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Biomedical subjects

L F Rogers

Publications and source records attributed to L F Rogers.

At least 73 records · Page 4Linked to original sources
PubMed1993

Case report 758. Reflex sympathetic dystrophy syndrome (RSDS).

We report the angiographic and venographic findings in a case of reflex sympathetic dystrophy syndrome (RSDS) of the lower extremity. The hypervascular intraosseous lesion which initially simulated an arteriovenous malformation provides important information about the vascular nature of this lesion.

Foot Diseases↗
PubMed1993

MR evaluation of the anterior cruciate ligament: value of supplementing sagittal images with coronal and axial images.

OBJECTIVE: Most studies evaluating the anterior cruciate ligament have focused on sagittal MR images for the diagnosis of injury. Limitations of sagittal images have been reported, however, including nonvisualization and incomplete visualization of the ligament. This study was undertaken to assess the value of adding coronal and axial MR images to sagittal images in the evaluation of the anterior cruciate ligament. MATERIALS AND METHODS: We reviewed oblique sagittal T1-weighted, coronal T2-weighted, and axial T2-weighted images to determine the status of the anterior cruciate ligament in 325 patients. All patients had arthroscopy. Sagittal images were initially interpreted alone and then in combination with coronal and axial images. RESULTS: Sagittal T1-weighted images alone had a 94% sensitivity and an 84% specificity for determining the status of the anterior cruciate ligament. A multiplanar evaluation of the anterior cruciate ligament resulted in a change in MR interpretation in 21 patients (6%), which led to an improved sensitivity of 98% and a specificity of 93%. Diagnostic confidence was improved in an additional 14 patients (4%). CONCLUSION: Our results show that the efficacy of MR imaging for the detection of anterior cruciate ligament tears is greater when axial and coronal images are used in combination with sagittal images than when sagittal images are used alone.

Adult↗
PubMed1993

Transient lateral patellar dislocation: diagnosis with MR imaging.

OBJECTIVE: Transient lateral patellar dislocation is frequently difficult to diagnose accurately on the basis of clinical findings. Accordingly, we studied the MR findings in 26 cases to determine if MR imaging is useful in establishing the diagnosis. MATERIALS AND METHODS: A retrospective review of 1450 MR examinations of acutely injured knees was performed to determine the MR findings resulting from transient lateral patellar dislocation. A distinctive constellation of MR findings reflecting the known mechanism of injury indicative of transient lateral patellar dislocation was found in 26 patients. Patellar dislocation was not clinically suspected before imaging in 19 (73%) of these 26 patients; most patients had been referred for suspected injury of the cruciate ligaments or menisci. Axial, sagittal, and coronal MR images were obtained in all patients, and all had clinical follow-up. Correlation of MR findings with surgical findings was possible in six. RESULTS: Specific components of the constellation of MR findings included disruption or sprain of the medial retinaculum in 25 (96%) of 26 patients, lateral patellar tilt or subluxation in 24 patients (92%), lateral femoral condyle contusion in 21 patients (81%), osteochondral injury in 15 patients (58%), and joint effusion in all 26 patients (100%). Concomitant injury to major ligaments or menisci was present in eight (31%). CONCLUSION: Our findings suggest that patients with transient lateral patellar subluxation have a distinctive constellation of MR findings that can be used to distinguish this entity from other common knee injuries.

Adolescent↗
PubMed1992

Computed tomography of posterior fracture-dislocations of the shoulder: case reports.

Computed tomographic (CT) evaluation of seven posterior shoulder dislocations in five patients is reported. Computed tomography provided better visualization of the trough fracture in the humeral head than did conventional x-ray films or tomography. It also demonstrated fracture fragments not seen on conventional roentgenograms. The two cases of bilateral dislocation and one case of unilateral dislocation were caused by seizures. The two other cases of unilateral dislocation were caused by trauma.

Adult↗
PubMed1992

Anterior cruciate ligament injury: MR imaging diagnosis and patterns of injury.

The anterior cruciate ligament (ACL) is an important stabilizer of knee motion. Injury of the ACL can lead to substantial disability; an accurate diagnosis of ACL injury is vital in both short-term and long-term patient care. Magnetic resonance (MR) imaging has emerged as the study of choice to evaluate the status of the ACL and other associated structures in the knee. Sagittal MR images have been commonly used in the evaluation of the ACL. However, the authors believe that coronal and axial imaging planes can add useful information about ACL injury and, thus, lead to improved accuracy and confidence regarding diagnosis. Multiplanar imaging can readily demonstrate meniscal, ligamentous, and bone marrow injuries that commonly occur with the most frequent mechanisms of ACL injury. These mechanisms, in order of frequency, include internal rotation and valgus stress, hyperextension, and varus stress with external rotation. An understanding of these mechanisms is helpful in the MR diagnosis of ACL injury.

Anterior Cruciate Ligament Injuries↗
PubMed1991

Cortical bone metastases.

