Biomedical subjects

P A Ruwe

Publications and source records attributed to P A Ruwe.

6 recordsLinked to original sources

PubMed1992

Can MR imaging effectively replace diagnostic arthroscopy?

A study was performed to determine whether magnetic resonance (MR) imaging is cost-effective and reduces the need for diagnostic arthroscopy of the knee. During a 9-month period, 103 consecutive patients with knee injury that justified diagnostic arthroscopy underwent MR imaging. The MR images were interpreted by means of consensus of three radiologists and reviewed with the referring sports medicine orthopedists. After the examination, 44 patients (42.7%) underwent immediate arthroscopy. The 59 other patients (57.3%) did not undergo arthroscopy; follow-up was performed in 55 of these 59 patients (93%) at a mean of 22 months. The outcome was successful in 49 of 55 patients (89%); 40 patients had normal function and no limitation in activity, six patients with chronic injury of the anterior cruciate ligament underwent reconstruction, and three patients underwent arthroscopy with negative findings. Without the use of MR imaging, all patients in this study would have undergone diagnostic arthroscopy. Because of the diagnoses based on MR images, 53 patients (51.4%) avoided a potentially unnecessary diagnostic arthroscopy, and, as a result, the net savings was $103,700 in the 103 patients.

Adolescent↗

PubMed1992

Clinical determination of femoral anteversion. A comparison with established techniques.

We evaluated femoral anteversion preoperatively in fifty-nine patients (ninety-one hips), using a clinical method that we developed, Magilligan radiographs, and computed tomographic scans. These measurements were then compared with values for anteversion that were obtained intraoperatively. To determine femoral anteversion clinically, the patient was placed in the prone position and the maximum lateral trochanteric prominence was related to the degree of internal rotation of the hip. Compared with computed tomographic scanning and Magilligan radiographic determination, the clinically determined anteversion correlated most closely (to within 4 degrees) with the amount measured at the time of the operation. The clinical method was found to be superior to radiographic techniques for determination of the degree of femoral anteversion in children who have not had a previous operation about the hip.

Biometry↗

PubMed1991

Familial incidence of Paget's disease and secondary osteogenic sarcoma. A report of three cases from a single family.

This report describes a family of three siblings with a long history of polyostotic Paget's disease. Because of the severe osseous involvement with Paget's disease, all three patients had problems that required orthopedic surgery. Subsequent to these surgeries, two patients developed osteogenic sarcoma at sites unrelated to their past procedures, one in the sacrum and one in the calvarium. Both patients died shortly after their diagnosis because of the aggressive spread of the tumor. Although the etiology of Paget's disease and its complication of osteogenic sarcoma still remain to be clarified, this and other case reports suggest a possible environmental or hereditary contribution to developing osteogenic sarcoma in Paget's disease. Patients with a familial clustering of polyostotic Paget's disease may benefit from more thorough screening tests to detect malignant transformation.

Aged↗

PubMed1990

Paget's disease in the hand: correlation of magnetic resonance imaging with histology.

A 62-year-old white woman was seen initially with a 4-month history of swelling over the dorsum of her wrist and thumb pain at the basal joint. Radiographs revealed pantrapezial arthritis and a marked increase in the radiodensity of the capitate. Tomograms showed slight enlargement of the capitate, and magnetic resonance imaging revealed a dramatic decrease in the signal intensity on T1- and T2-weighted images. A biopsy of the capitate was done at the time of thumb carpometacarpal joint arthroplasty. Active Paget's disease was diagnosed. It is postulated that loss of marrow fat in active Paget's disease decreased the T1- and T2-weighted signals in a manner similar to processes, such as Gaucher's disease and osteonecrosis.

Female↗

PubMed1990

A functional evaluation of cryopreserved peripheral nerve autografts.

This study compared the functional return following the repair of a 2.0-cm defect in the rat sciatic nerve with frozen (with or without treatment with a cryoprotectant, dimethyl sulfoxide [DMSO]) or fresh nerve grafts. In addition, a control group in which the defect was left ungrafted was evaluated. Recovery was assessed by functional studies (sensory testing, gait analysis, joint contractures, and tibialis anterior muscle weight), biochemical analysis (muscle hydroxyproline concentration), and histologic studies (axonal counts and fiber density). Sensory testing and gait analysis were not helpful because of cross-over innervation of the saphenous nerve and lack of recovery of the foot intrinsic muscles, respectively. The hind-limb contractures of the group with fresh nerve grafts (18 degrees +/- 3 degrees) were similar to those with DMSO-cryopreserved grafts (14 degrees +/- 4 degrees). Both of these groups had statistically smaller contractures than the non-DMSO-cryopreserved group (45 degrees +/- 8 degrees) and the gap control group (49 degrees +/- 6 degrees), (p less than 0.01). The tibialis anterior (TA) muscle-weight ratio (MWR) and the muscle-hydroxyproline-concentration ratio (MHPCR) showed a similar pattern, with no significant difference between the fresh (MWR, 0.5785 +/- 0.068 and MHPCR, 1.527 +/- 0.405) and DMSO-cryopreserved (MWR, 0.5675 +/- 0.0989 and MHPCR, 1.660 +/- 0.456) groups; both of these groups showed greater neurologic recovery when compared to the non-DMSO-cryopreserved (MWR, 0.3364 +/- 0.0266 and MHPCR, 3.441 +/- 0.300) and gap control (MWR, 0.2134 +/- 0.0775 and MHPCR, 4.869 +/- 2.351) groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1988

Refracture of bones of the forearm after the removal of compression plates.

Of thirty-seven patients who had sixty-two diaphyseal plates removed from the forearm after fixation of a fracture, seven patients had a refracture, two of whom refractured both bones of the forearm. Six of the seven refractures were in patients who initially had had a fracture of both bones, and all were in patients in whom the original fracture had been caused by major trauma. The interval from the time of removal of the plate to refracture ranged from forty-two to 121 days. Only one of the seven patients who had a refracture had had adequate compression of the original fracture. The average interval from the time of the original trauma to internal fixation was two days in six patients who had a refracture and who originally had had primary plating, compared with 8.5 days in the patients who did not have a refracture. One of the seven patients who had a refracture had originally had delayed plating after closed treatment had failed. In retrospect, radiolucency at the site of the original fracture was seen in most patients when the plate was removed.

Adolescent↗