DOCSLIB.ORG

Juvenile Osteochondrosis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Juvenile Osteochondrosis Juvenile Osteochondrosis Objectives • Definition • Anatomy and Physiology of Normal/Abnormal bone growth • Types • Clinical Presentation • Maaageetnagement • Prevention Definition • Group of growth cartilage abnormalities that occur at the apophysis,atthejointsurface,andatthe, at the joint surface, and at the physeal plate • They have been defined by Siffert as “idiopathic conditions characterized by disorderliness of endochondral ossification,,g including both chondrogenesis and osteogenesis that comes upon a formerly normal growth mechanism” Definition • Etiology – Debatable; vascular , hormonal , genetic , and metabolic factors as well as infections have all been proposed as precipitating or contributing causes. • These conditions may merely represent abnormalities of maturation. • Because diagnosis typically depends on radiographic confirmation, many of the osteochondroses carry the name of the individual who first described their radiographic appearance. Normal Physiology Pathophysiology of Osteochondrosis • The osteochondrotic process is essentially degeneration of the epiphyseal osseous nucleus. • This process is almost certainly due to either – (1) interference with the blood supply, which leads to necrosis of the cartilage-canal vessels in the subchondral bone and adjacent epiphysis – (2) failure of the bony centrum to enlarge and disordered proliferation of the cartilaginous cells in the epiphysis. Secondary changes (eg, fragmentation, collapse, and sequestrum formation) develop in accordance with the characteristics of the affected region. Location Eponym Carpal Scaphoid Presier disease Lunate KienbÖck disease Medial cuneiform Buschke disease Patella Köhler disease Talus Mouchet disease Tarsal Scaphoid Köhler disease Vertebral body Calvé disease (LCPD) Vertebral epiphysis Scheuermann disease Iliac cres t BhBuchman disease Symphysis pubis Pierson disease Ischiopubic junction Van Neck disease Ischial Tuberosity Valtancoli disease Calcaneal apophysitis Sever disease Accessory tarsal navicular Haglund disease Second metatarsal Freiberg disease/infarction 5th metatarsal base Iselin disease Talus Diaz disease Distal tibial epiphysis Lewin disease PilProximal tibia l epihiphys is Bloun t disease Tuberosity of the tibia Osgood-Schlatter 20 patellar center Sinding-Larsen-Johansson syndrome Lesser trochanter of the femur Monde-Felix disease Greater trochanter of the femur Mandl or Buchman disease Capital epiphysis of the femur LCPD Phalanges Thiemann Syndrome Metacarpal heads Mauclaire disease Proximal epiphysis of the radius Schaefer disease Distal epiphysis of the ulna Burns disease Types • Articular Osteochondrosis – Primaayry: Primaayry invo lve me nt tot of the eatcua articular a nd depp epiphysea yseacatageal cartilage and dasubjacet a subjacent eedocodandochondral ossification center – Freiberg disease – Secondary: Secondary involvement of the articular and epiphyseal cartilage as a consequence of ischemic necrosis of subjacent bone – Perthes disease, Köhler disease, osteochondritis dissecans • Non-Articular Osteochondrosis – Tendinous attachments - Osgood-Schlatter syndrome, Monde-Felix disease – Ligamentous attachments - Vertebral ring – Impact sites - Sever disease • Physea l OtOsteoc hon dros is – Long bones – Tibia vara (Blount disease) – Scheuermann disease/kyphosis Clinical Presentation of Osteochondrosis • Localized tenderness • Limited movement of adjacent joints • Swelling • Gait disturbance (when the disease affects the lower limbs) • Reactive effusion in an adjacent joint (sometimes observed) – If systemic signs- Look for other causes!!! Articular Type: Primary Freiberg’s Infraction Case • 12 year old male • Presents with vague, non-localized knee pain • Endorses occasional locking symptoms • Exam: quad weakness, full knee extension lagging