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1.
J Bone Miner Res ; 35(10): 2070-2081, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33463757

RESUMO

Craniometaphyseal dysplasia (CMD), a rare genetic bone disorder, is characterized by lifelong progressive thickening of craniofacial bones and metaphyseal flaring of long bones. The autosomal dominant form of CMD is caused by mutations in the progressive ankylosis gene ANKH (mouse ortholog Ank), encoding a pyrophosphate (PPi) transporter. We previously reported reduced formation and function of osteoblasts and osteoclasts in a knockin (KI) mouse model for CMD (AnkKI/KI) and in CMD patients. We also showed rapid protein degradation of mutant ANK/ANKH. Mutant ANK protein displays reduced PPi transport, which may alter the inorganic phosphate (Pi) and PPi ratio, an important regulatory mechanism for bone mineralization. Here we investigate whether reducing dietary Pi intake can ameliorate the CMD-like skeletal phenotype by comparing male and female Ank+/+ and AnkKI/KI mice exposed to a low (0.3%) and normal (0.7%) Pi diet for 13 weeks from birth. Serum Pi and calcium (Ca) levels were not significantly changed by diet, whereas PTH and 25-hydroxy vitamin D (25-OHD) were decreased by low Pi diet but only in male Ank+/+ mice. Importantly, the 0.3% Pi diet significantly ameliorated mandibular hyperostosis in both sexes of AnkKI/KI mice. A tendency of decreased femoral trabeculation was observed in male and female Ank+/+ mice as well as in male AnkKI/KI mice fed with the 0.3% Pi diet. In contrast, in female AnkKI/KI mice the 0.3% Pi diet resulted in increased metaphyseal trabeculation. This was also the only group that showed increased bone formation rate. Low Pi diet led to increased osteoclast numbers and increased bone resorption in all mice. We conclude that lowering but not depleting dietary Pi delays the development of craniofacial hyperostosis in CMD mice without severely compromising serum levels of Pi, Ca, PTH, and 25-OHD. These findings may have implications for better clinical care of patients with CMD. © 2020 American Society for Bone and Mineral Research.


Assuntos
Dieta , Hiperostose/terapia , Fosfatos/administração & dosagem , Animais , Doenças do Desenvolvimento Ósseo , Anormalidades Craniofaciais , Modelos Animais de Doenças , Feminino , Técnicas de Introdução de Genes , Humanos , Hipertelorismo , Masculino , Camundongos , Proteínas de Transporte de Fosfato/genética
2.
World Neurosurg ; 128: 37-46, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31048045

RESUMO

BACKGROUND: Intracranial meningiomas are brain tumors that have probably been known the longest, largely because of the occasional production of grotesque cranial deformities that have attracted the attention and interest of humankind. Because of the tendency of some intracranial meningiomas to cause skull deformation and thickening, these tumors have given rise to various speculations and theories related to their origin, starting in prehistoric times up to the present. METHODS: From the Steinheim skull and "pharaonic meningiomas" to the first meningioma monograph and the first explanations of Harvey Cushing regarding the mechanism of hyperostosis, this review aims to weave again the story of Arachne. We identify the main contributors who have tried to understand and explain the tendency of some of these tumors to cause hyperostosis or other skull bone involvements. CONCLUSIONS: The contribution of neurosurgeons or pathologists over the centuries is of undeniable importance and is the basis for understanding future molecular mechanisms.


Assuntos
Hiperostose/história , Neoplasias Meníngeas/história , Meningioma/história , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , Humanos , Hiperostose/complicações , Hiperostose/terapia , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/terapia , Meningioma/complicações , Meningioma/terapia , Crânio/patologia
3.
J Bone Miner Res ; 31(10): 1845-1854, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27164190

