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Biomedical subjects

I W McCall

Publications and source records attributed to I W McCall.

At least 55 records · Page 3Linked to original sources
PubMed1985

Spondylarthrography: the demonstration of spondylolysis by apophyseal joint arthrography.

Twenty selected patients with spondylolysis have been studied following apophyseal joint arthrography. In each instance a communication with the defect of the pars interarticularis was demonstrated by the extension of contrast medium from injection into the adjacent facet joint. The clinical and radiological features are described. The anatomical basis of the abnormality is presented using macroscopic and radiographic correlation from a dissected cadaveric specimen of spondylolysis. Sixty-five per cent of the patients experienced significant relief of pain symptoms when long-acting local anaesthetic was introduced into the facet joint.

Adult↗
PubMed1985

Acute traumatic intraosseous disc herniation.

The clinical, radiologic, and discographic findings are reviewed in eight patients with acute traumatic intraosseous disc herniation. The syndrome should be considered in adolescent patients having severe back pain with limited radiation to the upper thigh, following significant compression/flexion stress to the spine. The intraosseous disc herniation can be confirmed by discography and reproduction of symptoms during the procedure is a helpful confirmatory feature. The radiologic natural history of the lesion is presented, and the role of bone scintigraphy is discussed. This type of injury may be responsible for considerable pain and disability in the adolescent age group and has proved extremely difficult to manage except by conservative treatment and analgesics.

Acute Disease↗
PubMed1985

Fracture of the cervical spine in ankylosing spondylitis.

The radiological features, clinical findings and mortality rates of patients with ankylosing spondylitis complicated by cervical trauma have been reviewed. All patients had long-standing disease and half had sustained their fractures as a result of trivial accidents. There were 19 cervical fractures in 18 patients, which were chalkstick in type and occurred predominantly at the 6th and 7th cervical levels. Ten fractures passed through the upper part of the vertebral body, one through the mid-vertebral body and the final eight were through the disc space. The site of the fracture line was related to neurological outcome. Those patients whose fracture line ran through the disc space had significantly less neurological injury and a much better prognosis. Distraction at the fracture site had some relation to prognosis but horizontal displacement and angulation were not found to be of importance. This study confirms that cervical fracture with neurological complications may follow minor trauma in ankylosing spondylitis. The site of the fracture in relation to the vertebral bodies and discs appears to be of some prognostic relevance and careful radiological assessment of all patients with ankylosing spondylitis and cervical injury should be undertaken.

Adult↗
PubMed1985

Radiological evaluation of asymmetrical limitation of hip abduction during the first year of life.

Asymmetrical limitation of abduction of the hip may be found on screening of children in the first year of life. The clinical features identified may occur in congenital dislocation of the hip but most infants do not have or develop hip dislocation. Radiological changes are present on the side of limitation of abduction and include a higher acetabular angle, retardation of femoral head epiphyseal development, pelvic obliquity and a rotational deformation of the pelvis in the transaxial plane. The appearances are postural deformities due to persistent infant positioning and are self-correcting. If aggressive treatment methods are to be avoided, the radiologist should not confuse these changes with those of congenital hip dislocation or subluxation.

Female↗
PubMed1984

Myelography in severe lumbosacral spondylolisthesis.

The radiological and myelographic appearances of 14 patients with severe lumbosacral spondylolisthesis have been reviewed in relation to compression of the cauda equina and their clinical symptomatology. Patients could be separated into two groups as defined by the position of the L5 neural canal. In Group 1, the arch was displaced downwards and the cauda equina compression was due to pressure from the L5/S1 disc and was related to the degree of listhesis. L5 root sheath abnormalities predominated in this group. In Group 2 the neural arch maintained a more normal position and the compression, which was unrelated to the degree of slip, occurred between the arch and the posterior aspect of the sacrum. S1 root lesions occurred in these patients due to pressure from the arch. Clinical symptoms and signs were also more prominent in this group.

Adolescent↗
PubMed1984

Spondylolisthesis: the angle of kyphosis.

A reproducible method of measurement of kyphosis in spondylolisthesis using the cranial surface of the fifth lumbar vertebra and the caudal surface of the first sacral vertebra is described. This measurement is useful in the prognosis of spondylolisthetic patients as the progression of slipping is determined by both the angle of kyphosis and degree of slip. The angle is also important in operative correction of spondylolisthesis. This method is readily used and reproduced in severe slips.

Adult↗
PubMed1983

Gallium 67 scanning in rheumatoid arthritis.

Gallium 67 scans were performed on both knees of 38 patients with rheumatoid arthritis. There was a significantly higher level of 67Ga accumulation in those knees with clinically active synovitis (p less than 0.001). Synovial white cell concentration was also elevated in the group with active synovitis. The white cell concentration correlated with the 67Ga knee/femoral ratio at the p less than 0.001 level. 67Ga activity in the synovial fluid was predominantly in the supinate and activity was also present in the synovium. The findings indicate that 67Ga uptake occurs in rheumatoid joints and reflects the degree of synovial inflammation.

Arthritis, Rheumatoid↗
PubMed1982

Severe kyphosis due to congenital dorsal hemivertebra.

