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Biomedical subjects

D Resnick

Publications and source records attributed to D Resnick.

At least 271 records · Page 15Linked to original sources
PubMed1989

Inflammatory disorders of the vertebral column: seronegative spondyloarthropathies, adult-onset rheumatoid arthritis, and juvenile chronic arthritis.

A variety of inflammatory disorders may involve the spine and sacroiliac joint. Of these, the seronegative spondyloarthropathies (consisting principally of ankylosing spondylitis, psoriasis, Reiter's syndrome, and certain intestinal diseases), adult-onset rheumatoid arthritis, and juvenile chronic arthritis are particularly important. The imaging abnormalities accompanying these disorders, supplemented with some clinical and pathologic data, are the subject of this review.

Arthritis, Juvenile↗
PubMed1989

Quantitative dual-energy radiographic absorptiometry of the lumbar spine: in vivo comparison with dual-photon absorptiometry.

Quantitative dual-energy radiographic absorptiometry (DRA) and dual-photon absorptiometry (DPA) were compared to determine the best means of assessing bone density. Both methods were used to evaluate the lumbar spine in 107 women (aged 35-84 years [mean, 64 years]) referred for evaluation of osteoporosis risk. High correlation was documented between measurements derived by the two techniques, with a .95 linear regression coefficient for the total spine density measurement. Age-related regression equations were similar in slope but manifested different intercepts. Bone mineral density values derived with DRA were consistently lower than those obtained with DPA (conversion equation: DPA density = [1.067 X DRA density] + 0.163). Besides the inherent imperfections of each system, it was found that inaccurate identification of intervertebral spaces on the low-resolution DPA images introduced errors in patient data. DRA may replace DPA as the dedicated projectional densitometric procedure of choice for technical reasons, but at present a conversion equation must be used to compare DRA data to DPA data.

Adult↗
PubMed1989

Axial bone density in rheumatoid arthritis: comparison of dual-energy projection radiography and dual-photon absorptiometry.

The usefulness of dual-energy projection radiography (DEPR) in the evaluation of rheumatoid arthritis was compared with that of dual-photon absorptiometry (DPA). Bone density measurements of the lumbar spine and the proximal femur were obtained with DPA in 75 patients (45 women and 30 men). For comparison, the bone density of the lumbar spine was measured with DEPR in a subset of 52 patients (33 women and 19 men). High correlation was documented between DEPR and DPA measurements of the lumbar spine. No significant relationship between bone density and age was observed, in contrast to the known relationship in healthy subjects regardless of sex, site of measurement, or measurement technique. Bone density values in the spine and the proximal femur were significantly reduced for both sexes as compared with matched normative data. Interlevel variation in lumbar vertebral density as measured with DEPR was not significantly different in patients with rheumatoid arthritis as compared with control subjects. Significant correlation between bone density determination and body weight, as well as duration of menopause, was noted, whereas duration of disease, functional status, and cumulative corticosteroid dose were not predictive. Rheumatoid arthritis did not appear to influence the relationship between DEPR and DPA measurements of the spine, and neither method nor site of measurement exhibited a consistent advantage in discriminating patients with rheumatoid arthritis from healthy control subjects.

Absorptiometry, Photon↗
PubMed1989

Osteosclerosis of the phalanges in Werner syndrome.

Werner syndrome is an autosomal-recessive disease characterized by premature aging, shortness of stature, scleroderma-like skin changes, endocrine abnormalities, and cataracts. Although radiographic findings have been well documented, the presence of distinctive osteosclerotic changes in the phalanges of the hands and feet has not been emphasized in previous publications. The authors' review of radiographs of both hands in nine patients and of both feet in six patients with Werner syndrome documented the frequent occurrence of phalangeal sclerosis related predominantly to endosteal thickening. In the hand, sclerosis was present in every patient, was generally symmetric in distribution, predominated in the distal phalanges, and demonstrated an ulnar predilection. Similar changes in the phalanges of the feet were demonstrated in only two patients. The presence of osteosclerosis in the phalanges of the hand alone or both the hand and foot, when combined with osteoporosis and periarticular calcification, suggests the diagnosis of Werner syndrome.

Adult↗
PubMed1989

Diffuse idiopathic skeletal hyperostosis: diagnostic significance of radiographic abnormalities of the pelvis.

Retrospective evaluation of the osseous pelvis in 93 patients with severe diffuse idiopathic skeletal hyperostosis (DISH) revealed 14 locations of radiographic abnormalities. Two osteoradiologists independently studied these sites for abnormalities in a prospective, blinded fashion in 103 patients over the age of 45 years. Lateral radiographs of the thoracolumbar spine were quantitatively and qualitatively evaluated to determine whether DISH, spondylosis deformans, or a normal spine was present. Statistical analysis was performed for evaluation of interobserver reliability, the relationship between pelvic and spinal abnormalities, and the significance and predictive values of pelvic abnormalities for DISH versus non-DISH and DISH versus spondylosis deformans. Although significantly higher frequencies and greater extents of radiographic abnormalities at 10 of 14 pelvic locations were noted for DISH compared with non-DISH, this number decreased to four of 14 locations when compared with spondylosis deformans. The alterations in three of these four pelvic sites consisted of ossification of ligaments. These changes appear to be good indicators of the presence of spinal DISH and support the concept that DISH is an entity separate from spondylosis deformans.

Adult↗
PubMed1989

Intraosseous fat necrosis associated with acute pancreatitis: MR imaging.

