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Biomedical subjects

E Cardinal

Publications and source records attributed to E Cardinal.

At least 19 recordsLinked to original sources
PubMed2000

Posterior ankle impingement syndrome: MR imaging findings in seven patients.

PURPOSE: To report the magnetic resonance (MR) imaging findings in seven patients with posterior ankle impingement (PAI) syndrome. MATERIALS AND METHODS: Seven patients-three ballet dancers, one badminton player, one soccer player, one hockey player, and one construction worker-who presented with posterior ankle pain were assessed with MR imaging. Their clinical records and imaging studies were reviewed. The MR imaging studies were assessed for the presence of abnormal bone marrow signal intensity, osseous lesions, and soft-tissue abnormalities. RESULTS: One patient was treated surgically. In all patients, MR imaging demonstrated abnormal bone marrow signal intensity in the os trigonum and/or lateral talar tubercle, consistent with bone contusions. Two patients had a fragmented os trigonum or lateral tubercle, and two had a pseudoarthrosis of the posterolateral talus. Increased signal intensity was seen with distention of the posterior recess of the tibiotalar joint in two patients and with distention of the posterior recess of the subtalar joint in four patients. Three patients had fluid accumulation in the flexor hallucis longus tendon sheath. CONCLUSION: Bone contusions of the lateral talar tubercle and os trigonum are prevalent MR imaging findings of PAI syndrome. MR imaging clearly depicts the osseous and soft-tissue abnormalities associated with PAI syndrome and is useful in the assessment of this condition.

Adolescent↗
PubMed1999

Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations.

STUDY DESIGN: Independent evaluation by two observers of 132 lumbar discs in 45 patients with chronic low back pain investigated by both magnetic resonance imaging and discography. OBJECTIVES: To assess some of the fundamental differences between lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity on T2-weighted magnetic resonance images. SUMMARY OF BACKGROUND DATA: Moderate interobserver agreement has been reported when the morphologic terms normal, bulge, protrusion, and extrusion are used. The validity of this nomenclature remains unknown. METHODS: Discs were evaluated on magnetic resonance images for central and peripheral signal characteristics, height, contour, and nerve root compression. Discograms were classified according to degrees of disc degeneration, disruption, and pain reproduction. RESULTS: Loss of intervertebral height or abnormal signal intensity on magnetic resonance imagery was significantly associated with disc disruptions extending into or beyond the outer anulus on discograms. All 23 protrusions (100%) and 12 of 15 disc bulges (80%) were associated with Stage 2 or 3 anular disruptions and, in most instances, similar or exact reproduction of pain during disc injection. There was no significant difference between disc protrusions, disc bulges, and discs with normal contour but abnormal signal, with respect to degree of disc degeneration, extent of disruptions, or presence of discogenic pain. CONCLUSIONS: In patients with chronic low back pain, loss of disc height or abnormal signal intensity is highly predictive of symptomatic tears extending into or beyond the outer anulus. Disc bulges and disc protrusions do not represent discs with significantly different internal architecture, based on the findings of discography, and are no more suggestive of symptomatic tears than discs showing normal contour but decreased height or abnormal signal intensity.

Adult↗
PubMed1999

Vertebral involvement in SAPHO syndrome: MRI findings.

We report on the MRI findings in the vertebrae and surrounding soft tissues in two patients with the SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis). The MRI findings include abnormal bone marrow signal, either focal or diffuse, of the vertebral bodies and posterior elements; hyperintense paravertebral soft tissue swelling and abnormal signal of the intervertebral discs. These changes are consistent with discitis and osteitis.

Acquired Hyperostosis Syndrome↗
PubMed1999

Joint sonography.

Sonographic evaluation of joint and periarticular pathology clearly has applications in numerous clinical scenarios, not only for diagnosis but in some situations for US-guided biopsy, aspiration, and injections. It is a rapid, inexpensive technique that with adequate equipment, training, and expertise makes it compelling for use as a first-line imaging modality for the assessment of periarticular masses, localized pain, possible infection, joint swelling, as well as posttraumatic articular and periarticular lesions.

