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Biomedical subjects

P Haghighi

Publications and source records attributed to P Haghighi.

At least 55 records · Page 3Linked to original sources

Enlargement of the third intercondylar tubercle of Parsons as a sign of osteoarthritis of the knee: a paleopathologic and radiographic study.

PURPOSE: To correlate presence and size of the third intercondylar tubercle of Parsons (TITP) with occurrence and severity of osteoarthritis of the knee. MATERIALS AND METHODS: In 100 paleopathologic tibial specimens and on 160 clinical knee radiographs, size of the TITP was correlated with osteoarthritis of medical and lateral femorotibial joints (FTJ) and with prominence of tibial spines. RESULTS: TITP size correlated significantly with osteoarthritis of the tibial plateau in the paleopathologic specimens (P<.0001). TITP size correlated significantly with osteoarthritis of medial FTJ and tibial spines on radiographs (P<.0001). Of 85 patients without osteoarthritis of the medial FTJ, 49 (58%) had no TITP, 33 (39%) had small TITPs, and three (4%) had medium or large TITPs. TITPs were found in 15 (88%) of 17 patients with pronounced osteoarthritis. CONCLUSION: Frequency and prominence of TITPs are increased in patients with osteoarthritis of the medial FTJ and prominent tibial spines. Prominent TITP is a secondary sign of osteoarthritis. At histologic examination, increasing size of TITPs represents osteophytosis or enthesopathy of the TITP.

Adolescent↗

Extrasynovial spaces of the cruciate ligaments: anatomy, MR imaging, and diagnostic implications.

OBJECTIVE: The purpose of our study was to define the anatomy of the extrasynovial space that cruciate ligaments occupy by examining the pattern on MR imaging of normal fluid distribution in the joints around the cruciate ligaments and correlating this distribution with histologic analysis of synovial reflections around the cruciate ligaments. MATERIALS AND METHODS: MR images of five cadaveric knees were obtained serially after larger and larger amounts of contrast material were injected into the joint space. The patterns of fluid distribution around cruciate ligaments were noted. In two other cadaveric knees, the synovial sheath around the anterior cruciate ligament was injected directly with contrast material under CT guidance. Anatomic and histologic correlation was made with findings on corresponding MR images. RESULTS: The pattern of fluid distribution is bounded by the synovial reflections around cruciate ligaments. When maximum joint distention is achieved, fluid almost surrounds the cruciate ligaments. The area without fluid is a triangular space between the anterior and posterior cruciate ligaments that appears on the midsagittal image. This triangular space of the cruciate ligaments is an extrasynovial space within which both the anterior cruciate ligament and the posterior cruciate ligament reside. CONCLUSION: The overlying synovial membrane of the cruciate ligaments does not normally allow joint fluid to enter the substance of the ligaments or the triangular space of the cruciate ligaments. Therefore, fluid collections seen on MR imaging in these extrasynovial spaces or structures likely arises from injury to the cruciate ligaments.

Adult↗

Clonal changes in inflammatory pseudotumor of the lung: a case report.

BACKGROUND: Pulmonary inflammatory pseudotumor, also known as plasma cell granuloma among many other names, is widely believed to be an inflammatory or reactive lesion rather than a neoplasm, although its pathogenesis is still controversial. METHODS: Cytogenetic analysis was performed on a lung mass that showed typical clinical and pathologic features of inflammatory pseudotumor. Ultrastructural and immunohistochemical studies were performed in addition to routine histologic examination. RESULTS: Cytogenetic study of the lesion revealed clonal anomalies of t(1;2)(q21;p23) and del(4)(q27). The patient, a 30-year-old woman, presented with an asymptomatic but enlarging right lower lobe mass for which partial right lower lobectomy was performed. The lung mass was well circumscribed radiographically and grossly. Microscopically, it was characterized by a loosely arranged spindle cell proliferation with prominent plasma cell infiltration. Fibroblastic and myofibroblastic differentiation of the spindle cells was demonstrated by ultrastructural and immunohistochemical studies. CONCLUSION: To the authors' knowledge, this is the first report of clonal cytogenetic changes in a clinically and pathologically typical case of inflammatory pseudotumor in the lung. This finding suggests that pulmonary inflammatory pseudotumor might be a true neoplasm rather than a purely inflammatory or reactive lesion.

