W Martel's research while affiliated with Concordia University–Ann Arbor and other places

de Quervain disease is a stenosing tenosynovitis of the first dorsal wrist compartment. The purpose of this study was to determine whether focal radial styloid abnormality (cortical erosion, sclerosis, or periosteal bone apposition) as shown by radiography can be an indicator of de Quervain tenosynovitis. A retrospective review of 49 radiographs from 45 patients in whom the clinical diagnosis of de Quervain tenosynovitis was confirmed (positive findings on Finkelstein's test) and 64 radiographs from 62 asymptomatic patients was carried out independently by two musculoskeletal radiologists in a blinded fashion. Findings on radiographs were assessed for focal radial styloid abnormality and assigned a diagnostic grade (1, definitely normal; 2, probably normal; 3, equivocal; 4, probably abnormal; 5, definitely abnormal). Receiver operating characteristic curves were constructed and compared. Kappa statistics for interobserver and intraobserver variability were calculated. The presence of focal radial styloid abnormality correlated significantly with the presence of de Quervain tenosynovitis (p < 0.05). The areas under the receiver operating characteristic curves for each reviewer equaled 0.71 and 0.76. Kappa values for interobserver variability equaled 0.44 (moderate agreement), and intraobserver variability equaled 0.62 (substantial agreement). Focal radial styloid abnormality is an indicator of de Quervain stenosing tenosynovitis of the wrist.

Tumoral calcinosis is a frequently misdiagnosed disorder. This study details the radiologic and pathologic characteristics of tumoral calcinosis that distinguish it from most other entities. Radiologic and pathologic findings, and medical records of 12 patients with tumoral calcinosis were reviewed and compared with equivalent information about 5 patients with other calcified lesions. The 12 patients ranged in age from 15 months to 62 years. Six had idiopathic tumoral calcinosis and 6 had secondary tumoral calcinosis. A consistent radiologic finding for tumoral calcinosis was a dense calcified mass that was homogeneous except for a "chicken wire" pattern of lucencies, which correlated histologically with thin fibrous septae. Other characteristics of tumoral calcinosis included fluid-calcium levels, demonstrated in four patients, and smooth osseous erosions adjacent to the mass, demonstrated in three patients. Five cases of tumoral calcinosis were originally confused with other calcified lesions; however, the radiologic findings were characteristic of tumoral calcinosis in retrospect.

Although monarticular erosive osteoarthritis is uncommon, it is not rare. In our example, there was a monarticular presentation of cartilage destruction, soft tissue swelling, and linear periosteal bone apposition. Such bone apposition adjacent to affected joints is not uncommon in erosive osteoarthritis. However, when observed in the context of monarticular disease, particularly when accompanied by soft tissue swelling, it could easily be mistaken for an infectious arthritis.

The purpose of this study was to evaluate the character and evolution of bone lesions attributable to amyloid deposition in patients on long-term dialysis. Thirty-five patients who were treated with hemodialysis for 5 to 22 years were studied by a review of medical records and hand radiographs. The frequency, distribution, character, and evolution of skeletal cyst-like lesions believed to be secondary to amyloid deposition were evaluated in relation to dialysis duration. The number and size of these lesions increased with dialysis duration, present in 28% of the patients after 5 through 9 years of hemodialysis and in 91% after 15 through 22 years. In contrast, the changes of hyperparathyroidism decreased. Of patients with skeletal wrist lesions, radiographs of symptomatic large joints were available in 15; five had bone abnormalities. Skeletal amyloid deposition was verified pathologically in nine sites (five patients). It is concluded that skeletal lesions believed to be due to amyloid deposition increase with dialysis duration and most commonly affect the wrists. They have a distinctive character, distribution, and evolution and are often associated with carpal tunnel syndrome.

The authors retrospectively reviewed three cases of histologically documented osteoid osteoma in which magnetic resonance (MR) imaging was performed prior to surgical excision. In all three cases, MR imaging demonstrated abnormal signal intensity characteristics, and use of gadopentetate dimeglumine resulted in enhancement. These findings correlated with a reactive soft-tissue mass with myxomatous change, as well as with cell-depleted, juxtanidal bone marrow that contained proteinaceous material. These MR imaging findings can easily be confused with those of a malignant tumor or osteomyelitis.