Search PubMed⌕ Search

Biomedical subjects

M N Pathria

Publications and source records attributed to M N Pathria.

49 records · Page 3Linked to original sources
PubMed1988

Rheumatoid arthritis: similarity of radiographic abnormalities in men and women.

To test the hypothesis that there are significant differences in the radiographic appearance of rheumatoid arthritis between men and women, the authors blindly evaluated bilateral hand and wrist radiographs in 32 men with definite rheumatoid arthritis and 32 age- and disease duration-matched women (mean age, 56.4 years; mean disease duration, 10.5 years). Radiographically, disease distribution and severity were identical in these matched groups. Superimposed osteoarthritis was frequent in both groups and related to age. Ill-defined bone proliferation was present in 13 of 64 hands in both groups. Cystic changes and well-defined erosions were present in 12 of 64 male hands and six of 64 female hands, but this difference was not statistically significant. In women, presence of cysts and bone proliferation was related to disease duration, whereas men exhibited these atypical features independent of disease duration. There was no statistically significant difference in the frequencies of typical and atypical features of rheumatoid arthritis between the two sexes, and the authors postulate that previously reported differences relate to patient selection and lack of adequate matching.

Arthritis, Rheumatoid↗
PubMed1988

Isolated dislocation of the tarsal navicular: a case report.

Isolated dislocation of the tarsal navicular is a rare injury that is not mentioned in standard orthopedic textbooks and described only once in the English literature. Because of the rarity of this condition, the best means of treatment has not been established. A patient with this unusual dislocation was recently diagnosed and treated. Open reduction was eventually required, which was followed by the development of ischemic necrosis of the navicular.

Adult↗
PubMed1988

Spontaneous osteonecrosis of the tarsal navicular in adults: imaging findings.

We encountered five otherwise healthy adults with alterations of the tarsal navicular bone compatible with spontaneous osteonecrosis. Four women had bilateral involvement and one man had unilateral involvement. The patients were 23-71 years old. The disorder was initially described by Mueller and Weiss and should not be confused with Koehler disease (osteochondrosis of the tarsal navicular in children). This group of patients was compared with five other patients (29-74 years old) with similar radiographic and clinical changes in whom an underlying disease (rheumatoid arthritis, renal failure, trauma, and lupus erythematosus) associated with osteonecrosis was known. Routine radiography in both groups defined characteristic abnormalities of the navicular bone (decreased size, a comma-shaped configuration, increased radiodensity, fragmentation, and medial or medial and dorsal osseous protrusion). MR in three patients confirmed alterations consistent with osteonecrosis. Three of the patients without underlying disease had bilateral involvement on plain films, with flat feet and hindfoot valgus deformity, leading to local pain and deformity. In a fourth patient, bilateral distribution was documented by MR as marrow alterations. Although no certain pathogenic explanation for spontaneous osteonecrosis of the tarsal navicular is known, trauma and chronic stress changes caused by physiologic pressure on the medial longitudinal arch in hindfoot valgus and increased tension forces of the plantar aponeurosis during weight-bearing (in pes planus) may be important. Discrimination of primary from secondary osteonecrosis of the tarsal navicular bone is not possible by radiologic means alone, although bilateral distribution, particularly in women, favors the diagnosis of spontaneous disease.

Adult↗
PubMed1988

Neuroarthropathy associated with chronic alcoholism.

Neuroarthropathy involving the feet is seen most commonly in patients with diabetes mellitus. Chronic alcoholism has been implicated as a cause of neuroarthropathy, but many alcoholics have coexistent diabetes mellitus, which may not be detected by measuring blood glucose levels alone. We report five chronic alcoholic patients with neuroarthropathic alterations of the feet in whom coexistent diabetes mellitus was excluded by using laboratory methods that are more sensitive than those employed in previously reported series of alcoholic neuroarthropathy. The radiographic features of neuroarthropathy in our five cases consisted of hypertrophic changes at the tarsal joints in four, bony fragmentation at the tarsal and metatarsal regions in three, fracture dislocation at the tarsometatarsal joint in two, and multiple pathologic fractures in one. We conclude that alcoholism can result in neuroarthropathy in the absence of diabetes mellitus.

