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ABSTRACT: A three-year-old girl presented with slow-growing swellings at the left foot and upper right humerus. Radiographs show multiple enchondromas in both feet, proximal humeri and scapulae, as well as at multiple sites in the hands, distal forearm bones and pelvis, in keeping with multiple enchondromatosis in Ollier disease. The clinical presentation and imaging features of enchondromas and the different types of enchondromatosis are discussed.
Singapore medical journal 11/2008; 49(10):841-5; quiz 846. · 0.73 Impact Factor
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ABSTRACT: A 37-year-old Indian man presented with a two-year history of right hip pain. Radiographs showed small faint dense nodules at the inferomedial aspect of the right hip joint. Diagnosis of synovial osteochondromatosis was made on MR imaging, where multiple ossified loose bodies surrounded by a joint effusion, as well as enhancing synovium, were seen. Synovectomy and removal of 31 loose bodies were performed, and the diagnosis was confirmed histologically. The clinical manifestations and imaging features of synovial osteochondromatosis are discussed.
Singapore medical journal 06/2008; 49(5):430-3; quiz 434. · 0.73 Impact Factor
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W C Peh
American journal of orthopedics (Belle Mead, N.J.) 01/2002; 30(12):878.
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ABSTRACT: This work considers the design and operation of a solenoid radiofrequency (RF) coil for magnetic resonance (MR) mini-imaging of finger joints using a whole-body system. The considerations were focused on the requirements of high sensitivity, easy patient access, and cost-effectiveness. The proposed design is a short, two-turn solenoidal coil that accomplishes high spatial uniformity over a 2-cm region of interest (ROI). The coil resembles an oversized ring, and easily fits fingers that are spread. An experimental demonstration of the proposed approach is given by imaging the proximal interphalangeal joint in healthy volunteers using a 2.5-cm field of view (FOV). Spin-echo and gradient-recalled-echo T1-weighted sequences, and a 3D spoiled-gradient-echo sequence were used.
Journal of Magnetic Resonance Imaging 01/2002; 14(6):800-2. · 2.70 Impact Factor
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British Journal of Radiology 01/2002; 74(888):1159-60. · 1.31 Impact Factor
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W C Peh
American journal of orthopedics (Belle Mead, N.J.) 12/2001; 30(11):827.
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ABSTRACT: A 31-year-old woman developed a right breast mass following cyclosporine A therapy after a renal transplant. Several large breast masses continued to grow bilaterally. Mammography and ultrasonography showed features of giant fibroadenomas. The diagnosis was confirmed by biopsy of one of the masses. Awareness of the association between cyclosporine A therapy and fibroadenoma development in renal transplant recipients is highlighted.
Australasian Radiology 12/2001; 45(4):517-9. · 0.51 Impact Factor
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ABSTRACT: Sleep apnoea has been reported to occur in subjects with acromegaly. This study evaluates the relationship among biochemical activity, sleep apnoeic activity and upper airway anatomic profile in acromegaly, and the effect of Sandostatin LAR, a long-acting somatostatin analogue, on these parameters.
Fourteen subjects with acromegaly were recruited.
Subjects were assessed at baseline and those with apnoea-hypopnoea index (AHI) > or = 5 were reassessed after 6 months of treatment with Sandostatin LAR 20-30 mg IMI 4-weekly. Biochemical activity was assessed with levels of GH and IGF-1. Sleep disordered breathing was assessed with overnight polysomnography. Upper airway anatomic profile was defined with computerized tomographic cephalometry.
Of 14 subjects (age 42.0 +/- 8.1 years, mean +/- SD; 11 men) at baseline, there was a positive correlation between GH and tongue length (VT; P = 0.004), and between AHI and cephalometric indices: length of soft palate (PMU; P = 0.002); mandibular plane-hyoid bone distance (MPH; P = 0.017), maximum thickness of soft palate (Max-SP; P = 0.018) and VT (P = 0.027). Eight patients had sleep disordered breathing (AHI > or = 5) which was predominantly obstructive in nature (AHI = 29.4 +/- 22.6). After treatment, there were significant improvements in hormonal profile: GH, mU/l (before, 51.5 +/- 27.8; after, 8.0 +/- 7.4; P = 0.017) and IGF-1, nmol/l (before, 95.5 +/- 23.4; after, 35.0 +/- 12.4; P = 0.012); sleep-disordered breathing: AHI (before, 29.4 +/- 22.6; after, 13.4 +/- 11.12; P = 0.025), snoring episodes (before, 486 +/- 240; after, 165 +/- 170; P = 0.05); cephalometric indices, mm: MPH (before, 18.8 +/- 12.1; after, 14.8 +/- 8.4; P = 0.018), VT (before, 72.3 +/- 4.4; after, 69.7 +/- 4.3; P = 0.05). There was a positive correlation between the reduction in GH and AHI (r = 0.738, P = 0.037).
