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Biomedical subjects

C A Helms

Publications and source records attributed to C A Helms.

At least 109 records · Page 6Linked to original sources
PubMed1985

Multinuclide digital subtraction imaging in symptomatic prosthetic joints.

One hundred eleven patients with symptomatic prosthetic joints (86 hips, 23 knees, and two shoulders) were evaluated for prosthetic loosening and infection by combined technetium-99m-MDP/gallium-67 digital subtraction imaging. Clinical correlation was based on the assessment of loosening and bacterial cultures obtained at the time of surgery in 54 patients, joint aspiration cultures obtained in 37 patients, and long-term clinical follow-up for greater than 1.5 years in an additional 15 patients. Results revealed an 80%-90% predictive value of a positive test for loosening, and a 95% predictive value of a negative test for infection. However, because of the low sensitivities and specificities observed, this approach to the evaluation of symptomatic prosthetic joints does not seem cost effective.

Adult↗
PubMed1985

Hypothesis: the nervous system may contribute to the pathophysiology of rheumatoid arthritis.

No current theory of the mechanisms involved in the pathophysiology of rheumatoid arthritis (RA) explains its important clinical features. We hypothesize that neural mechanisms are involved in this pathophysiology and they explain at least 3 clinical features: specific high risk joints are more likely to develop arthritis; specific high risk joints have more severe arthritis; and RA is bilaterally symmetric. If our hypothesis is correct, it will provide a rationale for the development of new therapies for what is now an inadequately treated disease.

Arthritis, Rheumatoid↗
PubMed1985

Magnetic resonance imaging of the hip.

Magnetic resonance imaging of the musculoskeletal system in general and the hip in particular offers many exciting opportunities for innovative and revolutionary diagnostic avenues, the full potential of which awaits further investigative and clinical experience.

Bone Marrow Diseases↗
PubMed1985

Characteristic CT manifestations of uncommon spinal disorders.

This article identifies many disorders seen on CT scans of the spine that should be recognized to avoid submitting the patient to additional diagnostic tests or even surgery. These disorders are not easily categorized, however, and could best be described as normal variants and pitfalls in CT diagnosis of the spine.

Humans↗
PubMed1985

Magnetic resonance imaging of the musculoskeletal system.

MRI is a complementary technique to CT in the examination of the spine, the hip, and musculoskeletal tumors. In some cases, it provides diagnostic information not available with any other modality, including CT. MRI has the potential to be very useful in the assessment of various marrow-based disorders and may someday obviate the need for contrast-aided studies of ligaments, tendons, and cartilage.

Aged↗
PubMed1984

Dislocation of jaws.

Pluri-directional tomographic and arthrotomographic findings are described in six patients with dislocation of the jaw severe enough to require medical assistance. A grooved defect along the posterior aspect of the condylar head was noted in two of the six patients. The arthrotomographic findings that were obtained in one patient that was dislocated at the time of the arthrogram did not suggest a meniscocondyle incoordination as a mechanism. However, arthrotomographic findings in the six reported cases suggest that significant intra-articular soft tissue damage may result.

Adult↗
PubMed1984

Diagnosis by computed tomography of temporomandibular joint meniscus displacement.

CT may be a practical alternative to arthrography for diagnosing displacement of the meniscus in the TMJ. In a study of 75 patients, 69 were diagnosed by CT to have meniscal displacement. Thirty-four diagnoses were subsequently confirmed by surgery or arthrography. Disadvantages of CT are cost (almost twice as much as an arthrogram), inability to diagnose perforations, and inability to judge meniscus dynamics, which can be done by fluoroscopy. Advantages are patient comfort, safety, and decreased total radiation dose. Continued research and clinical correlation will be needed to determine the role of CT in the diagnosis of meniscus displacement of the TMJ. However, initial results are promising, and CT may quickly replace arthrography as the diagnostic procedure of choice.

Adolescent↗
PubMed1984

The normal sacroiliac joint: a CT study of asymptomatic patients.

The sacroiliac (SI) joints of 45 asymptomatic subjects were prospectively studied to define better the normal appearance of SI joints on CT scans and thereby attach appropriate significance to CT signs of sacroiliitis. We evaluated joint space narrowing, subchondral sclerosis, erosions, ankylosis, osteophytes, subchondral cysts, and symmetry. The results indicate that the SI joints demonstrate symmetry in patients under the age of 30 (100% of subjects in this age group). Asymmetry was demonstrated in 77% of subjects over the age of 30 and in 87% of subjects over the age of 40. Abnormal CT findings of sacroiliitis, which occurred frequently in the asymptomatic population and thus by themselves are believed to be poor indicators of sacroiliitis, include nonuniform iliac sclerosis (83%), focal joint space narrowing in patients over the age of 30 (74%), and ill-defined areas of subchondral sclerosis, particularly on the iliac side (67%). Those CT findings of sacroiliitis that occurred infrequently in the asymptomatic population, and hence may represent good indicators of sacroiliac disease, include increased sacral subchondral sclerosis in subjects under the age of 40 (11%), bilateral or unilateral uniform joint space of less than 2 mm (2% or 0%, respectively), erosions (2%), and intraarticular ankylosis (0%).

