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Biomedical subjects

W A Murphy

Publications and source records attributed to W A Murphy.

At least 199 records · Page 11Linked to original sources
PubMed1979

Computed tomography of the osseous pelvis.

Computed tomography (CT) was used for study of the osseous pelvis in 43 patients with definitive pathological or clinical follow-up. CT accurately characterized and determined extent of bone and soft-tissue involvement; neoplasms and other disease processes, such as sacroiliac joint disease, were well localized. In cases of trauma, CT was able to identify, localize, and characterize fracture fragments and bone or joint displacement. CT was judged "useful" or "definitive" in 80% of all lesions and 96% of neoplasms studied.

Adolescent↗
PubMed1979

Brodie abscess: reappraisal.

Upon review, 25 cases of Brodie abscess demonstrated a radiological spectrum not previously appreciated. One third of the lesions were diaphyseal in location, and 50% had associated cortical thickening, while 40% showed a stimulated periosteal reaction, and 20% contained sequestra. The variable radiological appearance was underscored by the fact that the preoperative diagnosis was other than osteomyelitis in half the cases. A diverse nomenclature has proliferated to describe and catalogue bone abscess formation. Although the radiological spectrum is broad, the unanimity of clinical presentation, pathological findings, and response to surgical excision supports the concept of a single entity with variable expression.

Abscess↗
PubMed1979

Magnification radiography of the temporomandibular joint: technical considerations.

The design, application, and advantages of a temporomandibular joint (TMJ) positioning unit adapted to the RSI microfocus manigification system are described. The reasons for improved TMJ images with this system are discussed and the rationale for film-screen choice presented. The issue of patient radiation exposure is also considered. This system provided superior TMJ images at acceptable levels of exposure.

Humans↗
PubMed1979

Adult hypophosphatasia. Clinical, laboratory, and genetic investigation of a large kindred with review of the literature.

Investigation of the kindred of a 58-year-old woman with all of the features of "adult" hypophosphatasia revealed 12 individuals in 3 generations with subnormal circulating total alkaline phosphatase (AP) activity. The pattern of inheritance suggested autosomal dominant transmission, with incomplete penetrance of the trait particularly in the young males. Hypophosphatasic individuals other than the proposita were clinically well but had loss of permanent teeth, showing that dental abnormalities could be the only clinical manifestation of the disorder. Radiographic investigation of the proposita revealed that completion of stress fractures was necessary for healing; maturation of incomplete fractures resulted in stable Looser zones. Skeletal survey and radionuclide bone imaging were unremarkable in hypophosphatasic individuals without fracture. Subclinical osteopenia was found in several affected women by metacarpal cortical width and bone densitometric measurements. Laboratory studies showed increased plasma and urinary phosphoethanolamine levels in affected individuals. Phosphoethanolamine and phosphoserine appeared to be natural subtrates for AP since a negative correlation existed between each substrate and circulating total AP activity. Phosphoethanolamine and phosphoserine levels were greatest in the clinically affected proposita; furthermore, only she showed absence of leukocyte AP activity. Heat fractionation of her total circulating AP activity suggested severe reduction in the bone isoenzyme. Hypophosphatasic children had higher levels of total circulating AP than affected adults; the increase was apparently secondary to increased bone isoenzyme. Iliac crest bone biopsies showed greater abnormality in affected women. Osteoidosis was particularly pronounced in the proposita's younger affected sister and hypophosphatasic daughter. Histomorphometric analyses of the biopsies revealed a paucity of osteoblasts despite increased quantities of unmineralized matrix. The finding that hypophosphatasic children in this kindred had higher circulating total AP activity than adults and were able to model their skeleton normally, together with observations that the bone biopsy in adults had a paucity of osteoblasts, suggests that some factor(s) during growth is able to induce both AP activity and osteoblast function, or, that this disorder is an "abiotrophy" with deficient osteoblastic formation and/or accelerated destruction in adult life.

Adolescent↗
PubMed1978

Idiopathic multicentric osteolysis. Report of an affected father and son.

