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Biomedical subjects

A Hadjipavlou

Publications and source records attributed to A Hadjipavlou.

35 records · Page 2Linked to original sources
PubMed1991

Paget disease of the spine.

Seventy patients who had the radiographic features of Paget disease of the spine were evaluated clinically and with computed tomography, with the objective of correlation of the symptoms with the lesions. Of forty-five symptomatic patients, twenty-one had only pain in the back or neck and twenty-four patients had spinal stenosis with or without pain in the back or neck. Seven patients had a neurological deficit without pain, nineteen had so-called mechanical or arthritic pain, nine had pain that was attributable to the Paget lesion, and ten had a combination of the two types of pain. The most common cause of the spinal stenosis was expansion of bone that led to compression of the thecal sac and its neural elements. In one patient, the cord was compromised further by a pathological fracture of the eighth thoracic vertebra. There was a strong correlation between the presence of symptoms and the findings of spinal stenosis and arthropathy of the facets (zygapophyseal joints) on computed tomography. The spinal stenosis and the arthropathy of the facets were caused by the abnormal, hyperactive bone-remodeling, which resulted in the expansion of the osseous elements of the involved vertebra or vertebrae.

Aged↗
PubMed1991

Pseudonotch of the atlas vertebra simulating fracture with computed tomographic diagnosis. A case report.

Pseudonotch of the atlas represents a normal variation of the atlas related to a notched protuberance of the medial surface of its lateral masses. A case is presented in which cervical spine roentgenography revealed a prominent pseudonotch that mimicked a fracture of the lateral masses of the atlas. Minimal rotation of C-1 on C-2 was present without apophyseal joint subluxation. Computed tomography imaging provided an accurate diagnosis.

Adult↗
PubMed1987

Allografts in orthopedic surgery: a case report and literature review.

Recent advances in orthopedic surgery have reawakened interest in the use of osteochondral allografts. A case is presented of a 32-year-old man who was spared a hemipelvectomy for a huge chondrosarcoma of the pelvis by receiving a massive pelvic allograft. This is apparently the first report of such a procedure being performed in Canada. A history of allografting as well as the fate and immunologic aspects of bone grafts are presented. Bone-banking procedures and the clinical application of allografts in 1986 are discussed.

Adult↗
PubMed1986

Pagetic arthritis. Pathophysiology and management.

A review of the records of 112 patients demonstrate modern concepts of pathogenesis and treatment of Paget's disease. Pain from Pagetic arthritis should initially be treated by medical treatment aimed at modulation of bone blood flow. Patients, even with impressive arthritic reactions, can respond dramatically. Pain persists in patients with end-stage destruction of articular cartilage and/or stress microfractures. Patients with deformity without joint space loss may be candidates for osteotomy. Advanced cartilage destruction is treated by total arthroplasty and continuation of anti-Pagetic therapy after surgery, possibly to reduce the incidence of component loosening. Articular cartilage erosion and subchondral bone destruction are attributable to the disease process. Vascular invasion and joint surface collapse are associated with cartilage thinning and sequestration.

Arthritis↗
PubMed1985

Soft-tissue chondromas.

Soft-tissue chondromas are benign, relatively rare lesions. The clinicopathologic and radiologic features in six cases are presented and the literature is reviewed. Five of six cases had calcifications. Peripheral curvilinear calcification was seen in two cases, multiple ringlike areas characteristic of cartilage in one, and discrete ossification in another. Histopathologically, they were diverse, ranging from an immature pattern with a preponderance of chondroblasts to a more mature form with chondrocytes. Although these lesions resemble a wide variety of other soft-tissue lesions, they can usually be differentiated by their small size, characteristic location in the extremities, the nature of their calcifications, and the histopathologic features. The importance of this lesion is that it is benign. It must be distinguished from more aggressive soft-tissue neoplasms such as soft-tissue chondrosarcoma so as to spare the patient unnecessary radical therapy.

Adolescent↗
PubMed1983

Difficulty of diagnosing infected hypertrophic pseudarthrosis by radionuclide imaging.

Hypertrophic pseudarthrosis was studied with Tc-99m MDP and Ga-67 citrate in 11 patients. Two of the 11 pseudarthroses were complicated by infection. A high concentration of both radiopharmaceuticals was obtained at all 11 sites and their distribution patterns were identical. It was therefore impossible to distinguish the infected from the noninfected pseudarthroses by using Ga-67.

Bacterial Infections↗
PubMed1983

Observations on serial radionuclide blood-flow studies in Paget's disease: concise communication.

Twenty-four symptomatic patients with symptoms of active Paget's disease of bone were evaluated, during the course of their therapy, a total of 71 times (24 baseline and 47 follow-up examinations) by serial alkaline phosphatase levels (AP), Tc-99m MDP bone scans, and radionuclide blood-flow studies. The flow study correlated with disease activity in all of the baseline studies and in at least 85% of the follow-up studies. In five patients (seven follow-up studies) the changes in local blood flow correctly anticipated the eventual rise or fall of AP. In comparison with the bone scan, the changes in blood flow preceded the bone-scan alterations or were more reliable indicators of disease activity in 12 of the 13 follow-up studies in which the results of the two examinations disagreed. We conclude that the radionuclide flow study provides useful additional clinical information in the management of Paget's disease.

Alkaline Phosphatase↗
PubMed1982

Maquet osteotomy for chondromalacia patellae: avoiding the pitfalls.

The authors' modification of the classic Maquet procedure of anterior displacement of the tibial tubercle allows effective decompression of the patellofemoral joint. Strict adherence to the modified technique has prevented all major complications. Forty-four patients underwent this procedure. They were divided into a retrospective group of 20 and a prospective group of 24. Nine patients in the prospective group had the modified Maquet procedure following a failed Hauser operation. All had an excellent result due to decrease in the patellofemoral compression force. The modified Maquet procedure was also valuable in those who had an extensor lag following patellectomy (two patients), failed proximal realignment (three patients) and failed patellar shaving procedures (three patients).

Adolescent↗
PubMed1979

99mTc-PP and 67Ga imaging following insertion of orthopedic devices.

Deposition of 67Ga in bone does not explicitly imply osteomyelitis. Osteomyelitis complicating insertion of orthopedic devices is manifested by lack of congruence in the distribution patterns of 99mTc-PP and 67Ga. Congruent patterns can reflect the increased bone reaction to implantation or loosening of the device, not necessarily osteomyelitis. Both (a) nonseptic synovitis secondary to reactive bursa formation and (b) cellulitis exhibit an affinity for 67Ga and virtually none for 99mTc-PP, whereas the reverse is true for heterotopic bone. Thus combined sequential 99mTc-PP/67Ga imaging is necessary for evaluation of complications associated with internal orthopedic devices.

Adult↗
PubMed1976

Knee arthrodesis: long-term results.

A review of 41 patients in whom knee fusion was performed mainly for degenerative arthritis and sepsis disclosed that only 15% of patients were without complications. Complications were numerous and appeared both early and late - persistent knee and back pain were the most common. Many patients were unable to return to work or to participate in social activities. The optimal position for fusion is 15 to 20 degrees of flexion, which results in a smoother gait and less difficulty for the patient in driving a car. Because of the continued refinement in total knee joint replacement, the indications for knee arthrodesis should be confined to the treatment of chronic infection and failed total joint replacement.

Adolescent↗