Adult↗

Glenoid labrum: MR imaging with histologic correlation.

PURPOSE: To document the histopathologic basis of altered intralabral and sublabral signal intensity on magnetic resonance (MR) images. MATERIALS AND METHODS: Ten fresh cadaveric shoulder specimens underwent transaxial MR imaging with T1-weighted, proton-density-weighted, and T2-weighted spin-echo; multiplanar gradient-recalled echo (MPGR); three-dimensional Fourier transform gradient-recalled echo (GRE); spoiled gradient-recalled echo (SPGR); and T1-weighted, fat-suppressed sequences before and after intraarticular injection of gadolinium. Shoulders were then frozen and transversely sectioned, and histologic analysis of the labrum was performed. RESULTS: Altered intralabral signal intensity correlated with fibrovascular tissue, mucoid or eosinophilic degeneration, calcification, ossification, synovial tissue, or combinations of these findings. A sublabral transitional band of intermediate signal intensity correlated with a transitional zone of fibrocartilage. CONCLUSION: There are several causes of altered intralabral signal intensity. A transitional fibrocartilaginous zone correlates with sublabral increased signal intensity. Intraarticular administration of gadolinium improves evaluation of the glenoid labrum.

Aged↗

MR arthrography of the hip: improved imaging of the acetabular labrum with histologic correlation in cadavers.

OBJECTIVE: The objective of this study was to correlate findings on conventional MR imaging and MR arthrography of the hip with pathologic findings in cadavers with abnormal labra to determine (1) the efficacy of MR imaging in assessing labral degeneration, (2) whether delineation of the labrum from the joint capsule is possible, and (3) if the conspicuity of surface abnormalities of the labrum is improved by administering intraarticular contrast material. MATERIALS AND METHODS: Twelve cadaveric hip joints were obtained from elderly cadavers. Each hip was examined using fat-suppressed three-dimensional spoiled GRASS (gradient-recalled acquisition in the steady state) (SPGR) imaging and T1-weighted spin-echo imaging before and after intraarticular injection of contrast material. Thirty-six labral sections (three from each hip joint) were evaluated histologically to determine the labral-capsular relationship, the presence of degeneration, and the configuration of the labral base. These findings were correlated with the results of a blinded MR evaluation of these sections. RESULTS: Delineation of the labrum from the adjacent joint capsule was possible on SPGR and T1-weighted MR arthrographic images (34 of 36 and 33 of 36 specimens, respectively), but was not consistently possible on standard SPGR and T1-weighted MR images (7 of 36 and 4 of 36 specimens, respectively). The sensitivities and specificities of the various MR sequences in evaluating labral degeneration varied from 50% to 67%, and from 25% to 94%. Increased signal at the base was common in both the normal (n = 12) and the abnormal (n = 24) labrum. CONCLUSION: Conspicuity of the acetabular labral complex is enhanced with the intraarticular administration of contrast material. Although MR arthrography did not improve our specificity for diagnosing labral degeneration, the detection of surface abnormalities, particularly those near the base, was significantly improved.

Acetabulum↗

Botryomycosis in the acquired immunodeficiency syndrome.

Botryomycosis is a rare bacterial infection that may mimic fungal disease both clinically and histologically. Cutaneous botryomycosis is uncommon and usually appears as plaques with superficial pustules and crusts. On microscopic examination lesions are characterized by the presence of granules that resemble the sulfur granules of actinomyces with a granulomatous inflammatory response. An increased incidence has been reported in populations with altered immune function and the presentation may be atypical in patients with the acquired immunodeficiency syndrome. We report the successful treatment of a case of mucocutaneous botryomycosis in a patient with acquired immunodeficiency syndrome. A review of the literature is presented, with special emphasis on cutaneous manifestations of botryomycosis in patients with acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗

Rapidly destructive hip disease: clinical and imaging abnormalities.

