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Biomedical subjects

C W Hayes

Publications and source records attributed to C W Hayes.

At least 55 records · Page 3Linked to original sources
PubMed1991

Cross-sectional imaging of the patellofemoral joint and surrounding structures.

Computed tomography (CT) and magnetic resonance (MR) imaging are extremely useful in the accurate diagnosis of anterior knee pain, a common complaint arising from numerous causes (including fracture, chondromalacia patellae, and alignment and tracking abnormalities). Plain CT is effective for evaluating intraosseous lesions of the knee. Although CT arthrography provides excellent visualization of the patellar articular cartilage, the technique is expensive and invasive. Cine CT is an excellent method for assessing patellofemoral tracking and alignment. Kinematic MR imaging can also perform this function. In addition, MR imaging can provide valuable information concerning the status of patellar cartilage. Although MR imaging can accurately show high-grade chondromalacia patellae, it is less accurate in the detection of low-grade disease. The authors believe that MR imaging and plain radiography offer radiologists the greatest latitude in making a specific diagnosis of the cause of anterior knee pain; however, CT is a useful alternative.

Arthrography↗
PubMed1991

Mammographic follow-up of nonpalpable low-suspicion breast abnormalities: one versus two views.

A retrospective study involving 498 women with a total of 666 breast lesions was undertaken to determine the relative efficacy of one- and two-view mammography in the follow-up evaluation of "low-suspicion" abnormal mammographic findings. These abnormalities consisted of well-defined masses (47.1%), well-defined punctate microcalcifications (20.9%), and parenchymal asymmetry (32.0%). Confidence in the adequacy of the single-view follow-up was high in 91% of cases. The addition of the second mammographic view changed the one-view interpretation in approximately 1% of all cases. Two cancers were detected during the initial follow-up period. Both cancers were detected with single-view and standard two-view follow-up examinations, with high confidence. In this controlled retrospective study, the single-view follow-up examination was adequate for follow-up of most low-suspicion mammographic abnormalities. Monitoring by physicians, however, would be necessary to prevent an unacceptable number of patient recalls, which could make the one-view follow-up study impractical to use in some practices.

Adult↗
PubMed1991

Temporomandibular joint after meniscoplasty: appearance at MR imaging.

Twenty-five temporomandibular joints (TMJs) were studied in 20 patients who had undergone meniscoplasty. In all patients, preoperative magnetic resonance (MR) images showed anteriorly dislocated disks; all patients underwent a similar postoperative MR examination an average of 6 months after surgery. The results of these studies were correlated with clinical results of surgery, which were classified as poor, fair, good, or excellent at follow-up MR imaging. In 10 TMJs (eight patients [40%]) the clinical results were excellent or good; in 15 TMJs (12 patients [60%]), fair or poor. The position of the disk relative to its preoperative position was a good discriminator in determination of the clinical success of meniscoplasty. After surgery, in all patients with good or excellent results, the disks appeared to be in a normal or an improved position compared with that prior to surgery; in those with poor or fair results, the TMJs had anteriorly dislocated disks that showed no improvement.

Adolescent↗
PubMed1991

Occult breast masses: use of a mammographic localizing grid for US evaluation.

To determine if there was a problem of misidentification of mammographically detected masses with freehand ultrasound (US), the authors examined 50 mammographically distinct masses in 47 patients who were scheduled to undergo needle localization. In only six cases were the masses to be localized in an area of the breast that contained other mammographic opacities that could have led to problems of identification. The patients were first studied with freehand US. Results were then compared with those subsequently obtained with a fenestrated mammographic compression grid to guide the US evaluation. Needle localization was then performed. In five of 50 cases, masses detected with freehand US and initially believed to correspond to the mammographically detected mass were subsequently found to represent different areas of the breast when US was used with the compression grid. These results suggest that the potential for misidentification of masses with freehand US is real and that a mammographic grid localization device can be used to overcome this problem.

Breast Neoplasms↗
PubMed1991

Indications for radiography in patients with acute ankle injuries: role of the physical examination.

A prospective study was performed to test the hypothesis that a thorough physical examination can eliminate the need for a large number of radiographs obtained in patients with acute ankle trauma. Two hundred one patients were seen in the emergency department for acute ankle trauma and referred to the department of radiology for ankle radiographs. Radiology residents performed a brief but thorough physical examination of the ankle in all 201 patients. Solely on the basis of a strict set of physical examination criteria (examination for gross deformity, instability, crepitation, focal bony tenderness, severe soft-tissue tenderness, moderate or severe soft-tissue swelling, and ecchymosis), the radiologists determined whether or not the radiographs were indicated. All patients, irrespective of the physical examination, underwent ankle radiography, and the results were correlated with those of the physical examination. On the basis of the results of the physical examinations, 101 (50%) of the radiologic studies were not indicated. In only one of these patients was a fracture seen on radiographs. The radiograph in this case showed a small avulsion fracture of the dorsal aspect of the talus that was clinically insignificant (no cast or surgery was required). Our results suggest that a brief but thorough physical examination can eliminate the need for a large percentage of radiographs ordered in patients with acute ankle trauma.

