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Biomedical subjects

J Malghem

Publications and source records attributed to J Malghem.

At least 73 records · Page 4Linked to original sources
PubMed1996

Radiographic skeletal survey and radionuclide bone scan in Langerhans cell histiocytosis of bone.

BACKGROUND: The lack of a consensus in the literature on the imaging strategy in Langerhans cell histiocytosis (LCH) bone lesions in childhood. OBJECTIVE: To evaluate the relative value of radionuclide bone scan (RBS) and radiographic skeletal survey (RSS) in the detection of LCH bone lesions, both in the initial work-up of the disease and during the follow-up period. MATERIALS AND METHODS: Ten children with bone lesions evaluated by means of RSS and RBS in a retrospective study (1984-1993). RESULTS: Fifty radiologically and/or scintigraphically abnormal foci were detected: 27 anomalies in the initial work-up (12 by both RSS and RBS, 8 by RSS only and 7 by RBS only) and 23 additional anomalies during follow-up (10 by both RSS and RBS, 10 by RSS only and 3 by RBS only). RSS+/RBS- lesions (n = 18) are more frequently encountered in the skull (P = 0.038), and more frequently lack radiologic signs of osteoblastic activity (P = 0.020), than RSS+/RBS+ lesions (n = 22). RSS-/ RBS+ abnormalities (n = 10) were most frequently insignificant. CONCLUSION: In the initial work-up both RSS and RBS should be carried out, while in the follow-up only RSS should be performed.

Adolescent↗
PubMed1996

Antacid-induced osteomalacia.

The case of a 49-year-old woman suffering from generalized skeletal pain and multiple fractures accompanied by severe hypophosphataemia and low urinary phosphorus excretion is reported. She had been taking large amounts of antacids containing aluminum hydroxide for many years. A diagnosis of antacid-induced osteomalacia was made. It was confirmed by biological work-up, radiographs and bone biopsy. A dramatic biological, osteodensitometric, and clinical improvement was achieved by withdrawal of antacids and phosphorus administration. The literature concerning this unusual condition has been reviewed.

Adult↗
PubMed1996

Stage I multiple myeloma: value of MR imaging of the bone marrow in the determination of prognosis.

PURPOSE: To determine the prognostic value of bone marrow findings at magnetic resonance (MR) imaging in patients with stage I multiple myeloma. MATERIALS AND METHODS: In 24 patients with stage I multiple myeloma, findings from MR imaging of the vertebral, pelvic, and femoral bone marrow were analyzed and correlated to spontaneous outcome. Progressive multiple myeloma was observed in 12 patients and stable stage I multiple myeloma was observed in 12 after a follow-up period of 4-67 months (median, 27 months). RESULTS: In 17 patients, MR imaging findings were normal, and in seven patients, bone marrow abnormalities were depicted on MR images. Of the 12 patients with progressive multiple myeloma, six had bone marrow abnormalities that were depicted at MR imaging. In the group of patients with progressive multiple myeloma, the six patients with abnormal MR imaging findings showed earlier disease progression (median, 10 months) than the six patients in whom MR imaging findings were normal (median, 32 months) (P < .0001). Multivariate analysis of clinical and MR imaging findings showed that MR imaging (P = .006) were two independent factors in the prediction of disease progression. CONCLUSION: MR imaging of the bone marrow in patients with stage I multiple myeloma is an independent factor in the prediction of disease progression.

Bone Marrow↗
PubMed1996

Sequential quantitative MR analysis of bone marrow: differences during treatment of lymphoid versus myeloid leukemia.

PURPOSE: To assess the use of bulk T1 measurements with magnetic resonance (MR) imaging for monitoring treatment response in leukemic patients, with separate analysis of patients with acute lymphoid (ALL) and those with acute myeloid leukemia (AML). MATERIALS AND METHODS: Bulk T1 values were determined repeatedly during the first 4 weeks of treatment in 16 patients with ALL (age range, 16-72 years) and the first 6 weeks of treatment in 51 patients with AML (age range, 17-75 years). Bulk T1 values were compared in all patients with AML or ALL and in those who did or did not respond to treatment. RESULTS: MR imaging of lumbar bone marrow demonstrated statistically significant differences in initial bulk T1 values and in changes in bulk T1 values during treatment between patients with ALL and those with AML. Changes in bulk T1 after the 2nd week of treatment were statistically significantly different between patients with and those without a response who had ALL but not in those with AML. CONCLUSION: Sequential quantitative MR imaging during treatment appears valuable for prediction of response in patients with ALL but not in those with AML. Further investigations are needed to determine what influence MR imaging can have on patient care, but patients with ALL should be analyzed separately from those with AML.

