PubMed Health⌕ Search

Biomedical subjects

Jeffrey J Peterson

Publications and source records attributed to Jeffrey J Peterson.

At least 19 recordsLinked to original sources

Benign fatty tumors: classification, clinical course, imaging appearance, and treatment.

Lipoma is the most common soft-tissue tumor, with a wide spectrum of clinical presentations and imaging appearances. Several subtypes are described, ranging from lesions entirely composed of mature adipose tissue to tumors intimately associated with nonadipose tissue, to those composed of brown fat. The imaging appearance of these fatty masses is frequently sufficiently characteristic to allow a specific diagnosis. However, in other cases, although a specific diagnosis is not achievable, a meaningful limited differential diagnosis can be established. The purpose of this manuscript is to review the spectrum of benign fatty tumors highlighting the current classification system, clinical presentation and behavior, spectrum of imaging appearances, and treatment. The imaging review emphasizes computed tomography (CT) scanning and magnetic resonance (MR) imaging, differentiating radiologic features.

Diagnosis, Differential↗

Injuries of the fingers and thumb in the athlete.

Injuries of the fingers and thumb in the athlete are common. Mallet finger, jersey finger, boutonniere deformity, Bennett and Rolando fractures, and gamekeeper's thumb are just a few of the injuries that can occur in athletes. A thorough understanding of the mechanism of injury, osseous and soft tissue abnormalities, imaging features, and treatment is important in the care of athletes. Prompt and accurate diagnosis is important and may help minimize outcomes of malunion, posttraumatic arthritis, and debility.

Athletic Injuries↗

Bone graft materials and synthetic substitutes.

Bone graft materials quickly are becoming a vital tool in reconstructive orthopedic surgery and demonstrate considerable variability in their imaging appearance. Functions of bone graft materials include promoting osseous ingrowth and bone healing, providing a structural substrate for these processes, and serving as a vehicle for direct antibiotic delivery. The three primary types of bone graft materials are allografts, autografts, and synthetic bone graft substitutes.

Biocompatible Materials↗

Postoperative infection.

Infectious disease complicating surgery involving the musculoskeletal system is one of the most important causes of postoperative morbidity and mortality. Timely detection and accurate localization of infectious processes have important clinical implications and are critical to appropriate patient management. Imaging studies can play an important role in the detection of infection and can help guide appropriate clinical management. The diagnosis of postoperative infection can be made by a variety of imaging modalities. This article reviews the various methods and modalities available for the detection of postoperative infection.

Diagnostic Imaging↗

Postoperative imaging of the shoulder.

The management of the postoperative shoulder has improved, in part because of advances in imaging techniques. As disability and pain may occur or persist after shoulder surgery, it is imperative that clinicians have a detailed anatomic delineation before further treatment. Variations in surgical techniques, surgical distortion of native anatomy, and metallic artifacts decrease the accuracy of postoperative imaging. Pitfalls may be avoided with knowledge of postoperative alterations of the rotator cuff, labrum and capsule.

Arthrography↗

Fluorescence spectroscopy of single lead sulfide quantum dots.

We report the observation of fluorescence from single PbS quantum dots (QDs) using confocal microscopy in an inert atmosphere. Single PbS QDs exhibit a narrowing of the fluorescence line width (relative to the ensemble) and fluorescence intermittency ("blinking"), consistent with the properties of other single QDs. However, single-particle line widths averaged 100 meV, indicating a significant homogeneous component to the ensemble line width. In addition, the duration of an on/off blinking event has a probability density that decays according to an inverse power law, indicating a broad distribution of kinetic rates to multiple on/off states.

Journal Article↗

MRI appearance of myocutaneous flaps commonly used in orthopedic reconstructive surgery.

OBJECTIVE: Our aim was to describe the MRI appearance of myocutaneous flaps and to determine whether postoperative radiation therapy affects imaging. MATERIALS AND METHODS: We retrospectively reviewed 30 myocutaneous flaps in 27 patients (n = 165 examinations; mean, 6.1 examinations per patient). Examinations were analyzed for flap type, location, degree of atrophy, signal intensity, and enhancement. RESULTS: Sixty-three percent (19/30) of the flaps developed high T1-weighted signal (mean, 15 months); 83% (25/30) developed high T2-weighted signal (mean, 10 months). This occurred sooner in those patients with postoperative radiation therapy (9 vs 12 months). T2-weighted signal returned to baseline in 32% (8/25) of the flaps (mean, 21 months); this occurred sooner in flaps not exposed to postoperative radiation (10 months vs 38 months). Seventy-one percent (20/28) of the flaps enhanced greater than the background musculature. Enhancement was seen more frequently in patients treated with postoperative radiation therapy than those not treated with radiation (83% vs 63%). All flaps atrophied; however, the two functional latissimus dorsi flaps atrophied less. Although increased T2-weighted signal and enhancement were seen in flaps after postoperative radiation therapy as compared with those without, this was not significant (p = 0.35 and p = 0.40, respectively). CONCLUSION: Myocutaneous flaps used in orthopedic reconstructive surgery typically show increased signal intensity on T2-weighted images and contrast enhancement initially, followed by some degree of atrophy and increased signal intensity on T1-weighted images. Postoperative radiation therapy may increase the likelihood that the flap will exhibit increased T2-weighted signal and enhancement.

