Asunto(s)
Neoplasias Óseas , Calcáneo , Calcinosis , Lipoma , Humanos , Lipoma/diagnóstico por imagen , Lipoma/diagnóstico , Lipoma/patología , Calcáneo/diagnóstico por imagen , Calcáneo/patología , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Calcinosis/diagnóstico por imagen , Calcinosis/diagnóstico , Calcinosis/patología , Imagen por Resonancia Magnética/métodos , Femenino , Masculino , Quistes Óseos/diagnóstico por imagen , Quistes Óseos/diagnósticoRESUMEN
Tenosynovial giant cell tumour (TGCT) encompasses a group of lesions that present with synovial differentiation and most commonly occur in the joint synovium, bursae, and tendon sheaths. Diffuse-type TGCT (Dt-TGCT), previously known as pigmented villonodular synovitis, is one of the most common benign soft-tissue tumours of the foot and ankle and usually affects young adults. The differential diagnosis of Dt-TGCTs remains a clinical problem because their clinical symptoms are similar to those of inflammatory arthritis, including rheumatoid arthritis. Moreover, persistent Dt-TGCTs can lead to articular deterioration, including osseous erosions and subchondral bone cysts. Joint-preserving procedures are considered optimal for treating younger patients with ankle osteoarthritis because the indication of ankle arthrodesis and total ankle arthroplasty is limited. Thus, ankle distraction arthroplasty could be an alternative for treating Dt-TGCT with articular deterioration in young patients. Here, we report about a woman in her early 30s who presented with ankle pain owing to a Dt-TGCT with an articular cartilage defect and subchondral bone cysts. We performed ankle distraction arthroplasty combined with an autologous bone graft. A follow-up examination at 2 years revealed preservation of physical function and pain alleviation. These findings suggest that distraction arthroplasty is a viable treatment option for remedying the destruction of the articular cartilage and subchondral bone owing to Dt-TGCTs in young adults.
Asunto(s)
Quistes Óseos , Cartílago Articular , Tumor de Células Gigantes de las Vainas Tendinosas , Sinovitis Pigmentada Vellonodular , Femenino , Adulto Joven , Humanos , Sinovitis Pigmentada Vellonodular/diagnóstico , Sinovitis Pigmentada Vellonodular/cirugía , Cartílago Articular/cirugía , Cartílago Articular/patología , Trasplante Óseo , Tumor de Células Gigantes de las Vainas Tendinosas/diagnóstico , Tumor de Células Gigantes de las Vainas Tendinosas/cirugía , Tumor de Células Gigantes de las Vainas Tendinosas/patología , Artroplastia , Quistes Óseos/diagnóstico , Quistes Óseos/cirugía , Dolor/cirugíaRESUMEN
BACKGROUND: The intraosseous ganglia is a benign cyst, rarely locate in the olecranon process. As intraosseous ganglia can mimic malignant bone tumor, computed tomography (CT) is important for diagnosis even when magnetic resonance imaging (MRI) suggests malignant bone tumor, such as chondrosarcoma. CASE PRESENTATION: In this paper, we report a 42-year-old woman with intraosseous ganglia in the olecranon process of the ulna. She complained pain in right elbow for 3 weeks. MRI revealed an intraosseous mass which initially diagnosed as chondrosarcoma. However, followed computed tomography (CT) demonstrated scattered intralesional gas and no underlying mineralization, and we can exclude chondrosarcoma from diagnosis. CONCLUSIONS: The intraosseous ganglia can mimic bone tumor in MRI; therefore, CT is essential for accurate characterization of bone tumor. Even if MR imaging strongly suggests chondrosarcoma of the bone, CT should be performed as additional study.
