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A Cotten

Publications and source records attributed to A Cotten.

At least 73 records · Page 4Linked to original sources
PubMed1997

[Giant cell tumors of the spine. Report of a case, literature review].

Giant cell tumors of bone are uncommon in the vertebrae above the sacrum. We report the case of a giant cell tumor of the third lumbar vertebra, revealed by lumbar and radicular pain. X ray, computed tomography and magnetic resonance imaging showed osteolysis of the body and vertebral arch of L3. Histologic evaluation gave a conclusion of a giant cell tumor, grade 2. Spondylectomy of L3 was performed using a combined approach (anterior and posterior) in two stages. The patient had a good functional result without recurrence at three years and six months. A review of the literature indicates that the radiological appearance is nonspecific but shows the extent of the tumor. Diagnosis can be based only on histological features. Radiotherapy could induce malignant transformation. Radical resection limits the risk of recurrence. Total spondylectomy is recommended for giant cell tumors when both the body and arch are involved.

Adult↗
PubMed1997

[Uncommon etiology of extradural hematoma].

Intracranial or spinal epidural hematomas are almost always of post-traumatic origin, and rarely related to rupture of a dural vascular malformation or a hemostasis disorder. We report a case of spontaneous cerebral epidural hematoma observed in a young girl with homozygous sickle cell disease. After analysis of post-operative cerebral MRI, showing skull bone infarction inside and around the bone flap, it was considered that the skull bone infarction could be responsible for a diploic venous thrombosis with subsequent "spontaneous" epidural hematoma.

Adolescent↗
PubMed1997

[SAPHO syndrome and aseptic osteitis].

Palmoplantar pustulosis and severe acne are sometimes associated with aseptic skeletal lesions, but such skeletal conditions can be observed without skin lesions. The acronym SAPHO (Synovitis, Acne, Palmoplantar pustulosis, Hyperostosis, Osteitis) has been suggested for this cluster of manifestations. The most frequent site of the disease is the upper anterior chest wall, characterized by predominantly osteosclerotic lesions, hyperostosis, and arthritis of the adjacent joints. Osteosclerosis of the vertebral bodies, hyperostosis, and erosions of the vertebral plates can be encountered. Unilateral sacroiliitis of frequently observed. Long bone involvement consists of osteosclerosis or osteolysis with periosteal new bone formation. Peripheral arthritis is rarely associated with joint destruction. The pathogenesis of this syndrome remains unknown, but a link with seronegative spondylarthropathies is probable. Awareness of the SAPHO syndrome should facilitate proper diagnosis and treatment.

Acquired Hyperostosis Syndrome↗
PubMed1996

[Sapho syndrome].

Explore the source record for details and available documents.

Acne Vulgaris↗
PubMed1996

Percutaneous vertebroplasty for osteolytic metastases and myeloma: effects of the percentage of lesion filling and the leakage of methyl methacrylate at clinical follow-up.

PURPOSE: To determine whether the percentage of vertebral lesion filling and the leakage of methyl methacrylate have any clinical significance at follow-up. MATERIALS AND METHODS: Forty percutaneous vertebroplasties were performed for metastases (30 cases) and myeloma (10 cases) in 37 patients. A computed tomographic scan was obtained 1-8 hours after methyl methacrylate injection and was used to assess the percentage of lesion filling by methyl methacrylate and the leakage of methyl methacrylate into the epidural tissues, neural foramina, intervertebral disks, venous plexus, and paravertebral tissue. The results were correlated with those obtained at clinical follow-up. RESULTS: Partial or complete pain relief was sustained in 36 of 37 patients. Pain relief was not proportional to the percentage of lesion filling. Clinical improvement was maintained in most patients. The 15 epidural leaks, eight intradiskal leaks, and two venous leaks of methyl methacrylate had no clinical importance. Two of eight foraminal leaks produced nerve root compression that required decompressive surgery. One of 21 paravertebral leaks produced transitory femoral neuropathy. CONCLUSION: Pain relief can occur despite insufficient lesion filling. In most patients, intradiskal and paravertebral leaks of cement had no clinical importance.

Bone Cements↗
PubMed1996

Evaluation of destructive spondyloarthropathies in hemodialysis by computerized tomographic scan and magnetic resonance imaging.

OBJECTIVE: The incidence of destructive spondyloarthropathies (SpA) in hemodialysis can reach 50% after 10 years of treatment. Few studies have analyzed the magnetic resonance (MR) appearance of destructive SpA and data are controversial. Our objective was to evaluate the computerized tomographic (CT) scan and MR appearance of destructive SpA in comparison to infectious spondylodiscitis. METHODS: 23 destructive SpA were observed in 11 patients who had undergone hemodialysis [mean duration of treatment 12 years (89-228 mo)]: 17 SpA of the cervical spine, one of the dorsal, and 5 of the lumbar spine. CT scans at all levels demonstrating narrowing and discovertebral erosions were performed without injection. MRI was performed with T1 and T2* weighted spin echo sequences (0.5T) without gadolinium injection. Radiographs were analyzed by 2 independent examiners. The data concerning MRI of infectious spondylodiscitis were based on a study of 57 personal cases and literature reports. RESULTS: CT scan appearance was similar in all cases, especially showing multiple small well defined lucencies of the vertebral endplates. In 9 patients, MRI showed low signal intensity of the disk and the adjacent vertebral endplates on T1 and T2* sequences. In no case was discal or vertebral high signal intensity on T2* sequence noted. No periodontoidal pseudotumor was observed. CONCLUSION: CT scans and MRI of destructive SpA, even nonspecific, are different from those observed in infectious spondylodiscitis, particularly due to the absence of discal and vertebral hypersignal on T2* sequences.

