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1.
Z Rheumatol ; 59(4): 220-32, 2000 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-11013983

RESUMO

There are numerous diseases which can irreversibly stiffen the whole spine or parts of the axial skeleton. Due to didactic reasons one can distinguish 3 groups of such disorders: Paradigmatic diseases of the spine with an inherent proneness to stiffness. Rare diseases which involve a certain danger of stiffening the spine. Rigidity of the spine due to scientifically unrecognised morphologic phenomena.


Assuntos
Diagnóstico por Imagem , Hiperostose/diagnóstico , Doenças Profissionais/diagnóstico , Doenças da Coluna Vertebral/diagnóstico , Suporte de Carga/fisiologia , Diagnóstico Diferencial , Humanos , Hiperostose/etiologia , Doenças Profissionais/etiologia , Fatores de Risco , Doenças da Coluna Vertebral/etiologia , Espondilite Anquilosante/diagnóstico
2.
Eur J Radiol ; 27(3): 241-9, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9717640

RESUMO

Solitary osteosclerotic bone lesions around the sacroiliac (SI) joints are described as seen on plain radiographs or conventional tomography, with the descriptive attributes ranging from round to ovoid over square and triangular to multiform. The etiology of the solitary osteosclerotic lesions around the SI joint can often be concluded from the radiographic appearance, sometimes complemented by the presentation on CT and/or scintigraphy.


Assuntos
Osteosclerose/diagnóstico por imagem , Articulação Sacroilíaca/diagnóstico por imagem , Doenças da Coluna Vertebral/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Radiografia , Neoplasias da Coluna Vertebral/diagnóstico por imagem
3.
Rofo ; 168(2): 128-32, 1998 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-9519043

RESUMO

AIM: Description of a subtype of arthrosis deformans of the hand which is characterised as osteoclastic arthrosis. PATIENTS AND METHODS: Retrospective analysis of radiographs of the hands of 150 women and 100 men with radiological findings of arthrosis deformans. RESULTS: 5% of women and 2% of men showed at least one digital joint with subchondral osteolysis of one or both articulating bones involving at least a third of the phalanx. This subchondral osteolysis far exceeds the cysts which are situated in the epiphyseal part of the articular region. It may develop within a year. CONCLUSION: Osteoclastic arthrosis of the finger is a subtype of polyarthrosis of the hand. Serial observations suggest that an osteoclast stimulating substance is produced by the cysts or arises directly from the synovial fluid; this enters the subchondral part of the bone through clefts which may or may not be visible radiologically and that this produces osteoclastic activity. The most important differential diagnoses are chronic tophaceous gout and a benign tumor.


Assuntos
Artrite/diagnóstico por imagem , Reabsorção Óssea/diagnóstico por imagem , Dedos/diagnóstico por imagem , Mãos/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Adulto , Idoso , Artrite/classificação , Reabsorção Óssea/classificação , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/classificação , Osteólise/classificação , Osteólise/diagnóstico por imagem , Radiografia , Estudos Retrospectivos
4.
Clin Rheumatol ; 16(1): 13-24, 1997 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-9132321

RESUMO

The objective of this report is to provide a description of diagnostically significant scintigraphically recognizable sites and patterns of acquired hyperostosis syndrome (AHYS) on the anterior chest wall (ACW), which is involved in 82% of AHYS patients. In 49/90 of our own AHYS patients, planar bone scans of the ACW were performed with the gamma camera, applying an average of 650 MBq of 99mTc-phosphate complexes. In addition, 53 atraumatic patients with extrathoracic cancer were available for routine whole-body scintigraphy. None of these patients had increased uptake identifiable as metastasis clinically or by imaging modalities in either the ACW or the rest of the skeleton. The scintigraphic involvement of the various morphological ACW structures is described in AHYS. Moreover, attention is called to the diagnostic significance of focal hyperactivities at the anterior end of the 2nd-8th rib of adults, which are in the 5th place with respect to their frequency in AHYS. The diagnostic significance of sternocostal-joint involvement in AHYS can likewise be recognized by bone-scan scintigraphy and will be discussed. Bone scintigraphy is more sensitive than radiomorphological imaging in AHYS. This, however, only applies under three conditions. 1. The increased radiotracer uptake in the upper sternocostoclavicular region must be assessed on both the anterior and the posterior view of the ACW scan. 2. In addition to the anterior view of the routine scintiscan, further anterior scans with reduced scan time of the gamma camera are usually necessary. This ensures better visibility of the involvement of certain morphological structures that are important for AHYS diagnosis. Moreover, a statement can be made about the inflammatory ossifying activity/inactivity of the AHYS on ACW.3. Increased radionuclide uptake in the manubrium sterni and corpus sterni on the anterior scan should be verified by additional lateral or oblique scans of the thorax (sternum).