RESUMO

Familial tumoral calcinosis (FTC)/hyperostosis-hyperphosphatemia syndrome (HHS) is a rare disorder caused by mutations in the genes encoding fibroblast growth factor-23 (FGF23), N-acetylgalactosaminyltransferase 3 (GALNT3), or KLOTHO. The result is functional deficiency of, or resistance to, intact FGF23 (iFGF23), causing hyperphosphatemia, increased renal tubular reabsorption of phosphorus (TRP), elevated or inappropriately normal 1,25-dihydroxyvitamin D3 (1,25D), ectopic calcifications, and/or diaphyseal hyperostosis. Eight subjects with FTC/HHS were studied and treated. Clinical manifestations varied, even within families, ranging from asymptomatic to large, disabling calcifications. All subjects had hyperphosphatemia, increased TRP, and elevated or inappropriately normal 1,25D. C-terminal FGF23 was markedly elevated whereas iFGF23 was comparatively low, consistent with increased FGF23 cleavage. Radiographs ranged from diaphyseal hyperostosis to massive calcification. Two subjects with severe calcifications also had overwhelming systemic inflammation and elevated C-reactive protein (CRP). GALNT3 mutations were identified in seven subjects; no causative mutation was found in the eighth. Biopsies from four subjects showed ectopic calcification and chronic inflammation, with areas of heterotopic ossification observed in one subject. Treatment with low phosphate diet, phosphate binders, and phosphaturia-inducing therapies was prescribed with variable response. One subject experienced complete resolution of a calcific mass after 13 months of medical treatment. In the two subjects with systemic inflammation, interleukin-1 (IL-1) antagonists significantly decreased CRP levels with resolution of calcinosis cutis and perilesional inflammation in one subject and improvement of overall well-being in both subjects. This cohort expands the phenotype and genotype of FTC/HHS and demonstrates the range of clinical manifestations despite similar biochemical profiles and genetic mutations. Overwhelming systemic inflammation has not been described previously in FTC/HHS; the response to IL-1 antagonists suggests that anti-inflammatory drugs may be useful adjuvants. In addition, this is the first description of heterotopic ossification reported in FTC/HHS, possibly mediated by the adjacent inflammation. © 2016 American Society for Bone and Mineral Research.


Assuntos
Calcinose , Fatores de Crescimento de Fibroblastos/genética , Glucuronidase/genética , Hiperostose Cortical Congênita , Hiperostose , Hiperfosfatemia , N-Acetilgalactosaminiltransferases/genética , Adolescente , Adulto , Calcinose/sangue , Calcinose/genética , Calcinose/patologia , Calcinose/terapia , Criança , Estudos de Coortes , Feminino , Fator de Crescimento de Fibroblastos 23 , Humanos , Hiperostose/sangue , Hiperostose/genética , Hiperostose/patologia , Hiperostose/terapia , Hiperostose Cortical Congênita/sangue , Hiperostose Cortical Congênita/genética , Hiperostose Cortical Congênita/patologia , Hiperostose Cortical Congênita/terapia , Hiperfosfatemia/sangue , Hiperfosfatemia/genética , Hiperfosfatemia/patologia , Hiperfosfatemia/terapia , Proteínas Klotho , Masculino , Polipeptídeo N-Acetilgalactosaminiltransferase
5.
Endocrine ; 52(3): 414-26, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26892377

RESUMO

During the past 15 years there has been an expansion of our knowledge of the cellular and molecular mechanisms regulating bone remodeling that identified new signaling pathways fundamental for bone renewal as well as previously unknown interactions between bone cells. Central for these developments have been studies of rare bone disorders. These findings, in turn, have led to new treatment paradigms for osteoporosis some of which are at late stages of clinical development. In this article, we review three rare skeletal disorders with case descriptions, pycnodysostosis and the craniotubular hyperostoses sclerosteosis and van Buchem disease that led to the development of cathepsin K and sclerostin inhibitors, respectively, for the treatment of osteoporosis.


Assuntos
Doenças Ósseas/etiologia , Doenças Ósseas/terapia , Descoberta de Drogas , Osteoporose/terapia , Remodelação Óssea/fisiologia , Descoberta de Drogas/métodos , Humanos , Hiperostose/etiologia , Hiperostose/terapia , Osteocondrodisplasias/etiologia , Osteocondrodisplasias/terapia , Osteoporose/etiologia , Doenças Raras , Sindactilia/etiologia , Sindactilia/terapia
8.
Rheum Dis Clin North Am ; 39(4): 735-49, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24182852

RESUMO

Autoinflammatory bone disease is a new branch of autoinflammatory diseases caused by seemingly unprovoked activation of the innate immune system leading to an osseous inflammatory process. The inflammatory bone lesions in these disorders are characterized by chronic inflammation that is typically culture negative with no demonstrable organism on histopathology. The most common autoinflammatory bone diseases in childhood include chronic nonbacterial osteomyelitis (CNO), synovitis, acne, pustulosis, hyperostosis, osteitis syndrome, Majeed syndrome, deficiency of interleukin-1 receptor antagonist, and cherubism. In this article, the authors focus on CNO and summarize the distinct genetic autoinflammatory bone syndromes.


