F Feldman

New York Presbyterian Hospital, New York City, NY, United States

Are you F Feldman?

Claim your profile

Publications (51)170.58 Total impact

  • F Feldman
    [Show abstract] [Hide abstract]
    ABSTRACT: Musculoskeletal radiologists, owing to recent advances in imaging technologies and techniques, are playing an increasingly important role in documenting, diagnosing, and treating an increasing variety of bone and soft-tissue lesions. However, improved visualization of anatomic aberrations-"seeing better"-must be paired with "knowing more," on the basis of complete familiarity with all aspects of the biology, physiology, pathophysiology, and static anatomy of the musculoskeletal system. Only with foreknowledge of the latter can the musculoskeletal radiologist fully maximize the benefits of the former.
    Radiology 09/2000; 216(2):309-16. · 6.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thoracic imaging of a patient treated for pulmonary tuberculosis with oleothorax therapy before the antibiotic era demonstrated a rare complication. Gross invasion by lipid with subsequent pathologic fracture of the adjacent thoracic vertebra may give rise to symptomatic spinal cord compression. Magnetic resonance imaging is a useful modality for help in diagnosing treatment complications of oleothorax.
    Radiology 03/1999; 210(2):515-7. · 6.21 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study sought to determine if the presence or absence of meniscofemoral ligaments exerts an influence on the prevalence of tears of the lateral meniscus. We reviewed the sagittal and coronal magnetic resonance images of 173 knees for lateral meniscus tears and the presence of the meniscofemoral ligaments. One or both meniscofemoral ligaments were present in 142 of 173 knees (82%). Fifty-four knees had lateral meniscus tears, 27 of which involved the posterior horn. Thirty-three percent of knees with meniscofemoral ligaments had a lateral meniscus tear, and 23% of knees without meniscofemoral ligaments had a lateral meniscus tear (no significant difference). We found no association between the presence of the meniscofemoral ligaments and tears of the lateral meniscus. Our study questions the importance of preserving or reconstructing these ligaments in instances of meniscal transplantation.
    American journal of orthopedics (Belle Mead, N.J.) 12/1998; 27(11):729-32.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study is to compare fat-suppressed T2-weighted fast spin-echo sequences with T2-weighted multiplanar gradient-echo sequences in revealing rotator cuff disorders. Oblique coronal fat-suppressed fast spin-echo images and gradient-echo images of 39 patients who underwent surgery of the shoulder were retrospectively reviewed. Images from the two techniques were reviewed separately. Each set of images was interpreted twice by four musculoskeletal radiologists independently and without knowledge of the surgical findings. Sensitivity and specificity for both sequences were determined. The kappa statistic was used to calculate intraobserver and interobserver agreement of interpretations. For detecting any tear, the sensitivity of the four readers was 71-96% using fast spin-echo and 58-100% using gradient-echo imaging. Confidence intervals showed no difference between the two sequences. Sensitivity of detecting full-thickness tears was 83-100% for both sequences. Interobserver agreement was good. T2-weighted gradient-echo and fat-suppressed T2-weighted fast spin-echo sequences depict rotator cuff tears equally well and take less time to acquire than conventional dual-echo spin-echo sequences.