Asunto(s)
Quistes Óseos/diagnóstico , Neoplasias Óseas/diagnóstico , Condrosarcoma/líquido cefalorraquídeo , Imagen por Resonancia Magnética/métodos , Adulto , Condrosarcoma/diagnóstico , Femenino , Humanos , Tomografía Computarizada por Rayos X/métodosRESUMEN
INTRODUCTION: when faced with a chronic digital injury, the differential diagnosis between osteomyelitis or primary tumor is raised. Coexistence between osteomyelitis and epidermoid bone cyst is not uncommon. MATERIAL AND METHODS: in this article, we describe two cases of epidermoid cysts in distal phalanx of the hand associated with osteomyelitis and a review of the literature is presented. RESULTS: both osteomyelitis and epidermoid bone cyst have been related to the presence of previous trauma at the site of the lesion, nail alterations and chronic phlogotic signs, so it is important to reach a diagnosis of certainty through an anatomopathological study and to perform a good surgical debridement to ensure the healing of both entities. CONCLUSIONS: surgical debridement associated with curettage and filling of the bone defect with bone substitute with antibiotic is a good therapeutic option in the treatment of these lesions.
INTRODUCCIÓN: ante una herida crónica a nivel digital se plantea el diagnóstico diferencial entre osteomielitis o tumor primario. No es infrecuente la coexistencia entre osteomielitis y quiste óseo epidermoide. MATERIAL Y MÉTODOS: en este artículo describimos dos casos de quistes epidermoides en falange distal de la mano asociados a osteomielitis y se presenta una revisión de la literatura. RESULTADOS: tanto la osteomielitis como el quiste óseo epidermoide se han relacionado con la presencia de un traumatismo previo en el sitio de la lesión, alteraciones ungueales y signos flogóticos crónicos, por lo que es importante llegar a un diagnóstico certero mediante un estudio anatomopatológico y realizar un buen desbridamiento quirúrgico que asegure la curación de ambas entidades. CONCLUSIONES: el desbridamiento quirúrgico asociado a curetaje y relleno del defecto óseo con sustituto óseo por medio de antibiótico es una buena opción terapéutica en el tratamiento de estas lesiones.
Asunto(s)
Quistes Óseos , Quiste Epidérmico , Falanges de los Dedos de la Mano , Osteomielitis , Humanos , Quiste Epidérmico/complicaciones , Quiste Epidérmico/diagnóstico , Quiste Epidérmico/cirugía , Osteomielitis/diagnóstico , Osteomielitis/terapia , Antibacterianos/uso terapéutico , Quistes Óseos/diagnóstico , Quistes Óseos/tratamiento farmacológicoRESUMEN
Aneurysmal (ABC) and simple bone cysts (SBC) have been traditionally distinguished by radiological and histopathological features. However, there is some radiological and histopathological overlap between ABC and SBC. ABC is characterised by USP6 fusions while, recently, NFATC2 fusions have been found in a large proportion of SBC. Identifying these fusions may assist in confirming the diagnosis of either ABC or SBC. To elaborate the potential benefit of molecular testing, we report a prospective series of 19 consecutive bone cysts with comprehensive radiological, histopathological and molecular diagnostics. Integrating radiological, histopathological and molecular findings, 11 cysts were diagnosed as SBC and 8 as ABC. Radiologically, 6 of 11 SBC and 6 of 8 ABC were diagnosed as ABC. Fibrin-like collagen deposits were identified in 8 of 11 (73%) SBC and 3 of 8 (38%) ABC. Nodular fasciitis-like areas were identified in 6 of 8 (75%) ABC and in 7 of 11 (64%) SBC. A USP6 fusion was identified in all 8 ABC, including a novel RBM5-USP6 fusion. An NFATC2 fusion was found in 7 of 11 SBC (FUS-NFATC2 fusion in 5 and EWSR1-NFATC2 in 2 cases). There is radiological and histopathological overlap between SBC and ABC in a significant proportion of cases. A diagnosis of ABC is frequently suggested radiologically in SBC, and fibrin-like deposits, thought to be specific for SBC, may be found in some ABC. Molecular testing may significantly improve diagnostic accuracy in bone cysts.
