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Biomedical subjects

B N Weissman

Publications and source records attributed to B N Weissman.

At least 55 records · Page 3Linked to original sources
PubMed1988

Chronic osteomyelitis: the relative roles of scintigrams, plain radiographs, and transmission computed tomography.

We evaluated the relative contribution of transmission computed tomograms (CT), plain radiographs, and bone/gallium scans in the diagnosis of 27 patients with suspected active chronic osteomyelitis. All patients were imaged with all modalities and had surgical proof of the presence or absence of disease. At surgery, osteomyelitis was shown to be active in 20 patients, 15 of whom had sequestra, and inactive in the remaining seven. CT depicted all 15 sequestra, but was falsely positive in three patients, all of whom had bone remodeling only and had negative bone/gallium scintiscans. Plain radiographs had a limited value; they detected sequestra, which was the only findings to indicate the presence of active disease, in 5 patients out of the 15 with surgical proof thereof. The authors conclude that, considering the shortcoming of other modalities with regard to depicting sequestra, scintigraphy is helpful in confirming the presence or absence of active disease and therefore in preventing unnecessary surgery.

Adult↗
PubMed1987

Disease activity in osteomyelitis: role of radiography.

To determine the impact of radiographic findings on the interpretation of bone and gallium scans of patients with active osteomyelitis, the authors reviewed the medical records and radiologic examinations of 104 patients. The only diagnostic finding of active disease on radiographs was the presence of a sequestrum (three patients). Other findings--such as erosion, soft-tissue swelling, and periosteal reaction--proved nonspecific and did not differentiate active from inactive disease. Furthermore, these findings did not significantly change the sensitivity or specificity of the bone and gallium scans, either in detecting or in excluding the presence of active disease.

Adolescent↗
PubMed1987

Spondyloarthropathies.

This paper reviews the radiologic features of disorders involving the spine and sacroiliac joints. Analysis is divided into conditions involving the sacroiliac joints, disorders producing bony bridging in the spine, and disorders producing focal vertebral destruction. Conditions discussed include the seronegative spondyloarthropathies, degenerative disorders, infections, and DISH.

Arthritis↗
PubMed1986

Chronic osteomyelitis: bone and gallium scan patterns associated with active disease.

Bone and gallium scans are used to assess osteomyelitis patients with prior bone disease. To refine the criteria for interpreting these scans, the data from 136 consecutive patients with clinically suspected osteomyelitis were reviewed. Active osteomyelitis was diagnosed with surgery or biopsy and culture in 49 patients, excluded with the same criteria in 16, and excluded by clinical follow-up for at least 6 months in 71. Five different scintigraphic patterns were found. The true-positive and false-positive ratios, the likelihood ratios, and posterior probabilities for active osteomyelitis in each pattern were calculated. Only one pattern (gallium uptake exceeding bone-seeking radiopharmaceutical uptake) was indicative of active disease. Other patterns slightly raised or decreased the probability of disease. The extent of these changes varies directly with the prior probability of disease, determined from patient-specific factors (e.g., clinical data, laboratory data, findings on plain films) known best by the referring clinician.

Gallium Radioisotopes↗
PubMed1985

Computed tomography of the hindfoot with rheumatoid arthritis.

We are performing direct, coronally oriented computed tomographic (CT) scans of the subtalar joint in patients with rheumatoid arthritis. To date, 16 examinations have been performed in 14 patients, 5 of whom were scheduled to undergo subtalar arthrodesis. Scans were 4-7-mm thick and spanned the length of the subtalar joint. CT scans depicted and localized subtalar abnormalities clearly and precisely. On CT scans, patients showed a characteristic constellation of abnormalities including: soft tissue swelling, cartilage space narrowing, bony erosions, and a pes planovalgus alignment abnormality (consisting of increased heel valgus angulation, and a tendency toward flattening of the sustentaculum tali, and medial and downward slippage of the talar head). The clarity of the CT images facilitated the surgeon's pre- and postoperative evaluation. In particular, it was easy to plan the correction of the valgus deformity, anticipate any special requirements for reinforcing the articular surfaces, and assess the results of surgery. We conclude that coronal CT scans clearly demonstrate abnormalities and help the surgeon evaluate the rheumatoid hindfoot.

