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Biomedical subjects

A B Goldman

Publications and source records attributed to A B Goldman.

At least 19 recordsLinked to original sources
PubMed1992

Case report 706: Silicone-induced reactive synovitis.

In a patient with a disrupted silicone prosthesis, the presence of a swollen articulation should suggest the presence of silicone-induced reactive synovitis. Diagnosis of the entity rests on the identification of particulate matter by polarized microscopy and/or scanning electron microscopy--studies that will not be performed routinely unless the diagnosis is suggested preoperatively. The case presented is that of a 68-year-old woman in whom a silicone elastomer trapeziometacarpal prosthesis had been implanted 5 years previously. Painful swelling had ensued, and biopsy confirmed the diagnosis.

Aged↗
PubMed1991

Arthrography for rheumatic disease. When, why, and for whom.

The primary rheumatologic indication for an aspiration/arthrogram is the diagnosis of a septic joint. A second indication is the evaluation of a patient who has monoarticular complaints and normal plain radiographs. A third indication in patients who have known arthritis is that the contrast study can be used to evaluate the extent of cartilage destruction, identify complications that exacerbate pain, and determine if a soft tissue mass near the joint is related to the arthritis.

Arthritis, Infectious↗
PubMed1990

Posterior limbus vertebrae: a cause of radiating back pain in adolescents and young adults.

Four cases of posterior limbus vertebrae are presented, three in the lumbar spine and one in the lower thoracic spine. All four patients have myelographic documentation of herniated disc material affecting the spinal canal. One patient underwent an additional discogram that confirms the pathophysiology of the limbus vertebra by demonstrating that contrast material injected into the nucleus pulposus tracks between the body and the detached fragment.

Adolescent↗
PubMed1989

Calcific tendinitis of the long head of the biceps brachii distal to the glenohumeral joint: plain film radiographic findings.

Calcific tendinitis is a painful condition related to deposition of hydroxyapatite crystals; it favors large joints. The shoulder, specifically the tendons of the rotator cuff and the insertion of the long head of the biceps on the superior glenoid rim, is a well-recognized location for this abnormality. The purpose of this article is to describe a second site of calcific tendinitis of the biceps, distal to the joint and corresponding to the junction of the tendon and muscle. Radiographs in 119 cases of calcific tendinitis of the shoulder, obtained between 1980 and 1988, were reviewed. Twenty had calcific tendinitis in the region of the tendon of the long head of the biceps (nine at the glenoid insertion and 11 adjacent to the humeral shaft). All 11 patients with calcific tendinitis at the more distal site had a small, homogeneous deposit adjacent to the proximal humeral shaft. The densities in these 11 cases followed the normal course of the tendon of the long head of the biceps and were therefore medial to the proximal humeral shaft on the internal rotation view, lateral to the proximal humeral shaft on the external rotation view, and anterior to the proximal humeral shaft on the axillary projection. The major differential diagnosis of calcific tendinitis of the tendon of the long head of the biceps is loose bodies trapped in the biceps tendon sheath. Although the position of the soft-tissue densities in these two entities is similar, loose bodies have an appearance of bone, and their source (degenerative arthritis or recurrent dislocations) is usually apparent. A site of calcific tendinitis distal to the glenohumeral joint that is detectable on plain films is reviewed. Accurate diagnosis depends on understanding the anatomy of the tendon of the long head of the biceps brachii. The clinical charts of the 11 patients also are summarized, with emphasis on the association between the roentgen finding and bicipital tendinitis and impingement syndrome.

Adult↗
PubMed1988

The Segond fracture of the proximal tibia: a small avulsion that reflects major ligamentous damage.

The Segond fracture is a small vertical avulsion injury of the lateral aspect of the proximal tibia just distal to the plateau. It results from excessive internal rotation and varus stress. The plain film and arthrographic findings were studied in nine patients with the fracture. Although previous publications have relied primarily on the anteroposterior projection for diagnosis, the injury was apparent only on the tunnel view in two of our cases. The arthrogram was particularly important in identifying abnormalities of the anterior cruciate ligament (nine of nine cases) and/or meniscal tears (six of nine cases). The arthrographic findings related to the lateral ligamentous damage depended on the severity of the injury and on the interval between the injury and the arthrogram. In our series, the Segond fracture was uniformly associated with detachment of the capsular portion of the lateral collateral ligament and tears of the anterior cruciate ligament. In the majority of cases, there were associated injuries of the menisci and other supporting ligaments.

