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Biomedical subjects

P H Lander

Publications and source records attributed to P H Lander.

9 recordsLinked to original sources
PubMed1990

Imaging of the facet joints.

Facet joints have a variable anatomic orientation, and their imaging must be adapted to this variation. They have an important role in the stability and mobility of the spine at all levels. They are the sites of microtrauma leading to degenerative changes. Trauma may cause subluxation, dislocation, and fracture. As synovial joints, they manifest inflammatory processes and can present as part of a systemic disease. The facet joints are a component of a trijoint complex at each motion segment and cannot be separated biomechanically. Their visualization and analysis must be integrated with the adjoining soft tissue, and with neural and bone components.

Diagnostic Imaging↗
PubMed1986

Subperiosteal osteoid osteoma of the talus.

We report three patients with subperiosteal osteoid osteoma of the talus. All showed an erosion of the dorsal surface of the talus with medullary bone sclerosis. Adjacent paraosseous soft tissue calcification was seen in two lesions. Computed tomography demonstrated the nidus of the osteoid osteoma in two cases.

Adolescent↗
PubMed1986

Paget disease with contraction of long bones.

The evolution of Paget disease characterized both by expansion and subsequent contraction of the long bones of the ipsilateral upper extremity over a 10-year period is described.

Female↗
PubMed1986

Paget disease of the spine: CT with clinical correlation.

Thirty-six patients with pagetic involvement of the spine were evaluated clinically and by computed tomography (CT). Pagetic phase, modeling expansion, degree and site of spinal stenosis, and pagetic facet joint arthropathy were recorded for each involved vertebral segment. CT demonstrated spinal stenosis in 20 patients, 11 of whom exhibited spinal stenosis on plain films. Twenty-one patients had symptoms of neck or back pain, with associated neurologic dysfunction in 13. Spinal stenosis was present in 81% of the symptomatic patients and 20% of the asymptomatic patients. Severe pagetic facet arthropathy was present in 17 of the symptomatic patients. We conclude that spinal stenosis is an important cause of vertebral pain and neurologic dysfunction.

Aged↗
PubMed1986

A dynamic classification of Paget's disease.

A new dynamic classification of Paget's disease is proposed, incorporating both the radiographic phases of bone remodelling and the scintigraphic findings. Osteolytic, mixed and osteoblastic phases are associated with increased scintigraphic activity, while the osteosclerotic phase of remodelling is associated with normal or diminished activity and an osteoblastic radiographic appearance. Abnormal modelling of bone leading to deformity is produced by accelerated apposition or absorption at the periosteal and endosteal envelopes of the bone. In 112 patients with symptoms from Paget's disease, 527 lesions were classified. The most frequent remodelling phase was the mixed one and the most common modelling state was bone expansion with endosteal and periosteal apposition. Of 88 patients treated medically, 12 had lesions which progressed to increased bone formation without a change in modelling, and the active lesions in seven patients became inactive. Prolonged treatment with disodium etidronate led to progressive osteopenia in 11 patients.

Bone and Bones↗
PubMed1985

Spontaneous stress fractures of the femoral neck.

The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and avascular necrosis of the femoral head.

Aged↗
PubMed1985

Soft-tissue chondromas.

Soft-tissue chondromas are benign, relatively rare lesions. The clinicopathologic and radiologic features in six cases are presented and the literature is reviewed. Five of six cases had calcifications. Peripheral curvilinear calcification was seen in two cases, multiple ringlike areas characteristic of cartilage in one, and discrete ossification in another. Histopathologically, they were diverse, ranging from an immature pattern with a preponderance of chondroblasts to a more mature form with chondrocytes. Although these lesions resemble a wide variety of other soft-tissue lesions, they can usually be differentiated by their small size, characteristic location in the extremities, the nature of their calcifications, and the histopathologic features. The importance of this lesion is that it is benign. It must be distinguished from more aggressive soft-tissue neoplasms such as soft-tissue chondrosarcoma so as to spare the patient unnecessary radical therapy.

Adolescent↗