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At least 1,045 records · Page 58Linked to original sources
PubMed2005

High-frequency ultrasonographic examination of the finger pulley system.

OBJECTIVE: The purpose of this study was to determine the ability of high-frequency ultrasonography to provide for direct evaluation of the annular and cruciform finger pulley system. METHODS: In the first part of the work, a cadaveric study was performed to outline the normal anatomy of the annular and cruciform finger pulley system. Eighteen cadaveric hands were cut (n = 10) or dissected (n = 8). Two musculoskeletal radiologists retrospectively reviewed in consensus the photographs of anatomic sections and dissections. This cadaveric study gave the 2 readers the opportunity to learn the normal anatomy of the finger pulley system. In the second part of the work, the annular and cruciform finger pulley system of 20 hands of volunteers was evaluated by ultrasonography with a 17-MHz linear transducer. Images were retrospectively analyzed by means of consensus of the 2 radiologists with respect to the visibility of each finger pulley. RESULTS: For annular (A) pulleys, high frequency ultrasonography showed A1, A2, A3, and A4 in 100%, 100%, 65%, and 100% of cases, respectively. For cruciform (C) pulleys, high-frequency ultrasonography showed only C1 in 45% of cases. Direct visualization of A5, C2, and C3 was not possible. CONCLUSIONS: High-frequency ultrasonography allows excellent depiction of finger pulleys except for annular pulley A5 and cruciform pulleys C2 and C3.

Aged↗
PubMed1999

[A case of amyopathic dermatomyositis presenting blister and oral ulcer].

An 84-year old man was admitted to Mitoyo General Hospital because of progressive malaise and edematous erythema on both eyelids (Heliotrope erythema). He also noted blister on his neck as well as erythema on the extensor surface of finger joints (Gottron's sign), elbows and knees. Neither weakness nor pain of his proximal muscle was elicited on physical examination on admission. His blood test disclosed positive inflammatory signs (i.e., mild elevation of ESR and positive CRP) without elevated value of muscle enzymes. Electromyogram showed normal pattern. Infiltration of inflammatory cells was not revealed by histological examination of biopsied muscle. A diagnosis of 'amyopathic dermatomyositis' was made based on these observations. Computed tomography of his chest disclosed interstitial pneumonia spreading over both lower lung fields. Colon fiberscopy revealed a polyp in his descending colon, which was classified into group I on cytological examination. He was treated with two sets of methylprednisolone (mPSL) pulse therapy (500 mg/day, 3 consecutive days, intravenously) followed by 30 mg/day of oral prednisolone (PSL). His skin lesions responded well to the above treatment and the dose of oral PSL was tapered. One month after the initiation of treatment, severe stomatitis as well as a large ulcer beneath his tongue developed accompanying an intractable pain. Mucosal biopsy revealed necrotizing vasculitis in medium-sizedartery at the bottom of ulcer. Another set of mPSL pulse therapy brought a prompt relief of his symptom and prohibited the recurrence of oral lesion. It should be noted that our patient did not fulfill the diagnostic criteria for DM because of the lack of muscular symptoms whereas he had characteristic skin lesions. Regarding the frustration possibly encountered at the time of diagnosing amyopathic DM, both sensitivity and specificity of the skin lesion for the diagnosis of DM were investigated. Moreover, the rarity of blister as a skin manifestation of DM was discussed as well.

Aged↗
PubMed2000

[Hypertrophic pulmonary osteoarthropathy. A paraneoplastic syndrome associated with lung cancer].

The case report presents a 52-year-old woman. The patient was a smoker, but did not have any pulmonary symptoms. Four months before admission she developed pains in her knee, ankle, elbow and finger joints. Bone scintigraphy showed periosteal new bone formation along the femur and tibia and increased tracer uptake in the hands. These findings were diagnosed as HPOA. Chest X-ray revealed a lung tumour.

Carcinoma, Non-Small-Cell Lung↗
PubMed1976

[Chewing pads, a variant of knuckle pads].