Acromioclavicular Joint↗
PubMed1998

Ultrasound-guided interventional procedures in the musculoskeletal system.

Ultrasound is a low-cost, nonionizing, readily available diagnostic technique for the evaluation of tendons, muscles, soft tissue masses, cysts, and other fluid collections. Ultrasound is also a valuable tool for guiding a variety of musculoskeletal interventions. Procedures that can be performed under ultrasound guidance include aspiration of fluid for analysis, injection for medication, decompression of cysts, drainage of abscess and hematoma, biopsy, treatment of calcified tendinitis, and foreign body retrieval.

Biopsy, Needle↗
PubMed1996

Understanding medication-related needs of low-literacy patients.

An important thrust in preparing pharmacy students to provide pharmaceutical care is acquiring sensitivity to the unique medication-related needs of at-risk patient populations. Low literacy, which affects 21% to 23% of the American population, defines one such population. In collaboration with the Lafayette Adult Reading Academy (LARA), the authors developed an evolving project to increase pharmacy studies' understanding of the medication-related needs and perspectives of low-literacy patients. This was accomplished through a relation-building, three-step oral interview process. The interviewers asked open-ended questions to assess each patient's medication use habits and perspectives. The interview sensitized the pharmacy students to the needs of low-literacy patients for pharmaceutical care. The principal finding was that a caring relationship between pharmacists and patients is prerequisite to patients' openness to share and receive advice about problems and misconceptions associated with their medication use experiences.

Adult↗
PubMed1996

US of the snapping iliopsoas tendon.

PURPOSE: To determine the value of ultrasound (US) in the diagnosis of snapping iliopsoas tendon. MATERIALS AND METHODS: In three patients, dynamic US of the hip was performed as the flexed, abducted, and externally rotated hip was extended. The contralateral hip was also evaluated. Hip arthrography was performed in all three patients, magnetic resonance imaging in two, and iliopsoas bursography in two, which was successful in only one case. One patient underwent surgical release of the iliopsoas tendon. RESULTS: At US, an abnormal jerk of the iliopsoas tendon during hip motion was correlated with the painful audible snap. The motion of the contralateral iliopsoas tendon was smooth. No intraarticular abnormality was found in two patients, and an associated labral tear was suspected at arthrography in the third patient. The patient who underwent surgical release of the iliopsoas tendon had great improvement. CONCLUSION: US is a useful dynamic noninvasive technique for the diagnosis of snapping iliopsoas tendon.

Adult↗
PubMed1996

Plantar fasciitis: sonographic evaluation.

PURPOSE: To evaluate the sonographic findings of plantar fasciitis. MATERIALS AND METHODS: Both feet of 15 patients who had a clinical diagnosis of plantar fasciitis were evaluated with ultrasound (US) by using a 7.0-MHz linear-array transducer. Heel pain was unilateral in 11 patients and bilateral in four. Sagittal sonograms were obtained, and the thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. Other observations included hypoechoic fascia, fiber rupture, perifascial fluid collections, and calcifications. Both feet of 15 healthy volunteers were also evaluated as a control group. RESULTS: Plantar fascia thickness was significantly increased in the heels in patients with plantar fasciitis (3.2-6.8 mm; mean, 5.2 mm +/- 1.13) compared with their asymptomatic heels (2.0-4.0 mm; mean, 2.9 mm +/- 0.70) (P < .0001) and compared with the heels of the patients in the control group (1.6-3.8 mm; mean, 2.6 mm +/- 0.48) (P < .0001). The proximal plantar fascia of 16 (84%) symptomatic heels were diffusely hypoechoic compared with none of the patients' asymptomatic heels and only one heel of a patient in the volunteer group. No fascia rupture, perifascial fluid collection, or calcifications were identified. CONCLUSION: Increased thickness of the fascia and hypoechoic fascia are sonographic findings of plantar fasciitis. US may be a valuable noninvasive technique for the diagnosis of plantar fasciitis.

