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Biomedical subjects

D Resnick

Publications and source records attributed to D Resnick.

At least 289 records · Page 16Linked to original sources
PubMed1989

Sternocostal joints. Anatomic, radiographic and pathologic features in adult cadavers.

Using radiographic-pathologic correlation, we studied the sternocostal joints derived from 27 consecutive cadavers and one additional cadaver with rheumatoid arthritis. Radiographic findings that were tabulated included joint space narrowing, sternal or costal osteophytes, articular calcification, vacuum phenomena, and the degree of ossification of the costal cartilages. The first sternocostal joint could be classified as either a synchondrosis or synostosis in every instance; however, a joint cavity lateral to the first sternocostal joint represented a normal variation and was seen radiographically in 10 specimens. The second sternocostal joint was synovial in type and intimately related to the manubriosternal joint; cavitation within this joint was present bilaterally in 36% of our specimens. Degenerative changes in the sternocostal articulations were characterized much more frequently by sternal osteophytes than by costal osteophytes or joint space narrowing. Calcification compatible with chondrocalcinosis was observed in two cadavers. Radiographic and pathologic evidence of synovial inflammation was evident in the sternocostal joints of the rheumatoid specimen.

Aged↗
PubMed1988

Computed tomography with multiplanar reformation and three-dimensional image reconstruction in the preoperative evaluation of adult hip disease.

Computed tomography (CT) with multiplanar reformation and three-dimensional (3D) image reconstruction was used pre-operatively to outline the bony morphological changes and femoral-acetabular relationships in 25 adult patients suffering from hip disease. Diagnoses included ischaemic necrosis of the femoral head, osteoarthritis, rheumatoid arthritis, calcium pyrophosphate dihydrate (CPPD) crystal deposition disease, previous trauma and chronic dislocation. Polyethylene models of the femora and acetabula were constructed from three-dimensional contouring of CT data and compared with resected specimens in patients subjected to subsequent total hip arthroplasty. Information provided by this imaging technique was useful in both selecting and guiding the most appropriate surgical procedure and it was found that models depicted the actual bony contours with reasonable accuracy. CT combined with multiplanar reformation and 3D analysis may be the optimal pre-operative means of assessment of the diseased adult hip.

Acetabulum↗
PubMed1988

Destructive spondyloarthropathy in hemodialysis patients. Report of four cases and prospective study.

A destructive spondyloarthropathy is reported in four patients undergoing maintenance hemodialysis for chronic renal disease. In a separate investigation a controlled, prospective radiographic study of the cervical spine revealed this spondyloarthropathy in 4 (15%) of 26 long-term dialysis patients. A single disc level was involved in three patients, and two disc levels were involved in one patient. This spondyloarthropathy correlated with the duration of dialysis but not with the radiographic evidence of renal osteodystrophy or severity of laboratory abnormalities associated with hyperparathyroidism. Three of these four patients also had discovertebral erosions or destruction involving the lumbar spine. Cervical spine flexion views revealed evidence of ligamentous laxity or instability in three (12%) dialysis patients, all with vertebral resorption and disc space narrowing. It is postulated that this instability may contribute to the development of cervical discovertebral lesions or be a secondary manifestation of disc destruction.

Adult↗
PubMed1988

Radiologic and pathologic patterns of end-plate-based vertebral sclerosis.

Degenerative spondyloarthropathy is the result of a number of related pathologic processes, including loss of disc elasticity, repetitive mild trauma, and osteoporosis. The effects are manifested microscopically in a number of patterns reflecting alterations in stress, healing microfractures, and bone-cartilage interactions along the vertebral end-plate. The microscopic changes lead in turn to radiographically evident vertebral body sclerosis. The resultant sclerosis is not always in the classic band-like pattern along the vertebral end-plate, and the atypical patterns may be difficult to recognize as degenerative in origin. In a detailed analysis of clinical and postmortem material, we have categorized both the pathologic and radiographic patterns of benign non-Pagetic vertebral body sclerosis. This radiographic classification provides a unified framework for clinical recognition of the various patterns of degenerative sclerosis.

Adult↗
PubMed1988

Chronic unreduced dislocations of the glenohumeral joint: imaging strategy and pathologic correlation.