final 10 degrees. • Positive Wilson test (knee flexed 90 degrees and tibia internally rotated) • Diagnosis? Articular Type: Secondary Osteochondritis Dessicans Knee OCD Knee Complications • The general rule is the younger the patient, the better the prognosis. Guidelines for treatment are outlined by the following categories: • Category 1 (ie, girls younger than 11 y, boys younger than 13 y): These patients usually do well with non-operative treatment. • Category 2 (girls aged 11-15 y, boys aged 13-17 y): These patients are near skeletal maturity. Treatment depends on the looseness of the lesions. • Category 3: Physeal closure and skeletal maturity have occurred. Treatment is based on the size and stability of the lesion . – Grade 1 - Positive radiography findings and an intact articular surface – Grade 2 - Articular injury noted at arthroscopy – Grade 3 - Loose lesion (stays within crater) – Grade 4 - Loose fragment within joint Treatment of OCD Knee Conservative • In children with non-displaced fragments, initial treatment includes limitation of activity with the use of crutches and restricted range of motion (knee immobilizer, range-of-motion brace). • Recommend a trial of non-operative treatment for 3-6 months. If symptoms persist or failure to unite is observed, proceed with surgical treatment Treatment of OCD Knee Surgical – Arthroscopy – Drilling – for improved vascularity – Pinning – for loose body stabilization – Excision of loose bodies – OATS (Osteochondral Autograft Transplantation Surgery) • Involves harvesting cylindrical osteochondral grafts from other areas of the knee to reconstruct a weight-bearing surface. A maximum 1-cm lesion (crater) depth is allowed for use of this treatment method. – Osteochondral allograft transplantation is similar to OATS except that a freshly harvested allograft condyle is used. The advantages are that the exact condyle curvature can be reconstructed and no further defect is created during autograft harvest. Case • 13 year old baseball pitcher • PtdithlbiPresented with elbow pain • Endorses catching/locking symptoms • Exam: crepitus, muscular atrophy • Differential: Panner’s disease vs. OCD of the elbow Elbow Osteochondrosis • Panner’s disease: Osteochondrosis of the capitellum (Little League Elbow) – Affects children generally 5-10 yrs old – Affects growth plate – Symptoms resolve as bone matures • OCD elbow – Affects adolescents – Localized injury to subchondral bone; results from repetitive lateral compression of the elbow during overhead motions – Crepitus/locking and catching due to loose bodies Complications of Little League Elbow • Most complications arise from a thrower attempting to return to pitching too soon before rehabilitation is complete, or from a pitcher who continues to play while symptomatic. • Presence of pain while performing competitive pitching is highly correlated with an increased risk of medial epicondylar avulsion fracture and the subsequent need for surgical stabilization. • Athletes should be counseled to stop or avoid pitching at any time when elbow pain is present, and these individuals should seek an evaluation before returning to pitching. Little League Elbow Surgery • Medial epicondylar fractures may require either closed reduction and casting or surgical reattachment with fixation if displacement, elbow instability, or failure of conservative treatment occurs. • If loose bodies or osteophytes are present with olecranon injuries, surgical removal may be indicated in those who are symptomatic. Bone grafting may also be used in cases of olecranon nonunion when rest and immobilization have failed. • All throwers who have had surgical treatment for elbow pain require some form of progressive reha bilitat ion inc ludi ng a thhbihilihilihorough biomechanical pitching analysis. Pitchers should be counseled that many do not return to the previous level of throwing following surgical treatment of