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Biomedical subjects

A Greenspan

Publications and source records attributed to A Greenspan.

At least 73 records · Page 4Linked to original sources
PubMed1993

Periosteal chondroma masquerading as osteochondroma.

The authors describe two cases of a lesion that closely resembled osteochondroma occurring at the posterior aspect of the distal femur in the popliteal region. Histopathologic examination after open biopsy revealed that the lesions were periosteal chondromas, and they were resected. Osteochondroma, particularly that undergoing malignant transformation, should perhaps be considered in the differential diagnosis of periosteal chondroma; the key to distinguishing between these two lesions is the separation of periosteal chondroma from the medullary portion of the bone by intervening cortex.

Adult↗
PubMed1992

Imaging strategies in the evaluation of soft-tissue hemangiomas of the extremities: correlation of the findings of plain radiography, angiography, CT, MRI, and ultrasonography in 12 histologically proven cases.

Twelve patients with the histologic diagnosis of soft-tissue hemangioma of the extremities (nine intramuscular, two subcutaneous, and one synovial) were evaluated in a retrospective study using plain film radiography (n = 12), angiography (n = 8), computed tomography (CT; n = 4), magnetic resonance imaging (MRI; n = 3), and ultrasonography (US; n = 2). In eight of nine intramuscular lesions, the plain film demonstration of phleboliths suggested the diagnosis, while the plain radiographs were normal in three. Angiograms showed the pathognomonic features of soft-tissue hemangioma in six patients. MRI was characteristic in all three patients: The lesion demonstrated intermediate signal intensity on T1-weighted spin echo images and extremely bright signal on T2-weighting. US showed a hypoechoic soft-tissue mass in one case and a mixed echo pattern in the other. In one case, a central echogenic focus with acoustic shadowing consistent with a calcified phlebolith was identified, and one lesion exhibited increased color flow and low resistance arterial Doppler signal. CT showed a nonspecific mass in one of four cases and a mass with phleboliths in three. If a deep hemangioma is suspected, we recommend initial imaging with plain radiography followed by MRI. US may be useful in confirming the presence of a mass in doubtful cases or if MRI is unavailable. CT offers no distinct advantage over the combined use of plain radiography and MRI. Although angiography demonstrated the pathognomonic features in all six deeply situated lesions, because of its invasiveness it should be reserved chiefly for those patients undergoing surgical resection.

Adolescent↗
PubMed1992

Pelvic injuries in child abuse.

Three cases of child abuse are described in which pelvic injuries were prominent findings on radiologic examination: Two patients had pelvic fractures, and one was found to have heterotopic ossification of the soft tissues of the pelvis and thighs corresponding to extensive bruising in the pubic, genital, buttock, and thigh areas, resulting from physical and sexual abuse. These represent uncommon radiographic findings. Skeletal survey in cases of suspected child abuse should include the entire pelvis, and special attention should be paid to the ischiopubic rami the most common site of these rare pelvic injuries.

Burns↗
PubMed1992

Is there a role for diskography in the era of magnetic resonance imaging? Prospective correlation and quantitative analysis of computed tomography-diskography, magnetic resonance imaging, and surgical findings.

We herein report the results of a prospective study to define the role of diskography in the diagnosis of low back pain in an emerging era of magnetic resonance imaging (MRI). The study involved 32 patients (78 disks) with a clinical diagnosis of lumbar disk herniation; all were studied by computed tomography-diskography (CT-D), and 25 (51 disks) were also examined using MRI. The disks were graded on these studies according to a staging scheme modified from Modic. Ten of the patients (13 disks) having both CT-D and MRI underwent exploratory surgery, and the staging at surgery served as the standard against which the evaluative studies were judged. Surgical staging was compatible with the CT-D and MRI results in five disks, while in another five disks it was compatible only with the CT-D results. In the remaining three disks, both CT-D and MRI misidentified the stages. In six disks, CT-D more accurately defined the stage of disease than did MRI, whereas MRI was more precise than CT-D in only one disk. While having documented the value of CT-D as a source of information, particularly when surgery is contemplated, and as an effective means of staging disk herniation, we recommend MRI as the ideal screening test for lumbar radiculopathy and low back pain, reserving diskography for problematic cases.

Adult↗
PubMed1992

Imaging of the postoperative spine.

In the current literature on the imaging modalities of the spine, several papers deal with the diagnostic evaluation of the postoperative spine. Particular attention is focused on the use of MR imaging in evaluating the postoperative spine in symptomatic and asymptomatic patients. Other papers discuss application of different radiologic modalities such as conventional tomography, CT, sonography, and scintigraphy. The effectiveness of various imaging techniques in evaluating the postsurgical changes in the spine is the subject of this review.

Humans↗
PubMed1992

Acute gout involving the acromioclavicular joint following treatment with gemfibrozil.

Gout affecting the acromioclavicular joint is extremely rare. We describe a case of acute gout involving the acromioclavicular joint in a patient with seronegative spondyloarthropathy, following use of the fibric acid derivative, gemfibrozil. This case broadens the differential diagnosis of acute acromioclavicular joint arthritis; further studies are needed to determine if there is a causal relationship between use of gemfibrozil and an acute attack of gout.

Acromioclavicular Joint↗
PubMed1991

Bone island (enostosis): clinical significance and radiologic and pathologic correlations.

This study was undertaken to explain the increased scintigraphic activity of some bone islands by correlating the clinical, radiographic, scintigraphic, and histopathologic findings. The material for the study consisted of six patients with bone islands who had undergone histopathologic examinations of the lesions. Based on histopathologic-radiologic correlations, we postulate that the osteoblastic activity of a bone island makes it appear "hot" on scintigraphy, although other factors such as the size of the lesion may play some role in this phenomenon. In addition, we tried to find a logical algorithm for the radiologic evaluation and management of sclerotic lesions that look like bone islands but exhibit increased uptake of radiopharmaceuticals on bone scan examination. We emphasize that the morphology of the lesion, as demonstrated on the radiologic examination, rather than its degree of activity on the bone scan is a guide to the correct diagnosis.

