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Biomedical subjects

J Hodler

Publications and source records attributed to J Hodler.

At least 19 recordsLinked to original sources
PubMed1992

Bone excrescence at the medial base of the distal phalanx of the first toe: normal variant, reactive change, or neoplasia?

In a review of 157 anteroposterior (AP) foot radiographs in 117 adult and pediatric patients, we observed a medial excrescence on the plantar aspect of the terminal phalanx of the hallux in 88.5% of the feet. Histologic analysis documented the presence of reactive bone. The bony outgrowth appears after closure of the adjacent physeal plate and is rarely symptomatic. Its high prevalence indirectly implies that it is not specific to any particular type of foot. Although certain types of foot may contribute to its development, we believe that repetitive forces occurring during ambulation induce this reactive bone formation.

Adipose Tissue↗
PubMed1992

Chronic wrist pain: spin-echo and short tau inversion recovery MR imaging and conventional and MR arthrography.

The accuracy of T1-, proton-density-, and T2-weighted magnetic resonance (MR) imaging sequences and gadolinium-enhanced MR arthrography in evaluation of the triangular fibro-cartilage complex (TFCC) and the scapholunate (SL) and lunotriquetral (LT) ligaments was studied in 15 patients with chronic wrist pain. Arthrography and arthroscopy were used as standards of reference. Twelve patients also underwent imaging with short tau inversion recovery (STIR) sequences. MR imaging was more reliable in evaluation of the morphology of the TFCC and SL ligament than in that of the LT ligament. With arthrography as the standard, sensitivity was 0.721, specificity was 0.947, and accuracy was 0.887 for the TFCC; these values were 0.500, 0.864, and 0.765 for the SL ligament and 0.519, 0.455, and 0.490 for the LT ligament. No visualization of the SL ligament indicated a tear, but this sign was not helpful in evaluation of the LT ligament. Fluid in the distal radioulnar joint had a high association with TFCC tears. Accuracy with MR arthrography was higher than with the other sequences. STIR images were effective in evaluation of the TFCC. The combination of proton-density-and T2-weighted images appears to be useful because morphologic characteristics and the presence of fluid can be evaluated.

Arthrography↗
PubMed1992

Rotator cuff disease: assessment with MR arthrography versus standard MR imaging in 36 patients with arthroscopic confirmation.

Standard proton-density- and T2-weighted magnetic resonance (MR) imaging and MR arthrography were used to depict rotator cuff disease in 36 shoulders in 36 patients; the findings were compared with arthroscopic findings in every patient. In 19 rotator cuffs normal at arthroscopy, MR arthrography revealed no tear in 16 patients, a partial tear in one patient, and a full-thickness tear in two patients. Standard proton-density- and T2-weighted images were normal in 15 of these patients and revealed a partial tear in two patients and a full-thickness tear in two patients. In 13 partial tears found at arthroscopy, MR arthrography showed a partial tear in six patients, no tear in five patients, and a full-thickness tear in two patients; standard MR imaging revealed a partial tear in one patient, no tear in 10 patients, and a full-thickness tear in two patients. All four full-thickness tears proved with arthroscopy were correctly diagnosed with both MR imaging methods. The main advantage of MR arthrography was better depiction of partial tears in the articular surface.

Adolescent↗
PubMed1992

Meniscal changes in the elderly: correlation of MR imaging and histologic findings.

In elderly patients, degenerative changes of the meniscus are common and may mimic a tear. The magnetic resonance (MR) image findings of 179 meniscal sections in 20 cadaver knees were correlated with the histologic and gross pathologic findings. The sensitivity of standard T1-weighted spin-echo images and their corresponding meniscal windows in depicting meniscal tears was 80.6%, specificity was 72.4%, and accuracy was 76.7%. These results are not as good as results reported previously. A major difficulty is the occurrence of grade 3 meniscal signal intensity and diffuse intrameniscal signal intensity in torn and intact menisci. MR imaging in elderly patients, however, is still useful in the diagnosis of meniscal abnormalities. Normal low signal intensity depicted within a meniscus at MR imaging and changes in grades 1 and 2 intrameniscal signal intensity are reliable signs of an intact meniscal surface. Grade 3 and diffuse meniscal signal intensities do not allow a specific diagnosis; menisci with these characteristics should be described as degenerated with a high probability of a tear.

