RESUMEN
The orthopedic surgeon is frequently confronted with the decision of when to perform a bone biopsy and whether to do a needle biopsy or an open biopsy. Frequently consultations are received from other services requesting bone biopsies with questionable indications. The indications and contraindications for performing bone biopsies are discussed as well as advantages and disadvantages of either closed or open technique. Four selective cases are discussed with illustrations. The challenge of undiagnosed osseous lesions is best met by rational evaluation of each individual case and coordinated with the team effort of the primary care physician, surgeon, pathologist, and radiologist. The decision for either an open or closed biopsy technique must be based on the experience and skills of the surgeon and pathologist.
Asunto(s)
Biopsia , Enfermedades Óseas/patología , Absceso/patología , Adulto , Anciano , Infecciones Bacterianas/patología , Biopsia/efectos adversos , Biopsia/métodos , Biopsia con Aguja/efectos adversos , Reacciones Falso Negativas , Femenino , Displasia Fibrosa Ósea/patología , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Hueso Púbico/patologíaRESUMEN
Bilateral simultaneous patellar tendon rupture is a rare entity. Most case studies in the literature have been reported in patients with an underlying systemic condition, i.e. systemic lupus erythematosus, rheumatoid arthritis, or associated with a history of steroid injections about the infrapatellar tendon. A recent case report treated at Dwight David Eisenhower Army Medical Center without a predisposing underlying systemic condition or history of injection is presented. Our patient is the youngest to be reported in the literature. The literature is reviewed on this subject, and the mechanism of injury presented.
RESUMEN
Nonossifying fibromas appear to be histiocytic lesions. On the basis of light and electron microscopic studies, as well as behavior, they are identical to benign fibrohistiocytomas found in soft tissues. The fibroblastic appearance of some of these lesions by light and electron microscopy, especially in older lesions, reflects the ability of histiocytes to behave as facultative fibroblasts. Final data of the cell of origin for these lesions must await more definitive studies by other methods, perhaps using immunologic, immunoperoxidase and/or surface markers techniques.