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1.
Med Mol Morphol ; 53(2): 82-85, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31820106

RESUMO

The aim of this study is to reveal the morphological property about the loose bodies (LBs) of temporomandibular joint (TMJ) by scanning electron microscope (SEM). We obtained specimens from two female cases of released loose body by surgical operation. These specimens were fixed by soaking in a mixture of 5% glutaraldehyde or 4% formaldehyde for one week. They were cut into half pieces. These specimens were observed at an accelerating voltage of 3 kV under a SEM (JSM-5500, JEOL, Tokyo). In the electron microscopic findings, it seems to be separated into two different parts as inside part and outside part. On the inside part, collagen fibers were running very densely in the same direction in an orderly neatly manner. Whereas, we observed waved collagen fibers running irregularly with many spaces on the outside part. Outside part seems to be porous pattern compared with inside part. It might be that the surface and outside part included many active fibroblasts. As results, it seems that the LBs might develop in a multi-layer style, in which fibrous tissues were piled up loosely around the inside part. The proliferating activity of LBs grows from the inside to outside of SC in TMJ.


Assuntos
Condromatose Sinovial/patologia , Corpos Livres Articulares/patologia , Articulação Temporomandibular/ultraestrutura , Condromatose Sinovial/etiologia , Condromatose Sinovial/cirurgia , Colágeno/ultraestrutura , Feminino , Fibroblastos/patologia , Fibroblastos/ultraestrutura , Humanos , Corpos Livres Articulares/complicações , Corpos Livres Articulares/cirurgia , Microscopia Eletrônica de Varredura , Articulação Temporomandibular/patologia , Articulação Temporomandibular/cirurgia
2.
Eur Spine J ; 26(Suppl 1): 167-169, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28185063

RESUMO

Lumbar spinal stenosis is most often a degenerate condition observed in the older population. We describe the case of a lady with typical claudicant symptoms with an unusual cause of stenosis identified at the time of her decompressive surgery. On review of the literature this is only the second case of osteochondral loose body as a cause for lumbar spinal stenosis and thus remains a rare phenomenon.


Assuntos
Corpos Livres Articulares/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Estenose Espinal/diagnóstico por imagem , Descompressão Cirúrgica/métodos , Feminino , Humanos , Claudicação Intermitente/etiologia , Corpos Livres Articulares/complicações , Corpos Livres Articulares/cirurgia , Vértebras Lombares/cirurgia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Estenose Espinal/etiologia , Estenose Espinal/cirurgia
3.
Foot Ankle Surg ; 23(2): e13-e16, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28578802

RESUMO

Late stage ankle osteoarthritis often presents with debilitating pain. It is common to find osteophytes and loose body formation around the joint. Total ankle arthroplasty can preserve joint mobility and pain relieve for such patient. However, when trying to remove the osteophytes and loose bodies at the posterior ankle joint, there is risk of damaging posterior structures such as the neurovascular bundle during the procedure. We are presenting a case where the posterior loose bodies remained untouched during the operation, and patient showed spontaneous resolution of the lesions with time. Patient enjoyed good function outcome after the surgery.


Assuntos
Articulação do Tornozelo , Artroplastia de Substituição do Tornozelo , Corpos Livres Articulares/complicações , Corpos Livres Articulares/patologia , Osteoartrite/cirurgia , Remissão Espontânea , Humanos , Corpos Livres Articulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoartrite/complicações
4.
J Man Manip Ther ; 31(3): 206-213, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36309809

