DOCSLIB.ORG

A Comparative Study of Vertebral Pathologies and Anomalies in Two Medieval British Populations

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
A Comparative Study of Vertebral Pathologies and Anomalies in Two Medieval British Populations A COMPARATIVE STUDY OF VERTEBRAL PATHOLOGIES AND ANOMALIES IN TWO MEDIEVAL BRITISH POPULATIONS A thesis submitted in partial fulfilment of the requirements of Liverpool John Moores University for the degree of Master of Philosophy Clair Richardson February 2018 I would like to dedicate this work to my grandfather Roy 1938 – 2015 “Do you not know that a man is not dead while his name is still spoken?” – Terry Pratchett, Going Postal 1 Disclaimer: All of the photographic images used within this study were taken by and are owned by the author of this thesis. 2 Abstract A holistic approach to palaeopathological studies using historical documentation and clinical, archaeological and epidemiological literature can provide important information as to the health, lifestyles, socioeconomic and occupational status of individuals from the past. Applying this approach, the study provides an overview and comparative analysis of the spinal health of two contemporaneous British skeletal samples from the medieval period; St Owen’s Cemetery, an urban based population from Gloucester (n=68) and Poulton a rural, agrarian community from Cheshire (n=70). Sex and age at death were estimated using a variety of osteological techniques and descriptive statistics and Chi-square statistical tests were computed to identify and assess inter- and intra-population differences. Although some significant differences were observed, both skeletal samples had similar types and anatomical locations of the pathological conditions observed. St Owen’s Cemetery exhibits higher frequencies of degenerative conditions and vertebral fractures, whereas Poulton displays higher frequencies of congenital conditions such as lumbosacral anomalies and cervical vertebral synostosis (possible Klippel-Feil Syndrome). Age of onset of degenerative conditions is markedly earlier in Poulton indicating occupational status from a younger age than their contemporaries in St Owen’s. Females are more affected by degenerative conditions and vertebral fractures than the males in both samples. The frequency of the aforementioned conditions increases dramatically with age suggesting the fractures could be related to osteoporosis. Significant differences were observed between population samples in the frequency of osteoarthritis in the thoracic segment of middle adult males and females in which St Owen’s exhibit double the amount. This indicates that biomechanical stresses were more likely to have been placed on the thoracic segment such as carrying heavier loads and repetitive bending and twisting in a singular occupational role in an urban setting such as a craft (cordwainer) or working for a merchant guild. Frequency of infectious lesions is comparable in both samples, indicating similar exposure to pathogens albeit there may be differences in the type of infections present. Males are more affected than the females in the rural sample suggesting that pathogens in the soil and livestock may be the cause of the lesions observed. The findings of this study are generally consistent with other published data, although frequency of vertebral 3 trauma in the urban sample far exceeds other contemporary sites. The study presented here provides a glimpse into medieval life in both the large town and the rural farming community in the British Isles. Further studies include comparing data from more contemporary urban and rural populations to produce a more holistic study on medieval health and lifestyle in the British Isles including further analysis of larger skeletal samples from Poulton and St Owen’s. Additional observation of complete skeletons including body mass and stature and radiographic analyses will give further supportive evidence for some diagnoses. 4 Table of Contents List of Figures ................................................................................................... 8 Abbreviations .................................................................................................. 12 Acknowledgments .......................................................................................... 13 Chapter 1: Introduction................................................................................... 14 Chapter 2: Literature Review .......................................................................... 19 2.1 Anatomy of the Spine ........................................................................... 19 2.2 Significance of the Spine in Palaeopathology.................................... 21 2.3 Sex and Gender in Palaeopathology ................................................... 21 2.4 The Osteological Paradox .................................................................... 22 2.5 Joint Conditions .................................................................................... 