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Biomedical subjects

L A Gilula

Publications and source records attributed to L A Gilula.

At least 217 records · Page 12Linked to original sources
PubMed1984

Carpometacarpal dislocations.

Dislocations at the carpometacarpal joints are uncommon and can be overlooked due to the subtle nature of the radiographic findings. The diagnosis requires a proper understanding of the normal radiographic anatomy of the carpometacarpal joints. To aid in our understanding of the injury, anatomic dissections of the hand were performed. From these, we drew several conclusions about the mechanism of injury. Diagnostic criteria were then developed and applied in the review of a series of CMC dislocations. The incidence and diagnostic characteristics are presented. A systematic approach emphasizing the posteroanterior view and utilization of the parallel "M", principles of parallelism, symmetry, overlapping articular surfaces, and a distinct cortical rim are presented.

Adolescent↗
PubMed1983

Primary Ewing's sarcoma of the ribs. A report from the intergroup Ewing's sarcoma study.

Thirty-six patients with primary Ewing's sarcoma of the ribs have been reviewed. Of these, 21 had clinically localized disease at diagnosis and were entered on protocol IESS 7299, eight had regional and seven metastatic disease at diagnosis and were entered on protocol 7450. The 21 with localized disease were treated with surgical excision or biopsy, followed by local radiotherapy (in all but one patient) and randomization to one of three chemotherapy regimens. Eleven patients (52%) remain disease-free for periods ranging from 18 to 64 months, respectively. Seven of eight patients who underwent complete surgical excision of the primary lesion remain disease-free, compared with four of 12 (excluding one patient who died disease-free) who remain disease-free after partial excision or biopsy. However, analysis of size of tumor at diagnosis reveals that smaller primary tumors have a better prognosis irrespective of extent of surgery. Protocol IESS 7450, consisted of radiotherapy to all areas of known disease and four drug chemotherapy. Four (50%) with regional disease but none with metastatic disease have remained alive and continuously disease-free. It is concluded that an aggressive approach to Ewing's sarcoma of the ribs is justified by the results, as even regional disease may be curable. The apparent prognostic advantage for those patients undergoing surgical excision may be explained by patient selection.

Adolescent↗
PubMed1983

Wrist arthrography. The value of fluoroscopic spot viewing.

Wrist arthrography is a valuable procedure for the identification of scapholunate or lunotriquetral ligament tears. The addition of sequential filming during the injection of contrast material permits the arthrographer to determine accurately the specific ligament which is ruptured.

Contrast Media↗
PubMed1983

Post-traumatic palmar carpal subluxation. Report of two cases.

Traumatic carpal instability can be difficult to detect and may present complicated management problems. Post-traumatic palmar carpal subluxation has been previously described only as a theoretical ligament instability. Such a condition implies disruption of the normal ligament attachments either within or around the carpus, or both, which very often results in altered intercarpal relationships and in disturbed kinematics. Post-traumatic palmar carpal subluxation is a form of carpal ligament instability that we could not find in any previous reports. We are reporting the cases of two patients who were followed for three years after such an injury. After closed reduction and non-operative management, both patients had a satisfactory functional result.

Adult↗
PubMed1982

Tumoral calcinosis: case report and review.

A case of tumoral calcinosis is presented. The characteristic clinical, radiologic, and pathologic features of this uncommon disease are described and the various speculations about its etiology are examined, based on a review of the approximately 150 cases which comprise the world literature concerning this disease. The differential diagnosis of periarticular calcified soft tissue masses is discussed.

Calcinosis↗
PubMed1981

Fluoroscopic evaluation of skeletal problems.

Fluoroscopically positioned spot films are widely used in gastrointestinal and chest roentgenography. Little or no mention is made of the diagnostic use of fluoroscopic spot filming for skeletal roentgenography in major tests or recent literature, and a rough survey of practicing radiologists showed us that such procedure was frequently underutilized or not utilized. While skeletal pathology is usually depicted quite accurately by plain radiographs there are times when a problem may be rapidly and simply clarified by fluoroscopically positioned spot films. In an attempt to assess the value of fluoroscopy for evaluation of musculoskeletal problems, we reviewed 46 cases in which fluoroscopically positioned spot films were obtained.

