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At least 343 records · Page 19Linked to original sources
PubMed1977

Congenital triangular bones in the hand.

From the literature we found reports of 105 patients whom we judged had a triangular deformity of one of the bones of the hand or foot. We found 49 patients of our own with 84 delta-shaped phalanges limited strictly to the hand. This represents an incidence of 3.5% of our congenital abnormalities of the upper extremity. The deformity is associated with many abnormalities: syndactyly, polydactyly, symphalangism, triphalangeal thumb, cleft hand, and hypoplastic hand are the most frequent Triangular deformity of the bone of the index finger usually is associated with Apert's syndrome. Triangular deformity of the proximal phalanx of the ring finger often is found with central polydactyly. Our average follow-up time on these 49 patients was 14 years, giving us a chance to establish some guidelines and general rules about the natural history and treatment of the delta bone.

Abnormalities, Multiple↗
PubMed1999

South Turkwel: a new pliocene hominid site in Kenya.

New fossils discovered south of the Turkwel River in northern Kenya include an associated metacarpal, capitate, hamate, lunate, pedal phalanx, mandibular fragment, and teeth. These fossils probably date to around 3.5 m.y.a. Faunal information suggests that the environment at South Turkwel was predominantly bushland. The mandibular and dental remains are fragmentary, but the postcranial fossils are informative. Comparisons with Australopithecus, modern human, chimpanzee and gorilla hand bones suggest that the Turkwel hominid was most like Australopithecus afarensis and A. africanus. Carpometacarpal articulations are intermediate between those of modern humans and African apes, suggesting enhanced gripping capabilities compared with extant apes. The hamulus was strikingly large, similar in proportion only to Neandertals and some gorillas, suggesting the presence of powerful forearms and hands. There are no indicators of adaptations to knuckle-walking or suspensory locomotion in the hand, and the pedal phalanx suggests that this hominid was habitually bipedal.

Animals↗
PubMed1999

Prognostic importance of magnetic resonance imaging in bone marrow involvement of Hodgkin disease.

BACKGROUND: Determination of bone marrow involvement is important in staging Hodgkin disease (HD), so we compared the effectiveness of magnetic resonance imaging (MRI) with bone marrow biopsy in diagnosing bone marrow involvement in HD patients. PROCEDURE: Twenty-six patients with the diagnosis of HD were included in this study. The ages of the patients were between 4 and 24 years, with a median of 12. Eleven of them had stage III or IV disease and 15 had been previously diagnosed as having HD and were in relapse. They were evaluated by bone marrow biopsy and MRI of lumbar vertebrae. The biopsies were taken from the anterosuperior iliac spine with an age-appropriate Jamshidi biopsy needle. Within 14 days following biopsy, MRI of lumbar vertebrae was carried out. RESULTS: MRI revealed decreased signal intensity in T1-weighted images in 7 of 26 patients. On the other hand, bone marrow biopsies showed HD involvement in three out of seven patients. The remaining 19 patients who had normal bone MRI were negative for HD in their bone marrow biopsies. The patients with positive MRIs and negative biopsy for HD had bone pain. One of them had a femoral periosteal reaction on bone survey; the other two had height loss in their lumbar vertebral bodies. There was a statistically significant difference in the disease-free survival rates between MRI-positive and -negative patients in the following 24 months period (P < 0.0001). CONCLUSIONS: This study suggests that MRI is a useful method for diagnosing bone marrow involvement in HD, in that our MRI-positive patients had a higher relapse rate in the 24 months follow-up period than the MRI-negative patients.

Adolescent↗
PubMedDate not supplied

[Roentgen diagnosis of hypo- and hyperparathyroidism].

