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Biomedical subjects

W K Taconis

Publications and source records attributed to W K Taconis.

At least 19 recordsLinked to original sources
PubMed2000

Abnormal bone scans of the tibial tunnel 2 years after patella ligament anterior cruciate ligament reconstruction: correlation with tunnel enlargement and tibial graft length.

Tibial bone tunnels were examined with bone scans 2 years after patella ligament ACL reconstruction in 68 patients. At 2 years, scan uptake at the tibial tunnel was increased in 29% of patients. Marked increase of scintigraphic uptake was associated with tibial tunnel enlargement of more than 35% and a graft length in the tibial tunnel over 14 mm. Scan uptake was correlated to tunnel enlargement (r = 0.64, P < 0.01) and tunnel enlargement was correlated to graft length inside the tibial tunnel (r = 0.59 P < 0.001). No correlation was found between scan uptake or tunnel enlargement and anterior laxity, sagittal tunnel position and subjective outcome. Scintigraphy indicates the enlarged tibial tunnels are filled with remodelling bone. Tibial fixation location influences ligament healing inside the tunnel: Return of osseous homeostasis at the tibial tunnel can take more than 2 years when fixation is more than 14 mm below the joint.

Adolescent↗
PubMed2000

Abnormal bone scans in anterior cruciate ligament deficiency indicate structural and functional abnormalities.

Many patients with anterior cruciate ligament (ACL) deficiency have an abnormal bone scan. This finding has not yet been explained. Suggested explanations include intra-articular (structural) or kinematic (functional) abnormalities. We examined the relationship between bone scintigraphy and cartilage degeneration or meniscal lesions in the ACL-deficient knee in 95 consecutive patients who had bone scintigraphy 1-3 days prior to arthroscopic ACL reconstruction. Intra-articular abnormalities of the knee did not explain all scintigraphic patterns of this study. We did not find clinically useful positive predictive values for scintigraphic patterns considered to indicate cartilage degeneration or a lateral meniscus lesion. A clinically useful positive predictive value was found only for medial meniscus lesions when time since ACL rupture was more than 18 months, and for local cartilage degeneration when markedly increased uptake was seen when time since ACL rupture was more than 4 months. Considering these findings, alternative explanations are discussed, based on specific aspects of abnormal kinematics and adaptive bone metabolism of the ACL-deficient knee.

Adolescent↗
PubMed1999

[Insufficiency fractures of the sacrum].

In two women aged 85 and 62 years respectively, with pain in the lower back and the hip region, insufficiency fractures of the sacrum were diagnosed. They were treated by bed rest and pain medication with good clinical outcome. Especially in older, postmenopausal women who have been treated for a malignancy (possibly with irradiation of the pelvis), the possibility of sacral insufficiency fractures should be kept in mind. Many unnecessary and sometimes invasive investigations to exclude tumour or metastases can be avoided by adequate diagnostic imaging: first conventional X-ray investigation followed by skeletal scintigraphy. A typical H-shaped pattern of sacral uptake is diagnostic of insufficiency fractures. As this pattern is seen in only approximately 20% of the patients, additional CT will often be necessary. CT can demonstrate the fracture lines and exclude bone destruction or a soft tissue mass. In case CT is not conclusive MRI is indicated.

Aged↗
PubMed1999

Value of diagnostic ultrasound in patients with chronic scrotal pain and normal findings on clinical examination.

OBJECTIVES: Chronic scrotal pain is a frequent complaint. In many patients with scrotal pain, scrotal ultrasound is performed when the physical examination reveals no abnormalities. We evaluated the yield of scrotal ultrasound in patients with chronic scrotal pain and a normal physical examination. METHODS: The study involved the findings in 111 patients with scrotal pain lasting longer than 2 weeks, in whom physical examinations and urinalyses were normal and who underwent ultrasound evaluation. Follow-up data were available. RESULTS: The median age at first presentation was 37 years. The median duration of pain at presentation was 5 months. The pain in the scrotum was localized to the right side in 37% of patients, to the left in 41 %, and bilaterally in 22%. Eighty-three percent had intermittent complaints, and 17% experienced continuous pain. In searching for a cause of the scrotal pain, 65% of patients were found to have a relevant medical history, such as regional surgery, infection, trauma, and low back pain, and 57% described provocative factors. Scrotal ultrasound revealed 12 epididymal cysts less than 0.5 cm and three subclinical varicoceles, but no clinically significant abnormalities. After a median follow-up of 12 months, the pain continued in 70%, although without the development of serious scrotal pathologic features. CONCLUSIONS: Scrotal ultrasound has no diagnostic value in patients with chronic scrotal pain in whom the physical examinations and urinalyses are normal. A patient's history may suggest an extrascrotal cause of his pain.