Genetic, rheumatologic, immunologic, metabolic, and renal studies of a father and son with idiopathic multicentric osteolysis are reported. The disorder appeared through mutation. The father developed symptoms as an infant, his son at age 4 years and 9 months. Both have micrognathia and hypotelorism and were exceptionally tall during the symptomatic phase of their disease. Biopsies of the son's wrist showed normal synovium, encroachment on cartilage by fibrocellular tissue, and both osteoclastic resorption and repair of affected bone. Hydroxyproline in his urine was increased. No immunologic, renal, or other metabolic abnormalities were identified.

Adult↗
PubMed1978

Isolated clustered microcalcifications in the breast: radiologic-pathologic correlation.

Thirty-one consecutive cases of mammographic isolated, clustered microcalcifications which prompted breast biopsy were studied by radiologic and histopathologic methods. Isolated, clustered microcalcifications were sensitive, but nonspecific cancer markers; 35% of the lesions were malignant and half of these were noninvasive. Radiologic and histopathologic similarities, and overlap between benign and malignant disease, prevented accurate differentiation. Breast biopsy is indicated when isolated, clustered microcalcifications are discovered by mammography.

Adult↗
PubMed1978

99mTc-pyrophosphate bone imaging in osteopoikilosis, osteopathia striata, and melorheostosis.

Technetium-99m pyrophosphate bone images were contrasted with radiographic findings in two patients with osteopoikilosis, one with osteopathia striata, and one with melorheostosis. Despite the striking radiographic findings, scans were normal in osteopoikilosis and osteopathia striata. In melorheostosis, focal increased radiopharmaceutical accumulation appeared in each radiographically abnormal area. Technetium-99m pyrophosphate bone images should prove helpful when superimposed osseous disease must be differentiated from osteopoikilosis, osteopathia striata, or melorheostosis.

Adult↗
PubMed1978

Shoulder arthrography as a treatment modality.

Some patients undergoing shoulder arthrography with a stiff and painful joint have a small volume capsule or a frozen shoulder. In certain cases when the rotator cuff is intact, the arthrographic procedure has been therapeutic and joint distention has effected a return to normal function. Four such cases are presented.

Anesthesia, Local↗
PubMed1978

Intraarticular methyl methacrylate: a complication of hip surgery.

Methyl methacrylate, used as a grout during hip arthroplasty, can inadvertently become lodged between acetabular and femoral components during surgery. After resumption of ambulation, crescentic fragments may extrude into the pseudocapsule. If mobile methyl methacrylate fragments lodge within the joint, late surgical failure may result because of methyl methacrylate's abrasive character. Two cases of total hip replacement and one case of femoral arthroplasty are reported in which intraarticular methyl methacrylate was identified retrospectively; all three patients remain asymptomatic at the time of the report.

Aged↗
PubMed1977

Elbow fat pads with new signs and extended differential diagnosis.

Although fat pad signs are classically associated with fracture, there are many nontraumatic disease processes which lead to positive fat pad signs. Any intraarticular fluid or tissue accumulation may result in an abnormal posterior fat pad. A "paradoxical" positive posterior fat pad sign may occur in some instances of extraarticular disease. An extended differential diagnosis is presented.

Arthritis, Infectious↗
PubMed1977

Analysis of gas in vacuum lumbar disc.

In three cases in which chemonucleolysis with chymopapain was used for the treatment of back and sciatic pain, gas from the vacuum phenomenon of a degenerated lumbar intervertebral disc was recovered. In one of these, the gas analyzed by gas chromatography contained 90%--92% nitrogen.

Chymopapain↗
PubMed1977

Arthrography in the diagnosis of unexplained chronic hip pain with regional osteopenia.

Three cases of chronic hip pain with radiographic periarticular osteopenia and normal joint spaces are reported. The articular nature of symptomatology, periarticular demineralization, and radionuclide localization suggested intraarticular disease. Computed tomography did not disclose the cause of hip pain when utilized in two instances. Positive contrast hip arthrography was the only diagnostic modality which demonstrated the chondromatosis or adhesive capsulitis responsible for pain. Differential diagnosis and pathophysiologic mechanisms are briefly reviewed.

Aged↗