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Biomedical subjects

C Orzincolo

Publications and source records attributed to C Orzincolo.

105 records · Page 6Linked to original sources

Humeral head osteonecrosis caused by electrical injury: a case report.

Various musculoskeletal abnormalities caused by electrical injury are described. Such abnormalities usually include fractures or dislocation of adjacent bones and joints. Osteonecrosis is a noteworthy, but less common, consequence of electric shock. The case is discussed of a 52-year-old woman who had received an electric shock (220-V alternating household current) to the right hand and developed osteonecrosis in the ipsilateral humeral head, most likely caused by bone "melting." An osteonecrotic lesion may therefore develop in a joint at a distance from the point of electrical contact, and this must always be kept in mind in diagnosis and treatment.

Electric Injuries↗

[Transient regional osteoporosis].

Transient osteoporosis of the hip and regional migratory osteoporosis are uncommon and probably underdiagnosed bone diseases characterized by pain and functional limitation mainly affecting weight-bearing joints of the lower limbs. These conditions are usually self-limiting and symptoms tend to abate within a few months without sequelae. Routine laboratory investigations are unremarkable. Middle aged men and women during the last months of pregnancy or in the immediate post-partum period are principally affected. Osteopenia with preservation of articular space and transitory edema of the bone marrow provided by magnetic resonance imaging are common to these two conditions, so they are also known by the term regional transitory osteoporosis. The appearance of bone marrow edema is not specific to regional transitory osteoporosis but can be observed in several diseases, i.e. trauma, reflex sympathetic dystrophy, avascular osteonecrosis, infections, tumors from which it must be differentiated. The etiology of this condition is unknown. Pathogenesis is still debated in particular the relationship with reflex sympathetic dystrophy, with which regional transitory osteoporosis is often identified. The purpose of the present review is to remark on the relationship between transient osteoporosis of the hip and regional migratory osteoporosis with particular attention to the bone marrow edema pattern and relative differential diagnosis.

Diagnosis, Differential↗

Bone marrow imaging in plasma cell dyscrasias: review of 130 cases.

Skeletal radiography, bone and bone marrow scintigraphy have been performed in 130 patients with plasma cell dyscrasias (119 multiple myeloma, 9 MGUS and 2 Waldenström disease). Our results confirm: 1) that radiography is much more sensitive than scintigraphy in the identification of the lesions typical of myeloma, but in the first stage bone scintigraphy and especially bone marrow scintigraphy are more sensitive than x-ray for the detection of regions affected by focal lesions; 2) that bone scintigraphy is of particular value in detecting some abnormalities in specific sites not fully visualized by x-ray; 3) that bone marrow scintigraphy is a valuable diagnostic tool in the early stage of myeloma, especially for evaluating the progression of the disease, because it is able to demonstrate not only focal lesions, but also bone marrow expansion. We believe that bone marrow scintigraphy may be a useful technique in the early diagnosis and follow-up of multiple myeloma, particularly in the detection of unusual forms (i.e., "smouldering" myeloma), but it remains only an "additional" technique for bone imaging.

Bone Marrow↗

[Enthesopathies. Radiography and xeroradiography compared].

The term "enthesis" designates the sites of tendon, ligament and articular capsule insertion to bone. Entheses are fundamental to the cybernetic regulation and correlation of postural and motion functions in the body. They also hold a key position in the locomotor system diseases. "Enthesopathy" is a disease occurring at these sites (primary enthesopathy), which can occur alone or together with different disorders, including inflammatory, degenerative, metabolic and traumatic conditions (secondary enthesopathy). Enthesopathy may lead to articular and non-articular manifestations: common sites of involvement include the spine and pelvis, femoral trochanter, humeral tuberosity, patella, olecranon and calcaneus. In acute enthesopathy, all the signs of acute inflammation may be present. In subacute or chronic forms, pain and tenderness localized in the entheses are found. Radiographic patterns include bone erosion, hyperostosis (enthesophytes), bone fragmentation and crystal deposits.

