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S J Ostlere

Publications and source records attributed to S J Ostlere.

At least 19 recordsLinked to original sources
PubMed2006

Low-grade osteosarcoma of the ethmoid sinus.

Osteosarcoma uncommonly arises in craniofacial bones and has only rarely been reported to arise in the ethmoid sinus. Most primary osteosarcomas arising in paranasal sinuses are high-grade malignancies. A low-grade osteosarcoma arising in the ethmoid sinus has not previously been described. We report the clinical, radiological and histological findings of a case of low-grade (parosteal osteosarcoma-like) osteosarcoma which arose in the ethmoid sinus.

Adult↗
PubMed2004

Prevalence and epidemiological variation of anomalous muscles at guyon's canal.

Ultrasound was performed in 116 wrists of asymptomatic volunteers to determine the prevalence and morphology of anomalous muscles in Guyon's canal in the normal population. The size of the muscle was correlated with sex, hand-dominance and occupation. Anomalous muscles were identified in 47% of volunteers and 35% of wrists (male prevalence (50%); female prevalence (21%)). All were variants of abductor digiti minimi. Bilateral muscles were present in 50% of index cases in both sexes. Mean muscle thickness was 1.7 mm overall with no inter-sex variation. Muscle thickness did not vary with hand dominance or manual employment. The prevalence of anomalous muscles is higher than previously reported and may be sex-linked. The size of the muscle may be an important factor in determining whether an anomalous muscle is significant in cases of ulnar nerve compression at Guyon's canal.

Female↗
PubMed2004

Genetic influences in the aetiology of tears of the rotator cuff. Sibling risk of a full-thickness tear.

From a retrospective, cohort study of 205 patients diagnosed with full-thickness tears of the rotator cuff, we determined, using ultrasound, the prevalence of such tears in their 129 siblings. Using 150 spouses as controls, the relative risk of full-thickness tears in siblings versus controls was 2.42 (95% CI 1.77 to 3.31). The relative risk of symptomatic full-thickness tears in siblings versus controls was 4.65 (95% CI 2.42 to 8.63). The significantly increased risk for tears in siblings implies that genetic factors play a major role in the development of full-thickness tears of the rotator cuff.

Adult↗
PubMed2003

MRI of mycetoma of the foot: two cases demonstrating the dot-in-circle sign.

Radiological and histological findings of two patients with fungal mycetoma of the foot are presented. MRI revealed multiple 2-5 mm lesions of high signal intensity interspersed within a low-intensity matrix. Within many of the lesions a minute low-intensity focus was identified. Ultrasound showed distinct hyperechoic foci within a hypoechoic mass. We speculate that the low-signal matrix represents fibrous tissue, the high-intensity lesions correspond to granulomata and the central low-signal focus to the characteristic organised fungal elements (grains) present in this condition. This "dot-in-circle sign" on MRI reflects the unique pathological features of mycetoma and is likely to be a highly specific sign for this lesion.

Aged↗
PubMed2001

Limited magnetic resonance imaging in low back pain instead of plain radiographs: experience with first 1000 cases.

AIM: We report our experience with the first 1000 patients with non-traumatic low back pain (LBP) without radiculopathy undergoing limited sequence magnetic resonance imaging (MRI) instead of plain radiography. METHODS: Between January 1996 and December 1998, 1042 patients with low back pain unresponsive to conservative treatment were examined using a limited MR protocol comprising sagittal T1-weighted and STIR imaging. Plain radiographs were not performed. RESULTS: Malignancy, infection, vertebral fracture, spondylitis, pars defects and cord tumours were detected in 20%. Of the 82 osteoporotic vertebral fractures detected, 51 (62%) were recent and 31 had normal marrow signal indicating that they were old. Eighty pars defects were identified, 45(56%) had spondylolisthesis, 29(37%) were undisplaced and 6 (7%) had pars oedema only. Neoplastic disease was found in 17(8%) of which none was suspected before imaging. Benign neoplastic diseases such as vertebral AVM/haemangiomata were excluded. Twenty-one patients had a variety of disorders including ankylosing spondylitis (7), large vessel aneurysm (3), discitis (2), ovarian cyst (2), sequestered disc (2), sacral insufficiency fracture (2) and one patient each with burst fracture, retroperitoneal haematoma and a previously unsuspected horseshoe kidney. CONCLUSION: The majority of patients with LBP are best assessed clinically and imaging is usually not required. In patients with worrying symptoms, MRI with a limited protocol detects a greater number of abnormalities than previously reported studies using plain radiographs and has replaced plain radiography in our hospital. We report our experience with the first 1000 patients and highlight issues such as protocols, detection rates and communication issues.

