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Biomedical subjects

T E Keats

Publications and source records attributed to T E Keats.

At least 19 recordsLinked to original sources
PubMed1997

Plain film evaluation of degenerative disk disease at the lumbosacral junction.

OBJECTIVE: Diagnosing degenerative disk disease (DDD) at the lumbosacral junction (LSJ) on plain films is often difficult, compared with other disk levels. The purpose of this study was to determine whether criteria for diagnosis of DDD at the LSJ can be established for plain films. DESIGN AND PATIENTS: We retrospectively reviewed 100 lumbar MRI scans of patients who also had lumbar plain films. Using MRI as the reference standard, the LSJ was classified as normal (n=35) or exhibiting mild (n=45) or severe (n=20) DDD by two radiologists using accepted criteria. Measurements were performed on the plain films by two other radiologists and the average measurements were tabulated according to the three categories of DDD defined by MRI. Plain film measurements included the anterior and posterior disk heights (ADH, PDH), Farfan's ratio, determined by adding ADH to PDH and dividing that number by the measured anteroposterior (AP) length of the inferior end plate of L5 [(ADH+PDH)/AP length of L5], and lumbosacral angle (LSA). Subsequently, five additional radiologists interpreted the radiographs by visual inspection only, for DDD at the LSJ, both before and, several weeks later, after being provided with the quantitative data for normal versus DDD. RESULTS AND CONCLUSION: There was a statistically significant difference between normal disk and increasing severity of DDD on radiographs using the parameters of PDH and Farfan's ratio. There was no statistically significant difference regarding ADH or LSA. Diagnostic accuracy by visual inspection was not significantly altered using the quantitative data for interpretation of DDD (68% correct before, 69.5% correct after). Analysis of results indicates that PDH is the most reliable and easily used criterion for detection of DDD at the LSJ. A PDH < or =5.4 mm on plain lateral film indicates DDD; PDH > or =7.7 mm indicates the absence of DDD on plain film.

Adult↗
PubMed1997

Acute knee trauma: how many plain film views are necessary for the initial examination?

OBJECTIVE: To determine whether anteroposterior (AP) and lateral views of the knee are equivalent to four views in acute fracture detection. DESIGN: Three musculoskeletal radiologists retrospectively interpreted the plain film knee examinations of each patient, establishing ground truth for the presence or absence of a fracture. Cases were presented to four masked senior radiology residents twice--once as a two-view study and again as a four-view study--with 4 weeks separating the two reading sessions to minimize recall bias. Sensitivity, specificity, and diagnostic performance were calculated. PATIENTS: Ninety-two patients presenting to the emergency department with acute knee trauma were evaluated with at least a four-view plain film examination. RESULTS AND CONCLUSIONS: Mean sensitivity for fracture detection using four views (85%) was significantly higher than that using two views (79%). Mean specificity and receiver operating characteristic curve areas were not significantly different using two or four views. Four views are more sensitive than AP and lateral views alone in detection of acute knee fracture.

Acute Disease↗
PubMed1996

Imaging of bursae around the shoulder joint.

The authors present a review of the anatomy of the major bursae around the shoulder joint and discuss the use of the different imaging modalities which demonstrate their radiologic features. The calcified subacromial-subdeltoid bursa has a characteristic appearance on plain radiographs. When inflamed it can be visualized by ultrasound and magnetic resonance imaging. Calcific bursitis may involve the subcoracoid bursa. This bursa may mimic adhesive capsulitis of the shoulder or complete rotator cuff tear when injected inadvertently during shoulder arthrography. Less well known are three coracoclavicular ligament bursae. These are also subject to calcific bursitis and have a typical radiologic appearance.

Bursa, Synovial↗
PubMed1992

Case report 733. Calcific tendinitis of the origin of the medial and lateral heads of the rectus femoris muscle and the anterior iliac spin (AIIS).

