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Biomedical subjects

J J Kaye

Publications and source records attributed to J J Kaye.

At least 19 recordsLinked to original sources
PubMed1991

Imaging of disorders of the spine.

Although many papers were published during the past year on disorders of the spine, in this review, papers were chosen and grouped under five broad headings: 1) spinal trauma, 2) disk disease, 3) neoplastic disease, 4) spinal arthritis, and 5) other studies of interest. Although some of the articles chosen for review dealt with conventional radiography, the majority were on applications of CT and MR imaging to conditions affecting the spine.

Diagnostic Imaging↗
PubMed1991

Radiographic methods of assessment (scoring) of rheumatic disease.

The major features of various global and detailed methods of assessment (scoring) of the hands and wrists of patients with rheumatoid arthritis are reviewed. Relative advantages and disadvantages of the methods are presented. Detailed radiographic scores relate best to other measures of patient status. Although scoring is not a difficult skill, the work is tiring, tedious, and time-consuming. Quantitative methods have done much to further our understanding of rheumatoid arthritis; they hold the promise of further discoveries.

Finger Joint↗
PubMed1990

Problems with the Steinbrocker staging system for radiographic assessment of the rheumatoid hand and wrist.

Hand and wrist radiographs of 202 patients with rheumatoid arthritis were graded with the classical Steinbrocker Staging System, and were also assigned quantitative scores for joint space narrowing, erosion, and malalignment according to a detailed scoring method. Steinbrocker Stage scores were correlated significantly with total detailed scores (r = 0.60 to 0.66, P less than 0.001). However, the ranges of detailed total and subtotal scores among the various Steinbrocker Stage scores were broad, with considerable overlap. Practical problems in applying the Steinbrocker staging method were identified in 26.5% of the hands graded with the Steinbrocker method. Additionally, analysis of scoring data showed discrepancies between the scoring methods in 25.2% of the hands examined; one-half of these discrepancies were felt to result from the global or overall approach of the Steinbrocker method in contrast to individual joint analysis. Asymmetry in assigned stages between right and left hands was found in 15.8% of patients. The detailed scoring method, although more time-consuming, appears superior to the Steinbrocker Stage for quantitative assessment of patient radiographic status in rheumatoid arthritis.

Arthritis, Rheumatoid↗
PubMed1990

Arthritis: roles of radiography and other imaging techniques in evaluation.

Imaging studies are performed on patients with arthritis for a variety of reasons: to determine whether an arthritic condition is present; to establish the specific diagnosis; to determine the extent of disease; to assess the activity of disease; to detect complications of disease; to evaluate progression of disease; to judge the efficacy of drug treatment; to help in selection of surgical candidates; to aid in the choice of surgical procedures; to size, design, or fabricate prostheses; and to identify complications of surgery. Conventional radiography is still the mainstay of all examinations in arthritic patients. Arthrography is best applied to evaluate complications of disease and of surgery, although it may be useful in disease detection and in determining the specific diagnosis. Nuclear medicine studies are best used to identify complications of surgery and may also be useful to assess disease activity or extent. Ultrasound is useful to detect dissecting synovial cysts and deep venous thrombosis. The most valuable role of computed tomography is in the design and fabrication of prostheses and in evaluating complex anatomy of involved joints. Magnetic resonance imaging may be useful in early detection of articular cartilage damage and may assist in determination of the specific diagnosis; enhancement with contrast material may aid in assessment of disease activity.

Arthritis↗
PubMed1990

Cervical spine trauma.

The conventional radiographic examination remains as the single best initial study in patients with potential cervical spine injury. Computed tomography is the best, most readily available second study. Specific cervical spine injuries are presented as they follow a classification based on mechanism of injury.

Cervical Vertebrae↗
PubMed1990

Thoracic and lumbar spine trauma.

The frequency and distribution of fractures of the thoracic and lumbar spine are reviewed. Classifications of thoracolumbar spine injuries are considered. Compression or wedge fractures, burst fractures, lap seat-belt-type injuries, and fracture-dislocations are considered with discussion of findings on conventional radiography and computed tomography. The concepts of stability and instability are briefly discussed and the relative advantages of computed tomographic imaging are reviewed.

Fractures, Bone↗
PubMed1989

Self-report questionnaire scores in rheumatoid arthritis compared with traditional physical, radiographic, and laboratory measures.

STUDY OBJECTIVE: To assess whether scores on a simple self-report questionnaire to depict the clinical status of patients with rheumatoid arthritis are correlated with traditional measures of physical, radiographic, laboratory, functional, and global status. DESIGN: The self-report questionnaire was administered at the same time the following variables were assessed: American Rheumatism Association functional class, joint count, hand radiograph, erythrocyte sedimentation rate, rheumatoid factor titer, walking time, grip strength, button test, and global self-assessment. SETTING: University rheumatology clinic, the rheumatology clinic of a Veterans Administration hospital, and a private rheumatology practice. PATIENTS: The study included 259 patients who met the criteria of the American Rheumatism Association for a diagnosis of definite or classic rheumatoid arthritis. INTERVENTIONS: Standard rheumatologic care for patients with rheumatoid arthritis. MEASUREMENTS AND MAIN RESULTS: Self-report questionnaire scores were significantly correlated with the joint count, radiographic score, erythrocyte sedimentation rate, grip strength, button test, walking time, American Rheumatism Association functional class, and global self-assessment. Patients were categorized into five questionnaire score categories of 1.00, indicating no dysfunction, and 1.01 to 1.50, 1.51 to 2.00, 2.01 to 3.00, and 3.01 to 4.00, indicating progressive dysfunction. In these five categories, more than ten involved joints were seen in 11%, 37%, 67%, 79%, and 100% of patients, respectively, and erythrocyte sedimentation rates greater than 20 mm/h in 29%, 49%, 64%, 74%, and 85% of patients, respectively. Similar results were seen for other physical and radiographic measures. The questionnaire score was as effective in explaining other measures of clinical status as was any other available measure. CONCLUSIONS: A simple self-report questionnaire provides information similar to many traditional measures in rheumatoid arthritis and appears to be an attractive, cost-effective approach to assessing and monitoring quantitatively the status of an individual patient.