Adolescent↗
PubMed1997

Multifocal giant cell tumors in the spine. A case report.

STUDY DESIGN: This is a case report of a patient with two giant cell tumors, the first in thoracic spine and the second, two years later, in the sacrum. OBJECTIVES: To report the first patient in whom multifocal primary giant cell tumors have been found in the spine. SUMMARY OF BACKGROUND DATA: There have been no similar previous reports. METHODS: The diagnoses were made by biopsy. RESULTS: Curative removal of both tumors was achieved. CONCLUSIONS: More than one primary giant cell tumor in the spine can develop.

Adult↗
PubMed1997

Synovial chondrosarcoma: report of a case and review of the literature.

Primary synovial chondromatosis is a relatively uncommon condition. Synovial chondrosarcoma is considered to be very rare and it is not always clear whether the sarcoma develops by malignant transformation of synovial chondromatosis or whether it arises de novo. Differentiation of the two conditions on clinical and radiographic features is not possible and on histological criteria can be difficult. We report the case of a 59-year-old man who, 4 years after a synovectomy for synovial chondromatosis, developed a synovial chondrosarcoma of the hip. The literature is reviewed.

Chondrosarcoma↗
PubMed1996

Avascular osteonecrosis of the femoral head treated with a vascularized iliac bone graft: preliminary results and follow-up with radiography and MR imaging.

Treatment of avascular necrosis (AVN) of the femoral head with a vascularized iliac bone graft was studied in nine patients (12 hips). The condition of the femoral head was classified radiographically before and after surgery. Magnetic resonance (MR) imaging was performed to demonstrate the extent and signal intensity characteristics of the area of AVN and to assess the viability of the graft. The radiologic results were correlated with the clinical findings. Although radiography showed progression of disease in six patients, seven of the nine patients demonstrated clinical improvement. The MR imaging results correlated better with the clinical findings: MR imaging demonstrated progression of AVN in only two patients (two hips) and no progression or reduced necrosis in six patients (nine hips). Nine of the 11 grafts (eight patients) evaluated with MR imaging appeared viable after a mean follow-up of 50 months. MR imaging appears useful in assessing marrow changes and graft viability after treatment of AVN of the femoral head with a vascularized iliac bone graft.

Adolescent↗
PubMed1996

Vertebral osteomyelitis caused by thoracic empyema, or vice versa?

Thoracic empyema and vertebral osteomyelitis is a rare combination. We report a case of vertebral osteomyelitis possibly caused by a progressive thoracic empyema. The causative pathogen was Escherichia coli. Computed tomographic (CT) scan and magnetic resonance imaging (MRI) suggested the diagnosis of vertebral osteomyelitis, confirmed by transthoracic needle aspiration and operative findings. Aetiology and treatment are discussed.

Empyema, Pleural↗
PubMed1994

Desmoplastic fibroma of bone: a report of 18 cases.

Desmoplastic fibroma is a rare benign primary bone tumor, histologically identical to the extra-abdominal desmoid tumor of soft tissues. The incidence in major series of bone tumors is 0.1%-0.3%. In the present study 18 cases from the files of the Netherlands Committee on Bone Tumors are reported, with an emphasis on the radiographic features. Eight female and ten male subjects were affected, with a fairly even age distribution from the second to the seventh decade of life. The most frequent sites of involvement were the femur and the pelvis. Radiographically the lesions nearly always demonstrated benign features with respect to pattern of destruction, margins, and reactive bone formation; however, soft tissue extension was sometimes present. Although desmoplastic fibroma usually presents with pain or swelling, in 5 of the 18 cases the existence of the lesion was an accidental finding, and in 2 cases the patient had long-standing, vague complaints of pain. Though overall benign radiographic features may support the final diagnosis, the main and often troublesome histological differential diagnosis is of a low-grade fibrosoma. En bloc resection is the treatment of choice in view of the high incidence of recurrence after curettage.

Adolescent↗
PubMed1993

Giant cell tumor in children and adolescents.

