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At least 253 records · Page 14Linked to original sources
PubMed1987

Distinct distribution of periarticular erosions of the bones of the hand in chronic renal failure.

The frequency of radiological changes of the bones of the hand in 142 patients on hemodialysis, 19 on CAPD, and 15 patients with advanced renal insufficiency not requiring dialysis was analyzed. Forty-seven percent of all patients had subperiostal cortical bone resorptions, 31% periarthritis calcarea, 22% periarticular erosions, 3% chondrocalcinosis and 1% aseptic necrosis. Sixty-six percent of the periarticular erosions were observed in the distal and proximal interphalangeal joints of fingers II, III, IV and V, whereas only 33% were found in the remaining joints (120 vs. 62, p less than 0.001). The distal interphalangeal joints showed about 70% more often periarticular erosions than the proximal interphalangeal joints (77 vs. 43, p less than 0.001). Since patients with chronic renal failure exhibit a decreasing incidence of periarticular erosions from the distal interphalangeal joints to the intercarpal joints, while patients with rheumatoid arthritis have their erosions preferentially localized in the proximal interphalangeal, metacarpophalangeal and wrist joints, it can be concluded that renal osteodystrophy causes a distinct distribution of periarticular erosions of the bones of the hand.

Arthritis↗
PubMed1997

Early bone formation around calcium-ion-implanted titanium inserted into rat tibia.

Rat tibia tissue into which calcium ion (Ca2+)-implanted titanium was surgically placed was histologically analyzed to investigate the performance of the Ca(2+)-implanted titanium as a biomaterial. Calcium ions were implanted into only one side of titanium plates at 10(17) ions/cm2 and the Ca(2+)-treated titanium was surgically implanted into rat tibia for 2, 8, and 18 days. Tetracycline and calcein were used as hard-tissue labels. After excision of the tibia, the tissues were fixed, stained, embedded in polymethyl methacrylate, and sliced. The specimens were observed using a fluorescence microscope. A larger amount of new bone was formed on the Ca(2+)-treated side than on the untreated side, even at 2 days after surgery. In addition, part of the bone made contact with the Ca2(+)-treated surface. On the other hand, bone formation on the untreated side was delayed and the bone did not make contact with the surface. Mature bone with bone marrow formed in 8 days. Neither macrophage nor inflammatory cell infiltration was observed. The results indicated that Ca(2+)-implanted titanium is superior to titanium alone for bone conduction.

Animals↗
PubMed2000

Detailed analyses of periarticular osteoporosis in rheumatoid arthritis.

Periarticular osteopenia is the earliest radiographic sign of rheumatoid arthritis (RA). Recent studies using dual-energy X-ray absorptiometry (DXA) have indicated that the loss of periarticular BMD can be quantified by whole-hand bone mineral density (BMD) measurements. The aim of this study was to analyze periarticular BMD in more detail by DXA and quantitative ultrasound (QUS). In a cross-sectional study 23 women aged 30-76 years with early RA, mean disease duration 26 +/- 19 months, and 18 men aged 42-69 years, mean disease duration 24 +/- 25 months, were examined. All patients received antirheumatic therapy. The reference population consisted of 103 age-matched controls (68 females, 35 males) and young healthy controls. BMD measurements were performed using a DXA Expert XL densitometer (Lunar). BMD of the whole-hand and two subregions was determined: two subchondral regions of interest (S.CH.) were set within the trabecular bone, distal to the proximal interphalangeal joints of digits II and III excluding the dense subchondral bone of the metacarpophalangeal (MCP) joint and two metacarpal regions of interest (MCP) were set including the entire MCP joint of these fingers. QUS measurements at the proximal phalanges of digits II-V were performed using a DBM Sonic (Igea); amplitude-dependent speed of sound (Ad-SoS) was determined. In comparison with whole-hand BMD measurements, bone loss was pronounced in patients with a disease duration of 18-72 months at the subchondral regions of interest in both genders compared with age-matched controls (women: mean BMD loss S.CH. -23%, p<0.001, whole-hand -16%, p<0.001; men: mean BMD loss S.CH. -19%, p < 0.05, whole-hand -12%, p<0.05). The bone changes were also shown by QUS (women: Ad-SOS values of 1950 +/- 90 m/s in RA vs 2137 +/- 35 m/s in young healthy controls (p <0.005); men AD-SOS 1956 +/- 87 m/s in RA vs 2146 +/- 41 m/s in young healthy controls (p <0.05)). These results show that BMD and Ad-SOS values are significantly lowered in patients with early RA and indicate that periarticular osteoporosis in early RA might possibly be better detected using detailed hand scan analyses.

