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Biomedical subjects

D Resnick

Publications and source records attributed to D Resnick.

At least 253 records · Page 14Linked to original sources
PubMed1990

Cauda equina syndrome complicating ankylosing spondylitis.

The cauda equina syndrome is an uncommon and poorly understood complication of ankylosing spondylitis. The clinical and radiologic findings in five patients with this syndrome are described. Typical findings include cutaneous sensory impairment of the lower limbs and perineum with sphincter disturbances. Motor impairment occurs less frequently, and associated pain is an inconstant feature. Enlargement of the caudal sac and dorsal arachnoid diverticula that erode the lamina and spinous processes are characteristic myelographic and computed tomographic findings. The pathogenesis of the cauda equina syndrome in ankylosing spondylitis remains unknown but may be due to demyelination, post-irradiation ischemia, or compression from spinal arachnoiditis.

Adult↗
PubMed1990

Rheumatoid knee: role of gadopentetate-enhanced MR imaging.

Physical examination is often insufficient in distinguishing between joint effusion and inflamed synovium in the knee joints of patients with rheumatoid arthritis. The authors prospectively evaluated the role of intravenously administered gadopentetate dimeglumine in distinguishing between these two conditions. Fourteen patients with classic rheumatoid arthritis were examined first by a rheumatologist and then by means of magnetic resonance (MR) imaging with T1- and T2-weighted sequences. T1-weighted images were also obtained following the intravenous administration of gadopentetate dimeglumine. T1-weighted images obtained prior to contrast material administration demonstrated an identical low-intensity signal from both effusion and inflamed synovium, and T2-weighted images demonstrated increased signal intensity in both cases. Intravenous administration of gadopentetate dimeglumine allowed distinction between effusion and abnormal synovium, with the effusion remaining of low signal intensity and the synovium demonstrating enhancement and increased signal intensity. The authors conclude that the use of gadopentetate allows distinction between synovial thickening and joint effusion in the knee, which may affect treatment decisions.

Adult↗
PubMed1990

Scapholunate advanced collapse: a common wrist abnormality in calcium pyrophosphate dihydrate crystal deposition disease.

Scapholunate advanced collapse (SLAC) is a pattern of wrist malalignment that has been attributed to posttraumatic or spontaneous osteoarthritis of the wrist. Its features, however, also have been observed in patients with idiopathic calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. To determine the frequency and characteristics of SLAC in this disease, the authors reviewed wrist radiographs in 168 well-documented cases of this disorder. Forty-four of the cases (26%) revealed wrist abnormalities typical of SLAC. Associated findings included bilateral involvement (63%); calcification in or near the triangular fibrocartilage (70%); scapholunate widening or dissociation (70%); and arthropathies of the trapezioscaphoid (57%), metacarpophalangeal (second through fifth) (52%), first carpometacarpal (40%), and radiolunate (14%) joints. Results strongly suggest that CPPD crystal deposition disease is one of the major causes of SLAC. Furthermore, radiolunate arthropathy was found in 14% of the patients with SLAC and CPPD crystal deposition disease, which is different from other observations.

Aged↗
PubMed1990

Is MR better than arthrography for evaluating the ligaments of the wrist? In vitro study.

The purpose of this study was to determine the relative merits of MR imaging and three-compartment digital arthrography in the assessment of carpal ligaments in vitro. We performed MR imaging and arthrography in 10 normal wrists of fresh cadavers ranging in age from 48 to 71 years, and compared the appearance of the interosseous ligaments and triangular fibrocartilage complex with findings on anatomic sections of the joints. In six of the specimens, relatively T1-weighted MR images, 800/20 (TR/TE), preceded three-compartment digital arthrography performed with standard contrast material. In the other four specimens, arthrography, using an MR solution of iodinated contrast material mixed with cupric sulfate and gelatin, was performed before MR imaging. This was done to mimic the intraarticular fluid that might be seen in an injured wrist. MR allowed accurate assessment of the triangular fibrocartilage complex and scapholunate ligament in eight of 10 cases. Consistent MR visualization of the lunotriquetral ligament was difficult. Three-compartment digital arthrography allowed accurate assessment of the triangular fibrocartilage complex and scapholunate and lunotriquetral ligaments in all 10 cases. We concluded that MR is useful but inferior to arthrography in the evaluation of interosseous ligaments and the triangular fibrocartilage complex.

Aged↗
PubMed1990

Insufficiency fracture of the sternum caused by osteopenia: plain film findings in seven patients.