Acute Disease↗
PubMed1996

Distribution of serouslike bone marrow changes in the lower limbs of patients with anorexia nervosa: predominant involvement of the distal extremities.

OBJECTIVE: To assess the distribution of marrow changes in the bones of the lower limbs of patients with anorexia nervosa (AN) and to correlate the importance of the extent of marrow changes with clinical and hematologic data. MATERIALS AND METHODS: The frequency of serouslike marrow (low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images) was determined with MR imaging in the bones of the feet, distal tibias, and proximal femurs in 19 patients with AN. RESULTS: Serouslike marrow was found with an increasing frequency from proximal to distal in the lower-limb bones (femur, 31%; distal phalanx of the first toe, 79%). The patients with abnormal femoral marrow (n = 6) were more severely emaciated and had lower leukocyte and neutrophil counts than the patients with normal femoral marrow (n = 13). Among these patients, the six patients with at least two involved bones in the feet had lower blood cell counts than the seven patients with fewer than two involved bones. CONCLUSION: In the lower limbs of patients with AN, marrow changes predominate in the distal aspects. This distribution pattern is the reverse of that seen in most bone marrow disorders but is similar to the normal conversion of hematopoietic to fatty marrow. The importance of the blood cell count changes is correlated with the extent of marrow changes in the limbs.

Adolescent↗
PubMed1996

MR imaging of the acetabular labrum: variations in 200 asymptomatic hips.

OBJECTIVE: The purpose of this study was to describe the MR appearance of the acetabular labrum in asymptomatic subjects and correlate the MR appearance with age and sex. MATERIALS AND METHODS: We evaluated high-resolution T1-weighted spin-echo coronal MR images of one hip in each of 200 asymptomatic individuals (84 men, 116 women; mean age, 44 years old; range, 15-82 years old). The labral shapes (triangular, round, flat, or absent), the intralabral signal intensity changes, and the possible extension of the intralabral signal intensity changes to the labral surface were assessed on two sections for each subject and correlated with age and sex. RESULTS: Triangle was the dominant shape seen on MR imaging (66%). However, its frequency decreased significantly with age. Absence of labrum was the second most frequent pattern (14%) and increased significantly with age. Round and flat labra were found in 11% and 9% of subjects, respectively, with no significant age correlation. The frequency of homogeneous labra with low signal intensity decreased with age. Intralabral areas of high signal intensity communicating with the free surface increased with age. CONCLUSION: The large variability of the MR appearance of the labrum in asymptomatic hips must be considered when interpreting MR examinations of patients in whom labral lesions are suspected.

Acetabulum↗
PubMed1996

Gout in the cervical spine: MR pattern mimicking diskovertebral infection.

We report the MR features of a surgically proved cervical spine involved with gouty tophi in a patient with a long history of hyperuricemia. Tophi appeared as sharply delineated areas of low signal intensity on T1 and T2 MR images and showed intense and homogeneous signal enhancement on post-contrast images.

Arthritis, Gouty↗
PubMed1995

Acute myeloid leukemia: lack of predictive value of sequential quantitative MR imaging during treatment.

PURPOSE: To assess the use of magnetic resonance (MR) imaging in monitoring treatment response in patients with acute myeloid leukemia (AML). MATERIALS AND METHODS: Bulk T1 and T2 were determined with at least four MR imaging examinations (strictly timed) during the first 6 weeks of treatment in 29 patients with AML (age range, 16-75 years; 15 female, and 14 male). Bulk T1 and T2 in responder (n = 22) and nonresponder (n = 7) patients were compared. RESULTS: Relative to pretreatment bulk T1 values, bulk T1 had increased a mean of 11% at week 1 and had decreased a mean of 7% and 39% at weeks 2 and 6, respectively. Values in nonresponder patients were not statistically significantly different (+11%, -14%, -38%). CONCLUSION: MR imaging of lumbar bone marrow in patients with AML demonstrated statistically significant changes in bulk T1 during treatment that correlated with changes in cellularity. However, neither the early increase in bulk T1 nor the rate or magnitude of the subsequent decrease in bulk T1 were indicative of a positive response to treatment.

