W Reinus | Temple University (original) (raw)

Papers by W Reinus

The American journal of gastroenterology, 1992

We studied common duct (CD) diameter using real time ultrasound in 551 patients. The patients wer... more We studied common duct (CD) diameter using real time ultrasound in 551 patients. The patients were divided into two groups: those referred for evaluation of the biliary tree [biliary-referred group (BRG)], and those referred for a problem unrelated to potential biliary tree pathology [non-biliary-referred group (NBRG)]. Potentially obstructed CDs were excluded from analysis. The CD diameter in the NBRG patients was found to increase after cholecystectomy (p less than 0.0003), but not in patients in this group with intact gallbladders and cholelithiasis. Dilation was observed in the BRG patients with either cholelithiasis (p less than 6 x 10(-7)) or cholecystectomy (p less than 4 x 10(-10)) compared to patients with intact gallbladders without cholelithiasis. To our knowledge, the former phenomenon has not been described in the literature. Our NBRG data suggest that the normal CD diameter should be set at 5 mm and 8 mm, respectively, for patients with intact gallbladders and patients...

American Journal of Roentgenology, 1986

American Journal of Roentgenology, 1985

Fifty patients were analyzed after a randomized double-blind study comparing Hexabrix and Hexabnx... more Fifty patients were analyzed after a randomized double-blind study comparing Hexabrix and Hexabnx-20 in ascending phlebography. Measures of safety and patient tolerance indicated that both concentrations of Hexabrix appeared safe and were well tolerated. All studies were diagnostic, and the image quality was rated as excellent in 80% of the Hexabrix group and 72% of the Hexabrix-20 group.

American Journal of Roentgenology, 1985

Thirty-nine consecutive patients referred for shoulder arthrography underwent shoulder sonography... more Thirty-nine consecutive patients referred for shoulder arthrography underwent shoulder sonography to determine the ability of sonography to detect rotator cuff tears. Fifteen patients had arthrographically proven rotator cuff tears. Of these, 14 were detected by sonography, for a sensitivity

Medicine, 1997

Although the etiology of Paget bone disease (PBD) is unknown, increasing evidence implicates a &a... more Although the etiology of Paget bone disease (PBD) is unknown, increasing evidence implicates a "slow virus" infection of the skeleton, perhaps in genetically predisposed individuals. PBD is rare in Asia. We describe a Korean family with PBD. The propositus noticed bowed limbs at approximately 25 years of age. Radiologic studies made when he was 55 years old revealed essentially panostotic PBD. Serum alkaline phosphatase (ALP) activity and osteocalcin (OC) levels were markedly elevated. An iliac crest specimen showed classic histopathologic changes of PBD. Additionally, palpable swellings were first observed at age 45 years at his occiput, pubic ramus, ileum, and facial bones. They contained numerous multinucleated cells and were originally diagnosed as giant cell tumors. However, we found that, like osteoclasts, these cells expressed considerable tartrate-resistant acid phosphatase activity. These "extraskeletal osteoclastomas" resolved rapidly with dexamethasone treatment. Two daughters, 20- and 24-years-of-age, were discovered by study of his 5 children to have elevated serum ALP activity and OC levels and widespread PBD. Both women, however, are without palpable masses and are asymptomatic. The propositus' father, who died at age 55 years, had similar skeletal deformities beginning at age 20 years, but was not examined. Leukocytopenia was found in the 3 living family members with PBD. There was no evidence for linkage of the PBD to HLA loci. The condition appears to be transmitted as an autosomal dominant trait and is manifest in young adult life. Multicentric extraskeletal osteoclastomas with remarkable sensitivity to dexamethasone treatment appear to be another unusual feature of this family's disorder. In this family, the stimulus for PBD is so great that the PBD is apparent at an early age, affects essentially the entire skeleton, and leads to the formation or extension of osteoclast-like cells into nonosseous tissues (extraskeletal osteoclastomas). This 3-generation kindred in Korea, where PBD is rare, shows a strong clustering of PBD compatible with autosomal dominant inheritance. Leukocytopenia appears to distinguish affected family members, but any role for this abnormality in the pathogenesis of PBD is unclear. Our findings support a heritable diathesis for PBD, perhaps mediated by an immune deficiency.

