Doxycycline Injection Treatment for Unicameral Bone Cysts: a Case Series
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Percutaneous Injection of Calcium Phosphate Composite in Pediatric Unicameral Bone Cysts: a Minimum 5-Year Follow-Up Study
Sport Sciences for Health (2019) 15:207–213 https://doi.org/10.1007/s11332-018-0513-7 ORIGINAL ARTICLE Percutaneous injection of calcium phosphate composite in pediatric unicameral bone cysts: a minimum 5-year follow-up study Marco Turati1,2 · Marco Bigoni2,3 · Lilia Brahim1 · Emeline Bourgeois1 · Giovanni Zatti2,3 · Ahmad Eid1 · Jacques Griffet1 · Aurélien Courvoisier1 Received: 4 September 2018 / Accepted: 9 November 2018 / Published online: 24 November 2018 © Springer-Verlag Italia S.r.l., part of Springer Nature 2018 Abstract Background Unicameral bone cyst (UBC) is a common lesion in skeletally immature patients. Multiple treatments are pro- posed as curettage and autologous bone graft, percutaneous local corticoids injections, decompression with internal fixation, and injection of bioresorbable cement. Decompression, curettage, and percutaneous bioresorbable cement injection showed interesting results, but until now, no long-term follow-up was reported in pediatric patients with UBC. Methods We retrospectively evaluated 13 pediatric patients with UBC treated with curettage, decompression, and injection of a calcium phosphate composite (CPC) at a single institution with an average F-U of 5.46 years (range 5–7 years). Func- tional outcomes were evaluated according to the Musculoskeletal Tumour Society (MSTS) Score. Radiographic healing was assessed with the modified Neer Outcome Rating System. Complications were recorded. Results The mean MSTS score was 29.61 (range 28–30). No joint limitation or any pain was recorded. All patients returned to their previous level of activity. Complete healed cysts were observed in 76.9% of patients (10 of 13) and partially healed in 23.1% (3 of 13). Three fractures of the humerus occurred without any further consequence. -
Imaging of Osteomyelitis: the Key Is in the Combination
Special RepoRt Special RepoRt Imaging of osteomyelitis: the key is in the combination An accurate diagnosis of osteomyelitis requires the combination of anatomical and functional imaging techniques. Conventional radiography is the first imaging modality to begin with, as it provides an overview of both the anatomy and the pathologic conditions of the bone. Sonography is most useful in the diagnosis of fluid collections, periosteal involvement and soft tissue abnormalities, and may provide guidance for diagnostic or therapeutic interventions. MRI highlights sites with tissue edema and increased regional perfusion, and provides accurate information of the extent of the infectious process and the tissues involved. To detect osteomyelitis before anatomical changes are present, functional imaging could have some advantages over anatomical imaging. Fluorine-18 fluorodeoxyglucose-PET has the highest diagnostic accuracy for confirming or excluding the diagnosis of chronic osteomyelitis. For both SPECT and PET, specificity improves considerably when the scintigraphic images are fused with computed tomography. Close cooperation between clinicians and imagers remains the key to early and adequate diagnosis when osteomyelitis is suspected or evaluated. †1 KEYWORDS: computed tomography n hybrid systems n imaging n MRI n nuclear Carlos Pineda , medicine n osteomyelitis n ultrasonography Angelica Pena2, Rolando Espinosa2 & Cristina Osteomyelitis is inflammation of the bone that osteomyelitis. The ideal imaging technique Hernández-Díaz1 is usually due to infection. There are different should have a high sensitivity and specificity; 1Musculoskeletal Ultrasound Department, Instituto Nacional de classification systems to categorize osteomyeli- numerous studies have been published con- Rehabilitacion, Avenida tis. Traditionally, it has been labeled as acute, cerning the accuracy of the various modali- Mexico‑Xochimilco No. -
Treatment of Aneurysmal Bone Cysts with Titanium Elastic Nails in Children