elbow injuries; however, outcomes vary based on the individual circumstances. Case • 3 year old girl • Presentedhd with spontaneous rig hddlht sided limp • On exam – Tenderness over the Tarsal/Navicular • Osteochondrosis? Articular Type: Secondary Kohler’s Disease of the Tarsal Navicular Non-Articular - Tendonous Osgood Schlatter’s Non-Articular Sever’s Disease Physeal Osteochondrosis Blount’s Disease Physeal Osteochondrosis Scheuermann’s Kyphosis Treatment Algorithm • Protection and prevention of additional trauma • Prevention of secondaryyy deformity • Reduction of the transmission of mechanical stresses to the bone during the process of reossification • Facilitation of reossification • Removal of osteochondrotic fragments that have become loose bodies • Compensation for fixed bony deformities by means of realignment • Intervention with salvage surgery if indicated Rehab Protocol • Typical Program 5 phases – Phase I – Decreasing inflammation – Phase II – Improving Range of Motion – Phase III – Improve Strength and Proprioception – Phase IV – Return to Functional Skills – Phase V – Return to Sport • Children Progress faster than adults • One must master 75-80% of the goals of each phase before progressing to the next phase Questions? References • Resnick D. Osteochondroses. In: Resnick D. Diagnosis of bone and joint disorders. 4. 4th. Philadelphia, Pa: WB Saunders; 2002:3686-741. • Symposium: the osteochondroses. Clin Orthop Relat Res. Jul-Aug 1981;(158):1-98. • Bertone AL, Bramlage LR, McIlwraith CW, Malemud CJ, Malemud CL. Comparison of proteoglycan and collagen in articular cartilage of horses with naturally developing osteochondrosis and healing osteochondral fragments of experimentally induced fractures. Am J Vet Res. Nov 2005;66(11):1881-90. • Monfort J, Garcia-GiraltN, López-Armada MJ, Monllau
Load more

Recommended publications
  • Pycnodysostosis with a Cathepsin K Mutation: a Case Report
    Ada Medica et Biologica Vol. 49, No.l, 31-37, 2001 Pycnodysostosis with a Cathepsin K Mutation: A Case Report Hiroshi YAMAGIWA1, Mayumi ASAOKA2, Hisayoshi KATO2, Minoru SHIBATA3, and Naoto ENDO1 'Department of Orthopedic Surgery, "Rehabilitation, and 3Plastic Surgery, Niigata University School of Medicine, Niigata, Japan Received October 16 2000 ; accepted January 22 2001 Summary.Pycnodysostosis (PKND) is a type of osteo- the distal phalanges, frequent fractures, and skull sclerosing bone disease. Recent studies have demon- deformities with delayed suture closure4'5'. The cathe- strated that several cathepsin K mutations can be psin K gene, which wa cloned originally from rabbit identified in PKND families. A fifty-three-year-old Japanese womandiagnosed with PKND with typical osteoclasts6', was highly expressed in osteoclasts. features suffered from the nonunion of the right tibial This molecule plays an important role in bone resorp- shaft. We did open reduction and performed a vascular- tion and remodeling. Cathepsin K knockout mice ized fibular graft using an external fixator. A low- show impaired osteoclastic bone resorption, which intensity pulsed ultrasound device was used three leads to osteopetrosis7'8). Recent studies have demon- months after surgery. Union of the tibia was completed strated several mutations in patients with about one year after surgery. Histomorphometric anal- PKND1'9-10'11'. In this paper, we present a clinical, ysis of the iliac bone revealed that the patient had low histomorphometric, and genomic study of a patient turnover bone with increased bone volume. Analysis of with the typical form of pycnodysostosis. Since the cathepsin K coding region from the genomic DNA parental consanguinity has been noted in more than of the patient and her family (consanguineous parents 30% of cases, we also analyzed her consanguineous and three sisters who were all of normal stature) revealed that the patient had a deletion of genomic parents and three sisters.