Activities of Daily Living↗
PubMed1989

Evidence of significant radiographic damage in rheumatoid arthritis within the first 2 years of disease.

Quantitative radiographic scores for joint space narrowing erosion, and malalignment in the hands and wrists of 200 patients with rheumatoid arthritis (RA) were significantly correlated with duration of disease. Nonetheless, most of the 42 patients who reported disease for less than 2 years had evidence of radiographic damage, including 35 with joint space narrowing, 28 with erosions but only one with malalignment. Significant radiographic damage in the absence of malalignment may be seen in many patients within the first 2 years after presentation of RA.

Age Factors↗
PubMed1988

Radiographic and joint count findings of the hand in rheumatoid arthritis. Related and unrelated findings.

Radiographic and physical joint count findings of the hands and wrists of 148 patients with rheumatoid arthritis (RA) were analyzed in a cross-sectional study. Quantitative radiographic scores for joint space narrowing, erosion, and malalignment were correlated highly with joint count scores for limitation of motion and deformity, and were correlated at considerably lower levels with joint swelling scores. Radiographic scores, however, were not correlated at all with joint count tenderness scores. That 2 of the most widely used indices of RA disease activity, radiographic erosion scores and joint count scores for tenderness, were independent of one another at a selected timepoint, should be considered in the design of clinical trials and long-term observation of patients with RA.

Arthritis, Rheumatoid↗
PubMed1988

Associations of HLA-DR4 with rheumatoid factor and radiographic severity in rheumatoid arthritis.

Possible associations between HLA-DR4 and laboratory, radiographic, joint count, functional, and demographic measures of clinical status were analyzed in 154 white patients with rheumatoid arthritis. Overall, 65 percent of the patients were HLA-DR4 positive, similar to other series. HLA-DR4 was associated significantly with the presence of rheumatoid factor and more severe radiographic changes. HLA-DR4 was not associated with significant differences in demographic, joint count, or functional measures of clinical status. HLA-DR1 was not associated significantly with differences in the presence of rheumatoid factor, radiographic changes, or other measures of clinical status. Selective associations of HLA-DR4 with rheumatoid factor and radiographic scores were more marked in men than in women. Patients who were putatively homozygous for HLA-DR4 were all seropositive and had more severe radiographic changes than patients who were heterozygous for HLA-DR4.

Activities of Daily Living↗
PubMed1988

Insufficiency fractures of the femoral neck in association with chronic renal failure.

The femoral neck is a relatively uncommon location for stress fractures. As with other stress fractures, those occurring in the femoral neck can be divided into fatigue and insufficiency fractures. Chronic renal failure (CRF) is an underlying condition that can predispose patients to insufficiency fractures of the femoral neck. We report 12 such fractures occurring in eight patients with CRF; half had bilateral fractures. In addition, 50% of the fractures were of the tensile (transverse) type, which may progress to complete fracture.

Adult↗
PubMed1988

Primary extraosseous osteogenic sarcoma of the mediastinum: clinical, pathologic, and radiologic correlation.

We have presented a rare case of primary involvement of the anterior mediastinum by osteogenic sarcoma in which CT was useful in demonstrating calcium within the mass, and in distinguishing the mass from surrounding bony structures. Although rare, extraosseous osteogenic sarcoma should be included in the differential diagnosis of a calcified anterior mediastinal mass.

Diagnosis, Differential↗
PubMed1988

Detection of occult infection following total joint arthroplasty using sequential technetium-99m HDP bone scintigraphy and indium-111 WBC imaging.

Preoperative exclusion or confirmation of periprosthetic infection is essential for correct surgical management of patients with suspected infected joint prostheses. The sensitivity and specificity of [111In]WBC imaging in the diagnosis of infected total joint prostheses was examined in 28 patients and compared with sequential [99mTc]HDP/[111In]WBC scintigraphy and aspiration arthrography. The sensitivity of preoperative aspiration cultures was 12%, with a specificity of 81% and an accuracy of 58%. The sensitivity of [111In]WBC imaging alone was 100%, with a specificity of 50% and an accuracy of 65%. When correlated with the bone scintigraphy and read as sequential [99mTc]HDP/[111In]WBC imaging, the sensitivity was 88%, specificity 95%, and accuracy 93%. This study demonstrates that [111In]WBC imaging is an extremely sensitive imaging modality for the detection of occult infection of joint prostheses. It also demonstrates the necessity of correlating [111In]WBC images with [99mTc]HDP skeletal scintigraphy in the detection of occult periprosthetic infection.

Adult↗
PubMed1987

Pain in the athlete's knee.

When the athlete develops knee pain, conventional radiographs are often helpful to establish the correct diagnosis. Knee arthrography may provide additional information when conventional radiography shows no specific abnormality. A number of causes of knee pain in the athlete are illustrated.

Athletic Injuries↗