The internal organs and the bone and joint system of 970 patients with hyperparathyrosis and the bone and joint system of 146 persons with hypoparathyrosis, as well as of patients with other nosology, in whom these diabetes are suspected, underwent roentgenoscopy. It is suggested that indirect thyroid lymphography, combined with esophagoscopy, is an effective method for revealing changes in the parathyroid glands. The characteristic signs of hyperparathyrosis are subperiosteal resorption of the hand bones and specific osteoporosis of the cranial bones, particularly in their combination with systemic skeletal osteoporosis. The main hypoparathyrosis symptoms are osteosclerosis, accompanied by calcification of the soft tissues.

Adenoma↗
PubMed1984

Acrofacial dysplasia resembling geleophysic dysplasia.

We report on a 12-year-old girl with acrofacial dysplasia, growth retardation, joint contractures, mitral valve incompetence and focal hepatic storage of material reacting histochemically as glycoprotein. The patient's phenotype resembles that of patients with geleophysic dysplasia but differs with respect to facial appearance, milder changes of hand bones and normal capital femoral epiphyses. It is undecided if her disorder is part of a wider phenotypic spectrum of geleophysic dysplasia or a different entity.

Abnormalities, Multiple↗
PubMed1988

Orthopedic pitfalls in emergency medicine.

Acute orthopedic problems make up a large part of everyday emergency department practice. Misdiagnosis of these injuries often results from failure to consider certain clinical entities as a cause of the patient's complaints, and may result in unnecessary complications for the patient. Indeed, missed orthopedic injuries are the leading cause of malpractice claims in emergency medicine. The orthopedic injuries that most notoriously escape detection by the primary care physician are closed tendon injuries of the hand, carpal bone injuries, occult fractures about the elbow, femoral neck fractures, posterior dislocation of the shoulder, epiphyseal plate injuries, fractures of the pubic ramus, patellar tendon rupture, Lisfranc injuries, compartment syndromes, and multiple injuries. If the physician is unaware of these entities when evaluating the patient, he will not make the diagnosis. This review is designed to heighten the primary care physician's awareness of these injuries, which are a common source of problems in the emergency department.

Aged↗
PubMed2002

A comparison between radiographic and sonographic assessment of hand and wrist bones for the estimation of skeletal age in the child patient.

AIM: The purpose of this study was to examine, with a sonographic investigation, the hand and wrist bones of a group of young patients and to compare the results with those obtained with a classical radiographic assessment. MATERIALS AND METHODS: Some 25 subjects, 9-18 years of age, who presented problems concerning their short stature or precocious puberty, were evaluated. Each subject was examined by a standard radiographic assessment and by a sonographic investigation with real-time imaging. Sonographic examination was performed on the metacarpus-phalanx articulation of the first finger in order to locate the sesamoid bone. Sonographic examination was also performed on the second and third phalanxes of the third finger and on the distal portion of the radius to evaluate the characteristics of growth cartilage in the area. RESULTS AND STATISTICS: In all the cases where a sesamoid bone was present, this was correctly identified by the sonogram, even up to the initial appearance of its ossification nucleus. Sensitivity, specificity, and diagnostic accuracy were all 100%. The capping phenomenon seen in radiographs was not detected by sonographic investigation in any of the cases. Sonographic evaluation of the fertile cartilage of the third finger distal phalanx demonstrated a sensitivity of 89%, a specificity of 100% and a diagnostic accuracy of 92%. Sonographic evaluation of the radius cartilage showed a sensitivity of 95%, a specificity of 100% and a diagnostic accuracy of 96%. CONCLUSION: Sonographic evaluation of hand and wrist bones cannot accurately reproduce the results of the classical radiographic evaluation. However, the sonographic investigation may be useful, when integrated in a radiographic investigation.

Journal Article↗
PubMed1981

The detection of spinal pseudarthrosis in ankylosing spondylitis.

