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Biomedical subjects

M Moinard

Publications and source records attributed to M Moinard.

At least 19 recordsLinked to original sources
PubMed2005

[Interventional sonography].

Diagnostic and therapeutic interventional procedures are rapidly expanding and, when guided by imaging, are more efficient then when performed with a blinded technique. Compared to fluoroscopy and CT, ultrasound does not utilize ionizing radiation. It can facilitate needle placement for arthrography, tenography or bursography or it can guide a variety of procedures such as aspiration, arthrocentesis, local steroid injections and needling of tendon calcifications. Technological improvements have increased the precision of ultrasound guidance and have contributed to reduce the risk of complication. Real time scanning allows simultaneous visualization of the target and of needle progression and has diminished the rate of complications, that are infrequent if the operator uses a strict sterile technique and respects the contraindications.

Humans↗
PubMed2003

[Monostotic fibrous dysplasia of the calcaneus: two case reports].

The authors report two unusual cases of aggressive monostotic fibrous dysplasia involving the calcaneus. This lesion occurs on the 2th decade of life. The main symptom is talalgia. On plain films, differential diagnosis includes aggressive cystic or pseudocystic lesions of the calcaneus. On MR imaging, the tumor matrix is more suggestive of the diagnosis. Treatment of this aggressive form of fibrous dysplasia consists of a surgical curettage completed by cryotherapy and graft because of a high level of recurrence.

Adult↗
PubMed2002

[Imaging of chilhood and adolescent scoliosis].

Scoliosis is frequent, especially during the peripubertal period, which corresponds to the period of greatest activity. About 75% of scoliosis are idiopathic, while the remaining 25% can be divided into neuromuscular, congenital and miscellaneous etiologies. When it is associated with pain, a comprehensive work up should be undertaken to identify the underlying etiology of the scoliosis. Idiopathic scoliosis is typically evaluated using standard radiographs. The number of follow-up radiographs and radiation exposure must be maintained to a minimum. Radiation safety guidelines and protocols must be implemented. Large cassettes can be replaced by digital acquisitions using units with reconstruction software. The technique of evaluation of these scoliosis series radiographs as well as their results will be reviewed. Recent data regarding the evaluation of spinal and pelvic balance parameters in the standing position will be introduced. Atypical idiopathic and other scoliosis require additional evaluation. Computed tomography, with 2D and 3D reformations, is ideal for evaluation of bony anomalies. MRI is ideal for evaluation of the spinal canal and cord, from the skull base down to the sacrum, for all patients with surgical scoliosis or patients with neurological symptoms. The increased availability of MR imaging has resulted in an increased number of so-called idiopathic asymptomatic scoliosis where an underlying anomaly can be identified.

Adolescent↗
PubMed2001

Giant cystic Schmorl's nodes: imaging findings in six patients.

OBJECTIVE: We describe the imaging findings of an unusual type of Schmorl's node appearing as giant cystlike lesion of the vertebral bodies. CONCLUSION: Giant cystic Schmorl's nodes are unusual entities; their radiologic appearance differs dramatically from the classic description and is diagnostically challenging. However, the appearance of these nodes on conventional radiographs and especially on MR images is characteristic. Knowledge of this entity would help to eliminate unnecessary invasive diagnostic or therapeutic procedures.

Adolescent↗
PubMed1999

Anterolateral compartment of the ankle in the lateral impingement syndrome: appearance on CT arthrography.

