Temporomandibular joint after meniscoplasty: appearance at MR imaging

Article Abstract:

Temporomandibular joint (TMJ) dysfunction affects a large number of adults in the US. It is characterized by pain and a clicking sound during joint movement and is caused by abnormal positioning of the joint disk. Magnetic resonance (MR) imaging, an imaging technique that uses magnetism, is useful in detecting this disk abnormality and in assessing the disk following treatment. One possible treatment for TMJ dysfunction is meniscoplasty, or surgical repositioning of the disk. This study examined the correlation between the position of the disk following meniscoplasty, as seen on MR images, and the clinical improvement experienced by patients. MR images were taken of 25 TMJs in 20 patients both before and after treatment. Clinical outcome was based on results of a physical examination and a questionnaire given to each patient at the time of postoperative MR imaging. Clinical results were excellent for four TMJs, good for six, fair for seven, and poor for eight. MR images showed that the disks were either in the proper position or close to it following treatment in the ten TMJs with excellent or good clinical results. In the patients whose clinical results were either fair or poor, MR images revealed little difference in the disk positions when the before and after MR images were compared. In no case was the position of the disk worse following surgical treatment. These results indicate that MR imaging is useful in assessing the outcome of meniscoplasty performed on the TMJ; MR images that indicate a good or excellent outcome correlate with good or excellent clinical findings. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Temporomandibular joint disorders, Meniscus (Anatomy)

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Pneumocystis carinii pneumonia: Effect of corticosteroid treatment on radiographic appearance in a patient with AIDS

Article Abstract:

Pneumocystis carinii pneumonia (PCP) was until the last decade a rarely seen parasitic lung infection. It is now seen frequently in patients with compromised immune systems, particularly those infected with HIV, the AIDS virus. A number of drug therapies for PCP have been tested in the past few years. A few studies have indicated that corticosteroid drugs may be effective in treating PCP. This case study reports the dramatic improvement seen in an AIDS patient with PCP treated with the corticosteroid prednisone. The patient was a 35-year-old male suffering from a cough and high fever. PCP was diagnosed and treatment with sulfamethoxazole and trimethoprim was initiated. When his condition did not improve, he was hospitalized and treatment with pentamidine was begun, with prednisone therapy started the following day. Within 24 hours of prednisone therapy, his fever decreased in severity and chest X-rays showed his lungs were clearing. When the steroid dose was halved, his temperature increased for a short time. When it was halved again, his temperature increased and clinical and X-ray results showed increased severity of the PCP. Steroid treatment was increased, which quickly improved his condition; afterwards prednisone therapy was slowly reduced and no relapse occurred. The case is illustrative of a patient with PCP responding well to treatment once prednisone was included. Further examination of the use of steroids in treating PCP is needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Complications and side effects, Corticosteroids, Adrenocortical hormones, Pneumocystis carinii pneumonia, AIDS (Disease), Prednisone

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