Absorptiometry, Photon↗
PubMedDate not supplied

Comparison of bone and 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography in the evaluation of bony metastases in lung cancer.

UNLABELLED: Positron emission tomography (PET) is a proven accurate modality used for the detection of active malignant tumors. The performance of PET in detecting bony metastases, however, has not been adequately investigated. PURPOSE: The aim of this study was to compare the performance of bone and 2-deoxy-2-[18F]fluoro-D-glucose (FDG) PET scans in evaluating bony metastases from lung cancer. PROCEDURE: This retrospective study evaluated 85 patients with lung cancer who underwent both FDG-PET and bone scans within three weeks of each other for initial staging or restaging. The number and sites of bony lesions on FDG-PET and bone scans were correlated. Concordant lesions between the two modalities were considered to be positive for malignancy; discordant lesions were compared with X-rays, computed tomography (CT), magnetic resonance imaging (MRI), and/or follow-up findings. The mean follow-up interval was 7.9 months. RESULTS: Bone scans were positive for lesions in 24 patients and negative in 61 patients while FDG-PET was positive for bony lesions in 17 patients and negative in 65 patients. FDG-PET was indeterminate for rib involvement in three patients having an underlying lung cancer, whom were evaluated separately. A total of 88 and 41 bony lesions were identified on bone scans and FDG-PET, respectively. Correlation of bone scans with other imaging modalities and clinical follow-up findings revealed a sensitivity, specificity, positive and negative predictive value of 81%, 78%, 34%, and 93%, respectively and for FDG-PET 73% (P=0.81), 88% (P=0.03), 46% (P=0.5,) and 97% (P=0.04), respectively. Using bone scans, 10 patients were correctly diagnosed with bony metastases, 54 were correctly diagnosed free of bony metastases, 17 patients were falsely diagnosed with metastases, and metastases were missed in one patient. Using FDG-PET scans, eight patients were correctly diagnosed with bony metastases, 66 were correctly diagnosed free of bony metastases, seven patients were falsely diagnosed with metastases, and one patient had metastases which were missed. Of the three patients with lung cancer close to the chest wall in whom FDG-PET was indeterminate for rib involvement, the bone scans were truly positive for rib involvement in two of them, and truly negative in the remaining patient. CONCLUSIONS: FDG-PET scans demonstrated significantly higher specificity and negative predictive values than bone scans for evaluating bony metastases from lung cancer. On the other hand, bone scans are more sensitive with higher positive predictive values than FDG-PET scans, but the differences were not statistically significant.

Aged↗
PubMed1996

[Short stature due to a partial idiopathic deficiency of the growth hormone. The role of the TW2 method in assessing treatment with r-hGH].

The Tanner-Whitehouse 2 (TW2) method to assess skeletal maturation (reviewed by Nicoletti for the Italian population) was used to study, from January, 1991, to December, 1994, a series of 26 Italian patients. The patients, 18 men (69.3%) and 8 women (30.7%), came from inhomogeneous family stocks and were all affected with short stature due to partial idiopathic GH deficiency; they were treated with replacement therapy with the biosynthetic recombinant human growth hormone (r-hGH). Each patient underwent 3 wrist and left hand radiographs, the first one made on the basis of medical and endocrinologic assessment. The patients were reexamined after one and two years of treatment with the analysis of stature growth and of the skeletal maturation of hand bones. At one year, the average chronological age of our patients was 12.42 year (range: 9.4-15.2 years), their average bone age was 11.13 years (range: 6.5-14 years) and their average height was 137.81 cm (range: 117-155.5 cm). The patients were then retrospectively examined on the basis of bone maturation and final height, at the end of two years' therapy. At the end of treatment, height was above the third percentile in all patients and therefore within the expected personal target on the basis of genetic stature. The TW2 indexes of bone maturation, after one year of treatment, had increased by 44.84% (range: 27-77%) of the total maturation increase at two years. Moreover, after one year of treatment, average stature increase was 55.81% (range: 42-72%) of the total stature increase at two years. After two years of treatment, TW2 indexes showed an average 55.16% increase in bone maturation (range: 23-73%) of total maturation and average stature increase was 44.19% (range: 28-56%) of the total stature increase. Our results confirmed that skeletal growth and bone maturation are two distinct processes. Particularly, we noted that, while after one year of r-hGH therapy skeletal growth (especially in the long bones) prevails over bone maturation, after two years maturation prevails. In conclusion, our experience confirms the TW2 method as a simple and highly informative method which can be used in any radiologic center.