RESUMO

INTRODUCTION: The subacromial/subdeltoid bursa can develop inflammation and effusion related to autoimmune, infectious, and musculoskeletal disorders. Rice bodies, or loose bodies within bursa, have been described as an uncommon complication of bursitis and have been the subject of case studies over a number of years. However, they have not been described in anatomical or physical therapy-related literature. METHODS: A donor body dissected for a physical therapy anatomy course was found to have an enlarged subacromial/subdeltoid bursa. This bursa, along with the biceps brachii tendon sheath, and the subscapularis muscle bursa, were filled with numerous rice-like bodies. The bursal wall was well developed and thickened. Tissue specimens were obtained of the suspected rice bodies, the subacromial/subdeltoid bursal wall, and the biceps brachii tendon sheath. The tissue was embedded, sectioned, and processed with hematoxylin and eosin or Masson's Trichrome staining for blinded histologic assessment. RESULTS: The tissue samples from within the bursa were identified as tissue similar to that in prior descriptions of rice bodies. Tissue samples from the bursal wall and tendon sheath were identified as similar to synovial membranes. CONCLUSIONS: Rice bodies found within the cadaveric body were similar histologically to those described in rheumatology, radiology, and orthopedic literature. Anatomists teaching future health-care providers and practicing physical therapists should be familiar with rice bodies as a potential finding in cadavers, and patients.


Assuntos
Bursite , Corpos Livres Articulares , Articulação do Ombro , Humanos , Ombro/patologia , Bolsa Sinovial/patologia , Bursite/terapia , Articulação do Ombro/patologia , Corpos Livres Articulares/complicações , Corpos Livres Articulares/patologia , Cadáver
5.
Artigo em Inglês | MEDLINE | ID: mdl-35457572

RESUMO

Synovial chondromatosis (SC) is a rare benign disease involving multifocal generation of ectopic cartilage in the synovial tissue. Herein, we report two cases of SC in the temporomandibular joint: a 38-year-old woman (patient 1) and 39-year-old woman (patient 2). Both patients had trismus, jaw joint noises, and jaw-opening pain in the temporomandibular joint. Cone-beam computed tomography (CT) and magnetic resonance imaging (MRI) in patient 1 showed multiple calcified loose bodies around the right mandibular condyle. In addition, CT and MRI in patient 2 showed multiple calcified loose bodies around the left mandibular condyle and temporal bone perforation. Following establishing a diagnosis of SC, both patients underwent tumor resection via open surgery. In immunohistochemical examinations of the resected tissues, tumor cells showed intense nuclear staining with labeled anti-Gli1 antibody. Gene sequencing revealed that both patients had a homozygous mutation in the Gli1 gene (rs2228226 G>C). In conclusion, we suggest that the Gli1 gene (rs2228226 G>C) may be involved in the etiology of SC.


Assuntos
Condromatose Sinovial , Corpos Livres Articulares , Proteína GLI1 em Dedos de Zinco , Adulto , Condromatose Sinovial/diagnóstico por imagem , Condromatose Sinovial/genética , Condromatose Sinovial/cirurgia , Feminino , Humanos , Corpos Livres Articulares/complicações , Corpos Livres Articulares/cirurgia , Imageamento por Ressonância Magnética , Mutação , Articulação Temporomandibular , Proteína GLI1 em Dedos de Zinco/genética
6.
Arthroscopy ; 27(7): 1014-7, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21616628

RESUMO

Subcutaneous emphysema of the upper extremity is rare. Crepitation on physical examination and visible gas on radiographs raise the concern of gas gangrene due to gas-producing bacteria. Rapid establishment of a differential diagnosis is necessary to initiate proper treatment. We present a case of subcutaneous emphysema after elbow arthroscopy caused by a noninfectious genesis. A 59-year-old woman with loose bodies in her left elbow due to mild degenerative joint disease and restricted range of motion was offered an elbow arthroscopy with removal of loose bodies and arthrolysis. Postoperatively, the elbow was actively put alternatively in maximum extension and flexion. On the first postoperative day, rapidly ascending swelling and subcutaneous crepitation starting from the hand to the forearm were noted. There was no clinical evidence of infection. Radiographs showed subcutaneous air. Frequent blood tests and clinical evaluation ruled out a potentially life-threatening bacterial infection, and the signs resolved after 1 week without surgical treatment. Presumably, the intensive postoperative range-of-motion exercises led to a sucking in of air into the wound during each movement. This case illustrates that it is important to differentiate nonbacterial from bacterial causes of soft-tissue gas formation to initiate the appropriate treatment.


