An endoscopic view of the British Health Service.
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Biomedical subjects
Publications and source records attributed to C E Graham.
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Recent developments in isotope imagery have allowed orthopaedic surgeons some insight into stress areas of the skeleton that are not readily seen on routine X-rays. This X-ray imagery has been used in evaluating patients with painful heel syndrome. In 97.7% of the cases, the bone scan was positive on the side of the heel that had the pain. An X-ray technique exposing the painful heel at a 45 degree angle on the medial side with the cassette underneath the foot showed a bony condensation in many of the cases which was thought to represent a fatigue fracture. Based on these bone scans and X-ray findings, a classification system has been devised. A flow chart is described using logical progression in the diagnosis and treatment phase of this problem.
Microscopic evaluation of the interdigital neuroma is described in 24 nerves which were evaluated at six cross-section areas for size of the nerve and width of the perineural along with the fascicle diameter and the size and number of blood vessels inside each fascicle. A relationship was noted between the level of the distal edge of the intermetatarsal ligament. Cross-section that was taken at that area showed changes distally in nerve diameter, fascicle number and size, blood vessel number and size, and perineural width. These changes are consistent with the interdigital neuroma as an entrapment condition.
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