Assuntos
Doenças Ósseas/imunologia , Doenças Hereditárias Autoinflamatórias/imunologia , Acne Vulgar/diagnóstico , Acne Vulgar/imunologia , Acne Vulgar/terapia , Síndrome de Hiperostose Adquirida/diagnóstico , Síndrome de Hiperostose Adquirida/imunologia , Síndrome de Hiperostose Adquirida/terapia , Anemia Diseritropoética Congênita/diagnóstico , Anemia Diseritropoética Congênita/imunologia , Anemia Diseritropoética Congênita/terapia , Doenças Ósseas/diagnóstico , Doenças Ósseas/terapia , Querubismo/diagnóstico , Querubismo/imunologia , Querubismo/terapia , Doença Crônica , Doenças Hereditárias Autoinflamatórias/diagnóstico , Doenças Hereditárias Autoinflamatórias/terapia , Humanos , Hiperostose/diagnóstico , Hiperostose/imunologia , Hiperostose/terapia , Síndromes de Imunodeficiência , Inflamação , Proteína Antagonista do Receptor de Interleucina 1/imunologia , Osteíte/diagnóstico , Osteíte/imunologia , Osteíte/terapia , Osteomielite/diagnóstico , Osteomielite/imunologia , Osteomielite/terapia , Síndrome , Sinovite/diagnóstico , Sinovite/imunologia , Sinovite/terapia
9.
Med Tr Prom Ekol ; (1): 22-4, 2013.
Artigo em Russo | MEDLINE | ID: mdl-23785805

RESUMO

The article covers results of studies concerning time of fluorosis development in patients with signs of connective tissue dysplasia syndrome (CTDS). if compared with patients without CTDS, and of studies concerning hyperostosis coefficient in accordance with presence or absence of CTDS. Efficiency of physical therapy and balneotherapy for these patients are also reported by the authors.


Assuntos
Doenças do Tecido Conjuntivo , Fluoretos Tópicos/intoxicação , Hiperostose , Doenças Profissionais , Exposição Ocupacional/efeitos adversos , Adulto , Balneologia/métodos , Estudos de Coortes , Doenças do Tecido Conjuntivo/epidemiologia , Doenças do Tecido Conjuntivo/etiologia , Doenças do Tecido Conjuntivo/fisiopatologia , Doenças do Tecido Conjuntivo/terapia , Progressão da Doença , Terapia por Exercício/métodos , Humanos , Hiperostose/epidemiologia , Hiperostose/etiologia , Hiperostose/fisiopatologia , Hiperostose/terapia , Masculino , Metalurgia , Doenças Profissionais/epidemiologia , Doenças Profissionais/etiologia , Doenças Profissionais/terapia , Federação Russa/epidemiologia , Índice de Gravidade de Doença , Síndrome , Fatores de Tempo , Resultado do Tratamento , Recursos Humanos , Adulto Jovem
10.
Eur J Nucl Med Mol Imaging ; 38(5): 884-93, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21079950

RESUMO

PURPOSE: (18)F-Fluoride PET/CT is a relatively undervalued diagnostic test to measure bone metabolism in bone diseases. Hyperostosis cranialis interna (HCI) is a (hereditary) bone disease characterised by endosteal hyperostosis and osteosclerosis of the skull and the skull base. Bone overgrowth causes entrapment and dysfunction of several cranial nerves. The aim of this study is to compare standardised uptake values (SUVs) at different sites in order to quantify bone metabolism in the affected anatomical regions in HCI patients. METHODS: Nine affected family members, seven non-affected family members and nine non-HCI non-family members underwent (18)F-fluoride PET/CT scans. SUVs were systematically measured in the different regions of interest: frontal bone, sphenoid bone, petrous bone and clivus. Moreover, the average (18)F-fluoride uptake in the entire skull was measured by assessing the uptake in axial slides. Visual assessment of the PET scans of affected individuals was performed to discover the process of disturbed bone metabolism in HCI. RESULTS: (18)F-Fluoride uptake is statistically significantly higher in the sphenoid bone and clivus regions of affected family members. Visual assessment of the scans of HCI patients is relevant in detecting disease severity and the pattern of disturbed bone metabolism throughout life. CONCLUSION: (18)F-Fluoride PET/CT is useful in quantifying the metabolic activity in HCI and provides information about the process of disturbed bone metabolism in this specific disorder. Limitations are a narrow window between normal and pathological activity and the influence of age. This study emphasises that (18)F-fluoride PET/CT may also be a promising diagnostic tool for other metabolic bone disorders, even those with an indolent course.


