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Biomedical subjects

D Resnick

Publications and source records attributed to D Resnick.

At least 109 records · Page 6Linked to original sources
PubMed1997

Cupid's bow contour of the vertebral body: evaluation of pathogenesis with bone densitometry and imaging-histopathologic correlation.

PURPOSE: To investigate the Cupid's bow contour by means of bone densitometry and imaging-histopathologic correlation. MATERIALS AND METHODS: Radiographs and histologic slices were obtained in 64 cadaveric thoracolumbar spines to assess the morphology, distribution, and histopathologic features of the Cupid's bow contour. Dual-energy x-ray absorptiometry and radiography were performed in the lumbar spine in 406 healthy subjects. Bone density and body height and weight were then related to the presence of the Cupid's bow contour. The Cupid's bow contour was compared with the fish vertebra of osteoporosis and Schmorl node. RESULTS: No clinically important relationship was found between lumbar bone density, body height and weight, and prevalence of the Cupid's bow contour. Histologic examination showed thickened bone in the Cupid's bow end plate with annular fibers inserting into this region. In cadavers, the Cupid's bow contour occurred at multiple lumbar and thoracic levels, with the highest frequency in the lower lumbar spine. Lateral radiographs enabled better detection of the contour change. CONCLUSION: The Cupid's bow deformity is a developmental phenomenon that is unrelated to osteopenia or mechanical stress on the spine.

Absorptiometry, Photon↗
PubMed1997

Intraosseous venous drainage anomaly in patients with pretibial varices: imaging findings.

PURPOSE: To determine a set of distinctive imaging findings seen in symptomatic patients with pretibial varices. MATERIALS AND METHODS: Medical records and imaging studies of patients who presented with pretibial varices over an 8-year period were collected from four institutions. Findings in six symptomatic patients with pretibial varices were retrospectively reviewed. Radiographic and magnetic resonance (MR) imaging findings were available from all six patients; findings from several other modalities were also available in some patients. RESULTS: Conventional radiographs showed a small osteolytic defect in the anterior cortex of the midtibia and a prominent, longitudinally oriented, radiolucent groove in the proximal half of the tibial diaphysis. MR images showed pretibial varices connected to an enlarged vessel in the tibia that eventually exited through the nutrient foramen. Computed tomographic (three patients), sonographic (four patients), venographic (four patients), arteriographic (two patients), and surgical (three patients) findings demonstrated that these patients had an unusual intraosseous varix that traversed the anterior cortex, medullary cavity, and posterior cortex of the tibia. CONCLUSION: Recognition of these findings can prevent misdiagnosis and may prove helpful in the planning of appropriate treatment.

Adolescent↗
PubMed1997

Short echo time projection reconstruction MR imaging of cartilage: comparison with fat-suppressed spoiled GRASS and magnetization transfer contrast MR imaging.

PURPOSE: To evaluate short echo time (TE) projection reconstruction magnetic resonance (MR) imaging in the detection of cartilage lesions. MATERIALS AND METHODS: Twenty-seven cartilage regions of 10 human patellar specimens were examined with the following MR sequences: short TE projection reconstruction (repetition time msec/TE msec, 400/0.15), fat-suppressed three-dimensional spoiled gradient-recalled acquisition in the steady state (Spoiled GRASS) (50/10, 60 degrees flip angle), and magnetization transfer contrast (MTC) subtraction (400/6). MR findings were correlated with histopathologic grading of the cartilage. RESULTS: For detection of cartilage lesions, sensitivity of projection reconstruction imaging (100%) was significantly greater (P = .03) than that of MTC (62%) but not significantly greater (P > .05) than that of Spoiled GRASS (81%) imaging. Accuracy of projection reconstruction was significantly greater than that of MTC (P = .004) and Spoiled GRASS (P = .03) imaging. Unmasking of collagen fibers was most predictive of abnormal signal intensity of the cartilage with all sequences. CONCLUSION: In vitro, short TE projection reconstruction MR imaging provides superior delineation of cartilage lesions when compared with two other sequences. On Spoiled GRASS and MTC images, signal intensity of the superficial layer of cartilage is not a reliable sign for surface integrity.

Aged↗
PubMed1997

Collateral ligaments of the elbow: conventional MR imaging and MR arthrography with coronal oblique plane and elbow flexion.

