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Biomedical subjects

R G Dussault

Publications and source records attributed to R G Dussault.

At least 19 recordsLinked to original sources
PubMed1995

The radiographic signs of arthritis: a computer teaching module.

This article describes the steps involved in production of a computer teaching module on the radiographic diagnosis of arthritis. The module was part of a research project aimed at producing seven computer teaching modules. Several staff radiologists and residents were involved, as well as a consultant on medical education. A generic shell program was used as a frame for all seven modules. The author of each module then filled in the empty pages of the shell with the appropriate text and images, along with additional short program scripts. The module on the radiographic diagnosis of arthritis described and illustrated the basic radiographic signs of arthritis. Practice cases were also included, and interactive and hypermedia features were implemented. The modules were then evaluated by means of task list tests and interviews. The experience was judged to have been successful, although the amount of time spent by some authors was much more than expected.

Arthritis↗
PubMed1995

MR imaging of Achilles tendon in patients with familial hyperlipidemia: comparison with plain films, physical examination, and patients with traumatic tendon lesions.

OBJECTIVE: The purpose of this study was to evaluate the MR imaging characteristics of Achilles tendons in patients at risk for tendon xanthomas because of familial hyperlipidemia and to compare these findings with those seen on plain radiographs and physical examination. We also wished to determine if MR imaging could be used to differentiate xanthomas from traumatic tendinopathy in a second group of patients who had no history of hyperlipidemia but who had a history of trauma to the Achilles tendon. SUBJECTS AND METHODS: We evaluated the MR imaging studies of 26 Achilles tendons in 13 patients with heterozygous familial hypercholesterolemia (n = 11) and type III dysbetalipoproteinemia (n = 2). The size, shape, and signal characteristics of the Achilles tendon were recorded. A tendon was considered abnormal by MR if there was high signal, a convex anterior border, or an anteroposterior measurement greater than 7 mm. Findings on plain radiographs and physical examination of the Achilles tendons were evaluated in the same group of patients. In the group of patients with hyperlipidemia, palpable abnormalities of the Achilles tendon were present in 14 of 26 tendons. Plain radiographs were interpreted as showing abnormalities in 18 of the 26 tendons. In a second group of 21 tendons in patients with no history of hyperlipidemia but with traumatic tendinopathy, studies were evaluated for the size, shape, and signal characteristics of the Achilles tendon. RESULTS: On MR images, 24 of 26 tendons showed signal abnormalities, and 19 of 26 were enlarged. Abnormal signal was a diffuse stippled pattern with many low-signal round structures of equal size surrounded by high-signal material on all pulse sequences. Abnormal signal was seen in tendons of both normal and abnormal size. Bilateral and symmetric changes were found in all but one patient. Tendinopathy in patients without known hyperlipidemia appeared indistinguishable from tendon xanthomas in six (29%) of 21 tendons. The other tendons (71%) were distinctly different from xanthomas without a uniform stippled signal pattern. CONCLUSION: MR imaging of patients with familial hyperlipidemia showed an abnormal stippled signal pattern with or without enlargement or abnormal configuration of the tendon. MR imaging is a more sensitive method than physical examination and plain films for detecting abnormalities in Achilles tendons of patients with hyperlipidemia. Although the MR signal pattern of xanthomas is often different from that of partial tendon tears, tendon degeneration, or tendinitis, a significant overlap in appearance can be observed and the MR appearance of a xanthoma is not pathognomonic.

Achilles Tendon↗
PubMed1994

Magnetic resonance imaging of the elbow.

Technical improvements in MR imaging have resulted in the ability to detect soft tissue and bone pathology, with great facility in the elbow joint. This allows application of MRI to the elbow in the same valuable ways it has been used in other joints for a much longer period.

Elbow Joint↗
PubMed1994

Imaging and differential diagnosis of masses within a joint.

Careful analysis of conventional radiographs remains the first step in the investigation of intra-articular abnormalities. However, other imaging techniques, such as ultrasonography, arthrography, computed tomography and magnetic resonance imaging, may add critical information that allows the correct diagnosis. The authors discuss the evaluation of masses within a joint on the basis of plain film analysis, as well as the contribution of additional imaging techniques to the differential diagnosis.

Arthritis, Infectious↗
PubMed1992

Occult fracture patterns of the knee associated with anterior cruciate ligament tears: assessment with MR imaging.

One hundred consecutive magnetic resonance (MR) images of the knee in patients with acute complete anterior cruciate ligament (ACL) tears were reviewed to evaluate the prevalence and patterns of associated occult fractures. Eighty-nine occult fractures were identified in 56 knees. All occult fractures were in the posterior aspect of the lateral tibial plateau. Of these, occult fractures were isolated in 24 cases (43%) and were in combination with fractures in the middle aspect of the lateral femoral condyle in 26 (46%), with fractures in the posterior aspect of the medial tibial plateau in four (7%), and with fractures involving all three areas in one (2%). Disruption of the ACL under valgus stress leads to anterior translation of the tibia and relative external rotation of the femur. This allows impaction of the posterior portion of the lateral tibial plateau against the middle of the lateral femoral condyle and accounts for the unique pattern of occult fractures associated with ACL tears. An occult fracture of the posterior lateral tibial plateau with or without an associated fracture in the lateral femoral condyle ("kissing contusion") is a relatively frequent finding in acute ACL tears and, when present, is highly suggestive of such an associated tear.

Adolescent↗
PubMed1992

MR imaging of the normal shoulder: variants and pitfalls.