    [Show full text]
  • Investigating the Genetic and Genomic Basis of Osteochondrosis in Thoroughbred Horses from Australia and New Zealand
    Investigating the genetic and genomic basis of osteochondrosis in Thoroughbred horses from Australia and New Zealand Kao Castle The University of Sydney A thesis submitted to the Faculty of Veterinary Science, The University of Sydney, in fulfilment of the requirements for the Degree of Doctor of Philosophy December 2012 i Declaration I declare that the work presented in this thesis is, to the best of my knowledge and belief, original, except as acknowledged in the text, and that the material has not been submitted, either in whole or in part, for a degree at this or any other university. (Kao Castle) 17 December 2012 ii Statement of Contributions The identities of the studs and horses that participated in the research described in this thesis are protected by confidentiality agreements. On this basis, the names of stud staff and veterinarians who provided data for this research are not listed as authors or named in the acknowledgements, although their input was invaluable. Chapter 2, Skeletal lesions and injuries in Australasian Thoroughbred weanling and yearling radiographs (draft manuscript). Castle K., Tammen I., Thomson P.C., Jeffcott L.B., Raadsma H.W. and Nicholas F.W. • Dr Tammen supervised components of this work, contributed to discussions, and provided feedback on the presentation of results. • Associate Professor Thomson provided advice on statistical techniques to compare results between the weanling and yearling populations, and provided feedback on the presentation of results. • Professors Jeffcott and Raadsma contributed to planning the data collection strategy, and provided feedback on the presentation of results. • Emeritus Professor Nicholas supervised components of this work, contributed to discussions and provided extensive feedback on the presentation of the results, and edited the manuscript.
    [Show full text]
  • Distal Humerus Nonunion After Failed Internal Fixation: Reconstruction with Total Elbow Arthroplasty Dawn M
    (aspects of trauma • an original study) Distal Humerus Nonunion After Failed Internal Fixation: Reconstruction With Total Elbow Arthroplasty Dawn M. LaPorte, MD, Michael S. Murphy, MD, and J. Russell Moore, MD ABSTRACT onunion occurs in 2% ing treatment option. In the 1980s, In nonunion after distal humerus to 5% of distal humerus TEA for nonunion with tightly con- fracture, osteoporosis, devas- fractures.1 The condition strained or custom prostheses had cularized fracture fragments, is difficult to treat, and fair to moderately good results but and periarticular fibrosis limit Nno single treatment modality has a high complication rates (4/7, 57%6; potential reconstructive options. high success rate with few compli- 5/14, 36%10). According to a recent We assessed pain relief, func- 2-6 11 tional gains, and complications cations. Without intervention, the review, however, 31 (86%) of 36 in 12 patients whose long-stand- patient is left with a painful, unstable, patients had a satisfactory result with ing, painful nonunions after previ- and often flail extremity and with a semiconstrained prosthesis, and ous treatment with rigid internal limitations in activities of daily liv- only 7 (19%) of the 36 patients had fixation were reconstructed with ing. Frequently, there is an associ- complications. a semiconstrained total elbow ated ulnar neuropathy. Osteoporosis, In the current study, we assessed arthroplasty, frequently with a devascularized fracture fragments, outcomes (complications, symptoms, triceps-sparing approach and and periarticular fibrosis limit poten- function) after semiconstrained anterior ulnar nerve transposition. tial reconstructive options for long- TEA for long-standing distal humer- At mean follow-up of 63 months, 11 patients had good pain relief and standing distal humerus nonunions.
