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1.
J Hand Surg Asian Pac Vol ; 26(4): 722-727, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34789109

RESUMO

Aneurysmal bone cyst (ABC) is a benign expansile bone tumor without metastasis capability. Only 3-4% of ABCs occur in the hand and they mainly take place in metaphysis' of long bones like metacarpals or phalanges. Carpal ABCs have been reported as individual case reports in the literature due to rarity. A patient presented with pain in her right wrist. Magnetic resonance imaging revealed a well circumscribed one cm sized mass in the pisiform bone that resembled an aneurysmal bone cyst. Total pisiformectomy was performed. Treatment options are total excision or curettaging in ABCs. But rarity of these lesions may delay the diagnosis process for the inexperienced surgeon.


Assuntos
Cistos Ósseos Aneurismáticos , Neoplasias Ósseas , Falanges dos Dedos da Mão , Pisciforme , Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética
2.
Tech Hand Up Extrem Surg ; 25(4): 264-268, 2021 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-33782357

RESUMO

Pisotriquetral (PT) joint arthritis is a common cause of ulnar-sided wrist pain. Open pisiform excision is a well-established procedure and is indicated when the conservative treatment fails. Although arthroscopic visualization of the PT joint is part of the routine examination in a patient with ulnar-sided wrist pain, therapeutic arthroscopy of the PT joint is limited to one case in the literature through the standard dorsal portals. Arthroscopic pisiform excision is a novel technique described by the authors. The first aim of this procedure is pain relief maintaining wrist stability and strength. With this minimally invasive approach we believe that preserving the flexor carpi ulnaris and the PT ligament complex we maintain their biomechanical function, while at the same time, reducing scar tenderness and postoperative discomfort with better esthetic results and less recovery time. In addition to standard dorsal portals, a direct PT portal was used to have access to the PT space and as a working portal to complete the pisiform excision.


Assuntos
Articulações do Carpo , Osteoartrite , Pisciforme , Artralgia/cirurgia , Artroscopia , Articulações do Carpo/cirurgia , Humanos , Osteoartrite/cirurgia , Pisciforme/cirurgia , Articulação do Punho/cirurgia
3.
BMJ Case Rep ; 14(1)2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33408102

RESUMO

A pisiform dislocation is an uncommon injury which can lead to significant morbidity if missed. The literature regarding pisiform dislocation is limited and largely from case reports. In this case, we present a 51-year-old right-hand dominant male who sustained the injury after a fall. He attended the emergency department on the same day and a closed reduction was able to be performed under a haematoma block. On review in follow-up clinic the patient's symptoms had completely resolved.


Assuntos
Acidentes por Quedas , Redução Fechada , Luxações Articulares/diagnóstico , Pisciforme/lesões , Traumatismos do Punho/diagnóstico , Moldes Cirúrgicos , Humanos , Luxações Articulares/etiologia , Luxações Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Pisciforme/diagnóstico por imagem , Resultado do Tratamento , Traumatismos do Punho/etiologia , Traumatismos do Punho/cirurgia
4.
Hand (N Y) ; 15(1): 64-68, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-30027757

RESUMO

Background: Increasing severity of carpal tunnel syndrome (CTS), as graded by nerve conduction studies (NCS), has been demonstrated to predict the speed and completeness of recovery after carpal tunnel release (CTR). The purpose of this study is to compare the cross-sectional area (CSA) of the median nerve in patients with severe and nonsevere CTS as defined by NCS. Methods: Ultrasound CSA measurements were taken at the carpal tunnel inlet at the level of the pisiform bone by a hand fellowship-trained orthopedic surgeon. Severe CTS on NCS was defined as no response for the distal motor latency (DML) and/or distal sensory latency (DSL). Results: A total of 274 wrists were enrolled in the study. The median age was 51 years (range: 18-90 years), and 72.6% of wrists were from female patients. CSA of median nerve and age were comparatively the best predictors of severity using a linear regression model and receiver operator curves. Using cutoff of 12 mm2 for severe CTS, the sensitivity and specificity are 37.5% and 81.9%, respectively. Conclusions: Ultrasound can be used to grade severity in younger patients (<65 years) with a CTS-6 score of >12.