    American Journal of Roentgenology 08/1998; 171(1):223-7. · 2.74 Impact Factor
  • Source
    American Journal of Roentgenology 01/1998; 169(6):1641-7. · 2.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To investigate gadolinium's role in imaging musculoskeletal infection by comparing the conspicuity and extent of inflammatory changes demonstrated on gadolinium-enhanced fat-suppressed T1-weighted images versus fat-suppressed fast T2-weighted sequences. Eighteen patients with infection were imaged in a 1.5-T unit, using frequency-selective and/or inversion recovery fat-suppressed fast T2-weighted images (T2WI) and gadolinium-enhanced frequency-selective fat-suppressed T1-weighted images (T1WI). Thirty-four imaging planes with both a fat-suppressed gadolinium-enhanced T1-weighted sequence and a fat-suppressed T2-weighted sequence were obtained. Comparison of the extent and conspicuity of signal intensity changes was made for both bone and soft tissue in each plane. In bone, inflammatory change was equal in extent and conspicuity on fat-suppressed T2WI and fat-suppressed T1WI with gadolinium in 19 planes, more extensive or conspicuous on T2WI in three planes, and less so on T2WI in two planes. Marrow was normal on all three sequences in 10 cases. In soft tissue, inflammatory change was seen equally well in 20 instances, more extensively or conspicuously on the T2WI in 11 instances, and less so on T2WI in 2 instances. One case had no soft tissue involvement on any of the sequences. Five abscesses and three joint effusions were present, all more conspicuously delineated from surrounding inflammatory change on the fat-saturated T1WI with gadolinium. The average imaging time for the fat-saturated T1WI with gadolinium was 6.75 min, while that of the T2-weighted sequences was 5.75 min. Routine use of gadolinium is not warranted. Instead, gadolinium should be reserved for clinically suspected infection in or around a joint, and in cases refractory to medical or surgical treatment due to possible abscess formation.
    Skeletal Radiology 12/1997; 26(11):654-8. · 1.74 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A patient with classic clinical and biochemical features of tumor-induced osteomalacia (hypophosphatemia, phosphaturia, and undetectable serum concentrations of 1,25-dihydroxyvitamin D [1,25(OH)2D]) was studied before and after resection of a benign extraskeletal chondroma from the plantar surface of the foot. Presurgical laboratory evaluation was notable for normal serum concentrations of calcium, intact parathyroid hormone (PTH), parathyroid hormone-related protein (PTHrP), and osteocalcin, increased serum alkaline phosphate activity, and frankly elevated urinary cyclic adenosine monophosphate (cAMP) and pyridinium cross-link excretion. Quantitative histomorphometry showed severe osteomalacia and deep erosions of the cancellous surface by active osteoclasts. After resection, serum 1,25(OH)2D normalized within 24 h, while renal tubular phosphorus reabsorption and serum phosphorus did not normalized until days 2 and 3, respectively; serum Ca declined slightly, and serum intact PTH, osteocalcin, and urinary pyridinium cross-link excretion increased dramatically. Urinary cAMP excretion declined immediately after resection and then began to increase concomitant with the increase in serum intact PTH. A second bone biopsy taken 3 months after resection demonstrated complete resolution of the osteomalacia, increased mineral apposition rate (1.09 mu/day), resorption surface (9.2%), mineralizing surface (71%), and bone formation rate (0.83 mm3/mm2/day), and marked decrease in cancellous bone volume (13.1%) and trabecular connectivity compared with first biopsy. Tumor extracts did not affect phosphate transport in renal epithelial cell lines or 1 alpha-hydroxylase activity in a myelomonocytic cell line. The patient's course suggests that the normal 1,25(OH)2D and phosphorus metabolism is due to a tumor product that may be acting via stimulation of adenylate activity. Increased bone resorption prior to surgical resection suggests that the tumor may also produce an osteoclast activator. The rise in resorption surface and pyridinium cross-link excretion, increase in serum osteocalcin and bone mineralization, normalization of osteoid width, and fall in cancellous bone volume after resection are consistent with healing of osteomalacia by rapid remodeling.