    [Show full text]
  • Nonunion with Bone Loss
    Nonunion with Bone Loss Tim Weber, MD Jeff Anglen, MD, FACS Original Authors; March 2004; Revised June 2006 and 2010 Etiology • Open fracture – segmental – post debridement – blast injury • Infection • Tumor resection • Osteonecrosis Classification Salai et al. Arch Orthop Trauma Surg 119 Classification Not Widely Used Not Validated Not Predictive Salai et al. Arch Orthop Trauma Surg 119 Evaluation • Soft tissue envelope • Infection • Joint contracture and range of motion • Nerve function: sensation, motor • Vasculature: perfusion, angiogram? • Location and size of defect • Hardware • General health of the host • Psychosocial resources Is it Salvageable? • Vascularity - warm ischemia time • Intact sensation or tibial nerve transection • other injuries • Host health • magnitude of reconstructive effort vs patient’s tolerance • ultimate functional outcome Priorities • Resuscitate • Restore blood supply • Remove dead or infected tissue (Adequate debridement) • Restore soft tissue envelope integrity • Restore skeletal stability • Rehabilitation Bone Loss - Initial Treatment • Irrigation and Debridement Bone Loss - Initial Treatment • Irrigation and Debridement • External fixation Bone Loss - Initial Treatment • Irrigation and Debridement • External fixation • Antibiotic bead spacers Bone Loss - Initial Treatment • ANTIBIOTIC BEAD POUCH – ANTIBIOTIC IMPREGNATED METHYL- METHACRALATE BEADS – SEALED WITH IOBAN Bone Loss - Initial Treatment • Irrigation and Debridement • External fixation • Antibiotic block spacers Beads Block Bone Loss - Initial
    [Show full text]
  • Case Report Chondroblastoma of The
    CASE REPORT CHONDROBLASTOMA OF THE PATELLA ASSOCIATED WITH AN ANEURYSMAL BONE CYST R. TREBŠE1, A. ROTTER2,V. PIŠOT1 Chondroblastoma is a rare, benign tumor of bone, cartilage germ cells, and they redefined the tumor accounting for about 1% of all bone tumor cases. It as “benign chondroblastoma”. tends to affect the epiphyseal ends of long bones, Chondroblastoma is rare, representing about 1% most often in males during the first and second of all primary bone tumors (1, 5, 9). It is typically decades of life. It has well-characterized radio- centered in an epiphysis. Although it occurs most graphic and histologic features but despite its histo- often in the end of a long tubular bone, it can logically benign appearance a few cases of metastases appear in any secondary center of ossification. It is have been reported. Local recurrences after curet- tage and bone grafting occur in 11% to 25% of cases. most probably a tumor of cartilaginous origin and The features of a patellar chondroblastoma are the is more common in males by a ratio of about 2-to- same as for other locations. In reviewing the litera- 1 (1, 5, 9). Seventy percent of chondroblastomas ture we found an unusually high male-to-female occur during active epiphyseal plate growth, and ratio. It is interesting that the usual treatment of the about two-thirds of the patients are in the second patellar chondroblastoma has been patellectomy, decade of life (5). whereas curettage and bone grafting has predomi- Local pain of several months’ duration and nated in the other locations.
    [Show full text]
  • Elbow Arthroscopy for Osteochondral Lesions in Athletes
    SPORTS SURGERY ELBOW ARTHROSCOPY FOR OSTEOCHONDRAL LESIONS IN ATHLETES – Written by Luigi Pederzini et al, Italy Several sports specific injuries of the elbow OSTEOCHONDRAL DEFECT have been well-described. For example, Definition and symptoms the prevalence of medial elbow instability Osteochondral defect is a detachment is high in throwing athletes such as of bone and cartilage in a joint that can Osteochondral baseball players. Similarly, javelin throwers, cause pain. The clinical presentation defect is a volleyball players and tennis players are is characterised by an acute or chronic frequently complaining about elbow pain. onset of symptoms. The majority of detachment of This can be the result of intensive training patients with osteochondral defects of or chronic overuse which results in an the elbow complain of pain. In some bone and cartilage acute or chronic injury. Some of these patients the defect is associated with injuries can be osteochondral lesions such a loose body, and the patient presents in a joint that as osteochondral defects, osteochondrosis clinically with pain, giving way, swelling, can cause pain... of the capitulum humeri or osteochondritis catching, clicking, crepitus and elbow dissecans (OCD). stiffness aggravated by joint movements. characterised Standard X-rays are the initial studies of choice, but sometimes are negative. by an acute or Magnetic resonance imaging (MRI) and 3D computed tomography (CT) scan can chronic onset of be extremely useful in establishing an symptoms. accurate diagnosis and to add in pre- operative planning. 210 OSTEOCHONDROSIS OF CAPITULUM HUMERI (PANNER’S DISEASE) Definition and symptoms Panner’s disease, an ostechondrosis of the capitellum, is a rare disorder that usually affects the dominant elbow in individuals younger than 10 years old.
