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1.
Tuberculosis of the patella 总被引:1,自引:0,他引:1
M. S. Dhillon S. Srinivas Rao M. S. Sandhu Rakesh K. Vasisht O. N. Nagi 《Skeletal radiology》1998,27(1):40-42
A rare case of tuberculosis of the patella is presented. Diagnostic features include an osteolytic lesion in the patella
with flaky sequestrum, associated with typical clinical features. Treatment should be urgent and should include a regimen
of surgical debridement along with four antitubercular drugs. Once the joint is involved, the end results become less satisfactory. 相似文献
2.
Shah J Patkar D Parikh B Parmar H Varma R Patankar T Prasad S 《Skeletal radiology》2000,29(8):447-453
Objective. To describe the imaging findings in sterno-clavicular tubercular involvement.
Design and patients. Fifteen patients with pathologically proven tuberculosis of the sternum and clavicle were retrospectively evaluated. Routine
radiography, computed tomography (CT) and magnetic resonance imaging (MRI) were used in some or all of the patients. Clinical
information and imaging features were evaluated in each case.
Results. Eight patients had sterno-clavicular joint (SCJ) involvement, five had isolated sternal involvement and two had isolated
clavicular involvement. Seven patients were evaluated with only CT, six with only MRI and two with both. There were eight
male and seven female patients, varying in age between 16 and 78 years. Fever, swelling and pain were common presenting symptoms.
Two patients were HIV positive. Radiographs were positive in only eight patients. Destruction and signal intensity (SI) changes
of the sternum and clavicle, destruction of the cartilage, soft tissue changes representing granulation tissue/abscess, displacement
of the adjacent structures (vessels, trachea, etc.) and inflammatory changes in the adjacent structures in the form of cellulitis
and myositis were common imaging features.
Conclusions. All imaging methods can provide complementary information regarding sterno-clavicular tubercular involvement that is helpful
for determination of the therapy. MRI is useful in determining the extent of the lesion, particularly marrow involvement and soft tissue extent.
Received: 6 December 1999 Revision requested:18 January 2000 Revision received: 23 February 2000 Accepted: 14 March 2000 相似文献
3.
Tuberculosis remains a major international health problem despite advances in radiological diagnosis and antituberculous therapy. Disseminated tuberculous infection affecting a single bone and manifested as multifocal lytic cortical lesions is rare and unusual. We report on a 50-year-old man with multifocal involvement of the femur by tuberculosis and demonstrate positive reaction using tuberculosis-polymerase chain reaction on formalin-fixed, paraffin-embedded histological specimens. 相似文献
4.
MRI in chronic recurrent multifocal osteomyelitis 总被引:3,自引:0,他引:3
Objective. To review our experience of chronic recurrent multifocal osteomyelitis (CRMO) and to assess the value of MRI in this rare
disease, which mainly affects children and adolescents.
Design and patients. Seventeen patients from our departments were reviewed. All underwent conventional radiography and MRI, and most had bone
scintigraphy. All had undergone bone biopsy, with microbiological and histopathological examinations, to exclude infectious
disease, tumours and tumour-like lesions.
Results and conclusion. CRMO affects predominantly the tubular bones of the limbs, followed by the clavicle and the spine. Other locations are rare.
Diagnosis is important in avoiding unnecessary diagnostic procedures and to initiate appropriate therapy, and is usually based
on a characteristic course and the appearances on radiography. However, CRMO lesions of tubular bones and the spine exhibit
quite characteristic MRI features which support the diagnosis, while the appearance of the early clavicular lesion is non-specific.
At all sites of CRMO in the skeleton, MRI is valuable in assessing the extent and activity of the lesion. It may exclude pyogenic
involvement of the bone and soft tissues and guide effective biopsy. 相似文献
5.
Patankar T Krishnan A Patkar D Kale H Prasad S Shah J Castillo M 《Skeletal radiology》2000,29(7):392-396
Objective. To review imaging studies of isolated involvement of the sacrum due to tuberculosis and determine the role of imaging in
the diagnosis and management of these patients.
Design and patients. A retrospective analysis of 15 cases of isolated sacral tuberculosis imaged with MR imaging was performed. The CT images
were also reviewed where available, and the various lesion characteristics were identified. We also reviewed the medical records
in an attempt to determine the impact of the imaging studies on the management of these patients.
