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Biomedical subjects

R A Dickson

Publications and source records attributed to R A Dickson.

At least 91 records · Page 5Linked to original sources
PubMed1984

The pathogenesis of idiopathic scoliosis. Biplanar spinal asymmetry.

A clinical, cadaveric, biomechanical and radiological investigation of the pathogenesis of idiopathic scoliosis indicates that biplanar asymmetry is the essential lesion. Many normal children have coronal plane asymmetry (an inconsequential lateral curvature of the spine), and certainly all have vertebral body asymmetry in the transverse plane, but when median plane asymmetry (flattening or more usually reversal of the normal thoracic kyphosis at the apex of the scoliosis) is superimposed during growth, a progressive idiopathic scoliosis occurs. Idiopathic kyphoscoliosis cannot and does not exist, from the mildest cases in the community to the most severe cases in pathology museums. Median plane asymmetry is crucial for progression and the lateral profile of the spine must be carefully scrutinised. Increased anterior vertebral height at the apex of the curve with posterior end-plate irregularity characterises the median plane asymmetry and suggests that idiopathic scoliosis is the reverse of Scheuermann's disease.

Adolescent↗
PubMed1984

Idiopathic scoliosis in three dimensions. A radiographic and morphometric analysis.

Eleven articulated scoliotic spines were examined radiographically and morphometrically. Measurement of the curve on anteroposterior radiographs of the specimens gave a mean Cobb angle of 70 degrees, though true anteroposterior radiographs of the deformity revealed a mean Cobb angle of 99 degrees (41% greater). Lateral radiographs gave the erroneous impression that there was a mean kyphosis of 41 degrees while true lateral projections revealed a mean apical lordosis of 14 degrees. Morphometric measurements confirmed the presence of a lordosis at bony level, the apical vertebral bodies being significantly taller anteriorly (P less than 0.02). There were significant correlations (P less than 0.01) between the true size of the lateral scoliosis, the amount of axial rotation and the size of the apical lordosis. This study illustrates the three-dimensional nature of the deformity in scoliosis and its property of changing in character and magnitude according to the plane of radiographic projection.

Anthropometry↗
PubMed1983

Femoral neck fractures--two populations.

A survey of 128 patients with femoral neck fractures has emphasised the difference in physical condition and clinical behaviour between those with cervical fractures and those with trochanteric fractures. The latter group of patients manifest advanced biological ageing and present a greater health care problem. Maintenance of mobility in the elderly may alleviate this situation.

Age Factors↗
PubMed1983

Scoliosis in the community.

Screening for scoliosis at schools has become more and more popular despite the lack of knowledge concerning the clinical course of idiopathic scoliosis. An epidemiological study of 5303 schoolchildren showed three types of scoliosis in the community: (1) pelvic tilt scoliosis (an inconsequential deformity caused by an inequality in the length of the legs but accounting for almost 40% of curves detected); (2) spinal scoliosis (a minor asymmetry of the spine in the coronal plane that tends to remain static or to resolve and which may be normal in growing children, accounting for the remaining 60%); and (3) progressive scoliosis (10% of the spinal scolioses measuring 10 degrees or more that progress by 5 degrees or more a year). Progressive scoliosis resembles idiopathic scoliosis because in girls with right thoracic curves the potential for progression is appreciable. Until the natural history is better established growing awareness in the community of spinal deformity should help earlier detection, and screening should be directed towards providing subjects for further epidemiological work.

Adolescent↗
PubMed1983

The relationship of complications to the time between myelography and discectomy.

This paper describes the relationship between post-myelographic symptoms and the timing of a subsequent spinal operation. A prospective study was performed comparing the post-operative symptoms of patients who underwent discectomy within 48 hours of myelography (Group 1) with those of patients who underwent discectomy at least seven days after myelography (Group 2). After myelography there was no statistical difference in the incidence of nausea and headache in the two groups. However, after operation the incidence of headache and nausea was significantly greater in patients who underwent early discectomy. The incidence of urinary retention was significantly greater in Group 1 at 24 hours after operation but not at 48 and 72 hours. We conclude that the temptation to perform discectomy shortly after myelography should be resisted until at least one week has elapsed between the two procedures, except in emergency situations.

Adult↗
PubMed1982

Arthrodesis of the wrist in rheumatoid disease.

Twelve cases of wrist fusion for rheumatoid disease have been assessed pre and postoperatively in terms of symptoms, function, union, and complications. Improvement in hand function can be attributed to the provision of a painless stable wrist, and fusion in the straight position is in no way detrimental to personal hygiene. Delayed wound healing and pin migration are not uncommon complications but do not affect the end-results, which is radiological union from third metacarpal to radius - a definitive situation.

Arthritis, Rheumatoid↗
PubMed1981

The fractured carpal scaphoid. Natural history and factors influencing outcome.

The scaphoid fracture is commonest in young men in the age group 15 to 29 years, who have the highest incidence of non-union, take the longest time to unite, lose more time from work, and spend the longest time as outpatients. A union rate of 95 per cent can be achieved using standard simple treatment. All but a few fractures are visible on the first radiograph, and failure of visualisation at this stage is not associated with a bad outcome. The postero-anterior and semipronated views are the most important to scrutinise. Crank-handle injuries have a particularly bad prognosis when they produce a transverse fracture of the waist of the scaphoid. Poor prognostic factors are displacement during treatment, the fracture line becoming increasingly more obvious, and the presence of early cystic change. The severity of trauma is an important factor to elicit from the history.

Adolescent↗
PubMed1980

School screening for scoliosis: cohort study of clinical course.

A visual examination of 1764 Oxford schoolchildren for scoliosis was followed by low-dose radiography of the spine in those who showed evidence of asymmetric body topography; radiography was repeated a year later to assess progression. Forty-four children had curves of 10 degrees or more. Two had a congenital abnormality and the remaining 42 were classified according to the type of curve: sacral tilt (compensatory), spinal (idiopathic), or combined (sacral tilt and spinal). Progression occurred in 6 (14%) children, none of whom had only a sacral tilt. These results suggest that only by measuring sacral tilt can benign compensatory curves be differentiated from true idiopathic scoliosis.

Adolescent↗
PubMed1979

The production of prostaglandins in response to experimentally induced osteomyelitis in rabbits.

Osteomyelitis was induced in the tibiae of rabbits by injection of staphylococcus aureus and sodium tetradecylsulphate (STD); additional rabbits were injected with STD alone. Confirmation of osteomyelitis was based on positive culture of the same phage type bacteria from the tibiae and on the characteristic radiographical and histological appearance of osteomyelitis. Only tibiae which proved to be infected by the above criteria showed significantly increased in vitro release and content of Prostaglandin E and Prostaglandin F2 alpha compared with tibiae injected with STD (P less than 0.05). After two weeks infection, infected tibiae released nine times more Prostaglandin E and five times more Prostaglandin F2 alpha than tibiae injected with STD alone. After four weeks infection, infected tibiae released less Prostaglandin E (P less than 0.05) than after two weeks infection but the release of Prostaglandin F2 alpha was similar. The production of large amounts of prostaglandins by bones in response to infection may be the cause of the rapid bone resorption and sequester formation observed in osteomyelitis.

Animals↗