The bone scans and radiographs of 27 patients with solitary or multiple cortical bone metastases were retrospectively studied. Thirty-six cortical metastases were identified in 32 appendicular long bones. Origin of the tumors included lung, breast, kidney, pancreas, larynx, uterus, and site unknown. Cortical metastases have hitherto been reported as individual cases or in small numbers. The large number reported herein suggests that the occurrence of these lesions may be more common than previously expected. A cortical metastasis was the only evidence of metastatic disease in eight of the 27 patients.

Aged↗
PubMed1990

Case report 620. Progressive systemic sclerosis (PSS) with paraspinous and intraspinous calcifications.

Progressive systemic sclerosis (PSS) is a connective tissue disorder of unknown etiology and pathogenesis characterized by fibrosis of the skin (scleroderma) and variable involvement of several organ systems including the gastrointestinal tract, lungs, heart, and kidneys. Calcinosis cutis is a frequent finding, commonly seen in the soft tissues of the fingertips and over the knees and elbows. Calcifications may also occur in areas of muscle necrosis and have been reported in articular synovium. This report describes a patient with PSS in the form of subcutaneous calcifications and scleroderma who was noted to have extensive paraspinous and intraspinal calcific deposits, causing severe narrowing of the spinal canal. The radiographs of 66 patients with PSS seen at Northwestern Memorial Hospital of soft tissue calcifications.

Calcinosis↗
PubMed1990

Evaluating the multiply injured patient radiographically.

In the multiply injured patient there are obvious lesions that often overshadow other lesions, creating a significant possibility that they will be overlooked. Because of the high incidence of missed lesions in such patients, it is a good idea to approach the patient with the presumption that one may be overlooking something and ask oneself what other lesions may be associated with the known lesions. We have enumerated several injuries that frequently occur together and have called them clinical dyads. It is hoped that knowledge of the associations will prevent oversight of the second lesion. The radiographic examination serves as an extension of the physical examination, confirming clinical suspicions and documenting the extent of many injuries. We have outlined what we believe is a prudent radiographic examination in a multiply injured patient. It provides information about the areas most likely to have injuries but is not so extensive that it hinders patient care. It is a starting place or survey and may lead to other, more complicated radiographic studies should the findings warrant them.

Communication↗
PubMed1989

The value of a structured course for an elective in radiology for senior medical students.

The authors recently revised the elective course for senior medical students at Northwestern University Medical School. The new course is well structured with clearly stated objectives, self-instruction seminars, specialized teaching conferences conducted by attendings and residents, student presentations, and a final examination. The enrollment in the course has increased steadily, especially among students not planning a career in radiology. Student surveys obtained immediately after completion of the new course demonstrated a clear positive response despite the increased workload. Follow-up surveys also showed a greater comfort level and expertise with radiographic images in students who participated in the more structured course. Final grade distribution was based on multiple factors and resulted in 16% honors reduced from previous honors rate of 24%.

Curriculum↗
PubMed1989

Superior mediastinal widening from spine fractures mimicking aortic rupture on chest radiographs.

Mediastinal widening on chest radiographs associated with lower cervical and upper thoracic spine fractures can mimic the radiographic findings of aortic rupture. Frontal chest radiographs from 54 patients with traumatic fractures of at least one vertebral body from C6 to T8 were examined for signs suggestive of aortic rupture. These signs included (1) mediastinal width equal to or greater than 8 cm; (2) presence of a left apical cap; (3) a right paratracheal stripe of 5 mm or more; and (4) deviation of the nasogastric tube, when present, to the right of the T4 spinous process. Thirty-seven patients (69%) had radiographic signs suggestive of aortic rupture on the initial anteroposterior chest film. The single patient in this group who actually had an aortic rupture died in the emergency department shortly after admission. The spine fracture could be identified on the initial chest radiograph in 19 (51%) of the 37 patients. These results show that a widened mediastinum on chest radiographs after trauma is not a specific finding of aortic rupture. In these cases, the upper thoracic spine should be examined closely on the initial frontal chest radiograph for evidence of fracture. If a fracture of the upper thoracic spine is identified, an aortic rupture is unlikely in the absence of clinical signs and symptoms supporting this diagnosis.

Adolescent↗
PubMed1989

Flexion teardrop fracture of the cervical spine: radiographic characteristics.

Teardrop fracture of the cervical spine is a confusing and loosely used term, often referring to any fracture with a triangular fragment in the involved body. The flexion teardrop fracture is a specific entity that should not be confused with other types of injury with a teardrop fragment. In a radiographic analysis of 45 patients with flexion teardrop fracture, the most characteristic feature was posterior displacement of the upper column of the divided cervical spine, observed in 78% of the cases. Other radiographic characteristics included backward displacement of the posterior fragment of the involved body, widening of the interlaminar and interspinous spaces, widening of the facet joint with backward displacement of the inferior facet, and kyphotic deformity of the cervical spine at the level of injury. The injury was frequently associated with sagittal-body and laminar fractures and occurred predominantly at the C5 level.

Cervical Vertebrae↗