Female↗
PubMed2000

Pregnancy-associated osteoporosis: does the skeleton recover?

Osteoporosis in pregnancy is a rare clinical problem of unknown cause. If the bone loss results from the pregnancy alone it should improve toward normal after delivery; in contrast, where bone density was low before pregnancy, due to some other secondary cause, significant postpartum improvement might not be expected. Thirteen women (age 23-37 years) with pregnancy-associated osteoporosis presenting with either pain in the back and vertebral collapse (8 subjects) or pain in the hip (5 subjects) had consecutive dual-energy X-ray absorptiometry measurements of bone mineral density (BMD) for up to 8 years after an affected pregnancy. The BMD results were expressed as a Z-score in relation to an age-matched mean. The mean initial (0-6 months postpartum) BMD was low in both groups and at both sites. In the back pain group the mean spine Z-score (Ll-L4) was -3.34 (range -2.25 to -4.66) and mean total hip Z-score was -2.41 (range -1.44 to -3.82). In the hip pain group the mean spine Z-score was -2.00 (range -1.48 to -2.65) and mean hip Z-score was -2.19 (range -1.12 to -3.26). Subsequent mean hip and spine BMD increased significantly toward the lower end of the normal range. We conclude that a reversible part of the bone loss is related to the pregnancy itself. A low BMD before pregnancy cannot be excluded. Knowledge that the bone density increases after an affected pregnancy, combined with the known rarity of recurrent symptoms in subsequent pregnancies, is important in prognosis.

Adult↗
PubMed2000

Assessment of patellar maltracking using combined static and dynamic MRI.

Between January 1995 and Jul 1997, 474 patients with anterior knee pain resistant to conservative treatment were referred for MR of the knee. The MR examination consisted of routine sequences with an additional patellofemoral dynamic examination using a technique that has been developed at this institution. The dynamic study examines both knees simultaneously, with the patient supine and the quadriceps loaded. No gating or restraint apparatus is needed. Patellar subluxation or tilt was present in 188(40%) of cases, bilateral in 104 and unilateral in 84 cases (right 39, left 45). It was classified as mild in 51%, moderate in 39% and severe in 10%. Subluxation was more prevalent in females than males (42% vs. 37%) and this was most obvious in the severe group where 68% were female. In 90 knees selected at random, four measurements of patellofemoral morphology were obtained using reconstructed images from a volume gradient echo sequence. These measurements were correlated with the degree of subluxation or tilt. A tibial tubercle distance greater than 20 mm, a femoral sulcus angle greater than 150 degrees, sulcus depth less than 4 mm were specific for subluxation but no measurement proved to be sufficiently sensitive to preclude a tracking study. MRI can be used to define more precisely the anatomy of the extensor mechanism and its relationship to the femur and tibia, in both a static and dynamic setting. In this way, patients with anterior knee pain can be classified more accurately and the outcomes of treatment more reliably assessed.

Adult↗
PubMed1999

Proximal patellar tendinosis and abnormalities of patellar tracking.