Arthritis↗
PubMed1981

Computed tomography of the sternoclavicular joint and sternum.

Computed tomography (CT) was used to examine 17 patients with various pathologic conditions (trauma, neoplasm, infection, or arthropathy) involving the sternoclavicular joint or sternum. CT required less time to perform and caused less discomfort to the patient than did conventional linear tomography. CT also demonstrated abnormalities better or provided additional useful diagnostic information in the majority of patients. When plain radiographs are not conclusive, CT is the preferred radiologic modality for the evaluation of the sternoclavicular joint and sternum.

Adolescent↗
PubMed1981

The use of computed tomography to distinguish osteochondroma and chondrosarcoma.

Computed tomography (CT) was performed prior to surgery on six patients with osteochondroma and six with chondrosarcoma. Criteria for distinguishing these two types of cartilage tumors were developed from classical radiological descriptions and known pathological characteristics. Application of these criteria to CT images permitted accurate diagnosis of eleven of the tumors and provided anatomical information important for surgical planning. Review of six previously published cases of cartilage tumors supported the findings. CT appears to be effective in the preoperative differentiation of osteochondroma and chondrosarcoma, including cases where this distinction cannot be made with conventional radiographs.

Adolescent↗
PubMed1981

Percutaneous skeletal biopsy 1981: a procedure for radiologists--results, review, and recommendations.

A retrospective study of 169 percutaneous skeletal biopsies performed by radiologists at the Mallinckrodt Institute of Radiology and Barnes Hospital between October 1974 and July 1980 showed an overall accuracy of 94%; a negative result had a predictive value of 92%. A review of the English-language literature revealed that nearly 10,000 aspiration or trephine musculoskeletal biopsies have been reported during the past 50 years; historical accuracy is approximately 80%, but this figure is probably an underestimate because true-negative cases may not have been well documented or tabulated. The authors believe that percutaneous skeletal biopsy should be considered a radiological procedure, and that radiologists could and should perform this procedure as part of a team effort.

Biopsy↗
PubMed1981

Detection of bone-marrow metastases using quantitative computed tomography.

A method is described for using quantitative computed tomography (CT) to detect subtle skeletal metastases not readily identified or precisely located by conventional methods. Four patients with intramedullary metastases are presented along with data from 13 control subjects. The results indicate that CT may demonstrate intramedullary changes that occur in skeletal metastases and that cannot be detected by other techniques. A difference in medullary CT number greater than 20 HU between limbs is abnormal. This asymmetry, however, is not specific for metastatic disease, and clinical judgment must be exercised in interpreting this finding.

Adenocarcinoma↗
PubMed1981

Percutaneous transluminal angioplasty. Radiological-pathological correlation.

Radiological and pathological assessment of the degree and extent of arterial injury caused by balloon angioplasty was performed in 20 renal arteries obtained at autopsy. Intact arteries were studied angiographically before and after dilatation and then examined histologically. Both normal and diseased arteries were subjected to varying degrees of dilatation. Damage ranged from minimal intimal disruption to major tears of the muscular media. Equivalent dilatory force created greater damage in the distal (muscular) than in the proximal (elastic) portion of the renal artery. There was no evidence of plaque remodeling or compression.

Aged↗
PubMed1981

Subtleties of Lisfranc fracture-dislocations.

Tarsometatarsal (Lisfranc) fracture-dislocations can be very difficult to recognize radiographically. The evaluation of the Lisfranc joint can be simplified by meticulously studying the alignment of the metatarsal bases with their corresponding tarsal bones. The usefulness of this observation has been confirmed by: anatomic descriptions, biomechanical analysis, and clinical foot radiographs. Subtle abnormalities identified at the Lisfranc joint using this observation included: metatarsal subluxations identified only on a single projection, associated tarsal subluxations and dislocations, irreducible metatarsal subluxations after closed manipulation, and recurrent metatarsal subluxations after reduction.

Adult↗