22 2.5.1 Osteoarthritis (OA) / Degenerative Joint Disease (DJD) ......................... 22 2.5.2 Intervertebral (IDD) / Degenerative Disc Disease (DDD) ......................... 25 2.5.3 Schmӧrl’s Nodes (SN) ............................................................................... 26 2.5.4 Diffuse Idiopathic Skeletal Hyperostosis (DISH) ..................................... 27 2.5.5 Vertebral Osteophytosis (VO) ................................................................... 28 2.6 Infectious Diseases .............................................................................. 29 2.6.1 Tuberculosis (TB) ...................................................................................... 30 2.6.2 Brucellosis ................................................................................................. 30 2.6.3 Spinal Osteomyelitis (SO) ......................................................................... 31 2.7 Metabolic Diseases ............................................................................... 31 2.7.1 Osteoporosis ............................................................................................. 32 2.7.2 Paget’s Disease of Bone (PDB) ................................................................ 33 2.8 Congenital Conditions and Vertebral Anomalies ............................... 33 2.8.1 Transitional Vertebrae, Sacralisation and Lumbarisation ...................... 33 2.8.2 Spina bifida ................................................................................................ 34 2.8.3 Scoliosis .................................................................................................... 34 2.8.4 Kyphosis .................................................................................................... 35 2.8.5 Klippel-Feil Syndrome (KFS)/ Cervical Vertebral Synostosis ................ 35 2.9 Trauma ................................................................................................... 36 2.9.1 Spondylolysis and Spondylolisthesis ...................................................... 36 2.9.2 Stress, Crush and Burst Fractures .......................................................... 37 2.10 Summary ............................................................................................. 37 Chapter 3: Site Information and Hypotheses ................................................ 39 5 3.1 Poulton, Cheshire ................................................................................. 39 3.2 St Owen’s Cemetery, Gloucester ......................................................... 42 3.3 Medieval Burial Practices ..................................................................... 48 Chapter 4: Materials and Methods ................................................................. 50 4.1 Skeletal Samples ................................................................................... 50 4.2 Biological Profiling ............................................................................... 51 4.2.1 Sex Estimation ........................................................................................... 51 4.2.2 Age Estimation .......................................................................................... 53 4.3 Observation of Pathological Lesions .................................................. 55 4.3.1 Joint Conditions ........................................................................................ 55 4.3.2 Infectious Diseases ................................................................................... 61 4.3.3 Congenital Conditions and Vertebral Anomalies .................................... 62 4.3.4 Trauma ....................................................................................................... 68 4.3.5 Data Analysis ............................................................................................. 70 Chapter 5: Results .......................................................................................... 71 5.1 Skeletal Samples ................................................................................... 71 5.2 Joint Conditions .................................................................................... 72 5.2.1 Osteoarthritis (OA) .................................................................................... 72 5.2.2 Intervertebral Disc Disease (IDD) ............................................................. 81 5.2.3 Schmörl’s Nodes (SN) ............................................................................... 84 5.2.4 Diffuse Idiopathic Skeletal Hyperostosis (DISH) ..................................... 90 5.2.5 Vertebral Osteophytes .............................................................................
Load more

Recommended publications
  • M ONITOR a Semi-Annual Data and Research Update Texas Department of Health, Bureau of Epidemiology
