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Biomedical subjects

W A Fuchs

Publications and source records attributed to W A Fuchs.

At least 19 recordsLinked to original sources
PubMed1992

Diffuse idiopathic skeletal hyperostosis (DISH) of the elbow: a cause of elbow pain? A controlled study.

Elbow pain is a common complaint and elbow hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the relationship between spinal and extraspinal hyperostotic features and the clinical relevance of elbow hyperostosis we have performed the first controlled, double-blinded study of 85 hospitalized probands, 33 with and 52 without thoracospinal hyperostosis on lateral chest X-ray. Elbow and shoulder hyperostosis were graded on bilateral standard radiographs. Elbow pain was assessed by an interviewer using a standardized questionnaire and extraskeletal causes of elbow pain were recorded. The prevalence of elbow hyperostosis was increased in cases with thoracospinal hyperostosis compared to controls (82% versus 58%, chi 2 = 5.32, P less than 0.025, n = 85, olds ratio (OR) 3.30 (95% CI 1.16-9.35)). Similarly, the prevalence of elbow hyperostosis was increased in cases with shoulder hyperostosis compared to controls (83% versus 60%, chi 2 = 4.51, P less than 0.05, n = 84, OR = 3.20 (95% CI 1.06-9.66)), emphasizing the multifocal nature of hyperostotic features. Elbow pain was only slightly more prevalent in cases with elbow hyperostosis compared to controls (21% versus 13%, chi 2 = 0.75, NS, OR = 1.84 (95% CI 0.46-7.44)). We conclude that elbow hyperostosis is a radiological finding of doubtful clinical relevance.

Aged↗
PubMed1992

The prevalence of palpable finger joint nodules in diffuse idiopathic skeletal hyperostosis (DISH). A controlled study.

The presence of clinically palpable finger joint nodules (Heberden's and Bouchard's nodes) was documented in 123 consecutive cases with diffuse idiopathic skeletal hyperostosis (DISH) of the thoracic spine and 191 matched DISH negative controls. The prevalence of palpable finger joint nodules was almost twice as frequent in cases with spinal DISH compared to controls (46% versus 31%, chi 2 = 7.67, P less than 0.01; multivariate adjusted odds ratio OR = 1.84; 95% CI: 1.14-2.98). This increase was most marked at the proximal interphalangeal joint, in males and in patients up to the age of 65 years. In addition and independent of other variables such as hyperostotic features, age and sex, the prevalence of palpable finger joint nodules was about twice as high in probands with a history of physically heavy work compared to those without (43% versus 26%, chi = 9.18, P less than 0.005; multivariate adjusted odds ratio OR = 2.10; 95% CI: 1.26-3.52). From these results we conclude that DISH should be considered as an independent risk factor in the development of finger joint nodules.

Aged↗
PubMed1992

Swollen lower extremity: role of MR imaging.

The authors assessed the use of magnetic resonance imaging in differentiating lymphedema, phlebedema, and lipedema of the lower limb. They examined 14 patients: five with lipedema, five with lymphedema, and four with phlebedema. T1- and T2-weighted transaxial sequences were performed before administration of gadolinium tetraazacyclododecane-tetraacetic acid (DOTA) and T1-weighted spin-echo sequences were performed after administration of Gd-DOTA in each patient. Images of patients with lipedema showed homogeneously enlarged subcutaneous layers, with no increase in signal intensity at T2-weighted imaging or after Gd-DOTA administration. Patients with phlebedema had areas containing increased amounts of fluid within muscle and subcutaneous fat. In lymphedema, a honeycomb pattern above the fascia between muscle and subcutis was observed, with a marked increase in signal intensity at T2-weighted imaging. After Gd-DOTA administration, there was only a slight increase in signal intensity in the subcutis in lymphedema and phlebedema and a moderate increase in signal intensity in muscle in phlebedema.

Adolescent↗
PubMed1991

[Rational radiology].

Quality control is essential in pulmonary radiology. It concerns both image quality and radiation dose. A rational approach to radiodiagnostic investigations is mandatory. Radiological diagnosis is based upon sound knowledge and experience.

Humans↗
PubMed1991

MRI and sonography of the shoulder.

We prospectively evaluated the diagnostic value of sonography and magnetic resonance imaging (MRI) in 24 shoulders in 23 patients with suspected rotator cuff tears using arthrography as gold standard. Sonography demonstrated 14 of 15, MRI 10 of 15 rotator cuff tears, respectively. Sonography diagnosed seven of nine intact rotator cuffs correctly, MRI eight of nine. In a retrospective study we reviewed the diagnostic value of sonography and MRI in other pathologies of the shoulder including intra-articular pathology, humeral head and acromioclavicular joint pathology, and calcification. We conclude that with regard to cost and patient compliance, sonography should be the first radiologic examination in suspected rotator cuff tears if performed by an experienced sonographer. MRI is superior in depicting additional pathology and is less operator dependent. It may thus become the method of choice for the evaluation of the rotator cuff and related pathology in the future.

Adult↗
PubMed1991

Nonionic polyethylene glycol-ferrioxamine as a renal magnetic resonance contrast agent.