Although the evaluation of acute or recurrent dislocations of the glenohumeral joint (GHJ) using routine radiography, specialized views, arthrography, and computed tomography (CT) has been extensively studied, methods of evaluation and osseous pathology of chronic unreduced GHJ dislocations are not well documented. In order to define such methods and pathology, we studied nine patients with chronic (greater than 6 months) unreduced anterior, posterior, superior, or central dislocations as well as one patient with a chronic rotator cuff injury; and seven scapular specimens, six with matching humeral specimens, with osseous abnormalities similar to those in the patients. We examined 15 additional scapular specimens with evidence of subluxation secondary to chronic rotator cuff injury. Standard, reformatted, and three-dimensional (3D) CT techniques were used to evaluate both the patients and the specimens. Our results indicate that characteristic alterations occur in the scapula and humeral head that are far more extensive than the classic Hill-Sachs, Bankart, and trough lesions. Such alterations occur at sites of osseous contact between the malpositioned humerus and scapula and are modified owing to prolonged adjustments made by the patients in an attempt to increase GHJ motion. Although routine radiography and specialized views are of some value, standard and 3D CT provide a more accurate analysis of the location and extent of the bone abnormalities and, as such, should be employed, particularly in the evaluation of patients in whom surgery is being considered.

Acute Disease↗
PubMed1988

Cloning and characterization of the Aeromonas caviae recA gene and construction of an A. caviae recA mutant.

A recombinant plasmid carrying the recA gene of Aeromonas caviae was isolated from an A. caviae genomic library by complementation of an Escherichia coli recA mutant. The plasmid restored resistance to both UV irradiation and to the DNA-damaging agent methyl methanesulfonate in the E. coli recA mutant strain. The cloned gene also restored recombination proficiency as measured by the formation of lac+ recombinants from duplicated mutant lacZ genes and by the ability to propagate a strain of phage lambda (red gam) that requires host recombination functions for growth. The approximate location of the recA gene on the cloned DNA fragment was determined by constructing deletions and by the insertion of Tn5, both of which abolished the ability of the recombinant plasmid to complement the E. coli recA strains. A. caviae recA::Tn5 was introduced into A. caviae by P1 transduction. The resulting A. caviae recA mutant strain was considerably more sensitive to UV light than was its parent. Southern hybridization analysis indicated that the A. caviae recA gene has diverged from the recA genes from a variety of gram-negative bacteria, including A. hydrophila and A. sobria. Maxicell labeling experiments revealed that the RecA protein of A. caviae had an Mr of about 39,400.

Aeromonas↗
PubMed1988

Traction osteophytes of the lumbar spine: radiographic-pathologic correlation.

Previous reports have emphasized two types of osteophytes on the anterior aspects of the lumbar vertebral bodies: the common claw osteophyte and the less common but more significant traction osteophyte, which is indicative of spinal instability. To delineate the importance of the traction osteophyte, a radiographic-pathologic study was conducted. The results indicate that claw osteophytes are more frequent than traction osteophytes, that both may coexist in a single vertebral body, and that, in most cases, these osteophytes appear to represent different stages of the same pathologic process.

Humans↗
PubMed1988

Infection versus tumor in the spine: criteria for distinction with CT.

To develop criteria to distinguish among pyogenic infection, nonpyogenic infection, and neoplastic processes in the spine by means of computed tomography (CT), the authors retrospectively analyzed 17 cases of pyogenic infection (20 sites), 40 cases of neoplastic disease (56 sites), and five cases of granulomatous infection (eight sites). Reliable criteria for pyogenic infection were complete prevertebral soft-tissue involvement, diffuse osteolytic destruction, gas within both bone and soft tissue, and a process centering on an intervertebral disk. Neoplastic disease was characterized by posterior element involvement, partial or absent prevertebral soft-tissue swelling, and osteoblastic alterations. In a limited number of cases, nonpyogenic infection was characterized by focal lytic bone involvement and marginal sclerosis. Blinded testing of these criteria indicated potential for improved diagnostic accuracy in clinical practice.

Humans↗
PubMed1988

Patterns of femoral head migration in osteoarthritis of the hip: a reappraisal with CT and pathologic correlation.

Although medial, superior, and axial patterns of migration of the femoral head in osteoarthritis of the hip have been well described, it is not clear what anatomic and biomechanical factors determine the direction of migration. The authors studied 22 patients with bilateral (11 patients) or unilateral (11 patients) osteoarthritis by means of conventional radiography and computed tomography (CT) to define any relationships between migration in the coronal plane and that in the transverse plane and to determine whether femoral anteversion, acetabular anteversion, femoral neck-shaft angle, or acetabular inclination were related to particular migration patterns. Anterior migration was evident in 14 of the 19 hips with a superior migration pattern, whereas posterior migration was present in five of the seven hips with a medial migration pattern. In the remainder of cases, no migration in the transverse plane was present. Femoral anteversion as determined with CT, femoral neck-shaft angle, angle of acetabular inclination, and acetabular anteversion angle in this relatively small sample were all found to be within normal limits and appeared to have no influence on the occurrence of a specific pattern of femoral head migration.