Results. Fifteen patients (5 male, 10 female) presented with symptoms of 3–15 months’ duration. Chronic localized backache with muscle
spasm was the commonest presenting symptom; discharging sinuses with abscess formation was found in six patients, five of
whom were children. MR imaging of the sacrum revealed a hypointense marrow signal on T1-weighted images and hyperintense signal
on T2-weighted images in 14 of 15 patients, the S2 vertebra being always involved. CT revealed osteolytic changes in the sacrum
in all the five patients in whom CT was performed. All patients showed marked clinical improvement within 1 year of anti-tuberculous
chemotherapy.
Conclusion. Isolated tuberculosis of the sacrum is uncommon but should be suspected in patients presenting with chronic low backache
or children with discharging sinuses/abscesses and showing sacral destruction on CT or MR imaging. MR imaging can identify
cases and enables early institution of anti- tuberculous chemotherapy.
Received: 31 August 1999 Revision requested: 1 November 1999 Revision received: 27 March 2000 Accepted: 14 April 2000 相似文献
6.
Objective. To describe the sonographic findings of septic arthritis of the acromioclavicular joint.
Design and patients. A retrospective study of five male patients was carried out. Four of the patients were referred because of signs and symptoms
suggestive of glenohumeral joint septic arthritis, one for signs and symptoms suggestive of septic arthritis of the acromioclavicular
joint. All the acromioclavicular joints were evaluated with ultrasound, aspirated and the aspirate cultured.
Results. All patients had normal ultrasound findings of their glenohumeral joints and distended acromioclavicular joints as determined
by ultrasound. Ultrasound examination elicited focal tenderness over the acromioclavicular joint. Aspirates of each acromioclavicular
joint grew pyogenic organisms.
Conclusion. Infection in the acromio-clavicular joint is uncommon, but is seen in increased frequency in immune-compromised patients
and intravenous drug users. A normal glenohumeral joint on ultrasound in a patient suspected of having a septic shoulder should
prompt careful review of the acromioclavicular joint. Aspiration of the acromioclavicular joint is easily performed under
ultrasound guidance.
Received: 16 May 2000 Revision requested: 18 July 2000 Revision received: 10 October 2000 Accepted: 27 November 2000 相似文献
7.
Tuberculous gluteal abscess without bone involvement 总被引:1,自引:0,他引:1
A cold abscess secondary to tuberculous spondylitis or osteomyelitis is a well-recognized entity. However, a soft tissue
tuberculous abscess without bone involvement is rare. We present such a case. 相似文献
8.
Discrete synchronous multifocal osteoid osteoma of the humerus 总被引:1,自引:0,他引:1
A 24-year-old patient is described who had a 4-year history of pain in the right upper arm, with distinct night pain, that
responded to salicylates. From the findings on conventional radiography, bone scintigraphy and MRI a multifocal osteoid osteoma
was suspected, with one focus in the cancellous region of the greater tuberosity and a second cortical focus at the proximal
humeral diaphysis. The resection ’’en bloc’’ of both tumors and histological examination confirmed the diagnosis. The patient
was painfree after the curative resection of the two osteoid osteomas. Osteoid osteoma is a frequently found benign bone tumor,
accounting for approximately 11% of cases. In rare cases a multicentric occurrence has been described. A possible occurrence
of more than one osteoid osteoma in a single bone, not verified histologically, has been reported only three times in the
literature. In patients with scintigraphic and radiographic findings of two foci, discrete synchronous multifocal osteoid
osteomas should be suspected. 相似文献
9.
Objective. To report the development of high-resolution targeted magnetic-resonance imaging (MRI) techniques (not using injections
of contrast media) to investigate and monitor rheumatoid arthritis (RA) in the metacarpophalangeal (MCP) joints.
Design and patients. A total of 25 RA patients (age range 30–68 years) with varying degrees of disease severity ranging from early onset through
active disease to the burnt-out stage, were imaged. (One patient subsequently underwent surgery and histological data was
obtained.) A series of 10 control subjects were also studied – two for each 10-year age range. All the RA subjects were assessed
for disease activity using standard clinical criteria and radiography as part of normal procedures. MRI was carried out using
a targeted system and novel radiofrequency coil. Images of the MCP were performed at very high resolution with 1.5 mm slice
thickness and in-plane resolution 130 μm. Standard gradient-echo (GE) sequences were used for anatomical imaging, multiple-echo
GE sequences used to produce effective spin-spin relaxation time (T2*) maps and optimised binomial-pulse presaturation used
in conjunction with a GE sequence to generate magnetization-transfer (MT) ratio maps.