Assuntos
Hiperostose Esternocostoclavicular/diagnóstico por imagem , Osteíte/diagnóstico por imagem , Costelas/diagnóstico por imagem , Esterno/diagnóstico por imagem , Acne Vulgar/complicações , Acne Vulgar/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Hiperostose Esternocostoclavicular/complicações , Incidência , Masculino , Pessoa de Meia-Idade , Osteíte/complicações , Psoríase/complicações , Psoríase/epidemiologia , Cintilografia , Sensibilidade e Especificidade , Síndrome , Tórax/diagnóstico por imagem
6.
Aktuelle Radiol ; 6(5): 249-56, 1996 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-8991428

RESUMO

Increasing age is a risk factor for the development of osteoarthrosis of the joints of the hand in adults between 21 and 60 years of age. Only in the very old (> or = 80 years) is osteoarthrosis of the hand part of the age related degeneration. The literature contains different parameters and indices correlating the amounts of minerals and ashes of metacarpal bones. Our results speak in favour of the presumptions published by Exton-Smith et al. (1969 b) that bone mass belongs among the biological characteristics of old age. Our investigations of hand roentgenograms reveal that remodeling of the joint socket as described by pathologists is not a general but an elective phenomenon. With age the wrist shows only an increasing angle of the radial joint surface (males, right hand) and there is a variation of form in the medial sesamoid bone at the first metacarpus (males, left hand).


Assuntos
Densidade Óssea/fisiologia , Deformidades Adquiridas da Mão/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Osso e Ossos/diagnóstico por imagem , Feminino , Articulações dos Dedos/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Articulação do Punho/diagnóstico por imagem
10.
Aktuelle Radiol ; 5(6): 346-50, 1995 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-8580130

RESUMO

The introduction of the world's first Medical Desktop-Conference via public phone lines (ISDN-S2M) in spring 1994 for the weekly discussion of radiological findings with 25 orthopedic surgeons has proved the effectiveness of this system developed by the project BERMED. The use of standard hard- and software as well as ISDN are the most important factors to keep the system costs low. Technical advantages can be seen in the immediate, loss-free transmission of image and other patient-related data and in the integration of digital archives. Medical advantages are the 24-hour-availability of the radiologist and quality-control of the radiologists work. Practitioners and external hospitals can be tied closely to radiological service centers by using ISDNetwork.


Assuntos
Redes de Comunicação de Computadores/instrumentação , Sistemas de Informação em Radiologia/instrumentação , Software , Telerradiologia/instrumentação , Redes de Comunicação de Computadores/economia , Análise Custo-Benefício , Alemanha , Humanos , Sistemas de Informação em Radiologia/economia , Software/economia , Telerradiologia/economia
11.
Z Rheumatol ; 53(6): 351-6, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7871908

RESUMO

There are significant correlations between the surface of the acetabular roof sclerosis (supercilium acetabuli) in the hip joint on a normal a.p. radiograph and the corresponding surface of cartilage. This correlation can be defined through mathematical formulas and scaled afterwards. These scales are determined on the basis of our clinical experience with the new supercilium acetabuli score. The score is related to the biomechanical situation of the hip joint and describes 3 classes: Class I = optimum, class II = balance, class III = imbalanced correlation between the supercilium acetabuli and the corresponding part of the joint space. For simple measurement of both surfaces, we developed a measuring instrument, the superciliometer, with which it is possible to obtain standardized conclusions describing the functional morphology of the cartilage in the pressure distribution zone of the hip joint, irrespective of whether there are already any visible radiological signs of coxarthrosis or not.