Assuntos
Síndrome do Túnel Carpal/diagnóstico , Eletrodiagnóstico/estatística & dados numéricos , Nervo Mediano/diagnóstico por imagem , Índice de Gravidade de Doença , Ultrassonografia/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Eletrodiagnóstico/métodos , Feminino , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Condução Nervosa , Pisciforme/diagnóstico por imagem , Curva ROC , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Ultrassonografia/métodos , Punho/diagnóstico por imagem , Adulto Jovem
5.
JBJS Case Connect ; 9(4): e0278, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31770115

RESUMO

CASE: A 32-year-old man presented to the emergency department with several carpal bone fractures and a locked distal pisiform dislocation after trauma. Treatment consisted of open surgical and reduction, osteosynthesis with a single Kirschner wire, and ligament repair. The patient's functional outcome was excellent, and his Mayo wrist score was 90 at 36 months after injury. CONCLUSIONS: Pisiform dislocations may be difficult to diagnose because anteroposterior and lateral radiographs may not be sufficient to visualize the injury. A 30° semisupinated wrist x-ray and computed tomography can be helpful. A satisfactory clinical result may be achieved if distal pisiform dislocations are detected early and managed surgically with open reduction and ligament repair.


Assuntos
Ossos do Carpo/lesões , Fixação Interna de Fraturas/métodos , Luxações Articulares/cirurgia , Pisciforme/lesões , Traumatismos do Punho/cirurgia , Adulto , Fios Ortopédicos , Humanos , Masculino , Articulação do Punho/cirurgia
6.
Hand Clin ; 35(3): 353-363, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31178092

RESUMO

Vascularized bone flaps (VBFs) improve union rates for scaphoid nonunions compared with nonvascularized grafts. Volar VBFs are indicated in cases of scaphoid nonunion with avascular necrosis and/or humpback deformity. Four volar VBFs are described in this article. The volar carpal artery and pronator quadratus VBFs are most commonly used. The pisiform VBF can be used for replacement of the proximal pole of the scaphoid; it is covered by articular cartilage. The ulna VBF has greater donor morbidity; the ulnar artery is harvested and a palpable donor site deformity results.


Assuntos
Fraturas não Consolidadas/cirurgia , Rádio (Anatomia)/irrigação sanguínea , Rádio (Anatomia)/transplante , Osso Escafoide/cirurgia , Osso Esponjoso/irrigação sanguínea , Osso Esponjoso/transplante , Osso Cortical/irrigação sanguínea , Osso Cortical/transplante , Fixação Interna de Fraturas , Humanos , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/transplante , Osteonecrose/cirurgia , Pisciforme/irrigação sanguínea , Pisciforme/cirurgia , Cuidados Pós-Operatórios , Osso Escafoide/lesões , Ulna/irrigação sanguínea , Ulna/transplante
7.
Hand Surg Rehabil ; 38(3): 165-168, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30904496

RESUMO

Pisiformectomy is the gold standard treatment for pisotriquetral arthritis resistant to conservative treatment. We evaluated the long-term clinical and functional outcomes after pisiformectomy in resistant pisotriquetral arthritis cases. We retrospectively evaluated 11 patients (12 wrists), mean age of 59 years (49-69) treated by pisiformectomy using a standardized surgical technique. Pisiformectomy was performed for primary osteoarthritis in 10 cases, for post-traumatic osteoarthritis in 1 case and for pisotriquetral instability in 1 case. The clinical and functional evaluation was carried out by an independent examiner. Mean time to review was 90 months (63-151). Pain on a Visual Analog Scale (/10) decreased significantly to 1.1 from 6.8 preoperatively. Mean range of motion was 79° in flexion, 61.5° in extension, 18° in ulnar deviation and 36° in radial deviation. Mean grip strength of the operated wrist was 86% of the non-operated wrist. Functional scores significantly improved with a gain of 40 points for the QuickDASH and 53 points for the PRWE. Based on this long-term follow-up study, pisiformectomy seems to alleviate wrist pain and improve the quality of life in a low-demand population with pisotriquetral osteoarthritis resistant to conservative treatment. When compared to the pisotriquetral arthrodesis, pisiformectomy is easier to perform, allows quicker mobilization of the wrist and leads to good functional outcomes.


