Sandra Moore, M.D.

Autopsy features of sudden death due to isolated eosinophilic coronary arteritis: Report of two cases
Omalu B.; Hammers J.; Diangelo C.; Moore S.; Luckasevic T.
2011 ;7(3):153-156, Journal of Forensic Nursing
Isolated eosinophilic coronary arteritis (IECA) has been reported as a cause of sudden unexpected death and has recently been recognized as a newly emerging vasculitic disease. We identified eight case reports and two case series of sudden death due to IECA in the medical literature and we present two new cases of sudden death due to IECA. Our cases further support the proposition that IECA may be a newly emerging distinct vasculitis, which can go undiagnosed and present with sudden death. At autopsy IECA presents with isolated non-necrotizing predominantly eosinophilic inflammation of the coronary arteries without vasculitis in any other organ or blood vessel. The mean age of death of our two cases and the previously reported cases of IECA is 47 years, comprising 13 females and 3 males with a range of 34-64 years. All cases died suddenly and unexpectedly. Past medical history of recurrent chest pain was documented in 63% of cases. The patho-etiology of IECA may involve an aberrant immune response or hypersensitivity reaction. Elucidation of the pathology of IECA may be translated into definitive diagnostic, interventional, and preventive modalities, which will further reduce the person years of life lost to heart disease. 2011 International Association of Forensic Nurses
— id: 148757, year: 2011, vol: 7, page: 153, stat: Journal Article,

Bisphosphonate-related complete atypical subtrochanteric femoral fractures: diagnostic utility of radiography
Rosenberg, Zehava Sadka; La Rocca Vieira, Renata; Chan, Sarah S; Babb, James; Akyol, Yakup; Rybak, Leon D; Moore, Sandra; Bencardino, Jenny T; Peck, Valerie; Tejwani, Nirmal C; Egol, Kenneth A
2011 Oct;197(4):954-960, American journal of roentgenology
OBJECTIVE: The objective of our study was to evaluate the diagnostic utility of conventional radiography for diagnosing bisphosphonate-related atypical subtrochanteric femoral fractures. MATERIALS AND METHODS: Retrospective interpretation of 38 radiographs of complete subtrochanteric and diaphyseal femoral fractures in two patient groups-one group being treated with bisphosphonates (19 fractures in 17 patients) and a second group not being treated with bisphosphonates (19 fractures in 19 patients)-was performed by three radiologists. The readers assessed four imaging criteria: focal lateral cortical thickening, transverse fracture, medial femoral spike, and fracture comminution. The odds ratios and the sensitivity, specificity, and accuracy of each imaging criterion as a predictor of bisphosphonate-related fractures were calculated. Similarly, the interobserver agreement and the sensitivity, specificity, and accuracy of diagnosing bisphosphonate-related fractures (i.e., atypical femoral fractures) were determined for the three readers. RESULTS: Among the candidate predictors of bisphosphonate-related fractures, focal lateral cortical thickening and transverse fracture had the highest odds ratios (76.4 and 10.1, respectively). Medial spike and comminution had odd ratios of 3.8 and 0.63, respectively. Focal lateral cortical thickening and transverse fracture were also the most accurate factors for detecting bisphosphonate-related fractures for all readers. The sensitivity, specificity, and overall accuracy for diagnosing bisphosphonate-related fractures were 94.7%, 100%, and 97.4% for reader 1; 94.7%, 68.4%, and 81.6% for reader 2; and 89.5%, 89.5%, and 89.5% for reader 3, respectively. The interobserver agreement was substantial (kappa > 0.61). CONCLUSION: Radiographs are reliable for distinguishing between complete femoral fractures related to bisphosphonate use and those not related to bisphosphonate use. Focal lateral cortical thickening and transverse fracture are the most dependable signs, showing high odds ratios and the highest accuracy for diagnosing these fractures
— id: 137889, year: 2011, vol: 197, page: 954, stat: Journal Article,

The use of MRI in the evaluation of myopathy
Lovitt, S; Moore, SL; Marden, FA
2006 MAR ;117(3):486-495, Clinical neurophysiology
MRI has revolutionized the practice of many branches of medicine. However, within the field of Neurology MRI is used almost exclusively to examine the structure of portions of the central nervous system. Despite a limited number of objective tests, MRI remains an underutilized tool in the examination of the peripheral nervous system. This review will briefly discuss the limitations of current testing, and then summarize how the physics of MRI helps predict normal and abnormal findings in disease affecting skeletal muscle. The cardinal radiologic abnormalities affecting muscle (atrophy, hypertrophy, pseudohypertrophy, mass, and altered signal intensity) are reviewed. Special attention is given to how MRI can be utilized during the evaluation of such disorders. Finally, the roles of MRI as a prognostic tool and as a potential endpoint in long-term management of myopathy are evaluated. (c) 2005 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved
— id: 63787, year: 2006, vol: 117, page: 486, stat: Journal Article,