Age Factors↗
PubMed1992

Craniovertebral junction: normal anatomy with MR correlation.

The anatomy of the craniovertebral junction, although complex, may be well visualized by routine MR imaging. This essay discusses the anatomy of the complex articulations of the craniovertebral junction. Representative MR images and gross anatomic photographs are presented to illustrate the intricate ligamentous and articular anatomy. Knowledge of the normal anatomy of the occipitoatlantoaxial region is necessary in order to understand the common disorders that affect this area. The most common disorders are trauma and arthropathies, but also include congenital abnormalities and neoplasm. The resultant abnormal mechanics may lead to neurologic sequelae or pain.

Atlanto-Axial Joint↗
PubMed1992

Width of the articular cartilage of the hip: quantification by using fat-suppression spin-echo MR imaging in cadavers.

OBJECTIVE: Use of MR imaging to measure the width of the articular cartilage has not been thoroughly investigated. The value of a selective fat-suppression spin-echo sequence in the quantitative assessment of articular cartilage of the hip was studied in cadavers. MATERIALS AND METHODS: Sagittal and coronal images were acquired in 10 cadaveric hips (age range at time of death, 62-81 years). On the coronal and sagittal MR images that were closest to the center of the femoral head, marks were placed every 30 degrees, with the midpoint of the femoral head used as a reference. Cartilage thickness was measured in 123 resulting locations. Sixty-three positions included both femoral and acetabular cartilages, and 60 positions included femoral cartilage without an acetabular counterpart. The findings were compared with corresponding anatomic sections. RESULTS: For the 60 locations containing only femoral cartilage, significant correlation between MR and anatomic sections was found (Pearson correlation coefficient = .34, p = .0089). Of the 63 locations containing both femoral and acetabular cartilages, the two cartilage layers could be differentiated on the MR images in 50 locations. In these 50, the MR and anatomic measurements of the femoral cartilage correlated significant (r = .58, p less than or equal to .0001). Measurements of the acetabular cartilage in these 50 locations yielded no significant correlation (r = .25, p = .08). When the entire cartilage (femoral plus acetabular) was measured in all 63 locations, the correlation between MR and anatomic measurements was .29 (p = .02). The correlation coefficients obtained in this investigation indicate considerable scattering of the data. CONCLUSION: Our results show that measurements of articular cartilage thickness of the hip on fat-suppression spin-echo MR images are not sufficiently accurate to be of clinical value.

Aged↗
PubMed1992

The cruciate ligaments of the knee: correlation between MR appearance and gross and histologic findings in cadaveric specimens.

OBJECTIVE: Using anatomic and histologic correlation, we investigated the reasons for differences in the MR signal intensity between the normal anterior and posterior cruciate ligaments and for the focally increased signal intensity within these ligaments occasionally found in elderly patients. MATERIALS AND METHODS: The MR images of 18 anterior and 20 posterior cruciate ligaments obtained from cadavers (age at death, 56-88 years old; mean, 74 years) were evaluated blindly. Their overall signal intensity and focal regions of increased signal were noted. The findings then were correlated with corresponding anatomic and histologic sections. RESULTS: The anterior cruciate ligament had greater signal intensity than did the posterior cruciate ligament in 15 of 18 knees and had comparable signal intensity in three knees. No histologic basis to explain the different MR appearances of the anterior and posterior cruciate ligaments was found. Rather, differences in macroscopic anatomy appeared to be the best explanation. In the posterior cruciate ligament, the fibers were parallel, whereas they were diverging and twisted in the anterior cruciate ligament, causing volume-averaging artifacts. A focal area of signal increase was found in 29 of the 38 ligaments. In 17 of these 29 ligaments, mucoid and/or eosinophilic degeneration was found that appeared to have caused the focal MR signal change. In nine ligaments without focally increased signal on the MR images, only one had histologic evidence of degeneration. The predictive value of an abnormal finding on MR was 59%, and the predictive value of a normal finding on MR was 89%. The relationship between increased signal on MR and histologic degeneration was statistically significant (chi 2 test, p = .0126). CONCLUSION: The differences in the MR appearances of the anterior and posterior cruciate ligaments probably are due to differences in gross architecture. Increased MR signal within the cruciate ligaments occurring in elderly patients often can be attributed to degenerative changes.