OBJECTIVE: This article describes the appearance of the anterolateral recess of the posttraumatic ankle on CT arthrography and clearly shows the benefit of this technique in the diagnosis of soft-tissue impingement. MATERIALS AND METHODS: The study was carried out on 44 patients examined by CT arthrography and arthroscopy for chronic, posttraumatic ankle pain. The analysis principally concerned the lateral compartment--in particular, the synovial regularity and the cartilage of the talar dome. RESULTS: Four CT patterns were identified: type 0, uniform filling of the recess with clear limits; type I, intraarticular linear structure outlined by contrast agent; type II, nodular formation in the lateral groove; and type III, irregular appearance of the edges of the lateral groove. Ninety-one percent (10/11) of type II patterns were characterized as meniscoid lesions by arthroscopic examination, 100% (14/14) of type III patterns corresponded to an abundant fibrous reaction, and arthroscopic findings were normal for 100% (2/2) of type 0 patterns and 88% (15/17) of type I patterns. The latter was thus considered as a normal variant outlining the accessory anterior inferior tibiofibular ligament. Type II and III lesions were statistically associated (p = .001) with a chondropathy when time from initial trauma was greater than 22 months. CONCLUSION: CT arthrography provides evidence of anterolateral soft-tissue impingement--in particular, in type II or III patterns. These lesions are statistically associated with a chondropathy.

Adult↗
PubMed1996

[Acromio-clavicular joint cyst. Surgical treatment].

A chronic cyst of the acromioclavicular joint was treated in 3 patients who were followed up for an average period of 26 months. All three were over 60 years old and presented with a massive rupture of the rotator cuff with a subnormal range of passive motion; active motion was variably affected and was painful. The patients underwent resection of one cm of the lateral end of the clavicle, together with resection of the cyst and synovectomy of the upper part of the pathologic humero-acromial joint; the coraco-acromial ligament was left in place. With a mean follow-up of 26 months, the 3 patients have significant pain relief and no cyst has recurred. The authors propose a mechanism to explain the persistence of the cysts in patients with massive rotator cuff tear: elevation of the arm brings the humeral head upwards and forces synovial fluid into the acromioclavicular joint through a perforation in the frayed capsule; this communication is later obstructed by synovial fringes which prevent drainage of the fluid. Excision of the synovium cures the problem.

Acromioclavicular Joint↗
PubMed1996

Distal rupture of the tendon of biceps brachii. Evaluation by MRI and the results of repair.

We report ten cases of rupture of the distal part of the tendon of biceps brachii in patients aged from 27 to 58 years. MRI allowed assessment of the degree of retraction of the tendon which was related to the integrity of the bicipital expansion. When the retraction exceeded 8 cm the expansion was always ruptured. When there was doubt, or in longstanding injury, MRI allowed the lesions to be defined. Surgical repair was by reinsertion on the radial tuberosity at one or two fixation points in eight patients and reinsertion on the anterior brachial muscle in one. The other patient refused surgery. The MRI findings were confirmed at operation. Use of fixation points allowed minimal intervention, thereby reducing the risk of damaging the radial nerve. One year after operation, dynamometric evaluation of the strength of flexion and supination confirmed that the best results were obtained by reinsertion to the radial tuberosity.

Adult↗
PubMed1996

[Deep muscular lipoma of the shoulder. Apropos of 4 cases].

PURPOSE OF THE STUDY: The authors report 4 cases of inter and intra-muscular lipoma of the shoulder and make a review of the diagnosis of this localization. MATERIAL AND METHODS: All 4 cases had shoulder pain and some limitation of shoulder motion, one had hypoesthesia on the lateral side of the arm. 3 had magnetic resonance imaging (MRI) and two ultrasonography examination, three of them had a surgical resection and for one surgery was considered too aggressive and had a MRI control one year later. RESULTS: There was no problem for the surgical procedure and the histology confirmed the diagnosis. The last patient had a rehabilitation program and the MRI control showed lesion stability. DISCUSSION: Lipoma are rare, X-rays, ultra-sonography and CT scans are not sufficient, MRI is the best exploration to differentiate lipoma and lipo-sarcoma, but the main problem is for low grade sarcoma. Histology is the only way to make the diagnosis with the whole tumor.

Diagnosis, Differential↗
PubMed1996

[Imaging of Erdheim-Chester disease].