Assuntos
Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Fluoretos , Radioisótopos de Flúor , Hiperostose/diagnóstico por imagem , Hiperostose/metabolismo , Tomografia por Emissão de Pósitrons , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Hiperostose/genética , Hiperostose/terapia , Masculino , Pessoa de Meia-Idade , Osteosclerose/diagnóstico por imagem , Osteosclerose/genética , Osteosclerose/metabolismo , Osteosclerose/terapia , Fatores de Tempo , Adulto Jovem
11.
Calcif Tissue Int ; 87(2): 99-107, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20473488

RESUMO

In recent years study of rare human bone disorders has led to the identification of important signaling pathways that regulate bone formation. Such diseases include the bone sclerosing dysplasias sclerosteosis and van Buchem disease, which are due to deficiency of sclerostin, a protein secreted by osteocytes that inhibits bone formation by osteoblasts. The restricted expression pattern of sclerostin in the skeleton and the exclusive bone phenotype of good quality of patients with sclerosteosis and van Buchem disease provide the basis for the design of therapeutics that stimulate bone formation. We review here current knowledge of the regulation of the expression and formation of sclerostin, its mechanism of action, and its potential as a bone-building treatment for patients with osteoporosis.


Assuntos
Proteínas Morfogenéticas Ósseas/metabolismo , Proteínas Adaptadoras de Transdução de Sinal , Proteínas Morfogenéticas Ósseas/genética , Proteínas Morfogenéticas Ósseas/farmacologia , Anormalidades Craniofaciais/metabolismo , Anormalidades Craniofaciais/terapia , Previsões , Marcadores Genéticos/genética , Humanos , Hiperostose/metabolismo , Hiperostose/terapia , Mandíbula/anormalidades , Mandíbula/metabolismo , Osteoblastos/metabolismo , Osteocondrodisplasias , Osteócitos/metabolismo , Osteogênese , Osteosclerose/metabolismo , Osteosclerose/terapia , Transdução de Sinais , Crânio/anormalidades , Crânio/metabolismo , Sindactilia/metabolismo , Sindactilia/terapia
12.
Am J Rhinol Allergy ; 23(6): e23-8, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19769799

RESUMO

BACKGROUND: Nasal congestion is one of the most common complaints dealt with in otorhinolaryngology. Side effects of decongestants are frequently seen in patients with chronic nasal congestion. This leads to an increasing demand of alternative treatments such as acupuncture. Future studies on acupuncture should aim at objectifying effects by both physical measuring and double blinding. Therefore, we were interested in whether these effects can potentially be measured as increase in nasal airflow (NAF) in ventus ("wind") disease of traditional Chinese medicine (TCM). METHODS: Twenty-four patients with a history of nasal congestion due to hypertrophic inferior turbinates or chronic sinusitis without polyposis were additionally diagnosed according to the Heidelberg model of TCM. They were asked to score the severity of their nasal congestion on a visual analog scale (VAS). The acupuncturist was blinded according to the Heidelberg blinding assay. NAF was measured by using active anterior rhinomanometry (ARM). Specific verum acupoints according to the Chinese medical diagnosis were tested against nonspecific control acupoints. VAS and NAF were scored and measured before and 15 and 30 minutes after acupuncture. RESULTS: Control acupuncture showed a significant improvement in VAS and a deterioration of NAF. Verum acupuncture showed highly significant improvements in VAS and NAF. In addition, verum acupuncture improved NAF and VAS significantly over time. CONCLUSION: Our control and verum acupoints fulfill the condition of a control and verum treatment, respectively. Measuring NAF by RRM and scoring VAS are possible and reflect acupuncture effects in vivo.