    Texas Birth Defects M ONITOR A Semi-Annual Data and Research Update Texas Department of Health, Bureau of Epidemiology VOLUME 10, NUMBER 1, June 2004 FROM THE DIRECTOR The web site also has a useful glossary linked to risk factor summaries for a number of birth defects. INTERACTIVE WEB PAGE ALLOWS EASY RESEARCH SYMPOSIUM ACCESS TO TEXAS BIRTH DEFECTS DATA Birth defects data were recently highlighted at the Texas In partnership with Texas Department of Health's Center for Birth Defects Research Symposium on April 9 in San Anto- Health Statistics, birth defects data are now available on the nio. The following speakers provided insight into the causes Texas Health Data web site. Visitors to the site (http://soup- of birth defects: fin.tdh.state.tx.us/) will be able to query data from the Texas Birth Defects Registry. Linking Birth Defects and the Environment, with Prelimi- nary Findings from an Air Pollution Study in Texas (Peter The Registry uses active surveillance to collect information Langlois, Ph.D., TBDMD and Suzanne Gilboa, M.H.S., U.S. about infants and fetuses with birth defects, born to women Environmental Protection Agency) residing in Texas. Data are presented for 49 defect catego- ries, plus a category for “infants and fetuses with any moni- Neural Tube Defects: Multiple Risk Factors Among the tored birth defect” beginning with deliveries in 1999, when Texas-Mexico Border Population (Lucina Suarez, Ph.D., the Texas Birth Defects Registry became statewide. Texas Department of Health) The Embryonic Consequences of Abnormal
    [Show full text]
  • CASE REPORT Congenital Posterior Atlas Defect Associated with Anterior
    Acta Orthop. Belg., 2007, 73, 282-285 CASE REPORT Congenital posterior atlas defect associated with anterior rachischisis and early cervical degenerative disc disease : A case study and review of the literature Dritan PASKU, Pavlos KATONIS, Apostolos KARANTANAS, Alexander HADJIPAVLOU From the University of Crete Heraklion, Greece A rare case of a wide congenital atlas defect is report- diagnosed posterior atlas defect coexisting with an ed. A 25 year-old woman was admitted after com- anterior rachischisis, presenting with radicular arm plaints of radicular pain in the right arm. pain resistant to conservative therapy. In addition, a Radiographs incidentally revealed aplasia of the pos- review of the literature is presented with emphasis terior arch of the atlas together with anterior rachis- on the possibility of the association between the chisis. A review of the literature is presented and a atlas defect and early disc degeneration. possible association with early disc degeneration is discussed. CASE REPORT Keywords : spine ; congenital disorders ; computed tomography ; MR imaging ; disc degeneration. A 25 year-old woman presented with neck pain radiating to the right arm over the last 5 days. She also reported intermittent neck and arm pain for the INTRODUCTION past 4 years. The patient had consulted in our hos- pital for an episode of cervical pain one year previ- Malformations of the atlas are relatively rare and ously without arm pain but was discharged from exhibit a wide range including aplasia, hypoplasia the emergency department without any radiological and various arch clefts (2, 15). The reported inci- examination. Her symptoms deteriorated with neck dence in a large study of 1,613 autopsies with flexion, with pain referred to the upper thoracic regard to presence of congenital aplasia is 4% for the posterior arch and 0.1% for the anterior arch (5- 8).
    [Show full text]
  • Musculoskeletal Radiology.Pdf
    MS 1 Acute osteomyelitis Acute osteomyelitis Plain radiographs reviewed Spine Other bones MRI Acute osteomyelitis Acute osteomyelitis diagnosed not diagnosed CT, MRI or Nuclear medicine Diagnosis Normal established scan Osteomyelitis Treatment excluded 144 MS 1 Acute osteomyelitis REMARKS 1 Plain radiograph 1.1 Regional radiographs should be the initial examination to determine whether there is any underlying pathological condition. 1.2 Typical findings of bone destruction and periosteal reaction may not appear until 10- 21 days after the onset of infection because 30-50% of bone density loss must occur before radiographs become abnormal. 1.3 Plain radiographs are unreliable to establish the diagnosis of osteomyelitis in patients with violated bone. 1.4 Plain radiographs of spine are not sensitive to detect vertebral osteomyelitis but findings of endplate destruction and progressive narrowing of adjacent disc space are highly suggestive of infection. 2 Nuclear medicine 2.1 Scans should be interpreted with contemporary radiographs. 2.2 Three-phase Technetium-99m methylene diphosphonate (Tc-99m-MDP) bone scan 2.2.1 Bone scan is more sensitive than plain radiography (up to 90% sensitivity). 2.2.2 Bone scan can be positive as early as 3 days after onset of disease (10-14 days earlier than plain radiograph). 2.3 Gallium scan 2.3.1 Gallium scan is helpful as conjunction with a bone scan. Combined gallium and bone scan studies has sensitivity of 81-90% and specificity of 69-100% 2.4 White blood cells (WBC) scan 2.4.1 This is sensitive and specific for bone infection and particularly useful in violated bone.