Spinal pseudarthrosis in ankylosing spondylitis can be difficult to detect radiologically. This paper assesses the value of bone radioscintigraphy in relation to radiological examination. The patterns of tracer uptake in the spine were recorded in 16 patients in whom established ankylosing spondylitis was complicated by pseudarthrosis. Twenty such lesions were identified in 16 patients, mostly occurring at one level in a junctional region of the spine. Four patients had two lesions. Standard radiography failed to demonstrate this abnormality in seven patients and in these, tomography was required to confirm the scintigraphic findings. On the other hand, bone scanning was much less accurate in detecting the minor forms of marginal vertebral end plate destruction (spondylo-discitis) than conventional radiology. This study suggests that 99TcmMDP scanning is a useful primary investigation for the detection of spinal pseudarthrosis in patients with chronic ankylosing spondylitis who suffer late onset back pain.

Adolescent↗
PubMed1990

Metacarpophalangeal pattern profile analysis in Rubinstein-Taybi syndrome.

Metacarpophalangeal pattern profile (MCPP) was determined in 49 radiographs of 40 patients with Rubinstein-Taybi syndrome. Two recognizable hand profiles were seen, depending on the configuration of the thumb and on age. Patients with a straight thumb showed a short first proximal phalanx, and short third medial phalanx. Patients with a radially deviated thumb had a short first proximal phalanx. Depending on age, a relatively large (infancy) or markedly short (older patients) first distal phalanx was found. The similarity between the patients was high. A third group of patients did not show a particular hand profile, but only small hand bones. The pattern variability indices were high in all groups of patients. MCPP analysis in Rubinstein-Taybi syndrome seems to be a powerful, but not pathognomonic, diagnostic tool.

Abnormalities, Multiple↗
PubMed1984

Primary hemangiopericytoma of bone in the hand: a case report.

Primary hemangiopericytoma of the bone is rarely described in the literature. This is a case report of primary hemangiopericytoma of the second metacarpal that was treated by en bloc resection and replacement with iliac bone graft. An excellent result was present 2 years after the operation.

Adult↗
PubMed1981

[Sonographic demonstration of the fetal extremities in the mid-trimester (author's transl)].

In 251 pregnancies fetal extremities were systematically examined by means of an ultrasound sector scanner between the 12th and 28th week of gestation. The procedure is demonstrated by typical pictures. The long tubular bones, hands and feet were visualized regularly, and differentiation of radius and ulna or tibia and fibular was possible. Studies took between 5 and 25 minutes. In all cases the length of the diaphyses was determined, resulting normal growth tables and rate of growth curves. Between the 12th and 28th week, the humerus grows from 9 to 51 mm., the radius from 7 to 46 mm., the femur from 10 to 55 mm., and the tibia from 8 to 48 mm. Sonographic depiction of fingers and clavicles was also quite successful. For best results, examinations were done between the 16th and 20th week. In three fetuses later aborted, sonographic and direct (after preparation) measurements of bone length for the diaphysis differed by no more than 4%. The study shows that visualization of the extremities regularly succeeds in the mid-trimester. A multitude of localized or systemic limb malformations may be recognized. In cases with known predisposition to malformations a regular ultrasonic checkup should be performed, thus extending the scope of prenatal diagnosis.

Extremities↗
PubMed2004

Brachydactyly and short stature in a kindred with early-onset parkinsonism.

In a Dutch kindred we have identified a deletion of the DJ-1 gene, leading to autosomal-recessive parkinsonism. The parkinsonism patients also had short stature and brachydactyly. In the family and a control group from the same community, we used the DJ-1 deletion as a marker for the originally linked PARK7 region and found a significant association with body height (P = 0.005), which suggests a gene in linkage disequilibrium with DJ-1 to be implicated in short stature. Analysis of hand-bone length showed incomplete segregation of the PARK7 region with brachydactyly, such that a gene in PARK7 is unlikely to fully explain the brachydactyly. Since the bone length reduction was more pronounced in the homozygous parkinsonism patients than in their heterozygous relatives, however, the PARK7 region may contain a modifier gene for growth.

Age of Onset↗