Assuntos
Terapia por Acupuntura , Hiperostose/terapia , Medicina Tradicional Chinesa , Obstrução Nasal/terapia , Sinusite/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Progressão da Doença , Método Duplo-Cego , Feminino , Humanos , Hiperostose/complicações , Hiperostose/fisiopatologia , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Obstrução Nasal/fisiopatologia , Projetos Piloto , Estudos Prospectivos , Ventilação Pulmonar , Rinomanometria , Sinusite/complicações , Sinusite/fisiopatologia , Conchas Nasais/patologia
13.
No Shinkei Geka ; 36(8): 717-23, 2008 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-18700535

RESUMO

We report a case of idiopathic hypertrophic pachymeningitis presenting with cranial hyperostosis. A 64-year-old man had suffered from pulsating headache during the last 3 months. CT showed bony thickening of the sphenoid ridge, and MRI with Gd-DTPA revealed a linear or nodular enhanced mass along the left sphenoid ridge, extending to the anterior and middle cranial fossae and cavernous sinus. Preoperative steroid therapy resulted in improved clinical symptoms and shrinkage of the enhanced lesion. To clarify the nature of the lesion, biopsy was performed. Granulation tissue infiltrated by lymphocytes and plasma cells was identified, suggesting inflammatory changes. Histologic examination of the cranial bone showed fibrosis in the bone marrow. We considered the hyperostosis to have resulted from a long-term nonspecific inflammatory reaction. Idiopathic hypertrophic pachymeningitis associated with skull changes is rare. There are only 4 reported cases including ours. This rare condition is important in the differential diagnosis of cranial hyperostosis.


Assuntos
Hiperostose/diagnóstico , Hiperostose/etiologia , Meningite/complicações , Crânio , Diagnóstico Diferencial , Diagnóstico por Imagem , Humanos , Hiperostose/patologia , Hiperostose/terapia , Masculino , Meningite/diagnóstico , Meningite/patologia , Meningite/terapia , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos , Prednisolona/administração & dosagem
15.
J Oral Maxillofac Surg ; 63(11): 1567-75, 2005 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-16243172

RESUMO

PURPOSE: Bisphosphonates inhibit bone resorption and thus bone renewal by suppressing the recruitment and activity of osteoclasts thus shortening their life span. Recently three bisphosphonates, Pamidronate (Aredia; Novartis Pharmaceuticals, East Haven, NJ), Zoledronate (Zometa; Novartis Pharmaceuticals), and Alendronate (Fosamax; Merck Co, West Point, VA) have been linked to painful refractory bone exposures in the jaws. MATERIALS AND METHODS: One hundred-nineteen total cases of bisphosphonate-related bone exposure were reviewed. RESULTS: Thirty-two of 119 patients (26%) received Aredia, 48 (40.3%) received Zometa, 36 (30.2%) received Aredia later changed to Zometa, and 3 (2.5%) received Fosamax. The mean induction time for clinical bone exposure and symptoms was 14.3 months for those who received Aredia, 12.1 months for those who received both, 9.4 months for those who received Zometa, and 3 years for those who received Fosamax. Sixty-two (52.1%) were treated for multiple myeloma, 50 (42%) for metastatic breast cancer, 4 (3.4%) for metastatic prostate cancer and 3 (2.5%) for osteoporosis. Presenting findings in addition to exposed bone were 37 (31.1%) asymptomatic, 82 (68.9%) with pain, 28 (23.5%) mobile teeth, and 21 (17.6%) with nonhealing fistulas. Eighty-one (68.1%) bone exposures occurred in the mandible alone, 33 (27.7%) in the maxilla, and 5 (4.2%) occurred in both jaws. Medical comorbidities included the malignancy itself 97.5%, previous and/or maintenance chemotherapy 97.5%, Dexamethasone 59.7%. Dental comorbidities included the presence of periodontitis 84%, dental caries 28.6%, abscessed teeth 13.4% root canal treatments 10.9%, and the presence of mandibular tori 9.2%. The precipitating event that produced the bone exposures were spontaneous 25.2%, tooth removals 37.8%, advanced periodontitis 28.6%, periodontal surgery 11.2%, dental implants 3.4% and root canal surgery 0.8%. CONCLUSIONS: Complete prevention of this complication in not currently possible. However, pre-therapy dental care reduces this incidence, and non-surgical dental procedures can prevent new cases. For those who present with painful exposed bone, effective control to a pain free state without resolution of the exposed bone is 90.1% effective using a regimen of antibiotics along with 0.12% chlorohexidine antiseptic mouth.


