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At least 379 records · Page 21Linked to original sources
PubMed1977

Mechanism of head and neck response to -Gx impact acceleration: a math modeling approach.

Mathematical modeling has attained wider acceptance in recent years. In particular, the use of computer programs to simulate the dynamic response of a human in a crash situation has become an attractive alternative to full-scale experimental testing. This paper analyzes data on the dynamic response of the living human head and neck to -Gx impact acceleration, where the motion of the subject's head and neck in the midsagittal plane was monitored with inertial instrumentation and high-speed photography for confirmation. The Calspan "3D Computer Simulator of Motor Vehicle Crash Victims" was used to predict expected responses for the deceleration pulses employed. These estimates were compared to the fully instrumented human test runs. The standard 15-segment and 14-joint representation of the occupant was modified to include two sternoclavicular joints, increasing the articulation in the upper torso. Analysis of the data indicated that muscular activity in the head and neck seemed to be evident and does influence motion of the head, even at relatively high (10-G peak, 530 G/s onset) acceleration levels. Simulation of muscular contraction, using a spring-damper arrangement, improved the results significantly. Additionally, possible limitations to head-to-neck motion, such as ligament restrictions, were also modeled.

Acceleration↗
PubMed2003

Disseminated infection due to Scedosporium apiospermum in a patient with acute myelogenous leukemia.

A 62-year-old man diagnosed with acute myelogenous leukemia which had developed from myelodysplastic syndrome received cytarabine and idarubicine as an induction therapy. The patient developed pneumonia and bacterial sepsis during profound neutropenia. Fever and sepsis improved by using many anti-bacterials and anti-fungals but he became febrile again and complained of severe lumbar pain. 67Ga scintigram showed abnormal uptake in the lumbar vertebra and left sternoclavicular joint, suggesting a diagnosis of discitis and osteomyelitis in the lumbar vertebra and sternoclavicular arthritis. We biopsied the site several times but culture of the biopsy specimen could not isolate any pathogens, and high fever persisted for about 10 months despite administration of various anti-bacterials and anti-fungals. Finally we inserted a catheter into the abscess at the iliopsoas muscle and Scedosporium apiospermum was isolated in the bloody pus obtained from the catheter. Itraconazole and amphotericin B were restarted, and the high fever and lumbar pain improved rapidly. The findings of S. apiospermum infection in this patient emphasizes the importance of being aware of this pathogen in patients with hematologic malignancy during the neutropenic phase.

Amphotericin B↗
PubMedDate not supplied

[Resection of the acromial and sternal end of the clavicle].

The causes of complaints in the acromioclavicular joint include arthrosis after dislocation of the joint, metastases, polyarthritis, tuberculosis, or hyperparathyroidism. Some causes have not yet been identified. If conservative therapy is unsuccessful the condition may be treated by resection of the acromial end of the clavicular, as first described by Gurd and Mumford. The present paper reports the results obtained in 22 patients who were followed up. Complete freedom from pain was achieved in 59% of the cases and improvement in 23.7%, while in 13.6% the results had to be classified as unchanged or poor. An analysis of these results admits the conclusion that with restricted indication and in particular in post-traumatic conditions, it is certainly possible to achieve results which make this technically simple procedure the treatment of choice in arthrosis of the acromioclavicular joint; this is borne out by the literature. In much rarer cases, changes in the sternoclavicular joint have to be surgically treated. Here also, the majority of cases are post-traumatic changes, and here again most of them are conditions following anterior luxation. Analogously to resection at the acromial end of the clavicula, a resection at its sternal end may also produce successful results. With reference to three of the authors' own cases, the clinical picture is considered and the results are presented and discussed; however, since the various surgical techniques cannot be compared, a final evaluation is only possible to a limited extent.

Acromioclavicular Joint↗
PubMed1995

Evaluation of arthritis in Reiter's disease by bone scintigraphy and radiography.

Tc-99m MDP bone scans were used to evaluate the articular inflammation in 38 patients with Reiter's disease and compared with clinical examination and radiologic findings. Our data showed that Reiter's disease predominantly involves the lower limbs, especially the heels, which may be a characteristic feature of Reiter's disease. Bone scans revealed a high diagnostic sensitivity in the detection of clinical arthritis in all peripheral joints, especially in the small joints of the four limbs. The diagnostic sensitivity of radiography was generally lower than bone scintigraphy. In the presence of positive radionuclide findings, clinical arthritis was found in most joints. The scintigram, however, detects a greater number of abnormalities than does clinical assessment in the sternoclavicular joints, shoulders, metacarpophalangeal joints, and tarsals. Because of its high sensitivity, bone scintigraphy is capable of detecting subclinical arthritis, and might provide more objective evidence of early inflammatory joint disease and additional information regarding the pattern of joint involvement. In view of the advantages of low patient radiation exposure, high sensitivity, and the ability to survey the whole body, we consider bone scintigraphy as useful and better than radiography in the detection of early articular inflammation and in establishing the extent and pattern of arthritis in Reiter's disease.

