Biomedical subjects

Nancy M Major

Publications and source records attributed to Nancy M Major.

23 records · Page 2Linked to original sources

PubMed2002

Fine-needle aspiration cytology of articular and periarticular lesions.

BACKGROUND: The cytologic diagnosis of joint and articular surface-based lesions traditionally has been accomplished by examination of fluids or effusions. Although exfoliative cytology remains an accurate diagnostic test, not all joint-based lesions will produce effusions that are amenable to this type of examination. Fine-needle aspiration (FNA) represents an excellent alternative to traditional cytologic or histologic methods of diagnosis in joint pathology. METHODS: The authors reviewed FNA materials for the period 1992-2001 from lesions of joint spaces and periarticular soft tissues. All diagnoses based on cytologic materials that were included in this study were confirmed with histologic follow-up. Cytologic and histologic materials were prepared using standard methods. RESULTS: The authors found six relatively common lesions that were amenable to diagnosis by FNA. These included rheumatoid nodule, gouty tophi, ganglion cysts, pigmented villonodular synovitis, synovial chondromatosis, and synovial sarcoma. There are potential pitfalls in discriminating gout from pseudogout and synovial chondromatosis from chondrosarcoma. CONCLUSIONS: In most instances, mass-producing lesions of the joint space or the periarticular soft tissues can be diagnosed successfully by FNA. The common lesions are easily recognizable and are cytologically distinctive.

Arthritis, Rheumatoid↗

PubMed2002

Elbow effusions in trauma in adults and children: is there an occult fracture?

OBJECTIVE: The purpose of this study was to evaluate whether a detectable abnormality was present on MR imaging without a visible fracture on conventional radiography in the setting of trauma. A recent retrospective study based on the presence or absence of periosteal reaction on follow-up radiographs concluded that fractures were not always present. The discrepancies in the literature over the usefulness of joint effusions as an indicator of fracture caused us to evaluate whether fractures were present more often than identified by conventional radiography. To do this, we used MR imaging. MATERIALS AND METHODS: Thirteen consecutive patients (age range, 4-80 years; seven children and six adults), whose post-trauma elbow radiographs showed an effusion but no fracture, underwent screening MR imaging. RESULTS: All patients showed bone marrow edema. Four of the seven children had fractures on screening MR imaging, and all adults had some identifiable fractures. CONCLUSION: Preliminary data using screening MR imaging suggests that an occult fracture usually is present in the setting of effusion without radiographically visualized fracture.

Adolescent↗

PubMed2002

Femoral head osteochondral lesions in painful hips of athletes: MR imaging findings.

OBJECTIVE: This study describes the MR imaging findings of focal osteochondral lesions found in the hips of 11 athletes with persistent pain and normal findings on radiographs. CONCLUSION: Osteochondral lesions of the femoral head are seen on MR imaging as focal, medial areas of high T2-weighted and low T1-weighted signals and should be considered as a possible cause of persistent hip or groin pain in young, high-level athletes because the institution of appropriate treatment may help to prevent late degenerative sequelae.

Adolescent↗

PubMed2002

MR imaging of the knee: findings in asymptomatic collegiate basketball players.

OBJECTIVE: The purpose of our study was to evaluate the knees of asymptomatic high-level collegiate basketball players before the beginning of the basketball season to gain an understanding of nonclinical findings in this patient population. SUBJECTS AND METHODS: Bilateral knee MR imaging examinations of 17 varsity basketball players (12 men and five women) were performed before basketball season began. All of the subjects were imaged on a 1.5-T magnet. The MR imaging studies were reviewed by two musculoskeletal radiologists. Structures analyzed were the menisci, ligaments, cartilage, plicae, and bone marrow. The presence of a joint effusion was also noted. RESULTS: Fourteen (41%) of the 34 knees had bone marrow edema, eight (24%) showed signal in the patellar tendon, and 14 (41%) had abnormal cartilage signal or a focal abnormality. Twelve (35%) of the 34 knees showed a joint effusion. Two knees (6%) showed abnormal signal along the infrapatellar plica. Four knees (12%) were noted to have a discoid meniscus. CONCLUSION: An MR examination of the knees of high-level collegiate basketball players may show changes unique to this population. The changes seen on MR imaging in these athletes may be asymptomatic abnormalities. For instance, changes suggestive of patellar tendinopathy were identified in these asymptomatic subjects.

Adult↗

PubMedDate not supplied

The drop sign, a radiographic warning sign of elbow instability.

Persistent instability or redislocation is uncommon but of significant concern in treating elbow dislocations. Finding an objective, static radiographic sign that might correlate with the presence of instability was the purpose of this study. Pre- and post-reduction radiographs of 10 consecutive simple and complete adult elbow dislocations were reviewed and compared with radiographs of 20 consecutive adult elbows without any trauma history. A statistically significant measured increase in static ulnohumeral distance was noted on the routine unstressed post-reduction lateral radiographs of patients sustaining dislocation. We have termed this increased distance the drop sign. It differs from the radiographic ulnohumeral separation noted during O'Driscoll's test for posterolateral rotary instability, which is present only with axial compression. The drop sign becomes concerning only if persistent after the first reduction radiograph and may be a warning sign of the presence of instability.

Elbow Joint↗