Assuntos
Articulações do Carpo/fisiopatologia , Osteoartrite/cirurgia , Pisciforme/cirurgia , Piramidal/fisiopatologia , Idoso , Seguimentos , Força da Mão/fisiologia , Humanos , Pessoa de Meia-Idade , Osteoartrite/fisiopatologia , Pisciforme/fisiopatologia , Amplitude de Movimento Articular/fisiologia , Estudos Retrospectivos , Escala Visual Analógica
8.
Medicine (Baltimore) ; 97(48): e13229, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30508905

RESUMO

No surgical procedure perfectly treats advanced Kienböck disease. Although vascularized os pisiform transferring (VOPT) is one of the main therapeutic approaches, reports on long-term follow-up and case series for this technique are scarce.We collected postoperative results in 11 patients with advanced Kienböck disease who underwent VOPT between 1986 and 2001 in our Hospital. Follow-up durations ranged from 15 to 26 years.At the last follow-up, excellent and good results were found in 81.8% according to the Modified Green and O'Brien score. Postoperative imaging revealed significantly reduced pisiform bone; carpal height ratio and Nattrass index were decreased, while the radioscaphoid angle was increscent, compared with preoperative and mid-term follow-up results.The favorable long-term results demonstrated that VOPT is a dependable and durable procedure for the treatment of advanced Kienböck disease, with pain relief and functional improvement despite some radiographic findings such as wrist osteoarthritis occurrence.


Assuntos
Osteonecrose/cirurgia , Pisciforme/transplante , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteonecrose/diagnóstico por imagem , Pisciforme/irrigação sanguínea , Pisciforme/diagnóstico por imagem , Complicações Pós-Operatórias , Estudos Retrospectivos , Fatores de Tempo , Adulto Jovem
10.
J Orthop Sci ; 23(3): 511-515, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29503035

RESUMO

BACKGROUND: The association of scaphoid or other carpal bone fractures with distal radius fractures is frequently reported, whereas few studies have described pisiform malalignment associated with distal radius fractures. The purpose of this study was to investigate the frequency and characteristics of pisiform malalignment associated with distal radius fractures. METHODS: We performed a retrospective study by reviewing the data of 152 consecutive patients with a mean age of 63 years who were treated surgically for distal radius fractures during a five-year period. We evaluated the pisotriquetral joint via preoperative sagittal computed tomography (CT) and assessed pisiform malalignment. Pisiform malalignment was defined as follows: (1) wide type, joint space ≥4.0 mm; (2) non-parallel type, loss of parallelism of the joint surface of ≥20°; or (3) overriding type, proximal or distal overriding of the pisotriquetral joint ≥2.0 mm. We investigated the relationship between pisiform malalignment and the patterns of distal radius fractures. Pisiform malalignment was assessed using postoperative CT to determine whether it had been reduced. RESULTS: Pisiform malalignment was observed in 48 cases involving 44 patients with a mean age of 58 (17-81) years. The patients included 16, 17, and 15 cases of the wide type, non-parallel type, and overriding type, respectively. Distal radius fractures with dorsal displacement exhibited pisiform malalignment significantly more frequently than those with volar displacement. No significant difference was noted between intra- and extra-articular fractures or between patients with and without distal ulnar fractures. Among the 22 pisiform malalignment cases assessed via postoperative CT, 15 cases were reduced, and 7 cases remained malaligned. The non-parallel type exhibited the lowest reduction rate among the 3 types. CONCLUSIONS: Among distal radius fractures, 29% were complicated by pisiform malalignment. Distal radius fractures with dorsal displacement exhibited a significantly increased frequency of pisiform malalignment compared to those with volar displacement.


Assuntos
Mau Alinhamento Ósseo/epidemiologia , Fraturas Intra-Articulares/diagnóstico , Fraturas Intra-Articulares/etiologia , Pisciforme , Fraturas do Rádio/diagnóstico , Fraturas do Rádio/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Mau Alinhamento Ósseo/diagnóstico por imagem , Feminino , Humanos , Incidência , Fraturas Intra-Articulares/cirurgia , Masculino , Pessoa de Meia-Idade , Fraturas do Rádio/cirurgia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fatores de Risco , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
Turk J Med Sci ; 48(1): 110-116, 2018 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-29479967

RESUMO

Background/aim: The aim of this study was to assess the diagnostic utility of the ultrasonographic ratio of median nerve cross-sectional area (m-CSA) to ulnar nerve cross-sectional area (u-CSA), the m-CSA/u-CSA ratio, in carpal tunnel syndrome (CTS). Materials and methods: Fifty patients with positive symptoms and electromyography results of CTS and 50 healthy matched control subjects were evaluated. Ultrasonographic m-CSA and u-CSA measurements of each participant were made at the level of the pisiform bone and the m-CSA/u-CSA ratio was calculated. Results: Using the m-CSA cut-off value of 11.95 mm2 showed a sensitivity of 80% and a specificity of 80% while using a cut-off value 2.95 for the ratio of m-CSA/u-CSA showed a sensitivity of 86% and a specificity of 72% in the diagnosis of CTS. Conclusion: The ratio of m-CSA/u-CSA at the level of the pisiform bone was not detected to be superior to m-CSA in the diagnosis of CTS.