Adolescent↗
PubMedDate not supplied

Osteitis condensans of the clavicle: does fibrocartilage play a role? A report of two cases with spontaneous clinical and roentgenographic resolution.

Two cases of osteitis condensans of the medial clavicle with an unusual course toward spontaneous resolution of clinical and roentgenographic manifestations are reported. The relevant literature is reviewed. A pathogenic hypothesis for condensing osteitis of the clavicle, ilium, and pubis is suggested. At all these sites, the sclerosis occurs in bone overlaid by fibrocartilage. In contrast, joint aspects spared by the sclerosis are covered with hyaline cartilage. We report data documenting this fact at the sternoclavicular joint.

Adult↗
PubMed2002

Post-traumatic posterior sternoclavicular dislocation: case report and review of the literature.

Injuries to the sternoclavicular joint are an uncommon problem, but can be life-threatening if not diagnosed and treated properly. Both anterior and posterior sternoclavicular dislocations or subluxations can occur, the latter being a rare injury. In this case report we report the imaging findings of both conventional radiography and multidetector CT on a 16-year-old man who developed a posterior sternoclavicular dislocation while participating in a football match. The current literature regarding this subject is also reviewed.

Journal Article↗
PubMed1991

A re-evaluation of the osteoarticular manifestations of psoriasis.

A distinctive peripheral arthropathy associated with psoriasis is well recognized, the classical pattern describing an asymmetrical oligoarthritis with predominant distal interphalangeal joint (DIP) involvement. There is some dispute about the frequency of this classical pattern and of the pattern of symmetrical polyarthritis resembling rheumatoid arthritis. Some of the dispute may be a result of loose definitions. In this clinical and scintigraphic study of 50 patients with psoriatic arthritis we have used tighter definitions of disease pattern and have found that 68% of this group had a symmetrical polyarthritis similar to that found in rheumatoid arthritis. Yet, arthritis associated with psoriasis differs from rheumatoid arthritis in a number of ways including the pattern of joint involvement, extra-articular osseous features, and radiological changes. Scintigraphic changes in psoriatic arthritis suggest that subclinical involvement of the manubriosternal and sternoclavicular joints is common, suggesting an association between psoriasis vulgaris and arthro-osteitis. A modified classification of the osteoarticular manifestations of psoriasis is proposed.

Adult↗
PubMed1985

Amyloidosis of the joints: evidence that human hip capsules have a unique predisposition for amyloid of the senile systemic type.

Amyloid-containing tissues were sampled from 19 capsules and 10 cartilages from hip, knee and sternoclavicular joints of 16 elderly patients. Heart ventricles from 3 of these patients were also studied. Histochemistry and immunofluorescence were performed and amyloid fibrils extracted from one hip capsule. The results indicate that 9 of 13 hip capsules contained prealbumin-like amyloid fibril protein ASc1, a finding characteristic of senile systemic amyloidosis. The amyloid of 16 out of 17 other joint structures showed no reaction with anti-ASc1 or antisera to 3 other systemic forms of amyloid, indicating that they represent localized forms of amyloid.

Aged↗
PubMed1994

[Bone and joint sites of African histoplasmosis (Histoplasma duboisii). Apropos of a case and review of the literature].

The authors report a case of disseminated African histoplasmosis with bone and joint involvement in a black 28-year-old citizen of the Central African Republic who presented with a 17-month history of multiple osteoarticular lesions (sternoclavicular joints, humerus, ribs), cutaneous lesions (face, scalp, thorax), and lymphadenopathy. Clinical manifestations resolved rapidly under treatment with ketoconazole (600 mg/d for 10 days then 400 mg/day for nine months). Persistent yeast cells were then found upon examination of a lymph node biopsy specimen. The characteristics and diagnosis of osteoarticular lesions due to African histoplasmosis are discussed on the basis of a review of the literature. Bone and joint lesions due to African histoplasmosis have not yet been reported in patients with the acquired immunodeficiency syndrome. However, the expanding epidemic of human immunodeficiency virus infection in Africa can be expected to result in an increase in the incidence of African histoplasmosis. Imidazole derivatives are easier to use on a long-term basis than amphotericin B and have significantly improved our ability to treat African histoplasmosis.

AIDS-Related Opportunistic Infections↗
PubMed2002

Arthritis in children with familial Mediterranean fever.

