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1.
J Foot Ankle Surg ; 56(2): 395-397, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28089129

RESUMO

Magnetic resonance imaging (MRI) is a noninvasive modality of choice for the detection of static peroneal tendon pathologic features. The depiction of peroneal tendon subluxation using real-time kinematic MRI has not been previously reported. We describe the MRI and intraoperative correlation of peroneal tendon and retinacular pathologic findings, and the novel use of kinematic MRI in the illustration of peroneal tendon subluxation.


Assuntos
Traumatismos do Tornozelo/diagnóstico por imagem , Imageamento por Ressonância Magnética , Traumatismos dos Tendões/diagnóstico por imagem , Tenossinovite/diagnóstico por imagem , Idoso , Fenômenos Biomecânicos , Humanos , Imageamento Tridimensional , Masculino
2.
Surg Oncol ; 41: 101747, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35358911

RESUMO

AIM: We sought to systematically assess and summarize the available literature on the clinical outcomes and complications following radiofrequency ablation (RFA) for painful spinal osteoid osteoma (OO). METHODS: PubMed, Scopus, and CENTRAL databases were searched in accordance with PRISMA guidelines. Studies with available data on safety and clinical outcomes following RFA for spinal OO were included. RESULTS: In the 14 included studies (11 retrospective; 3 prospective), 354 patients underwent RFA for spinal OO. The mean ages ranged from 16.4 to 28 years (Females = 31.3%). Lesion diameters ranged between 3 and 20 mm and were frequently seen in the posterior elements in 211/331 (64%) patients. The mean distance between OO lesions and neural elements ranged between 1.7 and 7.4 mm. The estimated pain reduction on the numerical rating scale was 6.85/10 (95% confidence intervals [95%CI] 4.67-9.04) at a 12-24-month follow-up; and 7.29/10 (95% CI 6.67-7.91) at a >24-month follow-up (range 24-55 months). Protective measures (e.g., epidural air insufflation or neuroprotective sterile water infusion) were used in 43/354 (12.1%) patients. Local tumor progression was seen in 23/354 (6.5%) patients who were then successfully re-treated with RFA or open surgical resection. Grade I-II complications such as temporary limb paresthesia and wound dehiscence were reported in 4/354 (1.1%) patients. No Grade III-V complications were reported. CONCLUSION: RFA demonstrated safety and clinical efficacy in most patients harboring painful spinal OO lesions. However, further prospective studies evaluating these outcomes are warranted.


Assuntos
Neoplasias Ósseas , Ablação por Cateter , Osteoma Osteoide , Ablação por Radiofrequência , Neoplasias da Coluna Vertebral , Adolescente , Adulto , Neoplasias Ósseas/cirurgia , Feminino , Humanos , Osteoma Osteoide/cirurgia , Estudos Prospectivos , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/cirurgia , Resultado do Tratamento , Adulto Jovem
3.
Surg Oncol ; 38: 101618, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34153905

RESUMO

AIM: To evaluate the analgesic efficacy, safety, and local tumor control of iodine-125 (125I) seed brachytherapy (BT) for the management of spine and bone metastases. METHODS: A systematic literature search was conducted using PubMed, the Cochrane Library, and Scopus databases. Data regarding patient demographics, tumor characteristics, procedural parameters, and clinical outcomes were extracted and analyzed. RESULTS: Fourteen studies (7 prospective, 7 retrospective) were included, accounting for 689 patients, in our review. Analgesic efficacy was assessed at baseline and various postoperative time points. Significant improvement in pain was noted at 4- and 24-week follow-ups (p < 0.01). Interestingly, all studies that combined 125I seed BT with cement augmentation reported relatively higher levels of pain reduction (mean pain reduction ≥4 points) as compared to the studies which applied 125I seed BT as a stand-alone therapy (mean pain reduction ≥2 points), at the last follow-up. Local tumor control rates ranged widely from 14% to 100% at varying follow-ups. Median overall survival ranged between 10 months and 25 months. The overall complication rate was 19% (130/689) and mainly included minor subcutaneous hemorrhage, fever, myelosuppression, and seed displacement. Metrics assessing performance and quality of life demonstrated significant improvements from baseline to posttreatment. CONCLUSION: 125I seed BT, alone or in conjunction with cement augmentation, may be a viable salvage therapy in appropriately selected patients. However, further studies are needed to analyze the long-term efficacy of this intervention as a palliative and curative modality.


Assuntos
Neoplasias Ósseas/radioterapia , Braquiterapia/métodos , Radioisótopos do Iodo/uso terapêutico , Inoculação de Neoplasia , Neoplasias da Coluna Vertebral/radioterapia , Neoplasias Ósseas/secundário , Humanos , Neoplasias da Coluna Vertebral/secundário
4.
JBJS Case Connect ; 9(3): e0317, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31584903

RESUMO

CASE: We present an unusual case of a distal metaphyseal femur insufficiency fracture in an adolescent with a history of multiple low-energy appendicular fractures. A genetic workup was significant for a variant of unknown significance to the Col1A1 gene. CONCLUSIONS: To our knowledge, this is the first report of this collagen gene variant as a risk factor for multiple fractures. The case illustrates the presentation of this gene's phenotype and suggested medical management.


Assuntos
Fraturas do Fêmur/diagnóstico por imagem , Osteogênese Imperfeita/diagnóstico por imagem , Adolescente , Colágeno Tipo I/genética , Cadeia alfa 1 do Colágeno Tipo I , Humanos , Imageamento por Ressonância Magnética , Masculino , Osteogênese Imperfeita/genética , Radiografia
5.
JBJS Case Connect ; 8(3): e54, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30045077

RESUMO

CASE: A 29-year-old man with mild hemophilia A and Ollier disease presented with bilateral atraumatic forearm pseudotumors. Both forearm pseudotumors were successfully treated surgically with staged radical extirpation and factor VIII replacement therapy. CONCLUSION: Pseudotumors typically occur in adolescents with severe, poorly controlled hemophilia A. The development of factor VIII replacement therapy has progressively reduced the incidence of pseudotumors in patients in the developed world. No standardized therapy exists for pseudotumors that continue to bleed into the muscles despite nonoperative measures. Persistent masses require surgical removal with careful preoperative planning and a team approach.


Assuntos
Encondromatose/complicações , Encondromatose/patologia , Antebraço/patologia , Hemofilia A/complicações , Adulto , Encondromatose/diagnóstico por imagem , Encondromatose/cirurgia , Fator VIII/uso terapêutico , Antebraço/diagnóstico por imagem , Antebraço/cirurgia , Hemofilia A/terapia , Humanos , Masculino
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