Aged↗
PubMed1996

Abdominal aortic aneurysm. A rare cause of destructive lesions of the spine.

A case of destructive vertebral and discal lesions in a patient with chronic, noninfected rupture of an abdominal aortic aneurysm is reported. The main rheumatic manifestations of abdominal aortic aneurysms are reviewed. Perianeurysmal inflammation may contribute to the development of destructive vertebral and discal lesions.

Aged↗
PubMed1996

[Spinal tuberculosis. Study of clinical and radiological aspects from a series of 82 cases].

We present a retrospective study of 82 cases of spinal tuberculosis diagnosed over the last 30 years. An increasing incidence of this disease not related to HIV infection has become apparent since 1992. 24% of patients were born outside continental France. The intradermal reaction was negative in 10% of patients. Discovertebral lesions detected in 93% of patients was the most frequent radiological presentation. Spondylitis with osteolysis or bone sclerosis at single or multiple levels was seen in the others. Tuberculous lesion of the posterior arch was associated in 10% of patients. In most cases CT scan showed a fragmentary vertebral destruction which was characteristic of the disease. MRI revealed the precise extent of the lesions into the spinal canal. Morphologic features suggestive of the tuberculous nature of paravertebral abcesses could be demonstrated when slices were performed in the axial or coronal plan. Tuberculous involvement of the spine is still a frequent disease. The main clinical and radiological findings are presented.

Adolescent↗
PubMed1996

Preoperative percutaneous injection of methyl methacrylate and N-butyl cyanoacrylate in vertebral hemangiomas.

PURPOSE: To investigate the usefulness of preoperative percutaneous injections in vertebral hemangiomas. METHODS: Four patients presented with complicated vertebral hemangioma (spinal cord compression in three cases, intermittent spinal claudiction in one case). A three-part treatment was performed: initially, arterial embolization in three cases; 1 day later, percutaneous injections of methyl methacrylate into the vertebral body to strengthen it and of N-butyl cyanoacrylate into the posterior arch to optimize hemostasis during surgery; finally, the day after percutaneous injections, decompressive laminectomy and epidural hemangioma excision (when present). RESULTS: Laminectomy was performed with minimal blood loss. The epidural component present in three cases was excised without any difficulty. The follow-up (average, 20 months) showed no evidence of vertebral collapse. CONCLUSION: Percutaneous injections of methyl methacrylate and N-butyl cyanoacrylate might be useful before surgery for vertebral hemangiomas.

Aged↗
PubMed1996

[Evaluation of methods for radiographic measurement of the tibial slope. A study of 83 healthy knees].

PURPOSE OF THE STUDY: We compared on lateral X-rays of 83 healthy knees, 6 methods measuring the tibial sagittal slope. Each method determined the tibial slope according to an independent anatomical axis. The goals of the study were to: 1) detect the differences between the 6 methods; 2) determine if any mathematical relation could be observed between the 6 methods; 3) compare accuracy of proximal anatomical axis versus long anatomical axis to evaluate the tibial slope. MATERIAL: 50 healthy patients (83 knees) knees were included in the study. The patients (26 male and 24 females) were 39.3 +/- 15.8 years old. METHODS: We obtained true lateral X-rays orientated with an image intensifier in order to obtain the exact superposition of the femoral condyles. The measurements were carried out by an observer according to two procedures: 1) by manual goniometric measurements twice; the mean value between both lectures was recorded; 2) with a digitizer (Orthographics TM, Salt Lake City, Ut). We measured the angle between the tangent to the medial tibial plateau and the perpendicular direction to each of the studied anatomical axis: tibial proximal anatomical axis (TPAA); tibial shaft anatomical axis (TSAA); posterior tibial cortex (PTC); fibular proximal anatomical axis (FPAA); fibular shaft axis (FSA); anterior tibial cortex (ATC). The values obtained with the digitizer were used to compare the six methods. The values obtained with the TSAA were considered as reference. RESULTS: Tibial slope values were different with the 6 methods. ATC gave the higher values and PTC the smaller. The difference could be 5 degrees between two methods measuring the same posterior tibial slope. However different, the values obtained with the 6 methods were strongly correlated (R > 0.85; p = 0.0001). We determined mathematical relationships between the values obtained with the 6 methods according to the regression analysis. The correlation with the values obtained with TSAA (reference values) was stronger for TPAA and TPC (respectively R = 0.92 and R = 0.9). The mean error between manual and digitized measurements was 1.28 degrees, but for the same knee the error could exceed 4 degrees. The highest error was 4.64 degrees with the TSAA, likewise the error frequency was higher with the TSAA (12 knees with an error > 3 degrees versus 7 knees for the other methods (p = 0.01)). In our 33 bilateral knees, after one side measurement, the forecast of the contralateral tibial slope showed an error of 5 degrees or more in 5 patients (15.1 per cent) and an error of 3 degrees or more in 13 patients (39.3 per cent). Among the proximal anatomical axis, only the TPAA and the TPC were not influenced by age, sex, patient height or weight. CONCLUSION: Values of posterior tibial slope observed with the 6 methods were different but correlated. Among the proximal axis, the TPAA and PTC gave higher reliability. The values obtained with these two methods: 1) were not influenced by morphometric variables, 2) were strongly correlated with the references values obtained with the TSAA, 3) gave low error with manual measurements by comparing with digitized measurements. Forecast of the contralateral tibial slope after one side measurement is unreliable. Satisfactory accuracy could be obtained with a two times manual goniometric measurement, but using a digitizer improves measurement accuracy and is less time consuming.