Investigative Radiology, 1994

Use of a neural network to diagnose focal lesions of bone was evaluated. Imaging features of 709 ... more Use of a neural network to diagnose focal lesions of bone was evaluated. Imaging features of 709 lesions were encoded into a predetermined database. Data were divided into four groups and were analyzed using cross-validation by a two-layer feed-forward neural network. The lesions comprised 43 different pathologic diagnoses. Overall, the network was 85% accurate in distinguishing benign from malignant lesions. With a differential list of five diagnoses, the list was internally consistent regarding benign and malignant lesions 81.9% of the time. The network correctly diagnosed 56% of the lesions by pathologic diagnosis as its first choice. It included the correct diagnosis 71.8% of the time in a differential list of three diagnoses and 87.3% of the time in a differential list of nine diagnoses. Although not yet adequate for clinical use, neural network diagnosis of bone lesions is in its infancy and has important implications for the future analysis of focal bone lesions.

Orthopedics, 1987

Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the li... more Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the literature and past clinical experience at our institution, early establishment of the correct diagnosis enabling definitive treatment may be difficult. We describe six patients with tenosynovitis of tendons about the ankle, the value of tenography in staging the severity of their disease, and its value in choosing appropriate definitive therapy.

Journal of medical systems, 2000

A nonpreemptive queuing system based upon operations management theory is used to evaluate expect... more A nonpreemptive queuing system based upon operations management theory is used to evaluate expected steady state wait periods for traditional and distributed CT scheduling models. Both models are constructed using two classes of patient service--emergent and nonemergent. The former model uses only one point of service per scanner while the latter employs multiple points of service in order to accomplish all of the functions necessary to complete a CT scan. Sample data are drawn from a tertiary care hospital-based system using a traditional service model. Comparison of a traditional and distributed service system, each with emergent and nonemergent service classes, shows that breaking as many activities as possible out of the scanner should provide substantial improvements in cost efficiency and service for patients having CT scans. Nonemergent patients may experience as much as an 89% reduction in steady-state wait times while emergent patients may experience as much as a 59% reduct...

Investigative Radiology, 1995

To quantitate features that distinguish the plain radiographic appearance of eosinophilic granulo... more To quantitate features that distinguish the plain radiographic appearance of eosinophilic granuloma (EG) from other solitary lesions of bone. Seven hundred nine focal bone lesions, including 26 EGs, were analyzed according to demographic, anatomic, and plain radiographic features. Vector analysis of groups of features was performed to determine those that are most sensitive and specific for the appearance of EG in contrast to other lesions in the data base. The radiographic appearance of EGs was most consistently that of a medullary based lytic lesion (100%) with geographic destruction (76.9%), lobular contour (73.1%), and well-defined edges (73.1%). Long bone lesions showed these features more frequently than EGs in other locations. Periosteal reaction was visible in all long bone lesions but in only one nonlong bone lesion (5.9%). Characterization of EG in long bones as a lytic, medullary-based metaphyseal or diaphyseal lesion with geographic destruction, lobular contours, periost...

Skeletal Radiology, 1992

We analyzed 16 radiographic features of primary Ewing's sarcoma in 342 patients from the lESS 729... more We analyzed 16 radiographic features of primary Ewing's sarcoma in 342 patients from the lESS 7299 (Intergroup Ewing's Sarcoma Study) for prognostic significance. Of these, 3 features demonstrated a statistically significant relationship to survival: maximal tumor dimension, tumor location, and an appearance of honeycombing within the lesion. Those individuals with primary lesions centered in the pelvis, femur, or humerus had a worse survival rate than those with lesions centered elsewhere. Similarly, we observed an inverse relationship between the greatest dimension of the osseous portion of the lesion and survival. The radiographic finding of honeycombing also showed a statistical association with improved survival. However, this feature was observed infrequently, and its significance should be assessed further. Otherwise, no other feature that we analyzed showed any relationship to patient prognosis.

