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Biomedical subjects

W Martel

Publications and source records attributed to W Martel.

At least 55 records · Page 3Linked to original sources
PubMed1984

Isotretinoin therapy is associated with early skeletal radiographic changes.

Eight patients with disorders of keratinization (six with ichthyosis, one with Darier's disease, and one with palmar-plantar keratoderma) were treated with isotretinoin for 9 months (1 patient) to 1 year (7 patients). The patients ranged from 5 to 26 years of age. The average isotretinoin dose was 2 mg/kg/day (range, 1.0-2.9 mg/kg/day). Radiographic skeletal surveys were performed prior to therapy, and after 6 months and 1 year of therapy. After 1 year of isotretinoin treatment, six of the eight patients had small but unequivocal skeletal hyperostoses. Five of the patients had multiple hyperostoses. While only two patients were judged to have hyperostoses after 6 months of isotretinoin therapy during prospective evaluation, retrospective comparison with the radiographs obtained after 1 year revealed skeletal hyperostoses after 6 months of treatment in an additional three patients. Between 6 months and 1 year of therapy, some of the hyperostoses remained unchanged while others had progressed. In three patients, hyperostoses were seen at 12 months that were not detectable at 6 months. Based on this prospective study of skeletal changes during isotretinoin therapy, we recommend that patients taking high doses of isotretinoin for long periods be monitored radiographically.

Adolescent↗
PubMed1984

Ossification in the cephalic attachment of the ligamentum flavum. An anatomical and CT study.

A review of 50 anatomical specimens and 100 routine CT scans of the chest and abdomen demonstrated that ossification in the cephalic attachment of the ligamentum flavum is a common anatomical finding, but not as common on CT. Examination of hospital charts and plain radiographs of 26 patients with such ossification suggests that it is probably a normal variant; there was no evidence that it is related to diffuse idiopathic skeletal hyperostosis (DISH) or inflammatory arthropathy. Marked ossification may cause or contribute to neurological symptoms.

Adolescent↗
PubMed1984

Sonographic evaluation of the cartilage of the knee.

Real-time ultrasound was assessed as a means of evaluating osteoarthritis of the knee. The knee was maintained in complete flexion so as to expose the weight-bearing portion of the femoral condylar cartilage. After establishing the validity of the method in an excised bovine knee, 7 asymptomatic individuals, 10 arthritic patients, and several patients with other conditions were examined. The results indicated that sonography can be used to measure the thickness of the articular cartilage in man, as well as to detect changes in its surface and internal characteristics. Early changes of arthritis may be revealed in this manner.

Adolescent↗
PubMed1984

Early skeletal hyperostoses secondary to 13-cis-retinoic acid.

Prolonged therapy with retinoid drugs (chemically similar to vitamin A) often results in skeletal hyperostoses, similar to those seen in idiopathic skeletal hyperostosis. Eight patients, aged 5-26 years, with dermatologic disorders were treated with 13-cis-retinoic acid. Skeletal surveys were obtained before and during treatment. In 1 year, six of the eight patients had developed such skeletal hyperostoses in both axial and appendicular regions. The cervical spine was the most common site of involvement. None of the children demonstrated accelerated skeletal maturation. Two of the patients had mild musculoskeletal discomfort during this period. The findings indicate that high-dose 13-cis-retinoic acid therapy may cause skeletal hyperostoses, requiring radiographic monitoring during prolonged periods of treatment. An implication of these observations, relating to the etiology of idiopathic skeletal hyperostosis, is discussed.

Adolescent↗
PubMed1983

Myositis ossificans circumscripta: computed tomographic diagnosis.

Computed tomography was performed in five patients with myositis ossificans circumscripta. In three cases, and possibly four, CT scans obtained during the active stage of the pathologic process demonstrated findings that in general corresponded to the "zone phenomenon" seen on histology, although a distinct peripheral ring of ossification was not always present. In these patients, CT was useful in limiting the differential diagnosis and obviating surgery. In the fifth patient, with long-standing myositis ossificans, CT showed complete ossification indicative of the mature phase of the pathologic process and was helpful in planning surgical resection.

Adolescent↗
PubMed1983

Clinical utility of knee arthrography.

We evaluated how information obtained from knee arthrography was used in clinical management by means of questionnaires answered by orthopedists both before and after arthrography. In 55 of the 76 patients, the abnormality was considered "moderately severe," and in two patients "insignificant" before arthrography. After arthrography, 30 were considered "moderately severe," and 22 were thought "insignificant." There was a similar diminution in the perceived need for surgery when the results of arthrography were known. Arthrography alters patient management in that a normal arthrogram in a clinically equivocal case seems to convince the orthopedist that the injury is not significant and that surgery is not necessary.

Humans↗
PubMed1982

Ankylosing spondylitis in men and women: a clinical and radiographic comparison.