Adolescent↗
PubMed1980

[Skeleton of swimmers' hands].

The skeleton of the hand fingers was studied roentgenographically and osteometrically in swimmers 8--10 and 17--19 years of age. As the investigation demonstrated, it is necessary to take into account sports selection in order to study adaptive peculiarities of the osseous system in young sportsmen. Increasing rate in osteogenesis noted in the hand bones of swimmers 8--10 years old does not result from increasing physical loading on the hand but is a cause of the original selection of more physically suitable and biologically mature children for swimming. In order to study adaptive peculiarities of the most loaded skeletal parts in sportsmen, it is necessary to compare them rather with other sportsmen experiencing physical loading on similar skeletal parts, and differing only in the mode of performance, but not with persons nonsportsmen. Uniform lengthening of the metacarpal bones and uniform thickening of their compact substance on the radial and ulnar sides symmetrically on both hands is one of specific morphological features of the swimmers' hands adaptation to physical loadings.

Adaptation, Physiological↗
PubMed1987

Aneurysmal bone cyst of the hand.

Diagnosis of aneurysmal bone cyst in the hands is confused by rarity (2%) and overlapping characteristics of other lesions, especially benign osteoblastoma and giant-cell tumor. Pseudosinusoidal vascular channels create interfaces between liquid blood (maintained by fibrolysin) and connective tissue cells. The role of trauma is inexplicable.

Bone Cysts↗
PubMed2001

Congenital skeletal abnormalities: an introduction to the radiological semiology.

Despite the recent advances in the molecular diagnosis of congenital abnormalities, the initial identification and the decision to refer a patient for further molecular analysis and expensive genetic tests still relies frequently on clinical and radiological criteria. The radiological identification of syndromes, dwarfs and dysplasias is a difficult task, because there are so many findings to consider and so many syndromes to remember that the problem is overwhelming. There is a definite need for an easy and systematic analysis system, in order to try to categorize a skeletal dysplasia in a certain group. In this brief review, we suggest an approach to the evaluation of skeletal syndromes, based on the analysis of cardinal criteria, from which the most useful information is derived, and additional criteria, making further differentiation possible. Generally, cardinal information is derived from analysis of the long bones, hands, pelvis and the spine, whereas the analysis of other skeletal elements, like the skull, feet, and other flat bones is of additional value.

Bone Diseases, Developmental↗
PubMed1980

Giant-cell reparative granuloma of short tubular bones of the hands and feet.

Eight cases of giant-cell reparative granuloma were encountered in the short tubular bones of the hands and feet. This entity was originally described by Jaffe as a jaw lesion. Subsequently the lesion was found in the skull and facial bones. The name "giant cell reaction" was applied to similar lesions found in the short tubular bones of hands and feet. Thirteen prior cases have been reported and none recurred. Of the eight new cases described herein, four have recurred one or more times, requiring further treatment. No association with hyperparathyroidism was found. We prefer to designate these lesions as giant cell reparative granulomas of extragnathic sites. Because of overlapping ultrastructural and light-microscopic features, as well as similar biologic behavior, we feel that aneurysmal bone cyst and these giant-cell reparative lesions represent related responses to intraosseous hemorrhage.

Adolescent↗
PubMed1979

Growth of short bones of the hand in children with Down's syndrome.

In this study, we report the elongation of the diaphyses of the short bones of the hand in an institutionalised sample of children with Down's syndrome. These diaphyses are significantly shorter than normal which is typical of other physical dimensions of individuals with Down's syndrome. Sex differences were generally lacking in diaphyseal lengths; this is in agreement with earlier reports. Pubescent spurts were not detected, but their absence cannot be certain. Roche (1965) reports the common absence of pubescent spurts in stature in children with Down's syndrome. However, only the magnitude of growth in stature of a small sample of these Down's children differed from normal; this dissimilarity was the result of differences in adult statures of normal and Down's individuals (Rarick, Wainer, Thissen and Seefeldt, 1975). Benda (1960) speculates that growth of the short bones of the hand stops early; thus, the pubescent spurt may be prevented by premature, epiphyseal closure. This would be in partial agreement with reports for stature (Roche, 1965). In this sample of children with Down's syndrome the extra chromosome, No. 21, appears to affect the growth of short bones of the hand before seven years of age. The diaphyses of short bones of the hand in these children are shorter than normal by seven years of age and significantly so after eleven years of age; but thereafter, these bones grow normally except for the absence of a pubescent spurt. This pattern is similar to reports of growth in length of other parts of the skeleton in children with Down's syndrome.

