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Biomedical subjects

P Champsaur

Publications and source records attributed to P Champsaur.

At least 37 records · Page 2Linked to original sources

Symptomatic lumbar facet joint synovial cysts: clinical assessment of facet joint steroid injection after 1 and 6 months and long-term follow-up in 30 patients.

PURPOSE: To study the results of facet joint intraarticular steroid injections in patients with symptomatic lumbar facet joint synovial cysts. MATERIALS AND METHODS: Data from 30 patients (age range, 44-82 years; mean age, 67 years) with nerve root pain due to a lumbar facet joint synovial cyst and treated with facet joint steroid injection were retrospectively studied. On the basis of MacNab criteria, the clinical course of nerve root pain was evaluated after 1 (n = 30) and 6 (n = 28) months. Data from long-term follow-up (mean, 26 months) were also available in 14 nonsurgically treated patients. RESULTS: After 1 month, the nerve root pain outcome was excellent or good in 20 patients (67%) and fair or poor in 10 (33%). After 6 months, 10 (50%) of these 20 patients still had excellent or good results, and 18 (60%) of the 30 patients had a fair or poor clinical status, 14 of whom underwent surgery; two patients (7%) were lost to follow-up. Excellent and good results were maintained at further follow-up (range, 9-50 months). CONCLUSION: One-third of patients with symptomatic lumbar facet joint synovial cysts had long-lasting acceptable benefit from facet joint steroid injections in this study. Steroid injection should be indicated before surgery.

Aged↗

Anteroposterior atlantoaxial subluxation in cervical spine osteoarthritis: case reports and review of the literature.

Nontraumatic anteroposterior atlantoaxial subluxation (AAS) has been described in several rheumatic or inherited disorders, especially rheumatoid arthritis and to a lesser extent the inflammatory spondyloarthropathies. We describe AAS secondary to osteoarthritis (OA) of the cervical spine in a 76-year-old man and a 73-year-old woman with severe cervical OA, symptomatic C1-C2 facet joints, and signs of generalized OA. Only 6 similar cases exist in the literature. OA should be added to the causes of AAS, and conversely AAS should be assessed in cases with severe OA of the upper cervical spine.

Aged↗

[Imaging of the adult sinusitis: indications for using conventional techniques, CT scan and MRI].

CT scanning has become the major investigation for sinusitis which is not acute, but chronic. It is a good diagnostic tool, but also allows follow-up assessment of progress, and preoperative evaluation of particular problems related to abnormalities or anatomical variations. MRI scanning has a lesser place, and is most useful in evaluating certain types of pseudo-tumorous sinus conditions, or excluding local complications (in the anterior cranial fossa or orbit).

Adult↗

Osteoid osteoma of the acetabulum. Three cases treated by percutaneous resection.

The acetabulum is a rare location for osteoid osteoma. Conventional surgery of such lesions may require either a large bone resection, an arthrotomy, or a hip dislocation. This report describes the technique and results of percutaneous lesion removal using computed tomography guidance in three osteoid osteomas of the acetabulum. Histologic confirmation was obtained in the three cases. The three patients experienced complete pain relief with a mean followup of 36 months.

Acetabulum↗

High-resolution computed tomographic study of the retrotympanum. Anatomic correlations.

The aim of this study was to define the imaging of the retrotympanum precisely by means of high-resolution CT. Based on 66 scans of petrous bones performed in 49 patients observed in an otologic department, several retrotympanic structures were studied: the pyramidal eminence, ponticulus, subiculum, chordal ridge, tympanic sinus of Proctor, sinus tympani and recess of the facial n. The variations in morphology and depth were noted as well as the relationship between the pyramid and the facial canal. In a second phase the same anatomic structures were studied in 24 temporal bones removed from embalmed cadavers and investigated with the same radiologic technique. Anatomic correlations were made for six temporal bones to confirm the general applicability of our radiologic hypotheses. In CT the pyramidal eminence was visualised in 100% of cases, the chordal ridge in 52%, the ponticulus in 63% and the subiculum in 57%. As regards the different recesses, the sinus tympani was visualised in 95% of cases, the posterior tympanic sinus of Proctor in 38%, the fossula of Grivot in 47% and the facial recess in 80%. The mean depth of the sinus tympani was 2.7 mm and that of the tympanic sinus of Proctor was 1.65 mm; the fossula of Grivot was assessed as 2.1 mm and the facial recess as 2.2 mm. A better knowledge of these sinuses and their variations will aid the surgeon, particularly in a posterior tympanotomy or a retro-facial approach.

Adolescent↗

High-resolution computed tomography of the canals of the temporal bone: anatomic correlations.

The aim of this study was to define precisely the imaging of the canals of the temporal bone by means of high-resolution computed tomography (HR CT). Based on 24 temporal bones removed from embalmed cadavers and investigated with HR CT, several canals were studied: the canal of the chorda tympani (CdT), the canal of the auricular branch of the vagus nerve (ABV), the canal of the tympanic nerve, the canal of the carotico-tympanic nerve and that of the lesser petrosal nerve. Anatomic correlations for six temporal bones were made to confirm the validity of our radiologic hypotheses. In CT, in axial sections OM 0 degree, the posterior canal of the CdT was visualized in 71% of cases, the ABV canal in 4%, the inferior tympanic canal in 12.5%, the carotico-tympanic canal in no cases and the canal of the lesser petrosal nerve in 50% (and in 75% with an incidence of OM + 10 degrees). In coronal incidence, the posterior canal of the CdT was seen in 20% of cases, the ABV canal in 25%, the inferior tympanic canal in 85%, the caroticotympanic canal in 65% and that of the lesser petrosal nerve in 15%. The six anatomic comparisons confirmed the radiologic hypotheses in every case. These different structures are easy to identify in HR CT and are important to define so that any lesion (tumoral or vascular) developing in their vicinity may not be overlooked.