Calcific tendinitis at the site of origin of the rectus femoris muscle is a rare lesion. Presumed to be formed by deposition of hydroxyapatite crystals, this entity may be confused with other lesions such as os acetabuli or posttraumatic abnormalities. The characteristic location and appearance of the calcifications in a symptomatic patient with no history of trauma should allow diagnosis and subsequent symptomatic therapy.

Calcinosis↗
PubMed1991

Normal variants of the hand and wrist.

There are many normal anatomic variations in the hand and wrist that simulate pathologic processes. Recognition of these entities is extremely important in avoiding errors of commission and diagnosing diseases that do not exist. Many of these entities are not bilaterally symmetrical. This article illustrates many of these troublesome variants.

Hand↗
PubMed1990

Bilateral protrusio acetabuli in sickle cell anemia.

Extreme bilateral protrusio acetabuli is an unusual complication of hematologic disease. We have described a patient with sickle cell anemia who had this complication probably as a result of osteopenia. Thus sickle cell anemia should be added to the list of potential causes of protrusio acetabuli.

Anemia, Sickle Cell↗
PubMed1989

Intra-osseous ganglion. Report of four cases and review of the literature.

Intraosseous ganglia are histologically identical to their soft tissue counterparts. Most commonly seen adjacent to the hip, ankles, knee, or wrist, they are often mistaken for other neoplasms occurring in the epiphysis. We discuss the characteristic clinical, radiological, and pathologic features of four cases of intraosseous ganglia. Intraosseous ganglia should be included in the differential diagnosis of well-demarcated lucent epiphyseal lesions of bone.

Adult↗
PubMed1989

Idiopathic punctate necrosis of the phalanges of the feet.

Small areas of discrete radiolucency surrounded by well-defined margins of sclerosis are incidental asymptomatic findings in the proximal phalanges of the feet, usually in young males. Histologic examination of similar lesions discovered in the feet of cadavers shows fat necrosis. Although the etiology of these lesions is as yet unproven, musculoskeletal stress is suggested.

Cadaver↗
PubMed1988

The acromioclavicular joint: normal variation and the diagnosis of dislocation.

Acromioclavicular separation is a common traumatic injury. Diagnosis rests on clinical and radiographic findings. However, normal variation in the alignment of the acromioclavicular joint may make the roentgen diagnosis more difficult. We stress the variations of normal alignment at the acromioclavicular joint and offer suggestions for avoiding pitfalls in this clinical situation.

Acromioclavicular Joint↗
PubMed1988

Nontraumatic avulsion of the lesser trochanter: a pathognomonic sign of metastatic disease?

Isolated avulsion fractures of the lesser trochanter resulting from trauma are most commonly seen in adolescent athletes and are rare in adults. Standard therapy is nonsurgical with bedrest and immobilization of the leg. However, when this lesion is seen in the adult without significant trauma, it should be regarded as secondary to metastatic neoplasm until proven otherwise. Treatment should be surgical with prophylactic internal fixation of the hip to help prevent the commonly associated subtrochanteric pathologic fracture. In a patient without a known primary malignancy, biopsy should be carried out before therapy. We describe four patients with isolated avulsion fracture of the lesser trochanter due to metastatic carcinoma. Radiologists should be aware of this lesion because its presence has a decisive effect on therapy.

Adenocarcinoma↗
PubMed1987

Idiopathic synovial chondromatosis in two unusual sites: inferior radioulnar joint and ischial bursa.

Synovial chondromatosis is a rare disorder of unknown cause characterized by multiple calcific bodies in the vicinity of the affected joint. It is most commonly seen in the knee, hip, elbow, and shoulder. We describe three cases of synovial chondromatosis in two extremely uncommon sites, the inferior radioulnar joint and the ischial bursa, and review the literature on the subject. The characteristic radiographic appearance, even if in an uncommon location, should prompt the radiologist to suggest the correct diagnosis preoperatively.

Adult↗