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Biomedical subjects

B N Weissman

Publications and source records attributed to B N Weissman.

At least 37 records · Page 2Linked to original sources
PubMed1993

Enhancement of joint fluid with intravenously administered gadopentetate dimeglumine: technique, rationale, and implications.

This study reports findings on joint fluid enhancement after intravenous administration of gadopentetate dimeglumine. Ten subjects were studied: two asymptomatic volunteers and eight patients with suspected meniscal tears. The subjects underwent imaging at 1.5 T before, immediately after, and 42-60 minutes after intravenous administration of gadopentetate dimeglumine. The rate of fluid enhancement was assessed in three subjects, and the effects of exercise were studied. All subjects exhibited enhancement of joint fluid. Mean fluid enhancement for patients was 137% on initial and 262% on delayed images obtained after exercise. Exercise increased the rate and degree of fluid enhancement and distributed contrast material uniformly throughout the joint. The arthrographic effect of the fluid enhancement increased the number of perceived cartilage defects. This study documents enhancement of joint fluid in healthy subjects and in those with effusions. The arthrographic effect may provide a more convenient alternative to intraarticular injection of gadopentetate dimeglumine for MR arthrography.

Contrast Media↗
PubMed1993

Magnetic resonance imaging of arthritides affecting the shoulder.

MR imaging has thus far had a limited role in the evaluation of arthritis involving the shoulder. In certain cases, such as in amyloid and synovial osteo chondromatosis, however, MR imaging may be virtually diagnostic. It is likely that MR imaging will have an expanded role in the evaluation of arthritis in the future.

Arthritis↗
PubMed1992

Long-term prospective study of methotrexate in the treatment of rheumatoid arthritis. 84-month update.

OBJECTIVE: To determine the long-term efficacy and safety of low-dose methotrexate (MTX) in rheumatoid arthritis (RA). METHODS: Eighty-four-month open prospective trial at a single academic rheumatology center. RESULTS: Twenty-six patients were enrolled in a prospective study of the long-term efficacy of MTX in RA; a significant improvement had been demonstrated after 36 months of therapy. Twelve patients remained in the study at the 84-month visit; the mean weekly dosage of MTX was 10.2 mg. A significant improvement was still noted at 84 months in the number of painful joints, number of swollen joints, joint pain index, joint swelling index, and physician and patient global assessments. A 50% improvement in the joint pain index and joint swelling index was observed in more than 80% of the 12 patients still enrolled. A significant reduction in prednisone dosage was achieved; of 14 patients taking prednisone at entry, 7 had discontinued prednisone completely. Fourteen patients withdrew from the study: 10 between 0 and 36 months, and 4 between 36 and 84 months. Toxicity in 3 patients and visit noncompliance in 1 patient were the reasons for withdrawal between 36 and 84 months. At 84 months, 46% of the patients remained in the study; 11.5% had discontinued due to MTX toxicity. CONCLUSION: The effectiveness of MTX in the treatment of RA continues to be demonstrated in this prospective study, after 84 months of treatment.

Aged↗
PubMed1992

Evaluation of joint prostheses and orthopedic appliances.

Several recent articles describe imaging evaluation after joint replacement surgery. The following articles about total hip and knee replacement and silicone rubber prostheses are highlighted because they offer new observations or review typical problems after joint revision surgery.

Arthrography↗
PubMed1991

Radiographic detection of metal-induced synovitis as a complication of arthroplasty of the knee.

Radiographs of eighteen patients who had had a diagnosis of metal-induced synovitis subsequent to a knee-replacement arthroplasty were retrospectively reviewed. The presence of a dense line outlining a portion of the capsule or articular surface of the knee joint (the so-called metal-line sign) was noted in association with wear in eleven patients. In the nine patients who had a positive sign and also had specimens available for histological examination, there was dense deposition of metal particles, whereas in the six patients who did not have a metal-line sign and had specimens available for histological examination, five had only a slight amount of metal in the synovial tissue and one, a moderate amount. The presence of the metal-line sign was associated with metal-induced synovitis in eleven of the eighteen patients. The sign should be useful in helping to make this diagnosis preoperatively in many patients.

Chromium Alloys↗
PubMed1991

Magnetic resonance imaging of the knee.

Magnetic resonance imaging of the knee was the first successful application of this technique to the articular system. The advantages of magnetic resonance imaging over arthrography include its noninvasive nature, the ability to evaluate the knee in multiple planes without patient repositioning, the absence of ionizing radiation, the capacity to evaluate the joint even in the presence of joint effusion, and the ability to examine the inner structure of the meniscus as well as its surface. Although magnetic resonance imaging initially was used to study the menisci and cruciate ligaments, the technique has been expanded to include the evaluation of various conditions and all the structures of the knee joint and surrounding soft tissues.

Anterior Cruciate Ligament↗
PubMed1990

Complications of axial arthropathies.

Involvement of the cervical spine by rheumatoid arthritis may have severe consequences secondary to subluxation, erosive changes, and soft-tissue inflammation. Unfortunately, the severity of radiographic findings may not directly correlate with the occurrence of cervical myelopathy. MRI has emerged as a noninvasive method of assessing the condition of the spinal cord and thecal sac as well as more precisely defining the nature of inflammatory soft-tissue changes that may result in bony erosion and cord compression. Ankylosing spondylitis is an arthropathy that classically involves the axial skeleton. Complications include acute fracture and pseudarthroses of the spine. Rarely, the development of a cauda equina syndrome has been reported. In addition to classic erosive arthropathies affecting the axial skeleton, ossification of the posterior longitudinal ligament may be associated with the development of severe myelopathy. A recently described type of amyloidosis characterized by beta-2 microglobulin deposition has been reported in patients on long-term hemodialysis. Bony erosion is seen in the spine in these patients. A causal relationship between beta-2 microglobulin and hemodialysis spondylarthropathy has yet to be definitely established.