    [Show full text]
  • SAS Journal of Surgery (SASJS) Panner's Disease: About a Case
    SAS Journal of Surgery (SASJS) ISSN 2454-5104 Abbreviated Key Title: SAS J. Surg. ©Scholars Academic and Scientific Publishers (SAS Publishers) A Unit of Scholars Academic and Scientific Society, India Panner's Disease: About A Case Mohamed Ben-Aissi1, Redouane Hani1, Mohammed Kadiri1, Mouad Beqqali-Hassani1, Paolo Palmari2, Moncef Boufettal1, Mohamed Kharmaz1, Moulay Omar Lamrani1, Ahmed El Bardouni1, Mustapha Mahfoud1, Mohamed Saleh Berrada1 1Orthopedic surgery and traumatology department, Ibn Sina Hospital, Rabat, Morocco 2Orthopedic surgery and traumatology departemnt, Robert Ballanger Hospital, Paris, France Abstract: Panner's disease, or osteochondrosis of the lateral condylar nucleus, is an Case Report avascular necrosis leading to subchondral bone loss, it was first described in 1927. We report a case of Panner's disease, which has been evolving since 1 month, in a child of 8 *Corresponding author years sportsman practicing karate. The evolution was favorable with restitution ad Mohamed Ben-Aissi integrum in 8 months after a short anti-inflammatory treatment and a sports rest of 3 months, without any immobilization of the neither elbow nor surgical intervention. Article History Keywords: Osteochondrosis, Panner’s disease, Treatment. Received: 03.10.2018 Accepted: 06.10.2018 INTRODUCTION Published: 30.10.2018 Panner's disease, or osteochondrosis of the lateral condylar nucleus, is an avascular necrosis leading to a loss of subchondral bone fissuring the radio-humeral DOI: articular surfaces, occurring in the hyperspottive child, in connection with an overuse of 10.21276/sasjs.2018.4.10.7 the elbow [1, 2]. It was first described in 1927 by Dane Panner, a Danish orthopedic surgeon [2, 3].
    [Show full text]
  • (Xgeva®) Related Osteonecrosis of the Jaw: a Retrospective Study
    Journal of Clinical Medicine Article A Comparison of the Clinical and Radiological Extent of Denosumab (Xgeva®) Related Osteonecrosis of the Jaw: A Retrospective Study Zineb Assili 1, Gilles Dolivet 2, Julia Salleron 3 , Claire Griffaton-Tallandier 4, Claire Egloff-Juras 1 and Bérengère Phulpin 1,2,* 1 Faculty of Odontology, Lorraine University, 7 Avenue de la Forêt de Haye, 54505 Vandoeuvre les Nancy, France; [email protected] (Z.A.); [email protected] (C.E.-J.) 2 Department of Head and Neck and Dental Surgery, Institut de Cancérologie de Lorraine, 54519 Vadoeuvre-lès-Nancy, France; [email protected] 3 Cellule Data-Biostatistiques, Institut de Cancérologie de Lorraine, 54519 Vandoeuvre-lès-Nancy, France; [email protected] 4 Cabinet de Radiologie RX125, 125 Rue Saint-Dizier, 54000 Nancy, France; [email protected] * Correspondence: [email protected]; Tel.: +33-3-83-59-84-46 Abstract: Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect of antiresorptive medication. The aim of this study was to evaluate the incidence of denosumab-related osteonecrosis of the jaw and to compare the clinical and radiological extent of osteonecrosis. A retrospective study of patients who received Xgeva® at the Institut de Cancérologie de Lorraine (ICL) was performed. Patients for whom clinical and radiological (CBCT) data were available were divided into two groups: Citation: Assili, Z.; Dolivet, G.; “exposed” for patients with bone exposure and “fistula” when only a fistula through which the bone Salleron, J.; Griffaton-Tallandier, C.; could be probed was observed. The difference between clinical and radiological extent was assessed.