Investigative Radiology, 1988

Measurements of bone mineral using single and dual-energy quantitative computed tomography (CT) a... more Measurements of bone mineral using single and dual-energy quantitative computed tomography (CT) are examined in vivo in 108 vertebral bodies scanned on a Siemens DRH scanner. Pre and postprocessing dual-energy techniques are compared. In the range of clinically useful kilovoltage, the choice of beam energy does not make a significant difference to the single-energy bone mineral measurement. Postprocessing dual-energy measurement in vivo shows a statistically significant decrease in the amount of mineral measured compared to single-energy measurements, whereas the preprocessing measurement shows a significant increase.

Investigative Radiology, 1996

To determine if the clinical variables that are important for selecting patients for emergency cr... more To determine if the clinical variables that are important for selecting patients for emergency cranial computed tomography (CT) are population dependent. Prior to obtaining scans, physicians working in an emergency department in a level II trauma center completed a form describing the indication for the CT examination. These data were matched to the CT scan results and analyzed statistically using univariate and multivariate methods. These results were compared with a prior study at a level I trauma center. Of 551 patients having cranial CT, neurologic examination was positive in 340 and CT scan was positive in 122. The neurologic examination correlated strongly with the results of the CT scan (P < 0.00001). In this patient population, the most important clinical predictors of 17 abnormal CT scans from the 211 patients without positive neurologic examinations were seizure and a history of neoplasm. These high-yield variables differ from our prior retrospective study in which intoxication and amnesia were the important predictors in patients with negative examinations. The difference in predictors between the populations most likely results from different prevalences of trauma and ischemic disease. Abnormal neurologic examination is the most important criterion available to select patients for emergency cranial CT. Other variables (eg, seizure, amnesia, intoxication, and history of neoplasm) that help select patients without neurologic findings appear to be population dependent.

Orthopedics, 1987

Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the li... more Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the literature and past clinical experience at our institution, early establishment of the correct diagnosis enabling definitive treatment may be difficult. We describe six patients with tenosynovitis of tendons about the ankle, the value of tenography in staging the severity of their disease, and its value in choosing appropriate definitive therapy.

Journal of medical systems, 2000

A nonpreemptive queuing system based upon operations management theory is used to evaluate expect... more A nonpreemptive queuing system based upon operations management theory is used to evaluate expected steady state wait periods for traditional and distributed CT scheduling models. Both models are constructed using two classes of patient service--emergent and nonemergent. The former model uses only one point of service per scanner while the latter employs multiple points of service in order to accomplish all of the functions necessary to complete a CT scan. Sample data are drawn from a tertiary care hospital-based system using a traditional service model. Comparison of a traditional and distributed service system, each with emergent and nonemergent service classes, shows that breaking as many activities as possible out of the scanner should provide substantial improvements in cost efficiency and service for patients having CT scans. Nonemergent patients may experience as much as an 89% reduction in steady-state wait times while emergent patients may experience as much as a 59% reduct...

The American journal of sports medicine

The Journal of trauma, 1998

To show that magnetic resonance imaging (MRI) can be useful to diagnose radiographically invisibl... more To show that magnetic resonance imaging (MRI) can be useful to diagnose radiographically invisible greater tuberosity fractures in patients with clinical presentations suspicious for rotator cuff injury. Six patients with subtle greater tuberosity fractures who were sent for MRI because of possible rotator cuff tear are reviewed (age range, 27-51 years; mean, 40.5 +/- 8.4 years). Five of the patients recount direct trauma to their shoulders, whereas one noticed shoulder pain after a fall in which she fractured her ankle. MRI showed an area of edema confined to the greater tuberosity with linear low signal extending through the tuberosity consistent with a fracture in all cases. Although five patients had a complete set of shoulder radiographs before MRI, these were interpreted as normal in all cases. Full-thickness rotator cuff tears were not present in any of the cases. All of the patients were treated conservatively with good results. MRI can prevent unnecessary arthroscopy in pat...