Assuntos
Braço , Artroscopia , Articulação do Cotovelo/cirurgia , Corpos Livres Articulares/complicações , Corpos Livres Articulares/cirurgia , Enfisema Subcutâneo/etiologia , Antibacterianos/administração & dosagem , Anti-Infecciosos/administração & dosagem , Infecções Bacterianas/prevenção & controle , Diagnóstico Diferencial , Esquema de Medicação , Combinação de Medicamentos , Articulação do Cotovelo/diagnóstico por imagem , Articulação do Cotovelo/patologia , Terapia por Exercício/efeitos adversos , Feminino , Humanos , Injeções Intravenosas , Corpos Livres Articulares/patologia , Metronidazol/administração & dosagem , Pessoa de Meia-Idade , Penicilina G/administração & dosagem , Cuidados Pós-Operatórios/efeitos adversos , Radiografia , Amplitude de Movimento Articular , Enfisema Subcutâneo/diagnóstico por imagem
7.
Knee Surg Sports Traumatol Arthrosc ; 19(4): 671-3, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-21127839

RESUMO

Knee locking is often caused by a torn meniscus or loose body. A rare cause of knee locking is a superior dislocation of the patella following trauma with less than 20 reported cases in the English literature. An unusual case of a locked knee secondary to interlocking osteophytes between the medial femoral condyle and the inferior pole of the patella without any history of trauma is presented.


Assuntos
Traumatismos do Joelho/etiologia , Articulação do Joelho/fisiopatologia , Osteófito/complicações , Luxação Patelar/complicações , Amplitude de Movimento Articular/fisiologia , Doença Aguda , Idoso , Seguimentos , Humanos , Imageamento Tridimensional , Corpos Livres Articulares/complicações , Corpos Livres Articulares/diagnóstico por imagem , Traumatismos do Joelho/diagnóstico por imagem , Traumatismos do Joelho/fisiopatologia , Articulação do Joelho/diagnóstico por imagem , Masculino , Osteófito/diagnóstico por imagem , Luxação Patelar/diagnóstico por imagem , Luxação Patelar/terapia , Doenças Raras , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos
8.
Clin Orthop Relat Res ; 468(4): 1115-9, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19851818

RESUMO

BACKGROUND: Chondral lesions, peroneal tendon tears, and other disorders in patients with chronic ankle instability may not be detected by preoperative MRI. Also, MRI often is obtained and interpreted at the referring institution, leading to variability in reading. QUESTIONS/PURPOSES: We assessed the accuracy of the radiologists' and orthopaedic surgeon's reading of preoperative MRI for diagnosing ankle lesions in patients with ankle instability warranting surgery. PATIENTS AND METHODS: We retrospectively reviewed 133 patients who underwent 135 surgeries for lateral ankle ligament reconstruction with concomitant ankle arthroscopy and who had preoperative MRI. RESULTS: We found 72 associated lesions in 66 of the 135 surgeries, including 38 chondral injuries, 18 peroneus brevis tears, seven loose bodies, and nine other miscellaneous abnormalities. Eliminating eight lesions for which the decision to operate was not based on operative findings, there were 127 surgeries with 64 associated lesions that required intraoperative confirmation or were detected intraoperatively. In the original reports, the radiologists identified 39% (15) of the chondral injuries, 56% (10) of the peroneal tears, and 57% (four) of the loose bodies. Radiologists' MRI sensitivity for detecting lesions was 45%. The attending surgeon identified 47% (18) of the chondral injuries, 89% (16) of the loose bodies, 71% (five) of the peroneus brevis tears, and the posterior talus process lesion, with a sensitivity of 63%. CONCLUSIONS: Our data suggest orthopaedic surgeons should review preoperative MRIs and also suggest the sensitivity of MRI may not be adequate to detect lesions in these patients before surgery. LEVEL OF EVIDENCE: Level IV, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.