Treatment of Aneurysmal Bone Cysts with Titanium Elastic Nails in Children Yi-chen Wang Children's Hospital of Shanghai Xing Jia Children's Hospital of Shanghai Yang Shen Children's Hospital of Shanghai Sun Wang Children's Hospital of Shanghai Liang-chao Dong Children's Hospital of Shanghai Jing Ren Children's Hospital of Shanghai Li-hua Zhao ( [email protected] ) Research Keywords: Primary aneurysmal bone cyst, Titanium Elastic Nails, recurrence, ecacy Posted Date: July 6th, 2020 DOI: https://doi.org/10.21203/rs.3.rs-38776/v1 License: This work is licensed under a Creative Commons Attribution 4.0 International License. Read Full License Page 1/16 Abstract Background: The main treatment method of the primary aneurysmal bone cyst (ABC) is to curettage and bone grafts with high-speed burring, radiotherapy, sclerotherapy, arterial embolism and hormone therapy can be used for the lesions whose location cannot be easily exposed by the surgery. Regardless of the method, high recurrence rates are a common problem. The purpose of this study was to evaluate retrospectively the use of titanium elastic nails as a internal xation in the treatment of aneurysmal bone cysts in children. Methods: Children with histological primary aneurysmal bone cyst were evaluated between 2010 to 2017. The patients were divided into 2 groups according to the treatment plan. Patients in the study group operated with curettage and bone grafts with high-speed burring + internal xation of titanium elastic nails (TEN), and patients in the control group operated with curettage and bone grafts with high-speed burring. The curative effect of the children in the 2 groups were analyzed statistically according to the imaging results (Neer grading) and MSTS functional evaluation. -
Advances in the Pathogenesis and Possible Treatments for Multiple Hereditary Exostoses from the 2016 International MHE Conference
Connective Tissue Research ISSN: 0300-8207 (Print) 1607-8438 (Online) Journal homepage: https://www.tandfonline.com/loi/icts20 Advances in the pathogenesis and possible treatments for multiple hereditary exostoses from the 2016 international MHE conference Anne Q. Phan, Maurizio Pacifici & Jeffrey D. Esko To cite this article: Anne Q. Phan, Maurizio Pacifici & Jeffrey D. Esko (2018) Advances in the pathogenesis and possible treatments for multiple hereditary exostoses from the 2016 international MHE conference, Connective Tissue Research, 59:1, 85-98, DOI: 10.1080/03008207.2017.1394295 To link to this article: https://doi.org/10.1080/03008207.2017.1394295 Published online: 03 Nov 2017. Submit your article to this journal Article views: 323 View related articles View Crossmark data Citing articles: 1 View citing articles Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=icts20 CONNECTIVE TISSUE RESEARCH 2018, VOL. 59, NO. 1, 85–98 https://doi.org/10.1080/03008207.2017.1394295 PROCEEDINGS Advances in the pathogenesis and possible treatments for multiple hereditary exostoses from the 2016 international MHE conference Anne Q. Phana, Maurizio Pacificib, and Jeffrey D. Eskoa aDepartment of Cellular and Molecular Medicine, Glycobiology Research and Training Center, University of California, San Diego, La Jolla, CA, USA; bTranslational Research Program in Pediatric Orthopaedics, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA ABSTRACT KEYWORDS Multiple hereditary exostoses (MHE) is an autosomal dominant disorder that affects about 1 in 50,000 Multiple hereditary children worldwide. MHE, also known as hereditary multiple exostoses (HME) or multiple osteochon- exostoses; multiple dromas (MO), is characterized by cartilage-capped outgrowths called osteochondromas that develop osteochondromas; EXT1; adjacent to the growth plates of skeletal elements in young patients. -
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. -
Establishment of a Dental Effects of Hypophosphatasia Registry Thesis