    Journal of Bone and Mineral Research 10/1997; 12(9):1502-11. · 6.59 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the prevalence of meniscal protrusion (i.e. location of the outer edge of a meniscus beyond the tibial articular surface), and to determine its relationship with internal derangement, joint effusion, and degenerative arthropathy. Sagittal and coronal MR images of 111 abnormal and 46 normal knees were evaluated for the presence of meniscal protrusion. We set 25% as the minimum amount of displacement considered abnormal because this was the smallest amount of displacement we could confidently discern. Presence of meniscal tear, anterior cruciate ligament (ACL) injury, joint effusion, or osteophytosis was also recorded. Normal examinations demonstrated protrusion of the medial meniscus in 6.5% of sagittal images and 15% of coronal images, and of the lateral meniscus in 2% and 13%, respectively. Fisher's exact test demonstrated a statistically significant difference between the normal and abnormal groups for the medial meniscus on both sagittal (P < 0.0001) and coronal (P = 0.01) images, but not for the lateral meniscus in either plane (P > 0.2). A protruding medial meniscus was associated with effusion and osteophytosis (P < 0.05) but not with meniscal or ACL tear (P > 0.1). Posterior protrusion of the lateral meniscus was only associated with ACL injury (P < 0.0001); protruding anterior horns and bodies of lateral menisci were not associated with any of the four abnormalities. It is concluded that the medial meniscus may occasionally protrude more than 25% of its width, but protrusion is more often due to effusion and osteophytes. Protrusion of the posterior horn of the lateral meniscus is associated with ACL insufficiency, while protrusion of the body and anterior horn of the lateral meniscus is a normal variant.
    Skeletal Radiology 07/1997; 26(7):424-7. · 1.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To identify a normal groove in the posterior aspect of the talus as a potential pitfall in interpretation of ankle magnetic resonance (MR) images. In 40 patients, T1-weighted spin-echo and T2-weighted fast spin-echo sagittal MR images were retrospectively reviewed from 47 consecutive routine ankle examinations. The patients were referred for evaluation of ligament and tendon abnormalities, such as tendinitis and tear, and suspected osseous and osteochondral injuries. Images were assessed for the presence of an erosion-like defect in the posterior aspect of the talar dome. Radiographs were available in 13 cases. Sagittal T1-weighted spin-echo sequences were also performed in 14 embalmed cadaveric ankles, followed by sectioning and dissection of three specimens. A defect was seen in 45 of 47 ankle MR imaging examinations. Radiographs did not show the defect. All 14 cadaveric ankles demonstrated the defect at MR imaging. At anatomic dissection, the defect was a normal groove for the passage of the posterior talofibular ligament. The pseudodefect of the talar dome is a normal groove for the posterior talofibular ligament and should not be misinterpreted as an articular erosion or osteochondral defect.
    Radiology 07/1997; 203(3):857-8. · 6.21 Impact Factor
  • Academic Radiology 12/1996; 3(12):1065. · 2.08 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine the prevalence of Baker cyst in a general orthopedic population and its association with effusion, internal derangement, and degenerative arthropathy. Reports of 400 knee magnetic resonance imaging examinations were reviewed. Presence of Baker cyst, effusion, internal derangement (meniscal and/or anterior cruciate ligament tears), medial collateral ligament injury, and degenerative arthropathy was recorded. Uni- and multivariate logistic regressions were used to evaluate associations between Baker cyst and these conditions. Probabilities of having a Baker cyst given these conditions were also calculated. No association was found between Baker cyst and anterior cruciate ligament tear or medial collateral ligament injury. There were significant associations (P < .001) with effusion, meniscal tear, and degenerative arthropathy. There were also significant associations (P < .01) for effusion, meniscal tear, and degenerative arthropathy, independent of one another. Probability of having Baker cyst given the presence of any one variable was .08-.10; any two variables, .19-.21; and all three variables, .38. The association between Baker cyst and joint effusion was confirmed. A relationship with meniscal tear and degenerative joint disease independent of effusion was also demonstrated. The probability of having a Baker cyst increases as the number of these associated conditions increases.
    Radiology 10/1996; 201(1):247-50. · 6.21 Impact Factor
  • Source
    T T Miller, R B Staron, F Feldman
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to determine if the radiographic assessment of patella alta using the patellar tendon:patella ratio can be applied to sagittal MR images of the knee. Sagittal T1-weighted MR images of 46 knees were reviewed with corresponding radiographs. After lengths of the patella and patellar tendon were measured on the lateral radiographs and on the sagittal mid patellar images, the tendon:patella ratios were calculated. We found the mean tendon:patella ratio on radiographs to be 1.0 +/- 0.2 (SD) and on MR imaging, 1.1 +/- 0.1. These two values were not significantly different (p = .01) and had good-to-excellent correlation (r = .7). We found no statistical difference between the sexes on either radiographs or MR imaging, nor did we find statistical differences on MR imaging between the tendon:patella ratios of straight and wavy patellar tendons. As on radiographs, patellar height can be reliably assessed on sagittal MR imaging using the patellar tendon:patella ratio. On sagittal MR imaging, patella alta is suggested at values greater than 1.3 (1.1 + 2 SD).
