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Biomedical subjects

P L Munk

Publications and source records attributed to P L Munk.

At least 55 records · Page 3Linked to original sources

Intra-articular regional migratory osteoporosis of the knee.

We report a case of intra-articular regional migratory osteoporosis of the knee in a 53-year-old man. The case demonstrates an unusual pattern of migration of the marrow edema within the knee joint. This phenomenon has received scant attention in the radiological literature.

Analgesics↗

CT evaluation of periacetabular osteotomies.

We have previously described a simple and reproducible three-dimensional technique of CT for the measurement of the cover of the femoral head in acetabular dysplasia in adults. We now describe the application of this technique in ten patients with symptomatic dysplasia to assess the degree and direction of dysplasia and to measure the cover obtained at acetabular osteotomy. The indices obtained gave a useful indication of the degree and direction of the dysplasia and confirmed which components had been used most efficiently to achieve cover. The information is easily presented in graphical form and gives a clearer indication of the cover obtained than the indices derived from plain radiographs.

Acetabulum↗

Talocalcaneal coalition. Diagnosis with the C-sign on lateral radiographs of the ankle.

We analysed 42 weight-bearing lateral radiographs of the ankle, 20 of which were from patients with a clinical and plain radiological diagnosis of talocalcaneal coalition (TCC) who subsequently had CT. The remainder were from 22 healthy volunteers with no clinical findings suggestive of hindfoot pathology. Four observers, blinded to the CT findings, independently evaluated the radiographs on two separate occasions. With the 95% confidence interval and using the CT findings as the comparison we calculated the sensitivity, specificity, accuracy, and positive and negative predictive values for the C-sign, and for other signs known to be associated with TCC. Similarly, we also calculated the interobserver and intraobserver reliability for these signs using the kappa statistic. Our results suggest that the C-sign is highly sensitive and specific for TCC. It is an accurate indicator and significantly more reliable than other previously recognised radiological signs of TCC. Features of the C-sign, however, cannot be relied upon to indicate whether the TCC is fibrous or bony.

Adult↗

Tumour extent and T stage of nasopharyngeal carcinoma: a comparison of magnetic resonance imaging and computed tomographic findings.

PURPOSE: To compare magnetic resonance imaging (MRI) and computed tomography (CT) in defining the T stage and full tumour extent of nasopharyngeal carcinoma. PATIENTS AND METHODS: Forty-eight patients with pathologically proven nasopharyngeal carcinoma underwent MRI and CT examinations within 2 weeks of each other. Contrast medium was used in both examinations. The T stage and full tumour extent according to MRI and CT were compared. RESULTS: In 32 patients MRI and CT findings agreed completely. MRI findings resulted in assignment of a higher stage than CT findings in another 8 patients. In the remaining 8 patients MRI showed wider tumour spread than CT, although there was no discordance in the T stage assigned. CONCLUSION: When compared with CT in defining the full tumour extent and assigning the T stage in 48 patients with nasopharyngeal carcinoma, MRI showed more extensive disease in 16 patients, including 8 in whom the T stage was revised upward. Therapy was altered as a result of the MRI findings.

Adult↗

MR imaging of brachial plexopathy in breast cancer patients without palpable recurrence.

OBJECTIVE: To investigate the role of MR imaging in detecting brachial plexus (BP) abnormalities in breast cancer patients with plexopathy but without palpable masses. DESIGN: MR imaging of the BP was performed on 26 breast cancer patients with brachial plexopathy without palpable regional masses, using 0.5 T and 1.5 T imaging systems. Findings were correlated with the clinical diagnoses. PATIENTS: Twenty-six patients with brachial plexopathy and history of breast cancer were enrolled in the study. All patients presented with plexopathy symptoms. Fourteen patients were positive and 12 patients were indeterminate for BP metastasis according to clinical criteria. RESULTS AND CONCLUSION: MR imaging demonstrated masses involving the BP representing metastases in two patients. Nine patients had other regional abnormalities with a normal brachial plexus. It is concluded that MR imaging is useful in the assessment and direction of therapy of brachial plexopathy in breast cancer patients by detecting both metastases to the BP as well as other abnormalities, unrelated to the BP, which may explain the patient's symptoms.

Adult↗

Popliteal vascular malformation simulating a soft tissue sarcoma.

Differentiation of vascular abnormalities from soft tissue sarcomas may be difficult on clinical grounds, but is usually possible on imaging criteria. We report the MRI and digital subtraction angiography (DSA) findings in a patient presenting with a mass behind the knee. We discuss differentiating features and review the literature of similar cases.

Aneurysm, False↗

Malignant degeneration of an osteochondroma with unusual intra-bursal invasion.

Multiple hereditary osteochondromatosis is an uncommon autosomal dominant condition in which patients are predisposed to the development of chondrosarcoma. We report a case of a patient who developed a secondary low-grade chondrosarcoma in this setting. The tumor was associated with an unusual multinodular invasive growth pattern into a pre-existing bursa that was present overlying the osteochondroma.

Adult↗

Magnetic resonance imaging of the temporomandibular joint: diagnostic difficulty caused by extensive pneumatization of the mastoid air cells.

OBJECTIVE: During routine MR imaging of temporomandibular joints we have observed that an area of low signal is sometimes identified within the temporal bone overlying the glenoid fossa on proton-density sequences. This finding at times simulates a mass. CT in this situation has demonstrated marked pneumatization of the mastoid air cell extending to that portion of the temporal bone overlying the glenoid fossa. We undertook a clinical study to determine the frequency and appearance of such a finding. DESIGN AND PATIENTS: We reviewed the images of 12 patients who underwent both MR and CT examinations of their temporomandibular joints. The authors, by consensus, graded all 24 joints using a four-point scale for the presence and appearance of a low-signal area overlying the glenoid fossa on the MR images prior to seeing the corresponding CT images. We then compared our grading with the findings on CT to assess for the presence and extent of pneumatization of the temporal bone overlying the glenoid fossa. RESULTS: Of the 24 joints reviewed there was identical extent of low signal on MR imaging and extent of pneumatization on CT in 22 of 24 joints. In two of the 24 joints assessed there was overestimation of pneumatization due to extensive sclerosis secondary to surgery. CONCLUSION: The findings of an area of low signal overlying the glenoid fossa on a T2-weighted scan of a nonoperative temporomandibular joint is often due to extensive temporal bone pneumatization of the mastoid air cells. Recognition of the nature of this finding will avoid mistaking it for a fibrous or osseous lesion. Patients with previous operative history may, however, require further investigation with CT.

Adult↗