Adolescent↗
PubMed1995

[Involvement of the shoulder in rheumatoid arthritis].

The course of rheumatoid arthritis (R.A.) in the shoulder is evaluated in 100 patients in a retrospective study and in 73 patients in a prospective study. The involvement of the shoulder may occur at an early stage of the disease. However, usually it causes a significant handicap at a later stage. The retrospective study shows that 62% of the patients hospitalized between 1976 and 1992 for R.A. complained of pain, reduction in range of motion and functional disability of one or both shoulders. However, these historic cases cannot be used for a radiological study because the shoulders have been radiographed in 17% of cases only, probably because of the poor possibilities of surgical therapies available at this time. The survey of 72 patients received at the out- patient clinic between september 1992 and december 1993 who had a radiograph of the shoulder is the basis for the description of the progress of the disease. The erosions appear at the border of the cartilage where the synovium is attached and refers mainly to the cephalic articular cartilage. Narrowing of the subacromial space is often present with early appearance of subluxation in the cranial direction. The destruction often prevails in the area of humeral head but cases with predominant global joint space narrowing or with destruction of glenoid labrum and fossa exist as well. Secondary osteoarthritis was often observed. The involvement of the shoulders is not always symmetric. Unilateral involvement has been observed. The different evolutive processes will be illustrated and their frequency evaluated. The forms with predominant cephalic destruction constitute the best indications for total shoulder arthroplasty.

Acromioclavicular Joint↗
PubMed1994

Transient epiphyseal lesions in renal transplant recipients: presumed insufficiency stress fractures.

PURPOSE: To determine epiphyseal abnormalities in renal transplant recipients. MATERIALS AND METHODS: Initial and final findings on serial conventional radiographs and magnetic resonance (MR) images obtained in symptomatic joints of transplant recipients were determined and correlated. RESULTS: In 42 of 47 joints, T1-weighted MR images depicted 106 ill-delimited areas of low signal intensity. At 1-year follow-up, all lesions had disappeared. T1-weighted MR images depicted nine well-delimited regions of normal signal intensity delineated by a rim of low signal intensity in seven joints. No lesion had completely disappeared at follow-up. Initial radiographs either were normal or showed patchy osteoporosis (13 joints). Follow-up radiographs showed epiphyseal collapse of two femoral heads, with well-delimited lesions on MR images, and subtle subchondral sclerosis in 21 noncollapsed epiphyses. CONCLUSION: Initial MR imaging patterns of transient lesions (92% of lesions) are different from those of irreversible lesions. Transient lesions suggest insufficiency stress fractures, while irreversible lesions suggest avascular osteonecrosis.

Adult↗
PubMed1994

Anorexia nervosa: correlation between MR appearance of bone marrow and severity of disease.

PURPOSE: To identify bone marrow abnormalities on magnetic resonance (MR) images of patients with anorexia nervosa (AN) and to correlate the findings with body mass index (BMI) and blood cell count. MATERIALS AND METHODS: The signal intensity patterns in the lumbar, pelvic, and femoral marrow spaces were evaluated on MR images obtained in 14 patients with AN and 14 control subjects. RESULTS: Six patients with AN had a waterlike signal intensity pattern either throughout the three marrow spaces (five patients) or only in the marrow cavity of the proximal femur (one patient). Results of biopsy performed in one of the six patients showed that the marrow had findings typical of serous atrophy. The BMI values and blood cell counts in the six patients were lower than those of the eight other patients with AN and the 14 control subjects. CONCLUSION: Bone marrow has an unusual signal intensity and distribution at MR imaging in patients with AN who have a low BMI value and biologic signs of bone marrow dysfunction.

Adult↗
PubMed1994

Occurrence of a painful stress fracture of the femoral neck simultaneously with six other asymptomatic localizations in a runner.

The authors report the case of 38-year-old man who suffered severe right groin pain after an unusually long run. Total body bone scan disclosed several hot spots in the lower limbs corresponding radiographically to stress fractures. Biological work-up did not reveal any significant abnormality. Hip, lumbar and forearm bone mineral densities were low compared to age- and sex-matched controls (Z-score ranging from -2 to -2.5). The occurrence of multiple stress fractures in a jogger has been favored by low bone mass and by excessive exercise. This case underlines that a lot of stress fractures can remain asymptomatic even when readily visible on plain radiographs.

Adult↗