Search PubMed⌕ Search

Biomedical subjects

J C Mall

Publications and source records attributed to J C Mall.

At least 19 recordsLinked to original sources

MR arthrographic depiction of tears of the rotator cuff: benefit of abduction and external rotation of the arm.

PURPOSE: To show the effectiveness of positioning the arm in abduction and external rotation (ABER) during magnetic resonance (MR) arthrography for depiction of tears of the rotator cuff. MATERIALS AND METHODS: Five throwing athletes with shoulder pain were prospectively imaged with standard MR imaging, MR arthrography, and ABER MR arthrography. The status of the rotator cuff was recorded; arthroscopic correlation was obtained. RESULTS: One partial tear of the distal infraspinatus tendon was detected with ABER MR arthrography only. One full-thickness tear was detected with both MR arthrography and ABER MR arthrography, but the component of the tear that extended into the infraspinatus tendon was depicted with ABER MR arthrography only. One partial tear was detected with both MR arthrography and ABER MR arthrography; no additional information was provided by either technique alone. CONCLUSION: The ABER position may be useful in detection and characterization of tears of the rotator cuff, especially partial tears of the undersurface. This information would be useful in selection of patients for conservative therapy, arthroscopy, or arthrotomy.

Adult↗

Posterosuperior glenoid impingement of the shoulder: findings at MR imaging and MR arthrography with arthroscopic correlation.

PURPOSE: To determine the utility of magnetic resonance (MR) imaging and MR arthrography in the evaluation of arthroscopic findings of posterosuperior glenoid impingement. MATERIALS AND METHODS: The findings at MR imaging, MR arthrography, and physical examination with the patient under anesthesia were retrospectively reviewed in eight patients with arthroscopic evidence of posterosuperior glenoid impingement. RESULTS: All patients had shoulder pain; anterior instability was found in six patients. Other than bone marrow abnormalities, findings at MR imaging were not reliable for the detection of posterosuperior glenoid impingement. MR arthrography was superior to routine MR imaging in all four cases in which it was done; positioning the shoulder in abduction and external rotation was beneficial in three of four patients. CONCLUSION: Impingement of the rotator cuff on the posterior superior glenoid labrum is a cause of posterior shoulder pain in athletes who throw. MR arthrography may allow detection of abnormalities associated with this clinical entity.

Adolescent↗

Measurement of fetal shoulder width with computed tomography in diabetic women.

We conducted a feasibility study of the use of computed tomography (CT) to measure the width of the fetal shoulders and to predict large birth weight in infants of diabetic mothers. Computed tomography pelvimetry using low-dose digital radiographs was performed before delivery at term in 22 diabetic women. Shoulder width was estimated by direct electronic measurement on a single axial section through the shoulders of the fetus, and by orthopedic calipers within 48 hours of birth. Shoulder width by CT was 11.4-16.5 cm, and correlated significantly with postnatal measurements (r = 0.66, P = .01). Shoulder width by CT also correlated well with birth weight (r = 0.84, P less than .01), and measured more than 14 cm in all seven infants with birth weights more than 4200 g. Using 14 cm as a positive test and birth weight 4200 g as an abnormal result, the predictive value of a positive test was 78% and the predictive value of a negative test was 100%. This technique deserves further evaluation in assessing the risk of shoulder dystocia in potentially macrosomic infants.

Birth Weight↗

Emery-Dreifuss muscular dystrophy with autosomal dominant transmission.

A woman with early-onset, slowly progressive, humeroperoneal muscle weakness had marked restriction of neck flexion with contracture at the elbows. She developed exertional dyspnea at age 25, atrial fibrillation with slow ventricular rate was discovered, and a cardiac pacemaker was implanted. Her father had a similar disorder. There is at least one other report of autosomal dominant transmission of this clinical picture, which had previously only been reported as Emery-Dreifuss muscular dystrophy with X-linked recessive inheritance. Thus, more than one mode of inheritance is possible for this unusual and distinctive form of muscular dystrophy.

Adult↗

Post-chymopapain (chemonucleolysis)--clinical and computed tomography correlation: preliminary results.

Chymopapain was first used for treatment of lumbar disc herniation in 1964 and has been used extensively in Canada and Europe for the last decade, but was recently released for general use in the United States. The enzyme is thought to cause decrease in intradiscal pressure and in disc volume; however, little in vivo evidence exists to support this concept. High resolution computed tomography (CT) scans were performed for diagnosis and at a variable period following chemonucleolysis on 17 randomly selected patients. The results of the study were: disc space narrowing occurred almost invariably; retraction of the prolapsed or extruded disc occurred in many patients; clinical improvement was closely related to retraction of the prolapsed or extruded disc; the best clinical results were obtained in patients who were injected at a single level with a clearly demonstrable disc prolapse or herniation.

Adult↗

Evaluation of abdominal trauma by computed tomography.

