[The lumbar facet joint syndrome. A prospective study].
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Biomedical subjects
Publications and source records attributed to G Dugstad.
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Spinal computed tomograms and myelograms of 107 patients with sciatica or low back pain were interpreted with and without knowledge of clinical history. A significant number of interpretations was changed by knowledge of the clinical history. More studies were interpreted correctly without the clinical history than with it. Knowledge of the clinical history increased the number of false-positive and decreased the number of false-negative diagnoses. This study suggests a tendency of observers to interpret questionable myelographic or computed tomographic findings as positive when they correlate with clinical findings.
An open multicentre clinical trial with the new non-ionic contrast medium iohexol is reported. A total of 38 adult patients were included in the series. No serious side effects or complications occurred. The impression was that subjective reactions were less marked with iohexol than what is usually observed with conventional ionic contrast media.
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Amipaque 280 mg I/ml was compared to Isopaque Cerebral 280 mg I/ml for common carotid injection in twenty patients in a double blind trial. Simple comparison was also performed in examinations with selective external carotid injections. The reaction of the patients to the common carotid injection was mild on the whole but Amipaque caused significantly less discomfort than Isopaque. Selective external carotid injection of Amipaque caused very little discomfort while most patients complained of severe pain when Isopaque was used. No serious side-effect was observed.
The CT characteristics were studied in a series of 90 tumours, and the diagnostic criteria were determined for meningiomas glioblastomas, other gliomas and metastases. These criteria were then employed in another group of 46 tumours in which the histological diagnosis was not known at the time of examination. The over-all diagnostic accuracy was 85%, and it was largely the same for the various sub-groups. Careful combination of the CT characteristics, perfect techniques, and increased experience may further improve the diagnostic accuracy.
The total material of lumbar myelographies performed with metrizamide (Amipaque) up to November 1976 (48,000 examinations) has been reviewed to assess the incidence of side-effects. A detailed analysis of 2,457 examinations from Ullevål Sykehus has been performed in order to assess adverse effects and diagnostic reliability. Three epileptic seizures were recorded, two of these in known epileptics. The rate of minor side-effects was low and the diagnostic accuracy high.
A simple embedding method for brain slices using epoxy resin is described. The embedding can be done immediately after cutting the brain and can be completed in 5-6 hrs. Discoloration of the slices is insignificant.
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Iohexol was compared with Amipaque (metrizamide) in a double-blind study in one pair of injections in each of 20 patients referred for routine cerebral angiography. Catheter position, patient position, injection pressure, contrast medium volume, and concentration (300 mg l/ml) were the same in the two injections, with iohexol and Amipaque being used alternately. Except for these two injections iohexol was used throughout. The parameters studied included diagnostic information obtained (quality of the examination), circulation time, and comparison of patient reactions to the pair of injections (e.g., electrocardiogram, heart rate, and subjective reactions). The patients' reactions to the noncomparative part of the examination were evaluated also, and the patients were observed for possible adverse reactions after the examination. No difference could be detected between the two contrast media in this series. No serious adverse reactions occurred.