Assuntos
Síndrome do Túnel Carpal/diagnóstico , Nervo Mediano/patologia , Nervo Ulnar/diagnóstico por imagem , Adulto , Idoso , Síndrome do Túnel Carpal/diagnóstico por imagem , Síndrome do Túnel Carpal/patologia , Eletromiografia , Humanos , Conceitos Matemáticos , Nervo Mediano/diagnóstico por imagem , Pessoa de Meia-Idade , Pisciforme , Valores de Referência , Sensibilidade e Especificidade , Ultrassonografia/métodos , Adulto Jovem
12.
J Hand Surg Asian Pac Vol ; 23(1): 121-124, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29409413

RESUMO

Asymptomatic pisotriquetral arthroses caused ruptures of the flexor digitorum profundus tendon of the little finger in 2 elderly patients. Ruptures occurred with unnoticeable onset, and bilateral ruptures separately occurred with interval of several years in one patient. The tendon was ruptured in zone IV with perforation of the gliding floor through which the degenerative pisiform was visible. The gliding floor was repaired followed with excision of the pisiform, and the ruptured tendon was then transferred to the profundus tendon of the ring finger. Asymptomatic pisotriquetral arthrosis in old age can be an aspect of the pathological background of flexor tendon ruptures of the little finger that occur unnoticed.


Assuntos
Traumatismos dos Dedos/etiologia , Osteoartrite/complicações , Pisciforme , Traumatismos dos Tendões/etiologia , Piramidal , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Feminino , Traumatismos dos Dedos/cirurgia , Humanos , Osteoartrite/cirurgia , Pisciforme/cirurgia , Ruptura/etiologia , Ruptura/cirurgia , Traumatismos dos Tendões/cirurgia
13.
Tech Hand Up Extrem Surg ; 22(1): 26-30, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29356718

RESUMO

Few cases in which open reduction and internal fixation was performed for displaced pisiform fractures have been reported. We present a new surgical technique for the treatment of depressed intra-articular pisiform fractures. First, the depressed fragment was reduced by pushing the bone tamp. Then, the fracture void resulting from the reduction of the depressed fragment was filled with a shaped hydroxyapatite block. Finally, the fragments were sutured using braided polyblend polyethylene sutures. The postoperative radiography could achieve a well-reduced articular facet, and this procedure had a good clinical outcome.


Assuntos
Cimentos Ósseos , Durapatita , Fraturas Intra-Articulares/cirurgia , Pisciforme/lesões , Pisciforme/cirurgia , Suturas , Moldes Cirúrgicos , Feminino , Consolidação da Fratura , Humanos , Fraturas Intra-Articulares/diagnóstico por imagem , Pessoa de Meia-Idade , Pisciforme/diagnóstico por imagem , Polietilenos , Cuidados Pós-Operatórios , Adulto Jovem
14.
Acta Orthop Belg ; 84(4): 539-545, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30879461

RESUMO

The aim is to report the long-term clinical results after pisiform excision in patients with refractory flexor carpi ulnaris (FCU) tendinopathy. We performed pisiform excision in 14 patients with recalcitrant FCU tendinopathy, who had failed conservative treatment. Nine patients were followed-up for more than 2 years. Pre-operative pain visual analog scale (VAS) was extracted from the electronic medical records. Post-operative symptoms and function were assessed with pain VAS, quick disabilities of arm, shoulder and hand (DASH) score, patient rated wrist evaluation (PRWE) score, and satisfaction VAS for surgery at the final follow-up. After the mean follow-up period of 6 years, all patients showed improvement in pain VAS (from 5.9 to 1.2). The post-operative scores of quick DASH and PRWE were 3.5 and 13.1, respectively. Satisfaction VAS score was 8.8 and all patients returned to their work. Excision of the pisiform bone improved symptoms in patients with refractory FCU tendinopathy.