Adult↗
PubMed1991

Benign clavicular lesions that may mimic malignancy.

Nontraumatic lesions of the clavicle are infrequent. Of these, malignant tumors are more common than benign lesions. From January 1988 to January 1990, we examined 17 patients with benign lesions of the clavicle; in 8, the morphologic appearance of the lesion raised the possibility of malignancy in the differential diagnosis. The radiologic findings in these patients are presented. We propose that the unique shape and embryologic development of the clavicle may contribute to the atypical, aggressive presentation of some benign lesions in that bone.

Adult↗
PubMed1991

Sclerosing bone dysplasias--a target-site approach.

Sclerosing bone dysplasias are a poorly understood group of developmental anomalies, much of whose etiology is still obscure. The list of conditions constituting this group is relatively short: osteopetrosis (Albers-Schönberg disease), pycnodysostosis (Maroteaux-Lamy disease), enostosis (bone island), osteopoikilosis, osteopathia striata (Voorhoeve disease), progressive diaphyseal dysplasia (Camurati-Engelmann disease), hereditary multiple diaphyseal sclerosis (Ribbing disease), four types of endosteal hyperostosis (van Buchem disease, Worth disease, Nakamura disease, and Truswell-Hansen disease), dysosteosclerosis, metaphyseal dysplasia (Pyle's disease), craniometaphyseal dysplasia, melorheostosis (Leri disease), and craniodiaphyseal dysplasia. There are instances in which two or more of the above disorders coexist. These are termed "overlap syndromes", most commonly involving osteopathia striata, osteopoikilosis, and melorheostosis. A classification of these dysplasias is elaborated based on a targetsite approach that views them as disturbances in development associated with the processes of either endochondral or intramembranous bone formation, or both. Accumulated evidence suggests that many of these disorders stem from common defects in bone resorption and/or formation during the processes of skeletal maturation and modeling. Finally, the subgroup of overlap syndromes is emphasized as indicating a strong interrelationship between the sclerosing dysplasias of bone, with perhaps a common pathogenesis for many.

Bone Diseases, Developmental↗
PubMed1991

Condensing osteitis of the clavicle: a rare but frequently misdiagnosed condition.

Condensing osteitis of the clavicle is a benign, often painful disorder, marked by bony sclerosis at the sternal end of the clavicle. It can be mistaken for other abnormalities such as Friedrich disease, bone island, osteoid osteoma, sternoclavicular osteoarthritis, and even a metastasis and osteosarcoma. Clinical, radiologic, scintigraphic, and histologic features of this condition are discussed and a brief overview of the treatment is provided. Three histologically proved cases are added to the 13 previously reported in the literature. Recognition of condensing osteitis of the clavicle may avoid the occasional unnecessarily aggressive diagnostic approach taken to search for a malignant tumor.

Adult↗
PubMed1991

A review of Paget's disease: radiologic imaging, differential diagnosis, and treatment.

Paget's disease is a chronic, progressive disturbance of bone metabolism of unknown etiology. The author describes the radiographic presentation of this disorder and discusses the various imaging modalities that are useful in the diagnosis of Paget's disease and its complications. A brief description of currently available treatment options is included in this review.

Calcitonin↗
PubMed1991

Klippel-Feil syndrome. An unusual association with Sprengel deformity, omovertebral bone, and other skeletal, hematologic, and respiratory disorders. A case report.

An unusual presentation of Klippel-Feil syndrome prompts a detailed description of this anomaly and a review of the literature. The patient, a six-year-old boy, had, in addition, multiple associated congenital anomalies that included Sprengel deformity, omovertebral bone, scoliosis, hypoplasia of the right thumb, plagiocephaly, choanal atresia, and Diamond-Blackfan anemia.

Abnormalities, Multiple↗
PubMed1990

Antitumor activity of liposome-encapsulated doxorubicin in advanced breast cancer: phase II study.

Previous studies in animals have demonstrated liposome-encapsulated doxorubicin (LED) has substantially less cardiac toxicity than free doxorubicin but retains antitumor activity. In a phase I clinical study of LED, the maximum tolerated dose was 90 mg/m2 and dose-limiting toxicity was considered to have been reached when granulocytopenia was produced. We used LED to treat 20 patients with advanced, measurable breast cancer. LED was given at doses of 60-75 mg/m2 every 3 weeks as an intravenous infusion. Regression of disease was objectively measured in nine patients; in five of these patients, complete regression of the index lesion occurred. The mean duration of the responses was 7 months. Hematologic toxicity consisted of grade 1-2 leukopenia in some patients. Gastrointestinal toxicity and mucositis were generally mild and tolerable. Alopecia occurred in all patients and usually was complete. Twelve patients received cumulative doses of LED of greater than 400 mg/m2 and were evaluated with radionuclide ventriculograms. In eight patients, the cumulative dose was greater than 500 mg/m2, and five had endomyocardial biopsies. Four of these biopsy results were Billingham grade 0, while one (cumulative LED dose, 750 mg/m2) showed grade 1 changes with mild myofibrillar loss and dilatation of the sarcoplasmic reticulum involving less than 5% of cardiac myocytes. Two patients had decreases in left ventricular ejection fraction. One of these patients had received a total dose of LED of 630 mg/m2 and had a decline of 13% in left ventricular ejection fraction, but had no clinical evidence of congestive heart failure and had a Billingham grade 0 endomyocardial biopsy.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