In 30 volunteers with normal shoulders, the following conclusions were made with regard to normal anatomic features at magnetic resonance (MR) imaging: (a) The supraspinatus tendon has low signal intensity, except for a 1-cm area with intermediate signal intensity in the region of the "critical zone." (b) The deltoid tendon attachment on the inferior surface of the acromion may simulate a subacromial spur if not imaged in continuity. (c) Fluid in the long head of the biceps tendon sheath is normal if not completely surrounding the tendon. (d) The anterolateral branch of the anterior humeral circumflex vessels in the proximal bicipital groove adjacent to the biceps tendon mimics fluid in the tendon sheath. (e) Continuity or obliteration of the subacromial-subdeltoid bursal fat plane is an unreliable diagnostic sign since the fat plane is often focally absent. (f) Fluid is not detected in subacromial-subdeltoid bursae. (g) Undercutting of the anterior glenoid labrum by hyaline cartilage or a closely apposed middle glenohumeral ligament may simulate an anterior labral tear.

Adult↗
PubMed1992

[Adhesive capsulitis of the shoulder: a comparative study of arthrography with intra-articular corticotherapy and with or without capsular distension].

A double-blind, prospective study of 45 patients with adhesive capsulitis of the shoulder compared the therapeutic efficacy of distensive and nondistensive arthrography in combination with the intra-articular injection of corticosteroids. After 1 and 3 months there was no significant difference between the two treatments in the degree of pain or of limitation of movement experienced by the patients. More than 80% of the patients who experienced pain at rest and nocturnal pain improved under both treatment regimens. Scapulohumeral mobility increased significantly but only partially within the first month of treatment. Articular capacity and the duration of symptoms before treatment were of no prognostic value.

Adrenal Cortex Hormones↗
PubMed1991

Plain-film diagnosis of joint disease.

The authors describe a systematic approach to plain-film diagnosis of joint disease. The major radiologic criteria--soft-tissue swelling, joint-space narrowing, bone erosion, bone sclerosis and osteophytosis, and chondrocalcinosis--are considered first. Assessing the involvement of the minor criteria of joint disease--soft-tissue atrophy or calcification, malalignment, osteoporosis, abnormal growth, intra-articular bony ankylosis, bone fragmentation, periostitis, subperiosteal resorption or acro-osteolysis--narrows the probabilities to the more likely diagnoses. Further analysis includes the distribution of joint injury, whether mono- or polyarticular, symmetrical or asymmetrical. Added to clinical information, this approach leads to a specific or refined differential diagnosis.

Cartilage, Articular↗
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↗
PubMed1989

[Distention arthrography in the treatment of adhesive capsulitis of the shoulder].

Adhesive capsulitis of the shoulder is an idiopathic condition characterized clinically by pain and limitation of movement. The characteristic arthrographic features are those of limited capacity of the joint, pain during injection, and retracted recesses. Progressive distension of the capsule with 1% lidocaine and 40 mg of triamcinolone acetonide (Kenalog) is a recommended form of treatment for this condition. Twenty-five patients treated by this method were reviewed retrospectively. Eleven (44%) were completely relieved of their symptoms, 6 (24%) had a 50% improvement, and 8 (32%) had no relief. Patients with idiopathic adhesive capsulitis responded more favorably to the treatment than those with a traumatic etiology. The duration of symptoms had no correlation with the results of therapy. There were no complications from the treatment.

Adult↗
PubMed1988

Clinical evaluation of cervical facet joint infiltration.

Twenty-one patients with cervical facet syndrome underwent 39 facet joint infiltrations with corticosteroids using fluoroscopic guidance. There were 22 intra-articular and 17 peri-articular injections. This treatment relieved symptoms in 91% of patients. Follow-up ranged from one week to 12 months. However, symptoms usually recurred, specifically in 71% of patients with complete responses and in 42% of those with partial relief. There was no significant difference in response between patients receiving intra-articular or peri-articular injections (chi 2 = 2.283).

Adult↗
PubMed1988

[Stress fractures of the femoral neck].

Four young patients who developed a fatigue fracture of the femoral neck are presented. The clinical features of pain with movement are described. The role of nuclear medicine is discussed with emphasis on its importance in the early diagnosis of this entity. The radiologic stages based on the site and time of presentation are analyzed: 1) normal, 2) sclerotic bands perpendicular to the trabeculations, 3) incomplete fracture, 4) complete fracture.

Adult↗
PubMed1985

Cervical facet joint arthrography.

We describe a technique for cervical facet joint arthrography; a posterior approach is used. The patient is positioned prone, the neck flexed maximally, and the head turned 60-90 degrees opposite to the side of injection. The x-ray tube is angled cephalad in order to obtain a true tangent to the facet joint. The needle is inserted using fluoroscopic control in a direction parallel to the x-ray beam. Before the therapeutic infiltration, the intraarticular position of the needle is confirmed by injecting 0.3 ml of contrast medium.

Arthrography↗
PubMed1985

Complementary role of wrist arthrography in non-union of scaphoid fractures.

Plain radiographs and wrist arthrography of 11 patients with non-united fractures of the scaphoid were retrospectively studied. The arthrographic feature of non-union was found to be opacification of the fracture line and, secondly, of the midcarpal compartment, whereas in patients with fibrous or cartilaginous union no opacification of the fracture line was obtained. There was no single plain radiographic feature that could distinguish non-union from fibrous or cartilaginous union.

Adolescent↗
PubMed1984

Hand osteoarthropathy in pianists.

We evaluated radiographs of the hands of 20 pianists. The radiologic manifestations arising from long-term stress and strain applied to the hands were recorded. The changes are characterized by: 1) alignment adaptation consisting of axial radial rotation of the digits, particularly the fifth but also the third and fourth, 2) degenerative changes at the distal interphalangeal DIP and metacarpophalangeal MCP joints, and 3) mechanical remodeling manifested as periostal thickening and flattening of the phalangeal tufts associated with sclerosis. These findings suggest the existence of an occupational entity which might be described as pianist's osteoarthropathy.

Adult↗