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M N Pathria

Publications and source records attributed to M N Pathria.

At least 19 recordsLinked to original sources
PubMed1992

Case report 736: Retained surgical sponge (gossypiboma) with a foreign body reaction and remote and organizing hematoma.

This 50-year-old woman presented with progressive pain in the left thigh. Radiographs showed a 9 x 6 cm soft-tissue mass located at the lateral border of the left femur. Magnetic resonance (MR) examination showed an eccentric, nonhomogeneous, soft-tissue mass abutting the femur. The preoperative differential diagnosis was schwannoma, low-grade neurogenic tumor, large periosteal ganglion, or fibroma. At operation, the cut surface of the specimen had features of an organizing hematoma with recent remote hemorrhage and areas of fibrosis. Histopathological examination confirmed the presence of polarizable foreign body material in a background of foreign body reaction. The specimen represented a retained surgical sponge which had been present since the patient's surgery for a comminuted fracture 35 years earlier. Gossypiboma, or cotton balloma, is a term used to describe a mass within the body composed of cotton matrix. Radiopaque markers are now present on surgical sponges, and their appearances have been well documented. The gossypiboma, however, may still present a diagnostic problem if the marker is distorted by folding, twisting, or disintegration over a period of time. Without the radiopaque markers, retained sponges are difficult, if not impossible, to diagnose, as was the situation in this case.

Bone Resorption↗
PubMed1992

Meniscal changes in the elderly: correlation of MR imaging and histologic findings.

In elderly patients, degenerative changes of the meniscus are common and may mimic a tear. The magnetic resonance (MR) image findings of 179 meniscal sections in 20 cadaver knees were correlated with the histologic and gross pathologic findings. The sensitivity of standard T1-weighted spin-echo images and their corresponding meniscal windows in depicting meniscal tears was 80.6%, specificity was 72.4%, and accuracy was 76.7%. These results are not as good as results reported previously. A major difficulty is the occurrence of grade 3 meniscal signal intensity and diffuse intrameniscal signal intensity in torn and intact menisci. MR imaging in elderly patients, however, is still useful in the diagnosis of meniscal abnormalities. Normal low signal intensity depicted within a meniscus at MR imaging and changes in grades 1 and 2 intrameniscal signal intensity are reliable signs of an intact meniscal surface. Grade 3 and diffuse meniscal signal intensities do not allow a specific diagnosis; menisci with these characteristics should be described as degenerated with a high probability of a tear.

Age Factors↗
PubMed1992

Width of the articular cartilage of the hip: quantification by using fat-suppression spin-echo MR imaging in cadavers.

OBJECTIVE: Use of MR imaging to measure the width of the articular cartilage has not been thoroughly investigated. The value of a selective fat-suppression spin-echo sequence in the quantitative assessment of articular cartilage of the hip was studied in cadavers. MATERIALS AND METHODS: Sagittal and coronal images were acquired in 10 cadaveric hips (age range at time of death, 62-81 years). On the coronal and sagittal MR images that were closest to the center of the femoral head, marks were placed every 30 degrees, with the midpoint of the femoral head used as a reference. Cartilage thickness was measured in 123 resulting locations. Sixty-three positions included both femoral and acetabular cartilages, and 60 positions included femoral cartilage without an acetabular counterpart. The findings were compared with corresponding anatomic sections. RESULTS: For the 60 locations containing only femoral cartilage, significant correlation between MR and anatomic sections was found (Pearson correlation coefficient = .34, p = .0089). Of the 63 locations containing both femoral and acetabular cartilages, the two cartilage layers could be differentiated on the MR images in 50 locations. In these 50, the MR and anatomic measurements of the femoral cartilage correlated significant (r = .58, p less than or equal to .0001). Measurements of the acetabular cartilage in these 50 locations yielded no significant correlation (r = .25, p = .08). When the entire cartilage (femoral plus acetabular) was measured in all 63 locations, the correlation between MR and anatomic measurements was .29 (p = .02). The correlation coefficients obtained in this investigation indicate considerable scattering of the data. CONCLUSION: Our results show that measurements of articular cartilage thickness of the hip on fat-suppression spin-echo MR images are not sufficiently accurate to be of clinical value.

Aged↗
PubMed1992

Magnetic resonance imaging of bone marrow.

The development of MR imaging has been a great advance in the imaging of bone marrow disorders. MR imaging exhibits excellent soft-tissue contrast and therefore has a greater sensitivity for marrow disease than did previously available modalities. This article reviews the normal morphology and appearance of bone marrow, describes the MR appearance of normal bone marrow, and discusses the MR findings associated with various marrow disorders.