PURPOSE: To determine the best plane and position of the elbow for optimal visualization of normal and abnormal collateral ligaments with conventional magnetic resonance (MR) imaging and MR arthrography, to determine the normal appearance of the collateral ligaments at MR arthrography and to assess use of MR arthrography in evaluation of collateral ligamentous lesions. MATERIALS AND METHODS: Nine cadaveric elbow specimens were imaged with and without intraarticular administration of gadolinium-containing solution in several planes that were identified as potentially useful in a pilot study in two specimens. MR imaging findings were compared with anatomic findings. RESULTS: Normal and abnormal ligaments were best depicted in a 20 degrees posterior oblique coronal plane in relation to the humeral shaft with the elbows extended and a coronal plane aligned with the humeral shaft with the elbows slightly flexed (20 degrees-30 degrees of flexion). Gadolinium enhancement improved the delineation of normal and abnormal ligaments on T1-weighted images in each case. CONCLUSION: The posterior oblique coronal plane with the elbows extended or the coronal plane aligned with the humeral shaft with the elbows slightly flexed allows accurate assessment of the collateral ligaments. Gadolinium-enhanced MR arthrography of the elbow seems to be a promising technique.

Aged↗
PubMed1997

Extensive intraosseous gas associated with lymphangiomatosis of bone: report of three cases.

Asymptomatic pneumatosis may be found in patients with lymphangiomatosis of bone. The authors report three cases from three institutions in which development of intraosseous gas in association with lymphangiomatosis of bone was found incidentally at imaging. Soft-tissue emphysema also developed in two cases. In all three cases, intraosseous gas developed after biopsy or surgery in the areas involved with lymphangiomatosis.

Adolescent↗
PubMed1997

Symptomatic herniation pits of the femoral neck: anatomic and clinical study.

OBJECTIVE: The purpose of this study was to investigate the pathogenesis of herniation pits of the femoral neck, which are frequently considered a normal variant, and to describe the imaging abnormalities of such pits in three symptomatic patients. CONCLUSION: The changing relationship between the joint capsule and the iliopsoas muscle appears to be important in the pathogenesis of the herniation pit, especially in athletic persons. In some cases, these pits may enlarge, the overlying cortex may fracture, and significant clinical manifestations may be apparent.

Adult↗
PubMed1997

MR imaging truncation artifacts can create a false laminar appearance in cartilage.

OBJECTIVE: The purpose of this study was to investigate the laminar appearance of cartilage on MR images. MATERIALS AND METHODS: Theoretical modeling of truncation artifacts was used to predict spatial patterns and associated intensity variations in MR imaging. A numerical simulation of a ring model was used to show truncation artifacts as a function of the angle in the image plane for unequal in-plane resolutions. MR imaging of 10 cadaveric human patellae at several resolutions used an imaging protocol that produced high-contrast images of cartilage. The high-resolution image of each MR imaging set was reduced in resolution by low-pass filtering and compared with the acquired images of equivalent resolution. Variable-resolution images of the patella of a healthy human volunteer were also acquired. RESULTS: Truncation artifacts from opposing cartilage edges can create false laminae and artifactual intensities. The resulting geometric variations can alter the apparent width of the cartilage as well. The intensity variations produced by truncation artifacts can be as much as 22% of the actual intensity. The most pronounced artifactual trilaminar appearance occurs when cartilage thickness exceeds the image resolution by a factor of 4. Truncation artifacts vary as a function of the angle in the imaging plane for unequal resolutions in the two directions. CONCLUSION: Truncation artifacts can produce an artifactual laminar appearance in cartilage and alter the apparent cartilage width.

Artifacts↗
PubMed1997

Normal patellar retinaculum: MR and sonographic imaging with cadaveric correlation.

OBJECTIVE: The purpose of our study was to define retinacular anatomy with MR imaging and sonography. MATERIALS AND METHODS: Five cadaveric knee specimens underwent sonography and MR imaging using the following sequences: T1-weighted axial, sagittal, coronal, and five oblique planes and axial three-dimensional gradient-echo imaging. Three knees were injected with gelatin gadolinium solution before imaging. All five specimens were sectioned. Correlation was made between findings derived from MR imaging, sonography, and cadaveric sections. RESULTS: T1-weighted axial images without intraarticular gadolinium were most useful for revealing the superficial layer and deep ligaments of the retinacula; however, the oblique sagittal and oblique coronal planes showed the deep ligaments more clearly in their craniocaudal dimensions. Sonography revealed the retinacula as bilaminar structures with discrete superficial and deep layers but failed to distinguish the deep ligaments from one another. CONCLUSION: Conventional T1-weighted axial MR images showed the various components of the retinacula including the medial patellofemoral ligament, which is an important stabilizing structure. Oblique imaging planes may be a helpful adjunct to axial imaging planes. Sonography can consistently identify the retinacula and may be useful in their assessment.

Aged↗
PubMed1997

Measurements of cortical thickness in experimentally created endosteal bone lesions: a comparison of radiography, CT, MR imaging, and anatomic sections.