Assuntos
Traumatismos do Tornozelo/diagnóstico , Articulação do Tornozelo/patologia , Instabilidade Articular/diagnóstico , Imageamento por Ressonância Magnética/métodos , Adolescente , Adulto , Traumatismos do Tornozelo/complicações , Articulação do Tornozelo/fisiopatologia , Articulação do Tornozelo/cirurgia , Artroscopia , Cartilagem Articular/lesões , Cartilagem Articular/patologia , Cartilagem Articular/cirurgia , Ligamentos Colaterais/lesões , Ligamentos Colaterais/patologia , Ligamentos Colaterais/cirurgia , Feminino , Humanos , Instabilidade Articular/etiologia , Instabilidade Articular/cirurgia , Corpos Livres Articulares/complicações , Corpos Livres Articulares/diagnóstico , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica , Reprodutibilidade dos Testes , Estudos Retrospectivos , Tálus/lesões , Tálus/patologia , Traumatismos dos Tendões/complicações , Traumatismos dos Tendões/diagnóstico , Adulto Jovem
9.
Acta Orthop ; 81(3): 373-6, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20450424

RESUMO

BACKGROUND AND PURPOSE: Radial head fractures are common, and may be associated with other injuries of clinical importance. We present the results of a standard additional MRI scan for patients with a radial head fracture. PATIENTS AND METHODS: 44 patients (mean age 47 years) with 46 radial head fractures underwent MRI. 17 elbows had a Mason type-I fracture, 23 a Mason type-II fracture, and 6 elbows had a Mason type-III fracture. RESULTS: Associated injuries were found in 35 elbows: 28 elbows had a lateral collateral ligament lesion, 18 had capitellar injury, 1 had a coronoid fracture, and 1 elbow had medial collateral ligament injury. INTERPRETATION: The incidence of associated injuries with radial head fractures found with MRI was high. The clinical relevance should be investigated.


Assuntos
Articulação do Cotovelo/patologia , Fraturas do Rádio/patologia , Adulto , Idoso , Cartilagem Articular/lesões , Cartilagem Articular/patologia , Feminino , Humanos , Corpos Livres Articulares/complicações , Corpos Livres Articulares/patologia , Ligamentos Articulares/lesões , Ligamentos Articulares/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Fraturas do Rádio/complicações , Fraturas do Rádio/diagnóstico , Lesões no Cotovelo
10.
World Neurosurg ; 138: 193-196, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32145426

RESUMO

BACKGROUND: Posterior circulation stroke resulting from atlantoaxial dislocation (AAD), although uncommon, is a well-described entity. The normally coursed V3 segment of the vertebral artery (VA) is likely to be stretched because of C1-C2 dislocation and further compromised by the C1-C2 translational mobility. The persistent first intersegmental artery (PFIA), an anomalous variant does not course through the C1 transverse foramen, but rather crosses the posterior C1-C2 joints and is unlikely to be affected by the C1-C2 dislocation. Therefore, a patient with AAD and anomalous VA presenting with stroke should be evaluated for other etiologies of VA compromise. CASE DESCRIPTION: We report a patient of AAD with PFIA who presented with posterior circulation stroke. Careful radiological evaluation revealed a loose body (LB) adjacent to the medial aspect of the left C1-C2 facet compressing the anomalous VA. Intraoperatively, there was a large LB on the posteromedial border of the joint, compressing the VA. The anomalous VA was mobilized, and the offending element removed followed by fixation of the C1-C2. CONCLUSIONS: One should be aware of such an etiology of arterial compromise in cases of AAD with coexistent anomalous VA. An underlying LB or large osteophytes resulting from instability may be the offending cause, and needs to be dealt with, as fusion alone may not benefit the patient.


Assuntos
Articulação Atlantoaxial/patologia , Luxações Articulares/complicações , Acidente Vascular Cerebral/etiologia , Artéria Vertebral/anormalidades , Insuficiência Vertebrobasilar/etiologia , Adulto , Articulação Atlantoaxial/cirurgia , Humanos , Luxações Articulares/cirurgia , Corpos Livres Articulares/complicações , Corpos Livres Articulares/patologia , Corpos Livres Articulares/cirurgia , Masculino , Fusão Vertebral
11.
Arthroscopy ; 25(4): 365-8, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19341922