Establishment of a Dental Effects of Hypophosphatasia Registry Thesis Presented in Partial Fulfillment of the Requirements for the Degree Master of Science in the Graduate School of The Ohio State University By Jennifer Laura Winslow, DMD Graduate Program in Dentistry The Ohio State University 2018 Thesis Committee Ann Griffen, DDS, MS, Advisor Sasigarn Bowden, MD Brian Foster, PhD Copyrighted by Jennifer Laura Winslow, D.M.D. 2018 Abstract Purpose: Hypophosphatasia (HPP) is a metabolic disease that affects development of mineralized tissues including the dentition. Early loss of primary teeth is a nearly universal finding, and although problems in the permanent dentition have been reported, findings have not been described in detail. In addition, enzyme replacement therapy is now available, but very little is known about its effects on the dentition. HPP is rare and few dental providers see many cases, so a registry is needed to collect an adequate sample to represent the range of manifestations and the dental effects of enzyme replacement therapy. Devising a way to recruit patients nationally while still meeting the IRB requirements for human subjects research presented multiple challenges. Methods: A way to recruit patients nationally while still meeting the local IRB requirements for human subjects research was devised in collaboration with our Office of Human Research. The solution included pathways for obtaining consent and transferring protected information, and required that the clinician providing the clinical data refer the patient to the study and interact with study personnel only after the patient has given permission. Data forms and a custom database application were developed. Results: The registry is established and has been successfully piloted with 2 participants, and we are now initiating wider recruitment. -
Post-Traumatic Osteolysis of the Clavicle: a Case Report C
Arch Emerg Med: first published as 10.1136/emj.3.2.129 on 1 June 1986. Downloaded from Archives of Emergency Medicine, 1986, 3, 129-132 Post-traumatic osteolysis of the clavicle: a case report C. J. GRIFFITHS AND E. GLUCKSMAN Department ofAccident and Emergency Medicine, King's College Hospital, Denmark Hill, London, England SUMMARY A case of post-traumatic osteolysis of the clavicle occurring in a 25-year-old male is described. The condition should be suspected in anyone giving a history of persistent shoulder pain following trauma or intensive sporting activities. Characteristic resorp- tion of the distal tip of the clavicle is found on X-ray. The condition usually responds by copyright. within 2 years to conservative treatment. Previous reports ofthe condition are reviewed, and the possible pathogenesis and differential diagnosis discussed. INTRODUCTION Post-traumatic osteolysis of the clavicle is an uncommon condition characterized by http://emj.bmj.com/ persistent shoulder pain associated with decalcification of the distal tip of the clavicle following trauma to the acromio-clavicular joint (Madsen, 1963; Smart, 1972; Quinn & Glass, 1983). Patients usually give a history of previous trauma to the shoulder, but the condition may follow active sports such as weight training (Cahill, 1982) or the use of pneumatic tools (Ehricht, 1959). The condition usually resolves within 2 years in the absence of further trauma. This article describes a case of post-traumatic osteolysis of on September 28, 2021 by guest. Protected the clavicle, and discusses the diagnosis and possible pathogenesis of the condition. CASE REPORT A 25-year-old medical student (C.G.) was involved in a bicycle accident and received a direct blow to his right shoulder. -
In a Child with Myositis Ossificans Progressiva
Pediatr Radiol (1993) 23:45%462 Pediatric Radiology Springer-Verlag 1993 Chronic intoxication by ethane-l-hydroxy-l,l-diphosphonate (EHDP) in a child with myositis ossificans progressiva U. E. Pazzaglia 1, G. Beluffi 2, A. Ravelli 3, G. Zatti 1, A. Martini 3 1 Clinica Ortopedica, Ospedale F. Del Ponte, Varese, Italy 2 Servizio di Radiodiagnostica, Sezione Radiologia Pediatrica, Pavia, Italy 3 Clinica Pediatrica dell'Universit~ di Pavia, IRCCS Policlinico S. Matteo, Pavia, Italy Received: 4 February 1993/Accepted: 25 March 1993 Abstract. A child with myositis ossificans progressiva was opsy performed elsewhere did not show any relevant pathological treated for 8 years with ethane-l-hydroxy-l,l-diphospho- change. Treatment with steroid was started and continued for sev- eral months. nate (EHDP) 30-40 mg/kg per day. Latterly he com- One and half years later a large soft tissue swelling appeared in plained of severe, progressive bone and joint pain which the shoulder girdle and followed a course similar to the lesion in the made standing and walking almost impossible. A radio- sternodeidomastoid