The radiological appearance of giant cell tumors (GCT) in the developing skeleton was retrospectively assessed in 49 (10.6%) of the 462 patients with GCTs seen in consultation by the Netherlands Committee on Bone Tumors. There were 31 female and 18 male patients, all below 19 years of age. Thirty-four tumors were located in short and long tubular bones, two in the tarsus, while the others were in the pelvis, vertebral spine, and a rib. Involvement of the epiphysis in tubular bones was closely related to the age of the patient: the average age of the 3 patients with a lesion in the metaphysis was 11 years, that in the 6 patients with metadiaphyseal lesions 13 years, average age in the 10 patients with epimetaphyseal lesions 17 years, and it was also 17 years in the 17 patients with epimetadiaphyseal lesions. In tubular bones with the epiphyseal growth plates still open, the epiphysis was never involved, with the exception of two epimetadiaphyseal lesions in which closure of the growth plate was difficult to establish. Assessing GCT characteristics in this study population demonstrated that epiphyseal involvement increased with age and showed; to some extent, a predominance of female patients.

Adolescent↗
PubMed1990

The relationship between densitometry of the radius and vertebral fractures.

In 105 postmenopausal women with clinical suspicion of osteoporosis single photon absorptiometry (SPA) of the forearm and fracture percentage of the thoracic and lumbar spine were estimated. SPA was performed on the commonly used mid-radius site as well as on a modified distal radius site where radius and ulna are separated by five mm. Spine fracture percentage was inversely correlated with mid-radius SPA (r = -0.49) but more closely with distal radius SPA (r = -0.61). With bone mineral density values above 0.400 g/cm2 on the distal radius, no fractures were found. Between 0.325 and 0.400 g/cm2, 35% of the patients showed vertebral fractures but only up to a maximum of 30%. Below 0.325 g/cm2, 89% of the women had crushed vertebrae, often more than 30% of those measured. In conclusion, these results indicate that modified distal radius densitometry is superior to the commonly used mid-radius measurement and has some predictive value for the presence of vertebral fractures.

Absorptiometry, Photon↗
PubMed1988

Osteosarcoma in fibrous dysplasia.

Two cases are reported with osteosarcomatous transformation in fibrous dysplasia, one in the skull and one in the iliac bone. In both cases the patient was known to have longstanding polyostotic fibrous dysplasia; no radiation therapy was ever given. The incidence of sarcomatous transformation in fibrous dysplasia in the files of the Netherlands Committee on Bone Tumours is 0.5%. When strict criteria for spontaneous malignant transformation are used, the actual incidence is probably lower than is suggested.

Adult↗
PubMed1986

Fibrosarcoma of the jaws.

The records of 14 patients with fibrosarcoma of the jaws--10 in the mandible and four in the maxilla--from the files of the Netherlands Committee on Bone Tumours were studied. The mean age of the patients was 30 years; more men than women were involved; pain and especially swelling were the symptoms most frequently present. The radiographic appearance often indicated the malignant nature of the lesion. Histologically 42% of the tumours were low-grade malignant. The 5-year survival rate was 71%, which is more favourable than either fibrosarcoma located elsewhere in the skeleton or osteosarcoma of the jaws. Radical surgery is the therapy of choice. All cases with an unfavourable course acquired lung metastases.

Adolescent↗
PubMed1986

Clear cell chondrosarcoma: report of three cases and review of the literature.

Three cases of clear cell chondrosarcoma, located in the proximal tibia, rib and proximal femur, are reported. Clear cell chondrosarcoma is a cartilaginous tumour of low grade malignancy, most often located in the epiphysis of the long bones, especially of the proximal femur and humerus, with a relatively favourable prognosis. Clinical, radiological and pathologic features are discussed and a review of the literature is given.

Adult↗
PubMed1985

Fibrosarcoma of long bones. A study of the significance of areas of malignant fibrous histiocytoma.

A study was made of the clinical course of 102 cases of fibrosarcoma of long bones. Of these, 55 were predominantly fibroblastic or pure fibrosarcomata while 47 contained extensive areas resembling so-called malignant fibrous histiocytoma (MFH). Treatment was similar in the two groups, and the five-year survival was the same, 34%, in both groups. Lung metastases developed in 63% of the fibroblastic sarcomata and 59% of the MFH-like tumours. Our study indicates that there is no significant difference in behaviour in fibrosarcoma with or without marked MFH features. The histological grading of both groups of fibrosarcomata together was of prognostic value; five-year survival was 64% in 14 Grade I tumours, 41% in 32 Grade II tumours and 23% in 56 Grade III tumours.

Adolescent↗