RESUMO

PURPOSE: The purpose of this study was to investigate the results of arthroscopic treatment of acetabular labral tears (the most common indication for hip arthroscopy) in a consecutive series of patients with 10-year follow-up. METHODS: Since 1993, all of our patients undergoing hip arthroscopy have been prospectively assessed by use of a modified Harris Hip Score preoperatively and postoperatively at 3, 12, 24, 60, and 120 months. Variables recorded include age, sex, diagnosis, duration of symptoms, onset of symptoms, center-edge angle, Workers' compensation status, and pending litigation. From a cohort of 52 procedures performed on 50 patients who had achieved 10-year follow-up, 29 patients (31 hips) were treated for a tear of the acetabular labrum and represent the substance of this study. RESULTS: There was 100% follow-up, excluding 3 patients (5 hips) who died before their 10-year assessment. The mean age was 46 years (range, 17 to 84 years); there were 13 male and 13 female patients. The median Harris Hip Score improvement was 29 points (from 52 points preoperatively to 81 points postoperatively). Among 18 patients without arthritis, 15 (83%) continued to show substantial improvement (>or=18 points) at 10-year follow-up. Among 8 patients with associated arthritis, 7 (88%) were converted to total hip arthroplasty at a mean of 63 months. Two patients underwent repeat arthroscopy, which did not preclude a successful outcome at 10-year follow-up. There were no complications. CONCLUSIONS: Selective debridement of symptomatic tears can result in favorable long-term results. The presence of clinical findings of arthritis at the time of the index procedure is a poor prognostic indicator, with uniformly poor results at 10 years. LEVEL OF EVIDENCE: Level IV, therapeutic case series.


Assuntos
Acetábulo/lesões , Artroscopia/métodos , Desbridamento/métodos , Articulação do Quadril/cirurgia , Lacerações/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite/complicações , Artrite/cirurgia , Feminino , Seguimentos , Humanos , Corpos Livres Articulares/complicações , Corpos Livres Articulares/cirurgia , Lacerações/complicações , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Reoperação , Sinovite/complicações , Sinovite/cirurgia , Adulto Jovem
12.
J Am Acad Orthop Surg ; 16(5): 268-75, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18460687

RESUMO

Collectively, benign synovial disorders are not uncommon, and they may be seen in general orthopaedic practices. Symptoms are nonspecific, often delaying diagnosis. In fact, synovial chondromatosis, pigmented villonodular synovitis, synovial hemangioma, and lipoma arborescens often mimic each other as well as other, more common joint disorders in presentation, making diagnosis extremely difficult. It is important to diagnose these disorders correctly in order to provide appropriate treatment and avoid secondary sequelae, such as bone erosion and cartilage degeneration.


Assuntos
Condromatose Sinovial/diagnóstico , Hemangioma/diagnóstico , Lipoma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Sinovite Pigmentada Vilonodular/diagnóstico , Condromatose Sinovial/complicações , Condromatose Sinovial/cirurgia , Diagnóstico Diferencial , Hemangioma/cirurgia , Humanos , Corpos Livres Articulares/complicações , Corpos Livres Articulares/cirurgia , Lipoma/cirurgia , Imageamento por Ressonância Magnética , Neoplasias de Tecidos Moles/cirurgia , Sinovectomia , Membrana Sinovial/patologia , Sinovite Pigmentada Vilonodular/cirurgia , Tomografia Computadorizada por Raios X
14.
J Bone Joint Surg Br ; 89(10): 1329-35, 2007 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17957072

RESUMO

We retrospectively identified 18 consecutive patients with synovial chrondromatosis of the shoulder who had arthroscopic treatment between 1989 and 2004. Of these, 15 were available for review at a mean follow-up of 5.3 years (2.3 to 16.5). There were seven patients with primary synovial chondromatosis, but for the remainder, the condition was a result of secondary causes. The mean Constant score showed that pain and activities of daily living were the most affected categories, being only 57% and 65% of the values of the normal side. Surgery resulted in a significant improvement in the mean Constant score in these domains from 8.9 (4 to 15) to 11.3 (2 to 15) and from 12.9 (5 to 20) to 18.7 (11 to 20), respectively (unpaired t-test, p = 0.04 and p < 0.0001, respectively). Movement and strength were not significantly affected. Osteoarthritis was present in eight patients at presentation and in 11 at the final review. Recurrence of the disease with new loose bodies occurred in two patients from the primary group at an interval of three and 12 years post-operatively. In nine patients, loose bodies were also present in the bicipital groove; seven of these underwent an open bicipital debridement and tenodesis. We found that arthroscopic debridement of the glenohumeral joint and open debridement and tenodesis of the long head of biceps, when indicated, are safe and effective in relieving symptoms at medium-term review.