Radiology, 1993

Charts from 1,074 consecutive emergency department patients who underwent cranial computed tomogr... more Charts from 1,074 consecutive emergency department patients who underwent cranial computed tomography (CT) were reviewed for predictors of a CT abnormality. Twenty-six clinical variables and the results of neurologic examination were compared with cranial CT findings. Patients with focal neurologic deficit, unresponsiveness, and hypertension had an increased risk of a CT abnormality. Blurred vision, trauma, loss of consciousness, headache, and dizziness were each associated with a lower risk of a CT abnormality. Multivariate analysis showed that only focal neurologic deficit and unresponsiveness effectively helped predict a CT abnormality. In patients with negative neurologic findings, only intoxication and amnesia were associated with greater than 10% positive scans and an increased risk for a CT abnormality. The data indicate that positive neurologic findings coupled with intoxication and amnesia would have helped detect 90.7% of the positive scans and provide an effective initial...

Radiology, 1993

To report cases of plasmacytoma with a radiologic appearance simulating that of chondrosarcoma. T... more To report cases of plasmacytoma with a radiologic appearance simulating that of chondrosarcoma. The authors describe four cases of plasma cell tumors with scattered foci of calcification within their matrix, causing them to resemble chondrosarcoma radiographically. Histologic examination was performed in three of these cases. Biopsy specimens demonstrated that the calcification in these tumors was contained in areas of amyloid deposition. Although amyloid formation in association with plasma cell dyscrasias is well known, sufficient calcification within the amyloid to become radiographically identifiable has only rarely been reported. Calcification in amyloid produced by plasma cell tumors may at times simulate the appearance of chondrosarcoma.

The American journal of gastroenterology, 1992

We studied common duct (CD) diameter using real time ultrasound in 551 patients. The patients wer... more We studied common duct (CD) diameter using real time ultrasound in 551 patients. The patients were divided into two groups: those referred for evaluation of the biliary tree [biliary-referred group (BRG)], and those referred for a problem unrelated to potential biliary tree pathology [non-biliary-referred group (NBRG)]. Potentially obstructed CDs were excluded from analysis. The CD diameter in the NBRG patients was found to increase after cholecystectomy (p less than 0.0003), but not in patients in this group with intact gallbladders and cholelithiasis. Dilation was observed in the BRG patients with either cholelithiasis (p less than 6 x 10(-7)) or cholecystectomy (p less than 4 x 10(-10)) compared to patients with intact gallbladders without cholelithiasis. To our knowledge, the former phenomenon has not been described in the literature. Our NBRG data suggest that the normal CD diameter should be set at 5 mm and 8 mm, respectively, for patients with intact gallbladders and patients...

American Journal of Roentgenology, 1986

American Journal of Roentgenology, 1985

Fifty patients were analyzed after a randomized double-blind study comparing Hexabrix and Hexabnx... more Fifty patients were analyzed after a randomized double-blind study comparing Hexabrix and Hexabnx-20 in ascending phlebography. Measures of safety and patient tolerance indicated that both concentrations of Hexabrix appeared safe and were well tolerated. All studies were diagnostic, and the image quality was rated as excellent in 80% of the Hexabrix group and 72% of the Hexabrix-20 group.