    [Show full text]
  • Pediatric MSK Protocols
    UT Southwestern Department of Radiology Ankle and Foot Protocols - Last Update 5-18-2015 Protocol Indications Notes Axial Coronal Sagittal Ankle / Midfoot - Routine Ankle Pain Axial = In Relation to Leg "Footprint" (Long Axis to Foot) T1 FSE PD SPAIR T1 FSE Injury, Internal Derangement Coronal = In Relation to Leg (Short Axis Foot) PD SPAIR STIR Talar OCD, Coalition Protocol Indications Notes Axial Coronal Sagittal Ankle / Midfoot - Arthritis Arthritis Axial = In Relation to Leg "Footprint" (Long Axis to Foot) PD SPAIR PD SPAIR T1 FSE Coronal = In Relation to Leg (Short Axis Foot) STIR T1 SPIR POST T1 SPIR POST Protocol Indications Notes Axial Coronal Sagittal Foot - Routine Pain, AVN Axial = In Relation to Leg "Footprint" (Long Axis to Foot) T1 FSE PD FSE T1 FSE Coronal = In Relation to Leg (Short Axis Foot) PD SPAIR PD SPAIR STIR Protocol Indications Notes Axial Coronal Sagittal Foot - Arthritis Arthritis Axial = In Relation to Leg "Footprint" (Long Axis to Foot) T1 FSE PD SPAIR STIR Coronal = In Relation to Leg (Short Axis Foot) PD SPAIR T1 SPIR POST 3D WATS T1 SPIR POST Protocol Indications Notes Axial Coronal Sagittal Great Toe / MTP Joints Turf Toe Smallest Coil Possible (Microcoil if Available) PD FSE T1 FSE PD FSE Sesamoiditis FoV = Mid Metatarsal Through Distal Phalanges PD SPAIR PD SPAIR PD SPAIR Slice thickness = 2-3 mm, 10% gap Axial = In relation to the great toe (short axis foot) Coronal = In relation to the great toe (long axis foot / footprint) Appropriate Coronal Plane for Both Ankle and Foot Imaging UT Southwestern Department
    [Show full text]
  • Chronic Osteomyelitis of Jaw
    Chronic Osteomyelitis of Jaw Dr. Dhawal Goyal, 1 Dr. Nilima Malik, 2 Dr. Neha Gupta, 3 Dr. Manoj Agarwal, 4 Dr. Rajani Kalla, 5 Dr. Sanyam Agarwal 6 1. Dr. Dhawal Goyal MDS, Oral Private Practitioner 2. Dr. Nilima Malik MDS Oral and Maxillofacial Surgery 3. Dr. Neha Gupta Assistant Professor, Dept. of Prosthodontics, RUHS College of Dental Sciences, Jaipur 4. Dr. Manoj Agarwal Assistant Professor, Dept. of Conservative Dentistry & Endodontics, RUHS College of Dental Sciences, Jaipur 5. Dr. Rajani Kalla Assistant Professor, Dept. of Prosthodontics, RUHS College of Dental Sciences, Jaipur 6. Dr. Sanyam Agarwal Medical Officer, Dept. of Conservative Dentistry & Endodontics, RUHS College of Dental Sciences, Jaipur The prevalence of osteomyelitis of jaws in third Cultures, bone biopsy, conventional radiography, world country is still at a higher rate despite newer scintigraphy, CT scan are used to diagnose chronic and powerful antibiotics and advances in dental osteomyelitis of jaws. Computed Tomograph helps care. This may be due to low socio-economical in determination of cortex and medullary status, unavailability of primary health care involvement of diseased bone better as compared to services, and poor nutritional status in the rural conventional radiograph. areas. Therapy for osteomyelitis of jaws requires a Osteomyelitis may be defined as an inflammatory multidisciplinary approach. A precise condition of the bone that usually begins as an microbiologic diagnosis and adequate debridement infection of the medullary cavity, rapidly involves of necrotic tissue are essential. Acute the Haversian system and quickly extends to hematogenous osteomyelitis usually responds to periosteum of the affected area. The infection then antimicrobial therapy.