Assuntos
Artroscopia/métodos , Condromatose Sinovial/cirurgia , Corpos Livres Articulares/cirurgia , Articulação do Ombro/cirurgia , Adolescente , Adulto , Desbridamento , Feminino , Seguimentos , Humanos , Corpos Livres Articulares/complicações , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Tenodese/métodos , Resultado do Tratamento
15.
Orthop Nurs ; 25(2): 93-7; quiz 98-9, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16572024

RESUMO

Hip arthroscopy is a procedure that is gaining popularity for treating hip pain related to intraarticular cartilage lesions or loose bodies. It offers an alternative procedure that can decrease or eliminate hip pain and increase a patient's ability to do activities of daily living. This article provides a comprehensive overview of hip arthroscopy and also addresses the anatomy of the hip, appropriate diagnoses for the procedure, operative considerations and postoperative teaching.


Assuntos
Artroscopia/métodos , Lesões do Quadril/diagnóstico , Lesões do Quadril/cirurgia , Articulação do Quadril , Artropatias/diagnóstico , Artropatias/cirurgia , Atividades Cotidianas , Artroscopia/efeitos adversos , Cartilagem Articular/lesões , Contraindicações , Deambulação Precoce , Lesões do Quadril/complicações , Humanos , Artropatias/complicações , Corpos Livres Articulares/complicações , Corpos Livres Articulares/diagnóstico , Corpos Livres Articulares/cirurgia , Ligamentos Articulares/lesões , Imageamento por Ressonância Magnética , Anamnese , Dor/etiologia , Educação de Pacientes como Assunto , Assistência Perioperatória/métodos , Assistência Perioperatória/enfermagem , Exame Físico , Amplitude de Movimento Articular , Sinovite/complicações , Sinovite/diagnóstico , Sinovite/cirurgia
16.
Hand Surg ; 11(1-2): 59-62, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-17080531

RESUMO

We report a case with locking of the metacarpophalangeal (MP) joint of the thumb in a 15-year-old high school baseball catcher, which was caused by an intra-articular loose body arising from osteochondritis dissecans. The loose body was removed arthroscopically, enabling early return to full MP joint function.


Assuntos
Anquilose/etiologia , Corpos Livres Articulares/complicações , Articulação Metacarpofalângica , Adolescente , Humanos , Corpos Livres Articulares/diagnóstico , Corpos Livres Articulares/cirurgia , Masculino
17.
World Neurosurg ; 95: 623.e1-623.e4, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27353557

RESUMO

BACKGROUND: Multiple osseous loose bodies in the lumbar spine have never been reported. We describe a rare surgical case of multiple osseous loose bodies associated with lumbar isthmic spondylolisthesis. CASE DESCRIPTION: A 74-year-old man who experienced left foot numbness and bilateral gluteal pain was diagnosed with lumbar spondylolisthesis 7 years previously and managed conservatively. He reported recurrence of the left foot numbness 6 months previously, at which time aggressive (rather than conservative) therapy became a consideration. Radiographs of the lumbar spine revealed L5 isthmic spondylolisthesis with dynamic instability at L5/S1. Magnetic resonance imaging of the lumbar spine revealed multiple mass lesions dorsally located in the lumbar canal. Computed tomography myelography demonstrated multiple osseous materials near the isthmic portion at the L5 level where compression of the dural sac by the lesions induced lumbar canal stenosis. The patient underwent posterior decompression surgery that enabled total removal of the osseous lesions. Intraoperative findings revealed osseous lesions located in the fibrocartilage material and no connection of the lytic portion at the L5 level or ligamentum flavum. Postoperative course of the patient was uneventful as his neurological symptoms improved. CONCLUSIONS: We described the first instance of multiple loose bodies in the spinal canal with lumbar canal stenosis. It is presumed that long standing minor trauma due to dynamic instability with a trend of hyperossification induced secondary synovial osteochondromatosis forming multiple loose bodies.