Aged↗
PubMed1992

Injuries of the superior portion of the glenoid labrum involving the insertion of the biceps tendon: MR imaging findings in nine cases.

The goal of this investigation was to describe the MR appearance of traumatic fraying or detachment of the superior portion of the glenoid labrum including the insertion of the tendon of the long head of the biceps. This condition is caused either by an acute injury or by repeated overhead motion during participation in sports. In nine patients with such a lesion, the arthroscopic report and MR images were available for review. These patients were 22-64 years old (mean, 38). In four patients only fraying was noted during arthroscopy, in four patients the superior part of the labrum was detached together with the insertion of the biceps tendon, and in one case there was a bucket-handle tear of the superior portion of the labrum. The MR images were retrospectively evaluated by three osteoradiologists in conference. Signal changes within the labrum and detachment of the labrum were noted, and the findings were compared with the results of arthroscopy. MR imaging did not allow recognition of simple fraying. In two of the five cases with arthroscopic findings of detachment of the superior labrum from the glenoid rim, differentiation between complete and partial labral detachments was not possible even with MR arthrography. However, in these cases the patient's age and history led to the correct diagnosis. We conclude that early traumatic abnormalities of the superior portion of the labrum cannot be detected with MR imaging. Complete detachment, however, can be demonstrated if the patient's age and history are taken into consideration.

Adult↗
PubMed1979

[Acute combined alpha- and beta-adrenergic blockade in essential hypertension: effects on blood pressure, renal function, renin, and aldosterone].

In seven patients with uncomplicated essential hypertension the effects of an acute alpha-adrenergic blockade, alone and combined with a chronic beta-adrenergic blockade, on blood pressure, renal function as measured by standard clearance methods, plasma renin activity, and plasma aldosterone were evaluated. Acute alpha-adrenergic blockade with phentolamine (20 mg by intravenous infusion) significantly enhanced the antihypertensive effect of chronic beta-adrenergic blockade with slow-oxprenolol (160 mg/ day X 14 days) (- 14.5% verus - 7.4% for pulse pressure, - 12.4% versus - 6.0% for diastolic pressure, 2 alpha less than 0.05). Under combined adrenergic blockade renal plasma flow increased, glomerular filtration rate and filtration fraction decreased (2 alpha less than 0.05 each), whereas the fractional clearances of sodium, potassium, free water, and solute load remained unchanged. The activation of the renin-angiotensin-axis, elicited by alpha-adrenergic blockade alone, was suppressed by the preceding beta-adrenergic blockade. These findings demonstrate a favourable antihypertensive action of a combined blockade of alpha- und beta-adrenergic receptor sites without untoward side effects on renal function or the renin-angiotensin-axis.

Adult↗
PubMed1979

Selectivity as a clue to diagnosis of postural proteinuria.

In 14 patients with fixed and reproducible postural proteinuria and 14 patients with histologically proven glomerulonephritis, the selectivity of proteinuria was measured separately in the day and night urine collections. The selectivity of proteinuria in the urine collected in recumbency was lower in patients with glomerulonephritis than in patients with postural proteinuria. All patients with postural proteinuria showed an increment of the selectivity from day to night of at least 13 degrees, whereas the maximum increment in patients with glomerulonephritis was 5 degrees. The changes in selectivity from day to night in patients with postural proteinuria and patients with glomerulonephritis were significantly different and seem to be a useful discriminatory test.

Adolescent↗
PubMed1978

[Certain and disputed indications of immunosuppressive therapy in kidney diseases].

The effect of immunosuppressive agents in different glomerulopathies is reviewed and some guidelines for their use in clinical practice are proposed. The immunological aspects of pyelonephritis and interstitial nephritis are studied to evaluate future possibilities of either therapeutic immunosuppression or immunization in these diseases.

Glomerulonephritis↗