The clinical and radiographic records of 23 patients (15 women, eight men) with rapidly destructive hip disease (RDHD) were retrospectively reviewed. Criteria for RDHD included a history of hip pain of 1-6 months duration and the radiographic appearance of a rapidly progressive atrophic form of bone destruction involving both the femoral head and the acetabulum. Radiographs of the remainder of the appendicular skeleton were assessed in 14 patients. The mean patient age was 72 years. The average time from clinical presentation to the appearance of severe hip destruction was 14 months. Five patients demonstrated similar atrophic bone destruction around other articulations. No patients had clinical or laboratory evidence of sepsis or neurologic disease. Although previous reports have suggested that RDHD is degenerative in nature, similar involvement of other articulations suggests that it may represent a focal finding of a more generalized process.

Aged↗

Abnormalities of articular cartilage in the knee: analysis of available MR techniques.

In an attempt to improve the detection of chondral abnormalities with magnetic resonance imaging, a fat-suppressed three-dimensional gradient-recalled acquisition in the steady state (GRASS) and spoiled GRASS (SPGR) sequence was optimized by study of five cadaveric knee specimens. Results with this optimized sequence then were compared with results with three spin-echo (T1-, proton-density-, and T2-weighted) and two three-dimensional gradient-recalled echo sequences (GRASS and non-fat-suppressed SPGR) in the assessment of naturally occurring abnormalities of the patellofemoral compartment in 10 cadaveric knees. Results with the optimized fat-suppressed SPGR sequence were significantly better (P < .02) than results with the other five sequences and had a sensitivity of 96%, a specificity of 95%, and an accuracy of 95%. In addition, normal cartilage consistently appeared as a trilaminar structure with the fat-suppressed SPGR sequence, a feature that appeared to help in identification of chondral lesions.

Aged↗

AIDS and malignant mesothelioma--is there a connection?

A 35-year-old male homosexual, a former intravenous drug abuser, was found to be human immunodeficiency virus (HIV) positive in 1984. He developed AIDS in 1987 and began treatment with zidovudine in 1989. One year later he developed left apical pleural blebs, a pneumothorax and an exudative pleural effusion. A malignant mesothelioma developed at the pleural blebs in the left apex. He was treated with adriamycin but rapid progression of the malignancy occurred and he died three months later. At autopsy, a malignant mesothelioma, causing respiratory failure and death, was found. The patient had no exposure to asbestos and asbestosis was not present at autopsy. We postulate that the development of malignant mesothelioma was probably related to HIV immune suppression or HIV and/or cytomegalovirus or zidovudine and is a complication of AIDS similar to the development of other malignant neoplasms in patients with AIDS.

Acquired Immunodeficiency Syndrome↗

Calcium pyrophosphate dihydrate crystal deposition disease and pseudogout of the acromioclavicular joint: radiographic and pathologic features.

OBJECTIVE: To correlate the radiographic and pathologic findings in calcium pyrophosphate dihydrate (CPPD) crystal deposition disease and the pseudogout syndrome in the acromioclavicular (AC) joint, a relatively infrequent, but clinically important site. METHODS: We describe a case with a definite diagnosis of CPPD crystal deposition leading to pseudogout of the AC joint. We also identified 17 other patients with CPPD crystal deposition disease who showed intraarticular or periarticular calcification in this joint and investigated the radiographic findings in 26 AC joints in these 17 patients. We then correlated the results with the pathologic findings in 2 cadavers with AC joint manifestations of the disease. RESULTS: Intradiscal calcification, mainly linear or punctate in configuration, was found between adjacent bony margins in 9 of 26 AC joints (35%) or between the bony margins and extending above the upper articular bony margin in 14 AC joints (54%). Two joints (8%) showed diffuse calcification within the discs between, above, and below the articular bony margins. The remaining joint (3%) had intradiscal calcification only above the upper bony margins of the AC joint. All the joints with calcifications above the articular margins had associated globular or tumor-like soft tissue masses. A pseudogout attack at the AC joint may have nonspecific shoulder pain as its presenting symptom. CONCLUSION: CPPD crystal deposition disease leading to pseudogout syndrome of the AC joint is a clinically significant condition. We emphasize that careful assessment of the AC joint and adjacent soft tissue using intensive bright light on routine shoulder radiographs may increase the sensitivity of detecting discal and capsular calcifications in patients with pseudogout of the shoulder.

Acromioclavicular Joint↗

Degenerative changes of the menisci of the knee. Value of different MR pulse sequences.

