Assuntos
Fixação Intramedular de Fraturas , Fraturas do Quadril/cirurgia , Achados Incidentais , Cápsula Articular , Osteocondromatose/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Idoso , Feminino , Fraturas do Quadril/complicações , Humanos , Cápsula Articular/diagnóstico por imagem , Cápsula Articular/patologia , Osteocondromatose/complicações , Osteocondromatose/patologia , Reoperação , Neoplasias de Tecidos Moles/complicações , Neoplasias de Tecidos Moles/patologiaRESUMO
Nora's lesion, or bizarre parosteal osteochondromatous proliferation (BPOP), is a rare benign lesion that is made up of varying degrees of cartilage, bone, and spindle cells. Most notably, calcification of the cartilage or "blue bone," is a feature of the disorder. The condition principally affects long tubular bones of the hands and feet, and is generally seen in patients in their second and third decades of life. We present a case of BPOP occurring in the second interspace with symptoms that would be consistent with a more common diagnosis of predislocation syndrome, or a second interspace neuroma. This case study may help the clinician in considering a more subtle cause of a splay deformity in the second interspace, and walk through the diagnostic and treatment course for BPOP.
Assuntos
Neoplasias Ósseas/complicações , Pé Chato/etiologia , Osteocondromatose/complicações , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Neuralgia/etiologia , Osteocondromatose/diagnóstico , Osteocondromatose/terapia , Fotomicrografia , Radiografia , Cintilografia , Tecnécio , Dedos do Pé/diagnóstico por imagemRESUMO
We present a 22-year-old man with osteochondromatosis and osteochondroma involving bilateral patella and patellar tendon with restriction of joint movement and severe arthritis.
Assuntos
Neoplasias Ósseas/complicações , Articulação do Joelho , Osteocondroma/complicações , Patela , Ligamento Patelar , Artrite/etiologia , Artrite/fisiopatologia , Humanos , Masculino , Osteocondromatose/complicações , Patela/fisiopatologia , Ligamento Patelar/fisiopatologia , Amplitude de Movimento Articular , Adulto JovemAssuntos
Articulação do Tornozelo/diagnóstico por imagem , Osteocondromatose/diagnóstico por imagem , Articulação do Tornozelo/cirurgia , Fíbula/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Osteocondromatose/complicações , Osteocondromatose/cirurgia , Dor/etiologia , Radiografia , Tíbia/diagnóstico por imagemRESUMO
A 1-year-old sexually intact male Korat cat was referred for ophthalmological consultation due to anisocoria. Mydriasis with external ophthalmoplegia and absence of pupillary light responses in the right eye and nasofacial hypalgesia were seen. Cavernous sinus syndrome (CSS) was suspected. Bilateral deformities of the jaw and phalangeal bones, severe spinal pain and abnormal conformation of the lumbar spine were also present. Radiographic examination revealed several mineralised masses in the appendicular and axial skeleton, indicative of multiple cartilaginous exostoses. For further investigation of the CSS-related neurological deficits, the cat underwent computed tomography (CT) examination of the skull. CT images revealed a non-vascularised, calcified, amorphous mass originating from the right lateral skull base and superimposing on the sella turcica. Based on the severity of diffuse lesions and owing to the clinical signs of extreme pain, the cat was euthanased. A diffuse skeletal and intracranial osteochondromatosis was diagnosed histologically.
