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PubMed1991

[Dialysis-associated amyloid osteopathy--the radiological aspects].

Amongst the complications of dialysis, amyloid osteopathy is getting increasingly significant. It is due to deposition of beta 2-microglobulin. To determine the incidence and time of development of this complication, the skeletal radiographs of 185 patients undergoing dialysis, some for up to ten years, were analysed retrospectively. In about 10% of patients, the presence of beta 2-microglobulin osteopathy may be expected. The radiological features, sites of predilection and differential diagnosis of amyloid osteopathy and of other skeletal changes due to dialysis are discussed.

Amyloidosis↗
PubMed2001

Methotrexate osteopathy demonstrated by Technetium-99m HDP bone scintigraphy.

The authors report a case of methotrexate osteopathy as revealed by Tc-99m HDP bone scintigraphy in a patient with rheumatoid arthritis. Methotrexate is used widely in high doses as a chemotherapeutic agent. Lower doses are given in rheumatoid and psoriatric arthritis. Methotrexate affects bone metabolism, resulting in methotrexate osteopathy, characterized by osteoporosis, osseus pain, and even spontaneous (micro)fractures. Radiographic visualization of microfractures is difficult. Tc-99m HDP bone scans have been shown to be very sensitive in the visualization of changes in bone metabolism as a result of methotrexate osteopathy.

Antirheumatic Agents↗
PubMedDate not supplied

Congenital megaesophagus with hypertrophic osteopathy in a 6-year-old dog.

Congenital megaesophagus is often sufficiently debilitating to a young puppy to result in an owner's request for euthanasia. If medically managed, some puppies may develop a functional esophagus and mature normally; in others, the dilation may persist, but nutritional support may be sufficient to allow skeletal maturation. Hypertrophic osteoarthropathy or hypertrophic osteopathy is well recognized in many animal species. Pulmonary neoplasia is most commonly associated with development of the secondary bone changes, but numerous other causes exist. The chronic changes of hypertrophic osteopathy were identified in a 6-year-old German Shepherd that was debilitated by persistent congenital megaesophagus. To the investigators' knowledge, a relationship between long-term esophageal dilatation and hypertrophic osteopathy has only been reported once in a human patient.

Animals↗
PubMed1997

Methotrexate osteopathy in patients with osteosarcoma.

PURPOSE: To determine the frequency of osteopathy in patients treated with high-dose, short-term, intravenous methotrexate for osteosarcoma and whether this complication varies with patient age and methotrexate dose. MATERIALS AND METHODS: Radiographs and available scintigrams of 87 patients with osteosarcoma who received high-dose methotrexate were reviewed retrospectively for severe osteopenia, dense zones of provisional calcification, insufficiency fractures, and involvement of multiple bones. At least three of these radiographic abnormalities were required for the diagnosis of osteopathy. Patients with bone metastases were excluded. RESULTS: Eight patients (cumulative dose, 60-144 g/m2) exhibited adverse skeletal findings similar to those described in children with leukemia who received low-dose maintenance methotrexate. Images showed severe osteopenia (n = 8), dense zones of provisional calcification (n = 8), multiple bone involvement (n = 6), and insufficiency fractures (n = 6). Most commonly affected sites were the distal tibia (n = 7), distal radius and proximal humerus (n = 3), and calcaneus and public ramus (n = 2). The affected patients were significantly younger (mean age, 9.2 years; P < .001) than the 79 unaffected patients (mean age, 14.9 years). CONCLUSION: Osteopathy occurs in approximately 9% of children who receive high-dose methotrexate for osteosarcoma and is substantially more likely to occur in younger patients. The complication rate was not directly dose dependent.

Adolescent↗
PubMed1998

Osteopathy in broiler chicks fed toxic mimosine in Leucaena leucocephala.