OBJECTIVE: The purpose of this study was to evaluate the accuracy of cortical measurements of experimentally created endosteal cortical lesions and to assess the sensitivity of radiography, CT, and MR imaging in the detection and measurement of such lesions. MATERIALS AND METHODS: Thirty-six cortical lesions were created in three fresh cadaveric femurs. After performing radiography, CT, and MR imaging, we sectioned the specimens in the axial plane. We then measured the remaining cortex at the lesions and the normal cortex adjacent to the lesions on all images and corresponding anatomic sections. The measurements of thickness of the cortex as seen with the different imaging methods and the anatomic sections were compared. Measurements were repeated to evaluate the influence of different window settings on the MR imaging measurements. RESULTS: When measured on radiographs, cortical thickness was overestimated in 58% of lesions. With CT, cortical thickness was overestimated by 0-15% in 94% of all lesions. With MR imaging, cortical thickness was uniformly underestimated by 3-17%. Measurements made on MR images varied according to different window settings. The proton density-weighted sequence yielded the highest sensitivity in the detection of shallow cortical lesions; the T1-weighted spin-echo sequence was the least sensitive of the MR sequences. CONCLUSION: In our cadaveric study, cortical thickness in the presence of endosteal lesions was overestimated on radiographs and CT scans and underestimated on MR images. Measurements derived from MR imaging are strongly influenced by the window setting. MR imaging with the proton density-weighted sequence is the most sensitive for detection of shallow cortical lesions and is more sensitive than CT.

Bone Neoplasms↗
PubMed1997

Correlation between ossification of the stylohyoid ligament and osteophytes of the cervical spine.

OBJECTIVE: To investigate the correlation between ligamentous ossification or osteophytes of the cervical spine and ossification of the styloid process and stylohyoid ligament, and to determine any relation between diffuse idiopathic skeletal hyperostosis (DISH) of the thoracic spine and ossification of the styloid process and stylohyoid ligament. METHODS: Four patients having cervical spine DISH, an elongated styloid process and/or variable patterns of stylohyoid ligament ossification, and clinical findings compatible with Eagle's syndrome are described. Cervical computed tomography scans of 100 patients who also had lateral radiographs of the thoracic spine were reviewed. Point biserial and Spearman rank correlation analysis, McNemar test, chi-squared test, and Fisher's exact test were used to determine correlation between elongation of the styloid process and/or ossification of the stylohyoid ligament and (1) ligamentous ossification or osteophytes of the cervical spine (the characteristic spinal manifestation of DISH), and/or (2) DISH of the thoracic spine. RESULTS: (1) Elongation of the styloid process and variable patterns of ossification of the proximal, middle, and distal parts of the stylohyoid ligament, and (2) enlargement of this ligament were significantly correlated with transverse and anteroposterior dimensions of ligamentous ossification or osteophytes of the cervical spine at various levels. The prevalence of such abnormalities of this process and ligament was not significantly different between the patients with and without thoracic spine DISH. CONCLUSION: Variable types of styloid process-stylohyoid ligament complex abnormalities have significant correlation with ligamentous ossification and osteophytes of the cervical spine.

Aged↗
PubMed1997

Relationships between myoelectric activity, strength, and MRI of lumbar extensor muscles in back pain patients and normal subjects.

Eight normal individuals and eight patients with chronic back pain were evaluated. They undertook a treatment program lasting 8 weeks, with two exercise sessions each week. Myoelectric activity, lumbar extensor strength, and cross-sectional magnetic resonance imaging appearance of the lumbar paraspinal extensor muscles was assessed at the beginning and end of the program. Initial baseline and final extensor strength measurements were done isometrically at seven points through full range. Surface myoelectric activity was monitored during both flexion and extension exercise. Subsequently, electromyographic (EMG) signals were analyzed for mean frequency (MPF) and amplitude (RMS). An average functional improvement of 65% and reduction of pain complaint of 41% occurred in the eight patients with chronic low back pain. Extensor strength improved an average of 48% contrasted to 6% for the normal subjects. Four patients who showed severe fatty infiltration in the extensors had a decrease in the degree of infiltration and no change in muscle mass. Changes in fatty infiltration did not correlate with strength changes. The dynamic EMG changes documented a decrease in amplitude (RMS) and a smaller decrease in frequency (MPF) for the same resistance when used at the beginning and end of the program. Structural changes in the muscles are not always needed to achieve strength gains or symptomatic improvement.

Back Pain↗
PubMed1997

Shoulder imaging. Perspective.

At the outset of this issue on MR imaging of the shoulder, one perspective of shoulder imaging is provided, that of a senior bone radiologist, perhaps to shed some light on the question: What is the precise role of MR imaging in the assessment of shoulder disorders?

