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Biomedical subjects

I Watt

Publications and source records attributed to I Watt.

At least 127 records · Page 7Linked to original sources
PubMed1988

Synovial fluid collagenase in patients with destructive arthritis of the shoulder joint.

We studied synovial fluid (SF) collagenase in 10 women with severe rheumatoid arthritis (RA), 10 with pyrophosphate arthropathy, and 10 with idiopathic destructive disease of the shoulder conforming to a pattern recently described. SF cell counts were highest in the RA group. Particles were detected by polarized light microscopy and alizarin red staining. Crystals were seen in fluids from all 3 groups; pyrophosphate predominated in the pyrophosphate arthropathy group and alizarin red-positive particles in the idiopathic disease group. Collagenase and tissue inhibitor of metalloproteinase levels were estimated in SF after gel filtration. Tissue inhibitor of metalloproteinase activity was detected in all fluids, but tended to be highest in the RA group. Collagenase activity was detected in 3 RA fluids only. In no sample was collagenase found in an active form. These findings support the clinical concept of an aggressive destructive process which sometimes occurs in the shoulder joints of elderly women. Because we were not able to detect free collagenase in SF from any of the patients with idiopathic shoulder disease, the data suggest that high levels of active collagenase are not characteristic of this group of patients.

Apatites↗
PubMed1988

Idiopathic destructive arthritis of the shoulder.

IDA of the shoulder is a condition found predominantly in elderly females. Although the shoulder is primarily involved, other joints such as the hip and knee can be affected, and concurrent OA is common at other joint sites. Clinical features include voluminous, often blood-stained effusions, together with features of rotator cuff rupture and restriction of shoulder movement. Laboratory parameters are usually normal and examination of the synovial fluid reveals large amounts of basic calcium phosphate crystals. The synovium is hypertrophied and vascular and shows fibrin deposition. It contains calcified material extracellularly. An acute inflammatory infiltrate is absent. Radiographs demonstrate soft tissue swelling and subchondral sclerosis with marked bony attrition involving the acromioclavicular and glenohumeral joints, as well as the humeral head and neck. Although some aspects of the disease seem distinct, many features are shared with other types of destructive arthritis of the shoulder. The pathogenesis of this disorder is at present obscure, but it is clear that an understanding of the processes involved will provide a vital contribution to our understanding of the response of the joint to insult. With a multidisciplinary approach and adequate communication between interested workers this aim could seen be within our grasp.

Adult↗
PubMed1988

Bone scintigraphy and radiography in the early recognition of diabetic osteopathy.

Twenty-seven diabetic patients with clinical evidence of neuropathy were investigated by foot radiography, two-phase bone scintigraphy, biothesiometry and cardiovascular autonomic function testing. Typical signs of diabetic osteopathy on radiography were found in 10 subjects (37%), the degree of radiographic abnormality correlating with the severity of neurological impairment. Furthermore, all diabetics with evidence of severe neuropathy showed some evidence of osteopathy on foot radiographs. In all 10 cases of diabetic osteopathy diagnosed radiographically, abnormalities were shown on scintigraphy. In addition, five other patients showed scintigraphic abnormalities, without corresponding changes on radiography, and in this group the neurological impairment was less severe. Although confirmatory longitudinal studies are necessary, it seems likely that the earliest changes of diabetic neuropathic osteopathy may thus be recognized on bone scintigraphy, at a time when conventional radiographs are normal. This stage of diabetic osteopathy is associated with a lesser degree of neurological impairment.

Adult↗
PubMed1988

Cervical myelography of nerve root avulsion injuries using water-soluble contrast media.

Eight cases of cervical nerve root avulsion injury are presented which were investigated by cervical myelography using a water-soluble contrast medium. The previous literature describes the appearances of this lesion using an oil-based agent and has resulted in emphasis being placed on looking for a traumatic meningocele rather than an abnormality of the roots themselves. The excellent definition of the nerve rootlets and axillary pouch that are obtained with a water-soluble contrast medium resulted in more root lesions per patient being detected than with an oil-based medium. There was complete correlation with the surgical findings at all but one root level explored. The appearances of root avulsion injuries and the advantages of using a water-soluble contrast medium are discussed.

Adolescent↗
PubMed1988

Synovial chondromatosis.

We reviewed 53 cases of synovial chondromatosis and compared their clinical, radiological and pathological features. A radiological diagnosis is possible with increasing frequency as the disease progresses; in the early phase arthrography is helpful. Radiologically the disease may be classified as either extra-articular, or intra-articular; the intra-articular variety may be localised or generalised. Recurrence after operation was seen in 11.5% and was much the same after either synovectomy or simple removal of loose bodies. A protocol for treatment is proposed.

Adolescent↗
PubMed1988

Peripheral nerve entrapment at the wrist in pyrophosphate arthropathy.