The clinical spectrum of arthritis in 124 children with well-documented familial Mediterranean fever (FMF) was investigated in a retrospective study. Seven mutations in the FMF gene (MEFV) were also screened using restriction enzyme digestion and amplification refractory mutation system techniques in 110 patients. Mean age at the onset of FMF arthritis was 5.93+/-3.50 years, 75% of the patients being under 10 years of age. Arthritis in the lower extremities, upper extremities, and small joints of the hands and feet was noted in 122 (98%), 17 (14%), and 15 (12%) patients, respectively. Three patients had atypical arthritis involving temporomandibular, sacroiliac, and sternoclavicular joints. Although most of the arthritic attacks resolved within a few weeks, 12 (10%) patients developed protracted arthritis persisting for months. Amyloidosis was demonstrated in 17 (14%) patients who had not received colchicine treatment. Mutation analysis confirmed the diagnosis of FMF in 77 (62%) children. The clinical presentations of arthritis in FMF may be an important source of diagnostic confusion in FMF. Mutation analysis is of value in situations of diagnostic uncertainty.

Adolescent↗
PubMedDate not supplied

Osteomyelitis of the clavicle after subclavian vein catheterization.

Osteomyelitis of the clavicle or the sternoclavicular joint is a rare complication of subclavian vein catheterization. Soft tissue infections around the puncture site occur frequently and respond well to topical and antibiotic treatment. If symptoms persist for several weeks, osteomyelitis or sternoclavicular pyo-arthrosis should be considered. Bone and gallium scintigraphy scans and computerized tomography scans are helpful diagnostic measures.

Aged↗
PubMed2002

Growth of the mandible after replacement of the mandibular condyle: an experimental investigation in Macaca mulatta.

PURPOSE: The study goal was to investigate growth of the mandible after temporomandibular joint reconstruction in juvenile monkeys. MATERIALS AND METHODS: Sixteen juvenile monkeys (Macaca mulatta) were used as experiment subjects. Animals were equally divided into 4 experimental groups based on the method of temporomandibular joint reconstruction after bilateral condylar excision via extraoral vertical ramus osteotomies. Group Condyle animals had their condylar segments immediately replaced to serve as surgical controls. Group Bone animals were reconstructed with a bony strut. Group sternoclavicular joint (SCJ) animals were reconstructed with the sternal end of their clavicles. Group costochondral junction (CCJ) animals were reconstructed with costochondral junction of ribs. Standardized lateral cephalometric radiographs with the aid of tantalum bone markers were used to evaluate mandibular growth. Twenty animals were used as controls and were allowed to grow undisturbed for an 18-month period (Group Control). RESULTS: All animals showed good mandibular function and a Class I molar relationship after an 18-month follow-up period. Statistical and graphic comparisons showed no significant difference in mandibular growth among any of the groups. CONCLUSIONS: The results of this investigation suggest that, within the limits of this model, the choice of autograft for condyle replacement may be irrelevant.

Analysis of Variance↗
PubMed1981

[Tuberculosis of the calcaneus. Treatment and differential diagnosis (author's transl)].

Eight lesions in the calcaneus have been treated surgically between 1955 and 1979; of these, six were due to tuberculosis, one to chronic osteomyelitis and the other was a cyst. The diagnosis was confirmed bacteriologically and histologically. In all cases (average age 49.1 years) the human bacillus was proved to be the cause of an haematogenous infection. The lesion was confined to the posterior part of the bone and there was no extension into the calcaneo-navicular joint. Two patients presented with fistulae. The interval from the onset of symptoms to confirmation of the diagnosis averaged 9.1 months. Three patients had previously been treated for tuberculosis (lung, pleura, kidney) and another patient, who had a simultaneous tuberculous infection of a sternoclavicular joint had suffered from tuberculosis cervical lymphadenitis at the age of nine years.U

Bacteriological Techniques↗
PubMed1993

Interaction between the joints in the shoulder mechanism: the function of the costoclavicular, conoid and trapezoid ligaments.

By developing a measurement method based on the palpation of bony landmarks, the three-dimensional positions of the scapula and clavicle can be measured at several angles of humerus elevation. An analysis of these measurements shows the interaction between all joints of the shoulder mechanism. With the help of a biomechanical shoulder model the role of some of the extracapsular ligaments in the motion pattern of scapula and clavicle can be derived. In addition, the interaction between the rotations in the acromioclavicular and sternoclavicular joints is shown, and the possible implications for the treatment of joint problems in the shoulder are discussed.

Biomechanical Phenomena↗
PubMed1984

Posterior sternoclavicular dislocations: two case reports.

Posterior sternoclavicular joint dislocations are thought to be exceedingly uncommon. Two recent cases are discussed in terms of diagnosis, management, and potential risk to the patient. One dislocation was successfully reduced with lidocaine infiltrated and the second, seen 72 hours postinjury, required closed reduction under general anesthesia. Soon after injury these patients have a hollow at the sternoclavicular junction. Sternal oblique X-rays and tomograms are helpful in diagnosis. This entity may be promptly recognized and treated in the emergency department with gratifying results.

Adolescent↗