0.089). The mean baseline bulk T1 value of the femoral neck (but not of the femoral head), which inversely correlates with the amount of fat marrow, was significantly shorter in ON-positive than in ON-negative patients (p=0.0298). CONCLUSION: The development of CS-associated femoral head ON is correlated with a high fat content in the proximal femur before CS therapy.

Adipose Tissue↗
PubMed2005

Spontaneous rupture of the distal iliopsoas tendon: clinical and imaging findings, with anatomic correlations.

We report the clinical and imaging findings in two elderly female patients with spontaneous rupture of the distal iliopsoas tendon from the lesser trochanter of the femur. We emphasize the key contribution of magnetic resonance (MR) imaging to this diagnosis and provide an anatomic correlation. Spontaneous rupture of the distal iliopsoas tendon should be kept in mind in the differential diagnosis of acute groin pain in the elderly. MR imaging enables positive diagnosis, by showing mass effect on the anterior aspect of the hip joint, proximal muscle thickening, and abnormal signal intensity, and by demonstrating interruption of the psoas tendon, whereas the distal insertion of the lateral portion of the iliacus muscle remains muscular and is preserved.

Aged↗
PubMed2005

MR imaging of epiphyseal lesions of the knee: current concepts, challenges, and controversies.

This article focuses on spontaneous painful conditions involving the subchondral bone and marrow of mature knee epiphyses. MR imaging is the technique of choice for the work-up of these lesions and enables distinction of two main categories of lesions on the basis of T1-weighted images: avascular necrosis, and lesions presenting the bone marrow edema pattern. This latter category encompasses spontaneous osteonecrosis of the knee, and a variety of self-resolving conditions that may be differentiated by the study of the subchondral bone marrow area on T2-weighted images. Behind definite appellation of lesions, the challenge for the radiologist is to provide a prognosis: the distinction between self-resolving lesions from those that may evolve to epiphyseal collapse and joint impairment should be possible in most cases.

Bone Diseases↗
PubMed2005

Meniscal tears with fragments displaced in notch and recesses of knee: MR imaging with arthroscopic comparison.

PURPOSE: To retrospectively evaluate magnetic resonance (MR) imaging for the depiction of meniscal tears with partially detached meniscal fragments displaced in the intercondylar notch or in the meniscal recesses of the knee. MATERIALS AND METHODS: The institutional review board required neither its approval nor informed patient consent for the retrospective review of patient data; however, informed patient consent had been obtained before the MR imaging examinations were performed. The presence of meniscal tears with notch and recess fragments was determined at MR imaging and at subsequent arthroscopy in 101 consecutive knees to determine the value of MR imaging for the depiction of these lesions. Initial reports were reviewed to evaluate results of initial interpretations. MR images were retrospectively analyzed to determine the value of several MR image signs for the detection of displaced tears with notch or recess fragments. RESULTS: At arthroscopy, 37 (41%) of 91 torn menisci had partially detached fragments. Twenty-six torn menisci had notch fragments, and 14 had recess fragments; three torn menisci had one notch and one recess fragment each. At initial MR image analysis, 38 (36%) of 105 torn menisci had partially detached fragments. Twenty-eight torn menisci had notch fragments, and 13 had recess fragments; one torn meniscus had two recess fragments, and three torn menisci had one notch and one recess fragment each. At initial analysis, sensitivities and specificities were, respectively, 69% and 94% for detection of tears with notch fragments and 71% and 98% for detection of tears with recess fragments. At retrospective analysis of sagittal MR images, the presence of at least one sign indicative of meniscal tear with a notch fragment had sensitivities and specificities, respectively, of 65% and 78% for observer 1 and 77% and 73% for observer 2. The presence of at least one sign indicative of a meniscal tear with a recess fragment had sensitivities and specificities, respectively, of 64% and 77% for observer 1 and 64% and 76% for observer 2. CONCLUSION: Meniscal tears with notch and recess fragments are frequently seen at arthroscopy and can be depicted at knee MR imaging with moderate sensitivity and high specificity.

Adolescent↗
PubMed2004

High signal intensity of intervertebral calcified disks on T1-weighted MR images resulting from fat content.

