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Biomedical subjects

M I Burnstein

Publications and source records attributed to M I Burnstein.

10 recordsLinked to original sources
PubMed1990

Value of MR imaging in staging osteochondral lesions of the talus (osteochondritis dissecans): results in 14 patients.

Osteochondral lesions (osteochondritis dissecans) of the talus are common articular lesions that are usually traumatic in origin. Clinical management of these lesions is based on whether or not the fragments are attached. We studied the value of MR imaging in determining the stability of the osteochondral fragments. In 13 of 14 patients who had had correlative surgery, we accurately predicted the presence and extent of attachment of the fragment to the talus by performing preoperative MR imaging. The other patient had a false-positive diagnosis of a chondral fragment. All seven partially attached fragments had an irregular high-signal zone on T2-weighted images at the fragment/talar interface. The four unattached fragments had a complete ring of fluid surrounding the lesion. On the basis of these findings, we think MR of the ankle can be used to assess accurately talar osteochondral lesion stability and aid in clinical decision making.

Adolescent↗
PubMed1989

Longitudinal tibial epiphyseal bracket in Nievergelt syndrome.

A patient is described with lower extremity mesomelic dwarfism associated with bilateral congenital elbow, hip, and knee dislocations. Rhomboid-shaped tibiae and delayed ossification of the primary fibular ossification centers were demonstrated at birth. Plain films and magnetic resonance imaging revealed that the tibial deformities were due to the presence of longitudinal epiphyseal brackets. These brackets were observed at surgery and confirmed histologically. Recognition of the longitudinal epiphyseal bracket and its relationship to the tibial deformities seen in this patient with Nievergelt syndrome is important for planning surgical treatment.

Child, Preschool↗
PubMed1989

The enthesopathic changes of hypophosphatemic osteomalacia in adults: radiologic findings.

The enthesopathy (bone proliferation at sites of ligament, tendon, joint capsule, and interosseous membrane attachment) that may be present in adults who have longstanding hypophosphatemic osteomalacia, the most common type of osteomalacia, has received little attention in the radiologic literature. These proliferative enthetic changes may be associated with various musculoskeletal symptoms. The spectrum of proliferative enthesopathic changes, involving the axial and appendicular skeleton, is described in six patients 18-63 years old. Proliferative changes at the attachment of the annulus fibrosus were present in six of six patients and ranged in extent from tiny hyperostoses at a few levels to thin marginal symmetric syndesmophytes involving the entire lumbosacral spine and mimicking spondylitis. Thoracic spinal syndesmophytes were present in four patients and cervical hyperostoses of various magnitudes were present in three patients. Changes in the sacroiliac joints were present in four of six patients and varied from mild widening to symmetric intraarticular and anterior paraarticular bony bridging. Proliferative enthesopathy involving the pelvis and proximal femora was present in six of six patients. Appendicular changes included accessory ossicles within the wrist and hands and bony proliferation of the distal radius and metacarpal heads. These were noted in four patients. Ossification of the interosseous membrane of the forearms or the lower extremities was present in six patients and paraarticular bony proliferation about the elbows was noted in four patients. It is apparent that the severity of the enthesopathy that occurs may vary, and that hypophosphatemic osteomalacia should be recognized as a cause of enthesopathy even if other radiographic findings of osteomalacia may not be present on available radiographs.

Adolescent↗
PubMed1985

Metabolic bone disease in pseudohypoparathyroidism: radiologic features.

We reviewed the radiographs of six patients with pseudohypoparathyroidism (PHP) manifested by variable renal and skeletal resistance to parathyroid hormone (PTH). Features compatible with hyperparathyroid bone disease, osteomalacia, and rickets were observed. Skeletal changes of hyperparathyroidism included (a) subperiosteal bone resorption, (b) radiolucent lesions, caused by either brown tumors or bone cysts, (c) slipped capital femoral epiphyses, (d) focal areas of osteosclerosis, (e) periosteal neostosis, and (f) osteopenia with reduced cortical and trabecular bone volume. Histologic bone features were compatible with osteitis fibrosa in all patients, which suggests that the skeleton responded to the bone-remodeling effects of PTH despite hormonal resistance at other target sites. Skeletal changes of rickets included metaphyseal irregularities, cupping, and widening of the growth plates. Osteomalacia was indicated by Looser zones in one patient and confirmed by histologic evidence in three patients.

Adolescent↗