    [Show full text]
  • Anencephalic Fetus with Craniospinal Rachischisis – Case Report
    Case Study International Journal of Research - GRANTHAALAYAH ISSN (Online): 2350-0530 May 2021 9(5), 24–29 ISSN (Print): 2394-3629 ANENCEPHALIC FETUS WITH CRANIOSPINAL RACHISCHISIS – CASE REPORT 1 Ayse KONAC 1Gelisim University Health Sciences, Istanbul, Turkey ABSTRACT Anencephaly, in which a substantial part of the brain, skull, or scalp is miss- ing, is a lethal neural tube defect (NTD) that occurs during the fourth week of pregnancy after failed cranial neuropore closure. One in every 1,000 births is anencephalic, and newborns with this NTD are not viable or treatable. Associ- ated with anencephaly is rachischisis, or severe incomplete neural tube closure and exposure of the spinal cord. Ultrasonography can quickly diagnose anen- cephaly. Like other NTDs, nutritional and environmental factors both play a role in the development of anencephaly. Here, we report and discuss an unusual case of a 12-week gestation anencephalic fetus with craniospinal rachischisis and its embryological roots. In our case, except from the low socio-economic life of the patient, the Received 18 April 2021 absence of a predisposing factor that could cause such an anomaly, the abor- Accepted 4 May 2021 tion being in the irst trimester and the occurrence in the irst pregnancy of the Published 31 May 2021 patient as a result of 5-year infertility made us think that pathology examination Corresponding Author of the abortus material is important in complet or incomplete abortions. Ayse KONAC, ayse.konac1@gmail. com DOI 10.29121/ Keywords: Anencephaly, Neural Tube Defect, Rachischisis, İncomplet Abortion, granthaalayah.v9.i5.2021.3899 First Trimester Funding: This research received no speciic grant from any funding agency in the public, commercial, or not-for-proit sectors.
    [Show full text]
  • An Unusual Cause of Back Pain in Osteoporosis: Lessons from a Spinal Lesion
    Ann Rheum Dis 1999;58:327–331 327 MASTERCLASS Series editor: John Axford Ann Rheum Dis: first published as 10.1136/ard.58.6.327 on 1 June 1999. Downloaded from An unusual cause of back pain in osteoporosis: lessons from a spinal lesion S Venkatachalam, Elaine Dennison, Madeleine Sampson, Peter Hockey, MIDCawley, Cyrus Cooper Case report A 77 year old woman was admitted with a three month history of worsening back pain, malaise, and anorexia. On direct questioning, she reported that she had suVered from back pain for four years. The thoracolumbar radiograph four years earlier showed T6/7 vertebral collapse, mild scoliosis, and degenerative change of the lumbar spine (fig 1); but other investigations at that time including the eryth- rocyte sedimentation rate (ESR) and protein electophoresis were normal. Bone mineral density then was 0.914 g/cm2 (T score = −2.4) at the lumbar spine, 0.776 g/cm2 (T score = −1.8) at the right femoral neck and 0.738 g/cm2 (T score = −1.7) at the left femoral neck. She was given cyclical etidronate after this vertebral collapse as she had suVered a previous fragility fracture of the left wrist. On admission, she was afebrile, but general examination was remarkable for pallor, dental http://ard.bmj.com/ caries, and cellulitis of the left leg. A pansysto- lic murmur was heard at the cardiac apex on auscultation; there were no other signs of bac- terial endocarditis. She had kyphoscoliosis and there was diVuse tenderness of the thoraco- lumbar spine. Her neurological examination was unremarkable. on September 29, 2021 by guest.