Bone Marrow↗
PubMed1992

Intraosseous lipoma. A clinicopathologic study of four cases.

We describe the clinical, radiologic, and pathologic features of four cases of intraosseous lipoma. The patients ranged in age from 37 to 48 years, and three of them were men. Three patients presented with pain; in the fourth patient, the lesion was discovered incidentally. The involved bones were distal radius (in one patient), humerus (in two patients), and calcaneus (in one patient). In all cases, plain films revealed well-defined lytic lesions. Computed tomographic scan in all cases, and magnetic resonance imaging in one case, showed the lesions to have attenuation values and signal intensity identical to adipose tissue. Histopathologic examination of the curetted lesions revealed mature adipose tissue devoid of hematopoietic elements. Dystrophic calcification was present in two cases, necrosis of fat in one case, and extensive recent and remote hemorrhage in another case. As the roentgenographic differential diagnosis can be extensive, familiarity with this entity is important. These cases emphasize the characteristics of intraosseous lipoma, and they highlight the need for clinicopathologic and roentgenographic correlations.

Adult↗
PubMed1992

Musculoskeletal disorders: improving diagnostic accuracy with MRI.

Magnetic resonance imaging (MRI) is gaining wider acceptance for the diagnosis of musculoskeletal disorders in the elderly, including internal joint derangements, neoplasms, and osteonecrosis. For internal derangement of large joints such as the knee, MRI is a noninvasive alternative to arthrography and offers excellent visualization. It plays an important role in the diagnosis and staging of primary and secondary neoplasms, including both osseous and soft tissue sarcomas. MRI is also indicated for diagnosing osteonecrosis that cannot be detected using other imaging modalities.

Bone Neoplasms↗
PubMed1991

Spinal trauma.

Spinal trauma is classified according to the mechanism of injury and the presence or absence of stability. A variety of imaging modalities, including radiography, conventional tomography, computed tomography, and magnetic resonance imaging are available for assessment of the injured spine. This article discusses the role of these various methods in evaluating osseous, ligamentous, and neural damage. Common injuries are described at the upper and lower cervical, thoracic, and thoracolumbar regions.

Atlanto-Occipital Joint↗
PubMed1990

Early-onset primary osteoarthritis and mild chondrodysplasia. Radiographic and pathologic studies with an analysis of cartilage proteoglycans.

Three generations of a nonconsanguineous family with premature onset of primary (idiopathic) osteoarthritis (OA) were studied for clues to the etiopathogenesis of their disorder. Articular symptoms began in their second and third decades of life and involved multiple joints, both typical and atypical for primary OA. Radiographs of the majority of involved peripheral joints showed abnormalities typical of primary OA. Evidence of chondrodysplasia was found in the spines. Pathologic examination of femoral heads obtained at total hip arthroplasty from 3 affected family members showed moderate to severe OA. Articular cartilage proteoglycans from these specimens were evaluated for aggregatability with hyaluronic acid, levels of chondroitin sulfate and keratan sulfate, and core protein structure. The results from each patient's specimen differed from the results of the other specimens. We conclude that this family's disorder, primary OA associated with a mild chondrodysplasia, was a late-onset overlap form of an epiphyseal dysplasia, that a defect common to hyaline articular and physeal cartilage was primary, and that a single structural proteoglycan abnormality was not likely to be the underlying cause.

Cartilage↗
PubMed1989

Magnetic resonance imaging of posttraumatic spinal ligament injury.

We evaluated the role of magnetic resonance imaging (MRI) in the detection of ligament injury in 37 patients after acute traumatic spinal injury. Thirty-five patients had fractures, one had neurologic deficit with normal x-rays, and one had evidence of cervical instability on flexion/extension plain films. MRI examinations were performed acutely (average 10.8 d after injury) using T1- and T2-weighted multiplanar imaging. Two radiologists blindly evaluated all MRI examinations. Subsequently, 35 plain films, 16 tomograms, and 30 computed tomography (CT) scans were also evaluated. Nineteen patients were considered to have torn posterior ligaments on the basis of their clinical, radiographic and surgical findings. MRI detected ligament damage in 17. All patients considered to have intact posterior ligament complexes clinically and radiographically had no evidence of ligament damage on MRI. T2-weighted sequences were essential for detection of ligament injury. We conclude that MRI is an accurate method for assessment of the integrity of spinal ligaments after acute trauma.