Adult↗
PubMed1985

CT findings in normal and dislocating shoulders.

Computed tomographic (CT) scans of the shoulders of 10 normal individuals and six patients with a history of recent or recurrent shoulder dislocation were reviewed. In normal individuals, the surface of the glenoid was smooth and was always within 10 degrees of being perpendicular to the body of the scapula. As scans progressed from cephalad to caudad, the glenoid surface twisted and faced more anteriorly. The center of the humeral head always projected within the central one-third of the glenoid fossa. In the patients with dislocations, CT scans depicted a variety of lesions, including: bony abnormalities of the glenoid surface (fragmentation, fracture, irregularity) in three patients; abnormal glenoid-scapular angles in two; loose bodies in two; subtle subluxation, coracoid fracture, cystic humeral defect, and soft-tissue calcification in one patient each. Scans without intra-articular contrast could not demonstrate capsular or labral abnormalities. CT images are helpful in the pre- and postoperative assessment of some patients with shoulder dislocation.

Adult↗
PubMed1984

Computed tomography and conventional radiographs of the craniocervical region in rheumatoid arthritis. A comparison.

Radiographs and computed tomography (CT) scans of 12 patients with rheumatoid arthritis of the cervical spine were reviewed to determine whether CT provides additional information to that obtained from conventional radiography and tomography. Modalities were compared with respect to determination of the extent of erosion, C1-C2 subluxation, atlantoaxial impaction, and soft tissue findings. CT showed greater extent of erosion in 9 of 12 patients. In 11 patients with C1-C2 subluxation, CT and plain radiographs were both useful because it was necessary to demonstrate both sagittal and axial relationships. In the 5 patients with atlantoaxial impaction both CT and plain radiographs demonstrated the abnormal relationships between the odontoid and the foramen magnum. CT showed attenuation of the transverse ligament and the presence or absence of spinal cord compression, whereas plain radiographs did not. Nevertheless, significant new information regarding the spinal cord was obtained by CT in only 1 of the 12 patients. Computed tomography provides additional information about the rheumatoid cervical spine that is unobtainable by conventional modalities. In particular, CT demonstrates bone changes in the axial projection and facilitates evaluation of soft tissue, ligament, and spinal cord involvement. However, CT should be reserved for those instances in which plain radiographs and tomograms do not explain clinical findings.

Aged↗
PubMed1984

The value of conventional views and radiographic magnification in evaluating early rheumatoid arthritis.

Fifty-four patients with suspected early rheumatoid arthritis had radiographs taken of their hands and wrists in 4 views (posteroanterior [PA], oblique, reverse oblique, and Brewerton) using conventional techniques and, in the PA view, using radiographic magnification. The radiographs were "masked" and presented in random order to 2 radiologists specializing in bone and joint radiology who interpreted them for malalignment, erosions, joint space narrowing, and soft tissue swelling. The PA was the best conventional view for demonstrating malalignment, joint space narrowing, and soft tissue abnormalities; the Brewerton view was better for detecting erosive disease. Radiographic magnification was more sensitive than conventional films for evaluating erosive disease, but otherwise was no better than the conventional PA view. These results help the physician choose the radiologic technique or combination of techniques that is most likely to detect specific abnormalities.

Arthritis, Rheumatoid↗
PubMed1984

Computed tomography of the hindfoot.