American Journal of Roentgenology, 1985

Thirty-nine consecutive patients referred for shoulder arthrography underwent shoulder sonography... more Thirty-nine consecutive patients referred for shoulder arthrography underwent shoulder sonography to determine the ability of sonography to detect rotator cuff tears. Fifteen patients had arthrographically proven rotator cuff tears. Of these, 14 were detected by sonography, for a sensitivity

Medicine, 1997

Although the etiology of Paget bone disease (PBD) is unknown, increasing evidence implicates a &a... more Although the etiology of Paget bone disease (PBD) is unknown, increasing evidence implicates a "slow virus" infection of the skeleton, perhaps in genetically predisposed individuals. PBD is rare in Asia. We describe a Korean family with PBD. The propositus noticed bowed limbs at approximately 25 years of age. Radiologic studies made when he was 55 years old revealed essentially panostotic PBD. Serum alkaline phosphatase (ALP) activity and osteocalcin (OC) levels were markedly elevated. An iliac crest specimen showed classic histopathologic changes of PBD. Additionally, palpable swellings were first observed at age 45 years at his occiput, pubic ramus, ileum, and facial bones. They contained numerous multinucleated cells and were originally diagnosed as giant cell tumors. However, we found that, like osteoclasts, these cells expressed considerable tartrate-resistant acid phosphatase activity. These "extraskeletal osteoclastomas" resolved rapidly with dexamethasone treatment. Two daughters, 20- and 24-years-of-age, were discovered by study of his 5 children to have elevated serum ALP activity and OC levels and widespread PBD. Both women, however, are without palpable masses and are asymptomatic. The propositus' father, who died at age 55 years, had similar skeletal deformities beginning at age 20 years, but was not examined. Leukocytopenia was found in the 3 living family members with PBD. There was no evidence for linkage of the PBD to HLA loci. The condition appears to be transmitted as an autosomal dominant trait and is manifest in young adult life. Multicentric extraskeletal osteoclastomas with remarkable sensitivity to dexamethasone treatment appear to be another unusual feature of this family's disorder. In this family, the stimulus for PBD is so great that the PBD is apparent at an early age, affects essentially the entire skeleton, and leads to the formation or extension of osteoclast-like cells into nonosseous tissues (extraskeletal osteoclastomas). This 3-generation kindred in Korea, where PBD is rare, shows a strong clustering of PBD compatible with autosomal dominant inheritance. Leukocytopenia appears to distinguish affected family members, but any role for this abnormality in the pathogenesis of PBD is unclear. Our findings support a heritable diathesis for PBD, perhaps mediated by an immune deficiency.

Investigative Radiology, 1994

Use of a neural network to diagnose focal lesions of bone was evaluated. Imaging features of 709 ... more Use of a neural network to diagnose focal lesions of bone was evaluated. Imaging features of 709 lesions were encoded into a predetermined database. Data were divided into four groups and were analyzed using cross-validation by a two-layer feed-forward neural network. The lesions comprised 43 different pathologic diagnoses. Overall, the network was 85% accurate in distinguishing benign from malignant lesions. With a differential list of five diagnoses, the list was internally consistent regarding benign and malignant lesions 81.9% of the time. The network correctly diagnosed 56% of the lesions by pathologic diagnosis as its first choice. It included the correct diagnosis 71.8% of the time in a differential list of three diagnoses and 87.3% of the time in a differential list of nine diagnoses. Although not yet adequate for clinical use, neural network diagnosis of bone lesions is in its infancy and has important implications for the future analysis of focal bone lesions.

Orthopedics, 1987

Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the li... more Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the literature and past clinical experience at our institution, early establishment of the correct diagnosis enabling definitive treatment may be difficult. We describe six patients with tenosynovitis of tendons about the ankle, the value of tenography in staging the severity of their disease, and its value in choosing appropriate definitive therapy.

Journal of medical systems, 2000

A nonpreemptive queuing system based upon operations management theory is used to evaluate expect... more A nonpreemptive queuing system based upon operations management theory is used to evaluate expected steady state wait periods for traditional and distributed CT scheduling models. Both models are constructed using two classes of patient service--emergent and nonemergent. The former model uses only one point of service per scanner while the latter employs multiple points of service in order to accomplish all of the functions necessary to complete a CT scan. Sample data are drawn from a tertiary care hospital-based system using a traditional service model. Comparison of a traditional and distributed service system, each with emergent and nonemergent service classes, shows that breaking as many activities as possible out of the scanner should provide substantial improvements in cost efficiency and service for patients having CT scans. Nonemergent patients may experience as much as an 89% reduction in steady-state wait times while emergent patients may experience as much as a 59% reduct...