Case-Control Studies↗
PubMed1996

Amyloidosis of the shoulder in patients on chronic hemodialysis: sonographic findings.

OBJECTIVE: The purpose of this study was to determine the sonographic findings of amyloidosis in shoulders of patients on chronic hemodialysis. SUBJECTS AND METHODS: Sonograms were obtained for 19 shoulders of 11 patients on chronic hemodialysis with clinical findings suggestive of amyloidosis. Five patients had biopsy-proven amyloidosis, and one patient had positive shoulder joint fluid aspirate. The thicknesses of the following structures were measured: the rotator cuff, the subacromial-subdeltoid bursa, and the long head of the biceps tendon and its synovial sheath. The presence of intra- or periarticular masses or nodules, hyperechoic areas, bony erosions, and calcifications was specifically assessed. Shoulder sonograms from dialysis patients were compared with normal sonograms obtained for 20 asymptomatic shoulders of patients without renal disease. RESULTS: The mean rotator cuff thickness in the patients with amyloidosis was significantly greater than that in the normal group (p < .0001). Ten shoulders of six patients with amyloidosis but none of the control subjects had a rotator cuff thickness greater than 7 mm. The synovial sheath of the long head of the biceps tendon was thickened in 10 shoulders of patients with amyloidosis and in one normal shoulder. The subacromial-subdeltoid bursa was thickened in seven shoulders of patients with amyloidosis but not in any shoulders in the control group. Eight shoulder sonograms from dialysis patients showed intra- or periarticular nodules. CONCLUSION: Sonographic findings associated with amyloidosis of the shoulder include thickening of the rotator cuff, the synovial sheath of the long head of the biceps tendon, and the subacromial-subdeltoid bursa and the presence of nodules within or around the joint. Shoulder sonography may be useful as a noninvasive technique for the diagnosis of dialysis-related amyloidosis in the proper clinical setting.

Adult↗
PubMed1996

Kinematic magnetic resonance imaging of the normal shoulder: assessment of the labrum and capsule.

OBJECTIVE: To examine the normal shoulder, specifically the labrum and the capsule, with kinematic magnetic resonance imaging (MRI) in asymptomatic volunteers. SUBJECTS AND METHODS: Fourteen asymptomatic volunteers 22 to 53 years of age were studied with a 1.5-T Signa Advantage imager (GE Medical Systems, Milwaukee). Successive static gradient-echo images were obtained in the transverse plane at the mid-glenoid level as the shoulder was successively positioned from full internal to full external rotation. These images were correlated with standard transverse T1-weighted spin-echo images and gradient-echo volume images obtained in the neutral position. RESULTS: The anterior labrum was slightly mobile during rotation in 11 subjects and changed shape from blunted or round to triangular in 8 subjects. A wide variation in morphologic features of the anterior labrum was observed. During rotation, a slight increase in signal intensity was noted in the anterior labrum of five of the subjects. The posterior labrum maintained a relatively stable triangular shape in most cases. Dynamic study allowed assessment of the anterior capsule insertion in all cases. Three subjects had type 1 and 11 had type 2 capsular insertion. No cases of type 3 insertion were identified. CONCLUSIONS: Variation in the shape and signal intensity of the anterior labrum observed in normal asymptomatic volunteers during transverse kinematic examination of the shoulder should be taken into account during evaluation of shoulder instability, since this variation may be clinically insignificant. Kinematic MRI allows easy evaluation of the anterior capsule.

Adult↗
PubMed1996

Spinal metastases as a first presentation of malignant astrocytoma.

