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R G Stiles

Publications and source records attributed to R G Stiles.

26 records · Page 2Linked to original sources
PubMed1990

Diffuse idiopathic skeletal hyperostosis causing acute thoracic myelopathy: a case report and discussion.

A case of diffuse idiopathic skeletal hyperostosis presenting as acute thoracic myelopathy is reported. Diffuse idiopathic skeletal hyperostosis has long been regarded as a radiological entity with an innocuous clinical course. The manifestations of this disease are reviewed. There is mounting evidence that it is neither a clinically infrequent nor, as this case report illustrates, an exclusively benign condition.

Female↗
PubMed1990

A directed approach to MRI of the athletic knee.

Surface coil MRI is now frequently utilized to assess acutely injured knees. In dedicated athletes, unique considerations exist which modify standard diagnosis and therapy. Concrete clinical findings must justify the potential loss of livelihood from even a "negative" arthroscopy. Seventeen injured athletes were evaluated by an orthopedic surgeon experienced in sports injuries and a preliminary localizing diagnosis was rendered, followed by knee MRI. Of 17 patients with significant injuries, MRI agreed with operative findings or clinical follow-up in 15 cases. Knee MRI prompted early intervention in those patients with conflicting subjective and/or objective findings. Furthermore, it helped direct the arthroscopist's surgical approach and encouraged close examination of areas less optimally visualized arthroscopically. MR and arthroscopy were complementary modalities in diagnosing certain ligamentous and cartilaginous lesions. MR effectively evaluated the cruciate ligaments often difficult to visualize by arthroscopy; arthroscopy better assessed articular surfaces. A cooperative effort existed between orthopedic surgeon and radiologist in directing both the MR study and arthroscopy. This was of particular benefit in maximizing scan efficiency in these large individuals who often filled the gantry. The team directed approach between orthopedic surgeon and radiologist affords deliberate and efficient diagnosis and therapy in this select population.

Athletic Injuries↗
PubMed1988

Rotator cuff disruption: diagnosis with digital arthrography.

Shoulder arthrography is a reliable technique for use in the diagnosis of tears of the rotator cuff, although delineation of the precise site and size of tears requires meticulous double-contrast technique and considerable examiner expertise. The authors initiated a prospective evaluation of digital arthrography of the glenohumeral joint in 28 patients with clinical manifestations suggesting rotator cuff tear because they believed that examination with this technique would allow more accurate definition of the precise status of the cuff. Fifteen patients had normal studies. Ten complete and three partial rotator cuff tears were demonstrated with digital technique, and the precise site of the tear was demonstrated in all of these cases. The results indicate that digital arthrography of the glenohumeral joint may have some advantages over standard arthrography in the delineation of complete and partial tears of the rotator cuff, particularly in defining the exact site of tears.

Adult↗
PubMed1988

MR imaging diagnosis of rotator cuff tears.

Thirty-one symptomatic patients were studied with MR imaging to evaluate the sensitivity and specificity of shoulder MR in the diagnosis of rotator cuff tears. Correlative studies included arthroscopy in 19 patients and arthrography in 12 patients. Images were obtained on either a 0.5- or 1.5-T Philips superconducting magnet using spin-echo pulse sequences (650-850/30 [TR, TE], 2000/30, 100) with 5-mm slices oriented in an oblique coronal plane perpendicular to the glenohumeral joint. The MR studies were initially interpreted without knowledge of the results of other diagnostic procedures. The MR diagnosis of cuff tear was made when irregularity, discontinuity, and increased signal were identified in the rotator cuff. MR images showed tears in 10 patients (32%) and were negative for tear in 21 patients (68%). MR correlated with arthroscopy and arthrography in 17 of 18 normal patients, in eight of 10 patients with complete tears, and in one of three patients with partial tears. For complete rotator cuff tears, the sensitivity, specificity, and accuracy were 80%, 94%, and 89%, respectively. For all tears (partial and complete), the sensitivity, specificity, and accuracy were 69%, 94%, and 84%, respectively. These data suggest that MR imaging is an accurate procedure for the diagnosis of complete rotator cuff tears. The number of partial tears (three) in this series is too small to evaluate the value of MR imaging in the diagnosis of partial tears.

Adult↗
PubMed1988

Radiologic manifestations of arthritides involving the foot.

This article has discussed the radiographic manifestations of several of the more common articular disorders affecting the foot. An organized, thoughtful approach to radiographic analysis in patients with articular diseases of the foot generally ensures accurate diagnosis. This approach requires knowledge of the classic morphologic features of each articular disease as well as its typical distribution in the foot. Using knowledge of radiologic-pathologic correlation and the target area approach to disease, the physician can make an accurate diagnosis in most instances.

Arthritis↗
PubMed1981

Concurrent increases in resistance and transport after coronary obstruction in dogs.

We have extended earlier studies on coronary vascular permeability-surface area (PS) for [14C]sucrose to include observations of the transcoronary flow resistance before and after partial occlusion of the left anterior descending coronary artery. Multiple-tracer (MT) studies were conducted on 13 anesthetized dogs by inserting an isotope mixture (125I-albumin, 51Cr-red blood cells, [14C]sucrose, 3HOH) into a cannula connecting the carotid and the left anterior descending coronary artery. Analysis of blood sampled from the coronary sinus allowed calculation of PS, extravascular 3HOH volume (VT), and extravascular [14C]sucrose volume (VS). Flow reduction significantly reduced VT and VS and increased PS/VT relative to base line. Coronary resistance distal to the obstruction (R) decreased significantly immediately after flow reduction but then, over the low-flow period, increased significantly above this initial low-flow value. The mean R during reduced flow normalized to R immediately after flow reduction (Ri) correlated significantly with PS/VT during ischemia. Because R/Ri is not correlated with VT alone, we speculate that capillary permeability alterations may play a role in the deterioration of myocardial perfusion during ischemia.

Animals↗