Adult↗
PubMed1988

Ultrasonography of the popliteal fossa and lower extremities.

In this article, the numerous proven applications of diagnostic ultrasound to the assessment of disease processes affecting the popliteal fossa and lower extremities have been discussed. Popliteal cysts and aneurysms, hematomas, cellulitis, abscesses, soft tissue neoplasms, and other space-occupying fluid collections are readily identified using this technique. In addition, post-traumatic and inflammatory disorders affecting tendons, synovial thickening and effusion, derangement of articular cartilage, meniscal tears, and alterations in soft tissue thickness as well as foreign bodies are amenable to detection by sonography. With future technologic improvements in transducer design and computerized image reconstruction, diagnostic capabilities of this method in the lower extremities should continue to expand.

Aneurysm↗
PubMed1987

Carpal alterations in adult-onset Still disease, juvenile chronic arthritis, and adult-onset rheumatoid arthritis: comparative study.

A specific pattern of pericapitate involvement of the wrist has been described in the rheumatologic literature as characteristic of adult-onset Still disease (AOSD), a relatively rare disorder that is often diagnosed by exclusion after extensive and frequently invasive tests. To evaluate the potential diagnostic value of carpal radiography in suspected cases of AOSD, a retrospective blinded analysis of 48 patients (16 each with AOSD, juvenile chronic arthritis, and adult-onset rheumatoid arthritis) was performed. Pericapitate articular alterations without radiocarpal involvement were found to be distinctly unusual among patients with rheumatoid arthritis but frequent in the setting of AOSD. In juvenile chronic arthritis severe pericapitate involvement also occurs frequently but is more likely to be associated with interosseous fusion and severe pancompartmental disease.

Adult↗
PubMed1986

Driving ability after intravenous fentanyl or diazepam. A controlled double-blind study.

Uncomfortable or moderately painful radiologic diagnostic and therapeutic procedures are being performed increasingly on outpatients. If sedation and analgesia are used, patients cannot drive themselves home or return rapidly to normal activities. This study compares the effect of fentanyl (100 micrograms), diazepam (7.5 mg), and placebo on driving ability of young volunteers as measured by the thacometer. Speed and accuracy were impaired at 30 and 120 minutes by both drugs, and by fentanyl more than diazepam. This study design may be suitable for the assessment of whether patients can drive safely after other analgesic drugs.

Adult↗
PubMed1982

Some attentional effects of unilateral frontal lesions in the rat.

Visual learning, sensory neglect and motor behaviour were studied in rats with unilateral lesions of anteromedial (AM) or dorsolateral (DL) frontal cortex. The purpose was to determine whether the principal features of the syndrome seen after unilateral frontal eye field lesions in primates appear in the rat. In the first two experiments, rats were trained on a visual discrimination using shock avoidance. AM lesions greatly prolonged choice latency but did not increase errors, and this held both for binocular performance and for monocular performance with the contralateral eye. One group of AM-lesion animals was postoperatively maintained in the dark, and their latencies, binocular and monocular, did not differ from the DL controls. Thus, deprivation of visual experience prevented the effects of the AM lesion. The second experiment used simple sensory stimuli to test for visual, auditory and tactile neglect. Ipsiversive circling was also investigated. All rats with AM lesions neglected contralaterally and circled in the first postoperative week. Recovery was underway by the second week and complete in three weeks. The animals were trained preoperatively on a conditioned avoidance problem in which shock was signalled from various points in the visual field. Tested postoperatively, the AM-lesion rats avoided normally. The findings of the two experiments strongly suggest that the functions of AM cortex in the rat are similar to those of the frontal eye field in primates. This cortical region appears to be part of a system which prominently includes the superior colliculus and serves attentional/orienting functions.

Animals↗
PubMedDate not supplied

Magnetic resonance imaging in pachydermoperiostosis.