Adult↗

Principles of tumor imaging.

Tumors involving the upper extremity are not uncommon. Although there is a wide variety of lesions that may occur in the hand and wrist, there are certain lesions which have a predilection for this location. This chapter will highlight the spectrum of imaging modalities available for the evaluation of upper extremity tumors, providing imaging guidelines for optimum selection of radiological examinations. It presents an overview of imaging of the hand and wrist, emphasizing the fundamental principles inherent to tumor imaging. Modalities reviewed include nuclear scintigraphy, positron emission tomography, sonography, computed tomography, arteriography, magnetic resonance imaging, and magnetic resonance angiography.

Bone Neoplasms↗

MR imaging of tumors and tumor-like lesions of the hip.

In conclusion, a wide variety of tumors and tumor-like conditions have a predilection for the hip. The imaging evaluation of these lesions begins with radiographs. Radiographs can depict the extent of disease; any characteristic calcifications; and osseous changes, such as remodeling,periosteal reaction, or destruction. MR imaging has emerged as the preferred imaging modality of choice for evaluating osseous and soft tissue masses of the hip by providing information for diagnosis and staging. The MR imaging signal characteristics and enhancement patterns of malignant and benign hip tumors permit specific diagnoses in some cases. Synovial-based tumor-like processes of the hip can be characterized by MR signal characteristics, such as the hemosiderin within PVNS or the cartilage within synovial chondromatosis. Finally, MR imaging can serve to exclude underlying osseous or soft tissue tumors when radiographs display aggressive features of tumor-like processes.

Bone Neoplasms↗

Principles of bone and soft tissue imaging.

Tumors involving the upper extremity are common. Although there are a wide variety of lesions that may occur in the hand and wrist, certain lesions have a predilection for this location. This article highlights the spectrum of imaging modalities available for the evaluation of upper extremity tumors, providing guidelines for optimum selection of radiologic examinations while emphasizing the fundamental principles inherent to tumor imaging.

Bone Neoplasms↗

Palmar fasciitis and arthritis syndrome associated with metastatic ovarian carcinoma: a report of four cases.

Palmar fasciitis and polyarthritis syndrome (PFPAS) is an uncommon paraneoplastic syndrome associated with several malignant neoplasms. We identified 4 patients with PFPAS and ovarian carcinoma. Palmar fasciitis, at times severe, and inflammatory polyarthritis dominated the clinical presentation in all 4 patients. In 3 of our 4 patients the presentation of palmar fasciitis and inflammatory polyarthritis preceded the diagnosis of ovarian carcinoma. Magnetic resonance scanning and biopsy examination of palmar nodules in one patient revealed findings of inflammation and fibrosis. A literature review found 10 other cases of PFPAS associated with ovarian carcinoma. Improvement in palmar fasciitis and inflammatory arthritis often occurs after successful treatment of the ovarian carcinoma. Digital contractures, however, can persist. We recommend a gynecologic examination in any woman presenting with the sudden onset of unexplained hand pain, palmar inflammatory fasciitis, palmar fibromatosis, and digital contractures.

Aged↗

Cysts, geodes, and erosions.

Subchondral cystic lesions are common features that are associated with many arthropathies and synovial-based processes. Although not comprehensive in scope, this article correlated the pathophysiology and imaging features of several of these disorders to better understand the associated subchondral lucencies. The imaging features of these subchondral cystic lesions were described in each process, and, in some cases, demonstrated overlapping features. By becoming familiar with the disease processes and recognizing the imaging appearances and associated clinical findings, the radiologist will be better able to differentiate these benign entities from more aggressive processes, such as tumor. Subchondral cystic lesions are common features that are associated with many arthropathies and synovial-based processes. Although not comprehensive in scope, this article correlated the pathophysiology and imaging features of several of these disorders to better understand the associated subchondral lucencies. The imaging features of these subchondral cystic lesions were described in each process, and, in some cases, demonstrated overlapping features. By becoming familiar with the disease processes and recognizing the imaging appearances and associated clinical findings, the radiologist will be better able to differentiate these benign entities from more aggressive processes, such as tumor.

Adult↗

Imaging characteristics of cherubism.