Asunto(s)
Quistes Óseos Aneurismáticos/diagnóstico , Quistes Óseos/diagnóstico , Adolescente , Adulto , Quistes Óseos/metabolismo , Quistes Óseos Aneurismáticos/metabolismo , Proteínas de Ciclo Celular/metabolismo , Niño , Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Fascitis/patología , Femenino , Fusión Génica/fisiología , Humanos , Hibridación Fluorescente in Situ/métodos , Masculino , Persona de Mediana Edad , Factores de Transcripción NFATC/genética , Factores de Transcripción NFATC/metabolismo , Patología Molecular/métodos , Regiones Promotoras Genéticas/genética , Estudios Prospectivos , Proteínas de Unión al ARN/metabolismo , Proteínas Supresoras de Tumor/metabolismo , Ubiquitina Tiolesterasa/genética , Ubiquitina Tiolesterasa/metabolismoRESUMEN
Bone tumors of the foot are an uncommon finding. Most tumors are found incidentally on imaging and are benign. Care must be taken although due to the aggressive nature of malignant bone tumors that can occur in the calcaneus. Malignant lesions will more commonly present with symptoms of pain and swelling. Often misdiagnosed as soft tissue injuries, it is critical to be able to diagnose and treat these lesions early. Imaging plays an important role with plain films and advanced imaging. Surgical treatments can range from curettage with grafting to amputation for more aggressive lesions.
Asunto(s)
Quistes Óseos/diagnóstico , Quistes Óseos/terapia , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/terapia , Calcáneo , Calcáneo/cirugía , Condroblastoma/diagnóstico , Condroblastoma/terapia , Condroma/diagnóstico , Condroma/terapia , Condrosarcoma/diagnóstico , Condrosarcoma/terapia , Ganglión/diagnóstico , Ganglión/terapia , Tumor Óseo de Células Gigantes/diagnóstico , Tumor Óseo de Células Gigantes/terapia , Humanos , Lipoma/diagnóstico , Lipoma/terapia , Osteoblastoma/diagnóstico , Osteoblastoma/terapia , Osteocondroma/diagnóstico , Osteocondroma/terapia , Osteoma/diagnóstico , Osteoma/terapia , Osteosarcoma/diagnóstico , Osteosarcoma/terapia , Sarcoma de Ewing/diagnóstico , Sarcoma de Ewing/terapiaRESUMEN
Giant cell tumor of bone is extremely rare in the talus and is usually observed in the third decade of life. Herein, we report a case of a 19-year-old male with a giant cell tumor of bone in the talus mimicking a simple bone cyst that was treated by intralesional curettage and, for the first time, bone grafting with a synthetic bone substitute. The patient had no evidence of recurrence at 7-year follow-up but did have non-progressing mild degenerative joint disease and slightly limited range of movement at the ankle joint.
Asunto(s)
Sustitutos de Huesos/uso terapéutico , Tumor Óseo de Células Gigantes , Procedimientos Ortopédicos , Osteoartritis , Complicaciones Posoperatorias , Astrágalo , Quistes Óseos/diagnóstico , Neoplasias Óseas/diagnóstico , Neoplasias Óseas/patología , Neoplasias Óseas/cirugía , Trasplante Óseo , Legrado/métodos , Diagnóstico Diferencial , Tumor Óseo de Células Gigantes/diagnóstico , Tumor Óseo de Células Gigantes/patología , Tumor Óseo de Células Gigantes/cirugía , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Procedimientos Ortopédicos/efectos adversos , Procedimientos Ortopédicos/métodos , Osteoartritis/diagnóstico , Osteoartritis/etiología , Osteoartritis/fisiopatología , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/fisiopatología , Rango del Movimiento Articular , Astrágalo/diagnóstico por imagen , Astrágalo/patología , Astrágalo/cirugía , Resultado del Tratamiento , Adulto JovenRESUMEN
RATIONALE: Peroneal neuropathy is the most common type of peripheral neuropathy in the lower extremities. The peroneal nerve is usually compressed at the lateral aspect of the fibular head. Compression by ganglion cysts are one of the numerous underlying etiologies for peroneal nerve neuropathy and are most frequently located around the fibular neck and proximal tibiofibular joint. To the best of our knowledge, this is the first report of an extraneural ganglion cyst located at the level of the distal thigh that resulted in compressive peroneal neuropathy. PATIENT CONCERNS: We report a case of a 56-year-old man with sudden onset of left foot drop and gait disturbance caused by an extraneural ganglion cyst located in the popliteal fossa. DIAGNOSIS: Electrodiagnosis (EDX) suggested a peroneal nerve lesion. Subsequently, diagnostic ultrasonography (USG) revealed a cystic mass located within the left side of the supracondylar area of femur. Further magnetic resonance imaging confirmed that the mass was located at the proximal of popliteal fossa. INTERVENTIONS: Surgical excision was performed using a direct posterior approach. The cystic mass was compressing the common peroneal nerve, and was carefully and completely removed ensuring that all nerve branches were protected. OUTCOMES: A histopathologic evaluation confirmed the diagnosis of a ganglion cyst. There were no postoperative complications. Two months after the surgery, follow-up USG revealed no evidence of cyst recurrence or residual lesions. Six months after the surgery, the ankle dorsiflexor motor power improved and he experienced less pain and hypoesthesia. LESSONS: Physicians should bear in mind that the peroneal neuropathy can occur because of the ganglion cyst in the distal thigh. The thorough evaluation of EDX and USG is crucial for the early diagnosis and surgical intervention, although there is no abnormal finding around the fibular neck.