Sternal insufficiency fractures, whether nonbuckling (displaced or nondisplaced) or buckling, are rare and have been described in elderly osteopenic patients with accentuated kyphosis of the thoracic spine. We retrospectively analyzed the radiographs and clinical records in seven osteopenic patients with sternal insufficiency fractures and correlated the type of insufficiency fracture with the presence and degree of dorsal kyphosis, as well as the presence of chest pain, soft-tissue mass, and osteolysis. We found that displaced or nondisplaced nonbuckling fractures (five patients) may be associated with chest pain localized to the sternum (three patients), and may be present with (three patients) or without (two patients) associated thoracic kyphosis. This type of insufficiency fracture also may be accompanied by a soft-tissue mass and osteolysis (three patients), findings simulating pathologic fractures. All buckling insufficiency fractures (two patients) were associated with thoracic kyphosis and were asymptomatic. Our findings suggest that sternal insufficiency fractures may occur with or without exaggerated dorsal kyphosis. The fractures are an uncommon complication of osteopenia and may resemble pathologic fractures when osteolysis and soft-tissue swelling are present.

Adult↗
PubMed1990

Jogging causes acute changes in the knee joint: an MR study in normal volunteers.

As MR imaging allows evaluation of soft-tissue structures not previously possible with imaging techniques, we undertook a preliminary study to evaluate the effects of a popular form of exercise (jogging) on the knee. The specific question prompting our investigation was, does repetitive impulse loading produced by jogging cause acute structural changes within the knee that are visible by MR imaging? The knees of 10 healthy subjects were examined on a 1.5-T MR system before and immediately after 30 min of continuous jogging. The same extremity was examined each time, and the imaging sequences and photographic technique (meniscal windows) were identical for both examinations. Effusions developed in five of 10 subjects after exercise. In addition, five of 10 subjects had subtle increased signal intensity within their menisci. These results suggest that jogging frequently leads to acute changes in the knee that are visible on MR imaging. The significance of these changes is unknown.

Acute Disease↗
PubMed1990

MR imaging of the temporomandibular joint: a cadaver study of the value of coronal images.

Recent studies comparing cryosectional anatomy of the temporomandibular joint (TMJ) to its MR appearance have shown that the assessment of disk displacement is inaccurate when based on the sagittal plane alone. This article describes the MR appearance of the normal and abnormal (positional and osseous changes) TMJ in the coronal plane and compares these findings with their cryosectional anatomy. Twenty-two TMJs from unselected frozen cadavers were embedded in paraffin. Coronal and sagittal MR imaging was performed; specimens were then cut in the same plane as the coronal images. Disk position by cryosection was normal in 14 cases and abnormal in eight cases. Coronal MR images alone correctly depicted the TMJ disk position in 17 cases (77%) (13 normal, four abnormal). Complementary sagittal images were necessary for diagnosing anterior displacement in two cases (9%). MR was inaccurate in three cases (14%) of severe degenerative joint disease. Bone condition was correctly diagnosed on the basis of coronal images alone in all cases. Our study shows that coronal MR imaging alone of the TMJ in cadavers accurately shows disk position in 77% of cases. Complementary sagittal images were of benefit in the diagnosis of an additional 9% with anterior displacement. Disk position was assessed inaccurately in either plane in patients with severe degenerative joint disease. For a full MR assessment of the TMJ for disk position and bone condition, we recommend imaging in both coronal and sagittal planes.

Cadaver↗
PubMed1990

MR arthrography of the shoulder: comparison with conventional MR imaging.

Twenty-three patients underwent both conventional MR imaging of the shoulder and MR shoulder arthrography for clinically suspected labral or rotator cuff abnormalities. Images obtained before and after contrast administration were studied independently, and without knowledge of clinical findings, by two radiologists for the presence of abnormalities of the glenoid labrum or rotator cuff. Results were correlated with surgical findings in all patients. Nine patients had surgically proved labral tears. MR arthrography detected all nine labral abnormalities, while six of the nine were missed on conventional MR imaging. Fourteen patients had surgically proved rotator cuff tears. MR arthrography detected 11 of the 14 tears and missed three partial tears on the bursal surface. Conventional MR imaging detected nine cuff tears and missed five tears; two of these were complete rotator cuff tears and three were partial tears of the undersurface of the rotator cuff. Our results suggest that MR arthrography enhances the accuracy of MR in the evaluation of the glenoid labrum and rotator cuff tendon.

Adolescent↗
PubMed1990

Magnetic resonance imaging of the shoulder.