OBJECTIVE: To explain a cause of high signal intensity on T1-weighted MR images in calcified intervertebral disks associated with spinal fusion. DESIGN AND PATIENTS: Magnetic resonance and radiological examinations of 13 patients were reviewed, presenting one or several intervertebral disks showing a high signal intensity on T1-weighted MR images, associated both with the presence of calcifications in the disks and with peripheral fusion of the corresponding spinal segments. Fusion was due to ligament ossifications (n=8), ankylosing spondylitis (n=4), or posterior arthrodesis (n=1). Imaging files included X-rays and T1-weighted MR images in all cases, T2-weighted MR images in 12 cases, MR images with fat signal suppression in 7 cases, and a CT scan in 1 case. Histological study of a calcified disk from an anatomical specimen of an ankylosed lumbar spine resulting from ankylosing spondylitis was examined. RESULTS: The signal intensity of the disks was similar to that of the bone marrow or of perivertebral fat both on T1-weighted MR images and on all sequences, including those with fat signal suppression. In one of these disks, a strongly negative absorption coefficient was focally measured by CT scan, suggesting a fatty content. The histological examination of the ankylosed calcified disk revealed the presence of well-differentiated bone tissue and fatty marrow within the disk. CONCLUSION: The high signal intensity of some calcified intervertebral disks on T1-weighted MR images can result from the presence of fatty marrow, probably related to a disk ossification process in ankylosed spines.

Adipose Tissue↗
PubMed2004

End plate marrow changes in the asymptomatic lumbosacral spine: frequency, distribution and correlation with age and degenerative changes.

PURPOSE: To investigate the frequency and distribution of end plate marrow signal intensity changes in an asymptomatic population and to correlate these findings with patient age and degenerative findings in the spine. MATERIALS AND METHODS: MR imaging studies of the lumbosacral (LS) spine in 59 asymptomatic subjects were retrospectively reviewed by 2 musculoskeletal radiologists to determine the presence and location of fat-like and edema-like marrow signal changes about the end plates of the L1-2 through L5-S1 levels. The presence of degenerative changes in the spine was recorded as was patient age. Descriptive statistics were utilized to determine the frequency and associations of end plate findings and degenerative changes in the spine. Interobserver variability was determined by a kappa score. Binomial probability was used to predict the prevalence of the end plate changes in a similar subject population. The Fisher exact test was performed to determine statistical significance of the relationship of end plate changes with degenerative changes in the spine, superior versus inferior location about the disc and age of the patient population. RESULTS: Focal fat-like signal intensity adjacent to the vertebral end-plate was noted in 15 out of 59 subjects by both readers, and involved 38 and 36 out of 590 end plates by readers 1 and 2, respectively. Focal edema-like signal intensity adjacent to the vertebral end plate was noted in 8 out of 59 subjects by both readers and involved 11 and 10 out of 590 end plates by readers 1 and 2, respectively. Either fat or edema signal intensity occurred most often at the anterior ( p<.05) aspects of the mid-lumbar spine and was seen in an older sub-population of the study ( p<.05). CONCLUSION: End plate marrow signal intensity changes are present in the lumbar spine of some asymptomatic subjects with a characteristic location along the spine and in vertebral end plates.

Adult↗
PubMed2004

Imaging study findings in elastofibroma dorsi.

Elastofibroma dorsi is a tumor or pseudotumor typically located under the tip of the scapula. It is far from uncommon in older individuals. The mass contains both fibrous tissue and fatty tissue. Imaging studies can provide the definite diagnosis in many cases. Computed tomography (CT) and magnetic resonance imaging (MRI) are particularly effective, as they visualize the characteristic layered pattern of fatty tissue (low-density by CT, high-signal on T1 images and intermediate signal on T2 images by MRI) and fibrous tissue (similar to muscle in terms of density by CT and signal intensity by MRI). To a lesser extent, plain radiographs and ultrasonography identify a number of suggestive features (location and layered structure). When the lesion exhibits typical imaging features and produces no symptoms, as is usually the case, further investigations are probably unnecessary.

Fibroma↗
PubMed2003

Postoperative meniscus: assessment at dual-detector row spiral CT arthrography of the knee.

PURPOSE: To assess the effectiveness of dual-detector row spiral computed tomographic (CT) arthrography of the knee in the evaluation of the postoperative meniscus for recurrent or residual meniscal tear. MATERIALS AND METHODS: Spiral CT arthrography was performed in 20 patients who presented with pain after partial meniscectomy. Findings at the initial reading of the images and at two retrospective independent readings were compared with those at second-look arthroscopy performed in all patients. At initial interpretation, conventional criteria for meniscal tear were used, including partial- or full-thickness tear of any size and meniscal separation. At retrospective interpretation, criteria for meniscal tear included large partial- and full-thickness tear and meniscal separation but not small partial-thickness tear. Sensitivity and specificity for the detection of tear of the postoperative menisci were calculated for initial and retrospective readings. RESULTS: At initial interpretation, the sensitivity and specificity for the detection of tear of the postoperative menisci were 100% and 78%, respectively. At retrospective interpretation, the sensitivity and specificity for the detection of tear of the postoperative menisci were 79% and 89% at reading 1 and 93% and 89% at reading 2, respectively. CONCLUSION: Spiral CT arthrography is valuable for the assessment of postoperative menisci, but the application of conventional definitions of meniscal tear to arthrographic findings in postoperative menisci can lead to overestimation of the clinical importance of meniscal lesions.