MRI of sarcoidosis patients with musculoskeletal symptoms
Moore, Sandra L; Teirstein, Alvin; Golimbu, Cornelia
2005 Jul;185(1):154-159, American journal of roentgenology
OBJECTIVE: Our objective was to determine MRI findings in sarcoidosis patients with musculoskeletal symptoms. CONCLUSION: In sarcoidosis patients with musculoskeletal complaints, MRI reveals marrow and soft-tissue lesions that are occult or underestimated on radiographs. Axial and large-bone lesions may resemble osseous metastases on MRI. Most lesions detected are nonspecific in appearance, except nodular muscle lesions. MRI reveals features suggesting the diagnosis, but with standard protocols, no pathognomonic MRI features were determined
— id: 56121, year: 2005, vol: 185, page: 154, stat: Journal Article,

Nocardia osteomyelitis in the setting of previously unknown HIV infection
Moore, Sandra Leigh; Jones, Sian; Lee, Julia L
2005 Jan;34(1):58-60, Skeletal radiology
We present a case of primary Nocardia osteomyelitis in the setting of HIV infection. The clinical and radiographic manifestations of musculoskeletal nocardiosis are nonspecific and resemble those of Mycobacterium tuberculosis infection. To our knowledge no other cases of Nocardia osteomyelitis have been reported in the radiology literature
— id: 51519, year: 2005, vol: 34, page: 58, stat: Journal Article,

Accuracy of non-contrast MRI for diagnosis of SLAP lesions
Bhandarkar, P; Rafii, M; Moore, S; Sherman, O; Rokito, A
2004 APR ;182(4):57-57, American journal of roentgenology
— id: 46654, year: 2004, vol: 182, page: 57, stat: Journal Article,

Epothilone B analog (BMS-247550) at the recommended phase II dose (R
Chen, T; Molina, A; Moore, S; Goel, S; Desai, K; Hamilton, A; Griffin, T; Colevas, AD; Mani, S; Muggia, F
2004 JUL 15 ;22(14):155S-155S, Journal of clinical oncology
— id: 48676, year: 2004, vol: 22, page: 155S, stat: Journal Article,

Quality of anatomical preparation determines quality of CT and MR imaging
Reidenberg, JS; Moore, SL; Laitman, JT
2004 MAR 23 ;18(4):A19-A19, FASEB journal
— id: 46592, year: 2004, vol: 18, page: A19, stat: Journal Article,

Pegylated liposomal doxorubicin (PLD) and carboplatin (C): A phase I study of combination therapy with maintenance PLD
Hamilton AL; Pavlick A; Volm M; Adams S; Hochster H; Moore S; Mozina J; Cordner M; Utate M; Muggia F
2003 ;22:2003-2003 #1986, Proceedings (American Society of Clinical Oncology)
Anthracyclines and platinums have activity in GYN, lung, breast and upper GI tumors, lymphomas and sarcomas. C and PLD (Doxil, Caelyx) have non-overlapping toxicity profiles: C produces myelosuppression, nausea and peripheral neuropathy while PLD causes schedule-dependent mucocutaneous toxicity. This study aimed to define the RPTD of the two agents in combination. Design: Patients (pt) received C and PLD on D1 of a 21 day schedule. 5 dose levels (DL) were studied (C AUC / PLD mg/m2): DL1: 4/20; DL2: 4/25; DL3: 4/30; DL4: 5/30; DL5: 6/30. DLT were febrile neutropenia, G4 heme or G3 non-heme toxicity other than hypersensitivity (HSR). Pt with heme toxicity could omit C in later cycles and continue PLD until disease progression. Pt with mucocutaneous toxicity extended the PLD dosing interval to 28 days. Results: 20 pt were treated: 7M/13F. Age: med 58.5, range 36-85. Tumors: ovarian (EOC)(7), MMT (2), endometrial (1), cervix (2), H&N (3), NPC (2), leiomyosarc (1), breast (1), islet cell (1). Prior chemo: 13. Pt received a median of 4 cycles of C/PLD (range 1-8) and 8 pt received maintenance PLD after cessation of C. No DLT occurred at any DL. At DL5 (n=6 eval), C1 toxicities were G1-2 ANC/Hb (4), G2 vaginal mucositis (1), G2 HSR (1), G1-2 nausea/vom (2), G2 fatigue (1), G2 hand-foot syndrome (1), G1 diarrhea (1). No cardiac events were observed. RECIST responses were observed in 4 pts (MMT 2, NPC 1, EOC 1). In pt with EOC, Ca125 responses were seen in 4/4 evaluable pt. Conclusions: C and PLD can be safely administered together at full dose, and maintenance PLD is feasible. This combination warrants phase III evaluation in ovarian cancer and may be a useful regimen in other solid tumors. Supported by M01 RR00096 and the Lynne Cohen Foundation for Ovarian Cancer Research
— id: 79467, year: 2003, vol: 22, page: 2003, stat: Journal Article,