Results. High-quality high-resolution images of the MCP joints were obtained which highlighted normal anatomy and key features characterising
the disease state (e.g. pannus, bone erosions, vascularity). Accurate measurements of T2* and MT with variations of ±4% and
±2% respectively were achieved. In active disease, variations in T2* and MT could be determined throughout areas of pannus,
clearly demonstrating the heterogeneity of this erosive tissue. Pannus in MCP joints with active destruction was found to
have high values of T2* varying from 25 ms to 40 ms with pockets up to 100 ms, whereas pannus present in chronic destruction,
or burnt-out disease, had T2* values ranging from 21 to 29 ms. MT-active tissue was uniformly distributed in burnt-out disease,
which was confirmed histologically in one case, compared with a more heterogeneous distribution in active disease.
Conclusion. The MRI sequences and targeted system developed allow high-resolution studies of RA disease progression and activity. The
data confirm the variable pattern of the disease and, in particular, heterogeneity of pannus.
Received: 21 July 1999 Revision requested: 29 September 1999 Revision received: 10 February 2000 Accepted: 14 March 2000 相似文献
10.
Vuillemin-Bodaghi V Parlier-Cuau C Cywiner-Golenzer C Quillard A Kaplan G Laredo JD 《Skeletal radiology》2000,29(6):349-353
The most serious complication of Paget’s disease is sarcomatous degeneration of pagetic bone. Multifocal sarcomatous degeneration
occurs mainly in polyostotic Paget’s disease. Multifocal Paget’s sarcoma is uncommon and can arise in any site. We report
two cases of synchronous multifocal sarcomatous degeneration. The two patients were elderly women (aged 77 and 86 years, respectively)
who developed sarcomatous lesions concomitantly, in the first case report in left ilium, left tibia, and first lumbar vertebra
and in the second case report in the skull, right ilium, and sacrum. Whether these cases are due to the simultaneous development
of several primaries or to metastases from a single primary remains unclear.
Received: 3 August 1998 Revision requested: 14 September 1998 Revision received: 6 March 2000 Accepted: 14 March 2000 相似文献
11.
Objective, design and patients. Conventional frontal tomography of the sternum has to some extent been replaced by spiral computed tomography (CT). The objective
of this study was to analyse this change of procedure in terms of dosimetry by measurement of the radiation dose to individual
organs using an anthropomorphic Rando Alderson phantom. Results. The total effective radiation dose in examination of the sternoclavicular joints and the manubrium sterni was found to be
lower using spiral CT than conventional tomography, the values being 0.6 and 0.8 mSv, respectively. Conclusion. As spiral CT is diagnostically comparable and in some respects superior to tomography, its use is recommended for studies
of the sternum. 相似文献
12.
A 39-year-old man with acromegaly exhibited locking of metacarpophalangeal (MCP) joints of both index fingers. Large osteophytes
were found at the metacarpal heads by radiography and computerized tomography (CT). Magnetic resonance (MR) images revealed
hypertrophy of volar plates. We suggest that these characteristic acromegalic features caused locking of MCP joints. Surgery
was required on one of the joints to release the locking.
Received: 17 May 1999 Revision requested: 28 June 1999 Revision received: 19 July 1999 Accepted: 21 July 1999 相似文献
13.
C. C. A. Nolte-Ernsting Gerhard Adam Markus Bühne Andreas Prescher Rolf W. Günther 《Skeletal radiology》1996,25(5):413-420
Objective. The objective of this study was to determine the value of MRI in the detection of degenerative bone marrow abnormalities in
an animal osteoarthritis model. Design. In 10 dogs with experimentally induced unilateral osteoarthritis of the knee, MRI was performed using two-dimensional spin-echo
(2D-SE) and three-dimensional gradient-echo (3D-GE) imaging. Contrast enhanced T1-weighted 2D-SE sequences were also obtained
after injection of gadolinium-DTPA. The results were compared with the gross and histopathologic findings and with radiography.
Results. Histopathologic specimens revealed 21 osteosclerotic lesions and 5 intraosseous cysts. On 2D-SE images, 24 of 26 lesions were
detected, while 21 of 26 lesions were identified on 2D-GE sequences. Radiography, including conventional tomography, demonstrated
9 of 26 lesions. Regardless of the sequence weighting, all osteosclerotic lesions appeared hypointense on MRI. Signal loss
in bone sclerosis resulted primarily from the reduction of intact fat marrow, the increased bone density being of secondary
importance. Quantitative signal analysis allowed approximate estimation of the grade of sclerosis. On postcontrast images,
sclerotic bone remained hypointense, although significant but non-specific enhancement relative to the normal fat marrow was
observed. The extent of contrast enhancement did not correlate with the grade of osteosclerosis. All five cysts were readily
diagnosed by MRI. Cysts displayed either central or marginal contrast enhancement within their cavities. Conclusions. MRI provides a sensitive method for the diagnosis of osteoarthritic bone abnormalities, allowing their differentiation from
most non-degenerative subarticular lesions. 相似文献
14.