muscle. The child was admitted to another hos- graphic skeletal survey showed diffuse ricket-like lesions. pital 1 month later. Laboratory tests showed that inflammatory pa- Withdrawal of EHDP therapy produced substantial im- rameters, serum calcium and phosphate, alkaline phosphatase and provement in his general condition as well as in the radio- muscle enzymes were normal. Electromyography was also normal. graphic appearance of the bones. Multiple exostoses were A muscle biopsy was consistent with myositis ossificans progressiva. Therapy was started with ethane-l-hydroxyd,l-diphosphonate observed in this case and, particularly those around the (EHDP) 30 mg/kg per day. -
Management of the 'Young' Patient with Hip Disease
ARTHROPLASTY OF THE LOWER EXTREMITIES Management of the ‘Young’ Patient with Hip Disease SCOTT A. RITTERMAN, MD; LEE E. RUBIN, MD ABSTRACT abnormalities lead to impingement within the joint, altered Although hip arthritis typically affects older patients, biomechanics and ultimately cartilage loss.2 Secondary there is a rapidly growing population of “young” patients osteoarthritis can be due to an identifiable cause such as experiencing debilitating symptoms from hip disease. trauma to the femoral head, post-infection arthritis, slipped Most commonly, osteoarthritis and avascular necrosis af- capital femoral epiphysis, or hip dysplasia. fect this population, but a variety of other primary struc- As we age, the water content of cartilage increases with tural and metabolic causes can also occur. The expecta- a concomitant decrease in protein content, both leading to tions of these younger patients are often distinct from degeneration. The progressive loss of the cartilage matrix geriatric patients, and the challenges in optimizing their leads to recurrent bouts of inflammation as bone contacts care are unique in this demanding population. Selection bone, and reactive bone called osteophyte forms around the of the implant, bearing surface, and surgical technique joint. In the subchondral bone, hardening and cyst formation can all impact the success and longevity of total hip re- occurs. Repeated bouts of inflammation also extend into the placement. A consideration for respecting the native peri-articular soft tissues leading to deformity and contrac- bone stock is an important consideration that can poten- tures of the capsule, supporting ligaments, and tendons. Put tially reduce some of the future challenges of revision ar- together, these changes lead to pain, stiffness, and gait dis- throplasty in this young population. -
Outcomes of Prophylactic Intramedullary Fixation for Benign Bone Lesions
Orginal Article 364 Outcomes of prophylactic intramedullary fixation for benign bone lesions İyi huylu kemik lezyonlarında profilaktik intramedüller fiksasyon sonuçları Çağrı Neyişci, Yusuf Erdem, Ahmet Burak Bilekli Gülhane Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey Dergiye Ulaşma Tarihi: 26.09.2019 Dergiye Kabul Tarihi: 29.09.2019 Doi: 10.5505/aot.2019.64325 ÖZET Amaç: Bu çalışmada benign kemik lezyonu sebebiyle profilaktik intramedüller tespit ameliyatı yaptığımız hastaların sonuçlarını sunmayı amaçladık. Gereç ve Yöntem: Bu çalışmaya 2008-2017 yılları arasında benign kemik lezyonu nedeni ile küretaj, greftleme ve profilaktik intramedüller tespit ameliyatı yaptığımız 22 hasta dâhil edilmiştir. Lezyonlar preoperatif dönemde Mirels sınıflamasına göre incelenerek patolojik kırık riski belirlenmiştir. Tüm hastaların tedavisinde küretaj, greftleme ve intramedüller tespit yöntemi kullanılmıştır. Kontrol muayenelerinde hastalar; eklem hareket açıklıklarına, ağrı durumuna, lezyonun ve implantın radyolojik görüntüsüne göre değerlendirilmiştir. Bulgular: Hastaların yaş ortalaması 24,8 (aralık, 7-38) yıldı. Hastalar ortalama 35,8 (aralık, 13-80) ay takip edildi. Çalışmaya dâhil edilen 21 hastanın ilk başvuru nedeni ağrı olup 2 hastada ağrı fonksiyon kaybına neden olmaktaydı. Patolojik humerus kırığı olan bir hasta akut ağrı ve fonksiyon kaybı ile başvurdu, iki ay konservatif olarak takip edildi ve ardından profilaktik cerrahi yapıldı. Hastaların ortalama Mirels skoru 9,3 (aralık, 9-10)’tü. Takiplerde tüm hastaların ekstremite fonksiyonları tamdı. Ameliyat sonrası ortalama VAS 8,09'dan 2,54'e gerilemiştir. Sonuç:9 veya daha fazla Mirels skoruna sahip olan iyi huylu kemik lezyonları için profilaktik fiksasyonun, olası patolojik kırık riskini azalttığı, VAS skorlarını azalttığı, ayrıca fonksiyon kaybını önlediği ve daha erken normal aktivitesine geri dönüşe olanak sağladığı sonucuna vardık. -