    [Show full text]
  • WHO Manual of Diagnostic Imaging Radiographic Anatomy and Interpretation of the Musculoskeletal System
    The WHO manual of diagnostic imaging Radiographic Anatomy and Interpretation of the Musculoskeletal System Editors Harald Ostensen M.D. Holger Pettersson M.D. Authors A. Mark Davies M.D. Holger Pettersson M.D. In collaboration with F. Arredondo M.D., M.R. El Meligi M.D., R. Guenther M.D., G.K. Ikundu M.D., L. Leong M.D., P. Palmer M.D., P. Scally M.D. Published by the World Health Organization in collaboration with the International Society of Radiology WHO Library Cataloguing-in-Publication Data Davies, A. Mark Radiography of the musculoskeletal system / authors : A. Mark Davies, Holger Pettersson; in collaboration with F. Arredondo . [et al.] WHO manuals of diagnostic imaging / editors : Harald Ostensen, Holger Pettersson; vol. 2 Published by the World Health Organization in collaboration with the International Society of Radiology 1.Musculoskeletal system – radiography 2.Musculoskeletal diseases – radiography 3.Musculoskeletal abnormalities – radiography 4.Manuals I.Pettersson, Holger II.Arredondo, F. III.Series editor: Ostensen, Harald ISBN 92 4 154555 0 (NLM Classification: WE 141) The World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to the Office of Publications, World Health Organization, CH-1211 Geneva 27, Switzerland, which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. © World Health Organization 2002 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved.
    [Show full text]
  • Osteochondrosis and Arthrosis in Pigs Ii
    Acta vet. scand, 1974, 15, 26-42. From the Department of Pathology, Veterinary College of Norway, Oslo. OSTEOCHONDROSIS AND ARTHROSIS IN PIGS II. INCIDENCE IN BREEDING ANIMALS By Trygve Grendalen GR0NDALEN, TRYGVE: Osteochondrosis and arthrosis in pigs. 11. Incidence in breeding animals. Acta vet. scand. 1974, 15, 26-42. - Joint and bone lesions in breeding pigs are described on the background of an investdgatlon involving 174 sows and 155 boars from 7 months to 4% years old . Lesions, which consisted pre­ dominantly of arthrosis, degeneration of intervertebral discs, spon­ dylosis and epiphyseal separations, were demonstrated frequently in both sexes. Osteochondrosis, a condition previously demonstrated frequently in slaughter pigs, had either completely healed, undergone repair or developed into an arthrosis by the time the animal reached an age of about 1% years. Whereas a higher incidence of arthrosis of the intervertebral joints was found in boars than in sows, the reverse was true as regards degeneration of the intervertebral discs and anchylosing spondylosis. Possible reasons for this are discussed. Norwegian pigs show a higher incidence of lesions in the lumbar region of the vertebral column than has been described up to the present time in other countries. os teo c h 0 n d r 0 sis; art h r 0 sis; pig. A high incidence of osteochondrosis in joints and epiphyseal plates, and arthrosis, especially in the lumbar intervertebral joints, the distomedial hock joints, the elbow and stifle joint in pigs up to 120 kg live weight has been previously described (Grpndalen 1974). A review of the literature showed that osteo­ chondrosisand archrosis are widespread in pigs in various coun­ tries.
    [Show full text]