Adult↗
PubMed1984

Osteoid osteoma: radionuclide diagnosis.

The double-density sign, seen on radionuclide bone scans, is described for diagnosing osteoid osteomas and for localizing the nidus. Its use in differentiating the nidus of an osteoid osteoma from osteomyelitis is also described. The utility of computed tomography in localization of the nidus is also illustrated. The double-density sign was helpful in diagnosing seven cases of surgically confirmed osteoid osteoma.

Adolescent↗
PubMed1984

CT scanograms for measuring leg length discrepancy.

A method for measuring discrepancies in leg length using digitized radiographs obtained with a CT scanner is described. This method is more rapid and delivers 50 to 100 times less radiation than the conventional radiographic method.

Anthropometry↗
PubMed1984

Temporomandibular joint internal derangements: CT diagnosis.

Two hundred patients with suspected displaced temporomandibular joint meniscus were studied with computed tomography. In 75 cases confirmation of the CT diagnosis was subsequently obtained via surgery or arthrography; correlation was found in 73 cases (97%), with one false-negative and one false-positive examination. When meniscus displacement was graded as "mild," "moderate," or "severe," those cases diagnosed as moderate or severe were more likely to require surgery. The technique and interpretation of this technique is described; in most cases CT can replace arthrography in diagnosing displaced temporomandibular joint menisci.

Adolescent↗
PubMed1984

Skeletal changes in neuromuscular disorders mimicking juvenile rheumatoid arthritis and hemophilia.

Seven patients with neuromuscular disorders were examined, including one with cerebral palsy, one with Duchenne muscular dystrophy, two with paraplegia, and three with poliomyelitis; all exhibited skeletal changes mimicking those found in juvenile rheumatoid arthritis and hemophilia. These findings included apparent overgrowth of the epiphyses, periarticular osteoporosis, and joint-space narrowing in seven subjects; accentuation of the trabecular pattern in six; gracile bones and soft-tissue wasting in five; tibiotalar slant in two; and premature epiphyseal closure in one. Changes in osseous vascular dynamics and the debilitation or immobilization found both in patients with neuromuscular disorders and those with arthritis may help explain these overlapping findings. While the clinical distinction between the neuromuscular and arthritic disorders is straightforward, the similarity in radiographic appearance has received little attention. If the clinical history is inadequate, this may result in confusion or misinterpretation by the radiologist. In the absence of more specific findings, such as articular erosions or erosions of the femoral intercondylar notch, the differential diagnosis may be mistakenly limited to juvenile rheumatoid arthritis and hemophilia. In such cases, the neuromuscular disorders should also be considered in the differential diagnosis.

Adolescent↗
PubMed1983

Chronic repetitive trauma: a cause of atypical degenerative joint disease.

Six cases of amateur athletes who have severe atypical degenerative joint disease (DJD) are presented; their histories suggest that chronic, repetitive trauma was causative in the development of their arthropathy. Although many examples of this process have been reported in professional athletes, it has not been reported in amateurs. As participation in athletic activities increases we can, perhaps, expect to see more of this type of DJD in the future.

Adult↗
PubMed1983

Use of computed tomography in congenital dislocation of the hip.

The diagnosis of congenital dislocation of the hip is easily made on plain film; however, after the patient is placed in a spica cast with abduction, plain films and even tomograms often fail to show the position of the capital femoral epiphysis. The usefulness of computed tomography in the clinical setting is described by a sample case. The decreased radiation and increased accuracy of diagnosis should make computed tomographic scanning of the hips the procedure of choice over plain film or tomogram when evaluating congenital dislocation of the hip.

Casts, Surgical↗
PubMed1983

Computed tomography of the temporomandibular joint meniscus.

Fifteen patients with temporomandibular joint dysfunction were examined by computed tomography using standard CT techniques. The data obtained were evaluated and correlated with arthrographic findings or surgical observations. CT scans may become a valid alternative to the often painful procedure of arthrography for assessment of temporomandibular joint pathology if the potential pitfalls are avoided.

Adult↗