Aged↗

Vanishing osteosclerotic lesion of the humeral head.

We report on the spontaneous disappearance of a dense round lesion from within the greater tuberosity of the humerus. The patient was treated with oral non-steroidal anti-inflammatory agents for symptoms of subacromial bursitis. Symptoms resolved in 10 days and the lesion had vanished when radiographed 3 months later. We surmise the lesion to represent intraosseous crystal deposition.

Calcinosis↗

Postoperative follow-up of juvenile nasopharyngeal angiofibromas: assessment by CT scan and MR imaging.

The purpose of this study was to assess the radiological findings after surgical removal of juvenile nasopharyngeal angiofibromas (JNA). The postoperative CT and MRI scans of ten patients were reviewed. The cured group included six patients. The non-controlled group included six patients with eight recurrences. Two patients belonged to both groups as they were also followed and cured after surgery for relapse. Four recurrences were asymptomatic and diagnosed by imaging. The imaging patterns were matched to the patients clinical status and endoscopic findings. In the cured group, non-enhanced residual soft tissue masses were seen in all cases. In the non-controlled group, recurrence was always demonstrated on early postoperative CT or MR as a dramatically enhanced mass. The recurrence was located in the lateral or superior aspect of the nasopharynx (n = 3), deep to the fossa of Rosenmuller (n = 4) or out of the nasopharynx (n = 1). In two cases a remaining enhanced mass disappeared spontaneously on iterated examinations. Because of numerous asymptomatic relapses, a radiological workup is recommended four months after surgery, even in patients with normal endoscopy, to rule out posterolateral or extranasopharyngeal recurrences. Spontaneous evolution of residual masses must be appreciated on iterated imaging examinations.

Adolescent↗

Percutaneous removal of osteoid osteoma.

In most cases, osteoid osteomas can be removed through a percutaneous approach. The authors report their experience of percutaneous removal of osteoid osteomas under CT guidance. The literature on percutaneous treatments of osteoid osteomas is reviewed. The respective advantages of percutaneous removal and percutaneous destruction of the nidus using thermocoagulation or interstitial laser photocoagulation are discussed.

Anesthesia, Epidural↗

Percutaneous treatments of painful shoulder.

Percutaneous treatments are useful in two, frequent, painful conditions involving the shoulder. In frozen shoulder syndrome, distention arthrography with intra-articular injection of steroid is used to provide pain relief and to improve joint motion. In rotator cuff tendon calcifications, needle aspiration of calcific deposits is used to treat pain. Surgery should be restricted to failures of needle aspiration. The techniques of these procedures are described and their results are reported.

Adult↗

[Peritoneal splenosis simulating a right retroperitoneal mass].

We report a case of an incidentally diagnosed apparently isolated splenosis nodule located in the hepatorenal peritoneal recess. According to imaging features, this mass was a non-renal retroperitoneal tumor. In spite of the isolated location, the history of splenic rupture should have led to a heat-damaged red blood cell scintiscan and would thus have avoided percutaneous biopsy.

Adult↗

[Demonstration of a cranial autopsy performed during the Great Plague of Marseille (1720-1722)].

The excavation of the mass grave from the Monastery of the Observance dating from the Great Plague of Marseilles revealed the first evidence of an autopsy on the skull of a 15-year-old boy, performed during the spring of 1722. The reconstruction of the skull allows us to reconstitute the anatomic technique used, which is identical to those described in a surgical book dating from 1708. This research highlights the interest in correlating the biological and historical archives, and brings new anthropological data to the debate on the contagious nature of the plague.

Adolescent↗

Evidence of pin implantation as a means of verifying death during the Great Plague of Marseilles (1722).

The evidence obtained for the methods used in verification of death during the Great Plague of Marseilles in 1722 is presented here. This evidence was gathered during the excavation of a mass grave dating from this epidemic, and is based on two adjacent interments. The technique used at that time was the implantation of bronze pins into the toes. This method is precisely described in the medical treatises dating from this period, which list different death verification methods. The fear of "false death" and the burial of still living people characterized the end of the 17th and the 18th centuries. It should be noted that the main cause of apparent death is presented in the same medical treatises as the plague. This observation is the first anthropological evidence of the use of this forensic method to verify the fact of death.

Adult↗

-Cysts of the glenoid labrum-.

Cysts of the glenoid labrum are ganglia cysts extending near the glenohumeral joint with frequent clinical signs and symptoms of a compression of the subscapularis nerve. They are detected through MR examination. They are frequently associated to instability of the glenohumeral joint.

Humans↗

-Computed tomography arthrography and tendon imaging of the ankle-.

Ankle opacification dramatically increases the diagnostic value of CT examination of the foot and ankle. The procedure may be entirely performed on the CT table. The main results and indications of CT-arthrography of the ankle are presented. CT-tenography of the ankle which includes the opacification of a tendon sheath on the CT table, is also described.

Ankle Joint↗

-Cervical myelography using the lumbar route-.

Cervical myelography is obtained after injection of contrast medium into the lumbar subarachnoid space through a lumbar puncture. The patient is prone with a large radiolucent block under the pelvis so that the site of lumbar puncture is at a higher level than that of the cervical spine lordosis. Lumbar contrast is injected gently so that the contrast fluid slides along the ventral aspect of the dural sac and immediately reaches the cervical subarachnoid space. Then AP and lateral (with a horizontal X-ray beam) views are obtained. The patient has to remain firmly immobilized during the whole procedure to avoid blending of the contrast medium with CSF. This procedure is safe and allows cervical myelography to reach the same quality as that obtained through cervical puncture.

Cerebrospinal Fluid↗