Assuntos
Conservadores da Densidade Óssea/efeitos adversos , Difosfonatos/efeitos adversos , Doenças Maxilomandibulares/induzido quimicamente , Osteonecrose/induzido quimicamente , Osteopetrose/induzido quimicamente , Periodontite/complicações , Abscesso/complicações , Abscesso/terapia , Alendronato/efeitos adversos , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Conservadores da Densidade Óssea/uso terapêutico , Neoplasias Ósseas/complicações , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/secundário , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/patologia , Cárie Dentária/complicações , Cárie Dentária/terapia , Dexametasona/efeitos adversos , Dexametasona/uso terapêutico , Difosfonatos/uso terapêutico , Interações Medicamentosas , Feminino , Humanos , Hiperostose/complicações , Hiperostose/terapia , Imidazóis/efeitos adversos , Doenças Maxilomandibulares/diagnóstico , Doenças Maxilomandibulares/terapia , Masculino , Mieloma Múltiplo/complicações , Mieloma Múltiplo/tratamento farmacológico , Osteonecrose/diagnóstico , Osteonecrose/terapia , Osteopetrose/diagnóstico , Osteopetrose/terapia , Osteoporose/tratamento farmacológico , Pamidronato , Periodontite/terapia , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/patologia , Fatores de Risco , Extração Dentária/efeitos adversos , Ácido Zoledrônico
16.
Rev. paul. odontol ; 26(5): 33-35, set.-out. 2004. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: lil-405654

RESUMO

A hipertrofia benigna de masseter é uma patologia caracteriza por um abaulamento indolor da região de ângulo mandibular, podendo ser uni ou bilateral. O diagnóstico é exclusivamente clínico, confirmado durante o ato operatório. O presente trabalho apresenta um caso de hipertrofia benigna de Masseter tratado cirurgicamente com miectomia por acesso extra-oral, onde o resultado foi satisfatório, com controle de três anos sem recidiva. Além dessa modalidade de tratamento, a hipertrofia benigna de masseter pode ser tratada com outras técnicas cirúrgicas ou modalidades conservadoras. A comparação da eficácia entre as diferentes técnicas é discutida no presente trabalho


Assuntos
Humanos , Masculino , Adolescente , Músculo Masseter/anormalidades , Músculo Masseter/cirurgia , Toxinas Botulínicas Tipo A , Hiperostose/terapia , Hipertrofia/terapia
17.
Clin Sports Med ; 22(2): 407-22, ix, 2003 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12825539

RESUMO

Symptomatic arthritic involvement of the sternoclavicular joint is relatively uncommon and can be a result of distant trauma, infection, and sternocostoclavicular hyperostosis, post-menopausal arthritis, condensing osteitis of the proximal clavicle, or secondary to an underlying arthropathy. Patients with degenerative osteoarthritis due to trauma most commonly have had either an anterior or posterior dislocation, subluxation, or periarticular fracture. Medical claviculectomy with or without ligamentous stabilization is indicated only in situations of painful primary and secondary rheumatoid arthritis, or in patients with neoplastic lesions. Numerous authors have recommended surgical reconstruction but few have reported series larger than two or three cases. This article reviews a few specific arthropathy conditions about the sternoclavicular joint and discusses their nonoperative and operative management.


Assuntos
Hiperostose/terapia , Osteoartrite/terapia , Articulação Esternoclavicular , Adulto , Idoso , Artrite Reativa/etiologia , Artrite Reativa/terapia , Artroplastia/métodos , Clavícula/cirurgia , Feminino , Fraturas Ósseas/complicações , Humanos , Hiperostose/diagnóstico , Hiperostose/etiologia , Luxações Articulares/complicações , Instabilidade Articular/cirurgia , Masculino , Pessoa de Meia-Idade , Osteíte/diagnóstico , Osteíte/etiologia , Osteoartrite/diagnóstico , Osteoartrite/etiologia , Pós-Menopausa , Articulação Esternoclavicular/lesões
18.
Can Vet J ; 42(1): 63-6, 2001 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-11195528

RESUMO

An intact male, Great Dane puppy was evaluated for weakness, lethargy, reluctance to move, and inability to stand. Hypertrophic osteodystrophy was diagnosed based on clinical and radiographic findings. Clinical signs, radiographic lesions, gross pathology, histopathology, etiology, and treatment of the disease are discussed.


