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Biomedical subjects

P Le Hir

Publications and source records attributed to P Le Hir.

14 recordsLinked to original sources

[Reactive synovitis: MRI features with arthroscopic correlation].

OBJECTIVES: To evaluate MR imaging in detecting and characterizing secondary reactive synovitis and correlate the results with arthroscopy. MATERIALS AND METHODS: Retrospective study of 10 patients referred for MR imaging and arthroscopy of the knee or shoulder. The diagnosis of reactive synovitis was confirmed by arthroscopy and pathological examination. Synovial thickening was graded at MRI as follows. Grade 0: normal; grade 1: diffuse synovial thickening; grade 2: nodular synovial hypertrophy; grade 3: pseudotumoral synovial mass. RESULTS: Synovitis was described at MRI in 8 cases. There were 2 false negative results on MR imaging for the knee. Synovitis was secondary to knee trauma and rotator cuff tear or surgery of the shoulder. On arthroscopy, all synovial lesions were detected and confirmed at pathology. Synovitis was not detected at MRI (grade 0) in 20% of cases. Synovitis appeared diffuse (grade 1) in 30%, nodular (grade 2) in 30% and pseudotumoral (grade 3) in 20%. Bony erosions were adjacent to synovial thickening in 5 cases. CONCLUSION: Reactive synovitis can occur after trauma. MR imaging is useful in detecting and evaluating secondary reactive synovitis. Arthroscopy and synovial biopsy are necessary to exclude infectious or tumoral synovitis.

Adult↗

[Radiological spectrum of myositis ossificans circumscripta evolution].

Myositis ossificans circumscripta is a benign pathology of soft tissue occurring in young patients often after localized trauma. Histological and radiological appearances may mimic a malignant neoplasm, mainly sarcoma. We report a case characteristic of myositis ossificans circumscripta, to illustrate diagnostic arguments which are based on their appearance on conventional radiographs, computed tomography and magnetic resonance imaging and on their changes with time.

Adult↗

[Interventional lumbar spine radiology].

Three different techniques will be discussed. The first procedure is the biopsy of the lumbar vertebra or lumbar intervertebral disc for patients with tumors or infections of the lumbar spine. The different needles that can be used in function of consistency and location of the lesion will be shown. The transpedicular and posterolateral techniques will be described. Cementoplasty for tumors and selected patients with osteoporotic vertebral collapse generates much interest. The transpedicular and posterolateral techniques will be described. Indications and complications, more frequent in patients with tumors, will be reviewed. Finally, foraminal injections of steroids in patients with radicular symptoms secondary to degenerative change will be discussed. Techniques for needle placement will be reviewed. Results from these injections will also be reviewed.

Adrenal Cortex Hormones↗

[D-Dimer determination combined with clinical probability for the diagnosis of leg venous thrombosis].

OBJECTIVE: To evaluate the results of combination of D-Dimer test and simple clinical model for the diagnosis of deep vein thrombosis (DVT). MATERIALS AND METHODS: Inclusion: clinical suspicion of DVT. Non inclusion criteria were Clinical model performed by the referring physician included probability varying from high to low. D-Dimer test was performed by five different rapid techniques. Standard of reference was Doppler ultrasonography (DU) performed by a senior radiologist. RESULTS: Eight hundred and fifty-four DU were performed on a 14 months time period, including 206 suspicion of pulmonary embolism, 109 postoperative time period, 120 non-included or excluded patients, 278 incomplete observations, 141 complete observations. DVT was present in 33 cases and absent in the other 108 cases (prevalence 23%). Sensitivity and negative predictive value of the five tests were between 82 and 97% and 90 et 97%. The most sensitive test had a specificity of 36% and a positive predictive value of 32%. Combination of clinical model and D-Dimer test did not improve the diagnostic accuracy. CONCLUSION: None of the test evaluated in the present study, even when combined with the clinical model results, did allow the exclusion of DVT.

Formycins↗

[Adductor muscle pyomyositis simulating acute appendicitis: CT and MR imaging findings].

Pyomyositis is a primary bacterial infection of skeletal muscle. This infection tends to occur in the large muscles of the lower extremity. Pyomyositis of the proximal muscles of the thigh can simulate acute abdominal disease. Early diagnosis improves the outcome. Delayed diagnosis may lead to septicemia and shock. We report the CT and MRI findings in a patient with pyomyositis of the proximal muscles of the thigh.

Adult↗

[MRI appearance of a primary leiomyosarcoma of bone with epiphyseal involvement].

Primary leiomyosarcoma of bone is a rarely reported tumor of elderly subjects. It usually shows an aggressive osteolytic pattern on plain radiographs and involves predominantly the metaphyses of long bones. We report a case of primary leiomyosarcoma of bone, which is atypical by its epiphyseal location, a non-aggressive pattern on plain radiographs and its MR imaging features.

Aged↗

A scale of methodological quality for clinical studies of radiologic examinations.

PURPOSE: To develop and evaluate a scale for assessment of the methodological quality for clinical investigations of radiologic studies. MATERIALS AND METHODS: A scale was developed that included methodological standards compiled from established sources for assessing the methodological quality of study designs in clinical research and characteristics related to biases commonly observed in clinical radiologic research. The scale was composed of 15 standards and was tested with the results of 96 studies on imaging of liver hemangioma. Interrater reliability was measured between two observers by using percentage agreement and kappa statistics. Interrater reliability between two observers for a composite quality index that encompassed the 15 standards was measured with the intraclass correlation coefficient. RESULTS: Agreement between the two observers was almost perfect (kappa value, 0.8-1.0) for 11 standards and substantial (kappa value, 0.74-0.78) for four standards. Agreement between the observers with regard to the composite quality index also was high (intraclass correlation coefficient r, 0.91 [95% CI: 0.87, 0.94]). CONCLUSION: The scale appears to be reliable for the assessment of methodological quality of clinical investigations of radiologic studies.

Hemangioma↗

Symptomatic lumbar facet joint synovial cysts: clinical assessment of facet joint steroid injection after 1 and 6 months and long-term follow-up in 30 patients.

PURPOSE: To study the results of facet joint intraarticular steroid injections in patients with symptomatic lumbar facet joint synovial cysts. MATERIALS AND METHODS: Data from 30 patients (age range, 44-82 years; mean age, 67 years) with nerve root pain due to a lumbar facet joint synovial cyst and treated with facet joint steroid injection were retrospectively studied. On the basis of MacNab criteria, the clinical course of nerve root pain was evaluated after 1 (n = 30) and 6 (n = 28) months. Data from long-term follow-up (mean, 26 months) were also available in 14 nonsurgically treated patients. RESULTS: After 1 month, the nerve root pain outcome was excellent or good in 20 patients (67%) and fair or poor in 10 (33%). After 6 months, 10 (50%) of these 20 patients still had excellent or good results, and 18 (60%) of the 30 patients had a fair or poor clinical status, 14 of whom underwent surgery; two patients (7%) were lost to follow-up. Excellent and good results were maintained at further follow-up (range, 9-50 months). CONCLUSION: One-third of patients with symptomatic lumbar facet joint synovial cysts had long-lasting acceptable benefit from facet joint steroid injections in this study. Steroid injection should be indicated before surgery.

Aged↗

Rhinoscleroma with orbital extension: CT and MRI.

We describe the MRI features of a rhinoscleroma with orbital extension. This benign bacterial and granulomatous lesion of the paranasal sinuses gave homogeneous low intensity on T2-weighted images and enhanced with gadolinium. It could simulate a malignant sinonasal tumour or a fungal sinusitis; the diagnosis must be considered in patients from endemic areas.

Adult↗