Biomedical subjects
Publications and source records attributed to C Vallée.
Wrist imaging still relies first on plain X-Ray films, MRI allows excellent appreciation of the sculture of bones, ligaments, tendons and even nerves. C.T. is essentially useful in traumatology, while Wrist arthrography can be useful for detection of small ligament lesions.
A wrong patient's position on the CT scan table may lead to mistakes in the measurement of femoral neck anteversion. We present an experimental demonstration using a wood manufactured femur model. If the slices are performed with flexion of the thigh, the measurement is lower than the true value. Thus, to check the measurement on the picture of added slices, it is necessary to have a superimposition of the pictures of the upper part and the lower part of the femur. Otherwise, the measure is wrong and the mistake depends of the direction of the shifting: --if the lower part of the femur is higher, the anteversion measure is lower than expected. --if the lower part of the femur is lower, the anteversion measure is higher.
In summary, septic arthritis of a lumbar facet joint has been rarely discussed in the literature [1, 4]. In this case report the histological and bacteriological diagnosis was established by percutaneous needle biopsy guided by fluoroscopy and the response to treatment was confirmed by CT scans.
Biomechanical models of the cervical spine require knowledge of the position, size and orientation of the individual muscles that act on the cervical spine. We have developed a technique to stereometrically measure anatomical specimens. The apparatus is composed of three graduated metallic rods, which slide along a fixed support. This method is accurate to map the anatomy of individual muscles and provides quantitative data on their lines of action. Results are obtained from one specimen. The computer processing of the collected data allows formulation of a three-dimensional model of the neck muscles in man.
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Despite new imaging modalities such as MRI, the discography remains useful, particularly as the first step of chemonucleolysis. The anulography corresponds to a technical error due to the wrong position of the needle during the procedure. We have noticed 32 anulographies on 1226 discographies done in our department, between 1985 and 1989. The anulography exhibits a typical pattern that must be diagnosed; if not, that can lead to a diagnosis mistake or a wrong therapeutic attitude. The needle of discography must then be repositioned.
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CT scan sagittal reconstructions allow accurate angular measurements of the extent of the avascular necrosis of the hip, that is necessary to consider in view of an osteotomy of rotation Sugioka type. This method is performed on a supine patient with internal rotated and extended lower limbs, using 5 mm slices from the acetabular roof to the distal part of the femoral neck. A sagittal reconstruction through the middle of the femoral head is then performed, owing a direct measurement of the extent of the necrosis and of the theoretical rotation to be used in order to keep it out of the carrying zone. Twenty hips have been studied by this method which can be used post-operatively with satisfying results. It replaces the more radiating conventional tomographies. The protonic image of MRI will perhaps substitute it, but CT gives a "calcium" image probably more accurate for the analysis of the carrying zones.
Condensing pediculolaminar hypertrophy of mechanical origin is known as "Dahu's sign". Dahu's sign corresponds to hypertrophy of the vertebral hemi-arch found by CT scan and leads to suspicion of controlateral lysis of the isthmus. It is the CT scan equivalent of vertebral "anisocorism" by conventional radiology.
In the context of a particular case report, the authors recall that calcified discs may be responsible for root pain, hyperalgic sciatica or lumbago. In the present case, the pain responded to intra-discal injection of long-acting corticosteroids. The authors compare this case to 10 other personal cases and 16 cases reported in the literature.
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The authors report a retrospective study of 121 arthrographies of the hip in adults, excluding prostheses. The study was based on normal pathological values for angular measurement of the labrum acetabular: ECB angle (mean value: 15 degrees) enlarging the lateral cover of the head of the femur, VCE angle (mean value: 30 degrees) and a mean global VCB angle of 45 degrees. A certain equilibrium was observed between the covering capacity of the acetabulum and the covering capacity of the labrum acetabular. Numerous anomalies of the labrum were observed, including fissures in about 30% of cases. A large number of fissures were associated with other degenerative anomalies of the hip joint. A few fissures resulting in detachment of a strip of labrum were isolated and the possibility of their traumatic etiology and their pathogenic nature in clinical symptoms are discussed.
A method is described for control of a bicipital groove projection using a tele-controlled table with centering guided by direct screen imaging: the patient is placed in contralateral anterior oblique position with the arm in antepulsion to project the groove into the supraspinal fossa on a lateral scapular image.
The authors study the diagnostic accuracy of quasi axial view during discography about 136 discs with proved herniation. It is a good helm to the frontal and lateral views.
The authors describe a new view of the discography comparable to the axial CT imaging of the disc, so they used the name of "quasi-axial" view. They point the landmarks of this new picture.
A case of desmoid fibroma of anterior abdominal wall, an exceptional benign tumor, is reported. Based on results of CT scan imaging of this lesion, differential diagnosis of other expansive processes of abdominal wall are discussed. This benign tumor is a potentially serious lesion due to its infiltrating character and the high incidence of recurrence. The need for total surgical excision is emphasized.