    [Show full text]
  • Disorders of the Thoracic Spine: Pathology and Treatment
    Disorders of the thoracic spine: pathology and treatment CHAPTER CONTENTS • Extraspinal tumours involve the bony parts of the Disorders and their treatment e169 vertebrae. Benign tumours are usually located in the posterior parts (spinous and transverse processes), Tumours of the thoracic spine . e169 malignant tumours in the vertebral body. Extradural haematoma . e171 Spinal cord herniation . e173 Thoracic spinal canal stenosis . e173 Chest deformities . e173 Intraspinal tumours Fracture of a transverse process . e179 Spinal infections . e179 Thoracic neurofibroma Lateral recess stenosis . e180 Pathology Arthritis of the costovertebral and This benign tumour usually originates from the dorsal root and costotransverse joints . e180 arises from proliferating nerve fibres, fibroblasts and Schwann Arthritis of the thoracic facet joints . e181 cells. Sensory or motor fibres may be involved.1 Some confu- Paget’s disease . e181 sion exists about the terminology: various names, such as neu- rofibroma, neurinoma, neurilemmoma or schwannoma have been used. Some believe that all these terms cover the same type of tumour; others distinguish some slight histological dif- Disorders and their treatment ferences between them. Multiple tumours in nerve fibres and the subcutaneous tissues, often accompanied by patchy café Tumours of the thoracic spine au lait pigmentation, constitute the syndrome known as von Recklinghausen’s disease. Neuromas are the most common primary tumours of the Spinal neoplasms, both primary and secondary, are unusual spine accounting for approximately one-third of the cases. causes of thoracolumbar pain. However, because these lesions They are most often seen at the lower thoracic region and the are associated with high mortality, examiners must always be thoracolumbar junction.2 More than half of all these lesions are aware of the possibility of neoplastic diseases and must include intradural extramedullary (Fig 1), 25% are purely extradural, them in their differential diagnosis.
    [Show full text]
  • 2012 Meeting Program
    Western Orthopaedic Association 76th Annual Meeting June 13–16, 2012 The Hilton Portland Portland, Oregon 2012 Meeting Program Chuck Freitag Executive Director, Data Trace Management Services, a Data Trace Company Cynthia Lichtefeld Director of Operations, Data Trace Management Services, a Data Trace Company WOA Central Office, Data Trace Management Services 110 West Road, Suite 227 Towson, MD 21204 Phone: 866-962-1388 Fax: 410-494-0515 Email: [email protected] Visit us on the World Wide Web @ www.woa-assn.org Please notify the WOA Central Office of any changes in your home or office address. This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Ortho- paedic Surgeons and the Western Orthopaedic Association. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians. The American Academy of Orthopaedic Surgeons designates this live activity for a maximum of 28.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Cover Design by Lauren Murphy. Copyright © 2012 by Data Trace Publishing Company, Towson, MD. All rights reserved. Western Orthopaedic Association 76th Annual Meeting Portland, Oregon 2012 President’s Message Dear Colleagues, elcome to Portland for the 76th Annual Meeting of the Western Orthopaedic Association. Jeanne and I are honored to welcome you to The City of Roses. We hope Wyou enjoy the diverse and educational academic program in combination with unique social activities planned for you and your family.
    [Show full text]
  • CT Guided Core Needle Bone Biopsy for Non-Vertebral Osteomyelitis: Is It Necessary?
    CT Guided Core Needle Bone Biopsy for Non-Vertebral Osteomyelitis: is it Necessary? Cameron Smith DO, Gregory Bradley DO, Donald von Borstel DO Oklahoma State University Medical Center, Department of Radiology Disclosure statement . None of the authors have conflicts of interest or relevant financial relationships to disclose. Target audience . Seasoned and training musculoskeletal radiologists. Physicians involved in the care of osteomyelitis patients. Introduction . Osteomyelitis is inflammation of the bone marrow which results from infection. It can progress to osteonecrosis, bone destruction, and septic arthritis. Osteomyelitis is an important cause of permanent disability worldwide. Bimodal age distribution with incidence peaking in children under 5-years-old and adults over 50-years-old. Introduction . Etiology: . Hematogenous spread . Predominant etiology of infection in children. Less common in adults, however usually leads to vertebral osteomyelitis when it occurs. Contiguous spread . Infection originating from soft tissues and joints. Usually coincides with vascular insufficiency, such as patients with diabetes mellitus or peripheral vascular disease. Most commonly the lower extremities. Direct inoculation . Direct seeding of organism into the bone usually from open fractures, surgery, or puncture wounds. Introduction . Imaging diagnosis . Radiography . Low sensitivity and specificity for detecting acute osteomyelitis. Approximately 80% of patients within 1-2 weeks of infection have normal radiograph. Bone marrow edema is the earliest pathological feature and NOT well visualized on radiography. Useful as first-line imaging to exclude other differentials (i.e. fracture) and to assess progression from priors. Nuclear Medicine . Sensitivity of a 3-phase bisphosphonate-linked technetium bone scan is greater than that of radiography for early osteomyelitis. Diagnostic sensitivity of approximately 50-85%.