Asunto(s)
Quistes Óseos/complicaciones , Quistes Óseos/diagnóstico , Fémur , Ganglión/complicaciones , Ganglión/diagnóstico , Neuropatías Peroneas/etiología , Quistes Óseos/cirugía , Ganglión/cirugía , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Simple bone cysts (SBCs) are common benign lytic bone lesions in children. This study focused on exploring a clinical treatment method, minimally invasive intramedullary decompression and drainage with elastic stable intramedullary nailing (ESIN) combined with intralesional injections of steroids, and evaluated its effectiveness, complications and morbidity through functional and radiographic outcomes. METHODS: The postoperative recovery of 18 children who suffered from SBCs of humerus was evaluated (mean follow-up, 40 months) from January 2009 to December 2016. These patients (11 males, 7 females; 8 in the left, 10 in the right; mean age, 10.9 years old) were treated with minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids. The diagnosis was based on not only pre-operative typical medical images (X-rays/CT/MRI) but also surgical findings and pathological diagnosis. Radiological and functional outcomes were evaluated according to Capanna and Musculoskeletal Tumor Society (MSTS) score. The interclass differences were analyzed by t-test. RESULTS: According to Capanna and MSTS criteria, after treatment, 14 patients made full recoveries which was presented by all the cysts filled with bone tissue, and 4 patients made partially recoveries, which were presented by cystic spaces partially filled with low density bone. All the cysts responded to treatment method, and there was no cyst recurrence. All except 2 patients had good functional results. One of the two patients had irritation of the end of the nail and one patient had a valgus deformity. CONCLUSIONS: Treatment for SBCs of humerus by minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids is safe, effective and convenient. The clinical effect is satisfactory and worth popularizing.
Asunto(s)
Quistes Óseos/terapia , Descompresión Quirúrgica/instrumentación , Drenaje/instrumentación , Glucocorticoides/administración & dosificación , Húmero/patología , Procedimientos Quirúrgicos Mínimamente Invasivos/instrumentación , Adolescente , Quistes Óseos/diagnóstico , Quistes Óseos/patología , Clavos Ortopédicos/efectos adversos , Niño , Terapia Combinada/efectos adversos , Terapia Combinada/instrumentación , Terapia Combinada/métodos , Descompresión Quirúrgica/efectos adversos , Descompresión Quirúrgica/métodos , Drenaje/efectos adversos , Drenaje/métodos , Femenino , Estudios de Seguimiento , Humanos , Húmero/diagnóstico por imagen , Húmero/efectos de los fármacos , Húmero/cirugía , Inyecciones Intralesiones , Imagen por Resonancia Magnética , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/efectos adversos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
This paper is a commentary on the article entitled "Nomenclature of Subchondral Nonneoplastic Bone.Lesions1" by Gorbachova, Amber, Beckmann, Bennett, Chang, Davis, Gonzalez, Hansford, Howe, Lenchik, Winalski, and Bredella. The purpose of this commentary is to provide an orthopaedic perspective on the aforementioned article and critique their analysis and proposal regarding nomenclature of subchondral bone lesions. It provides an overview and a section by section evaluation of a well-designed and executed article.