Suprascapular nerve entrapment secondary to a lipoma
Hazrati, Yassamin; Miller, Suzanne; Moore, Sandra; Hausman, Michael; Flatow, Evan
2003 Jun;(411):124-128, Clinical orthopaedics & related research
Many causes of suprascapular nerve entrapment have been described including a small spinoglenoid notch, a tight ligament, boney spurs, and ganglion cysts. In the current patient, suprascapular nerve entrapment was caused by a lipoma in the suprascapular notch. The patient presented with painful shoulder motion that could have been attributed to rotator cuff and acromioclavicular joint disease. However, magnetic resonance imaging and electromyography were consistent with suprascapular nerve entrapment. Treatment of the rotator cuff disease and excision of the lipoma led to resolution of the patient's symptoms. This case is presented as an unusual cause of suprascapular nerve entrapment with a review of its course and anatomy
— id: 47550, year: 2003, vol: , page: 124, stat: Journal Article,

Advanced imaging of tuberculosis arthritis
Leigh Moore, Sandra; Rafii, Mahvash
2003 Jun;7(2):143-153, Seminars in musculoskeletal radiology
Musculoskeletal manifestations are seen in approximately 3% of tuberculosis (MTb) cases, more commonly in the spine. Extra-axial bone and joint MTb is infrequently encountered in the West. In the last decade, public health strategies for control of MTb have been so successful in industrialized countries that many clinicians are unfamiliar with the range of extrapulmonary manifestations of MTb and therefore hold a low index of suspicion for MTb in the diagnosis of bone and joint infection. MTb, however, persists as a serious and significant cause of musculoskeletal pathology in many parts of the world and for specific patient cohorts in industrialized countries. Knowledge of the patient groups at risk and awareness of the varied osteoarticular manifestations of MTb are essential for timely diagnosis and intervention and potential cure
— id: 44179, year: 2003, vol: 7, page: 143, stat: Journal Article,

Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging
Moore, Sandra L; Teirstein, Alvin E
2003 Nov-Dec;23(6):1389-1399, Radiographics
Magnetic resonance (MR) imaging reveals a broad range of musculoskeletal abnormalities in patients with sarcoidosis, including focal and diffuse muscle lesions, soft-tissue masses, joint abnormalities, and marrow infiltration of small and large bones. Long bone and axial skeletal involvement may be occult at conventional radiography but depicted at MR imaging, with an appearance that resembles that of osseous metastases. Sarcoidosis-related findings may be detected at dedicated MR imaging for osteoarticular symptoms in sarcoidosis patients or encountered incidentally at MR imaging performed for other indications. Correlation with clinical and laboratory findings is essential for correct diagnosis because the MR imaging findings are nonspecific in most cases. The radiologist should be aware of potential sarcoidal causes in the differential diagnosis of musculoskeletal lesions in patients with proved or suspected sarcoidosis. Such consideration will have a profound effect on the interpretation of images and on the study of patients with dual diagnoses of sarcoidosis and neoplasm
— id: 43833, year: 2003, vol: 23, page: 1389, stat: Journal Article,

Imaging the anterior cruciate ligament
Moore, Sandra L
2002 Oct;33(4):663-674, Orthopedic clinics of North America
MR imaging has surpassed all other imaging modalities to become the 'gold standard' for imaging evaluation of ACL injury. The accuracy and sensitivity of MR imaging for evaluation of ACL tears is excellent when correlated with clinical tests and arthroscopic findings, and is improved in equivocal cases with assessment of secondary signs for ACL tear. The MR imaging assessment of partial and chronic ACL tears is less accurate but is clinically useful. MR imaging provides information about associated injuries prior to surgery. Radiologic diagnostic methods for the assessment of ACL tears on MR images are well established; recent techniques such as dedicated cartilage imaging offer new information of use to clinicians about the sequelae of ACL injuries
— id: 43834, year: 2002, vol: 33, page: 663, stat: Journal Article,