    American Journal of Roentgenology 09/1996; 167(2):339-41. · 2.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To further evaluate the role of magnetic resonance (MR) imaging in diagnosing and managing muscle injuries, eight patients with muscle pain or palpable masses were imaged. MR findings were correlated with clinical follow-up data. Increased signal was noted on T2-weighted images in torn and overused muscles. One extensively scarred muscle required surgical biopsy to exclude a fibrous tumor. Three partial muscle tears were treated conservatively. One complete musculotendinous junction tear required tendon transfer. MR studies noninvasively identified and staged various muscle injuries, thereby influencing management.
    Clinical Imaging 10/1995; 19(4):263-9. · 0.60 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine if a symptomatic accessory navicular bone, a normal variant, displays a pattern of altered signal intensity on magnetic resonance (MR) images indicative of an abnormality that could account for the patient's foot pain. Both feet were imaged in seven patients with an accessory navicular bone on radiographs and unilateral foot pain. Five patients had focal medial foot pain, and two had vague, diffuse pain. T1-weighted spin-echo and T2-weighted fat-suppressed sequences were used. A bone marrow edema pattern (BMEP) was noted in the accessory navicular bones of the five patients with focal pain and in the adjacent navicular tuberosities of three of them. The two patients with vague pain showed no osseous or soft-tissue abnormalities. Two patients with positive MR images underwent surgical excision of the accessory navicular bone, and histologic examination revealed osteonecrosis in one patient. The BMEP in a symptomatic accessory navicular bone is indicative of chronic stress and/or osteonecrosis. This information can furnish an objective basis for surgical or conservative management.
    Radiology 07/1995; 195(3):849-53. · 6.21 Impact Factor
  • A Zwass, F Feldman
    [Show abstract] [Hide abstract]
    ABSTRACT: A 62-year-old man who had had chronic brucellosis for at least 14 years, presumably caused by ingestion of unpasteurized milk, presented with recurrent, multifocal osteomyelitis involving both tibias and a humerus, which had a pathologic fracture. Radiographs showed a large destructive lesion in the humeral diaphysis with a pathologic fracture and multiloculated radiolucencies, together with sclerotic zones in multiple long bones. Histologically, necrotizing, granulomatous inflammatory changes were compatible with a diagnosis of osteomyelitis. Bone biopsy cultures and agglutination titers were positive for Brucella abortus. The case represents an uncommon manifestation of Brucella infection which is particularly rare in the United States. A proper clinical examination should lead to consideration of the diagnosis.
    Skeletal Radiology 12/1994; 23(8):660-3. · 1.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The objective was to search for magnetic resonance imaging evidence of medial collateral ligament (MCL) injury in knees with proven tears of the anterior cruciate ligament (ACL) and medial meniscus; the three abnormalities that make up O'Donoghue's triad. Although the MCL injury can be unapparent clinically, knee joint stability may be compromised. The superficial portion of the MCL was evaluated on 19 MR studies of 16 knees with arthroscopically proven ACL and medial meniscal tears. MCL thicknesses were compared to those on MR images of 19 normal knees. The injured knees were of 13 men and 3 women, ranging in age from 19 to 56 years; the normal knees were of 10 men and 9 women, ranging in age from 19 to 55 years. The medial collateral ligaments of all injured knees were abnormal, and, as a group, they had greater thicknesses and more intraligamentous thickness variability than normal knees. The MR appearance of both ACL and medial meniscal tears served as indirect evidence of MCL injury, with irregular MCL thickening indicative of prior injury.