OBJECTIVE: To assess whether an association exists between patellar tendinosis and abnormal patellar tracking. DESIGN AND PATIENTS: The MRI examinations of 630 patients (i.e. 860 knees) referred with anterior knee pain over a 4-year period were assessed in retrospect for the presence of patellar tendinosis and abnormal patellar tracking. The images of the patients with patellar tendinosis were reviewed and the location within the patellar tendon was recorded. RESULTS: There were 44 knees with proximal patellar tendinosis. Twenty-four of these were considered to have normal patellar tracking and 20 to have abnormal patellar tracking. In the group of 816 knees without proximal patellar tendinosis, 581 were considered to have normal patellar tracking and 235 knees to have abnormal patellar tracking. When the two groups were compared there was a statistically significant difference in the ratio of patients with and without abnormal tracking. CONCLUSION: In patients referred with anterior knee pain or suspected abnormal patellar tracking there is a significant association between proximal patellar tendinosis and abnormal patellar tracking.

Adolescent↗
PubMed1999

Heterogeneous signal in bone marrow on MRI of children's feet: a normal finding?

OBJECTIVE: To describe the magnetic resonance (MR) appearances of the bone marrow of children's feet and to determine their frequency and significance. DESIGN AND PATIENTS: A review of MR studies obtained in a retrospective series of 35 children with foot pain and in a prospective series of 19 asymptomatic children was performed. The MR appearances on T1-weighted, T2-weighted and STIR sequences were assessed and the frequency of patchy areas of low signal intensity on T1-weighted and high signal intensity on T2-weighted or STIR sequences was determined and correlated with clinical features. RESULTS AND CONCLUSIONS: Low signal intensity on T1-weighted and high signal intensity on T2-weighted and STIR sequences were seen in 63% of symptomatic and 57% of asymptomatic children. In all cases where both feet were imaged, the changes were seen bilaterally. The marrow pattern varied from multiple discrete foci to more extensive confluent areas of high signal on the STIR sequence. These appearances are frequent and represent normal variation in the growing skeleton, and should not necessarily be interpreted as a sign of pathology.

Bone Marrow↗
PubMed1999

Mesenchymal chondrosarcoma associated with Goldenhar's syndrome.

Goldenhar's syndrome is characterised by bony abnormalities of the face, jaw and vertebral column. We report the first case of the development of a primary malignant neoplasm (mesenchymal chondrosarcoma) initially misdiagnosed as a meningioma, occurring in association with this syndrome.

Adult↗
PubMed1996

MRI diagnosis of partial tears of the anterior cruciate ligament.

In an attempt to define the magnetic resonance imaging (MRI) features of partial tears of the anterior cruciate ligament (ACL) we retrospectively analysed the MRI scans of 30 patients with a recent arthroscopic finding of a normal, a partial or a completely torn ACL. On review of the original reports MRI correctly predicted 9/9 (100 per cent) complete ACL tears, 11/12 (92 per cent) normal ACLs but only 1/9 (11 per cent) partial ACL tears. On analysis of the MRI there were four features which helped to differentiate partial ACL tears from either complete ACL tears or normal ligaments. These were the appearance of some intact fibres, thinning of the ligament, a wavy or curved ligament and the presence of an inhomogeneous mass posterolateral to the ACL. We propose that these findings may be indicators of partial ACL tear.

Adolescent↗
PubMed1995

Relative incidence and morphology of lateral and medial meniscal cysts detected by magnetic resonance imaging.

It is likely that meniscal cysts of the knee are a complication of meniscal tears which extend to the capsular attachment. They are reported as occurring three times more commonly on the lateral than the medial side. We reviewed 50 cases of meniscal cysts diagnosed on magnetic resonance imaging in patients with suspected internal derangement of the knee. Twenty-eight cysts involved the medial and 22 the lateral meniscus. The most common sites were the posterior third of the medial meniscus and the mid-third of the lateral meniscus. Fifteen cysts were suspected clinically, five on the medial side and 10 on the lateral side. Small cysts were only clinically predicted on the lateral side. We conclude that menial cysts are more common than previously thought and are more difficult than lateral cysts to detect clinically.

Adolescent↗
PubMed1995

Pregnancy-associated osteoporosis.