Adolescent↗
PubMed1991

Hyperparathyroidism.

Since the introduction of routine automated measurements of serum calcium levels in the 1970s, the detection of primary hyperparathyroidism has risen considerably. Nevertheless, the severe bone changes described by von Recklinghausen are still quite rare. The apparent rise in incidence is accounted for by the discovery of a large group of predominantly asymptomatic elderly patients who have mild primary hyperparathyroidism. Because the diagnosis is most often confirmed through laboratory tests, radiologic studies are now most useful in assessing the severity of the disease. The presence of bone changes is an accepted indication for parathyroid surgery in primary hyperparathyroidism. For patients with asymptomatic disease in whom nonsurgical treatment may be considered, radiographic evaluation is one of several techniques that may be used to assess progression. High resolution radiographs of the hands are most valuable in this regard. Accelerated bone mineral loss, as measured by quantitative techniques, will probably play a significant role in the future. Radiographic follow-up of patients with renal disease and secondary hyperparathyroidism is equally important, as increased bone or soft tissue changes may indicate a need for therapeutic change. Radiographically identifiable changes of hyperparathyroidism consist mainly of various types of accelerated bone resorption. Multifocal subperiosteal resorption is generally considered to be pathognomonic of hyperparathyroidism. Subligamentous, subchondral, endosteal, and intracortical resorption are also important manifestations of accelerated bone turnover. The earliest bone changes are visible in the hands and should be searched for especially carefully in the phalanges and terminal tufts. Only occasionally will changes be found elsewhere in the skeleton when hand changes are not present.

Aged↗
PubMed1990

Calcium hydroxyapatite deposition disease.

Calcium hydroxyapatite crystal deposition disease is characterized by the presence of basic calcium phosphate crystals--predominantly hydroxyapatite--in the periarticular soft tissues, especially the tendons. The entity is best recognized as "calcific tendinitis" at its most frequent site about the shoulder, but the disease involves numerous other sites and may be more appropriately termed calcific periarthritis. This article illustrates typical and atypical radiographic features of hydroxyapatite deposition, as well as some unusual manifestations of the disease. A brief review of various theories on the pathogenesis of the disease and a section on differential diagnosis is included.

Arthrography↗
PubMed1990

Patellar cartilage lesions: in vitro detection and staging with MR imaging and pathologic correlation.

Fourteen freshly disarticulated knee specimens were studied to assess the usefulness of magnetic resonance (MR) imaging in the detection and correct staging of patellar chondral lesions. Axial and sagittal images were obtained; T1-weighted spin-echo sequences were found satisfactory for defining cartilage morphology. Specimens were sectioned and examined grossly for cartilage changes such as softening, blistering, fibrillation, fissuring, and frank subchondral bone exposure. In a side-by-side comparison, all lesions classified grossly in the Shahriaree system as stage II or higher showed MR changes. Stage I changes could not be identified in disarticulated specimens. Stage III lesions showed cartilage irregularity (ulceration) or a loss of the normal, sharply defined margin between coapted cartilage, which represented "crabmeat" fibrillation. Stage IV lesions showed ulceration to bone, sometimes with subchondral bone changes. In this in vitro, preliminary study, MR imaging was found to be an accurate means for detecting and staging moderate and advanced patellar cartilage lesions.

Adult↗
PubMed1989

Age and bone mass in premenopausal women.

It is important to determine the bone mass in normal premenopausal women because increasing numbers of conditions have been identified that result in premenopausal osteoporosis. The relationship between age and bone density was evaluated in 57 carefully characterized normal, premenopausal women using both single energy quantitative computed tomography (SEQCT) and dual energy (DEQCT). The mean bone density measurements were 172 mg/ml K2HPO4 SEQCT and 185 DEQCT. Bone density showed no statistically significant decline between age 18 and age 44. Single- and dual-energy data were highly correlated with each other (r = 0.89), and dual energy appeared to confer no advantage. There was an inverse relation between density and age of menarche. Bone density did not correlate with ideal body weight, percentage fat, or subcutaneous fat area.

Adolescent↗
PubMed1989

Non-neoplastic lesions of vertebral bodies: findings in magnetic resonance imaging.