Adolescent↗
PubMed1988

Pigmented villonodular synovitis. Diagnosis and differential diagnosis.

PVNS is a proliferative disorder that can affect joints, tendons and bursae. Its etiology is unknown. The most widely accepted theories attribute this disorder to a chronic inflammatory response or a benign neoplasm of fibrohistiocytic origin. On gross specimens, the synovial changes are characterized by villous and/or nodular hyperplasia. This disorder occurs most frequently in the third or fourth decades of life and has no sex predilection. As a joint problem, it favors the knee and hip. As a tendon abnormality, it favors the digits. Plain film findings include 1) soft tissue swelling, 2) increased density of the synovium secondary to hemosiderin deposition, 3) multiple subchondral cysts, and 4) extrinsic cortical pressure erosions. Cartilage space narrowing, if present, is gradual and occurs later than the other plain film findings. Arthrography can demonstrate the nodular synovial changes and determine if the process is diffuse or focal. MRI can, in some cases, reveal areas of decreased signal within the hyperplastic synovium reflecting the deposition of hemosiderin. The major roentgen differential diagnoses of articular PVNS include uncalcified synovial chondromatosis, tuberculous arthritis, and hemophilic arthropathy.

Bone Cysts↗
PubMed1988

[Orthopedic problems in children caused by neuromuscular diseases].

In the child, neuromuscular diseases have an affect not only on the soft tissues but also on the skeleton, with consequences regarding statics and locomotion. Problems essentially involve the joints of the lower limb. Certain are due to muscular imbalance, eg. an unstable hip, coxa valga, hyperanteversion or miscellaneous abnormalities of the knee. Others are due to sensory denervation, resulting in "neurological joints". Vertebro-pelvic abnormalities also occur with manifestations, according to the individual case, including tilting of the pelvis, paralytic scoliosis or vertebral dysmorphism. It is easy to understand the importance of awareness of such abnormalities, which can be detected early radiologically, and then subjected to expert evaluation in order to be able to select in good time the most appropriate orthopedic management.

Bone Diseases↗
PubMed1979

Case report 91.

Explore the source record for details and available documents.

Adult↗
PubMed1979

Haemophilic arthropathy in the joints of the hands and feet.

Radiographs of the hands and feet of 72 haemophilic patients were reviewed for peripheral joint involvement. Fifty patients or 69% had changes in the small joints of their hands and/or feet with a total of 160 abnormal joints. In the hands the metacarpo-phalangeal joints were predominantly involved (42 of 50 joints), and in the feet, the metatarso-phalangeal joints (68 of 110 abnormal joints), as well as the posterior subtalar joint (36 of 110 joints). Röntgen abnormalities were characterized by irregularity and/or flattening of the articular cortices. The involvement of the small peripheral joint in haemophilic patients has not been a primary consideration in previous clinical and radiographic studies because of the more common and more debilitating changes in the large joints. The recognition of involvement of the small joints is described to avoid misinterpretation of the röntgen findings and to appreciate the incidence of involvement, especially with the increased availability of replacement therapy.

Adolescent↗
PubMed1978

Slipped capital femoral epiphyses complicating renal osteodystrophy: a report of three cases.

Three adolescents with bilateral slipped capital femoral epiphyses complicating renal disease are presented. In one case, the severity of the deformities necessitated total hip replacement. Pathological specimens were available for evaluation. In all 3 cases, epiphysiolysis was accompanied by severe subperiosteal reabsorption along the medial aspect of the femoral neck, widening of the cartilaginous growth plate, and coxa vara. The radiographic diagnosis of a minimally displaced femoral epiphysis may precede the clinical symptoms. Early recognition of this complication is important, since the treatment of choice is prophylactic surgical stabilization before disabling deformities occur.

Adolescent↗
PubMed1978

The double-contrast shoulder arthrogram. A review of 158 studies.