Asunto(s)
Enfermedades Óseas/clasificación , Enfermedades Óseas/diagnóstico , Cartílago Articular/patología , Terminología como Asunto , Quistes Óseos/clasificación , Quistes Óseos/diagnóstico , HumanosRESUMEN
A simple bone cyst is a tumor-like lesion that is not a true neoplasm. It usually presents as a solitary lesion within the proximal humerus and proximal femur. The etiology of simple bone cysts is still to be elucidated. We describe our experience in the successful surgical management of a rare case of two, large-sized, simple bone cysts involving the entire left humerus and right femoral head, respectively, in a 34-year-old male patient with Wilson's disease and concomitant hepatic cirrhosis. We theorized that Wilson's disease could be the cause of the delay or blockage of the natural healing process of the simple long-bone cysts, leading to their abnormal growth and development. To our knowledge, such a combined occurrence of multiple, simple long-bone cysts and Wilson's disease has not been reported in the literature to date.
Asunto(s)
Quistes Óseos/diagnóstico , Quistes Óseos/cirugía , Fémur , Degeneración Hepatolenticular/complicaciones , Húmero , Adulto , Quistes Óseos/etiología , Epífisis , Degeneración Hepatolenticular/diagnóstico por imagen , Humanos , MasculinoRESUMEN
RATIONALE: In the recent years, growing interest is focused on the use of platelet-rich plasma (PRP) in wound healing and tissue regeneration. There are a number of papers regarding the usefulness of PRP in the healing of ulcerations, skin injures, bone loss or distraction osteogenesis. Most authors emphasize the safety of PRP usage due to its authogenic nature. PATIENT CONCERNS: We present a case of a 14 -year-old boy admitted to our department due to simple bone cyst of the distal tibia, qualified for injection of PRP into the cyst. PRP was separated with the use of Magellan Autologous Platelet Separator System (Arteriocyte Medical Systems Hopkington, MA) according to the manufacturers' manual. Immediately after separation during short-term IV anaesthesia, 3 mL of PRP was installed to the bone cyst under image intensifier control. DIAGNOSES: Within the first 24âhours after exposure to PRP, the skin rash appeared. Physical examination revealed the small red papular, regionally purpuric eruptions, mainly concentrated on the upper extremities and on more warmed regions of skin, in association with pharyngitis, tonsillar enlargement, mucopurulent discharge in the posterior pharynx and swelling of the eyelids. INTERVENTIONS: As the patient received calcium citrate with the PRP injection additional calcium citrate test were performed. Skin prick testing (negative) was and an intradermal test was positive (10×13âmm). Treatment included Claritine (Loratidinum) and Clemastin (Clemastinum)-both antihistaminic drugs. OUTCOMES: All symptoms withdrew and the patient was released home after 4 days. The patient is in 6 years follow-up without any symptoms of allergic disease. LESSONS: Our case shows that safety of use of PRP is not absolutely sure. The pure autologous tissue is safe, but preparation for its use can substantially decrease this safety. In our patient, only limited skin reaction to calcium citrate was observed, but general reaction leading to anaphylactic shock cannot be excluded. In order to reduce the risk of side effects skin test should be performed but as there were no records of allergic diseases on family and patients medical history this should apply to all patients.
Asunto(s)
Antialérgicos/administración & dosificación , Quistes Óseos , Edema , Exantema , Párpados , Tibia , Adolescente , Quistes Óseos/diagnóstico , Quistes Óseos/terapia , Regeneración Ósea/fisiología , Edema/diagnóstico , Edema/tratamiento farmacológico , Edema/etiología , Exantema/diagnóstico , Exantema/tratamiento farmacológico , Exantema/etiología , Humanos , Hipersensibilidad/diagnóstico , Hipersensibilidad/tratamiento farmacológico , Hipersensibilidad/etiología , Inyecciones Intralesiones/efectos adversos , Inyecciones Intralesiones/métodos , Masculino , Plasma Rico en Plaquetas , Pruebas Cutáneas/métodos , Tibia/diagnóstico por imagen , Tibia/patología , Resultado del TratamientoRESUMEN
Bone cysts in the pediatric population are often found incidentally on radiographs or after a cyst has created cortical weakness leading to a pathologic fracture. Most bone cysts are benign, are pain free, and resolve spontaneously. The most common bone cyst is unicameral 1-chamber bone cyst, also known as simple bone cyst. General practice pediatricians may be the first to encounter these lesions, and this article aims to help elucidate their incidence, etiology, clinical findings, radiologic findings, and modern treatment approaches. The other differential diagnoses that should be considered, specifically, aneurysmal bone cyst, are also explored. This summary is not all inclusive, and it is recommended that all patients be referred to a pediatric orthopedist.