Pachydermoperiostosis is a rare inherited disorder that is manifest clinically by digital clubbing, extremity enlargement, painful and swollen joints, hypertrophic skin changes, and periosteal bone formation. This report illustrates the skeletal findings that may be seen with long-standing disease as evaluated with conventional radiography and with magnetic resonance (MR) imaging, with emphasis on the MR appearance of periosteal reaction in this disorder. There are features that suggest pachydermoperiostosis may represent a generalized enthesopathy.

Adult↗
PubMedDate not supplied

Grading liposarcomas with PET using [18F]FDG.

Five patients with liposarcomas of the thigh were studied using positron emission tomography (PET) with [18F]2-deoxy-2-fluoroglucose (FDG). There were three low-grade tumors (all National Cancer Institute Grade 1 myxoid liposarcomas) and two high-grade tumors (both pleomorphic liposarcomas, Grades 2 and 3). The low-grade liposarcomas were easily identified with an average dose uptake ratio (DUR) of 1.38 +/- 0.045 (mean +/- SD). The high-grade lesions were more avid for FDG with a mean DUR of 2.45 +/- 0.24. There was a significant difference (p = 0.004) in the DUR for the two groups and the histological grade of malignancy was highly correlated with the DUR for FDG (Rho = 0.89). These findings suggest that FDG-PET may be useful for distinguishing between low-grade and high-grade liposarcomas.

Deoxyglucose↗
PubMedDate not supplied

MR appearance of idiopathic synovial osteochondromatosis.

OBJECTIVE: A retrospective review of the MR examinations in 21 patients with idiopathic synovial osteochondromatosis (ISO) was performed to determine its MRI characteristics. MATERIALS AND METHODS: Twenty-one patients diagnosed with ISO had undergone MRI prior to surgery. The MR images were retrospectively evaluated for configuration and extent of lesion as well as for signal characteristics. RESULTS: Three distinct MR patterns were seen in ISO: A--lobulated homogeneous intraarticular signal isointense to slightly hyperintense to muscle on T1-weighted images and hyperintense on T2-weighted images (n = 3); B--pattern A plus foci of signal void on all pulse sequences (n = 17); and C--features of pattern A and B plus foci of peripheral low signal surrounding central fat-like signal (n = 2). The foci of signal void in pattern B and C corresponded to areas of calcification and the foci of peripheral low signal surrounding central fat-like signal in pattern C corresponded to areas of ossification. CONCLUSION: The MR appearance of ISO appears sufficiently unique to allow its differentiation from other causes of intraarticular pathology.

Adolescent↗
PubMedDate not supplied

Denervation hypertrophy of muscle: MR features.

OBJECTIVE: Denervation hypertrophy is an entity well recognized in the neurology literature, but with little mention in the radiology literature. Denervation hypertrophy occurs when a muscle paradoxically enlarges rather than atrophies in response to loss of innervation. The purpose of this report is to describe the MR appearance of true hypertrophy and pseudohypertrophy of muscle following denervation. MATERIALS AND METHODS: The clinical data and MRI findings in three patients with muscle enlargement due to denervation hypertrophy are reviewed retrospectively. Two women and one man aged 19-80 years were included. Denervation resulted from spinal stenosis in one patient, a herniated thoracic disc in another, and spina bifida with a tethered cord in the third. RESULTS: True hypertrophy of a single muscle was seen in one patient and pseudohypertrophy of two muscles was present in one patient. One patient had one muscle with true hypertrophy and one muscle with pseudohypertrophy. Electromyographic examination was performed and was consistent with denervation in two patients. Biopsy confirmation of denervation was obtained in two patients. All five abnormal muscles exhibited increased volume, well defined margins, and normal contour. In true hypertrophy the enlarged muscle was isointense with normal muscle on all MRI sequences. In pseudohypertrophy the MRI appearance was consistent with an excessive amount of fat interspersed throughout normal muscle. CONCLUSION: Magnetic resonance in these cases established muscle hypertrophy rather than neoplasm as the cause of a palpable mass. If muscle hypertrophy or pseudohypertrophy is seen on an MR examination of an enlarged extremity, the possibility of an underlying neurologic process should be considered.

Adult↗