Thirty-one men and 32 women with ankylosing spondylitis (AS) were evaluated to determine if there are notable differences between the sexes in the nature and course of this disease. The average age at onset was 22 years in women and 23 years in men. Eighteen men, but only eight women, had persistent spinal disease. Conversely, 19 women and only 10 men had clinical evidence of persistent extraspinal involvement. Four women and three men had definite radiographic evidence of articular erosions in the small joints of the appendicular skeleton. Although previous reports have emphasized that women are more likely than men to have AS of the cervical spine and sacroiliac joints, with sparing of the intervening segments, we found this pattern in four men and three women. Involvement of the appendicular skeleton appears to be more common in women and is more apparent clinically than radiographically.

Adult↗
PubMed1981

Ultrasonographic diagnosis of extremity masses.

Radiographic examination of soft tissue extremity masses is frequently inconclusive. In 18 patients with normal or nonspecifically abnormal radiographs, gray scale ultrasonography provided useful additional information. It was possible to distinguish fluid collections from solid masses, and recurrent venous thrombosis from hematoma in anticoagulated patients. Occasionally, specific diagnoses were suggested on the basis of ultrasonic morphologic characteristics. Diagnoses included soft tissue neoplasms, hematomas, aneurysms, synovial cysts, abscesses, and a lymphocele. Ultrasonically guided percutaneous needle aspiration was diagnostic to two cases. Features of differential diagnostic value relative to extremity solid masses and fluid collections are discussed. Ultrasonography is useful in evaluating these soft tissue masses.

Abscess↗
PubMed1981

Computed tomography in the evaluation of sacroiliac arthritis.

Computed tomography (CT) in the evaluation of the sacroiliac joints was compared with conventional radiography in a double-blind study. CT did not increase the probability of detecting sacroiliitis. Because only a few patients were evaluated near the onset of their disease, the sensitivity of CT as compared with that of routine radiography in detecting early morphological changes remains undetermined. An inexperienced observer may find it easier to evaluate CT scans than conventional radiographs of the sacroiliac joint; however, with optimal images, an experienced radiologist does not need CT to evaluate the sacroiliac joint in clinical practice.

Arthritis↗
PubMed1981

Further observations on the arthropathy of calcium pyrophosphate crystal deposition disease.

The arthropathy of calcium pyrophosphate dihydrate (CPPD) crystal deposition disease is distinctive and may affect lumbar spinal and sacroiliac joints, as well as appendicular joints. Subchondral pseudocysts that are a hallmark of the disease have a variable appearance, but often occur as a typical cluster of subchondral, coalescent lucencies with smudged, sclerotic margins. Structural joint collapse with fragmentation of cartilage and bone may occur and appear to be related, at least in some cases, to antecedent pseudocysts. Characteristic intra-articular osteochondral bodies are often extensive and may affect multiple joints; their pathogenesis is discussed. Articular synovial calcification is common and may be due to calcium hydroxyapatite, as well as CPPD, particularly if advanced degenerative changes are present. Recognition of the radiologic features may be encountered in CPPD crystal deposition disease is important for differential diagnosis.

Aged↗
PubMed1980

Erosive osteoarthritis and psoriatic arthritis: a radiologic comparison in the hand, wrist, and foot.

The medical records and radiographs of the hands, wrists, and feet of 50 patients with psoriatic arthritis and 34 with erosive osteoarthritis were reviewed. Polyarticular arthrutis in psoriatics is often unilateral and the joints of a single ray may be selectively affected. Their erosions ten to occur at the "bare areas" of joints, whereas in erosive osteoarthritis it is the subchondral cortex that is primarily affected. Linear periosteal bone apposition is common in the latter. The distribution of arthritis, sites of bone erosion, and character of periosteal bone apposition form distinctive patterns in these conditions which are important in differential diagnosis.

Adult↗
PubMed1979

Periosteal bone apposition in chondroblastoma.

Periosteal bone apposition in chondroblastoma of long bones is more frequent than generally recognized. This should not cause confusion in differential diagnosis. The findings does not seem to have prognostic significance.

Adolescent↗
PubMed1979

Radiologic features of Reiter disease.

The radiologic manifestations of Reiter disease in 56 patients are described. Although the findings are often nonspecific, certain features are distinctive, particularly when present in combination. These include subtle periosteal bone apposition at bony prominences, the infrequency of regional panarthritis and hip and shoulder involvement, the tendency for destructive arthritis to be confined to small joints, particularly in the feet, and a typically "discontinuous" spondylitis characterized by eccentric, laterally positioned vertebral hyperostoses which tend to bridge around the contigous disk. Attention is drawn to similar hyperostoses which occur above the true sacroiliac joints. The significance of these features, particularly in terms of differential diagnosis, is discussed.

Adolescent↗
PubMed1979

Arterial impressions on the stomach.

The splenic artery frequently produces a contour defect on the posteromedial aspect of the stomach, particularly in elderly individuals. When the artery is tortuous or aneurysmal, the impression is prominent and may simulate a neoplasm. Similarly, the aorta can produce a gastric impression. Recognition of these impressions on the stomach wall avoids erroneous diagnosis and unnecessary exploratory surgery.

Aged↗