Assuntos
Acetábulo/fisiopatologia , Cartilagem Articular/fisiopatologia , Articulação do Quadril/fisiopatologia , Osteoartrite do Quadril/fisiopatologia , Acetábulo/diagnóstico por imagem , Adulto , Idoso , Fenômenos Biomecânicos , Cartilagem Articular/diagnóstico por imagem , Feminino , Luxação Congênita de Quadril/diagnóstico por imagem , Luxação Congênita de Quadril/fisiopatologia , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Quadril/diagnóstico por imagem , Radiografia , Valores de Referência , Suporte de Carga/fisiologia
12.
Z Rheumatol ; 53(3): 142-9, 1994.
Artigo em Alemão | MEDLINE | ID: mdl-8091868

RESUMO

To examine the rate of side effects and the dose dependence of side effects 185 consecutive patients with active rheumatoid arthritis were randomized to receive 15 mg (group A) or 25 mg (group B) methotrexate (MTX) per week and studied prospectively over 12 months. Dose adjustments were performed according to tolerability and efficacy. With 168 patients eligible for evaluation the rate of withdrawal for any reason was 26% in group A and 27% in B. Withdrawal due to side effects occurred in 16% versus 18%, dose reduction due to side effects in 10% versus 9%. The higher dose was associated with a significantly higher rate of gastrointestinal side effects (28% vs. 17%, p < 0.05) and a tendency for more frequent elevations of transaminases. Other side effects were not dose dependent. A significantly higher rate of dose reduction due to improvement (35% versus 10%, p < 0.001), a more rapid decline of morning stiffness, and a higher number of patients reporting marked improvement are evidence in favour of higher therapeutic efficacy of the higher dose. In conclusion, an initial dose of 25 mg MTX/week is not associated with a higher rate of limiting side effects as compared with 15 mg/week. The efficacy of doses up to 25 mg/week should be examined in more detail.


Assuntos
Artrite Reumatoide/tratamento farmacológico , Metotrexato/administração & dosagem , Adulto , Idoso , Artrite Reumatoide/diagnóstico , Relação Dose-Resposta a Droga , Quimioterapia Combinada , Seguimentos , Humanos , Masculino , Metotrexato/efeitos adversos , Metilprednisolona/administração & dosagem , Metilprednisolona/efeitos adversos , Pessoa de Meia-Idade , Amplitude de Movimento Articular/efeitos dos fármacos
14.
Clin Investig ; 72(1): 4-11, 1993 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-8136615

RESUMO

The acquired hyperostosis syndrome (AHS) is a chronic inflammatory disorder of bone of unknown etiology. It is accompanied by circumscribed hyperostosis which can be associated with ossifying lesions at sites of tendinous and ligamentary insertions and erosive or non-erosive arthritis. The predominant location of lesions is the sternocostoclavicular region (approximately 80% of patients), less frequent are involvement of the spine, pelvis, and appendicular skeleton. In 20%-60% of cases AHS is associated with palmoplantar pustulosis, psoriasis, or severe acne (acne fulminans or conglobata). The X-ray appearance of AHS is a more or less homogeneous increase in density with blurred margins, which on scintiscan with labeled phosphate compounds is associated with intense accretion of tracer. These features are associated with a variable increase in the acute phase reactants and a conspicuously low increase, if any, in serum alkaline phosphatase. The therapeutic modalities which have been used so far are entirely symptomatic. Long-lasting improvement has been reported following percutaneous anti-inflammatory radiation therapy.


Assuntos
Hiperostose , Acne Vulgar/complicações , Diagnóstico Diferencial , Feminino , Humanos , Hiperostose/complicações , Hiperostose/diagnóstico por imagem , Hiperostose/patologia , Hiperostose/terapia , Inflamação , Masculino , Psoríase/complicações , Cintilografia , Articulação Esternoclavicular/diagnóstico por imagem , Articulação Esternoclavicular/patologia , Articulações Esternocostais/diagnóstico por imagem , Articulações Esternocostais/patologia , Síndrome , Tomografia Computadorizada por Raios X
16.
Wien Klin Wochenschr ; 105(5): 127-38, 1993.
Artigo em Alemão | MEDLINE | ID: mdl-8465519

RESUMO

The acquired hyperostosis syndrome (AHS) (best known synonym: pustulotic arthro-osteitis) is a system disease of the supporting and gliding tissue with sites of predilection characterized by inflammation-induced bony reconstruction of positive balance. This syndrome is affiliated with the seronegative spondylarthropathies. The main finding is the sternocostoclavicular hyperostosis in about 80% of patients. Focal hyperostoses also occur on the skeleton of truncus and extremities and joints. AHS is accompanied by psoriasiform and acneform dermatoses. Overlapping findings with spondylitis ankylosans are reported. Terminology, aetiology, nosology, pathogenesis, histomorphology, clinical and laboratory findings, complications, imaging diagnostic, differential diagnosis and therapy of AHS are discussed. Knowing AHS helps to prevent misdiagnoses (as especially bacterial osteomyelitis, spondylitis, osteoplastic tumor and metastases) and interventional diagnostic procedures.