Further studies of mimosine toxicity in broiler chicks were done to clarify a possibility of osteopathy. The mineral content and density of femur and the strength, ductility, and toughness for the index of mechanical properties significantly decreased in the 1% mimosine group, compared with those in the control and restricted groups. The stiffness had a decreasing tendency in the 1% mimosine group. Consequently, it was concluded that chicks fed ad libitum a 1% mimosine diet for 12 days developed osteopathy. The bone mineral density and the strength of the restricted group were lower than those of the control group, and those of the 1% mimosine group were still lower than those of the restricted group. Contents of pyridinoline and deoxypyridinoline in the excrement were significantly higher in the restricted group than those in the control group, but the contents in the 1% mimosine group were significantly lowest among the groups. Osteopathy in chicks fed mimosine, therefore, seemed to be done by loss of appetite and changing to a low turnover of bone caused by mimosine.

Amino Acids↗
PubMedDate not supplied

On diabetic osteopathy: a radiographic study of 21 patients.

Twenty-one diabetic patients with anesthetic peripheral neuropathy who never suffered a foot infection or local ulceration had roentgenograms of both feet to seek whether osseous changes characteristic of diabetic osteopathy were present. We found nine patients with vascular calcification (all 21 patients had palpable pedal pulses); four patients with ancient fractures; one patient with two phalangeal erosions; and two patients with equivocal osseous cystic lesions. No patient had findings typical of diabetic osteopathy. From this study, plus experience with other diabetic patients who had infected, ulcerated feet, we conclude that diabetic osteopathy represents healing or healed lesions of local osteomyelitis.

Bone Diseases↗
PubMed1992

Hypertrophic osteopathy in three horses and a pony.

Hypertrophic osteopathy was diagnosed in 3 horses and in a pony, ranging in age from 8 to 21 years. There were 2 females, 1 sexually intact male, and 1 gelding. In 3 animals, hypertrophic osteopathy was associated with pulmonary abscesses, bronchogenic squamous cell carcinoma, and ovarian granulosa-cell tumor, respectively, and resulted in death or euthanasia. Duration of the condition ranged from 1 to 4 months. In 1 horse, hypertrophic osteopathy was believed to be secondary to pregnancy, and resolved following uncomplicated delivery of a live foal.

Animals↗
PubMed2005

[Case report: Hypertrophic osteopathy in roe deer (Capreolus capreolus)].

This report describes a case of hypertrophic osteopathy in an approximately three years old male roe deer (Capreolus capreolus). The hunter reported that the animal was apparently healthy and showed no signs of movement imparities. At dissection, a combination of a lung abscess with bony swellings at the distal parts of the limbs was observed. Further investigation revealed that the bony swellings were caused by a severe periosteal hyperosteosis at the diaphyses of the digital phalanges, metacarpal and metatarsal bones. The periosteal new bone was characterized by the formation of coralliform osteophytes, typically seen in cases of hypertrophic osteopathy. As usual in animals with hypertrophic osteopathy, the pathological changes in this roe deer developed secondary to a intrathoracic lesion (lung abscess).

Animals↗
PubMed1989

[Psoriatic osteopathy].

In order to make evident an up to now only postulated generalized osteopathy in psoriatics in 24 patients with psoriasis and 24 patients with psoriatic arthritis the serum-calcium levels, the alkaline phosphatase in the serum and the excretion of hydroxyprolin in the urine were determined. Moreover, the bone bioptates of 25 patients with psoriatic arthritis and 10 patients with psoriasis were histologically examined and morphometrically measured, respectively. The examinations give evidence for the presence of a generalized "latent" osteopathy in the sense of an increased bone turnover rate without loss of bone volume (high turnover remodeling) in patients with psoriatic arthritis as well as in those with psoriasis without arthritis. As a common pathogenetically significant factor for dermatosis and osteopathy a latent vitamin D deficiency and a D-hormone resistance is discussed.

Alkaline Phosphatase↗
PubMed1986

[Alimentary, metabolic and toxic osteopathies in adults].

