Biomedical subjects

M V Maffey

Publications and source records attributed to M V Maffey.

4 recordsLinked to original sources

PubMed2003

Dysphonia and cervical hyperostosis: a case report.

We report a case of a 77-year-old man with a 3-year-history of progressive dysphonia, without dysphagia. His voice sounded breathy; the pitch and the loudness were low. He complained of a few episodes of voice breaking. At laryngostroboscopy the adduction motion of the left true vocal cord was slower than the contralateral one. A cervical spine X-ray demonstrated a generalized vertebral osteophytosis and a 3-centimeter-long anterior osteophytic spur, originating from C6. Evaluation with barium swallow showed a dislocation of the inferior cervico-oesophagus to the right, with a preservation of its lumen. Cervical-thoracic computed tomography showed a mild pressure produced by the osteophyte on the thyroid cartilage and the presence of the radiological criteria for Forestier's disease. Therefore, the presence of dysphonia in older adults without any primary laryngeal cause, indicates a radiological study of the cervical-thoracic region, in order to discover cervical osteophytosis.

Aged↗

PubMed2000

[Antero-posterior lesions of the superior glenoid labrum. Magnetic resonance evaluation].

PURPOSE: To assess MR potentials in the evaluation of superior glenoid labrum disease and possible associated conditions of the rotator cuff and of the anterior mechanism of the shoulder. MATERIAL AND METHODS: We retrospectively evaluated 51 patients (age range 18 to 53 years) with a diagnosis of anteroposterior lesion of the superior glenoid labrum. MR examinations were performed with a 0.2 T permanent magnet and a dedicated coil, using T1- and T2-weighted SE sequences on mostly coronal-oblique planes. Slice thickness was 4 mm. In 8 cases, the examination was completed with intra-articular injection of contrast agent. Twenty-eight patients were submitted to surgery (arthrotomy in 7 cases; arthroscopy in 21 cases). RESULTS: We considered only the cases with surgical confirmation and divided them into 2 groups: 15 patients with isolated alteration of the superior glenoid labrum and 13 patients with an anteroposterior lesion of the glenoid labrum associated with disease of the rotator cuff or of the anterior mechanism of the shoulder. MRI demonstrated 5 cases of superior labrum irregularities at the level of its glenoid insertional portion (type I lesion); 6 cases of detachment of the superior portion of the labrum (type II); 9 cases of bucket handle tear of the superior labrum with involvement of the insertional portion of the long head of the biceps tendon (type III); 8 cases of superior labrum tear extending within the long head of the biceps tendon (type IV). In the patients with associated disease MRI demonstrated supraspinatus tendon tear in 5 cases, lesion of the labrum also in its anteroinferior portion in 1 case, Hill-Sachs intraspongious fracture with involvement of the inferior glenohumeral complex in 1 case, and complete tear of the rotator cuff in 7 cases. Subsequent surgery always confirmed the presence of associated lesions, while the superior labrum lesion was not confirmed in 3 patients. In 4 cases, surgical findings provided a different classification of the lesion type than MRI. DISCUSSION: In the presence of a type I anteroposterior lesion of the superior glenoid labrum, coronal MRI can depict the loss of the triangular shape of the labrum. Type II lesions show detachment of the labrum, which appears on the MR images as a high signal intensity band passing through the labrum with caudocranial orientation. A superior glenoid labrum tear with a low signal intensity area within the joint indicates a type III lesion. Complete tear of the superior glenoid labrum with involvement of the long head of the biceps tendon demonstrated on the coronal T1-weighted SE and T2-weighted GE sequences is a sign of a type IV lesion. CONCLUSIONS: MRI can be a valuable diagnostic technique in type III and IV lesions of the superior glenoid labrum. It often provides important information about the possible presence of associated diseases, especially of the rotator cuff, which are helpful for treatment planning.

Adolescent↗

PubMed1998

US and MRI in a case of persistent Müllerian duct syndrome.

We report the US and MR appearances in a case of persistent Müllerian duct syndrome, a rare form of inherited male pseudohermaphroditism characterised by the presence of uterus and fallopian tubes in a normally virilised 46XY male.

Child, Preschool↗

PubMed1997

Overload syndromes of the peritalar region.

INTRODUCTION: The purpose of this study was to identify the diagnostic possibilities of the different diagnostic techniques in the evaluation of the pathological conditions affecting the peritalar region. MATERIALS AND METHODS: Between September 1995 and December 1996, 58 patients, with a painful syndrome at peritalar level were submitted to MRI, which was performed using a 'dedicated system' consisting of 0.2 and 0.5 T equipment. Spin-Echo T1-weighted and Gradient-Echo T2-weighted sequences were used on sagittal, coronal and axial planes, with slice thickness of 3-5 mm. Conventional radiography was previously performed in all patients, while 18 of them underwent CT. Surgery or arthroscopy was performed in 22 cases. 36 patients underwent clinical follow-up associated with conventional radiography in six cases, MRI in 11 and to both of them in six patients. RESULTS: After arthroscopy and surgery, an involvement of the tibio-talar joint was found (one pathogenic synovial plica, three meniscoid syndrome and 12 anterior impingement) in 16 patients. Concerning the subtalar joint, surgical examination revealed a cellulo-adipostis of the sinus tarsi in two patients, while in three cases osteochondral damage of the subtalar joint was identified. In the last patient, degenerative changes of the posterior tibial tendon associated with osteochondral pathology of the talo-navicular joint were found. MRI findings agreed with the surgical and arthroscopic ones in all patients except for the synovial plica; in this case, the MRI was negative. Follow-up performed on 36 patients revealed 12 tibio-talar joint, 17 subtalar joint and 7 talo-navicular joint pathological conditions. DISCUSSION: Concerning the tibio-talar joint, MRI findings were confirmed by arthroscopy in all cases of anterior impingement. Magnetic resonance (MR), due to its capability in detecting osteochondral damage and identifying osteophyte sites, results in the best imaging method for evaluating this condition. Meniscoid syndrome is easily detected by MRI only in the presence of sufficient scar tissue, while conventional radiography reveals the calcific stage. In sinus tarsi syndrome, the ligamentous damage associated with sero-hemorrhagic effusion at fatty tissue level may lead to a 'chopping' effect on the nerve endings: this condition is well demonstrated by MRI. In all cases of osteochondral alterations affecting both the subtalar and talo-navicular joint, it has been possible to obtain correct diagnosis with MRI, which also depicted well the tenosynovitis of the posterior tibial tendon. In cases of stress fracture of the navicular bone, both CT and MRI demonstrated the lesions well, even when, in the early phases, conventional radiography produced a negative result. In conclusion, MRI may be considered the choice method in the study of different pathological alterations affecting the peritalar region, also providing detailed information useful for a therapeutic approach.

Adult↗