Assuntos
Doenças do Desenvolvimento Ósseo/veterinária , Doenças do Cão/diagnóstico , Hiperostose/veterinária , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Doenças do Desenvolvimento Ósseo/diagnóstico , Doenças do Desenvolvimento Ósseo/terapia , Doenças do Cão/etiologia , Doenças do Cão/terapia , Cães , Eutanásia , Membro Anterior/diagnóstico por imagem , Membro Anterior/patologia , Membro Posterior/diagnóstico por imagem , Membro Posterior/patologia , Hiperostose/diagnóstico , Hiperostose/terapia , Masculino , Prognóstico , Radiografia
19.
Radiographics ; 15(5): 1147-54, 1995 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7501856

RESUMO

Palmoplantar pustulosis and severe acne are sometimes associated with peculiar aseptic skeletal conditions, but such skeletal lesions can be found without skin lesions. The term SAPHO syndrome has been coined for this cluster of manifestations. (The acronym SAPHO refers to synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis.) The most common site of the disease is the upper anterior chest wall, characterized by predominantly osteosclerotic lesions, hyperostosis, and arthritis of the adjacent joints. Osteosclerosis of the vertebral bodies, hyperostosis, and erosions of the vertebral plates can be encountered. Unilateral sacroiliitis is frequently observed. Long bone involvement consists of osteosclerosis or osteolysis with periosteal new bone formation. Peripheral arthritis can be present but is rarely associated with joint destruction. The pathogenesis of this syndrome remains unknown, but a link with seronegative spondyloarthropathies is probable. Radiologists should be aware of this unusual syndrome to avoid misdiagnosis (eg, tumor, infection), unnecessary surgery, and antibiotic therapy.


Assuntos
Acne Vulgar , Hiperostose , Osteíte , Psoríase , Sinovite , Acne Vulgar/diagnóstico , Adulto , Osso e Ossos/diagnóstico por imagem , Feminino , Humanos , Hiperostose/diagnóstico , Hiperostose/terapia , Masculino , Osteíte/diagnóstico , Osteíte/terapia , Prognóstico , Psoríase/diagnóstico , Radiografia , Cintilografia , Síndrome , Sinovite/diagnóstico , Sinovite/terapia
20.
Presse Med ; 24(7): 338-40, 1995 Feb 18.
Artigo em Francês | MEDLINE | ID: mdl-7899402

RESUMO

In 1987, our group proposed the acronym SAPHO (Synovitis Acne Pustulosis Hyperostosis Osteitis) to identify a clinical entity with characteristic manifestations formerly described under a wide variety of names. Since our first description, several new points have been recognized. For example it has been demonstrated that the skin lesions are not necessarily concomitant with osteoarticular manifestations sometimes separated by a long time interval. There are also several arguments suggesting a relationship with spondyloarthropathy. In addition, pseudo-tumoral fibrosis of anterior thoracic lesions which may lead to venous compression have been observed. It is difficult to determine the frequency of SAPHO. Most of the cases reported were observed in western Europe or Japan. Now that the concept has been accepted by our British colleagues, the number of cases reported has increased steadily, perhaps suggesting a reason for the apparently low frequency in the United States. The pathogenesis is still unknown. There is some evidence however that Propionibacterium acnes infection may be involved, at least in some cases, but formal proof is still lacking. Treating patients with SAPHO thus remains a question of debate. Non-steroid antiinflammatory agents are currently the treatment of choice although certain authors have tried colchicine and sulfasalazine or methotrexate with little success. There remains a good deal of work to be done before we thoroughly understand the SAPHO syndrome but we can nevertheless assure our patients that this strange bone disease is neither a tumour nor an infection and is never severely invalidating.


Assuntos
Acne Vulgar , Hiperostose , Osteíte , Psoríase , Sinovite , Acne Vulgar/complicações , Acne Vulgar/terapia , Humanos , Hiperostose/complicações , Hiperostose/terapia , Osteíte/complicações , Osteíte/terapia , Psoríase/complicações , Psoríase/terapia , Síndrome , Sinovite/complicações , Sinovite/terapia
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