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Biomedical subjects

J F Griffith

Publications and source records attributed to J F Griffith.

At least 19 recordsLinked to original sources
PubMed2003

Subcutaneous injection of metallic mercury.

Deliberate self-injection of metallic mercury into subcutaneous tissue is uncommon. A 41-year-old lady with a history of schizophrenia was admitted to our hospital after deliberate injection of metallic mercury into her right wrist and antecubital fossa. Physical examination was unremarkable except for the injection marks over right antecubital fossa and wrist. The presence of subcutaneous mercury deposits in her right elbow and wrist was confirmed by X-rays and ultrasound scan. Three days later, erythema, swelling, induration and tenderness were seen over the injection sites. At the operation on day 9, mercury streaks were seen within the brachialis muscle belly, surrounded by friable necrotic tissues along the tract. A similar picture was noted in her right wrist. The necrotic tissues and mercury streaks were removed. The patient had been unco-operative and she only received incomplete treatment with dimercaprol and 2,3-dimercaptosuccinic acid. Her total blood mercury level (normal < 50 nmol/L) decreased from 101-151 nmol/L in the first two weeks to 42 nmol/L 3 months later. Her 24-hour urinary mercury excretion (normal < 10 nmol) changed from 55.7-209.5 nmol in the first 7 weeks to 125.4 nmol 3 months later. This case illustrates that soft tissue metallic mercury can produce local necrosis and may allow continuous absorption with persistent elevations in blood and urinary mercury levels. Therefore, early surgical removal of subcutaneous mercury deposits is required to prevent local complications and minimize the risk of systemic absorption and toxicity.

Adult↗
PubMed2003

Rice-body formation in atypical mycobacterial tenosynovitis and bursitis: findings on sonography and MR imaging.

OBJECTIVE: This article describes rice bodies found in patients with atypical mycobacterial tenosynovitis and bursitis, emphasizing the sonographic and MR imaging appearances of these small bodies. CONCLUSION: Rice bodies occur in patients with atypical mycobacterial tenosynovitis and bursitis. When small, rice bodies are better visualized on MR imaging than on sonography, allowing the radiologist to consider appropriate diagnoses.

Aged↗
PubMed2003

An unusual cause of carpal tunnel syndrome.

Tuberculosis is an uncommon cause of carpal tunnel syndrome. We report a patient with systemic lupus erythematosus who developed hand numbness. Ultrasonic, operative and microbiological findings supported the diagnosis of median nerve compression secondary to a tuberculous abscess. The symptoms resolved with surgical excision and antituberculous chemotherapy.

Adult↗
PubMed2002

Discriminatory sonographic criteria for the diagnosis of carpal tunnel syndrome.

OBJECTIVE: Sonographic examination of the median nerve has been suggested as a useful alternative to electrophysiologic study in the diagnosis of carpal tunnel syndrome. To determine its usefulness and the best diagnostic criterion, sonograms of patients with the disease were compared with sonograms of healthy subjects in a case-control study. METHODS: Patients with carpal tunnel syndrome and asymptomatic controls who were matched for age and sex were enrolled and underwent sonography of the wrists. Eight separate sonographic criteria were analyzed in each wrist. Data from the patient group and the control group were compared to establish optimal diagnostic criteria for carpal tunnel syndrome, using receiver operating characteristic analytic techniques. RESULTS: Thirty-five patients with carpal tunnel syndrome and 35 asymptomatic controls were examined. Increased cross-sectional area of the median nerve was found to be the most predictive measure of carpal tunnel syndrome, proximal to the tunnel inlet, at the tunnel inlet, and at the tunnel outlet, with significant differences between patients and controls. Using a receiver operating characteristic curve, a cut-off value >0.098 cm(2) at the tunnel inlet provided a diagnostic sensitivity of 89% and a specificity of 83%. CONCLUSION: Sonographic measurement of the median nerve cross-sectional area is both sensitive and specific for the diagnosis of carpal tunnel syndrome.

