Biomedical subjects

M Starok

Publications and source records attributed to M Starok.

5 recordsLinked to original sources

PubMed2000

Skeletal muscle infarction in diabetes mellitus.

OBJECTIVE: To analyze the risk factors, clinical features, and methods of diagnosis of diabetic muscle infarction (DMI). METHODS: Three patients with diabetes mellitus (DM) and skeletal muscle infarction were studied, and 49 additional cases reported in the English literature (Medline database search) were reviewed. RESULTS: Review of all 52 patients with DMI revealed a number of typical features: equal sex distribution; mean age 41.5 years (range 19-81 yrs); a number of risk factors [long duration of DM (mean 15.2 yrs), poor control and microvascular diabetic complications (neuropathy, retinopathy, nephropathy) (94%), and insulin dependent type I DM (77%)]; a characteristic clinical presentation with painful diffuse muscle swelling (100%); and sometimes a muscle mass (44%), predilection for quadriceps (62%), hip adductors (13%) and leg muscles (13%), elevated serum creatine phosphokinase (47%), abnormal sonograms (81%), abnormal magnetic resonance image (MRI) findings (100%), typical histopathologic findings of a muscle infarct (100%) (ultrastructural evidence of microangiography in one patient); and a tendency toward spontaneous resolution although recurrences are common (51%). CONCLUSION: Skeletal muscle infarction is a rare complication of long standing, poorly controlled DM associated with multiple end organ microvascular sequelae. Increased clinical awareness is important for early recognition, particularly in a diabetic patient presenting with a painful thigh or leg swelling. MR imaging is the diagnostic study of choice, and in the appropriate clinical setting, may obviate the need for a muscle biopsy.

Adult↗

PubMed1998

Normal and abnormal medial meniscocapsular structures: MR imaging and sonography in cadavers.

OBJECTIVE: The purpose of this study was to develop imaging criteria for the diagnosis of meniscocapsular separation by correlating findings on MR imaging, MR arthrography, and sonography of normal and abnormal medial meniscocapsular structures with corresponding anatomic sections in cadavers. MATERIALS AND METHODS: Eight cadaveric knee specimens were examined with MR imaging, MR arthrography, and sonography before arthroscopy. In six specimens the following lesions were arthroscopically created: meniscocapsular separation (n = 3), medial collateral ligament (MCL) tear (n = 3), tear of the meniscofemoral extension of the deep MCL (n = 2), and coronary ligament tear (n = 2). After arthroscopy, all imaging studies were repeated. The specimens were sectioned for correlation with imaging studies. RESULTS: MR findings that correlated with meniscocapsular separation were interposition of fluid between the meniscus and the MCL, irregular meniscal outline, and increased distance between the meniscus and the MCL. On MR arthrography meniscocapsular separation correlated with interposition of contrast medium between the meniscus and the MCL. Tears of the meniscofemoral extension of the deep MCL were best shown on MR arthrography. Sonography showed deep and superficial MCL lesions but did not show meniscocapsular separations. CONCLUSION: In arthroscopically created meniscocapsular separation, the lesion is suggested on MR images when fluid is interposed between the meniscus and the MCL, when the meniscal outline is irregular, or when the distance between the meniscus and the MCL is increased. On MR arthrograms, a meniscocapsular separation is suggested when contrast medium is interposed between the meniscus and the MCL. Sonography does not allow accurate diagnosis of meniscocapsular separation.

Cadaver↗

PubMed1997

Pseudarthrosis: US evaluation after posterolateral spinal fusion: work in progress.

PURPOSE: To determine the value of ultrasound (US) in evaluation of pseudarthrosis after posterolateral spinal fusion. MATERIALS AND METHODS: In 10 patients who had undergone bilateral posterolateral thoracic or lumbar fusion with autologous bone graft and instrumentation more than 9 months previously, US was performed within 1 week before second-look surgery. A total of 20 sites each side of midline were evaluated for the presence of bone graft, solid fusion, clefts, fluid collections, and hardware visibility. US findings were compared with those at surgery. In three patients, standard radiographs were reviewed before US; blinded US evaluation was performed in the remaining seven patients. RESULTS: At US, all 10 sites of pseudarthrosis seen at surgery were identified correctly. Of 10 sites with solid fusion at surgery, US depicted six. At four sites (two patients), fusion was mistaken for or obscured by hardware. Overall, sensitivity was 100%, specificity was 60%, and accuracy was 80%. CONCLUSION: US can play a valuable role in the detection of posterolateral bone graft pseudarthrosis, especially when hardware is present.

Adult↗

PubMed1997

Normal patellar retinaculum: MR and sonographic imaging with cadaveric correlation.

OBJECTIVE: The purpose of our study was to define retinacular anatomy with MR imaging and sonography. MATERIALS AND METHODS: Five cadaveric knee specimens underwent sonography and MR imaging using the following sequences: T1-weighted axial, sagittal, coronal, and five oblique planes and axial three-dimensional gradient-echo imaging. Three knees were injected with gelatin gadolinium solution before imaging. All five specimens were sectioned. Correlation was made between findings derived from MR imaging, sonography, and cadaveric sections. RESULTS: T1-weighted axial images without intraarticular gadolinium were most useful for revealing the superficial layer and deep ligaments of the retinacula; however, the oblique sagittal and oblique coronal planes showed the deep ligaments more clearly in their craniocaudal dimensions. Sonography revealed the retinacula as bilaminar structures with discrete superficial and deep layers but failed to distinguish the deep ligaments from one another. CONCLUSION: Conventional T1-weighted axial MR images showed the various components of the retinacula including the medial patellofemoral ligament, which is an important stabilizing structure. Oblique imaging planes may be a helpful adjunct to axial imaging planes. Sonography can consistently identify the retinacula and may be useful in their assessment.

Aged↗

PubMedDate not supplied

Rheumatoid nodules: MRI characteristics.

Rheumatoid nodules are not uncommon in patients with rheumatoid arthritis. Two patients with rheumatoid arthritis and rheumatoid nodules are described. The MRI characteristics and enhancement patterns of five nodules are examined.

Diagnosis, Differential↗