Asunto(s)
Quistes Óseos/diagnóstico , Quistes Óseos/etiología , Quistes Óseos/terapia , Huesos/patología , Niño , Diagnóstico Diferencial , HumanosRESUMEN
Background: Cystic lesions of the carpal bones are rare entities that are infrequently reported in the literature. Scaphoid intraosseous cystic lesions represent a rare subset of carpal bone cysts. This review aims to summarize the available evidence on the evaluation and treatment of scaphoid cystic lesions to help guide clinical management. Methods: Systematic electronic searches were performed using PubMed, Ovid, and Embase databases. Studies included were graded for their risk of bias. Pooled descriptive statistics were performed on incidence, etiology, physical exam findings, treatment, and follow-up. Results: A total of 38 patients representing 41 scaphoid cystic lesions were pooled from 27 articles. Patients presented with wrist pain without fracture (n = 27), pathological fracture (n = 9), swelling only (n = 1), or were asymptomatic (n = 4). Cystic lesions of the scaphoid were initially revealed on imaging with radiographs alone (n = 22), radiographs in combination with computed tomography (CT) (n = 10) or magnetic resonance imaging (n = 6), CT alone (n = 1), or using all 3 modalities (n = 2). Intraosseous ganglia were identified most frequently (n = 31), followed by "bone cyst-like pathological change" (n = 3), unicameral bone cysts (n = 2), aneurysmal bone cysts (n = 2), primary hydatid cysts (n = 2), and cystic like changes post fall (n = 1). Treatment modalities included curettage and bone graft (n = 39) or below-elbow cast (n = 2). On follow-up (average of 21.3 months; n = 40), all patients improved clinically after treatment and were found to have full wrist range of motion without pain (n = 31), slightly reduced grip strength (n = 3), limited range of motion (n = 2), or persistent mild discomfort (n = 2). Conclusions: Scaphoid cystic lesions are most commonly intraosseous ganglia, but can include other etiologies as well. The main presenting symptom is radial wrist pain that usually resolves after treatment. The presence of intracarpal cystic lesions should be considered in the differential diagnosis of wrist pain.
Asunto(s)
Quistes Óseos/etiología , Quistes Óseos/terapia , Hueso Escafoides/patología , Adolescente , Adulto , Artralgia/diagnóstico , Quistes Óseos/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Articulación de la Muñeca/patología , Adulto JovenRESUMEN
BACKGROUND: Periprosthetic cystic osteolysis is a well-known complication of total ankle replacement. Several theories have been proposed for its aetiology, based on individual biomechanical, radiological, histopathology and outcome studies. METHODS: Studies that met predefined inclusion/exclusion criteria were analysed to identify literature describing the presence of peri-prosthetic ankle cystic osteolysis. Quantitative data from the selected articles were combined and statistically tested in order to analyse possible relations between ankle peri-prosthetic bone cysts and specific implant characteristics. RESULTS: Twenty-one articles were elected, totalizing 2430 total ankle replacements, where 430 developed peri-prosthetic cystic osteolysis. A statistically significant association (P<.001) was found between the presence of bone cysts and non-anatomic implant configuration, hydroxyapatite-coating, mobile-bearing and non tibial-stemmed implants. No significant association existed between the type of constraining and the presence of cysts (P>.05). CONCLUSIONS: Non-anatomic, mobile-bearing, hydroxyapatite-coated and non tibial-stemmed total ankle replacements are positively associated with more periprosthetic bone cysts.