Adult↗
PubMed2002

The clinical efficacy of neoadjuvant chemotherapy in squamous esophageal cancer: a prospective nonrandomized study of pulse and continuous-infusion regimens with Cisplatin and 5-Fluorouracil.

BACKGROUND: We evaluated cisplatin and 5-fluorouracil as preoperative adjuvant chemotherapy for patients with locally advanced squamous esophageal cancer and compared two different infusion regimens. The outcomes were also compared with those of our historical control patients treated by surgery alone. METHODS: From 1991 to 1997, 83 consecutive esophageal cancer patients underwent surgical exploration after completion of two cycles of cisplatin and 5-fluorouracil chemotherapy regimens, either in pulse or in continuous infusion cycles. Outcomes were compared with those of 76 historical control patients. Both groups were comparable in demographic characteristics and tumor stages. The resection rates, operative morbidity, mortality, and survival rates were compared. RESULTS: Partial response was achieved in 50% of patients who received chemotherapy. There was no chemotherapy-related mortality. The resection, morbidity, and mortality rates and median survival between the surgery-alone group and the chemotherapy group were 71.1% vs. 82%, 51% vs. 55%, and 4% vs. 10.8%, 12.0 vs. 13.5 months, respectively (P >.05). There was also no statistically significant difference between the two regimens. CONCLUSIONS: Preoperative adjuvant chemotherapy with cisplatin and 5-fluorouracil infusion, in pulse or continuous regimens, followed by surgery for squamous esophageal cancer patients had no added benefit in the overall survival.

Adult↗
PubMed2002

Closed retrograde nailing of pathological humeral fractures.

We treated 19 patients with 21 pathological humeral fractures secondary to metastatic disease. All patients were stabilized using retrograde Ender's nails. Open reduction was required in one patient and mean operative time was 40 min (range 30-65 min). All patients retained satisfactory elbow and shoulder function while 16 patients reported good pain relief. Functional recovery was rated as good in 15 patients, fair in three, and poor in one. In our experience the retrograde technique using Ender's nails provides secure stabilization with minimal morbidity, minimal blood loss, and short operative time, and is well suited for this category of patients.

Adult↗
PubMed2002

Unusual muscle pain in two patients with diabetic renal failure.

We report on two patients with diabetic muscle infarct, a painful musculoskeletal disorder complicating longstanding diabetes with established microangiopathy. Both patients had renal failure that was treated by dialysis. The underlying pathophysiological process was considered to be an arterial vascular event mediated through ischaemia-reperfusion injury. Clinicians should be alert to this condition. T2-weighted magnetic resonance imaging was valuable in establishing the diagnosis.

Adult↗
PubMed2002

Pseudoaneurysm complicating osteochondromas: symptom relief with embolization.

Pseudoaneurysm is a recognized vascular complication of osteochondromas. The diagnosis is confirmed by various imaging techniques including ultrasound, magnetic resonance imaging, and conventional angiography. Surgical repair and excision of the adjacent osteochondroma is considered the treatment of choice. The authors report a case of successful transarterial embolization using helical microcoils in the treatment of osteochondroma-related pseudoaneurysm of the superficial femoral artery. It resulted in complete obliteration of blood flow to the pseudoaneurysm and good symptomatic relief before subsequent semielective surgery. No complication was encountered during the procedure. Transarterial embolization is a safe mode of treatment in experienced hands. In patients with contraindications to surgery, embolization may be considered a definitive treatment.

Adolescent↗
PubMed2001

Sonography of the normal scapholunate ligament and scapholunate joint space.