This paper presents examples of non-neoplastic lesions of the spine that produce focal or diffuse signal alterations on MR images, and that may, therefore, be confused with metastases or primary neoplasms. Examples include endplate changes associated with degenerative disk disease, hemispherical spondylosclerosis, osteoporotic compression fractures, Paget's disease, focal and diffuse fatty infiltration, osteomyelitis, and changes associated with various arthritides. Distinguishing signal intensity characteristics on T1 and T2 weighted images and distinctive morphology are emphasized.

Fractures, Bone↗
PubMed1989

Body fat distribution measured with CT: correlations in healthy subjects, patients with anorexia nervosa, and patients with Cushing syndrome.

Computed tomography (CT) was used to study fat distribution in three groups of women of comparable age: 39 healthy volunteers, 15 patients with anorexia nervosa, and seven with Cushing syndrome. Patients with anorexia nervosa had a fivefold decrease in subcutaneous fat and only a twofold decrease in intraabdominal fat compared with the values for the volunteers. Patients with Cushing syndrome had less than a twofold increase in subcutaneous fat and greater than a fivefold increase in intraabdominal fat compared with values for the healthy subjects. These findings suggest that fat in different body compartments responds differently to disease processes and that CT can be used to measure these changes.

Adipose Tissue↗
PubMed1989

Temporomandibular joint motion: efficacy of fast low-angle shot MR imaging.

One hundred temporomandibular joints (TMJs) in 62 symptomatic patients and two healthy volunteers were prospectively examined with T1-weighted spin-echo and fast low-angle shot (FLASH) gradient-echo sequences. FLASH sequences were performed during opening of the mouth and provided a pseudodynamic depiction of TMJ motion. In 49 joints, FLASH sequences provided information that potentially influenced the therapeutic approach to the patient. This information was not available from standard T1-weighted images. The additional information fell into four general categories: (a) determination of the exact time of disk recapture, (b) distinction of normal variants from pathologically displaced disks, (c) clarification of discrepancies found between clinical examination results and T1-weighted images, and (d) elimination of motion degradation of images.

Adult↗
PubMed1989

Three-compartment wrist arthrography: use of a low-iodine-concentration contrast agent to decrease study time.

To decrease examination time, the authors used a contrast agent with a low iodine concentration for three-compartment (radiocarpal joint, distal radioulnar joint, midcarpal compartment) wrist arthrography. The material was used in 24 patients. Many patients demonstrated dissipation of contrast material in the radiocarpal joint by 30 minutes after injection. By 45 minutes, all patients demonstrated sufficient dissipation to permit the second injection. The technique produces diagnostic images and reduces the time required for the study.

Diatrizoate Meglumine↗
PubMed1988

Dynamic magnetic resonance imaging of the temporomandibular joint using FLASH sequences.

Magnetic resonance imaging (MRI) is a suitable modality for the visualization of the temporomandibular joint (TMJ) in both normal and pathologic conditions. Until recently, MRI had been unable to provide diagnostic dynamic images of the TMJ during opening. A series of 30 TMJ MRI examinations of 17 symptomatic patients and two normal volunteers (15 to 43 years old; 14 men and five women) was performed. Fast low angle shot (FLASH) sequences were used to provide a series of dynamic images of the TMJ in various phases of opening. In 30% of the joint examined, FLASH sequences contributed clinically significant information not available with standard T1-weighted sequences. These results suggest that FLASH images are particularly useful in distinguishing normal disc variants from pathologic conditions in which the disc is displaced anteriorly to a mild extent. The short imaging time of FLASH sequences decreases motion artifact in patients who have difficulty remaining still during the examination.

Adolescent↗
PubMed1988

Congenital brachial artery aneurysm in an infant--a case report.

An arterial aneurysm of any kind is rare in infancy, and one that occurs in the brachial artery is probably even more rare; when such an aneurysm is asymptomatic and congenital, it must be exceedingly rare. One such unique case is described herein, together with a brief review of the literature.

Aneurysm↗
PubMed1987

Calcific tendinitis in unusual sites associated with cortical bone erosion.

Five cases of calcific tendinitis with radiographic evidence of cortical bone erosion are presented. All five cases arose at unusual sites: two at the pectoralis major insertion on the proximal humerus, two at the insertion of the gluteus maximus, and one at the insertion of the adductor magnus. Biopsy was performed in four cases and revealed areas of histiocytic infiltration, amorphous spherules of calcification, and areas of giant cell reaction extending into the cortex. To our knowledge, calcific tendinitis presenting with radiographic evidence of bone erosion has not been reported previously.

Adult↗