PubMed Health⌕ Search

Biomedical subjects

K P Schellhas

Publications and source records attributed to K P Schellhas.

47 records · Page 3Linked to original sources
PubMed1987

Temporomandibular joint imaging. Practical application of available technology.

Clinical afflictions of the temporomandibular joint (TMJ) are common, but TMJ afflictions remain one of the most poorly understood and controversial areas of clinical practice. Theories of TMJ pathophysiology, diagnosis, treatment, and patient disposition abound. Many afflicted patients have undergone expensive, protracted, and fruitless therapeutic endeavors, many of which are without scientific basis, causing many health insurers to exclude evaluation and treatment of TMJ disorders from coverage. Medical imaging has a central role in establishing a correct diagnosis. Available imaging procedures include roentgenography, arthrography, videofluoroscopy, magnetic resonance imaging, and computed tomography.

Arthrography↗
PubMed1985

Outpatient DSA in cerebrovascular disease using transbrachial arch injections.

Experience with intravenous digital subtraction angiography (DSA) has proven disappointing in the outpatient evaluation of cerebrovascular disease. Vessel superimposition, patient motion, and poor vascular opacification all prevent definitive studies in a significant percentage of patients. These problems were addressed by turning to an intraarterial outpatient DSA technique composed of several elements: (1) right transbrachial catheterization of the ascending aorta using a thin, multiple side-hole, straight catheter; (2) arch injections of relatively small volumes of contrast material; (3) pulsed digital image acquisition with multiple projections; and (4) a limited period of postprocedure observation. A total of 43 outpatients and 16 inpatients was studied in this manner with only two complications, both local. Images of definitive quality and completeness were obtained in 82%-98% of cases, and included the major intracranial as well as the extracranial vessels and their circulatory dynamics. Because the iodine load per injection was relatively low, up to 10 angiograms per case were available for delineating superimposed anatomy and motion degradation. Variations in cardiac output had little impact on image quality, and the average case required less than 60% of the contrast load routinely used for intravenous DSA. The transbrachial approach proved as safe and convenient as intravenous DSA but was more thorough and dependable.

Adult↗
PubMed1980

Vertebrobasilar injuries following cervical manipulation.

Four cases of brainstem stroke syndromes followed mechanical cervical manipulation; vascular injury was confirmed angiographically. A comprehensive review of the literature on vertebrobasilar injuries disclosed the various mechanisms of injury and pathogenesis of subsequent vascular complications following cervical manipulation. Emphasis is given to the potentially devastating neurological complications, particularly in view of the increasing utilization of chiropractic therapy.

Adult↗
PubMedDate not supplied

Internal derangement of the temporomandibular joint: radiologic staging with clinical, surgical, and pathologic correlation.

The radiologic findings from 60 patients with 86 internally deranged temporomandibular joints (TMJ) upon whom sequential imaging procedures had been performed over a period of two months to ten years were analyzed and correlated with clinical, surgical (72 joints), and pathological observations. Internal derangement of the TMJ disc (meniscus) and osseous structures was found to be an irreversible and progressive disorder with characteristic stages. Internal derangements of the TMJ were divided into early (stage one), intermediate (stages two and three) and late stage (stages four and five) categories based upon radiologic findings obtained with radiography, lateral TMJ tomography and either two compartment arthrography or high field, surface coil MR. After sequential imaging studies, each patient and 72 deranged joints underwent surgical joint exploration and meniscectomy because of progressive joint disease and clinical disability. Surgically removed tissues underwent routine histological evaluation. Surgical and pathologic observations included disc displacement, deformity, hyalination, myxomatous degeneration, perforation of the disc attachments, capsular adhesions, synovitis and mandibular condyle lesions including osteochondritis dissecans (OCD), avascular necrosis (AVN), osseous remodeling and degenerative arthritis. There was excellent correlation between imaging studies and surgical observations. Internal derangement of the TMJ is an irreversible, generally progressive disorder which may be staged and followed with radiography, tomography and either two-compartment arthrography or high field, surface coil MR.

Adolescent↗