Three young male patients with chewing pads are reported. Their tic-like habit of chewing on the dorsal aspects over the middle joints of fingers I-IV caused a pad-like thickening of soft tissue. These chewing pads are a variant of "false" knuckle pads. The importance of a medical history and dermatological inspection is stressed to avoid unnecessary diagnostic procedures. This harmless augmentation of soft tissue is commonly confused with rheumatoid disease of the fingers, sarcoidosis or pachydermoperiostosis. Patients should be informed of the true nature of their pads, as discontinuation of their chewing habit will resolve their problems.

Adolescent↗
PubMedDate not supplied

Skin metastasis of breast cancer clinically undistinguished from amyopathic dermatomyositis.

We report a 65-year-old woman who consulted us on May 25, 1998, showing pruritic, partially flagellate erythema on the back and upper extremities, livedo lesions with erythema on the loins, and erythematous papules on the dorsal finger joints for 2 months. Histopathological findings of erythema on the back showed mononuclear cell infiltration around capillaries and marked edema in the dermis. Laboratory data were within normal range except for positive anti-nuclear antibody. She had undergone total left mastectomy on June 2, 1997 for breast cancer. Supraclavicular lymph node metastasis was found at the beginning of May, 1998. A diagnosis of amyopathic dermatomyositis associated with breast cancer was made. Erythema with itching gradually subsided from the end of August, 1998. Treatment with radiation and chemotherapy reduced lymph node swelling, but complete remission was not obtained. Erythema similar to the previous lesion but without itching re-appeared on the back from January, 2000. Histological findings of erythema showed many carcinoma cells similar to the primary lesion of left breast cancer in the whole dermis. A diagnosis of skin metastasis of breast cancer was made. These findings suggest that skin metastasis should be taken into account for patients with erythema on the trunk similar to dermatomyositis.

Adenocarcinoma↗
PubMed1975

The radiographic appearance of the rheumatoid hand.

The early diagnosis of rheumatoid arthritis ensures a timeous prognosis and appropriate therapy for this chronic disease. The radiograph of the hand is a valuable aid in making this diagnosis, but accurate interpretation is difficult. An outline of the X-ray changes seen in the rheumatoid hand is presented, and the salient points in the differential diagnosis are outlined.

Arthritis↗
PubMed2002

[Two-pin L fixation of fractures of the fifth metacarpal neck].

The authors present a retrospective review of 48 fractures of the fifth metacarpal neck in 48 patients, who underwent internal fixation using the two-pin L procedure. These fractures were treated between 1994 and 2000, in 5 female and 43 male patients with an average age of 27 years (range 14 to 58). Fighting and sporting accidents were the main etiology of injury. The indication for surgical treatment was volar displacement of over 30 degrees. The two-pin L procedure consists of stabilizing the fragments after reduction using one intra-medullary pin 2 mm in diameter introduced through a proximal approach, and a transverse distal pin 1.2 mm in diameter from the fifth toward the fourth metacarpal. All treatments were performed under nerve block. Early mobilization was authorized. Patients did not need any physiotherapy. Activity was resumed after three weeks, and the average time to the removal of pins was five weeks. In eight cases, it was necessary to remove the transverse distal pin around 21 days after surgery because of displacement of the pin causing pain under the skin. At three months follow-up, bone union was obtained in all cases, with a perfect range of motion of all finger joints, without any pain or reflex sympathetic dystrophy. The two-pin L procedure appears to be a reliable technique, which provided union in an anatomic position in all our cases, and also allowed early mobilization and provided good functional results.

Adolescent↗
PubMed2002

Restoration of movement using functional electrical stimulation and Bayes' theorem.

Various computational approaches have been applied to predict aspects of animal behavior from the recorded activity of populations of neurons. Here we invert this process to predict the requisite neuromuscular activity associated with specified motor behaviors. A probabilistic method based on Bayes' theorem was used to predict the patterns of muscular activity needed to produce various types of desired finger movements. The profiles of predicted activity were then used to drive frequency-modulated muscle stimulators to evoke multijoint finger movements. Comparison of movements generated by electrical stimulation with desired movements yielded root mean squared errors between approximately 18 and 26%. This reasonable correspondence between desired and evoked movements suggests that this approach might serve as a useful strategy to control neuroprosthetic systems that aim to restore movement to paralyzed individuals.

Algorithms↗