Diagnostic Imaging↗
PubMed1997

Normal regional anatomy of the shoulder.

The shoulder is a remarkable structure enjoying a greater range of motion than any other articulation in the human body. The shoulder is not a single joint but actually four separate articulations that act synergistically. The authors review the complex anatomy of the shoulder, presenting correlation between anatomic sections and MR arthrography.

Humans↗
PubMed1997

Arthrographic effect induced by therapeutic ultrasound in magnetic resonance imaging of the wrist: a preliminary investigation.

OBJECTIVE: To evaluate the potential arthrographic effect of therapeutic ultrasound applied before magnetic resonance imaging (MRI) of the wrist. SUBJECTS AND METHODS: MRI of the wrist was performed in 6 asymptomatic volunteers before and after ultrasound therapy of the carpus. For each patient, ultrasound therapy was performed by a trained physiotherapist for 10 minutes, with doses titrated to the maximum tolerated without pain. The amount of fluid within the wrist joints before and after therapy was assessed subjectively by 2 reviewers, as well as objectively by digital analysis. RESULTS: Subjective appraisal of the images indicated that after ultrasound therapy there was an increase in joint fluid within the distal radioulnar joint in 4 volunteers, the midcarpal joint in 4 and the radiocarpal joint in 2. Computerized digital analysis of joint fluid confirmed an average volumetric increase in wrist joint fluid of 52.8% in 3 of the volunteers. The discomfort of the therapy was graded as 1/10 by 5 of the subjects and 4/10 by a single subject. CONCLUSIONS: Therapeutic ultrasound may be a useful adjuvant tool in the noninvasive induction of joint fluid before MRI of the wrist.

Adult↗
PubMed1996

Structures of class A macrophage scavenger receptors. Electron microscopic study of flexible, multidomain, fibrous proteins and determination of the disulfide bond pattern of the scavenger receptor cysteine-rich domain.

Structures of secreted forms of the human type I and II class A macrophage scavenger receptors were studied using biochemical and biophysical methods. Proteolytic analysis was used to determine the intramolecular disulfide bonds in the type I-specific scavenger receptor cysteine-rich (SRCR) domain: Cys2-Cys7, Cys3-Cys8, and Cys5-Cys6. This pattern is likely to be shared by the highly homologous domains in the many other members of the SRCR domain superfamily. Electron microscopy using rotary shadowing and negative staining showed that the type I and II receptors are extended molecules whose contour lengths are approximately 440 A. They comprised two adjacent fibrous segments, an alpha-helical coiled-coil ( approximately 230 A, including a contribution from the N-terminal spacer domain) and a collagenous triple helix ( approximately 210 A). The type I molecules also contained a C-terminal globular structure ( approximately 58 x 76 A) composed of three SRCR domains. The fibrous domains were joined by an extremely flexible hinge. The angle between these domains varied from 0 to 180 degrees and depended on the conditions of sample preparation. Unexpectedly, at physiologic pH, the prevalent angle seen using rotary shadowing was 0 degrees , resulting in a structure that is significantly more compact than previously suggested. The apparent juxtaposition of the fibrous domains at neutral pH provides a framework for future structure-function studies of these unusual multiligand receptors.

Amino Acid Sequence↗
PubMed1996

Glenoid hypoplasia and its relationship to instability.

Glenoid hypoplasia, or dysplasia of the scapular neck, is usually a bilateral and symmetric finding. Associated findings include hypoplasia of the humeral head, elongation of the glenoid cavity, and alterations in the shape of the coracoid or clavicle. Glenoid hypoplasia has been reported sporadically in the radiologic literature, but the condition may be more frequent than previously thought. In this paper, we discuss the radiographic findings of glenoid hypoplasia and explore the possibility of an association between glenoid hypoplasia and shoulder instability.

Adolescent↗
PubMed1996

Cystic angiomatosis: case report and review of the literature.

The objective of this article was to offer a better characterization of the typical clinical presentation, radiologic findings, histology, treatment approaches, and differential diagnosis of cystic angiomatosis, a rare condition of which previous reports have been confusing because of unclear diagnostic criteria, different classifications, and variations in terminology. A case report using the improved imaging techniques of computed tomography scanning is presented in addition to an analysis and review of the previous literature, which relied heavily on plain film radiography, biopsy, and necropsy for diagnosis. A case report of a 26-year-old man initially symptomatic at age 12 is presented. Although a rare condition, cystic angiomatosis must be considered in pediatric and young adult patients presenting with diffuse, multifocal, cystic skeletal lesions, with or without visceral involvement.

Abdomen↗