    [Show full text]
  • Closed Spinal Dysraphism and Tethered Cord
    ACNRSO14_Layout 1 04/09/2014 22:14 Page 28 NEUROSURGERY ARTICLE Ruth-Mary deSouza trained in medicine at Closed Spinal Dysraphism Guy’s, Kings and St Thomas Medical School and graduated in 2008. She entered the London and Tethered Cord Neurosurgery training programme in 2010 and is currently an ST5 trainee on the South Thames Syndrome: A Review of Neurosurgery programme. David Frim Multidisciplinary Team Management is Professor of Surgery, Neurology and Paediatrics at the University of Chicago. He is an Summary internationally recognised • Embryology of spinal dysraphism clinical Neurosurgeon and Neurosciences Researcher • Clinical features of tethered cord syndrome who specialises in the care • Multidisciplinary management of closed spinal dysraphism of children and adults with congenital neurosurgical problems. Currently, Dr Frim serves as principal investigator on laboratory studies related to neural injury and clinical studies focusing on Abstract outcomes after treatment of congenital anomalies of the nervous system especially as related to cognition. The initial diagnosis as well as the long term management of occult spinal dysraphism and Dr Frim is joint senior author of the article. tethered spinal cord is often managed by a large number of healthcare professionals including Paediatricians, GPs, Neurologists, Neurosurgeons, Rehabilitation Physicians and Paige Terrien Church Therapists. We review the entity of spinal dysraphism. An approach to the evaluation and is an Assistant Professor of diagnosis of these entities is subsequently discussed. In addition, concepts involved in the Paediatrics at the pathophysiology, neurosurgical repair, and outcome are presented in the context of postop - University of Toronto. She is the Director of the erative management issues that rely upon the knowledge of all professionals who may Neonatal Follow Up Clinic encounter these patients.
    [Show full text]
  • Clinical Features, Diagnostic and Therapeutic Approaches to Haematogenous Vertebral Osteomyelitis AL
    European Review for Medical and Pharmacological Sciences 2005; 9: 53-66 Clinical features, diagnostic and therapeutic approaches to haematogenous vertebral osteomyelitis AL. GASBARRINI, E. BERTOLDI, M. MAZZETTI*, L. FINI***, S. TERZI, F. GONELLA, L. MIRABILE, G. BARBANTI BRÒDANO, A. FURNO**, A. GASBARRINI***, S. BORIANI* Department of Orthopaedics and Traumatology, Maggiore Hospital “C.A. Pizzardi” - Bologna (Italy) *Department of infections disease, Maggiore Hospital “C.A. Pizzardi” - Bologna (Italy) **Nuclear Medicine, Maggiore Hospital “C.A. Pizzardi” - Bologna (Italy) ***Internal Medicine, Catholic University - Rome (Italy) Abstract. – This article review the clinical Chronic ostemyelitis may require surgery in features and the diagnostic approach to case of a development of biomechanical insta- haematogenous vertebral osteomyelitis in order bility and/or a vertebral collapse with progres- to optimise treatment strategies and follow-up sive deformity. assessment. Haematogenous spread is consid- ered to be the most important route: the lumbar spine is the most common site of involvement Key words: for pyogenic infection and the thoracic spine for Vertebral osteomyelitis, Spondylodiscitis, Pyogenic os- tuberculosis infection. The risk factors for devel- teomyelitis, Skeletal tuberculosis. oping haematogenous vertebral osteomyelitis are different among old people, adults and chil- dren: the literature reports that the incidence seems to be increasing in older patients. The Introduction source of infection in the elderly has been relat- ed to the use of intravenous access devices and Haematogenous vertebral osteomyelitis the asymptomatic urinary infections. In young (HVO) is a relatively rare disorder which ac- patients the increase has been correlated with counts for 2-4% of all cases of infectious bone the growing number of intravenous drug 1 abusers, with endocarditis and with immigrants disease .