Assuntos
Doenças do Gato/etiologia , Seio Cavernoso/patologia , Osteocondromatose/veterinária , Animais , Doenças do Gato/patologia , Gatos , Masculino , Osteocondromatose/complicaçõesAssuntos
Artrite Reumatoide/complicações , Neoplasias Ósseas , Osteocondromatose , Adulto , Anticorpos Anticardiolipina , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/patologia , Feminino , Humanos , Osteoartrite do Joelho/etiologia , Osteocondromatose/complicações , Osteocondromatose/diagnóstico , Osteocondromatose/patologiaAssuntos
Neoplasias Ósseas/complicações , Síndromes Compartimentais/etiologia , Fíbula , Osteocondromatose/complicações , Osteocondromatose/cirurgia , Complicações Pós-Operatórias/etiologia , Tíbia , Adolescente , Neoplasias Ósseas/diagnóstico por imagem , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
Arthroscopic surgery of the hip is an evolving procedure that can facilitate the diagnosis and treatment of synovial-based disease. Radiographic studies have not reproducibly identified many of the synovial conditions that can affect the hip, and arthroscopy has provided a means to improved diagnostic accuracy and the ability to treat certain conditions. Arthroscopic intervention has been reported in synovial chondromatosis and osteochondromatosis, pigmented villonodular synovitis, inflammatory arthropathies including rheumatoid arthritis, and acute septic arthritis. Patients with other conditions that result in acute and chronic synovitis within the hip such as hemosiderotic synovitis secondary to hemophilia and chondrocalcinosis also may benefit from arthroscopic intervention. These synovial and intraarticular abnormalities have been associated with accelerated joint degeneration, and although the pathologic mechanisms have not been delineated clearly, the clinical description has been advanced using hip arthroscopy. Increased awareness of the association between synovial abnormalities and degeneration has resulted from arthroscopy applied to the hip in early stages of disease and early in the course of symptomatic dysfunction. The indications and treatment capabilities will continue to expand with additional understanding of early hip disease, improvements in equipment, and as outcome studies reveal that the patient benefits from the procedure.
Assuntos
Artroscopia , Articulação do Quadril/cirurgia , Corpos Livres Articulares/cirurgia , Sinovite/cirurgia , Artrite Infecciosa/complicações , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/cirurgia , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/cirurgia , Condrocalcinose/complicações , Condrocalcinose/diagnóstico , Condrocalcinose/cirurgia , Humanos , Corpos Livres Articulares/diagnóstico , Osteocondromatose/complicações , Osteocondromatose/diagnóstico , Osteocondromatose/cirurgia , Sinovite/diagnóstico , Sinovite/etiologiaRESUMO
A domestic shorthair cat was presented with quadriparesis and lumbar hyperesthesia that progressed over 4 months. There were linear and amorphous radiopaque masses throughout the soft tissue surrounding the long bones, vertebral bodies, ribs, pelvis, and scapula. The diagnosis of osteochondromatosis was confirmed by histopathology. Unlike previously reported patients with osteochondromatosis, most of the calcified masses in this cat were not connected to the periosteum; some were linear and were arranged parallel to the long bones involved.
Assuntos
Doenças do Gato/diagnóstico por imagem , Vértebras Lombares , Osteocondromatose/veterinária , Neoplasias da Coluna Vertebral/veterinária , Animais , Gatos , Diagnóstico Diferencial , Feminino , Membro Posterior , Coxeadura Animal/etiologia , Osteocondromatose/complicações , Osteocondromatose/diagnóstico por imagem , Dor/etiologia , Dor/veterinária , Radiografia , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/diagnóstico por imagemRESUMO
Hamartoses (HM) are defined as disorders involving nonneoplastic tissue overgrowth. Studies have examined the neuropsychological profiles of children with common HM, such as neurofibromatosis type 1. Limited information is known regarding neuropsychological profiles of rare HM such as Osteochondromatosis Syndrome (OS) and Klippel-Trenaunay Syndrome (KTS). The current investigation is, to our knowledge, the first attempt to define the cognitive phenotypes in two boys with OS and KTS. Results revealed significantly greater impairments involving sensorimotor and visuospatial skills, while verbal memory and language skills appeared relatively preserved. Significant neurobehavioral problems and marked social difficulties were evident. These findings suggest that these syndromes are on a Nonverbal Learning Disorder (NLD) continuum, with varying degrees of severity.
Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Síndrome de Klippel-Trenaunay-Weber/complicações , Síndrome de Klippel-Trenaunay-Weber/genética , Osteocondromatose/complicações , Osteocondromatose/genética , Logro , Atenção , Transtornos Cognitivos/genética , Humanos , Masculino , Testes Neuropsicológicos , Fenótipo , Índice de Gravidade de DoençaAssuntos
Artralgia/diagnóstico , Artralgia/etiologia , Articulação do Quadril , Quadril , Osteoartrite do Quadril/diagnóstico , Dor/etiologia , Artrite Infecciosa/diagnóstico , Artrite Reumatoide/diagnóstico , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico , Doença Crônica , Diagnóstico Diferencial , Hemartrose/diagnóstico , Humanos , Imageamento por Ressonância Magnética , Osteocondromatose/complicações , Osteocondromatose/diagnóstico , Osteonecrose/diagnóstico , Dor/diagnóstico , Fatores de Risco , Fatores de Tempo , Tuberculose Osteoarticular/diagnósticoAssuntos
Neoplasias Ósseas/terapia , Condrossarcoma/terapia , Osteocondromatose/complicações , Osteossarcoma/terapia , Sarcoma de Ewing/terapia , Biópsia , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/etiologia , Criança , Condrossarcoma/etiologia , Terapia Combinada , Fixadores Externos , Humanos , Imageamento por Ressonância Magnética , Osteocondromatose/genética , Osteossarcoma/diagnóstico , Osteossarcoma/etiologia , Prognóstico , Sarcoma de Ewing/diagnóstico , Sarcoma de Ewing/etiologiaRESUMO
Cushing's disease (CD), the chronic endogenous hypercortisolism derived from an ACTH-secreting pituitary adenoma, and multiple osteochondromatosis (MO), a congenital mesoderm dyschondroplasia, represent two distinct rare neoplastic diseases. Clinical appearance of MO usually occurs during the first-second decade of life. In fact, the growth of osteochondromas parallels the patient's growth, then becoming quiescent after the closure of the epiphyses and the achievement of final stature. Here we describe an uncommon case of a patient with a long-term history of childhood-onset CD, who surprisingly developed MO during the third decade of life, after the remission of CD. Indeed, a female patient had been followed for CD from the age of 12 to the age of 24 years, when CD definitively remitted. At the age of 26 the patient complained progressively worsening backache and pain at level of hips and feet. Standard radiography of skeleton showed multiple bone dysmorphisms at level of the four limbs, spine and pelvis consistent with multiple osteochondromas and exostoses. A diagnosis of MO was performed. Total body bone scintigraphy with 99mTc-MDP revealed an increased uptake of the radioligand, suggesting an increased metabolic turnover in correspondence of the majority of the osteochondromas. However, the negativity of the majority of the lesions at 99mTc-DMSA scintigraphy and the histological diagnosis of benign osteochondroma of the only positive lesion at 99mTc-DMSA evidenced that the high metabolic activity of the osteochondromas was not due to malignant transformation. However, the activity of the lesions was highly surprising considering that they usually become quiescent after the achievement of the final stature. In last analysis, the uncommon characteristics of MO and, particularly, its occurrence after stable remission of hypercortisolism, suggests a possible role of glucocorticoids in influencing the clinical course of the skeletal disease. The inhibitory effect of hypercortisolism on bone growth and maturation could explain the block in the proliferation of skeletal lesions during the developmental age, where CD was in the active phase, and the opposite effect of stimulation of the ostochondromas growth during stable normalization of cortisol secretion, after CD remission.
Assuntos
Síndrome de Cushing/complicações , Osteocondromatose/complicações , Hormônio Adrenocorticotrópico/sangue , Adulto , Progressão da Doença , Feminino , Humanos , Hidrocortisona/sangue , Osteocondromatose/diagnóstico por imagem , Radiografia , CintilografiaAssuntos
Neoplasias Ósseas/complicações , Lúpus Eritematoso Sistêmico/complicações , Osteocondromatose/complicações , Osteonecrose/complicações , Corticosteroides/uso terapêutico , Adulto , Neoplasias Ósseas/diagnóstico , Feminino , Humanos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/fisiopatologia , Osteocondromatose/diagnóstico , Osteonecrose/diagnósticoRESUMO
We report two cases of children with multiple hereditary osteochondromatosis (MHO) in whom painful restriction of hip movement developed due to intraacetabular osteochondromata. Excision of the lesions relieved pain and restored joint movement after 14 and 3 months' follow-up, respectively. Long-term follow-up of these patients is essential.