7 results on '"FELEA I."'
Search Results
2. Posttraumatic hip bulging mimicking an abscess in a patient with hip prosthesis: the role of ultrasonography.
- Author
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Damian LO, Simon SP, Felea I, Coman M, Fodor D, and Voica CM
- Subjects
- Diagnosis, Differential, Female, Humans, Middle Aged, Abscess, Degloving Injuries diagnostic imaging, Hip Prosthesis, Thigh diagnostic imaging, Thigh injuries, Ultrasonography methods
- Abstract
A 48-yr old female patient, with stage 4 rheumatoid arthritis, who had undergone multiple joint prostheses including four arthroplasties of the left hip, presented for a sudden-onset large bulge on the left thigh, after a minor local injury. Orthopedic examination and radiography excluded fractures. Ultrasonography revealed a large mixed hypo- and hyperechoic collection,with no Doppler signal, but with comet tail artifacts. Repeated cultures from the collection were negative. Fluid analysis revealed increased quantities of titanium and cobalt. The sudden-onset deformity and fluid collection were in favor of a shear lesion (Morel-Lavallée). The new collection communicated with a previously asymptomatic periprosthetic aseptic abscess, mimicking an infection. To our knowledge, Morel-Lavallée shear lesions have not been described in patients with hip prostheses. Their presence may add to the difficulties of ruling out silent infections in such patients. Ultrasonography is a very effective method for the diagnosis and follow-up of collections in this setting.
- Published
- 2019
- Full Text
- View/download PDF
3. Clinical and ultrasound findings in patients with calcium pyrophosphate dihydrate deposition disease.
- Author
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Vele P, Simon SP, Damian L, Felea I, Muntean L, Filipescu I, and Rednic S
- Subjects
- Chondrocalcinosis pathology, Female, Humans, Joints pathology, Knee Joint diagnostic imaging, Knee Joint pathology, Male, Middle Aged, Prospective Studies, Sensitivity and Specificity, Synovial Fluid diagnostic imaging, Chondrocalcinosis diagnostic imaging, Joints diagnostic imaging, Ultrasonography methods
- Abstract
Aim: To evaluate the presence and distribution of calcium pyrophosphate (CPP) deposits in joints commonly affected by CPP deposition (CPPD) disease (acromio-clavicular, gleno-humeral, wrists, hips, knees, ankles, and symphysis pubis joints) using ultrasound (US)., Material and Methods: Thirty consecutive patients fulfilling McCarty diagnostic criteria for CPPD were consecutively enrolled in the study. The data registered using the US included the affected joints, the calcification site, and the pattern of calcification (thin hyperechoic bands, parallel to the surface of the hyaline cartilage, hyperechoic spots, and hyperechoic nodular or oval deposits). The presence of CPP crystals in knees was confirmed by polarized light microscopy examination of the synovial fluid and radiographs of the knees were performed in all patients., Results: In 30 patients, 390 joints were scanned, (13 joints in every patient). The mean±standard deviation number of joints with US CPPD evidence per patient was 2.93±1.8 (range 1-9). The knee was the most common joint involved both clinically and using US examination. The second US pattern (with hyperechoic spots) was the most frequent. Fibrocartilage calcifications were more common than hyaline calcification. Using radiography as reference method, the sensitivity and specificity of US for diagnosis CPPD in knees was 79.31%, 95CI(66.65%-88.83%), and 14.29%, 95CI(1.78%-42.81%), respectively., Conclusions: The knee is the most frequent joint affected by CPPD. The second ultrasound pattern is the most common. CPPD affects the fibrocartilage to a greater extent than the hyaline cartilage.
- Published
- 2018
- Full Text
- View/download PDF
4. The role of ultrasonography in assessing disease activity in patients with rheumatoid arthritis and associated fibromyalgia.
- Author
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Ghib LJ, Tămaş MM, Damian LO, Felea I, Muntean LM, Rednic N, and Rednic S
- Subjects
- Arthritis, Rheumatoid complications, Biomarkers analysis, Case-Control Studies, Cross-Sectional Studies, Female, Fibromyalgia complications, Humans, Middle Aged, Severity of Illness Index, Ultrasonography, Doppler, Arthritis, Rheumatoid diagnostic imaging, Fibromyalgia diagnostic imaging
- Abstract
Aim: The purpose of this study is to compare and correlate US evaluation with clinical scores of the disease activity in patients with rheumatoid arthritis (RA) and concomitant fibromyalgia (FM)., Material and Methods: Ten patients diagnosed with RA according to the 2010 ACR/EULAR classification criteria and associated FM based on the ACR 1990 classification criteria and two control groups, one with RA (10 patients) and one with FM (10 patients), were included. Clinical assessment was performed and the disease activity scores were calculated. Synovial/tenosynovial hypertrophy, fluid collections in grey scale (GS), and Power Doppler (PD) US assessed by US in the 28 joints included in the disease activity score 28 (DAS28)., Results: GS US score and PD US scores were correlated with DAS28 only in patients with RA (Pearson r coefficients 0.3 and 0.5). Mean DAS28 score was significantly higher in the RA/FM group, compared to RA and FM (5.6 versus 4.6 versus 4.5, respectively). Patients with RA/FM had similar median US scores to RA patients, while in FM group significantly lower median US scores were detected (16 versus 9.5 versus 0 for GS US and 3.5 versus 1.5 versus 0 for PD US, respectively)., Conclusions: Disease activity scores should be interpreted with caution in patients with RA and FM. When available, US should be used to guide treatment decisions in patients with RA and FM.
