Biomedical subjects
D Resnick
Publications and source records attributed to D Resnick.
Distal femoral cortical defects, irregularities, and excavations.
A review of available radiographic and pathologic material revealed evidence that two distinct anatomical variations may be found on the posteromedial aspect of the distal femur. One, the femoral cortical irregularity, is a common finding on clinical radiographs, shows a definite predilection for children and adolescents, and is closely located to the site of attachment of tendinous fibers of the adductor magnus muscle. It is almost certainly related to stress, and can be associated with a degree of periosteal proliferation that simulates malignancy. In a study of prehistoric adult femoral specimens, the second lesion, the femoral cortical excavation, was a frequent finding. However, it appears to be less common in clinical radiology. It occurs at the osseous site of attachment of the medial head of the gastrocnemius, which supports a stress-related pathogenesis. Its relationship to fibrous cortical defects is not clear.
The effect of water-soluble contrast media on the synovial membrane.
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Patellofemoral abnormalities in renal osteodystrophy.
Seven patients with renal osteodystrophy demonstrated characteristic abnormalities of the patellofemoral compartment of the knee. The abnormalities consisted of narrowing of the patellofemoral space and ill-defined osseous erosions on the posterior surface of the patella, which in some cases were accompanied by similar alterations on the anterior surface of the femur. Clinical manifestations were not infrequent, including restriction of joint motion and a traumatic synovitis with accumulation of intra-articular fluid. The mechanism accounting for the patellofemoral alterations appears to be subchondral fracture of weakened trabeculae due to the presence of osteomalacia or osteitis fibrosa cystica, or both. Calcium pyrophosphate dihydrate crystal deposition is not required to produce these characteristic abnormalities.
Computed tomography and bone scintigraphy in the evaluation of tarsal coalition.
Three cases of talocalcaneal coalition were evaluated with routine radiography, conventional tomography, 99mTc-MDP bone scintigraphy, and computed tomography (CT). Routine radiography was normal in 1 case and demonstrated secondary findings suggesting coalition in 2. Conventional tomography confirmed the coalition in 2 patients. In all 3 cases, the scintigrams demonstrated increased uptake in the region of the coalition. CT provided the most graphic depiction of the coalition site and also identified an associated lesion involving the posterior subtalar joint, not recognized on conventional tomography. Scintigraphy may be useful as a screening procedure and can provide important localizing information in difficult cases.
Arthritides affecting the foot: radiographic--pathological correlation.
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Osteonecrosis of metacarpal and metatarsal heads following renal transplantation.
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Bilateral dysplasia of the scapular neck.
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The painful shoulder.
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Subacromial bursography. An anatomical and clinical study.
Impingement of the rotator cuff beneath the coracoacromial arch without associated rupture of the cuff or reactive bone changes on the undersurface of the acromion is a well established clinical diagnosis. The value of subacromial bursography in the assessment of this condition was investigated in an anatomical study of fifteen cadavera and a clinical study of thirty-one patients. The subacromial bursa is situated like a cap over the rotator cuff and can be demonstrated roentgenographically by the injection of contrast material in shoulders from cadavera and living subjects. This bursa is composed of subacromial and subdeltoid portions as well as a subcoracoid extension in some individuals. However, it is the anterior portion of the bursa, under the coracoacromial arch, that is most significant, since this overlies the deep structures involved in the impingement syndrome. The normal subacromial bursa easily accepts five to ten milliliters of contrast medium. However, if the bursal walls are thickened and edematous, the bursa will be difficult to demonstrate roentgenographically or it will accept only a few milliliters of contrast material. The findings in this study suggest that when the findings on the bursogram are normal, a diagnosis of chronic impingement by the coracoacromial arch should be questioned.
Diagnosis and treatment of diffuse pigmented villonodular synovitis of the hip.
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Double osteoid-osteoma in adjacent carpal bones.
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The "rugger jersey" vertebral body.
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Case report 145. Bilateral, almost symmetrical skeletal metastases (both femora) from bronchogenic carcinoma.
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Focal spinal abnormalities on bone scans in ankylosing spondylitis: a clue to the presence of fracture or pseudarthrosis.
Four cases of ankylosing spondylitis are presented in which radionuclide bone studies indicated focal abnormalities of the spine. In three patients, the area of abnormal nuclide uptake corresponded to a site of pseudarthrosis, and in the fourth an acute fracture was present. As such focal lesions on bone scans are unusual in cases of chronic ankylosing spondylitis in which a complication is not apparent, their presence can be a useful finding.
Spinal vacuum phenomena: anatomical study and review.
"Vacuum" phenomena relate to the accumulation of gas, principally nitrogen, in crevices within the intervertebral disk or vertebra. Their appearance does not uniformly indicate "degenerative" disk disease (primary intervertebral osteochondrosis), as gaseous collections may accompany other processes (vertebral osteomyelitis, Schmorl node formation, spondylosis deformans, vertebral collapse with osteonecrosis) affecting the disk and adjacent vertebral bodies. The location and appearance of the "vacuum" phenomena are helpful indicators as to the precise nature of the spinal disorder.
Plasma-cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes: the POEMS syndrome. Distinctive radiographic abnormalities.
Three patients with an unusual multisystemic syndrome characterized by polyneuropathy, organomegaly *especially hepatosplenomegaly), endocrine dysfunction, M-protein, and skin abnormalities (POEMS syndrome) are discussed. Characteristic radiographic features include single or multiple osteosclerotic lesions and peculiar variety of bony proliferation. The relationship of the disorder to multiple myeloma and plasmacytoma and the pathogenesis of the skeletal abnormalities remain obscure.
Rheumatoid arthritis and pseudo-rheumatoid arthritis in calcium pyrophosphate dihydrate crystal deposition disease.
Calcium pyrophosphate dihydrate (CPPD) crystal deposition disease can lead to many clinical syndromes. One syndrome simulates rheumatoid arthritis and is thus called "pseudo-rheumatoid arthritis." Since some patients have true rheumatoid arthritis with CPPD crystal deposition disease, the clinician may have difficulty differentiating those patients from others who have the pseudo-rheumatoid syndrome. Such a diagnostic problem can be solved radiographically. Eleven patients with CPPD crystal deposition disease were studied; five had true rheumatoid arthritis and six had pseudo-rheumatoid arthritis. Because osseous erosions were not apparent in the arthropathy of uncomplicated CPPD crystal deposition disease, the detection of skeletal erosive changes indicated a true rheumatoid arthritis process.