Bone Diseases↗

[Osteoarticular amyloidosis caused by dialysis].

The accumulation of amyloid in the bone and joint system has recently been recognized as a peculiar disease in patients undergoing long-term hemodialysis (5 years at least), especially in those who use cuprophan membranes. The pathology of amyloidosis is characterized by deposits of amyloid (beta 2-microglobulin mainly) in the bone, in the synovia, and in pericapsular soft tissues. The skeleton of 46 long-term hemodialysis patients (19 males and 27 females) was studied by X-ray: bone and joint abnormalities due to amyloid deposition were observed in 45% of cases. The shoulder, hip, and wrist were the most frequently involved joints. Destructive spondyloarthropathy was present in 15% of cases. The radiographic patterns of AOD are generally divided into axial and peripheral lesions. In the appendicular skeleton abnormalities include: well-defined lytic areas (geodes), pathologic fractures, marginal erosions, and periarticular soft tissue swelling. Destructive spondyloarthropathy is frequently present in the cervical spine (85% of our cases), and is characterized by narrowing of the intervertebral space, marginal erosion, and subchondral bone sclerosis of the vertebral body.

Adult↗

[Radiology of the hand in progressive systemic sclerosis].

Radiographs and xerographs of the hands of 35 patients with progressive systemic sclerosis (PSS), as defined by the ARA, were reviewed. Patients with "overlap" syndromes (i.e., mixed connective tissue disease, systemic lupus erythematosus or rheumatoid arthritis) have been excluded. Soft tissue changes included atrophy (hide-bound skin), and dystrophic calcifications, particularly in CREST patients (calcinosis, Raynaud phenomenon, esophageal dysmobility, sclerodactily and telangectasia). The most common bony change is resorption of distal phalanges; diffuse osteoporosis is also frequent; the distal interphalangeal and first carpometacarpal joints involvement appear as a distinctive feature of this erosive arthritis.

Adult↗

[The hand of the patient under periodic hemodialysis treatment. Comparative radiographic and xeroradiographic aspects].

Renal osteodystrophy is the skeletal response to long-standing chronic renal disease. The radiographic features include hyperparathyroidism (osteitis fibrosa cystica), rickets or osteomalacia, osteoporosis, osteosclerosis and soft tissue and vascular calcifications. Many investigators have verified that changes in the phalanges of the hand are the most sensitive indicator of renal osteodystrophy, especially subperiosteal bone resorption. The hands of 50 chronic dialysis patients were evaluated for at least one year for tuftal resorption (acro-osteolysis), subperiosteal and intracortical bone resorption, and periosteal new bone formation (periosteal neostosis), using fine detail radiography and optical magnification. At last control, only in a group of 17 subjects (34%), xeroradiography of the hand was also performed. Results indicate the importance of the use of fine detail radiography in the early diagnosis of renal osteodystrophy and that serial radiography of the hand is a proper method of evaluating progressive bone resorption. In addition, a significant difference (p less than 0.05) is demonstrated between xeroradiography and radiography to evaluate periosteal neostosis.

Adult↗

[Osteoporosis and the thalassemia "trait"].

The authors evaluated the prevalence of the thalassemia trait in a general population affected with femoral neck fractures. Our research was aimed at assessing whether hemoglobinopathy might affect osteoporosis, which is responsible for femoral fractures. Two hundred and thirty-eight patients admitted to St. Anna Hospital, Ferrara, for proximal femoral fractures, were retrospectively studied. The patients were 68 males and 170 females, aged 58 to 83 years (mean age: 70.4 years). The thalassemia trait was seen in 11.76% of cases, versus in 7-8% of the general population. The high prevalence of heterozygous beta-thalassemic subjects probably means that the beta-thalassemia condition is a further "variable" which is responsible for the more frequent occurrence of fractures of the proximal femur and is certainly related to an osteopenic condition much more severe than usual.

Aged↗