Necrosis of fatty bone marrow, caused by lipolytic enzymes, is a rare complication of several pancreatic disorders. A 44-year-old man with polyarthritis, subcutaneous nodules, and osteolysis associated with alcoholic pancreatitis underwent magnetic resonance (MR) imaging of the knees. In the marrow of the distal femur and proximal tibia, the images showed multiple foci of abnormal signal intensity compatible with the diagnosis of fat necrosis secondary to acute pancreatitis. Because MR imaging can depict abnormalities in fatty marrow that seem to precede necrosis, this modality may add early diagnostic information.

Acute Disease↗
PubMed1989

Diagnostic imaging of lower extremity trauma.

Traumatic injuries to the lower extremity are a common occurrence in today's society and may result in significant morbidity and mortality if not appropriately treated. Adequate radiographic evaluation is crucial to the assessment of these injuries. This article reviews the radiographic features and imaging approaches to the commonly encountered injuries of the lower extremity.

Femoral Fractures↗
PubMed1989

Diagnostic imaging of tarsal and metatarsal stress fractures. Part I.

As the preoccupation with physical fitness grows in this country, the problem of "stress fracture" has become more clinically significant. Reliable techniques for imaging the musculoskeletal system have also continued to grow, allowing the clinician to better diagnose and manage this condition. However, the radiographic findings of stress fracture are sometimes difficult to interpret. This review compares plain radiography, scintigraphy, CT, and MRI in the imaging of stress fractures.

Ankle Injuries↗
PubMed1989

Arthrography of the post-traumatic knee, shoulder, and wrist. Current status and future trends.

The current status of arthrography of the wrist, knee, and shoulder has been discussed with particular emphasis given to those conditions seen in patients following acute or chronic trauma. Cross-sectional techniques that impact on the current usage of arthrography of these joints also were discussed. Wrist arthrography remains the standard procedure for the evaluation of ligamentous abnormalities about the wrist. MR imaging is unlikely to make a large impact in this area until improvements in technique and surface coil technology allow routine visualization of the very small, but important, interosseous ligaments. MR imaging of the knee will likely replace arthrography except in those cases in which cost considerations or availability prevent its implementation. MR imaging undoubtedly will continue to contribute to the evaluation of shoulder abnormalities, but whether or not it will completely replace standard arthrography and CT arthrography depends upon the results of future studies.

Humans↗
PubMed1989

Fatigue fracture of the sacrum: a case report.

We report a patient with a stress fracture in the sacrum. This may be a cause of hip or back pain. In contrast to typically bilateral insufficiency fractures, fatigue fractures are usually unilateral and the appearances are not diagnostic on scintigraphy. As the plain film findings may be subtle and overlooked, computed tomography is more specific in delineating a sclerotic vertical fracture parallel to the sacroiliac joint. Recognition of the characteristic radiographic pattern in sacral fatigue fractures can avoid incorrect diagnosis and unnecessary tests or treatment.

Adult↗
PubMed1989

Diagnostic imaging of tarsal and metatarsal stress fractures. Part II.

As the preoccupation with physical fitness grows in this country, the problem of "stress fracture" has become more clinically significant. Reliable techniques for imaging the musculoskeletal system have also continued to grow, allowing the clinician to better diagnose and manage this condition. However, the radiographic findings of stress fracture are sometimes difficult to interpret. This review compares plain radiography, scintigraphy, CT, and MRI in the imaging of stress fractures.

Diagnostic Imaging↗
PubMed1989

Pathogenesis of discovertebral and manubriosternal joint abnormalities in rheumatoid arthritis: a cadaveric study.

The precise pathogenesis of discovertebral lesions in rheumatoid arthritis has long been debated with the emergence of 2 conflicting theories: discovertebral extension of synovial inflammation from a neighboring articulation (Luschka, costovertebral joint) and repetitive discal trauma with Schmorl's nodes. In order to address this controversy, we performed a radiographic-pathologic correlation of a rheumatoid cadaver and compared the alterations seen in the cervical and lumbar discovertebral junction; we further included an evaluation of the manubriosternal joint, another cartilaginous articulation. Our data confirmed that advanced discovertebral lesions in the cervical and lumbar spine are related primarily to endplate failure that itself is caused by apophyseal joint destruction and segmental spinal instability, although inflammatory rheumatoid lesions of the cervical intervertebral discs probably arising from the Luschka joints are also evident. Conversely, the lesions of the manubriosternal joint were produced by inflammatory changes related to the development of a synovial cavity in the articulation.

Arthritis, Rheumatoid↗
PubMed1989

Multiple stress fractures in the hindfoot in rheumatoid arthritis.

A case of nontraumatic bilateral multiple stress fractures of the hindfoot in a 60-year-old white man with rheumatoid arthritis (RA) is described. Review of the literature indicates that stress fractures of the calcaneus and other bones of the hindfoot are an unusual complication of RA and have not been reported previously. Factors leading to the development of stress fractures in the patient with RA are discussed.

Arthritis, Rheumatoid↗
PubMed1989

Conventional tomography in musculoskeletal trauma.

Conventional tomography utilizes controlled blurring of overlying structures, in effect, to remove these possible obscuring overlying structures and permit improved evaluation of anatomic detail within the specific layer or focal plane of interest. Although it has largely been replaced by true sectional imaging modalities such as CT and MR imaging, it remains a valuable tool in specific settings as in musculoskeletal trauma. It is particularly useful when the orientation of the pathology requires coronal or sagittal planes for optimal evaluation.

Arthrography↗