Adolescent↗
PubMed1995

[Percutaneous cementoplasty for malignant osteolysis of the acetabulum].

The development of malignant lesions in the acetabulum can lead to painful and disabling bone destruction. In carefully selected patients where the cortical still provides a sufficient barrier protecting the joint, percutaneous injection of ciment (10-15 cc) can be a successful mean of countering both pain and functional impairment. This easy-to-perform technique requires only local anaesthesia and can be highly cost-effective. The antalgic effect is rapid. Most patients are able to walk again within 1 to 5 days (an effect which is particularly spectacular in bedridden subjects) probably due to the reduced pain and to better distribution of the mechanical forces. Hospitalization is usually shortened. In our experience with 18 patients, clinical improvement has been maintained for up to 18 months (mean follow-up 7 months) if the osteolytic process remains under control. Secondary effects are not rare but usually temporary. Recurrent pain, fever and/or inflammatory processes have been observed and usually resolve within 1 to 4 days. Intra-articular leakage can be avoided by careful patient selection. In association with radiotherapy, percutaneous injection of ciment appears to be an useful alternative to surgery for patients with destructive malignant lesions of the acetabulum, particularly in those with a poor clinical status and a short life expectancy. This technique has already been shown to be effective in lesions of the vertebral bodies. Several teams have made further attempts in other localizations.

Acetabulum↗
PubMed1995

Synovial haemangioma of the knee: a frequently misdiagnosed lesion.

OBJECTIVE: The objective of this study was to assess the contribution of magnetic resonance (MR) imaging in the diagnosis and surgical planning of five cases of synovial haemangioma of the knee. PATIENTS AND METHODS: The clinical, radiological and arthroscopic features of five pathologically proven synovial haemangiomas of the knee were retrospectively reviewed. RESULTS: A diagnostic delay, on average of 8 years, had occurred in four of the cases. Plain films were unremarkable, except for one case with arthropathy mimicking haemophilia, Arteriography, performed in three patients, was normal in one. CT, performed in three patients, showed the lesion, but the extent of the latter was better demonstrated with MR imaging. Synovial haemangiomas had a high signal intensity of T2-weighted images, without any extensive mass effect. Fibrofatty septa within the lesion were observed in three cases and muscular and/or fatty invasion in two. Arthroscopy allowed diagnosis of the lesion in two cases, but showed only nonspecific synovitis in another two. CONCLUSION: This study emphasizes the valuable contribution of MR imaging in the diagnosis and surgical planning of synovial haemangiomas.

Adolescent↗
PubMed1995

Solitary cystic lymphangioma.

A young girl had a large isolated and localized multicystic lesion of the right humerus, which was revealed by a pathological fracture. MRI and bone biopsy showed liquid-filled bone cysts. The final diagnosis was localized cystic lymphangiomatosis.

Bone Neoplasms↗
PubMed1995

Pigmented villonodular synovitis of the hip: review of radiographic features in 58 patients.

Clinical and radiographic findings were retrospectively reviewed in a multicentric survey of 58 patients with histologically proven pigmented villonodular synovitis (PVNS) of the hip. The most common clinical features were mechanical pain (47 cases) and limitation of joint motion (47 cases). On plain films, a classic form with large and multiple lucencies was found in 36 cases, followed by an osteoarthritis-like form (9 cases), an arthritis-like form (8 cases), normal radiographic appearance (3 cases), osteonecrosis of the femoral head (one case) and joint destruction with acetabular protrusion (one case). Bilateral involvement of the hips was probable in two patients. In contrast to the knee, the hip showed a high prevalence of bony lesions and joint space narrowing. Although an uncommon disease, PVNS of the hip has to be considered when arthritis is associated with uncharacteristic clinical or radiographic findings.

Acetabulum↗