Experience with double-contrast arthrography indicates it is superior to the single-contrast technique. First, the double-contrast study provides additional information on the width of rotator cuff tears and on degeneration in the tendons. This information is valuable in choosing surgical candidates and electing the best surgical incision. Second, the air-distended capsule permits visualization of the entire intra-articular portion of the biceps tendon. Third, improved visualization of the articular cartilages is important in evaluating patients with previous anterior shoulder dislocations or inflammatory arthritis.

Cartilage, Articular↗
PubMed1978

Neuropathic injuries to the lower extremities in children.

Neuropathic injuries of the lower extremities in children due to meningomyelocele, congenital indifference to pain, and peripheral nerve damage were studied in 10 patients. The injuries fell into four categories: (a) fractures of the metaphysis and diaphysis of long bones, (b) epiphyseal separation, (c) Charcot joints, and (d) soft-tissue ulceration. These injuries are often unrecognized; untreated, they can lead to severe disability. For patients with impaired sensation, radiographs should be obtained at any sign of localized soft-tissue swelling, warmth, or hyperemia, especially near a joint. Following diagnosis, immobilization of the limb will lead to prompt healing of fractures and epiphyseal separation.

Child↗
PubMed1978

Acute chondrolysis complicating slipped capital femoral epiphysis.

Radiographs of 20 patients with acute chondrolysis complicating a slipped capital femoral epiphysis were reviewed with emphasis on the radiographic features and differential diagnosis. There was bilateral disease in five instances; radiographic follow-up ranged from 6 months to 5 years. The onset of chondrolysis occurred after surgery in 18 of the 25 abnormal hips. Acute necrosis of the articular cartilage is characterized radiographically by (1) persistent juxtaarticular osteoporosis; (2) progressive narrowing of all or a portion of the cartilage space; and (3) erosion of the subchondral cortices of the femoral head and acetabulum. The radiographic differential diagnosis varies with the stage of disease. The initial osteoporosis is indistinguishable from disuse. The rapid loss of the joint space, accompanied by destruction of the central portions of the subchondral bone, makes differentiation from postoperative infection a common problem. Late changes may resemble either degenerative joint disease or a chronic inflammatory arthritis. The accurate diagnosis of acute chondrolysis depends on correlation of the clinical history and radiographic findings.

Acute Disease↗
PubMed1978

Discogenic vertebral sclerosis.

Narrowing of a disc space, sclerosis of the adjacent vertebral bodies, and irregularity of the vertebral end plates constitute a roentgen complex classically associated with infectious spondylitis. However, narrowing of a disc space may be the result of a herniated nucleus pulposus, and in some individuals the reactive sclerosis is sufficiently intense to resemble infection. Roentgenographic recognition of discogenic vertebral sclerosis may obviate the need for further evaluation and biopsy. Forty-four cases of discogenic vertebral sclerosis, nine with surgical proof and four developing after disc surgery, are presented. Roentgen signs helping to distinguish it from infection include: (i) rounded sclerosis most frequently in the anterior vertebral body (100%), (ii) central lucency in the sclerosis (77%), (iii) associated degenerative changes at the intervertebral disc, e.g. vacuum phenomena (44%), (iv) absence of a para-spinal mass and (v) maintenance of vertebral body height.

Adult↗
PubMed1978

Proximal focal femoral deficiency.

The term proximal focal femoral deficiency (PFFD) is applied to a spectrum of conditions characterized by partial absence and shortening of the proximal femora and thought to result from an early disturbance of growing mesenchyme. The mildest cases, Classes A and B, exhibit a relatively normal acetabulum and capital femoral epiphysis, despite the dysplastic shaft. There may be a subtrochanteric varus deformity or a pseudoarthrosis accompanying the shortening of the femoral shaft. At the opposite end of the spectrum, the most severely deformed cases, Classes C and D, have involvement of the acetabulum, and the entire proximal femur. In cases of advanced dysgenesis, the findings include: a stunted severely shortened femur with a club-shaped or pointed proximal end, an iliac projection just above the anatomic site of the acetabulum, a spherical obturator foramen, and squaring of the iliac crest. Twenty-one patients (2 bilateral) with proximal focal femoral deficiency are presented (23 femurs). Differentiation of proximal focal femoral deficiency from other congenital and acquired deformities of the hip joint is essential for selecting the proper treatment.

Adult↗