Intraosseous hemangioma of the zygoma: CT and MR findings
Moore SL; Chun JK; Mitre SA; Som PM
2001 Aug;22(7):1383-1385, AJNR. American journal of neuroradiology
Intraosseous hemangiomas are uncommon, constituting less than 1% of all osseous tumors. The most frequent sites are the calvaria and the vertebral column. Involvement of the facial bones is rare, and occurs most commonly in the maxilla, mandible, and nasal bones. Only 20 cases of zygomatic involvement have been reported in the English-language literature. We report a case of an intraosseous hemangioma of the zygoma documented by CT and MR studies
— id: 32702, year: 2001, vol: 22, page: 1383, stat: Journal Article,

Imaging of musculoskeletal and spinal tuberculosis
Moore SL; Rafii M
2001 Mar;39(2):329-342, Radiologic clinics of North America
The diagnosis of tuberculosis of the musculoskeletal system is difficult for many reasons. As Walker states, to diagnose tuberculosis one must consider the possibility. The uncommonness of osteoarticular MTb results in clinician inexperience, which leads to overlooking the diagnosis. Subtle early manifestations may elude detection. Negative skin tests and normal chest films do not exclude the consideration of tuberculosis. The most conclusive means of reaching the diagnosis (biopsy and culture) necessitate invasive procedures that are not always definitive, and may require repeated attempts. Management and surgical decisions, however, rely on prompt diagnosis; diagnostic delay has prognostic implications and results in significant morbidity. Musculoskeletal tuberculosis produces no pathognomonic imaging signs, and in advanced stages mimics other disease processes. Despite these difficulties, the diagnostician's goal is to catch the disease as early as possible, because antibiotic treatment can lead to resolution and obviate more radical management. The radiologist must be aware of the groups at greatest risk, and typical and atypical presentations at imaging. The eventual eradication of MTb is conceivable, although not presently within our grasp. Maintaining reasonable suspicion and developing cognizance of the patterns of presentation allow the radiologist to diagnose efficiently the patient who presents with osteoarticular tuberculosis
— id: 32703, year: 2001, vol: 39, page: 329, stat: Journal Article,

MR imaging of the biceps muscle-tendon complex
Klug JD; Moore SL
1997 Nov;5(4):755-765, Magnetic resonance imaging clinics of North America
The anatomy of the biceps brachii muscle-tendon complex is reviewed. Particular attention is given to the tendon of the long head. Pathologic conditions affecting the biceps are discussed with respect to clinical features and current ideas regarding pathogenesis, which are correlated with the appearance at MR imaging
— id: 7182, year: 1997, vol: 5, page: 755, stat: Journal Article,

CT evaluation of infradiaphragmatic air in patients treated with mechanically assisted ventilation: a potential source of error
Balthazar EJ; Moore SL
1996 Sep;167(3):731-734, American journal of roentgenology
OBJECTIVE: The purpose of this study was to describe the CT features of infradiaphragmatic air that may develop in patients after mechanically assisted ventilation, its location, its pathway of transdiaphragmatic dissection, and its extension into the abdomen. MATERIALS AND METHODS: We retrospectively evaluated six consecutive adult patients with pneumomediastinum associated with positive end-expiratory pressure therapy who developed intraabdominal air and were imaged with CT in our institution-between 1993 and 1995. Abdominal CT examinations were reviewed and correlated with the clinical findings, follow-up examinations, and exploratory laparotomies in four patients. RESULTS: In four patients, air present in the anterior mediastinum (endothoracic fascia) was seen to extend into the anterior abdominal wall within the extraperitoneal space. In a fifth patient, the air was located extraperitoneally and intraperitoneally. In the remaining patient, air was present exclusively in the peritoneal cavity. In only two patients did we detect small amounts of air in the posterior retroperitoneum. In five patients, we also detected subcutaneous emphysema and/or air dissection into the muscle planes of the anterolateral abdominal wall. CONCLUSION: In patients on mechanically assisted ventilation, anterior mediastinal air can dissect through the diaphragm into the anterior abdominal extraperitoneal space. This anterior pathway of infradiaphragmatic extension of air can be erroneously diagnosed as intraperitoneal air, which may lead to unnecessary exploratory laparotomies. Also, anterior mediastinal air can enter the peritoneal cavity, particularly in patients with a history of median sternotomy
— id: 8050, year: 1996, vol: 167, page: 731, stat: Journal Article,

A tannic acid based preparation procedure which enables leucocytes to be examined subsequently by either SEM or TEM
McCarthy, D A; Pell, B K; Holburn, C M; Moore, S R; Perry, J D; Goddard, D H; Kirk, A P
1985 Jan;137(Pt 1):57-64, Journal of microscopy
A modification of the glutaraldehyde-osmium tetroxide-tannic acid-uranyl acetate (GOTU) fixation procedure is described which allows human leucocytes to be examined subsequently by either transmission electron microscopy (TEM) or scanning electron microscopy (SEM)
— id: 142611, year: 1985, vol: 137, page: 57, stat: Journal Article,