Assuntos
Hiperostose/etiologia , Osteoartrite/etiologia , Diagnóstico Diferencial , Humanos , Hiperostose/diagnóstico , Hiperostose/terapia , Hiperostose Esternocostoclavicular/diagnóstico , Hiperostose Esternocostoclavicular/etiologia , Hiperostose Esternocostoclavicular/terapia , Ossificação Heterotópica/diagnóstico , Ossificação Heterotópica/etiologia , Ossificação Heterotópica/terapia , Osteoartrite/diagnóstico , Osteoartrite/terapia , Tomografia por Raios X
17.
Rofo ; 157(3): 235-8, 1992 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-1391817

RESUMO

Adhesive (retractile) capsulitis of the hip joint is a rare complication (association) of (juvenile) diabetes mellitus. The clinical features, plain radiographic and CT findings and histomorphological appearances of this condition are described and attention is drawn to changes in the elastic tissue in the fibrosed capsule. Three diagnostic radiological features have been defined; in their presence, arthrography or diagnostic arthroscopy need not be performed.


Assuntos
Diabetes Mellitus Tipo 1/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Periartrite/diagnóstico por imagem , Tendinopatia/diagnóstico por imagem , Adulto , Doença Crônica , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/patologia , Articulação do Quadril/patologia , Humanos , Masculino , Periartrite/etiologia , Periartrite/patologia , Radiografia , Tendinopatia/etiologia , Tendinopatia/patologia , Aderências Teciduais/diagnóstico por imagem , Aderências Teciduais/etiologia , Aderências Teciduais/patologia
18.
Rofo ; 156(5): 411-4, 1992 May.
Artigo em Alemão | MEDLINE | ID: mdl-1596540

RESUMO

The capsule of the hip joint can always be demonstrated on antero-posterior radiographs provided two conditions are met: 1. the so-called gluteus minimus fat stripe is shown and 2. the exposure is made in maximal external rotation which can be either active or, better still, passive. Under these conditions the joint capsule appears as a soft tissue band stretched between the margin ot the acetabulum and the upper end of the greater trochanter. Effusions or oedemas of the hip joint cause lateral displacement of the gluteus minimus fat stripe. Anatomical and radiological comparisons, including computed tomography, confirm that the joint capsule of the hip can be demonstrated in this way.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Articulação do Quadril/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Músculos/diagnóstico por imagem , Postura , Tomografia Computadorizada por Raios X
19.
Rofo ; 156(5): 420-4, 1992 May.
Artigo em Alemão | MEDLINE | ID: mdl-1596542

RESUMO

Normal values in adults for the hip joint (3.5-6 mm), the sacro-iliac joint (1-3.5 mm) and the symphysis (up to 7.5 mm) were obtained by measurements of a.p. views of the pelvis. Contrary to the literature there was no sex difference as regards the CCD. The roentgenometric features of the female and male pelvis depend on the pubic angle, the transverse diameter of the pelvic inlet and the sulcus paraglenoidalis. In females there are age-related changes consisting of a reduction of the pubic angle, increasing height of the symphysis components of the pubis and an increase in the transverse diameter of the pelvis. In the male, age changes consist of an increase of the symphysis component of the pubis and the transverse diameter of the pelvis.


Assuntos
Envelhecimento , Ossos Pélvicos/diagnóstico por imagem , Caracteres Sexuais , Adulto , Idoso , Feminino , Articulação do Quadril/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/lesões , Sínfise Pubiana/diagnóstico por imagem , Radiografia , Valores de Referência , Articulação Sacroilíaca/diagnóstico por imagem
20.
Radiologe ; 31(10): 496-505, 1991 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-1956981

RESUMO

Patients with problems following implantation of cemented total hip prostheses must be clinically examined. This examination is followed by a series of diagnostic imaging procedures. These include X-ray diagnosis, 3-phase 99mTc-MDP bone scans, scintigraphy for inflammation, and arthrography, performed singly or as sequential studies. X-ray findings and scintigraphic patterns arousing or confirming a suspicion of aseptic (mechanical) or septic (infectious) loosening of the prosthesis are evaluated and discussed.


Assuntos
Prótese de Quadril/efeitos adversos , Infecções Relacionadas à Prótese/diagnóstico , Humanos , Falha de Prótese , Infecções Relacionadas à Prótese/diagnóstico por imagem , Radiografia , Cintilografia , Medronato de Tecnécio Tc 99m
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