Aged↗
PubMed1988

Three-dimensional quantitative CT of the proximal femur: relationship to vertebral trabecular bone density in postmenopausal women.

Dual-photon absorptiometry (DPA) of the proximal femur cannot independently measure cortical and high-turnover cancellous bone. In this investigation, integrated cancellous, cortical, and total bone densities in the femoral neck and intertrochanteric region were measured bilaterally in 22 women aged 42-75 years. Contiguous section data were analyzed with two different protocols by means of three-dimensional histogram software. Single-section quantitative computed tomography (CT) was used to determine mean mineral equivalent values for vertebral cancellous bone from T-11 to L-3 in each woman. Significant correlation was found between cancellous bone density at the two sites, as well as between total femoral and vertebral measurements. Femoral cortical bone density was predicted less well by means of the vertebral cancellous data. Cortical, cancellous, and total proximal femoral density values tended to exhibit bilateral symmetry. Quantitative three-dimensional volumetric CT affords comprehensive evaluation of proximal femoral mineral status because of its capability for selective measurement of cortical, cancellous, and total bone density.

Absorptiometry, Photon↗
PubMed1988

Rheumatoid arthritis: similarity of radiographic abnormalities in men and women.

To test the hypothesis that there are significant differences in the radiographic appearance of rheumatoid arthritis between men and women, the authors blindly evaluated bilateral hand and wrist radiographs in 32 men with definite rheumatoid arthritis and 32 age- and disease duration-matched women (mean age, 56.4 years; mean disease duration, 10.5 years). Radiographically, disease distribution and severity were identical in these matched groups. Superimposed osteoarthritis was frequent in both groups and related to age. Ill-defined bone proliferation was present in 13 of 64 hands in both groups. Cystic changes and well-defined erosions were present in 12 of 64 male hands and six of 64 female hands, but this difference was not statistically significant. In women, presence of cysts and bone proliferation was related to disease duration, whereas men exhibited these atypical features independent of disease duration. There was no statistically significant difference in the frequencies of typical and atypical features of rheumatoid arthritis between the two sexes, and the authors postulate that previously reported differences relate to patient selection and lack of adequate matching.

Arthritis, Rheumatoid↗
PubMed1988

Peribursal fat plane of the shoulder: anatomic study and clinical experience.

A comprehensive anatomic and radiographic analysis of the peribursal fat plane in 12 cadavers confirmed that the fat plane seen on radiographs represents extrasynovial fat lining the subacromial bursa and documented the anatomic relations of the bursa. A three-part retrospective clinical evaluation of rotator cuff tears, calcific tendinitis, and rheumatoid arthritis was performed. Two osteoradiologists blindly graded the appearance of the peribursal fat plane with the shoulder in external versus internal rotation in 21 patients with arthrographically intact rotator cuffs and 21 patients with disrupted rotator cuffs. The peribursal fat plane was seen better with disrupted rotator cuffs. The peribursal fat plane was seen better with the shoulder in internal rotation and was seen in 60% of control subjects but only 21% of patients with rotator cuff tears. Partial or complete obliteration of this fat plane is a sensitive (79%) but less specific (60%) indicator of rotator cuff tears. Obliteration of the peribursal fat plane by inflammatory processes in adjacent tissues, including calcific tendinitis and rheumatoid arthritis, occurred with a high frequency.

Adipose Tissue↗
PubMed1988

Rotator cuff disruption: diagnosis with digital arthrography.

Shoulder arthrography is a reliable technique for use in the diagnosis of tears of the rotator cuff, although delineation of the precise site and size of tears requires meticulous double-contrast technique and considerable examiner expertise. The authors initiated a prospective evaluation of digital arthrography of the glenohumeral joint in 28 patients with clinical manifestations suggesting rotator cuff tear because they believed that examination with this technique would allow more accurate definition of the precise status of the cuff. Fifteen patients had normal studies. Ten complete and three partial rotator cuff tears were demonstrated with digital technique, and the precise site of the tear was demonstrated in all of these cases. The results indicate that digital arthrography of the glenohumeral joint may have some advantages over standard arthrography in the delineation of complete and partial tears of the rotator cuff, particularly in defining the exact site of tears.

Adult↗