Erdheim-Chester disease is a form of Histiocytosis which involves the adults and is distinct from Histiocytosis X. It is characterized by a constant diaphyseal and metaphyseal bone involvement predominating in the lower links. The diagnosis can readily be envisaged when the typical radiological findings are present. Bone involvement may be isolated and well tolerated, or can be associated with systemic involvement and a severe prognosis. We describe three cases of women aged 46, 50 and 73 years. One patient presented with isolated bone lesions, while the two others had a multiorgan localization. From the three cases and from an extensive review of the literature, we describe the spectrum of bone and visceral lesions that can be seen by imaging. The emphasis is put on lesions of the skeletal system, the retroperitoneum, the nervous system, and the pericardium. Furthermore, the relationships between Erdheim-Chester disease and Histiocytosis X are discussed.

Aged↗
PubMed1994

[Epicondylitis induced by fluoroquinolones in athletes. Apropos of 2 cases].

Epicondylitis occurred in two leisure athletes who were taking fluoroquinolones. No similar cases have been reported in the literature. In both cases, pain occurred early after initiating drug therapy. Pain was intense and was not controlled by usual care. Echography demonstrated major inflammatory lesions with pseudo-necrosis. Magnetic resonance imaging confirmed the lesions and gave evidence of infraclinical lesions of the adjacent tendons. Surgical disinsertion of the epicondyles with biopsy was indicated due to the persistent pain. Histological examination revealed unspecific lesions of hyalin degeneration and a few giant cells in one case. Pain disappeared after surgery and the patients were able to return to their work, but neither was able to continue his sports activity. Lesions of the Achilles tendon have been observed in patients taking fluoroquinolone and the two cases reported here confirm the possibility of other localizations. Care must therefore be taken when prescribing these antibiotics in patients at risk (dialysis patients, those on corticosteroids, high-performance athletes).

Ciprofloxacin↗
PubMed1992

[Ectasia of the umbilical recess during the antenatal period. 3 case reports].

Having found three cases of ectasia of the umbilical recess in the antenatal period we decided to review the embryology and the ultrasound of the anatomy of the portal system. We consider that this is a normal anatomic variant of the portal system because the lesion is asymptomatic and regresses spontaneously.

Congenital Abnormalities↗
PubMed1990

[Intraperitoneal testicular fetus in fetu].

A 5-month-old boy presented with a right flank abdominal mass. Plain film of the abdomen showed a vertebral column within the mass. Surgery confirmed the diagnosis of fetus in fetu developed within an ectopic intraperitoneal right testicle. Fetus in fetu differs from teratoma by the presence of axial skeleton and organogenesis. When intratumoral axial skeleton is present, plain films are sufficient for the diagnosis.

Axis, Cervical Vertebra↗
PubMed1990

[Idiopathic achalasia of the esophagus in children. Report of 8 cases].

Achalasia of the esophagus is rare in children. The authors report eight cases and emphasize two atypical clinical records: The first one is a 3 month-old infant with respiratory distress and "near miss" Sudden Death Infant Syndrome. The second one is a ten year-old boy with association of achalasia of the esophagus, ACTH insensibility and alacryma. Theses cases are discussed.

Adolescent↗
PubMedDate not supplied

Traumatic tear of the rotator interval.

We studied 10 patients with capsular tear of the glenohumeral joint in the rotator interval -- the triangular space separating the supraspinatus and subscapular tendons. The patients, manual laborers and athletic people, had no previous shoulder pain. Tears appeared after forced internal rotation caused by trauma. The pain was anterior and radiated distally. Pain was absent at rest but recurred immediately after activity was resumed. On examination, range of motion was normal. Hawkins' impingement sign and the palm-up test usually caused pain. Radiographic findings were normal. Arthrography showed leakage of contrast medium into the subscapularis fossa. The tear was not visualized with ultrasonography or magnetic resonance imaging. Eight patients underwent an operation consisting of minimal acromioplasty with coracoacromial ligament resection, coracoidplasty, and suture of the rotator interval. All patients had relief of pain and return of full function.

Adult↗