    Skeletal Radiology 12/1994; 23(8):633-6. · 1.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Streak artifact on CT scans of metal containing areas has been a long standing problem. Although several artifact reducing methods have been used to improve image quality, most have been limited by requiring specialized equipment or lengthy complex calculations that are not automated. Others have shown that increasing the beam energy results in increased thickness of metal that may be imaged by CT without severe image degradation. We have studied the image quality of bone surrounding metal both with titanium and cobalt-chrome prostheses using various scanning techniques. In a double blind fashion, 28 radiology residents and attendings were surveyed as to the best technique for imaging bone detail surrounding metal. A series of images was arranged of an implanted titanium prosthesis, a cobalt-chrome prosthesis and a pelvis repaired with stainless steel pelvic reconstruction plates. Scans were performed using three techniques: 120 kVp, 170 mA, 2 s, 360 degrees rotation, 140 kVp, 140 mA, 3 s, 360 degrees rotation, 140 kVp, 140 mA, 4 s, 420 degrees rotation. Titanium was superior to cobalt-chrome (p < .0001 Wilcoxon Signed Rank Test). No advantage was noted for higher kVp or increased scan arc of 420 degrees compared to the standard 360 degrees. Titanium allows improved bone detail surround the metal than CT cobalt-chrome. We have found no advantage to using either high kVp or a 420 degrees scan arc to improve the image quality of bone surrounded by metal.
    Computerized Medical Imaging and Graphics 11/1994; 18(6):429-34. · 1.50 Impact Factor
  • Alicia Zwass, Frieda Feldman
    Skeletal Radiology 10/1994; 23(8):660-663. · 1.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Magnetic resonance (MR) studies were performed on 30 consecutive patients who continued to be symptomatic despite negative or inconclusive findings on radiographs and other imaging studies including radionuclide bone scans, computed tomography, and/or polytomography. There were 9 men and 21 women, 20-92 years old (mean age 63 years) whose MR studies were done 3-72 h after frank trauma in 22 cases and in another 8 after 1-4 weeks of increasing pain subsequently attributed to trauma or unaccustomed effort. MR studies were performed using 0.5-T (Phillips) or 1.5-T (Phillips, GE) superconductive magnets. Results indicated that: (1) MR images allowed identification of acute fractures in an emergency room setting, as well as subtle subacute or chronic fractures in the context of strong clinical suspicions despite negative or inconclusive radiographs and other subsequently indecisive imaging studies. (2) MR imaging is the most sensitive way of documenting the earliest changes in traumatized osseous and soft tissue structures simultaneously.
    Skeletal Radiology 09/1994; 23(6):439-44. · 1.74 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Previously developed criteria of normal distal radioulnar joint (DRUJ) axial geometry were applied to routine magnetic resonance (MR) images of 50 wrists. All wrists lacked clinically evident DRUJ instability. An attempt to apply the three geometric criteria to seven of the cases was not possible, since the prescribed landmarks were not visible. The remaining 43 cases were retrospectively divided into a symptomatic group (25 wrists), with clinical abnormalities referable to the ulnar side of the wrist, and an asymptomatic group (18 wrists), with no such abnormalities. Abnormal DRUJ geometry was found in 12 symptomatic and 2 asymptomatic wrists. This difference between the groups is significant (p = 0.02), suggesting that many symptomatic wrists exhibit different DRUJ geometry than is found in most asymptomatic wrists.
    Skeletal Radiology 08/1994; 23(5):369-72. · 1.74 Impact Factor

Publication Stats

1k Citations
170.58 Total Impact Points


  • 1987–2000
    • New York Presbyterian Hospital
      • Department of Radiology
      New York City, NY, United States
  • 1989–1997
    • Columbia University
      • College of Physicians and Surgeons
      New York City, NY, United States
  • 1994
    • CUNY Graduate Center
      New York City, New York, United States
    • Albert Einstein College of Medicine
      • Department of Radiology
      New York City, NY, United States
  • 1991
    • Aurora St. Luke's Medical Center
      Milwaukee, Wisconsin, United States