Assuntos
Procedimentos Ortopédicos , Pisciforme/cirurgia , Tendinopatia/cirurgia , Humanos , Satisfação do Paciente , Resultado do Tratamento
15.
J Hand Surg Am ; 43(1): 54-60, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29169722

RESUMO

Pisotriquetral instability is an often-overlooked condition that can lead to ulnar-sided wrist pain and dysfunction. Various case series and biomechanical studies have been published regarding the diagnosis and treatment of this condition. We review current methods for examining, diagnosing, and treating pisotriquetral instability.


Assuntos
Articulações do Carpo/cirurgia , Instabilidade Articular/terapia , Pisciforme/cirurgia , Piramidal/cirurgia , Anti-Inflamatórios não Esteroides/uso terapêutico , Artrodese , Articulações do Carpo/anatomia & histologia , Articulações do Carpo/diagnóstico por imagem , Glucocorticoides/uso terapêutico , Humanos , Imobilização , Instabilidade Articular/diagnóstico , Ligamentos Articulares/anatomia & histologia , Ligamentos Articulares/fisiologia , Anamnese , Exame Físico , Pisciforme/anatomia & histologia , Pisciforme/diagnóstico por imagem , Piramidal/anatomia & histologia , Piramidal/diagnóstico por imagem
16.
Hand (N Y) ; 12(5): 490-492, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28832198

RESUMO

BACKGROUND: Patients with suspected pisotriquetral osteoarthritis may show joint space narrowing. However, the extent of joint space narrowing and its deviation from the joint space width (JSW) in normal anatomy is unknown. In this pathoanatomic study, we therefore compared the JSW in the pisotriquetral joint between osteoarthritic patient wrists and healthy wrists. METHODS: We reviewed preoperative computed tomography (CT) scans of 8 wrists of patients with ulnar-sided wrist pain who underwent a pisiformectomy with confirmed pisotriquetral osteoarthritis at surgery. We also reviewed CT scans of 20 normal wrists from healthy volunteers serving as control group. Three-dimensional CT models of the pisiform and triquetrum were obtained from both affected and normal wrists, after which the minimum JSW was calculated in an automated fashion. RESULTS: In the patient group, the median (interquartile range) of the minimum JSW was 0.1 mm (0.0-0.2), and in the control group, 0.8 mm (0.3-0.9) ( P = .007). CONCLUSIONS: We showed that the pisotriquetral joint space in osteoarthritic patient wrists was significantly narrowed compared with healthy wrists. These results suggest that JSW evaluation has a potential diagnostic value in the work-up of patients with suspected pisotriquetral osteoarthritis. This is an interesting area for future clinical research, especially because no gold standard for diagnosing pisotriquetral osteoarthritis has been established yet.


Assuntos
Articulações do Carpo/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Pisciforme/diagnóstico por imagem , Piramidal/diagnóstico por imagem , Adulto , Articulações do Carpo/cirurgia , Estudos de Casos e Controles , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Osteoartrite/cirurgia , Pisciforme/cirurgia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Piramidal/cirurgia , Adulto Jovem
17.
Hand (N Y) ; 12(5): NP55-NP57, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28832208

RESUMO

BACKGROUND: Aneurysmal bone cysts are an uncommon form of benign primary bone tumors; affection of the hand is very rare. METHODS: A rigorous review of the literature showed that this type of tumor has not previously been described in the pisiform. In this article, we report the occurrence of an aneurysmal bone tumor in the pisiform of the left hand of a 19-year-old male. RESULTS: This tumor was successfully treated through surgical excision with an uneventful recovery. We describe the process behind the diagnosis of the lesion and the subsequent treatment in an attempt to highlight the rare but possible occurrence of aneurysmal bone cysts in the pisiform. CONCLUSION: Appropriate treatment of aneurysmal bone cysts in this location is required, due to the anatomical nature of the pisiform itself with the risks of pathologic fracture and ulnar nerve compression.


Assuntos
Cistos Ósseos Aneurismáticos/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/patologia , Pisciforme/diagnóstico por imagem , Cistos Ósseos Aneurismáticos/cirurgia , Humanos , Masculino , Pisciforme/cirurgia , Adulto Jovem
18.
Am J Phys Med Rehabil ; 96(12): 904-907, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28582272

RESUMO

From the perspective of a multidisciplinary team, the authors describe the first reported use of ultrasound guidance for steroid injection into the pisotriquetral joint to relieve wrist pain of a person with spinal cord injury undergoing acute inpatient rehabilitation. Musculoskeletal ultrasound guidance was used to improve the accuracy of a corticosteroid injection of the pisotriquetral joint and the basal thumb in a 70-year-old man with paraplegia experiencing multifocal degenerative wrist pain. There was no bleeding or bruising after the injections, and the patient reported complete pain resolution 1 wk after the injections, which continued for over 1 yr. A multidisciplinary team was key in diagnosis, selection of treatment, and evaluation of treatment effect. Corticosteroid injection of the pisotriquetral joint under ultrasound guidance can be used as a treatment modality for managing wrist pain stemming from that joint. Further investigation and studies evaluating the use of ultrasound versus other imaging modalities for injection of the wrist are indicated.


