Biomedical subjects
Publications and source records attributed to D Karasick.
The distal radioulnar joint can be evaluated by many different imaging techniques, including plain radiography, arthrography, tomography, nuclear medicine bone scanning, computed tomography, and magnetic resonance imaging. Each of these techniques has advantages and disadvantages that must be considered when determining the appropriate diagnostic evaluation for a particular patient.
This prospective study correlated the results of magnetic resonance (MR) imaging, arthrography, and arthroscopy in 27 patients with clinically suspected temporomandibular joint (TMJ) dysfunction. Open surgical confirmation was available in 12 TMJs. The variables assessed with each modality were disk position and morphology, disk perforation, joint adhesions, and degenerative joint disease. MR imaging was superior to dual joint arthrography with arthrotomography in delineation of the disk position. MR imaging accurately demonstrated the disk position in 11 joints (92%); arthrography was accurate in nine of the 12 joints (75%) with surgically confirmed dysfunction. Disk perforations and joint adhesions were not demonstrated with MR imaging. Arthroscopy was superior to arthrography and MR imaging in the detection of disk perforations, joint adhesions, and early degenerative changes along the articular eminence and glenoid fossa. The authors believe MR imaging should constitute the first line of imaging because it provides accurate information about disk position in a noninvasive manner. In most cases, information obtained with MR imaging is adequate in deciding whether to institute conservative or surgical management; in difficult cases, triple correlation may be needed.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Bilateral rotator cuff sonography was performed on 56 patients referred for shoulder arthrography to detect rotator cuff tears. Since one patient had bilateral arthrography there were 57 arthrograms. Twenty-seven shoulders had rotator cuff tears shown on arthrography, 15 of which were detected by sonography. Eleven were false negative by sonography, and one was indeterminate. Of the 30 shoulders with negative arthrograms, 28 had normal sonograms and two were false positive. Sensitivity was 58%, specificity was 93% and overall accuracy was 77%. The positive and negative predictive values were 88% and 72%. These results suggest that sonography has limited value in screening patients for rotator cuff tears and that a positive sonographic reading is more reliable than a negative one. Theories relating to the variable anatomic configuration of a tear are postulated to explain these results, which differ from those previously reported.
Thirty-eight patients with suspected rotator cuff tears were examined at 1.5 T by using a loop-gap resonator surface coil. The MR findings were compared prospectively in a blinded fashion with the results from double-contrast arthrography in all 38 patients, high-resolution sonography in 23 patients, and surgery in 16 patients. In the total group of 38 patients, MR imaging detected 22 of 22 tears and 14 of 16 intact cuffs as determined by arthrography. In the 16 surgically proved cases, MR and arthrography showed identical results, with 92% sensitivity in the diagnosis of 12 tears and 100% specificity in the diagnosis of four intact cuffs. In a subgroup of 23 patients, sonography detected nine of 15 tears and seven of eight intact cuffs as determined by comparison with arthrography. In 10 surgically proved cases, sonography was 63% sensitive in the diagnosis of eight rotator cuff tears and 50% specific in the diagnosis of two intact cuffs. For the diagnosis of rotator cuff tears, MR imaging is comparable to arthrography in both sensitivity and specificity. In this study, sonography was not as accurate in the diagnosis of rotator cuff tears as were the other two techniques. These results suggest that MR imaging should be considered the noninvasive test of choice for patients with suspected rotator cuff disease.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Low-back pain continues to be a major industrial health problem in terms of compensation costs and disability. Preemployment lumbar spine radiographic screening was first used on a large scale during the early post-World War II period. Since then, numerous publications have argued for or against its use. Nevertheless, studies have been limited to one company or industry, controls have been lacking, and the research design has often been poor. This paper summarizes the available information and argues for the need to design and implement a study to determine the value of preemployment radiographs in predicting future low-back pain and injuries.
Paget disease (osteitis deformans) is not a difficult diagnosis when presented with typical radiographic features. However, an atypical appearance or an unusual location can be a diagnostic challenge, so we have emphasized the less common presentations, with their diagnostic clues. We have also considered such complications as malignant degeneration, fracture, and coexistent systemic disease, which can obscure the underlying Paget disease. The etiology, pathogenesis, and effects on bone structure and function attributed to Paget disease are updated.
Anterior displacement of the tibial tubercle is a well-accepted orthopedic procedure in the treatment of certain patellofemoral disorders. The radiologic appearance of surgical procedures utilizing the Maquet principle has not been described in the radiologic literature. Familiarity with the physiologic and biochemical basis for the procedure and its postoperative appearance is necessary for appropriate roentgenographic evaluation and the radiographic recognition of complications.
A case is presented in which trauma, followed by open reduction and pinning, resulted in the formation of a radiocarpal septum that divided the joint into two distinct compartments. A simple resection of the septum was not sufficient, since it uncovered underlying carpal instability that required ligamentous reconstruction.
A retrospective study was undertaken to evaluate the radiologic appearance of salpingitis isthmica nodosa (SIN) in the fallopian tubes of 150 consecutive patients having hysterosalpingograms performed almost exclusively for primary and secondary infertility. SIN was observed in 13 of these 150 patients. The characteristic radiologic features of this condition are minute loculations of contrast medium adjacent to the tubal lumen which range in size up to 2 mm in diameter and are clustered together over a tubal length of 1 to 2 cm. Although the most frequent site of occurrence is in the proximal isthmic portion of the tube, there is occasional involvement of the distal isthmus and even the interstitial portion of the adjacent uterine cornu. Associated tubal abnormalities in this condition such as hydrosalpinx and tubal occlusion help explain the increased incidence of tubal pregnancy and infertility in patients with SIN.
Nontraumatic glenohumeral subluxation can occur in patients with hemiplegia or brachial plexus involvement by tumor. Two cases of inferior subluxation of the humeral head are presented and nontraumatic etiologies of the "drooping shoulder" are discussed.
We present a case in which osteochondritis dissecans of the lateral femoral condyle was associated with a torn discoid lateral meniscus. To our knowledge, this is the first reported case of this association in the radiographic and orthopedic literature. Previous trauma is suggested to play an important role in the development of both lesions.
Explore the source record for details and available documents.
Spinal-cord injured patients can have urinary tract changes related to their conditions. Altered renal position and vertical axis have not previously been identified. The urograms of 55 paralyzed patients were reviewed and compared with normal controls. Statistically significant differences (p less than 0.001) were noted in the position of the kidneys with respect to the renal angle and distance of the lower poles to the midline. No significant difference was noted between patients who were paraplegic vs. those who were quadriplegic. The more medial and vertical positioning of the kidneys was believed to be due to the psoas muscle atrophy in the spinal-cord-injured patients.
We report a patient with cystic fibrosis and biliary symptoms who demonstrates a tiny gallbladder on oral cholecystography and ultrasonography which should suggest the diagnosis of cystic fibrosis. The term "micro-gallbladder" has been introduced to describe the type of gallbladder seen in cystic fibrosis patients with biliary disease.