Asunto(s)
Articulación del Tobillo/cirugía , Artroplastia de Reemplazo de Tobillo/efectos adversos , Quistes Óseos/etiología , Prótesis Articulares/efectos adversos , Complicaciones Posoperatorias , Articulación del Tobillo/diagnóstico por imagen , Quistes Óseos/diagnóstico , Quistes Óseos/cirugía , Humanos , Tomografía Computarizada por Rayos XRESUMEN
Unicameral bone cysts (UBC) are benign bone tumor-like lesions. Mostly they are located in the metaphyseal-diaphyseal region of long bones in children and adolescents. The etiology of UBC is still unclear. There is no consensus about the protocol of UBC treatment. The aim of this study was to evaluate the effectiveness of three different techniques for the treatment of UBC. This study included 129 pediatric patients with UBC treated at University Children's Hospital in Belgrade during the 8-year period. The mean follow up was 7.14 years. The following parameters were observed: gender, age, site, length of cyst, cyst index, cortical thickness, presentation of pathologic fracture, healing of cyst, treatment complications and length of hospitalization. These parameters were correlated to three treatment modalities, i.e. intracystic methylprednisolone acetate injection (group 1), curettage with bone grafting (group 2) and osteoinductive procedure using demineralized bone matrix (group 3). We found statistically significant differences in healing of the cysts and length of hospital treatment between groups 1 and 2, and between groups 2 and 3. In conclusion, complete healing of UBC can be achieved only using open surgery procedure. Intracystic methylprednisolone acetate instillation can be considered a good option for initial treatment of UBC.
Asunto(s)
Quistes Óseos , Trasplante Óseo/métodos , Dentina/trasplante , Fracturas Espontáneas , Acetato de Metilprednisolona/administración & dosificación , Adolescente , Quistes Óseos/complicaciones , Quistes Óseos/diagnóstico , Quistes Óseos/epidemiología , Quistes Óseos/terapia , Regeneración Ósea , Niño , Croacia/epidemiología , Femenino , Fracturas Espontáneas/diagnóstico , Fracturas Espontáneas/etiología , Glucocorticoides/administración & dosificación , Humanos , Inyecciones Intralesiones , Masculino , Evaluación de Procesos y Resultados en Atención de SaludRESUMEN
Epiphyseal pseudotumor secondary to osteoarthritis are rare in patients under 50 years. We report here the case of a 48-year-old woman who complained of pain in the medial side of the left knee for three years. X-rays of the left knee showed a large lytic lesion containing multiple septae, with sclerotic margins at the upper end of the tibia, associated with knee osteoarthritis. An epiphyseal tumor of the left tibia was suspected. CT scan of the left knee concluded in a giant subchondral cyst secondary to osteoarthritis. Subchondral cysts or geodes are a common finding in patients with knee osteoarthritis. Nevertheless, some unusual aspects of the lesions may lead to diagnosis difficulties.
Asunto(s)
Granuloma de Células Plasmáticas/diagnóstico , Placa de Crecimiento/patología , Osteoartritis de la Rodilla/complicaciones , Osteoartritis de la Rodilla/diagnóstico , Tibia/patología , Quistes Óseos/diagnóstico , Diagnóstico Diferencial , Femenino , Granuloma de Células Plasmáticas/etiología , Granuloma de Células Plasmáticas/patología , Placa de Crecimiento/diagnóstico por imagen , Humanos , Rodilla/diagnóstico por imagen , Rodilla/patología , Persona de Mediana Edad , Radiografía , Tibia/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
This article includes a comprehensive and up-to-date review on the cysts of the oral cavity. Several classifications of odontogenic (OC) and non-odontogenic (non-OC) oral cysts and the surrounding regions have been proposed. We suggest a new critical classification based on an established relationship between anatomical area, histological origin and clinical behavior (frequency, rate of recurrence, malignant potential). Moreover, the differential cytokeratin (CKs) expression of the various cysts is reported as epithelium-specific markers of differential diagnosis. Finally, issues related to differential diagnosis and therapeutic approaches of the cysts included in the two groups are described.