    [Show full text]
  • Annual Meeting Abstracts of the Society of Skeletal Radiology (SSR) 2019, Scottsdale, Arizona, USA
    Skeletal Radiology (2019) 48:479–498 https://doi.org/10.1007/s00256-018-3131-1 ABSTRACTS Annual Meeting Abstracts of the Society of Skeletal Radiology (SSR) 2019, Scottsdale, Arizona, USA The Society of Skeletal Radiology will hold its Annual Meeting on March agreement, were performed. Clinicopathologic entities, such as 10th-13th, 2019, at the JW Marriott Scottsdale Camelback Inn Resort & osteochondritis dissecans, so-called transient osteoporosis of the Spa, Scottsdale, Arizona. The following scientific abstracts will be hip and spontaneous osteonecrosis of the knee, avascular necrosis, presented. and rapidly destructive osteoarthritis, were reviewed and recom- mendations on nomenclature were provided. Conclusion: There is controversy on the nomenclature and path- Podium 1 ophysiology of subchondral non-neoplastic bone lesions. This consensus statement is intended to summarize current understand- NOMENCLATURE FOR SUBCHONDRAL NON-NEOPLASTIC ing of the pathophysiology and imaging findings of these lesions, BONE LESIONS standardize and update the nomenclature and thereby improve patient management. Gorbachova T1,AmberI2,BeckmanN3,BennetL4, Chang E5, Davis L6, Gonzalez F7, Hansford B8, Howe BM9, Lenchik L10, Winalski C11, Bredella M12 Podium 2 1Albert Einstein College of Medicine Montefiore Medical Center, Philadelphia, PA, USA; 2Medstar Georgetown University Hospital, LOSS OF MUSCLE QUALITY IS CORRELATED WITH Washington, DC, USA; 3UT Houston- McGovern School of Medicine, DECREASED BONE MINERAL DENSITY IN PATIENTS Houston, TX, USA; 4University
    [Show full text]
  • “Sports Medicine Red Flags”
    “Sports Medicine Red Flags” Kyle J. Cassas, MD Primary Care Sports Medicine Steadman Hawkins Clinic of the Carolinas Disclosures • NONE Educational Objectives • Recognize and Recite important historical questions. • Formulate and Categorize a differential diagnosis. • Illustrate and Discuss Musculoskeletal Red Flags/Cases – Hip – Knee – Spine Important Points • Listen • History • “Follow Your Instinct” • Address Concerns • Persistent • “Hard Thing-Right Thing” History Road Map CHLORIDE • Character • Prior Episodes • Location • Aggrevating • Onset • Alleviating • Radiation • Associated Symptoms • Intensity/Severity • Duration • Events Important “Red Flag” History • Fever • Night Pain • Weight Loss • Pain at Rest • Malaise • Inability to WB • History of Cancer • Trauma or Travel • Extremes of Age • Rashes Differential Road Map VINDICATE VITAMIN C • Vascular • Vascular • Inflammation • Infection • Neoplasm • Trauma • Degenerative • Autoimmune • Intoxication • Metabolic • Collagen/Congenital • Idiopathic • Autoimmune • Neoplastic • Trauma • Congenital • Endocrine Cleidocranial Dysplasia • Pediatric Knee Differential • Inflammation • Trauma/Injury – Synovitis – Fractures – JIA • Sleeve • Tibial Spine Avulsion • Infection – Meniscus • Bucket Handle – Septic Joint – Ligament – Bone • ACL-Open Physis • Osteomeyelitis – Patellar Dislocation • Brodie’s Abscess – OCD Lesion • Malignancy • NAI/NAT – Tumor/Soft Tissue Lesions Adult • Inflammation • OA – RA – Tibial Stress Fx – PVNS • OCD Lesion • Infection – Idiopathic – Septic Joint – Patellar Dislocation
    [Show full text]