Amyloidosis↗
PubMed1990

Current topics in the radiology of joint replacement surgery.

Several methods of total hip joint replacement are currently used. Radiographic appearances after cemented, bone ingrowth, press-fit, and bipolar hip prostheses are reviewed. The roles of nuclear medicine and arthrographic procedures for identifying complications are discussed. Total knee prostheses and, in particular, complications related to the patellar component are described.

Arthrography↗
PubMed1989

Cemented total hip prosthesis: radiographic and scintigraphic evaluation.

Conventional radiographs, technetium-99m bone scans, and gallium-67 scans were reviewed in 44 patients who had undergone cemented total hip joint replacement and were imaged because of suspicion of prosthesis loosening or infection. A complete radiolucent line of 2 mm or wider along the bone-cement interface or metal-cement lucency on conventional radiographs was used as the criterion for prosthetic loosening with or without infection and proved to be 54% sensitive and 96% specific. Scintigraphic criteria for prosthetic loosening were increased focal uptake of the radiopharmaceutical for the femoral component and increased focal or diffuse uptake for the acetabular component. For bone scintigraphy, sensitivity was 73% and specificity was 96%. Combining the results of conventional radiographs and bone scans increased sensitivity to 84% and decreased specificity to 92% for the diagnosis of loosening, infection, or both. The study also showed that Ga-67 scintigraphy has a low sensitivity for the detection of infection.

Acetabulum↗
PubMed1989

Lipohemarthrosis of the knee: a review of recent experiences.

The radiographs of 268 patients with knee trauma were retrospectively reviewed. In 15 patients with intraarticular fracture, the images demonstrated fat-fluid levels. In 28 other patients with intraarticular fracture, only joint effusion without a fat-fluid level was depicted. The presence of a fat-fluid level in the knee indicated fracture in all patients in whom it was seen. The absence of such a level, however, did not exclude intraarticular fracture.

Exudates and Transudates↗
PubMed1989

The fate of acetabular allografts after bipolar revision arthroplasty of the hip. A radiographic review.

We reviewed the radiographs of thirty-one patients (thirty-two hips) who had had revision of the acetabular component of a total hip arthroplasty with a bipolar socket supplemented by allograft and were followed for twenty-four to forty-eight months. The grafts were categorized according to their consistency (solid or crushed bone), the location of the acetabular defect (peripheral [rim] or central), and the extent of the acetabular defect (contained--the medial part of the acetabular wall was intact, or non-contained--it was deficient). We recorded the time to incorporation of the graft, the amount of migration of the socket in the superior and medial axes, and the percentage of graft remaining at the time of the most recent follow-up. The time to healing was similar for all categories of grafts. The central, contained, solid grafts had less resorption than did the central, contained, crushed-bone grafts, as evidenced by less migration of the socket during follow-up. The non-contained grafts, in both peripheral and central locations, were associated with high rates of migration and of instability of the socket.

Acetabulum↗
PubMed1988

Long-term prospective trial of low-dose methotrexate in rheumatoid arthritis.

Twenty-six patients with severe rheumatoid arthritis who had completed a randomized crossover trial of methotrexate elected to continue to receive the drug in a long-term prospective study. At 36 months, 16 patients remained in the study. Over this period of time, significant improvement was noted in the number of painful and swollen joints, physician and patient global assessments, erythrocyte sedimentation rate, and prednisone dose. Adverse reactions occurred in 16 patients (62%), including nausea, alopecia, headache, stomatitis, herpes zoster, and diarrhea. Mild leukopenia (3 patients), thrombocytopenia (3 patients), and elevated transaminase levels (8 patients) resolved with temporary drug discontinuation. No patient withdrew due to drug toxicity. Liver biopsy specimens in 17 patients after 24 months of treatment showed no evidence of fibrosis or cirrhosis. A significant increase in the percentage of T3 and T4 blood cells and increases in lymphocyte proliferation to concanavalin A and purified protein derivative of tuberculin were found after 2 years of therapy. Our findings indicate that methotrexate has remained effective over 36 months of therapy, with acceptable toxicity levels and no evidence of systemic immunosuppression.

Aged↗
PubMed1988

Evaluation of a nonconstrained total shoulder prosthesis.

We reviewed the radiographs and medical records of 76 patients with 98 nonconstrained total shoulder prostheses: 68 were inserted for rheumatoid arthritis, 25 for osteoarthritis, and five for avascular necrosis. The radiographic follow-up averaged 36 months. Radiographic evidence of postoperative complications was noted in 37 (38%) of 98 shoulders: dislocation of the humeral head (six), upward migration of the humerus (24), loosening of the glenoid compartment (15), loosening of the humeral component (five), subsidence of the humeral component (seven), and heterotopic bone formation (six). Patients with a dislocated prosthesis had limitation of motion, poor function, and residual pain. No increase in pain was associated with proximal subluxation of the humerus. No correlations were found between any of the radiographic findings (the presence of radiolucent lines about the glenoid or humeral components, humeral subsidence, or ectopic ossification) and any of the clinical findings (pain relief, range of motion, motor power, or functional improvement).

Arthritis, Rheumatoid↗
PubMed1988

Arthritis in children.

Arthritis in children may be caused by many diseases and disorders. Some processes may be aborted by early diagnosis and treatment. Others may not cause true arthritis until the adult years, with a variable latent period. The spectrum includes congenital malformations, neoplasia (benign and malignant), infection, trauma, hematologic/vascular disorders, and connective tissue diseases. In all instances, early diagnosis is important. The growing skeleton has great potential to remodel if it is given adequate time.

Adolescent↗