Adolescent↗
PubMed1989

Diagnostic imaging of craniofacial fractures.

This article reviews common fractures involving the facial skeleton and describes their typical radiographic appearance. The roles of conventional radiography, supplemental projections, conventional tomography, and computed tomography are discussed. Nasofrontal, orbital, zygomatic, maxillary, and mandibular fractures are described and illustrated.

Facial Bones↗
PubMed1988

Traction osteophytes of the lumbar spine: radiographic-pathologic correlation.

Previous reports have emphasized two types of osteophytes on the anterior aspects of the lumbar vertebral bodies: the common claw osteophyte and the less common but more significant traction osteophyte, which is indicative of spinal instability. To delineate the importance of the traction osteophyte, a radiographic-pathologic study was conducted. The results indicate that claw osteophytes are more frequent than traction osteophytes, that both may coexist in a single vertebral body, and that, in most cases, these osteophytes appear to represent different stages of the same pathologic process.

Humans↗
PubMed1988

Infection versus tumor in the spine: criteria for distinction with CT.

To develop criteria to distinguish among pyogenic infection, nonpyogenic infection, and neoplastic processes in the spine by means of computed tomography (CT), the authors retrospectively analyzed 17 cases of pyogenic infection (20 sites), 40 cases of neoplastic disease (56 sites), and five cases of granulomatous infection (eight sites). Reliable criteria for pyogenic infection were complete prevertebral soft-tissue involvement, diffuse osteolytic destruction, gas within both bone and soft tissue, and a process centering on an intervertebral disk. Neoplastic disease was characterized by posterior element involvement, partial or absent prevertebral soft-tissue swelling, and osteoblastic alterations. In a limited number of cases, nonpyogenic infection was characterized by focal lytic bone involvement and marginal sclerosis. Blinded testing of these criteria indicated potential for improved diagnostic accuracy in clinical practice.

Humans↗
PubMed1988

Patterns of femoral head migration in osteoarthritis of the hip: a reappraisal with CT and pathologic correlation.

Although medial, superior, and axial patterns of migration of the femoral head in osteoarthritis of the hip have been well described, it is not clear what anatomic and biomechanical factors determine the direction of migration. The authors studied 22 patients with bilateral (11 patients) or unilateral (11 patients) osteoarthritis by means of conventional radiography and computed tomography (CT) to define any relationships between migration in the coronal plane and that in the transverse plane and to determine whether femoral anteversion, acetabular anteversion, femoral neck-shaft angle, or acetabular inclination were related to particular migration patterns. Anterior migration was evident in 14 of the 19 hips with a superior migration pattern, whereas posterior migration was present in five of the seven hips with a medial migration pattern. In the remainder of cases, no migration in the transverse plane was present. Femoral anteversion as determined with CT, femoral neck-shaft angle, angle of acetabular inclination, and acetabular anteversion angle in this relatively small sample were all found to be within normal limits and appeared to have no influence on the occurrence of a specific pattern of femoral head migration.

Aged↗
PubMed1988

Rheumatoid arthritis: similarity of radiographic abnormalities in men and women.

To test the hypothesis that there are significant differences in the radiographic appearance of rheumatoid arthritis between men and women, the authors blindly evaluated bilateral hand and wrist radiographs in 32 men with definite rheumatoid arthritis and 32 age- and disease duration-matched women (mean age, 56.4 years; mean disease duration, 10.5 years). Radiographically, disease distribution and severity were identical in these matched groups. Superimposed osteoarthritis was frequent in both groups and related to age. Ill-defined bone proliferation was present in 13 of 64 hands in both groups. Cystic changes and well-defined erosions were present in 12 of 64 male hands and six of 64 female hands, but this difference was not statistically significant. In women, presence of cysts and bone proliferation was related to disease duration, whereas men exhibited these atypical features independent of disease duration. There was no statistically significant difference in the frequencies of typical and atypical features of rheumatoid arthritis between the two sexes, and the authors postulate that previously reported differences relate to patient selection and lack of adequate matching.

Arthritis, Rheumatoid↗
PubMed1988

Isolated dislocation of the tarsal navicular: a case report.

Isolated dislocation of the tarsal navicular is a rare injury that is not mentioned in standard orthopedic textbooks and described only once in the English literature. Because of the rarity of this condition, the best means of treatment has not been established. A patient with this unusual dislocation was recently diagnosed and treated. Open reduction was eventually required, which was followed by the development of ischemic necrosis of the navicular.

Adult↗