The findings demonstrated that there was correlation between sleep apnoea severity and soft tissue overgrowth at the upper airway region in acromegaly. They also suggest that Sandostatin LAR improved obstructive sleep apnoea in acromegaly, and the effect might be partly mediated via a reduction in upper airway soft tissue, in particular that of the tongue, concomitant with a reduction in GH levels.
Clinical Endocrinology 10/2001; 55(4):477-83. · 3.17 Impact Factor
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W C Peh
American journal of orthopedics (Belle Mead, N.J.) 10/2001; 30(9):716-7.
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W C Peh
American journal of orthopedics (Belle Mead, N.J.) 09/2001; 30(8):665.
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ABSTRACT: Giant cell tumour of the tendon sheath is a soft tissue mass found occasionally in the hand. Its diagnosis can be readily made preoperatively if the characteristic MRI features are appreciated. This pictorial essay demonstrates and describes the imaging findings correlated with histopathological findings in a group of patients with proven giant cell tumour of the tendon sheath.
Australasian Radiology 09/2001; 45(3):274-80. · 0.51 Impact Factor
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ABSTRACT: Tears of the menisci in the knee are common after trauma, especially following sports injuries. A 21-year-old Chinese man with a flipped bucket-handle tear of the posterior horn of the lateral meniscus is reported. The MR imaging findings were confirmed at surgery. The classification and different types of meniscal tears, and the role of MR imaging in the diagnosis of meniscal lesions, are discussed.
Singapore medical journal 08/2001; 42(7):332-6. · 0.73 Impact Factor
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ABSTRACT: A 46 year old man presented with a growing mass over his wrist. Erosions of the triquetrum and hamate were present radiographically. Magnetic resonance imaging (MRI) showed a solid mass arising from the extensor carpi ulnaris tendon, which was T(1) hypointense and isointense, T(2) hypointense, and bloomed on gradient echo images. The preoperative diagnosis of giant cell tumour of the tendon sheath was confirmed on histopathological examination of the excised specimen. The clinical, pathological, and imaging features, with emphasis on MRI findings, of this condition are reviewed.
Annals of the Rheumatic Diseases 07/2001; 60(6):550-3. · 8.73 Impact Factor
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W C Peh
American journal of orthopedics (Belle Mead, N.J.) 07/2001; 30(6):512.
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American Journal of Roentgenology 07/2001; 176(6):1459-66. · 2.78 Impact Factor
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W C Peh
American journal of orthopedics (Belle Mead, N.J.) 06/2001; 30(5):435-6.
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ABSTRACT: A large number of artifacts occur in magnetic resonance (MR) imaging of the musculoskeletal system. These artifacts may potentially affect the quality of MR images, and may also simulate pathologic conditions and produce pitfalls in interpretation. Motion artifacts may be periodic or random. Protocol-error artifacts include saturation, wraparound, radiofrequency (RF) interference, shading, and partial volume averaging artifacts. Truncation artifacts occur when the number of phase-encoding steps of high spatial frequencies is insufficient (or under-sampled) for faithful reproduction of the true anatomic detail of the original image. Chemical shift artifacts are due to the protons in fat being mismapped relative to water protons. Susceptibility artifacts occur at the interfaces of structures with different magnetic susceptibilities. Artifacts special to the musculoskeletal system include the magnic angle phenomenon and spurious signal induced at very short echo times, both of which affect anisotropic structures such as tendon, ligament, and cartilage. Recognition and, if possible, correction of these artifacts are an important aspect of practical musculoskeletal MR imaging.
Skeletal Radiology 05/2001; 30(4):179-91. · 1.54 Impact Factor
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W C Peh
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ABSTRACT: An 80-year-old woman presented with severe low back pain of gradual onset. Her walking ability was affected. Physical examination was essentially negative. Bone scintiscans showed a butterfly-shaped area of increased sacral uptake as well as focal pubic uptake. The diagnosis of sacral and parasymphyseal insufficiency fractures was confirmed by CT. The patient recovered well with conservative management. The clinical and imaging features, and management of insufficiency fractures of the pelvis are discussed.
Singapore medical journal 05/2001; 42(4):183-6. · 0.73 Impact Factor
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W C Peh
American journal of orthopedics (Belle Mead, N.J.) 04/2001; 30(3):257-8.
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ABSTRACT: A 62-year-old man was incidentally found to have a palpable right paraumbillcal mass. Ultrasonography and intravenous urogram showed cross-fused renal ectopia. The embryology and clinical features of renal ectopia are discussed.
Singapore medical journal 04/2001; 42(3):139-41. · 0.73 Impact Factor