Adolescent↗
PubMed1991

Chondrosarcoma of the bones of the hand. Report of two cases.

Implantation of chondrosarcoma in the bones of the hands is an infrequent occurrence. We present two cases in which the fifth metacarpal and the proximal phalanx of the index finger, respectively, were affected in two patients aged 47 and 67 years, who, without previous known lesions, came to consultation on the appearance of pain and progressive local growth of tumour. After histological diagnosis we proceeded to disarticulation at the level of the affected bone. We review the literature on the appearance of this type of tumour in the hand.

Aged↗
PubMed2006

Aneurysmal bone cyst of the hand: a report of four cases.

Aneurysmal bone cysts are benign lesions that rarely occur in the bones of the hand. Curettage and bone grafting are the most common treatment modalities performed considering the possible functional loss after total excision. Four cases of aneurysmal bone cyst of the hand were identified. Three out of four cases were treated initially with curettage and bone grafting alone without any other local therapy. One had total excision of the lesion. There were two recurrences in the curettage group. Both were treated with excision and followed up for a minimum of 12 months. Curettage alone was associated with high recurrence rates. Total excision of the lesion was the most successful procedure employed. In view of the high recurrence rates following curettage alone and non-neoplastic nature of the lesion, adjuvant treatment modalities such as cryosurgery, electric cauterisation should be considered for initial treatment of ABC. Resection should be preserved for recurrent cases.

Adolescent↗
PubMed2004

Benign and malignant cartilage tumors of the hand.

Primary bone tumors of the hand and wrist are unusual but if present are frequently chondrogenic in origin. Enchondroma is the most common primary bone tumor of the hand and can be treated by curettage and bone grafting. Chondrosarcoma is rare and most likely the result of malignant degeneration of a pre-existing lesion. Wide en bloc resection is appropriate for chondrosarcoma and typically involves ray resection or partial hand amputation.

Bone Neoplasms↗
PubMed1984

Extended treatment of primary osteoporosis by sodium fluoride combined with 25 hydroxycholecalciferol.

Nineteen patients suffering from primary osteoporosis, all having at least one vertebral collapse, initially received 50 mg of sodium fluoride alone per day for 6-18 months. Subsequently fluoride was associated with 25-50 micrograms of 25 OH cholecalciferol (calcifediol) per day for 6-18 months in 12 of these patients and 9 were treated for 31-58 months. As control group, 9 patients were given placebo for 6-18 months. The effect of the treatment was assessed by three methods: 1) the metacarpal index (MI) determined by radiogrammetry, 2) the calcium content of the hand bone (Ca) measured by local neutron activation, 3) the iliac bone histomorphometry. MI and (Ca) did not change significantly at any time in any group. In each group there was a significant increase in trabecular bone volume, osteoid volume, osteoid surfaces and a significant decrease in mineralization fronts. On the other hand, the changes in osteoblastic surfaces, osteoclastic surfaces, number of osteoclasts/mm2 were not significant in any group. No change was observed in the placebo group. These data suggest that the increase in the trabecular volume of fluorided bone is mainly due to the increase in osteoid which itself is due to a bone mineralization defect despite the association of calcifediol. This is probably one of the reasons why (Ca) does not change significantly.

Aged↗
PubMed1989

[Marginal bone loss among adults: have the conditions changed since the 1950's?].

It has been suggested that periodontal diseases have declined during the last 2-3 decades in many populations. However, the present observations on marginal bone loss among 326 Norwegian dental patients aged 20-70 years, examined 35 years ago, were similar to comparable data published more recently. Consequently, they did not indicate any tendency towards change over time. Traditionally, the Periodontal Index (PI) has been the method of choice for assessing the prevalence and severity of periodontal disease in epidemiological studies. It was assumed that this may have lead to an overestimation of the periodontal destruction, and that the postulated improvement of the condition partly may be ascribed to methods of analysis rather than reality. The observations seemed to indicate that susceptibility to destructive periodontal disease may not be as universal as was previously thought; the majority of the patients could probably retain a considerable proportion of the supporting bone up in high age by routine prophylaxis and improved home care. On the other hand, bone destruction was a serious problem among a minority of "risk" individuals after the age of 40. This subgroup was estimated to make up about 10% of the population. Similar estimates also appeared in published studies on statistical samples from other populations. The individual resistance to periodontal destruction is probably very important for the marginal bone level. The constituent elements of the resistance concept do, however, need further elucidation.

Adult↗