Assuntos
Corpos Livres Articulares/diagnóstico por imagem , Vértebras Lombares/diagnóstico por imagem , Estenose Espinal/diagnóstico por imagem , Espondilolistese/diagnóstico por imagem , Idoso , Descompressão Cirúrgica , Humanos , Corpos Livres Articulares/complicações , Corpos Livres Articulares/cirurgia , Vértebras Lombares/cirurgia , Imageamento por Ressonância Magnética , Masculino , Mielografia , Radiografia , Canal Medular/diagnóstico por imagem , Canal Medular/cirurgia , Estenose Espinal/complicações , Estenose Espinal/cirurgia , Espondilolistese/complicações , Espondilolistese/cirurgia , Tomografia Computadorizada por Raios X
18.
J Am Dent Assoc ; 136(4): 484-9, 2005 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-15884318

RESUMO

BACKGROUND: The authors review the literature regarding osteocartilaginous loose bodies (that is, secondary synovial chondrometaplasia or secondary synovial chondromatosis) in the temporomandibular joint (TMJ), present a case report and stress the importance of early diagnosis. CASE DESCRIPTION: A 57-year-old woman was referred to an orthodontist with a chief complaint of bite changes that took place over several years as the patient intermittently experienced TMJ problems. The authors noted radiopacities around the right TMJ space on a panoramic radiograph. They referred the patient to an oral and maxillofacial surgeon for treatment. CLINICAL IMPLICATIONS: Asymmetrical occlusal changes in a nongrowing adult with progressive shifts from Class I to Class III malocclusion unilaterally may indicate a space-occupying lesion in the TMJ space on the affected side.


Assuntos
Corpos Livres Articulares/complicações , Má Oclusão/etiologia , Transtornos da Articulação Temporomandibular/complicações , Condromatose Sinovial/complicações , Condromatose Sinovial/patologia , Assimetria Facial/etiologia , Feminino , Seguimentos , Humanos , Corpos Livres Articulares/patologia , Pessoa de Meia-Idade , Transtornos da Articulação Temporomandibular/patologia
19.
Br J Radiol ; 73(874): 1120-6, 2000 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-11271909

RESUMO

This review illustrates the MR appearances of commonly encountered problems that can present as a "locked knee", as well as several unusual causes. Internal derangement of menisci, particularly bucket handle tears, predominate. Loose bodies as a result of trauma/degeneration and lesions such as cysts of the cruciate ligaments and focal pigmented villonodular synovitis are also illustrated. While meniscal tears are the major cause of "locked knee" in clinical practice, interference with normal knee kinematics is non-specific with regard to the diagnosis. Emphasis is therefore given to less frequently seen abnormalities that lead to a mechanical block of knee extension.


Assuntos
Articulação do Joelho , Ligamento Cruzado Anterior , Humanos , Artropatias/diagnóstico , Artropatias/etiologia , Corpos Livres Articulares/complicações , Corpos Livres Articulares/diagnóstico , Imageamento por Ressonância Magnética/métodos , Osteocondrite Dissecante/complicações , Osteocondrite Dissecante/diagnóstico , Sinovite Pigmentada Vilonodular/diagnóstico
20.
Am J Sports Med ; 23(2): 146-50, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7778696

RESUMO

Thirty adolescents with acute, primary patellar dislocation were assessed for a relationship between articular hypermobility and chondral injury. The 15 patients without articular hypermobility had a 2.5 times increased frequency of articular lesions when compared with 15 patients with hypermobility. Assessment of articular hypermobility should be part of the examination in patients with patellar dislocation.


Assuntos
Cartilagem Articular/lesões , Luxações Articulares/complicações , Instabilidade Articular/complicações , Patela/lesões , Doença Aguda , Adolescente , Artroscopia , Cartilagem Articular/patologia , Criança , Articulação do Cotovelo/fisiopatologia , Feminino , Fêmur/patologia , Humanos , Instabilidade Articular/fisiopatologia , Corpos Livres Articulares/complicações , Articulação do Joelho/fisiopatologia , Masculino , Articulação Metacarpofalângica/fisiopatologia , Patela/patologia , Polegar/fisiopatologia
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