Adolescent↗
PubMed2003

Polygonal deformation of the dural sac in lumbar epidural lipomatosis: anatomic explanation by the presence of meningovertebral ligaments.

BACKGROUND AND PURPOSE: In patients with epidural lipomatosis, axial lumbar spine CT and MR images occasionally reveal a geometric, polygonal or stellar, shape of the dural sac. The purpose of this study was to define the anatomic structures responsible for this radiologic appearance. We hypothesized that meningovertebral ligaments could anchor the dura mater to the osteofibrous walls of the spinal canal and account for the geometric deformation of the dural sac. METHODS: The epidural spaces were examined in 15 adult cadaveric and seven aborted fetal lumbar spines. For macroscopic studies, 70 adult vertebral segments were separated and dissected by removing the extradural fat. For microscopic examination, axial histologic sections were obtained from 35 fetal and five adult undissected vertebral segments. RESULTS: Meningovertebral ligaments were observed in the median, paramedian, and lateral aspects of the anterior and posterior epidural spaces of both adult and fetal lumbar spines. These ligaments anchor the outer surface of the dura mater to the osteofibrous walls of the lumbar canal. They may form an irregular longitudinal septum partitioning the epidural space. Histologic examination demonstrated the fibroelastic composition of these ligaments and suggested their possible perivascular morphogenetic origin. CONCLUSION: The morphologic and topographic features of the meningovertebral ligaments explain the polygonal, stellar, or Y-shaped deformation of the dural sac observed on axial CT and MR images in patients with lumbar epidural lipomatosis.

Aborted Fetus↗
PubMed2002

Assessment of knee cartilage in cadavers with dual-detector spiral CT arthrography and MR imaging.

PURPOSE: To assess dual-detector spiral CT arthrography in the evaluation of the entire knee cartilage obtained from cadavers. MATERIALS AND METHODS: Two independent observers characterized articular cartilage in 12 cadaver knees in which MR imaging and dual-detector spiral CT arthrography were performed and compared their findings to those found during macroscopic assessment. The sensitivity and specificity of MR imaging and spiral CT arthrography for detecting grade 2A or higher and grade 2B or higher cartilage lesions, the Spearman correlation coefficient between arthrographic and macroscopic grading, and kappa statistics for assessing interobserver reproducibility were determined. RESULTS: At spiral CT arthrography, sensitivities and specificities ranged between 80% and 88% for the detection of grade 2A or higher cartilage lesions and ranged between 85% and 94% for the detection of grade 2B or higher cartilage lesions. At MR imaging, sensitivities and specificities ranged between 78% and 86% and between 76% and 91% for the detection of grade 2A or higher and grade 2B or higher cartilage lesions, respectively. Spearman correlation coefficients between spiral CT arthrography or MR imaging and macroscopic grading of articular surfaces were 0.797 and 0.702, respectively. CONCLUSION: Dual-detector spiral CT arthrography of the knee is a valuable method for the assessment of open cartilage lesions of the entire knee.

Aged↗
PubMed2002

Anterior cruciate ligament tears and associated meniscal lesions: assessment at dual-detector spiral CT arthrography.

PURPOSE: To assess dual-detector spiral computed tomographic (CT) arthrography of the knee in the evaluation of anterior cruciate ligament (ACL) tears and associated meniscal lesions. MATERIALS AND METHODS: ACL and meniscal abnormalities in 125 consecutive patients who underwent dual-detector spiral CT arthrography of the knee were evaluated on the basis of both initial interpretations and retrospective review of CT images and were compared with arthroscopic findings. The sensitivity and specificity of CT arthrography for the detection of ACL tears and meniscal lesions in knees with abnormal ACLs were determined. RESULTS: The sensitivities and specificities for the detection of ACL tears were 90% and 96%, respectively, at initial interpretation and 95% and 99%, respectively, at retrospective interpretation. The sensitivities and specificities for the detection of meniscal tears in knees with abnormal ACLs were 92% and 88%, respectively, at initial interpretation and 96% and 94%, respectively, at retrospective interpretation. CONCLUSION: Dual-detector spiral CT arthrography of the knee is an accurate method for detecting ACL tears and associated meniscal lesions.

Adolescent↗
PubMedDate not supplied

Uncommon magnetic resonance imaging observation of lumbar subdural hematoma with cranial origin.

A patient with a history of pain, paresthesias, and weakness in both legs is reported. Magnetic resonance imaging (MRI) of the lumbar spine demonstrated subacute subdural hematoma. Brain MRI obtained 1 day later because of progressive headache showed hemorrhagic cortical metastasis and extensive subdural hematoma. It is hypothesized that the lumbar hematoma originated from the intracranial bleeding, which was substantiated by the observation of a thin hemorrhagic collection connecting cranial and lumbar hematomas on MRI. Cranial origin should be included in the differential diagnosis of spontaneous spinal subdural hematomas.

Adult↗