Biomedical subjects

N Chemla

Publications and source records attributed to N Chemla.

7 recordsLinked to original sources

PubMed1999

Study of the joint space of the hip on supine and weight-bearing digital radiographs.

AIM: To compare hip joint space on supine and weight-bearing anteroposterior digital radiographs. MATERIALS AND METHODS: Fifty anteroposterior views of the hip in 25 patients were taken in supine and weight-bearing positions on a fluoroscopic unit. Two observers in a double-blind study assessed the width of the joint space on an Easy Vision unit with an indirect method of measurement (metric index). RESULTS: Inter-observer and intra-observer variabilities of the metric index were less than 4.1%. There was no significant difference of the metric index of the hip (P>0.05), between supine and weight-bearing positions. CONCLUSION: There is no significant difference of the width of the joint space of the hip between supine and weight-bearing anteroposterior radiographs. Measuring joint space loss in osteoarthritis of the hip with anteroposterior views should be done with radiographs of the hip in the supine position to improve image quality.

Adult↗

PubMed1997

Clinical cure of fungal madura foot with oral itraconazole.

We report the case of a 26-year-old Malian patient who presented with mycetoma of the foot and frank bone involvement caused by Madurella mycetomatis. Long-term itraconazole therapy was clinically effective and well tolerated.

Administration, Oral↗

PubMed1996

Epidural lipomatosis not induced by corticosteroid therapy. Three cases including one in a patient with primary Cushing's disease (review of the literature).

We report three cases of epidural lipomatosis including one in a patient with primary Cushing's disease. Our literature review found 16 additional cases of symptomatic epidural lipomatosis in patients who were not receiving corticosteroids. The presenting symptoms were nonspecific. The main clinical symptoms were nerve root pain, weakness of the lower limbs upon exertion, paraparesis or isolated back pain. Degenerative lesions were common and were sometimes the cause of the symptoms. Cases were evenly distributed between the thoracic and lumbar spine. Of the 18 patients, 14 were men and eight were older than 54 years. Three-fourths of patients were obese. Spinal cord or nerve root compression occurred in some instances. Modern imaging techniques (computed tomography and magnetic resonance imaging) can establish the diagnosis rapidly. In patients without neurologic compromise, surgery should be considered only if symptoms fail to respond to weight reduction. The rate of occurrence of epidural lipomatosis in patients with Cushing's disease is probably underestimated. Routine investigation by magnetic resonance imaging of Cushing's disease patients who have manifestations known to occur in epidural lipomatosis would allow to evaluate the role of increased production of endogenous corticosteroids in the occurrence of epidural lipomatosis.

Adrenal Cortex Hormones↗

PubMed1995

C1-2 arthrography.

OBJECTIVE: To describe the technique of C1-2 arthrography and recommend it as a suitable treatment for pain due to C1-2 abnormalities. MATERIALS AND METHODS: One hundred patients with the following conditions were studied: cervical pain or neuralgia without radiographic changes (group 1, n = 23), osteoarthritis (group 2, n = 37), rheumatoid arthritis (group 3, n = 23), ankylosing spondylarthritis (group 4, n = 5) and diverse conditions (group 5, n = 12). The technique consists of lateral puncture of the posterior aspect of the C1-2 joint with a 20-gauge needle under fluoroscopic control, arthrography using 1 ml contrast medium, and a 1-ml long-acting steroid injection subsequently. RESULTS: The articular cavity has an anterior and a posterior recess. Sometimes the posterior recess is large. In 18% of cases the contralateral joint also opacifies. CONCLUSIONS: C1-2 arthrography appears to be an efficient and safe technique for the treatment of upper cervical pain due to C1-2 articular disorders.

Adolescent↗

PubMed1994

[Value and results of radioguided deep spinal biopsy].

MATERIAL AND METHODS. 76 percutaneous vertebral biopsies were performed with fluoroscopic guidance at the Radiology B Service, Hôpital Cochin in Paris, from November 1991 to March 1994. There were 12 cervical, 23 thoracic, 45 lumbar and sacral biopsies. There were 71 patients (28 women and 43 men), aged 22 to 88 years old (mean age 55.9). The needle used was either a trophine needle (Mazabraud) or a cutting needle (Surcut) or both. We have been doing vertebral percutaneous biopsies for 20 years in our radiology Service, and we published a review of 100 cases in 1983. The aim of this second review is to actualize the technique and the results. RESULTS. An accurate diagnosis was made in 80% of all cases. Diagnosis were: malignancy (34 cases), infection (21 cases), benign compression fracture (10 cases), miscellaneous (11 cases). There were two complications, one at the cervical spine (aggravation of a cervical cord compression) and one at the thoracic spine (pneumothorax). CONCLUSION. Percutaneous vertebral biopsy under fluoroscopic guidance is a safe and reliable method of obtaining a diagnosis in different spine lesions, avoiding thus, in most cases, a surgical procedure.

Adult↗

PubMed1994

[MRI of the knee. Value of delayed sequences after intravenous injection of gadolinium].

A prospective study of delayed sequences after intravenous injection of gadolinium for knee MRI shows the similar results as from the literature: enhancement of synovial fluid after 30 minutes. Sixteen patients were studied mainly with gradient echo. This phenomenon improves the visualisation of the intraarticular structures like meniscus, cruciate ligaments, or cartilage. This study leads to use this technique in case of difficulties like postoperative intraarticular lesions.

Cartilage, Articular↗

PubMedDate not supplied

Lumbar facet joint arthrography with the posterior approach.

Lumbar facet joint (LFJ) arthrography with intraarticular injections of long-acting steroids and local anesthetics is routinely used for therapeutic purposes in selected patients for relief of low back pain. The procedure may also be used for diagnostic reasons to establish the source of such pain. However, because direct access to the LFJ space is not always possible owing to degenerative changes such as osteophytes, another posterior approach has been proposed for LFJ arthrography. With the patient in the prone position, a spinal needle is inserted vertically into the inferior recess of an LFJ with fluoroscopic guidance and the patient under local anesthesia. To facilitate puncture, cushions are placed under the patient's abdomen to flatten normal lumbar lordosis, which enlarges the inferior recess of the LFJ. Use of cushions also results in a decrease in tissue thickness in the patient, thereby improving image quality and decreasing radiation exposure. LFJ arthrography can demonstrate the causative role of facet disease in abnormalities responsible for low back pain or sciatica and can be performed easily and rapidly with this direct posterior approach.

Anesthetics, Local↗