OBJECTIVE: We sought to describe the radiographic and imaging features of cherubism. CONCLUSION: Cherubism is a rare osseous disorder of children and adolescents. Although the radiologic characteristics of cherubism are not pathognomonic, the diagnosis is strongly suggested by bilateral relatively symmetric jaw involvement that is limited to the maxilla and mandible. Imaging typically shows expansile remodeling of the involved bones, thinning of the cortexes, and multilocular radiolucencies with a coarse trabecular pattern.

Adolescent↗

Malignant fatty tumors: classification, clinical course, imaging appearance and treatment.

Liposarcoma is a relatively common soft tissue malignancy with a wide spectrum of clinical presentations and imaging appearances. Several subtypes are described, ranging from lesions nearly entirely composed of mature adipose tissue, to tumors with very sparse adipose elements. The imaging appearance of these fatty masses is frequently sufficiently characteristic to allow a specific diagnosis, while in other cases, although a specific diagnosis is not achievable, a meaningful limited differential diagnosis can be established. The purpose of this paper is to review the spectrum of malignant fatty tumors, highlighting the current classification system, clinical presentation and behavior, treatment and spectrum of imaging appearances. The imaging review will emphasize CT scanning and MR imaging, and will stress differentiating radiologic features.

Humans↗

Postgraduate musculoskeletal fellowship training in the United States: current trends and future direction.

OBJECTIVE: To document current postgraduate musculoskeletal training program (accredited and unaccredited) curricula and approaches to education. DESIGN AND PATIENTS: Questionnaires were sent to all musculoskeletal training programs. Responses regarding radiology residency and fellowship program sizes, types of imaging and invasive procedures included, and other program parameters were solicited. Features of accredited and unaccredited programs were compared. Teaching approaches, including the use of web-based or distance learning were evaluated. RESULTS: Twenty-nine (73%) of 40 musculoskeletal programs responded to the questionnaire. Twenty-eight percent of programs were accredited and 72% unaccredited. Radiology residencies were also present at all responding institutions (the majority had a class size of 4-8/year). Residency programs in related specialties included pathology 96%, orthopedics and rheumatology 90%, oncology 83% and pain management 69%. The majority (93-100%) provided training in radiography, MRI and CT. Spine MRI was included in 69% of programs, ultrasonography in 62% and positron emission tomography in 24%. Arthrography and diagnostic and therapeutic injections (100%) were included in all programs. Other invasive procedures, including spine and radiofrequency ablation, were offered less frequently. Teaching approaches included conferences (100%), journal clubs (62%), multidisciplinary conferences (45-90%), web-based learning (30%) and distance learning (7%). Forty-one percent of programs offered off-site rotations. CONCLUSIONS: The majority of musculoskeletal training programs prepared trainees for private or academic practice. There are inconsistencies that could be improved to better prepare trainees for careers in musculoskeletal imaging.

Accreditation↗

Diagnosis of occult bone metastases: positron emission tomography.

The current standard of practice for the detection of osseous metastatic disease is the conventional bone scan of the entire body using technetium-99m methylene diphosphonate (Tc-99m MDP). Although Tc-99m MDP scintigraphy is sensitive for the detection of advanced skeletal metastatic lesions, early involvement may be missed because this technique relies on the identification of the osteoblastic reaction of the involved bone rather than the detection the tumor itself. Positron emission tomography (PET) has proven to be the gold standard in metabolic imaging. Fluorine -18 deoxyglucose (FDG) provides a means of quantitating the glucose metabolism, with the amount of tracer accumulation reflecting the glucose metabolism: high-grade malignancies tend to have higher rates of glycolysis than do low-grade malignancies and benign lesions; therefore, high-grade malignancies have greater uptake of FDG than that of low-grade or benign lesions. Positron emission tomography has been shown to be superior to scintigraphy in the detection of metastases because it detects the presence of tumor directly by metabolic activity, rather than indirectly by showing tumor involvement due to increased bone mineral turnover. This has allowed the detection of metastatic foci earlier with PET than with bone scintigraphy. Although the spectrum of PET applications is unknown, it now is approved for the diagnosis, staging and restaging of many common malignancies and has shown efficacy for the detection of osseous metastasis from several malignancies including lung carcinoma, breast carcinoma, and lymphoma.

Bone Neoplasms↗

Imaging characteristics of cystic adventitial disease of the peripheral arteries: presentation as soft-tissue masses.

OBJECTIVE: Our purpose was to identify the characteristic imaging features of cystic adventitial disease of the peripheral arteries. CONCLUSION: Patients with cystic adventitial disease of the peripheral arteries often present for evaluation of soft-tissue masses involving the extremities. Noninvasive imaging reveals a characteristic appearance allowing confident diagnosis.

Adult↗