A 46-year-old man presented with low dorsal pain and paresthesia. Computed tomography showed an osteolytic lesion involving most of the vertebral body and the left pedicle of the 12th thoracic vertebra (T12). Contrast-enhanced magnetic resonance imaging (MRI) of the spine showed an enhancing soft-tissue mass that involved the T11 and T12 vertebral bodies, as well as that of the first lumbar vertebra; the mass caused cord compression. Another lesion was identified at T9. The findings of percutaneous needle aspiration biopsy of the lesion were consistent with metastatic astrocytoma, a diagnosis confirmed at surgery. MRI of the brain showed an asymptomatic lesion of the left temporal lobe; histologic confirmation of malignant astrocytoma was obtained by stereotactic biopsy. This report shows that metastatic bone disease secondary to malignant astrocytoma may manifest itself before the primary lesion becomes symptomatic. This presentation of astrocytoma was unusual because there were no symptoms of the intracranial tumour and because metastatic disease to the bones is less common than to the chest and the lymph nodes.

Astrocytoma↗
PubMed1995

Bupivicaine arthrography of the post-arthroplasty hip.

Addition of bupivicaine, a medium-length-acting local anesthetic, to the contrast material in arthrography of total hip prostheses provides reliable information as to whether the source of pain is intracapsular or extracapsular. In 12 surgically proven cases, complete relief of pain after bupivicaine injection correctly identified an intracapsular source of pain in 10, with only 1 false-positive and 1 false-negative. These results compare favorably with the results of the contrast arthrograms in these patients in localizing the pain even if a specific diagnosis could not be reached. Bupivicaine as an adjunct to contrast material during arthrography provides additional information useful in management decisions regarding the necessity of revision arthroplasty.

Anesthetics, Local↗
PubMed1994

Case report 873: Lipoma arborescens (villous lipomatous proliferation of the synovial membrane).

A case of lipoma arborescens with typical features was presented. MR imaging established the preoperative diagnosis by visualizing the typical frond-like synovial projections containing fatty tissue. The extent of joint involvement must be fully documented because an open synovectomy is most appropriate in the management of this disease. Although lipoma arborescens is a rare condition, it is important to recognize the MR features due to the large volume of MR examinations of the knee which are performed.

Aged↗
PubMed1994

Occult dorsal carpal ganglion: comparison of US and MR imaging.

PURPOSE: To evaluate the usefulness of ultrasound (US) and magnetic resonance (MR) imaging in patients suspected of having an occult dorsal carpal ganglion. MATERIALS AND METHODS: The authors prospectively studied US and MR images of 14 wrists in 13 consecutive patients suspected of having an occult dorsal carpal ganglion. RESULTS: Eleven dorsal carpal ganglia were identified with US and nine with MR imaging. One patient refused the MR imaging study. Of two equivocal cases at MR imaging, one was a ganglion and another was a compressible capsular recess, as determined at US. One ganglion was missed with both techniques. The average diameter of the ganglion cysts was 4.9 mm. CONCLUSION: MR imaging and US are equally effective in the detection of occult dorsal carpal ganglia. Because of its dynamic capabilities and lower cost, US should be the initial imaging procedure for suspected occult dorsal carpal ganglia.

Adult↗
PubMed1994

Imaging and differential diagnosis of masses within a joint.

Careful analysis of conventional radiographs remains the first step in the investigation of intra-articular abnormalities. However, other imaging techniques, such as ultrasonography, arthrography, computed tomography and magnetic resonance imaging, may add critical information that allows the correct diagnosis. The authors discuss the evaluation of masses within a joint on the basis of plain film analysis, as well as the contribution of additional imaging techniques to the differential diagnosis.

Arthritis, Infectious↗
PubMed1992

Imaging pediatric hip disorders and residual dysplasia of adult hips.

The application of newer imaging modalities such as ultrasound, CT, and MR imaging has made a major contribution to the understanding of pediatric hip disorders. Multiplanar imaging has been a major advancement in the depiction of the complex hip joint anatomy. Direct visualization of cartilage in the immature joint is now possible with MR imaging. Sophisticated computer software programs allow three-dimensional reconstruction of the joint from CT and MR data. Manipulation of three-dimensional images allows preoperative simulation of proposed surgical reorientation of hips with deformity resulting from dysplasia and Legg-Calvé-Perthes disease.

Adult↗