Computed tomography (CT) was used in the evaluation of 100 patients suffering abdominal trauma. The type of trauma was blunt in 78 patients, penetrating in eight, and iatrogenic in 14. Forty per cent of cases had normal CT scans, while 60% showed substantial abdominal or retroperitoneal injuries. Surgery, clinical follow-up, and repeated radiologic examinations confirmed the accuracy of CT, and there were no cases in which medical or surgical management was inappropriately guided by CT. A wide variety of injuries was detected, including 19 splenic, eight hepatic, six pancreatic, 13 renal, 13 retroperitoneal or abdominal wall, and one intraperitoneal. CT has major advantages over plain radiography, radionuclide imaging, and angiography in assessment of trauma-induced injuries.

Abdominal Injuries↗

The role of computed tomography in renal trauma.

Computed tomography (CT) and excretory urography were performed in 15 patients thought to have major renal trauma. In 4 cases, CT demonstrated extravasation of urine not detected by urography, and in all cases parenchymal injuries and extrarenal hematomas were depicted more accurately by CT. CT also proved to be superior to excretory urography in distinguishing relatively minor renal injuries (confusion, incomplete laceration, intrarenal hematoma, small extrarenal hematoma) from major or catastrophic injuries (complete laceration, fracture, shattered kidney), which significantly influenced the choice of surgical or medical therapy. CT also detected concurrent injuries of the spleen, liver, and/or pancreas in 4 cases. The authors feel that CT is valuable in the assessment of major renal trauma.

Adolescent↗

Computed tomography of urinary calculi.

Computed tomography (CT) was used in the evaluation of nine patients with nonopaque calculi in the upper urinary tract. In each case the calculus was identified as a very high density object (370-586 Hounsfield units) with calcium oxalate and cystine stones having somewhat higher attenuation values than uric acid or xanthine stones. The differentiation between calculi and other "radiolucent" filling defects was readily made since calculi had much higher attenuation values than blood clot or neoplasm. CT of the upper urinary tract may obviate the need for more invasive procedures such as retrograde pyelography when nonopaque filling defects require differentiation.

Adult↗

CT diagnosis of splenic laceration.

Five patients with possible splenic injury after blunt abdominal trauma were examined by computed tomography (CT). The diagnosis of splenic laceration and hemoperitoneum (without subcapsular hematoma) was established in each patient and confirmed at surgery. The diagnostic findings are described and the advantages and disadvantages of CT in this clinical situation compared with radionuclide scanning and angiography are discussed.

Abdominal Injuries↗

Diagnosis of Caroli disease by computed tomography: report of two cases.

Two patients are discussed in whom Caroli diseases was diagnosed with the aid of computed tomography (CT). One patient had the pure form of the disease, characterized primarily by saccular dilatation of the intrahepatic bile ducts and clinically manifesting as recurrent cholangitis. The second patient had a form ccharacterized primarily by hepatic fibrosis and clinically manifesting as portal hypertension. These are the first patients studied with CT to be reported to the authors' knowledge; CT is recommended as the optimal noninvasive method to evaluate such patients.

Adult↗

99mTc-methylene diphosphonate bone imaging in the evaluation of total hip prostheses.

A retrospective study was performed to determine the accuracy of 99mTc-methylene diphosphonate bone imaging in the evaluation of total hip arthrosplasty for lossening and/or infection. Using focally increased activity at the tip of the femoral component or in the region of the acetabular component as a criterion, the examination was 77% specific and 100% sensitive for loosening and/or infection. A possible explanation for the increased uptake at the tip of the femoral component and the role of this examination in the management of a painful total hip prosthesis are discussed.

Bone Diseases↗

HLA-B27 associated arthropathies.

The association between histo-compatibility antigens and disease is reviewed, in particular that between HLA-B27 and spondylitic disorders, i.e., ankylosing spondylitis, Reiter's arthritis, psoriatic arthritis, and ankylosing hyperostosis. We determined whether the presence of HLA-B27 predicted specific radiographic findings and, conversely, whether specific radiographic changes predicted antigenic status. The prevalences of the HLA-B27 antigen in our patients were: ankylosing spondylitis, 100%; Reiter's arthritis, 93%; psoriatic arthritis, 55%; and ankylosing hyperostosis, 12%. The only specific radiographic finding associated with B27 positivity was severe spondylitis in psoriasis.

Arthritis↗

Post-thoracotomy lung herniation.

Two cases of lung herniation complicating thoracotomy are presented. The classification and radiographic findings of lung hernia are reviewed.

Adult↗

Direct radiographic magnification for skeletal radiology. An assessment of image quality and clinical application.

Recent advances in technology have made radiographic magnification of the skeleton clinically feasible. A new electron gun micro-focal tube combined with new high-resolution recording systems were used to perform magnification radiography which was then compared with conventional contact radiography. Quantitative evaluation included measurements of speed, contrast, resolution, and noise. Qualitative evaluation included an analysis of 215 clinical cases in which both techniques were used. The superior image quality of direct radiographic magnification is confirmed and the clinical areas in which it proved most helpful are defined.

Arthritis↗