We present a case of sarcoidosis with soft tissue masses and associated phalangeal erosive changes. Sarcoidosis of the musculoskeletal
system presenting as a soft tissue mass has been described previously but is rare. To our knowledge, the combination of soft
tissue masses and phalangeal erosions has never been described. 相似文献
15.
I. F. Abdelwahab Martin B. Camins George Hermann Michael J. Klein 《Skeletal radiology》1997,26(12):737-740
Posterior spinal tuberculosis or arch tuberculosis is a form of skeletal tuberculosis that selectively involves the vertebral
arch. It may mimic skeletal neoplasm clinically and radiographically. Although posterior spinal tuberculosis has been reported
in developing countries it has rarely been found in the United States. As a result, there is limited information about this
entity in the US literature. We are presenting our experience in a patient born in the United States. 相似文献
16.
MR imaging and CT in osteoarthritis of the lumbar facet joints 总被引:11,自引:0,他引:11
Objective. To test the agreement between MR imaging and CT in the assessment of osteoarthritis of the lumbar facet joints, and thus
to provide data about the need for an additional CT scan in the presence of an MR examination. Design and patients. Using a four-point scale, two musculoskeletal radiologists independently graded the severity of osteoarthritis of 308 lumbar
facet joints on axial T2-weighted and on sagittal T1- and T2-weighted turbo-spin-echo images and separately on the corresponding
axial CT scans. Kappa statistics and percentage agreement were calculated. Results. The weighted kappa coefficients for MR imaging versus CT were 0.61 and 0.49 for readers 1 and 2, respectively. The weighted
kappa coefficients for interobserver agreement were 0.41 for MR imaging and 0.60 for CT, respectively. There was agreement
within one grade between MR and CT images in 95% of cases for reader 1, and in 97% of cases for reader 2. Conclusion. With regard to osteoarthritis of the lumbar facet joints there is moderate to good agreement between MR imaging and CT. When
differences of one grade are disregarded agreement is even excellent. Therefore, in the presence of an MR examination CT is
not required for the assessment of facet joint degeneration.
Received: 12 June 1998 Revision requested: 20 October 1998 Revision received: 29 December 1998 Accepted: 14 January 1999 相似文献
17.
Yong-Koo Park Juhie Lee Moon Ho Yang S. Lee Woo Suk Choi Dong-Mok Ryu 《Skeletal radiology》1996,25(8):762-765
Myxoma of the jaw bone is a peculiar and rare tumor. A case of myxoma of the mandible is described in a 38-year-old man.
The plain X-ray showed multiple osteolytic destructive lesions in the molar root area. CT scans demonstrated osteolytic expansile
lesions with mild enhancement of the solid portion of the mass. Histologically, the tumor is composed of plump stellate cells
with abundant amorphous myxoid stroma. 相似文献
18.
David B. Stafford Johnson William Breidahl Joel S. Newman Kenneth Devaney Alan Yahanda 《Skeletal radiology》1997,26(8):501-504
Mesenchymal chondrosarcomas (MSCs) are a rare form of chondrosarcoma which usually arise in bone. Extraskeletal chondro-sarcomas
constitute a minority (14–25%) of MSCs. We describe the imaging features of an extraskeletal mesenchymal chondrosarcoma that
arose from the rectus abdominus muscle. 相似文献
19.
20.
活动性肺结核的CT诊断 总被引:1,自引:0,他引:1
进一步了解活动性肺结核的CT表现及其临床应用价值。材料和方法:回顾分析经病理和临床证实的32例活动性肺结核CT表现,并与20例非活动性肺结核作对照。结果:人28例活动性肺结核发生在上叶尖后段、下叶背段;有20例呈 不规则斑片状影,边界不清,密度不均;14例可见病灶钙化,其中9例发生在狭窄或阻塞支气管的增厚管壁上;11例在实变影中见多发性小空洞;病灶周围有支气管播散者15例;8例见纵隔淋巴结肿大,其 相似文献