Biomedical subjects
Publications and source records attributed to S Anda.
Following amputation of a lower extremity for osteogenic sarcoma, the lumbar muscles receive an asymmetric strain. This predisposes to low-back-pain. When this occurs, tumour-recurrence must be excluded. This report demonstrates the usefulness of high-resolution computed tomography (CT) in this clinical situation.
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The femoral anteversion was measured by ultrasound and biplanar radiography in 57 children, most of whom had clinical signs of increased anteversion. A modification of previously reported ultrasound techniques was introduced, as the transducer was tilted instead of being kept horizontally. Four different modes of ultrasound examination were evaluated. The most appropriate technique involved only one ultrasound scan at the hip level. The correlation between the results of ultrasound and radiography was good with less than 10 degrees discrepancy in the majority. Ultrasound is suitable for screening children with rotational disorders of the femur. The main advantage of the method is that exposure to radiation is avoided.
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Seven patients with acute chemical meningitis after metrizamide myelography are described. Five of the cases occurred within a time span of two months. Clinical and cerebrospinal fluid findings in the acute stage of the illness were similar to findings in acute bacterial meningitis. Possible causes of this complication are discussed.
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The anteversion angle (AV-angle) of the femur was measured according to the method of Rippstein in a series of 50 patients with "primary" osteoarthritis of the hip, and in a control group of 30 individuals of the same age without hip disease. The median AV-angle of the hips in osteoarthritic patients was 17.5 degrees, and in the control group 13 degrees. Osteoarthritic patients had a significantly increased AV-angle in relation to the control group (P = 0.0028). The greatest AV-angle in the hips of the control group was 25 degrees. In 18 hips of osteoarthritic patients an AV-angle greater than 25 degrees was found. Osteoarthritis was found in 15 of these hips; there was no osteoarthritis in the remaining 3 hips. Our results lead to the conclusion that increased femoral anteversion is a predisposing factor for hip osteoarthritis. This implies that derotational osteotomy in children can be a prophylactic procedure.
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Two cases exhibiting great variability of diaphragmatic CT appearance are reported. The literature on the effect of respiratory phase and muscular diaphragmatic contraction on the CT presentation is discussed.
Transpelvic CT was used to quantify the relationship between the acetabulum and proximal femur in 21 adult patients (33 hips) with congenital hip dysplasia (defined by a center edge angle of less than 20 degrees). The anterior and posterior acetabular sector angles (AASA and PASA) were measured, as well as the degree of acetabular and femoral anteversion. The results demonstrated deficient anterior acetabular support (i.e., decreased AASA) in approximately two-thirds of the dysplastic hips and reduced posterior support (i.e., decreased PASA) in one-third. The acetabular anteversion was normal. The femoral anteversion. however, was greater than normal in most hip. As important additional information is obtained by CT compared with conventional radiography, CT is recommended when operative procedures aimed at preventing or postponing osteoarthrosis are considered.
A new set of angles measured on standard axial CT images of the hip joint is defined. The angles provide information on the support of the femoral head from the anterior and the posterior part of the acetabulum. These angles have been measured in 82 adult hips, and correlated to a set of established parameters commonly measured at conventional roentgenography and on CT images of the hip joint. The defined angles may prove to be valuable in the total appreciation of hip joint function and stability.
Radiographic and real-time ultrasound measurements of femoral anteversion were compared in an anatomic study of 20 dried adult femurs. The real anteversion (AV) angle was determined by biplanar radiography. In four ultrasound measurements, the linear transducer was kept either horizontal or tilted. The measuring lines were either the anterior tangent of the femoral head--greater trochanter or the anterior tangent of the femoral neck. With the tilted transducer, the correlation between the head-trochanter AV angle and the real AV angle was high (r = 0.9452), and slightly less when the anterior neck AV angle was used (r = 0.9142). The clinical relevance is that the tilted transducer technique with the head-trochanter tangent is recommended for AV screening in patients with clinical signs of increased femoral anteversion. In adults 8.5 degrees has to be subtracted in order to obtain an approximation of the real AV angle.
A patient with a blow-out fracture of the right orbital floor presented with impediment of the inferior rectus muscle. Coronal CT disclosed a lateral hinged fragment from the orbital floor and herniation of intrabulbar content into the maxillary sinus. The inferior rectus muscle could not be identified intraorbitally in three sequential 3 mm coronal sections and it was concluded that the muscle was incarcerated, a presumption that was verified at surgery.