- Published
- 2015
- Full Text
- View/download PDF
5. Ultrasonography of the metacarpophalangeal joints in healthy subjects using an 18 MHz transducer.
- Author
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Fodor D, Felea I, Popescu D, Motei A, Ene P, Serban O, and Micu M
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Observer Variation, Prospective Studies, Reproducibility of Results, Metacarpophalangeal Joint diagnostic imaging, Transducers, Ultrasonography, Doppler instrumentation
- Abstract
Aim: To evaluate the metacarpophalangeal (MCP) joints (MCP2 and 5) in healthy subjects by ultrasonography (US) using a high frequency transducer (18 MHz) and to verify the interobserver agreement., Material and Methods: We enrolled 50 healthy volunteers (37 women, age between 30-58 years, mean age 41.7 years, divided into 3 groups according to age: 30-39, 40-49, and 50-58 years). The subjects were successively evaluated by 4 rheumatologists: 2 experienced (team A) and 2 beginners (team B) in US. Seven dorsal and palmar longitudinal scanning positions and a supplementary scan for MCP cartilage were performed. The bone surface (erosions, osteophytes), the intra-articular content (synovial thickening and vascularization, 4 grade scale), and the aspect of the metacarpal head cartilage were analyzed. The anterior palmar recess was measured. The time for examination was recorded., Results: Erosions were detected in 7% of joints by team A and 2% by team B (p<0.05, kappa agreement 0.567) in subjects over 40 years. The agreement by team A in the detection of the erosions was very good (kappa value 0.83). A moderate positive correlation was obtained between the presence of erosions and age (r= 0.401, p=0.004). Osteophytes were identified only on the dorsal scan in subjects over 50 years (in 3.5% of joints team A, 1.5% team B, p>0.05, kappa value 0.421). No grade 1 synovitis was observed by team A but 4 joints with grade 1 synovitis were identified by team B (p<0.05) from the dorsal scan. The dimensions of the palmar recess had large distribution (MCP 2 between 0.55-1.3 mm; MCP 5 between 0.6-1.2 mm). No statistical significant differences were obtained when comparing the dimensions of the two hands, the values obtained in age-groups (all p>0.05). No statistical significant correlations were obtained between the dimensions of palmar recess and the body mass index or dominant hand (all p>0.05). No pathological findings were found in the examination of the metacarpal head cartilage. Power Doppler investigation found the presence of grade 1 signal in 2.5% joints by team A and 1.5% by team B (p>0.05) only in the dorsal scans. The mean time for examination was 7.8+/-1.74 min in team A and 13.78+/-2.96 min in team B (p<0.05)., Conclusions: In healthy subjects pathological findings are occasionally encountered, especially erosions and osteophytes. Using an 18 MHz transducer the aspect of grade 1 synovitis was not encountered in healthy non-inflammatory MCP joints. There is a permanent need for standardized training and examination in musculoskeletal US.
- Published
- 2015
- Full Text
- View/download PDF
6. A case of alkaptonuria - ultrasonographic findings.
- Author
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Damian LO, Felea I, Boloşiu C, Botar-Jid C, Fodor D, and Rednic S
- Subjects
- Diagnosis, Differential, Humans, Knee Joint diagnostic imaging, Male, Middle Aged, Alkaptonuria complications, Alkaptonuria diagnostic imaging, Arthritis diagnostic imaging, Arthritis etiology, Chondrocalcinosis complications, Chondrocalcinosis diagnostic imaging, Ultrasonography methods
- Abstract
Alkaptonuria is a rare disease with autosomal recessive inheritance and variable expression. The weight-bearing joint involvement and spondylitis-like vertebral changes occur only after the 3rd decade. Musculoskeletal ultrasonographic findings in alkaptonuria were only rarely described, consisting mainly into enthesopathy and non-synovial tendon degeneration. We present the case of a 50 years old man with alkaptonuria and discuss the ultrasonographic findings and the relationship of the disease with chondrocalcinosis. The tendinous and synovial aspect may be peculiar and it could therefore allow recognition and screening for alkaptonuria, along with clinical and radiologic data.
- Published
- 2013
- Full Text
- View/download PDF
7. Ultrasound findings in AL musculoskeletal amyloidosis.
- Author
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Felea I, Fodor D, Schiotis R, Georgiu C, Bojan A, and Rednic S
- Subjects
- Female, Humans, Middle Aged, Amyloidosis diagnostic imaging, Musculoskeletal Diseases diagnostic imaging, Ultrasonography methods
- Abstract
Systemic AL amyloidosis is one of the differential diagnosis of chronic musculoskeletal disease, especially when swollen and painful joints is associated with claw hands. Ultrasound evaluation is a good diagnosis tool, showing a characteristic joint and tendon involvement and assisting in guided biopsy procedure. We report a 55 year old caucasian woman, diagnosed for two years with RA without improvement under different DMARDs, admitted for fixed flexion contractures of both hands ("claw hands"), worsening pain and swelling of small joints of hands and feet, elbows and shoulders. Pad shoulder sign and bilateral anterior wrist and elbow pads, macroglossia, thickened skin of fingers and ecchymotic rashes on forearm and around eyes were observed. Ultrasound examinations showed subdeltoid and bicipitoradial bursitis, presence of inhomogeneous hypoechoic material around bicipital tendons and tenosinovitis of the extensor tendons of the hand, and synovial thickening of elbow and shoulder joints. Complete analysis of the bone marrow biopsy and biopsy specimens from subacromial bursa were positive for AL amyloidosis.
- Published
- 2011
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