Deep soft tissue mass of the thigh.
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Adult↗
Biomedical subjects
P D Traughber
Publications and source records attributed to P D Traughber.
Lateral meniscus pseudotear or "line of Murray".
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Humans↗
Intraarterial fibrinolytic therapy for popliteal and tibial artery obstruction: comparison of streptokinase and urokinase.
Experience with using intraarterial fibrinolysis in the treatment of occlusive disease of the popliteal artery and runoff vessels is limited. We describe the techniques and results in 25 patients with 30 fibrinolytic infusions of the popliteal and tibial arteries and compare them with the initial and long-term results of treatment using streptokinase and urokinase. The roles of catheter delivery systems and systemic heparin in the prevention of pericatheter thrombus were also studied. Urokinase was initially successful in 18 (90%) of 20 intraarterial infusions, whereas streptokinase was effective in 8 (80%) of 10 intraarterial infusions. Urokinase had the advantages of a shorter effective infusion time and fewer complications. Long-term follow-up was available in 20 of the successfully treated patients. Sixteen of these patients were doing well with an average follow-up of 27 months. The duration of the initial occlusion may be useful in identifying patients at risk for early reocclusion. No limbs were lost because of complications of therapy. The coaxial catheter system with a divided fibrinolytic dose provided protection against pericatheter thrombus, while systemic heparin was ineffective. Our results suggest that urokinase is more effective than streptokinase for intraarterial infusion in the treatment of occlusion of the popliteal and tibial arteries; this procedure is an important alternative to surgery or an adjuvant to surgery in selected patients.
Arterial Occlusive Diseases↗
Negative bone scans of joints after aspiration or arthrography: experimental studies.
It has long been suspected anecdotally that needle aspiration or contrast arthrogram before bone scan may cause a false-positive bone scan. This dictum often directs the sequence of events in the clinical workup of joint disease, yet data to support or refute this are lacking. This study was undertaken to generate such data. Fifty-six joints in mature dogs were examined, including hips, knees, elbows, and shoulders. The joints were examined in pairs; one joint was injected with Conray 60 for an arthrogram, and the contralateral joint was injected with an equal volume of normal saline to simulate a joint aspiration. Confirmation of needle placement and injection into the joints was made with fluoroscopic and digital subtraction imaging. Numbers of attempts required for aspiration and quantity of contrast material extravasated were noted for each joint. Baseline 99mTc-HDP or 99mTc-MDP bone scans were done before the experimental joint aspirations, with follow-up scans at 24 and 96 hr. The scans showed no significant change from baseline after either needle aspiration or arthrogram. When the diagnostic workup suggests the need for such a procedure, it should be performed. In contradiction to popular belief, joint aspiration and/or arthrogram did not affect a subsequent bone scan.
Animals↗
Evaluation of loose bodies in the elbow with MR imaging.
The evaluation of loose bodies in the elbow is usually done by means of clinical examination, radiography, and postarthrographic computed tomography (CT). The authors review their experience with magnetic resonance (MR) imaging in place of post-arthrographic CT for the evaluation of loose bodies in the elbow. The prospective interpretation of MR studies of the elbow in 20 patients was compared with arthroscopic findings. All elbows were imaged in multiple planes with thin sections, surface coils, and combinations of T1, T2, and proton-density weighting. The sensitivity for showing loose bodies with MR imaging was 100%, and the specificity was 67%. Because this was a nonblinded study, the results are biased and caution must be used when extrapolating these results to the general population. In this limited experience, MR imaging has reliably shown loose bodies in the elbow, and in the authors' institutions has replaced postarthrographic CT for that purpose.
Adolescent↗
Bilateral pedicle stress fractures: SPECT and CT features.
This report discusses the first known reported case of bilateral pedicle stress fractures. The importance of early detection and appropriate therapy to promote early healing is emphasized. Bone scintigraphy with single photon emission CT is favored for initial evaluation with CT recommended to further evaluate areas of focal abnormal scintigraphic activity.
Adolescent↗
Shoulder MRI: arthroscopic correlation with emphasis on partial tears.
In 28 patients the preoperative MR results and arthroscopic examination findings, in which both sides of the rotator cuff were systematically examined, were compared. The interpretive MR criteria were both sensitive and specific for detection of full thickness tears: 100% (5 of 5) and 100% (23 of 23), respectively. Criteria were insensitive in 71% (10 of 14) but specific in 93% (13 of 14) for detection of all tears; 4 of 9 partial thickness tears were not detected of MR. The potential significance of these tears and the use of fat suppression MR sequences to improve detection and depiction of rotator cuff abnormalities are discussed.
Arthroscopy↗