Osteoblastic Heparan Sulfate Regulates Osteoprotegerin Function and Bone Mass
Osteoblastic heparan sulfate regulates osteoprotegerin function and bone mass Satoshi Nozawa, … , Haruhiko Akiyama, Yu Yamaguchi JCI Insight. 2018;3(3):e89624. https://doi.org/10.1172/jci.insight.89624. Research Article Bone biology Bone remodeling is a highly coordinated process involving bone formation and resorption, and imbalance of this process results in osteoporosis. It has long been recognized that long-term heparin therapy often causes osteoporosis, suggesting that heparan sulfate (HS), the physiological counterpart of heparin, is somehow involved in bone mass regulation. The role of endogenous HS in adult bone, however, remains unclear. To determine the role of HS in bone homeostasis, we conditionally ablated Ext1, which encodes an essential glycosyltransferase for HS biosynthesis, in osteoblasts. Resultant conditional mutant mice developed severe osteopenia. Surprisingly, this phenotype is not due to impairment in bone formation but to enhancement of bone resorption. We show that osteoprotegerin (OPG), which is known as a soluble decoy receptor for RANKL, needs to be associated with the osteoblast surface in order to efficiently inhibit RANKL/RANK signaling and that HS serves as a cell surface binding partner for OPG in this context. We also show that bone mineral density is reduced in patients with multiple hereditary exostoses, a genetic bone disorder caused by heterozygous mutations of Ext1, suggesting that the mechanism revealed in this study may be relevant to low bone mass conditions in humans. Find the latest version: https://jci.me/89624/pdf RESEARCH ARTICLE Osteoblastic heparan sulfate regulates osteoprotegerin function and bone mass Satoshi Nozawa,1,2 Toshihiro Inubushi,1 Fumitoshi Irie,1 Iori Takigami,2 Kazu Matsumoto,2 Katsuji Shimizu,2 Haruhiko Akiyama,2 and Yu Yamaguchi1 1Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, USA. -
Pathological Fracture of the Tibia As a First Sign Of
ANTICANCER RESEARCH 41 : 3083-3089 (2021) doi:10.21873/anticanres.15092 Pathological Fracture of the Tibia as a First Sign of Hyperparathyroidism – A Case Report and Systematic Review of the Current Literature ALEXANDER KEILER 1, DIETMAR DAMMERER 1, MICHAEL LIEBENSTEINER 1, KATJA SCHMITZ 2, PETER KAISER 1 and ALEXANDER WURM 1 1Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria; 2Institute for Pathology, INNPATH GmbH, Innsbruck, Austria Abstract. Background/Aim: Pathological fractures are rare, of the distal clavicles, a “salt and pepper” appearance of the suspicious and in some cases mentioned as the first sign of a skull, bone cysts, and brown tumors of the bones (3). malignant tumor. We present an uncommon case with a Primary hyperparathyroidism (PHPT), also known as “brown pathological fracture of the tibia diaphysis as the first sign of tumor”, also involves unifocal or multifocal bone lesions, which severe hyperparathyroidism. Case Report: We report the case represent a terminal stage of hyperparathyroidism-dependent of a female patient who was referred to the emergency bone pathology (4). This focal lesion is not a real neoplasm. In department with a history of progressively worsening pain in localized regions where bone loss is particularly rapid, the lower left leg and an inability to fully bear weight. No hemorrhage, reparative granulation tissue, and active, vascular, history of trauma or any other injury was reported. An x-ray proliferating fibrous tissue may replace the healthy marrow revealed an extensive osteolytic lesion in the tibial shaft with contents, resulting in a brown tumor. cortical bone destruction. Conclusion: Our case, together with Histologically, the tumor shows bland spindle cell very few cases described in the current literature, emphasizes proliferation with multinucleated osteoclastic giant cells and that in the presence of hypercalcemia and lytic lesions primary signs of bone resorption.