Skeletal changes in deficient or badly balanced nutrition (alimentary osteopathies) and osseous changes accompanying chronic disease of internal organs and metabolic disorders (metabolic osteopathies) are discussed. Basically, the classical generalised skeletal changes such as osteoporosis, osteomalacia, fibroosteoclacia and sclerosis of the bone can occur in their pure form or as a combination of two ore more of these disorders. Finally the exogenic toxic osteopathies are discussed, nowadays fluorosis being the most important. Other external factors may be drugs such as methotrexate and antiepileptic medications.

Adult↗
PubMed1985

Hypertrophic osteopathy associated with a bronchial foreign body and lobar pneumonia in a dog.

Hypertrophic osteopathy was diagnosed in a dog with a bronchial foreign body and lobar pneumonia. Hypertrophic osteopathy is generally associated with primary or secondary neoplasms of the lungs and rarely associated with nonneoplastic thoracic lesions. The foreign body and affected lung lobe were removed by pneumonectomy, resulting in recovery of the dog and resolution of the hypertrophic osteopathy lesions.

Animals↗
PubMed1984

[Femur head necrosis in metabolic and hormonal osteopathies--a radiologic-morphologic analysis].

The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with "idiopathic femoral head necroses" were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis is understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral head structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis.

Adult↗
PubMed1982

[Effect of ultraviolet irradiation on renal osteopathy in patients in the chronic hemodialysis program].

Under influence of the ultraviolet radiation the formerly lowered 25-hydroxycholecalciferol (25-OH-CC) level increases in persons with healthy kidneys. Such investigations were not yet carried out in patients undergoing dialysis. Since the insufficiency of active vitamin-D-metabolites plays an essential role in the development of the renal osteopathy, since 1978 in 13 patients undergoing dialysis a regular ultraviolet radiation has been performed, in order to stimulate the cutaneous vitamin-D-production. The time of observation was 31.7 +/- 14.3 months. Deionized water served for the production of dialysate. The calcium content was about 3.5 +/- 3.8 mval/l. The patients had very rarely bone and joint complaints. Severe clinical complications of renal osteopathy developed only in one female patient in the 3rd year of dialysis with a fracture of the neck of the femur as well as in a 2nd patient after transplantation of a kidney with permanently progressing demineralization and spondylitis. Controls of the courses showed only in 18.2% a progressing loss of the peripheral mineral content of the bones. The alkaline phosphatase was not increased, the alkaline bone phosphatase appeared with low and not provable activities. A suppression of the secondary hyperparathyroidism could not be proved. Parathormone was increased with 2.30 +/- 1.90 micrograms/l. The 25-OH-CC-levels were normal or slightly increased with 39.1 +/- 12.4 micrograms/l, whereas they were essentially lower in a comparative group without ultraviolet radiation. Therefore in connection with the very low rate of complications of the renal osteopathy with normalized 25-OH-CC-levels new therapeutic possibilities were the result in patients undergoing dialysis after ultraviolet radiation. The increasing importance consists also in the fact that 90% of the human vitamin-D-need are supplied via skin and it was proved by animal experiments that also after bilateral nephrectomy the formation of the active vitamin-D-metabolite 1,25-dihydroxycholecalciferol is possible by photosynthesis.

Adult↗
PubMed1994

[Preclinical diagnosis of metabolic osteopathy in feedlot bulls].