Investigative Radiology, 1995

To quantitate features that distinguish the plain radiographic appearance of eosinophilic granulo... more To quantitate features that distinguish the plain radiographic appearance of eosinophilic granuloma (EG) from other solitary lesions of bone. Seven hundred nine focal bone lesions, including 26 EGs, were analyzed according to demographic, anatomic, and plain radiographic features. Vector analysis of groups of features was performed to determine those that are most sensitive and specific for the appearance of EG in contrast to other lesions in the data base. The radiographic appearance of EGs was most consistently that of a medullary based lytic lesion (100%) with geographic destruction (76.9%), lobular contour (73.1%), and well-defined edges (73.1%). Long bone lesions showed these features more frequently than EGs in other locations. Periosteal reaction was visible in all long bone lesions but in only one nonlong bone lesion (5.9%). Characterization of EG in long bones as a lytic, medullary-based metaphyseal or diaphyseal lesion with geographic destruction, lobular contours, periost...

Skeletal Radiology, 1992

We analyzed 16 radiographic features of primary Ewing's sarcoma in 342 patients from the lESS 729... more We analyzed 16 radiographic features of primary Ewing's sarcoma in 342 patients from the lESS 7299 (Intergroup Ewing's Sarcoma Study) for prognostic significance. Of these, 3 features demonstrated a statistically significant relationship to survival: maximal tumor dimension, tumor location, and an appearance of honeycombing within the lesion. Those individuals with primary lesions centered in the pelvis, femur, or humerus had a worse survival rate than those with lesions centered elsewhere. Similarly, we observed an inverse relationship between the greatest dimension of the osseous portion of the lesion and survival. The radiographic finding of honeycombing also showed a statistical association with improved survival. However, this feature was observed infrequently, and its significance should be assessed further. Otherwise, no other feature that we analyzed showed any relationship to patient prognosis.

Investigative Radiology, 1988

Measurements of bone mineral using single and dual-energy quantitative computed tomography (CT) a... more Measurements of bone mineral using single and dual-energy quantitative computed tomography (CT) are examined in vivo in 108 vertebral bodies scanned on a Siemens DRH scanner. Pre and postprocessing dual-energy techniques are compared. In the range of clinically useful kilovoltage, the choice of beam energy does not make a significant difference to the single-energy bone mineral measurement. Postprocessing dual-energy measurement in vivo shows a statistically significant decrease in the amount of mineral measured compared to single-energy measurements, whereas the preprocessing measurement shows a significant increase.

Investigative Radiology, 1996

To determine if the clinical variables that are important for selecting patients for emergency cr... more To determine if the clinical variables that are important for selecting patients for emergency cranial computed tomography (CT) are population dependent. Prior to obtaining scans, physicians working in an emergency department in a level II trauma center completed a form describing the indication for the CT examination. These data were matched to the CT scan results and analyzed statistically using univariate and multivariate methods. These results were compared with a prior study at a level I trauma center. Of 551 patients having cranial CT, neurologic examination was positive in 340 and CT scan was positive in 122. The neurologic examination correlated strongly with the results of the CT scan (P < 0.00001). In this patient population, the most important clinical predictors of 17 abnormal CT scans from the 211 patients without positive neurologic examinations were seizure and a history of neoplasm. These high-yield variables differ from our prior retrospective study in which intoxication and amnesia were the important predictors in patients with negative examinations. The difference in predictors between the populations most likely results from different prevalences of trauma and ischemic disease. Abnormal neurologic examination is the most important criterion available to select patients for emergency cranial CT. Other variables (eg, seizure, amnesia, intoxication, and history of neoplasm) that help select patients without neurologic findings appear to be population dependent.