Assuntos
Corticosteroides/administração & dosagem , Artralgia/tratamento farmacológico , Articulações do Carpo/efeitos dos fármacos , Manejo da Dor/métodos , Ultrassonografia de Intervenção/métodos , Idoso , Artralgia/etiologia , Articulações do Carpo/diagnóstico por imagem , Seguimentos , Humanos , Injeções Intralesionais , Comunicação Interdisciplinar , Masculino , Medição da Dor , Pisciforme/fisiopatologia , Medição de Risco , Índice de Gravidade de Doença , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/diagnóstico por imagem , Vértebras Torácicas/lesões , Resultado do Tratamento , Piramidal/fisiopatologia
19.
Rom J Morphol Embryol ; 58(1): 271-275, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28523331

RESUMO

Chondrosarcoma is a malignant hyaline cartilage forming tumor. It is a rare pathology, with an estimated incidence of one in 200 000 individuals per year. It appears in two forms: primary, representing 90% of all cases and secondary emergence that develops on preexistent lesions. Primary chondrosarcomas are uncommon in the hand, with a frequency of only 1.5-3.2% of all chondrosarcomas. In conventional chondrosarcoma (cCS), the histological malignancy grading represents the main prognostic factor for surgical planning and prognosis. We present the case of a 60-year-old male, examined in the First Department of Orthopedics and Traumatology, "Dr. Pius Branzeu" Clinical Hospital, Timisoara, Romania, with non-specific symptoms in the right hand. After clinical examination and imagistics, surgery and histopathological examination of the tumor were performed. This showed a conventional well differentiated - G1 chondrosarcoma, as suggested also by imagistic and clinical context.


Assuntos
Neoplasias Ósseas/patologia , Condrossarcoma/patologia , Hamato/patologia , Mãos/patologia , Pisciforme/patologia , Neoplasias Ósseas/diagnóstico por imagem , Condrossarcoma/diagnóstico por imagem , Hamato/diagnóstico por imagem , Mãos/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pisciforme/diagnóstico por imagem , Membrana Sinovial/diagnóstico por imagem , Membrana Sinovial/patologia
20.
Skeletal Radiol ; 46(5): 693-699, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28229185

RESUMO

Hamate-pisiform coalition is an exceptional form of carpal coalition. Case reports are essential to gain a better understanding of this variant. We report a case of congenital bilateral hamate-pisiform coalition in a 20-year-old male discovered in the context of a right wrist trauma. Radiographs also revealed a bilateral scapholunate diastasis. Clinical examination and radiological findings suggested that the right wrist scapholunate diastasis was related to scapholunate instability. Left wrist scapholunate diastasis could be related to (1) a pathological feature or (2) a normal variant associated with hamate-pisiform coalition. Lateral radiographs showed a volar C-shaped osseous bridge corresponding to the coalition. We associated it with a new sign: the "carpal C-sign". Computed tomography with three-dimensional reconstruction provides helpful information about the type of coalition (osseous versus non-osseous) and excludes potential fracture. We discuss the specific embryologic features of the hamate-pisiform coalition, as well as its prevalence, radiographic classification, clinical significance, and treatment.


Assuntos
Hamato/diagnóstico por imagem , Ligamentos Articulares/lesões , Ligamentos Articulares/cirurgia , Pisciforme/diagnóstico por imagem , Traumatismos do Punho/diagnóstico por imagem , Adulto , Ossos do Carpo , Meios de Contraste , Diagnóstico Diferencial , Humanos , Imageamento Tridimensional/métodos , Ligamentos Articulares/diagnóstico por imagem , Masculino , Tomografia Computadorizada Multidetectores/métodos , Intensificação de Imagem Radiográfica/métodos , Radiografia/métodos , Articulação do Punho/diagnóstico por imagem , Adulto Jovem
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