The clinical features, investigation and outcome in 24 patients with pregnancy-associated osteoporosis, followed for up to 24 years from the first pregnancy are described. Symptoms occurred most often in the first pregnancy (17 patients) at a mean age of 27 years (range 21-36); the most frequent was back pain in late pregnancy or post partum (n = 18); less common was hip (n = 5) or ankle (n = 1) pain. In most, symptoms improved soon after delivery. Four subjects had pre-existing disorders known to reduce bone density (corticosteroid therapy, heparin treatment, mild osteogenesis imperfecta and previous anorexia nervosa). Radiographs showed vertebral collapse or localized osteoporosis of the hip, with MRI evidence of oedema. Forearm bone mineral density (BMD) was sometimes normal, but spinal BMD (measured by DXA) was low. Bone biopsies in eleven patients showed features compatible with osteoblast failure. Except for the patient with mild osteogenesis imperfecta, cultured dermal fibroblasts synthesized and exported normal Type I collagen. In 14 subsequent pregnancies (10 patients) there was no recurrence in ten and mild symptoms in the remainder. Excluding one patient who had repeated osteoporotic fractures and vertebral collapse, the long-term prognosis was good.

Adult↗
PubMed1993

Can MRI of the knee affect arthroscopic practice? A prospective study of 58 patients.

We made a prospective study of 58 patients with suspected internal derangement of the knee. They were examined by magnetic resonance imaging using 3-D gradient echo intermediate-weighted studies before having an arthroscopy. The preoperative clinical assessment was found to have a diagnostic sensitivity of 77% and a specificity of 43%, compared with 100% and 63% respectively for magnetic resonance imaging. Comparison of magnetic resonance imaging and arthroscopy confirmed the accuracy of magnetic resonance imaging in the diagnosis of internal derangement but the results for articular cartilage lesions were much less good, with a sensitivity of only 18% but a specificity of 100%. Acceptance of the magnetic resonance imaging findings could have resulted in a 29% reduction in the number of arthroscopies without missing any significant meniscal lesion.

Adolescent↗
PubMed1991

Case report 658: Chondrosarcoma of the proximal phalanx of right fourth finger secondary to multiple hereditary exostoses (MHE).

A case of grade 1 chondrosarcoma of the phalanx of a finger complicating MHE is presented. Although the cytological features did not include anaplasia, other histological features, the presence of MHE, and recurrence of the tumor after local excision aided in making the correct diagnosis. This case emphasizes the importance of correlating the histological features with the radiological and clinical findings of all bone tumors, and especially cartilaginous lesions.

Adult↗
PubMed1991

Osteoporosis and bone density measurement methods.

Recent technologic advances in bone mineral densitometry have resulted in increasingly precise and accurate methods of estimating bone mineral density. Dual-photon absorptiometry has been made obsolete by the introduction of dual-energy radiography, a development that is likely to result in more widespread use of densitometry. The technique allows a reproducible, low dose examination of the spine, hip, and total body. Although capable of selectively measuring trabecular bone, quantitative computed tomography is currently limited to the spine, and the reliability of the technique varies from center to center. Single-photon absorptiometry and ultrasound experimental methods are of limited value because only peripheral skeletal sites can be examined by these techniques. Although invaluable in epidemiologic research and in limited clinical situations, the role of densitometry in the management and prevention of involutional osteoporosis has not been established. The evidence indicates that densitometry is unlikely to be effective as a selective screening procedure. Long-term prospective studies are needed to clarify the role of densitometry in osteoporosis management.

Bone Density↗
PubMed1990

Subchondral cysts of the tibia secondary to osteoarthritis of the knee.

Subchondral cysts of the tibia secondary to osteoarthritis of the knee are not usually seen on radiographs. When present, they are typically small and present no diagnostic difficulty. Two cases of unusually large subchondral lesions of the medial tibial plateau are presented. The lesions were well defined and lay adjacent to the medial tibial cortex with their long axes in the sagittal plane. Both were associated with moderate medial compartment osteoarthritis. Additional information obtained from computed tomography indicated that these lesions were subchondral cysts secondary to osteoarthritis rather than tumors or other tumor-like conditions.

Aged↗