Orthopedics, 1987

Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the li... more Tenosynovitis can be a source of prolonged ankle pain and disability. Based on a review of the literature and past clinical experience at our institution, early establishment of the correct diagnosis enabling definitive treatment may be difficult. We describe six patients with tenosynovitis of tendons about the ankle, the value of tenography in staging the severity of their disease, and its value in choosing appropriate definitive therapy.

Journal of medical systems, 2000

A nonpreemptive queuing system based upon operations management theory is used to evaluate expect... more A nonpreemptive queuing system based upon operations management theory is used to evaluate expected steady state wait periods for traditional and distributed CT scheduling models. Both models are constructed using two classes of patient service--emergent and nonemergent. The former model uses only one point of service per scanner while the latter employs multiple points of service in order to accomplish all of the functions necessary to complete a CT scan. Sample data are drawn from a tertiary care hospital-based system using a traditional service model. Comparison of a traditional and distributed service system, each with emergent and nonemergent service classes, shows that breaking as many activities as possible out of the scanner should provide substantial improvements in cost efficiency and service for patients having CT scans. Nonemergent patients may experience as much as an 89% reduction in steady-state wait times while emergent patients may experience as much as a 59% reduct...

The American journal of sports medicine

The Journal of trauma, 1998

To show that magnetic resonance imaging (MRI) can be useful to diagnose radiographically invisibl... more To show that magnetic resonance imaging (MRI) can be useful to diagnose radiographically invisible greater tuberosity fractures in patients with clinical presentations suspicious for rotator cuff injury. Six patients with subtle greater tuberosity fractures who were sent for MRI because of possible rotator cuff tear are reviewed (age range, 27-51 years; mean, 40.5 +/- 8.4 years). Five of the patients recount direct trauma to their shoulders, whereas one noticed shoulder pain after a fall in which she fractured her ankle. MRI showed an area of edema confined to the greater tuberosity with linear low signal extending through the tuberosity consistent with a fracture in all cases. Although five patients had a complete set of shoulder radiographs before MRI, these were interpreted as normal in all cases. Full-thickness rotator cuff tears were not present in any of the cases. All of the patients were treated conservatively with good results. MRI can prevent unnecessary arthroscopy in pat...

Radiology, 1993

Charts from 1,074 consecutive emergency department patients who underwent cranial computed tomogr... more Charts from 1,074 consecutive emergency department patients who underwent cranial computed tomography (CT) were reviewed for predictors of a CT abnormality. Twenty-six clinical variables and the results of neurologic examination were compared with cranial CT findings. Patients with focal neurologic deficit, unresponsiveness, and hypertension had an increased risk of a CT abnormality. Blurred vision, trauma, loss of consciousness, headache, and dizziness were each associated with a lower risk of a CT abnormality. Multivariate analysis showed that only focal neurologic deficit and unresponsiveness effectively helped predict a CT abnormality. In patients with negative neurologic findings, only intoxication and amnesia were associated with greater than 10% positive scans and an increased risk for a CT abnormality. The data indicate that positive neurologic findings coupled with intoxication and amnesia would have helped detect 90.7% of the positive scans and provide an effective initial...

Radiology, 1993

To report cases of plasmacytoma with a radiologic appearance simulating that of chondrosarcoma. T... more To report cases of plasmacytoma with a radiologic appearance simulating that of chondrosarcoma. The authors describe four cases of plasma cell tumors with scattered foci of calcification within their matrix, causing them to resemble chondrosarcoma radiographically. Histologic examination was performed in three of these cases. Biopsy specimens demonstrated that the calcification in these tumors was contained in areas of amyloid deposition. Although amyloid formation in association with plasma cell dyscrasias is well known, sufficient calcification within the amyloid to become radiographically identifiable has only rarely been reported. Calcification in amyloid produced by plasma cell tumors may at times simulate the appearance of chondrosarcoma.