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Biomedical subjects

D D Sauser

Publications and source records attributed to D D Sauser.

14 recordsLinked to original sources
PubMed1995

Iliopsoas bursa imaging: efficacy in depicting abnormal iliopsoas tendon motion in patients with internal snapping hip syndrome.

PURPOSE: To evaluate the efficacy of both iliopsoas bursa imaging and therapeutic injections for determination of the cause of pain in patients with internal snapping hip syndrome. MATERIALS AND METHODS: Twelve patients underwent iliopsoas bursa imaging. One patient underwent the procedure bilaterally and five underwent repeated studies for a total of 21 studies. Eight patients also received therapeutic injections after bursa imaging. RESULTS: Abnormal motion of the iliopsoas musculotendinous unit that occurred synchronously with the snap was revealed in 15 of the 21 studies. Four studies revealed additional information that contributed to symptoms. Eight patients received therapeutic injections with relief of symptoms that ranged from 2 weeks to 2 years. CONCLUSION: Iliopsoas bursa imaging is a simple, rapid, and reproducible method with which abnormal iliopsoas tendon motion can be documented in patients with internal snapping hip syndrome and is also useful for diagnosis of other causes of atypical hip pain. Therapeutic injection into the iliopsoas bursa may delay or obviate surgery.

Adolescent↗
PubMed1990

The causes of bone scintigram hot spots in fluoride-treated osteoporotic patients.

We previously described new bone formation in fluoride-treated osteoporotic patients. Since then, several investigators have contended that fluoride-induced "hot spots," as seen on bone scintigrams, represent stress fractures. To further evaluate this issue we analyzed scintigrams, radiographs, and quantitative computer tomography (CT) scans of the spine and femoral condyles from 129 patients, obtained before and during therapy. Hot spots, new or of increased intensity, were more than twice as common in the weight-bearing peripheral skeleton than in nonweight-bearing sites (p less than 0.001). The hot spots were usually diffuse, multiple, bilateral, and mostly seen early in therapy, a pattern quite different from that expected of stress fractures. Previously, we postulated that mechanical stress and fluoride act synergistically to stimulate new bone formation. If this hypothesis were correct, we would expect to see a greater increase in femoral condyle bone density in patients with hot spots. Consistent with this hypothesis, patients who developed hot spots in the knees had a greater increase in condylar density (22 +/- 2.5 vs. 9 +/- 3.3 mg/cc) than those without hot spots and stress fractures were not seen in either group. Additionally, patients with more than 5 hot spots in the peripheral skeleton had greater increases in spinal and condylar density than those with fewer than 5 hot spots. Finally, stress fractures were found in less than 2% of our patients. While we do not exclude the possibility that some additional patients may have had stress fractures, our data support the hypothesis that the great majority of hot spots seen on the scintigrams are the sites of new bone formation.

Adult↗
PubMed1990

Imaging of the elbow.

The imaging needs for diagnosis of abnormalities in and about the elbow are presently satisfied in most instances by plain film radiography. Arthrography with tomography and CT has enabled us to delineate the joint space and articular surfaces better. The sensitivity of radionuclide imaging allows early detection of disease processes but lacks specificity. The advantages of MR imaging in the musculoskeletal system should allow improved diagnostic imaging capability about the elbow as it has for other joints.

Diagnostic Imaging↗
PubMed1988

Adhesive capsulitis of the wrist: arthrographic diagnosis.

Persistent pain and decreased range of motion are disabling complications of wrist trauma. Between 1978 and 1986, in ten patients with persistent pain following trauma, arthrography depicted changes characteristic of adhesive capsulitis. Adhesive capsulitis has been described in the shoulder, hip, and ankle, but little mention has been made of this entity in other joints. Confirmation of this diagnosis requires arthrography, since there are no characteristic findings on plain radiographs. Typical arthrographic findings include decreased capacity, small volar and styloid recesses, and adhesions preventing complete opacification of the joint. The arthrographic diagnosis allows proper institution of appropriate therapy.

Adult↗
PubMed1988

Imaging of peripheral nerve lesions.

The imaging of peripheral nerve lesions remains limited to the radiographic demonstration of secondary skeletal lesions in birth trauma, reflex sympathetic dystrophy, neuropathic arthropathy, leprosy, and congenital indifference to pain. Nerve root avulsions can be imaged directly and the newer imaging modalities now allow delineation of lesions that previously could not be studied using conventional radiography. The ability of ultrasound, CT, and MRI to differentiate soft tissue structures makes it possible, in many instances, to study the primary abnormality in trauma, nerve entrapment syndromes, and tumors. With fractures, the possibility of trauma to adjacent nerves can only be inferred on the radiographs, while the role that peripheral nerve injury plays remains controversial in other entities, such as amputation with replantation. Imaging of peripheral nerve lesions remains in its infancy. With further refinement in the signal-to-noise ratio made possible by advances in MRI technology, we may be optimistic about future imaging of peripheral nerve pathology.

Arthropathy, Neurogenic↗
PubMed1988

Adhesive capsulitis of the wrist. Diagnosis and treatment.