The MR relaxation properties of ferrioxamine-B, a chelate of iron, were investigated in vitro and in vivo to establish the potential use of the compound as a paramagnetic contrast agent. Whereas the paramagnetic relaxivity of ferrioxamine-B is such that, compared to gadolinium-DTPA (Gd-DTPA), two to three times higher concentrations are necessary to produce the same relaxation effects, the toxicity of the iron ion should be much lower because of the availability of physiological metabolic pathways. Preliminary experiments in three dogs under invasive cardiovascular monitoring demonstrated that high-dose bolus application (0.1-0.3 mmol/kg body weight) of ferrioxamine-B leads to a precipitous blood pressure drop to almost zero, lasting for several minutes. This reaction seems most likely the result of a negative inotropic effect of ferrioxamine-B. In order to reduce these side effects ferrioxamine was modified to a nonionic derivative, PEG-ferrioxamine-B. In vivo experiments with this compound did not demonstrate any substantial change in blood pressure. Dynamic MR imaging of the kidneys and the liver was performed after bolus injection of the compound in six dogs. The results indicate that PEG-ferrioxamine-B produces effects very similar to Gd-DTPA, resulting in T1-mediated signal intensity increases in the liver and in the early stages of passage through the kidneys. During the phase of medullary concentration, T2 effects seem to dominate visualization of the renal medulla. The nonionic PEG-ferrioxamine-B derivative appears to offer an alternative to gadolinium-containing chelates as an MR contrast agent.

Animals↗
PubMed1990

Diffuse idiopathic skeletal hyperostosis (DISH) of the shoulder: a cause of shoulder pain?

Shoulder pain is a common complaint and shoulder hyperostosis a frequent radiological condition. However, little is known about the association between the clinical and radiological findings. To evaluate the clinical relevance of shoulder hyperostosis we performed a controlled, blind study of 99 hospitalized probands with and without thoracospinal hyperostosis on lateral chest X-rays. The study included grading of the shoulder hyperostosis on the basis of three bilateral standard radiographs, assessing shoulder pain in a standardized way by an interviewer and recording extraskeletal causes of shoulder pain. The prevalence of shoulder hyperostosis was doubled in probands with thoracospinal hyperostosis compared to controls (chi 2 = 5.90, P less than 0.025, n = 99). Shoulder hyperostosis, irrespective of thoracospinal hyperostosis, predisposed to shoulder pain (40% versus 18%, chi 2 = 4.06, P less than 0.05, n = 74). Shoulder hyperostosis in combination with thoracospinal hyperostosis (shoulder DISH) predisposed to shoulder pain to an even greater extent (46% versus 12%, chi 2 = 6.64, P less than 0.01, n = 47). We conclude that shoulder hyperostosis is a radiological finding of potential clinical relevance.

Arthrography↗
PubMed1989

Diffuse idiopathic skeletal hyperostosis (DISH) of the spine: a cause of back pain? A controlled study.

This is the first controlled study of the frequency of back pain in a European caucasian population with diffuse idiopathic skeletal hyperostosis (DISH). Elderly patients admitted to hospital for reasons other than back pain were assessed for the presence of spinal DISH using the routine lateral chest radiograph films. A total of 106 probands (82 males, 24 females) with a mean age of 70 years fulfilled the criteria for DISH as defined previously. One hundred and seventy-eight patients (117 males, 61 females) not meeting these criteria were used as controls. The prevalence of back pain was assessed by a blinded interviewer using a structured questionnaire. Our primary hypothesis was that spinal DISH positive probands had not had back pain more often than controls. This controlled study showed no statistically significant difference in pain frequency between spinal DISH positive probands and controls at any spinal level. We conclude that back pain does not occur more often in radiographically defined DISH positive probands than in controls. The radiological finding of spinal DISH, as far as it does not lead to stenosis of the spinal canal or dysphagia, thus seems to be a finding without clinical relevance.

Aged↗
PubMed1989

[Modern radiologic imaging in the diagnosis of abdominal diseases. Magnetic resonance imaging and spectroscopy].

The diagnostic value of magnet resonance imaging for the diagnosis of pathological abdominal conditions has been limited sofar because of artefacts due to movement susceptibility. The current indications comprise: liver: differential diagnosis of metastases, cysts and hemangiomas, identification of small metastases, demonstration of malignant vascular invasion, evaluation of hemochromatosis; kidneys: evaluation of transplant rejection, analysis of complex cysts, demonstration of malignant tumoral invasion. The application of magnetic resonance will be greatly extended by the introduction of rapid image sequences and the application of specific contrast media.

Abdomen↗
PubMed1979

[Computer tomography in acute pancreatitis (author's transl)].

The computer tomographic appearances of acute pancreatitis have been analysed 33 patients. It is usually a simple matter to distinguish between the acute, oedematous pancreatitis, which can be treated conservatively, and the suppurative pancreatitis with haemorrhagic and necrotising features, which require surgical exploration.

Absorptiometry, Photon↗
PubMed1979

[Computer tomography following blunt abdominal trauma (author's transl)].

The computer tomographic appearances of lesions of parenchymatous organs following blunt abdominal trauma are described in 13 patients (five liver, four renal, two splenic and two pancreatic injuries). The value of abdominal computer tomography is discussed in relation to the interval between injury and time of abdominal examination and compared with the diagnostic value of abdominal angiography.

Abdominal Injuries↗
PubMed1979

Pain in peripheral arteriography-a comparison of a low osmolality contrast medium with a conventional compound.

The pain reaction to a new low osmolality contrast agent, sodium-methyl-glucamine-ioxaglate, in comparison to the conventional compound methylglucamine-ioxitalamate was tested and statistically evaluated in 12 patients using the visual analogue scale method. The intensity of pain experienced was significantly smaller following intra-arterial injection of the compound of low osmolality as compared to the conventional contrast agent.

Adult↗