MR imaging has proved to be of great value in the assessment of musculoskeletal imaging. Its superiority in evaluating knee and spine pathology is well established. Recent studies also have established an important role for MR imaging in the assessment of shoulder disorders. Multiplanar capabilities coupled with excellent contrast resolution that allows simultaneous delineation of osseous and soft-tissue structures make MR imaging a useful method for evaluating the complex anatomy of the shoulder.

Humans↗
PubMed1990

Pseudopseudarthrosis in a patient with ankylosing spondylitis.

There is a growing consensus that the mechanism leading to extensive discovertebral destruction (type III) in most patients with ankylosing spondylitis relates to fracture and subsequent pseudarthrosis. We introduced the term "pseudopseudarthrosis" to describe (in our case) the occurrence of abnormal motion between 2 fused spinal segments, resulting in extensive discovertebral destruction without fracture or pseudarthrosis.

Adult↗
PubMed1990

Magnetic resonance imaging of the knee.

MRI has been in widespread clinical use since 1985 and in this short time has dramatically altered musculoskeletal imaging. The technology continues to become increasingly sophisticated; as both clinicians and radiologists become more familiar with its possibilities, further elucidation of pathologic processes affecting the knee will occur. In addition, advanced computer software has allowed a decrease in imaging time, which will allow a decrease in cost of this once-expensive technique. At this time, in many centers, MRI has essentially replaced arthrography for evaluation of disorders of the knee. The advantages of MRI include its inherent contrast sensitivity that allows visualization of a wide variety of tissues, multiplanar capabilities, lack of ionizing radiation, noninvasiveness, rapidity of imaging, and acceptability to patients.

Bone Marrow↗
PubMed1990

Innovative approaches to noninvasive bone densitometry.

In conclusion, this review has endeavored to familiarize the practicing radiologist with some of the newer approaches to noninvasive bone densitometry that are currently being explored as potential improvements over existing techniques. Three-dimensional volumetric CT is a practical means of measuring bone density in the proximal femur, owing to the widespread availability of the necessary scanning equipment, and affords enhanced prediction of biomechanical parameters in the spine and hip, but suffers from limitations similar to those of conventional quantitative CT. Dual-energy projection radiography offers significant potential advantages over dual-photon absorptiometry from the standpoint of precision, radiation dose, image quality, and examination time, but remains to be thoroughly tested. Compton scattering appears to be a viable alternative to single-photon absorptiometry for bone density determinations in the peripheral skeleton. Neutron and proton activation analysis are unlikely to achieve widespread application, owing to their cyclotron-dependent nature, although the former will probably remain the optimal means for determining total body calcium. Experience with scanning-slit fluorography and magnetic resonance as applied to noninvasive bone densitometry is currently too limited to permit prediction of their ultimate role in this respect. As a final point, it should be noted that major incentives for mobilization of bone densitometric equipment currently exist: on Earth, as a means of facilitating patient access and saving money via joint ventures, and in space for monitoring the adverse effects of weightlessness on skeletal mass and the ability to function following return to a gravity environment.

Bone Density↗
PubMed1990

Current and innovative methods for noninvasive bone densitometry.

This article summarizes a variety of noninvasive techniques for measuring bone density in the clinical setting. Although dual-energy x-ray absorptiometry and quantitative computed tomography are currently the most widely used methods, older techniques such as radiogrammetry and single-photon absorptiometry continue to have research applications, and experimental approaches such as compton scattering and proton activation analysis may be important in the future. The evaluation of bone mass measurement underscores continuing progress in our understanding of bone metabolism and biomechanics, and has provided valuable insight into improvements in the therapy of osteoporosis and other forms of metabolic bone disease.

Absorptiometry, Photon↗
PubMed1990

Advanced imaging of the wrist.

Abnormalities of the wrist present a difficult diagnostic challenge requiring thorough evaluation of both osseous and soft-tissue structures. Advanced techniques such as scintigraphy, computed tomography, three-phase arthrography, and, most recently, magnetic resonance imaging have added greatly to our understanding of wrist pathology. This article discusses the application of these techniques in imaging the wrist.

Arthrography↗
PubMed1989

Computed tomography of rheumatologic disorders.

Diseases of the spine and peripheral joints can be diagnosed noninvasively by this revolutionary imaging modality. CT has retrospectively demonstrated superiority over myelography and other imaging techniques in delineating various pathologic conditions--e.g., trauma, neoplasm, and infection--as well as arthropathy. Specific technical approaches are described in detail.

Age Factors↗