Adhesive capsulitis occurs as a pathologic entity in the shoulder, hip, and ankle joints. Thickening and contracture of the wrist joint capsule were demonstrated on arthrograms performed on ten patients ranging in age from 20 to 82 years. The patients had pain and limited range of motion in the wrist. The findings included: (1) resistance to the injection of smaller than normal volumes of contrast material, (2) obliteration of recesses, and (3) extravasation of the contrast agent along the needle tract. Closed manipulation under general anesthesia of the wrist on four patients resulted in some improvement in range of motion. A distal ulna fracture in one older patient occurred as a complication of manipulation. Careful technique and judicious patient selection are of paramount importance.

Adult↗
PubMed1986

Osteoporosis: radiographic detection of fluoride-induced extra-axial bone formation.

New bone formation in the peripheral skeleton was detected radiographically in 67% (22/33) of patients studied for new periarticular pain among 72 patients with osteoporosis being treated with fluoride, 66-88 mg/d, for 6 or more months. Changes included periosteal and endosteal new bone formation as well as trabecular thickening and were localized in areas of high mechanical stress. Sufficient mineral deposition for radiographic detection required 6 or more months of fluoride treatment. Radiologists must differentiate fluoride-induced new bone formation from other-processes, such as fractures and tumor, and elicit information on fluoride intake in suspicious cases.

Bone Development↗
PubMed1986

Hip changes in spastic cerebral palsy.

Radiographs of the hips of 69 patients with cerebral palsy were evaluated for the angle of Wiberg, acetabular angle, degree of subluxation, shape of the femoral head, and, when the appropriate studies had been performed, anteversion and neck-shaft angles. Abnormalities included various degrees of superior lateral subluxation or dislocation, dysplasia of the acetabulum associated with femoral head displacement, flattening of the medial and/or lateral portions of the femoral head, an increase in the anteversion angle, functional increase in the neck-shaft angle, and, in long-standing cases, secondary degenerative joint disease and pseudoarticulation. Neuromuscular imbalances and abnormal ambulation caused by cerebral palsy change the biomechanical forces on the hip and result in characteristic osseous changes. Recognition and proper treatment of these changes can significantly alter the clinical course of the disease.

Adolescent↗
PubMed1983

Acute injuries of the lateral ligaments of the ankle: comparison of stress radiography and arthrography.

Anterior and inversion stress were applied to the lateral ligaments of the ankle and the findings compared with the arthrograms. Fifty-five patients underwent stress radiography of both ankles and arthrography of the injured ankle within 72 hours of acute injury to the lateral ligaments. Ten patients had normal arthrograms and 45 had evidence of ligamentous injury. Anterior stress measurements could not be correlated with arthrography, and no differentiation between single and double ligament tears could be made. Inversion stress testing was very accurate in predicting ligamentous injury when the angle of inversion was 10 degrees or greater but achieved this degree of accuracy in only 38.2% of patients.

Ankle Injuries↗
PubMed1980

CT evaluation of hip trauma.

Selection of treatment for fracture dislocations about the hip is based on the stability of the joint space, congruity of fracture fragments, the presence or absence of intraarticular fragments, and the overall condition of the patient. However, the condition of the acetabulum, femoral head, and joint space is frequently difficult to evaluate on conventional radiographs of the pelvis. To provide the orthopedist with more information on which to base treatment, 13 patients had computed tomography (CT) after accidents resulting in trauma to the hip and pelvis. The CT scan was believed to have significantly influenced the treatment in four of the patients and provided useful information in several others. CT was found to be helpful especially for evaluating presence or absence of intraarticular osseous loose fragments after reduction of the dislocated hip for evaluating congruity of the joint space after fractures of the femoral head and acetabulum. CT also provided useful information concerning the adjacent soft tissues and associated pelvic fractures.

Acetabulum↗
PubMed1978

Discogenic vertebral sclerosis.

Narrowing of a disc space, sclerosis of the adjacent vertebral bodies, and irregularity of the vertebral end plates constitute a roentgen complex classically associated with infectious spondylitis. However, narrowing of a disc space may be the result of a herniated nucleus pulposus, and in some individuals the reactive sclerosis is sufficiently intense to resemble infection. Roentgenographic recognition of discogenic vertebral sclerosis may obviate the need for further evaluation and biopsy. Forty-four cases of discogenic vertebral sclerosis, nine with surgical proof and four developing after disc surgery, are presented. Roentgen signs helping to distinguish it from infection include: (i) rounded sclerosis most frequently in the anterior vertebral body (100%), (ii) central lucency in the sclerosis (77%), (iii) associated degenerative changes at the intervertebral disc, e.g. vacuum phenomena (44%), (iv) absence of a para-spinal mass and (v) maintenance of vertebral body height.

Adult↗
PubMedDate not supplied

The shoulder and elbow in Apert's syndrome.

Nine children with Apert's syndrome were studied and found to have progressive bony dysplasia in the shoulder and elbow. The children showed loss of joint motion and radiographic abnormalities including subluxation and flattening of the humeral head with irregularities of the glenoid. The elbow showed flattening and subluxation of the radial head in radiographs and a positive click on physical examination. The limitation of motion and the presence of bony defects were progressive, suggesting that Apert's syndrome is a progressive generalized dysplasia.

Adolescent↗