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Biomedical subjects

M Morscher

Publications and source records attributed to M Morscher.

7 recordsLinked to original sources
PubMed1998

[Analysis of acetabulum migration in rheumatoid arthritis compared with cementless acetabular revision].

In a retrospective analysis the migration profile of 73 cementless total hip implants (Zweymüller Alloclassic) in 54 patients with rheumatoid arthritis were compared with the results of 58 implants of the same design in 50 patients undergoing cementless revision after loosening of an Endler cup. 258 conventional radiographs of the rheumatoid patients and 164 radiographs of the revision group were digitized. The migration analysis was performed using a modified Dickob's technique that allows for correction of different X-ray magnifications as well as horizontal and vertical tilting of the pelvis. The analysis of migration exceeded 2 mm in eight rheumatoid patients. In three of them clinical loosening of the acetabular cup was obvious. In the group of patients after cup revision a significantly higher amount of cranial migration was detected compared with the rheumatoid patients. This phenomenon could be explained by the destruction of the weight-bearing cranial acetabular sclerosis after reaming.

Acetabulum↗
PubMed1998

Different cup migration in rheumatoid arthritis and arthrosis: a radiographic analysis of 127 uncemented acetabular cups.

We compared retrospectively the radiographic migration profiles of 82 acetabular components in 61 patients having rheumatoid arthritis with those of 45 hips having arthrosis who underwent a standardized technique of cementless arthroplasty with the Zweymüller prosthesis (Alloclassic). We used a modification of Dickob's technique of digital migration analysis that corrects for magnification errors and horizontal pelvic tilt. The rheumatoid patients were stratified as having oligoarticular, polyarticular, or mutilating arthritis. The overall rate of acetabular loosening in rheumatoid hips after mean 88 (26-117) months was 4%. Loosening was seen only in cases with mutilating arthritis and acetabular protrusion, where the direction of cup migration was also clearly different from that detected in the other types of rheumatoid arthritis and in arthrosis. The different patterns of cup migration in cementless hip replacement for rheumatoid arthritis, depending on disease severity, is of importance when comparing outcome of total hip arthroplasty in rheumatoid patients.

Adult↗
PubMed1996

[MR imaging in gout].

The appearance of gouty tophus in magnetic resonance imaging (MRI) is characteristic. On T1- and T2-weighted SE images, the signal intensity of tophaceous lesions is similar to that of muscles. According to the histology, T2-weighted SE images demonstrate extremely hyperintense signals, which reflect the high protein content in the amorphous center of the tophus. The microscopic urate crystals deposited there have no MRI signal and are of no further diagnostic impact. Vascularized granulation tissue surrounding the tophus center enhance after intervenous application of contrast agents (Gadolinium). The inflamed tophus is associated with local edema, causing high signal intensity. MRI is superior to plain radiography for early detection of intraosseous tophi. Involvement of anatomical structures such as ligaments and tendons can be evaluated sufficiently. For peripheral joints, axial slice orientation is most helpful.

Adult↗
PubMed1996

[Infectious spondylitis in adults].

In adults, infectious spondylitis is a rare but severe disease, caused by a bacterial thrombus in tissue of reduced resistance. In conventional radiographs initial findings are a narrowing of the intervertebral space, local osteoporosis and poorly defined erosive borders of the vertebral endplates. These changes can be found at least three to six weeks after the onset of disease. However, in Szintigraphy and MRT pathologic alterations are evident after ten to twelve days. Thus, early diagnosis and treatment becomes possible. In early stages of the disease a localized lysis surrounded by a reactive sclerosis appears in predisposed areas of the vertebral body (subchondral, anterobasal, ventral, central). Apparently, a soft tissue tumor is associated. Sclerosis and reduction of the soft tissue tumor are the first signs of repair processes. After at least 12 weeks, computed tomography can reveal typical sintering of the vertebral body and occasionally the development of a bony sequester. In addition, MRT as well as CT can be helpful in the detection and localization of complications as abscesses or affection of the vertebral canal. The tuberculous spondylitis can sometimes cause difficulties in differential diagnosis. Clinical findings, affection of several vertebral bodies, large soft tissue tumors with appearance of calcification as well as not typical locations are strongly suggestive of tuberculous spondylitis, but these findings are not specific of the disease. Degenerative disorders such as erosive osteochondrosis or changing due to chronic dialysis (e.g. amyloid or crystal arthropathies) may cause even more problems in differential diagnosis. Typical for a blastomatous process is the integrity of the interverebral disc space, which is a rare finding in spondylitis.

Adult↗
PubMed1996

The effect of ultrasonographic screening on the incidence of developmental dislocation of the hip.

The effect of ultrasonographic screening and treatment with a Pavlik harness on the incidence of developmental dislocation of the hip has been studied retrospectively. Observations were made at three different consecutive periods; in the first, clinical screening was carried out, in the second, ultrasonography was added for children up to 3 months of age, and in the third ultrasonography was used within the first few days of birth. A significantly decreased dislocation rate was demonstrated in each group, suggesting that early ultrasonography was of value in the early detection of dislocation.

Austria↗
PubMed1991

[Nemaline myopathy: an unusual course].

A girl presents immediately post partum with postures and movements typical for severe muscular hypotonia (floppy infant). Her sucking and swallowing abilities are reduced. There is marked drooling. Broad alveolar ridges give the impression of a high-arched palate. Floppy infant-screening (muscle enzymes, EMG, NCV) was within normal ranges apart from a slight elevation of aldolase. Muscle biopsy performed at the age of two years revealed the diagnosis of nemaline myopathy. An onset of the disease with severe muscular hypotonia during neonatal period usually is linked with rapidly progressing, mostly lethal outcome. Our patient--in contrast--seems to suffer from a mild form.

Biopsy↗