Osteocondromatose em gato: relato de caso / Osteochondromatosis in a cat: case report

A osteocondromatose é caracterizada por nódulos únicos ou múltiplos decorrentes de um crescimento ósseo excessivo benigno. É encontrada em cães, gatos, equinos e humanos. Em felinos, tem maior incidência dos dois aos quatro anos de idade. A etiologia em gatos está relacionada ao vírus da leucemia felina, e também já foi encontrada relação com o fibrossarcoma. A manifestação clínica depende do local acometido e do tamanho da lesão. O diagnóstico definitivo é por meio de histopatologia e o prognóstico é desfavorável, pois ocorrem muitas recidivas. Este relato de caso objetiva descrever a apresentação dessa enfermidade em um felino jovem.(AU)

Osteochondromatosis is characterized by single or multiple nodules resulting from benign excessive bone growth. It is found in cats and dogs, horses and humans. In cats, a higher incidence is found in individuals from 2 to 4 years of age. The etiology in cats is related to the virus of feline leukemia, and is also related to fibrosarcoma. The clinical presentation depends on the area affected and the size of the lesion. The definitive diagnosis is by histopathology and the prognosis is poor because many relapses occur. This case report aims to describe the presentation of the disease in a young cat.(AU)

High resolution ultrasonography in the diagnosis of ulnar nerve lesions with particular reference to post-traumatic lesions and sites outside the elbow.

OBJECTIVE: Recent studies suggest that high resolution ultrasonography (HRU) is useful in evaluating ulnar neuropathy (UN) at the elbow. These studies do not include UN outside the elbow and lesions related to previous trauma. We investigate diagnostic utility of HRU in UN at any location of traumatic and non-traumatic etiology. METHODS: Patients with clinically suspected and electrophysiologically defined UN at the elbow and outside the elbow were included. Nerve conduction studies (NCS) were compared with HRU. HRU defined UN in terms of change in cross-sectional area. RESULTS: Our retrospective analysis included 46 UN. In 25 cases both NCS and HRU localised neuropathy to the elbow. In 15 where NCS was abnormal but non-localising, HRU localised the lesion in 14, 7 outside the elbow. In three of these, HRU characterised further pathology (synovial osteochondromatosis (n=2), myositis ossificans (n=1). Cross-sectional area of the ulnar nerve at the sulcus significantly correlated with distal NCS parameters. CONCLUSIONS: HRU is of greater use than NCS in the localisation of UN both at the elbow and outside the elbow and in UN related to previous trauma. SIGNIFICANCE: HRU is useful for the localisation of ulnar neuropathy.

Determination of bone age in children with cartilaginous dysplasia (multiple hereditary osteochondromatosis and Ollier's enchondromatosis).

Cartilaginous dysplasias (multiple hereditary osteochondromatosis [MHO] and Ollier's enchondromatosis [OE]) are common pediatric orthopaedic conditions. Long bone growth deformities commonly develop in children with MHO and OE. The timing of procedures frequently used to treat these deformities is often dependent upon the bone age. It was the purpose of this study to investigate bone ages in a series of 40 children with MHO and OE. There were 6 girls and 9 boys with OE, and 9 girls and 16 boys with MHO. Each child's age, gender, race, and diagnosis were recorded. Hand-wrist radiographs obtained during routine evaluation of hand-wrist deformities or scanograms were identified, randomly numbered, and blinded regarding the identity and age of the child. Each radiograph was reviewed by five different observers at two different times separated by a minimum of 3 weeks. Statistical analyses were performed, looking at differences between bone and chronological age; inter- and intraobserver variability in bone age assessment; and differences by observer. The average chronological age (n = 40) was 7.8 +/- 3.6 years, average bone age (n = 400) was 7.2 +/- 3.7 years, and average difference between chronological and bone age (n = 400) was 0.6 +/- 1.3 years (P < 10-6). Intra- and interobserver variability was +/-1.5 and +/-1.6 years. There were no differences between observers in the average chronological/bone age difference (P = 0.63). Clinicians should be aware of this average 0.6-year delay in bone age when planning an epiphysiodesis for limb length equalization in children with cartilaginous dysplasias.

Evaluation of the forearm in untreated adult subjects with multiple hereditary osteochondromatosis.

BACKGROUND: Limb-length discrepancy or angular deformities as a result of altered bone growth may lead to a decreased range of motion and impaired function as well as premature osteoarthritis in patients with multiple hereditary osteochondromatosis. The purpose of this study was to describe the function of the forearm in untreated patients in order to facilitate comparison with studies of the results of treatment of this condition. METHODS: The medical records of fifty-one pediatric patients were identified and served as the basis for identifying a cohort of adult relatives with the disorder. Participants were asked about pain and limitations in vocational or recreational activities and about concerns with regard to cosmetic appearance. Radiographs of the forearm and wrist were made to quantify the deformity. Functional outcome was assessed on the basis of a comparison with the norms for grip and pinch strength and for scores on the hand function test of Jebsen et al. Limitations in the range of motion of the upper extremities were converted to standard impairment ratings. RESULTS: Participants included twenty-two men and seventeen women with an average age of forty-two years (range, twenty to eighty years). Most of the patients were employed in careers of their choice, with only five (13%) indicating that they were limited in any way in the performance of their jobs. Twenty-six subjects (67%) participated in recreational activities, and sixty-eight arms (88%) were reported to be free of pain. Objective measurement of function demonstrated greater disability than that found from subjective reporting. Fourteen arms had an impairment rating of >10%, while twenty had decreased pinch strength and sixteen had decreased grip strength. Ten arms (13%) had decreased hand function according to the hand test of Jebsen et al. Radiographic evaluation demonstrated osteoarthritic changes in three limbs. CONCLUSIONS: Affected individuals had definite decreases in hand and wrist function, yet these did not result in major increases in pain or in limitations in daily work and recreation. This cohort provides a basis for comparison with the results of operative treatment in affected individuals with multiple hereditary osteochondromatosis.