Of 200 consecutive patients with confirmed pyrophosphate arthropathy, clinically significant median nerve entrapment was found in 14 (14%) of those with wrist involvement. Three of these had electromyographically confirmed combined median and ulnar nerve entrapment at the wrist (bilateral in 2). Chondrocalcinosis, but not changes of arthropathy, was closely associated with the presence of entrapment (p less than 0.001), implying that soft tissue factors are important in causation. Treated hypothyroidism was more common in those with nerve entrapment (p less than 0.01), suggesting a possible interaction of multiple factors in the pathogenesis of nerve entrapment.

Adult↗
PubMed1987

Severe subcutaneous calcification in the 'CREST' syndrome: evidence of high turnover of calcific deposits.

Four patients with mild CREST syndrome and extensive subcutaneous calcification have been studied over a 5-year period. There was no correlation between mineral deposition and other features of the disease and no obvious clinical or metabolic cause of the calcification. Mineral deposits, identified as crystalline carbonated apatite, were very labile. A clear pattern of radiographic evolution was apparent. Bone scans showed a higher uptake of isotope in new, developing deposits than in older lesions. Spontaneous formation and disappearance of adjacent deposits occurred in some patients. Loss of mineral could not be explained by extrusion through the skin.

Aged↗
PubMed1987

Bone scanning of the foot for unexplained pain.

This paper reports the results of bone scans on 78 painful feet. Scanning helped in the diagnosis of persistent foot pain following injury and it enabled stress fractures, fractures of the sesamoids and subtalar arthritis to be diagnosed earlier. It reliably excluded bone infection and was useful as a screening test when radiographs were normal.

Adolescent↗
PubMed1986

Skeletal quiz.

Explore the source record for details and available documents.

Adult↗
PubMed1986

A reappraisal of 'analgesic hip'.

Nineteen patients with hip radiographs typical of 'analgesic hip' (rapidly destructive, atrophic arthropathy involving both femoral and acetabular components) have been studied. Women predominated (14:5), and all were elderly (mean age 74 years, range 64-83 years). Destructive hip disease was unilateral in all but one case. The mean interval from symptom onset to typical x ray appearance was short (one year, range three to 24 months), and persistent pain unresponsive to drug therapy was characteristic. Screening showed no metabolic or neurological disease. Contrary to previous reports, non-steroidal anti-inflammatory drugs could not be incriminated in development of the disease. Clinical and radiographic similarity to apatite associated destructive arthritis of other large joints was striking, and occurrence of the latter, uncommon condition in five patients (five shoulders, two knees) suggests that both descriptions represent a common articular response at different joint sites.

Aged↗
PubMed1986

99mTc HMDP bone scanning in generalised nodal osteoarthritis. I. Comparison of the standard radiograph and four hour bone scan image of the hand.

The pattern of joint involvement on conventional radiographs and the four hour gammacamera image of 99Tc HMDP bone scans were studied in 33 patients with generalised nodal osteoarthritis. Both techniques showed the predominant involvement of the distal interphalangeal, scaphotrapezial, and first carpometacarpal joints. Some joints were abnormal just on one investigation: either x ray or scan alone. Others showed a marked dissimilarity in the severity of involvement on x ray compared with scan. This discrepancy between x ray and scan suggests that the scan is imaging a different process than the radiograph and offers a different way of assessing change in osteoarthritis.

Female↗
PubMed1986

99mTc HMDP bone scanning in generalised nodal osteoarthritis. II. The four hour bone scan image predicts radiographic change.

In 14 patients with generalised nodal osteoarthritis a four hour bone scan image was found to predict the changes that occur on the radiograph at follow up between three and five years later. The scan abnormality appeared to precede the development of radiographic signs, and joints abnormal on scintigraphy showed most progression. Normal joints and joints abnormal on x ray alone showed little progression, and those that did subsequently alter became abnormal on scan. Scanning may provide a sensitive technique for monitoring osteoarthritis, it may enable a greater understanding of the underlying disease process, and allow evaluation of modifying therapeutic procedures.

Female↗
PubMed1986

Cartilage-cell-containing tumours of the pelvis: a radiological review of 40 patients.

Cartilage-cell-containing tumours of the pelvis are responsible for a quarter of all primary bone lesions in this site. Benign tumours are uncommon but when present have classical radiological appearances similar to those described elsewhere. Only the rarest, chondromyxoid fibroma, may cause difficulty in diagnosis. Seventy-three per cent of cartilage-cell tumours are malignant and are either chondrosarcoma or chondroblastic osteosarcoma. Chondrosarcoma occurs after the second decade of life, usually with a longer history, and may be categorised as either a secondary peripheral or primary central tumour, each having typical radiological features. Chrondroblastic osteosarcoma tends to occur in younger patients with a shorter clinical history and is almost exclusively situated adjacent to a sacroiliac joint, producing purely lytic, sclerotic or mixed patterns of bone destruction. Experience suggests that computed tomography is the single most valuable further examination, since the pelvis is a complex structure with confusing overlying soft-tissue artefacts. This technique may indicate both the route and choice of optimal biopsy site.

Adolescent↗