PURPOSE: The aims of this study were to assess the visibility of the normal scapholunate ligament on sonography and to establish the normal scapholunate joint space width in the neutral position and radial and ulnar deviation. METHODS: Two hundred normal wrists in 100 subjects (55 men and 45 women; mean age, 40 years; range, 19-83 years) were examined with high-resolution sonography (5-12-MHz linear-array transducer). The visibility and thickness of the scapholunate ligament were recorded. The width of the scapholunate joint space, or interval, was measured in the neutral position and radial and ulnar deviation. The width of the distal radius was recorded as a comparative standard for the patients' body habitus. RESULTS: The dorsal scapholunate ligament was completely (100%) visible in 95 wrists (48%), partially (> or = 50%) visible in 60 (30%), barely (< 50%) visible in 15 (8%), and not visible in 30 (15%). The volar scapholunate ligament was completely visible in 13 wrists (7%), partially visible in 17 (9%), barely visible in 15 (8%), and not visible in 151 (76%). The proximal component of the ligament was not visible in any subject. Measurement of the scapholunate interval was limited by the lack of identifiable anatomic marks for reference. The mean width of the dorsal scapholunate interval was 4.2 mm (range, 2.3-6.3 mm) in the neutral position. The interval did not differ more than 2.5 mm between the left and right wrists. No predictable change in width on ulnar or radial deviation was evident. The mean scapholunate intervals and mean distal radial width were significantly wider in men than in women and on the right side than on the left side. CONCLUSIONS: The dorsal scapholunate ligament is completely or partially visible in 78% of normal wrists. Its detection following injury may help to exclude the possibility of scapholunate dissociation. There is a quite wide variation in scapholunate interval widths on sonography and an unpredictable response with stress testing. The absence of a visible scapholunate ligament on sonography does not indicate injury.

Adult↗
PubMed2001

Alveolar soft-part sarcoma: a rare soft-tissue malignancy with distinctive clinical and radiological features.

Alveolar soft-part sarcoma (ASPS) is a rare tumour. Certain distinctive clinical and radiological features suggest the correct diagnosis. There is moderate predilection for young women. ASPS almost always arises in skeletal muscle and occurs most frequently in the lower limbs. There is often a long clinical history and a large mass at presentation. Two young females with ASPS presented with very vascular tumours in the thigh, with prominent intra- and extra-tumoural blood vessels. The imaging findings and the existing literature are reviewed.

Adolescent↗
PubMed2001

MR imaging of children's knees.

The spectrum of paediatric knee disorders ranges from developmental and growth disorders, traumatic derangement, inflammation, infection, and diffuse marrow disorder to neoplasm. We present in this pictorial review the MR imaging findings used to characterize these various diseases affecting the knee region of children and adolescents.

Adolescent↗
PubMed2001

Acute elbow trauma in children: spectrum of injury revealed by MR imaging not apparent on radiographs.

OBJECTIVE: The objective of this study is to evaluate the frequency and significance of unrecognized bone or soft-tissue injury in pediatric patients with elbow trauma assessed with radiographs alone. SUBJECTS AND METHODS: Fifty children (32 boys and 18 girls; mean age, 7.3 years; age range, 2-12 years) with acute elbow trauma were examined with radiography and MR imaging. Radiographs were categorized into those showing normal findings, an effusion, an equivocal fracture, or an unequivocal fracture. MR examinations were assessed for an effusion, fracture, transphyseal fracture extension, physeal injury, bone bruising, and ligament or muscle injury. Average clinical follow-up was 1.6 years (range, 6-28 months) after injury. RESULTS: Radiographs showed normal findings in seven children (14%), an effusion only in 17 children (34%), and an unequivocal or equivocal fracture in 26 children (52%). MR imaging showed an effusion in 48 children (96%); unequivocal fracture in 37 children (74%), including transphyseal fracture in seven children (14%) and other physeal injury in three children (6%); bone bruising in 45 children (90%); ligament injury in six children (14%); and muscle injury in 19 children (38%). A less severe spectrum of injury occurred in children with normal findings on radiographs than in those with an effusion or fracture seen on radiography. Follow-up radiographs did not help in the detection of radiographically occult fractures. MR findings had no appreciable effect on patient treatment and no value in predicting duration of convalescence or clinical outcome at an average of 1.6 years after injury. CONCLUSION: In children with elbow trauma, MR imaging reveals a broad spectrum of bone and soft-tissue injury beyond that recognizable radiographically. However, the additional information afforded by MR imaging has little bearing on treatment or clinical outcome.

Acute Disease↗