Increased meniscal MR signal attributable to meniscal degeneration is a common finding. The role of different MR sequences in the analysis of the extent and distribution of meniscal degeneration in middle-aged and elderly patients has not been thoroughly evaluated. We retrospectively studied the role of different MR sequences in 175 anatomic meniscal sections originating from 20 freshly frozen knees from 10 cadavers using MR-anatomic correlation. T1-weighted and proton-density spin-echo images as well as postprocessed meniscal windows based on T1-weighted spin-echo images proved to be the most reliable in this diagnosis (53.7%, 54.9%, and 53.1% correctly diagnosed meniscal sections, respectively). T2-weighted spin-echo images and gradient-echo images proved to be less reliable (37.1% and 40.0% correctly diagnosed meniscal sections). While the T2-weighted spin-echo images commonly underestimated the extent of meniscal degeneration, gradient-echo images commonly overestimated the extent of such changes. These last two types of sequences should not be used alone in the description of meniscal degeneration.

Aged↗

Bone excrescence at the medial base of the distal phalanx of the first toe: normal variant, reactive change, or neoplasia?

In a review of 157 anteroposterior (AP) foot radiographs in 117 adult and pediatric patients, we observed a medial excrescence on the plantar aspect of the terminal phalanx of the hallux in 88.5% of the feet. Histologic analysis documented the presence of reactive bone. The bony outgrowth appears after closure of the adjacent physeal plate and is rarely symptomatic. Its high prevalence indirectly implies that it is not specific to any particular type of foot. Although certain types of foot may contribute to its development, we believe that repetitive forces occurring during ambulation induce this reactive bone formation.

Adipose Tissue↗

Osteoma of soft parts.

Osteomas of soft tissue are rare tumors. All previously reported cases occurred in the head, usually in the posterior tongue. We present two patients with soft-tissue osteomas in the thigh. Both masses were densely ossified and consisted of mature trabecular bone on computed tomography and magnetic resonance examination. Increased uptake of bone-seeking radiopharmaceutical was found on scintigraphy. Histologically, mature lamellar bone was seen with small amounts of cartilage seen in the periphery. Symptoms of mass effect which resolved following surgery were noted. We believe that this previously unrecognized soft-tissue appendicular neoplasm lies at the end of a spectrum of post-traumatic ossifying lesions which includes soft-tissue chondromas and osteochondromas, as well as myositis ossificans.

Aged↗

Urethral healing in rabbits.

We studied urethral healing in New Zealand white rabbits by histological examination after insult (urethral catheter) or injury (urethrotomy) specifically for acute and chronic inflammation, fibrosis, fistulas, squamous metaplasia, foreign body giant cells and urethral dilatation. Urethral catheterization resulted in increased inflammation and fibrosis compared to noncatheterized animals. Skin closure techniques and materials resulted in an inflammatory response that may extend to and involve the urethra. Minor differences in suture size were not an important variable but the persistence of suture material may have a role in the degree of inflammation and the formation of foreign body giant cells. Transepithelial closure techniques drag epithelial cells into subcutaneous tissues and may predispose to fistula formation.

Animals↗

Meniscal changes in the elderly: correlation of MR imaging and histologic findings.

In elderly patients, degenerative changes of the meniscus are common and may mimic a tear. The magnetic resonance (MR) image findings of 179 meniscal sections in 20 cadaver knees were correlated with the histologic and gross pathologic findings. The sensitivity of standard T1-weighted spin-echo images and their corresponding meniscal windows in depicting meniscal tears was 80.6%, specificity was 72.4%, and accuracy was 76.7%. These results are not as good as results reported previously. A major difficulty is the occurrence of grade 3 meniscal signal intensity and diffuse intrameniscal signal intensity in torn and intact menisci. MR imaging in elderly patients, however, is still useful in the diagnosis of meniscal abnormalities. Normal low signal intensity depicted within a meniscus at MR imaging and changes in grades 1 and 2 intrameniscal signal intensity are reliable signs of an intact meniscal surface. Grade 3 and diffuse meniscal signal intensities do not allow a specific diagnosis; menisci with these characteristics should be described as degenerated with a high probability of a tear.

Age Factors↗