Kyphotic deformity arising from failure of the formation of a vertebral body is described in nine patients. The study of the natural history demonstrates the progressive nature of this disorder resulting in severe deformity and neurological embarrassment. Early radiological recognition of this congenital deformity is essential and tomography is important in the early assessment. Tomography combined with myelography is essential to delineate the extent of bony abnormality and cord compression in severe kyphosis in order that adequate decompression and reconstructive surgery can be performed.

Adolescent↗
PubMed1981

Gallium-67 scanning in the painful total hip replacement.

Pain following total hip replacement is a significant clinical and diagnostic problem. Technetium scanning has proved a sensitive indicator of infection or loosening but does not differentiate between them. This study assessed the value of gallium-67 to aid this differentiation. Thirty patients underwent revision surgery. Fourteen were proven to be infected and 13 had positive gallium scans as also did two patients without infection. The implications of these false interpretations are discussed. Increased gallium activity was correlated with the patterns of the 99mTc scans and arthrographic appearances. It is concluded that gallium-67 scanning is a valuable adjunct to the assessment of the painful hip replacement when infection is suspected.

Aged↗
PubMed1981

Splenic opacification in homozygous sickle cell disease.

A prospective radiological and haematological study of 182 patients with homozygous sickle cell anaemia has been undertaken to assess the prevalence and pattern of splenic opacification and relate this to the blood indices. Opacification was observed in 31% of patients. In 55% of these, the pattern was punctate, whereas in 32% it was amorphous. A curvilinear appearance was seen in the remainder. In the amorphous group, a high percentage (72%), the spleen was severely contracted. The pattern of opacification and degree of contraction was related to age. The haematological indices indicate a lower haemolytic rate in patients with splenic opacification indicating a milder disease process with a greater persistence of the splenic capillary bed.

Adolescent↗
PubMed1981

The detection of spinal pseudarthrosis in ankylosing spondylitis.

Spinal pseudarthrosis in ankylosing spondylitis can be difficult to detect radiologically. This paper assesses the value of bone radioscintigraphy in relation to radiological examination. The patterns of tracer uptake in the spine were recorded in 16 patients in whom established ankylosing spondylitis was complicated by pseudarthrosis. Twenty such lesions were identified in 16 patients, mostly occurring at one level in a junctional region of the spine. Four patients had two lesions. Standard radiography failed to demonstrate this abnormality in seven patients and in these, tomography was required to confirm the scintigraphic findings. On the other hand, bone scanning was much less accurate in detecting the minor forms of marginal vertebral end plate destruction (spondylo-discitis) than conventional radiology. This study suggests that 99TcmMDP scanning is a useful primary investigation for the detection of spinal pseudarthrosis in patients with chronic ankylosing spondylitis who suffer late onset back pain.

Adolescent↗
PubMed1981

Alterations in vertebral growth following prolonged plaster immobilisation.

Long-term immobilisation in serial plasters for scoliosis, including the period of the adolescent growth spurt, leads to an increase in height of the vertebral bodies and a decrease of their height to width ratio. These changes are at the expense of the disc which is reduced in thickness. This stimulating effect on the vertebral body growth is probably due to the changes in mechanical factors.

Adolescent↗
PubMed1980

Cervicodorsal injury presenting as sternal fracture.

Clinically silent cervicodorsal fracture may occur following upper-thoracic injury in the presence of a characteristic buckling injury to the sternum. Failure to recognise the association may result in gross kyphotic deformity. Three examples are provided, illustrating the role of radiology in the management of this complex traumatic lesion.

Aged↗
PubMed1980

The supinator notch sign in rheumatoid arthritis.

Erosion of the ulna, giving a notch-like appearance in the region of the supinator groove, is reported in 18% of 110 unselected outpatients attending a rheumatoid clinic. The characteristic radiological, arthrographic and scintigraphic findings are presented. The mechanism, significance and differential diagnosis is discussed.

Aged↗
PubMed1979

The radiology of rheumatoid involvement of the cervical spine.

The radiological features of cervical spine involvement in rheumatoid arthritis are described. These include atlanto-axial subluxation, in both the horizontal and vertical planes, sub-axial dislocation, erosions, and vertebral end plate sclerosis. Detailed radiological investigation, using inclined plane radiography, auto-tomography, tomography, and myelography may all be required to demonstrate the abnormalities. Disorders of mobility can only be assessed with dynamic views and fluoroscopy and the mechanics of these derangements vary depending on the type of subluxation encountered. The cumulative effects of the lesions conform to certain characteristic patterns and include marked reduction of neck height, disorders of mobility, and changes in the capacity of the spinal canal. The discrepancy between these changes and the clinical and neurological findings is discussed.

Arthritis, Rheumatoid↗
PubMed1979

Sclerotic medullary spread in diaphyseal osteosarcoma.

Dense medullary sclerosis is reported in the shafts of long bones accompanying diaphyseal osteosarcoma. Histological evidence suggests that this indicates more extensive medullary spread of tumour than is readily apparent on standard radiographic examination. It would appear that these sclerotic lesions show active radio-isotopes retention following skeletal scintigraphy. The clinical and radiological features and prognostic implications of these findings are discussed.

Adolescent↗