This investigation used computed tomography (CT) to study the normal anatomy of the hindfoot and to demonstrate abnormalities in patients with rheumatoid arthritis, pes planovalgus , old trauma, and soft-tissue masses. The hindfeet of 10 normal volunteers and 17 patients were scanned in the coronal and axial transverse planes. The articular surfaces of the tibia, talus, and calcaneus were assessed, as were the relationships of each bone to the others. Normal subjects had markedly symmetrical hindfeet . The "heel valgus angle" (relating the calcaneus to the tibia) was 5.2 +/- 1.6 degrees (mean +/- standard error of the mean). The "sustentacular angle" (indicating the angle of elevation of the sustentaculum tali at the midsubtalar joint) was 18.3 +/- 1.3 degrees. The "medial offset" of the talar head with respect to the calcaneus (measured at the anterior subtalar joint) averaged 5.2 +/- 1.8 mm. Patients with rheumatoid arthritis had erosions involving both sides of the subtalar joint, leading to talocalcaneal alignment abnormalities. In patients with pes planovalgus the heel valgus angle was greater and the elevation of sustentaculum tali lower in the foot that was most severely affected. Bony talocalcaneal fusions, fractures, and the erosions of pigmented villonodular synovitis were detected on CT. The pattern of postoperative bone healing after attempted subtalar fusion could be demonstrated. We conclude that CT is a useful tool for pre- and postoperative evaluation of the hindfoot.

Adult↗
PubMed1984

Intravenous methylmethacrylate after total hip replacement.

In eight patients, radiographs made after total hip replacement revealed methylmethacrylate in the soft tissues of the thigh. In one of them the configuration of the density was that of a vein. In the other seven patients similar but less extensive soft-tissue densities were seen postoperatively. One patient had postoperative hypotension which was thought to be due to a myocardial infarction. In another patient, with a prior history of congestive heart failure, congestive heart failure developed again after total hip replacement. The relationship of these complications to the radiographic observations was not clear.

Aged↗
PubMed1983

Complications of intertrochanteric rotational osteotomy.

Intertrochanteric anterior rotational osteotomy is a recently developed surgical procedure to treat osteonecrosis of the femoral head. We reviewed the radiographic findings in four cases to acquaint radiologists with the usual appearance of the procedure and to assess surgical complications. In all cases, immediate postoperative radiographs showed rotation of the necrotic portion of the femoral head anteriorly so that it was no longer weight-bearing. Clinical and radiologic follow-up ranged from 12 to 30 months. In this time, three patients developed complications, including non-union of the osteotomy, further osteonecrosis with collapse of the femoral head, and worsening pain in the absence of progressive radiologic change. Radiology provides an important means of assessing rotational osteotomy, particularly in demonstrating sufficient rotation of the femoral head to assure nonweight-bearing by diseased bone. Also, surgical complications such as nonunion and hardware loosening may be identified. Nevertheless, the patient may deteriorate clinically even in the absence of radiologic demonstration of disease progression, and the absence of radiographic change does not assure a successful surgical outcome.

Adult↗
PubMed1983

Radiologic findings in late-onset systemic lupus erythematosus.

Systemic lupus erythematosus in the elderly has a different clinical and serologic course from that in young patients. Radiographic findings in patients in whom the diagnosis was made after age 50 were compared with findings in younger patients to see if the radiologic patterns are also different. The only significant radiographic difference between the two groups was that the older group had a greater incidence of soft-tissue swelling of the hands and wrists (p less than 0.001). There was no significant difference in osteopenia, erosion, soft-tissue calcification, alignment abnormalities, or intrathoracic findings. Of 24 patients over age 50, two developed lymphoma and another developed multiple myeloma. The data agree with clinical observations that there is a higher incidence of arthritis in late-onset lupus, but clinical findings of increased incidence of pleuropericardial disease are not confirmed radiographically. The coincidence of hematologic malignancy with late-onset lupus in this series is noteworthy.

Adolescent↗
PubMed1983

Femoral neck erosions: sign of hip joint synovial disease.

Pathologic synovial processes in the hip joint can cause characteristic extrinsic erosions of the femoral neck, which in extreme cases produce an "apple core" appearance. Nine such cases of synovial diseases, including synovial osteochondromatosis, pigmented villonodular synovitis, rheumatoid arthritis, and amyloidosis, that demonstrate this radiographic finding are presented. The anatomic relations of the hip joint that result in this appearance, differential diagnosis, and radiographic techniques useful in diagnosis are discussed.

Aged↗