Diagnostic significance of some clinico-biochemical parameters was investigated in 221 fattened bulls. An evaluation of the results has shown that the determination of concentrations of calcium, inorganic phosphorus and alkaline phosphatase activity in blood plasma was not of essential importance for diagnostics. The values of these parameters were within the reference range (Tab. I). The parameters determined by chemical analyses of bioptates from the tuber coxae of the fattened bulls with various forms of alimentary osteopathy showed characteristics, statistically significant differences in comparison with the control animals (Tabs. II, III, IV). In the bulls of group B/1 (clinically healthy, phosphorus deficit in the feed ration, acidogenic nutrition in part of the animals, lowered performance, occurrence of clinical cases of osteopathy in fattening facilities), a significant decrease in the values of ash per 1 g fat-free dry matter and per 1 cm3 spongy substance of the t. coxae and a significantly wider index Ca/P were determined. In the bulls of group B/2 (clinically healthy, deficit of phosphorus, calcium, proteins and energy in the feed ration, decreased performance, occurrence of clinical osteopathy), a significant decrease of ash per 1 g fat-free dry matter and per 1 cm3 of spongy substance of the t. coxae was determined, the Ca/P index was significantly narrower. In the bulls of group C/1 (bulls with clinical symptoms of skeleton disorder, phosphorus deficit in the feed ration, acidogenic nutrition in part of the animals), a significant decrease of ash per 1 g far-free dry matter and per 1 cm3 spongy substance of the t. coxae was found out, the Ca/P index was wider.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Methotrexate osteopathy in long-term, low-dose methotrexate treatment for psoriasis and rheumatoid arthritis.

BACKGROUND: In dermatology and rheumatology, methotrexate is frequently prescribed in low dosages per week; in oncology, high dosages per week are prescribed. Methotrexate osteopathy was first reported in children with leukemia treated with high doses of methotrexate. In animal studies, low doses of methotrexate proved to have an adverse effect on bone metabolism, especially on osteoblast activity. OBSERVATIONS: Methotrexate osteopathy is a relatively unknown complication of low-dose methotrexate treatment. We describe three patients treated with low-dose oral methotrexate in whom signs and symptoms were present that were similar to those found in children treated with high doses of methotrexate. All three patients had a triad of severe pain localized in the distal tibiae, osteoporosis, and compression fractures of the distal tibia, which could be identified with radiographs, technetium Tc 99m scanning, and magnetic resonance imaging. CONCLUSIONS: Methotrexate osteopathy can occur in patients treated with low doses of methotrexate, even over a short period of time. As pain is localized in the distal tibia, it is easily misdiagnosed as psoriatic arthritis of the ankle, but the diagnosis can be correctly made by careful investigation and use of imaging techniques. The only therapy is withdrawal of methotrexate. It is important that more physicians become aware of this side effect of methotrexate therapy, which can occur along with arthritic symptoms.

Aged↗
PubMed1997

Hypertrophic osteopathy associated with an intrathoracic neoplasm in a rabbit.

Hypertrophic osteopathy associated with an intrathoracic neoplasm was diagnosed in a 7.5-year-old spayed female White New Zealand rabbit. The rabbit was examined because it had a swollen foot and was anorectic. An intrapulmonary mass as well as periosteal proliferation in the tarsometatarsal region were observed on radiography. Histologic examination of necropsy specimens was used to confirm the diagnosis of hypertrophic osteopathy secondary to metastatic adenocarcinoma of the lungs. To the author's knowledge, hypertrophic osteopathy has not been reported in lagomorphs, but should be considered as a differential diagnosis in lame rabbits.

Adenocarcinoma↗
PubMed1994

Methotrexate osteopathy in infants with tumors of the central nervous system.

Methotrexate osteopathy, previously reported as a complication of maintenance-therapy for acute lymphoblastic leukemia, is characterized by osteopenia, particularly involving the lower extremities, thick, dense provisional zones of calcification, growth arrest lines, and corner fractures resembling scurvy. In attempts to postpone radiotherapy in infants under three years of age, the multicentric German therapy protocol for childhood central nervous system tumors (HIT-89 protocol) has employed high cumulative methotrexate doses. Here we describe osteopathy in three patients as a toxic side effect after administration of cumulative methotrexate doses of 20 g/m2, 80 g/m2 and 135 g/m2. The high prevalence of this adverse effect in infants with tumors of the central nervous system may be attributed to the long-term therapy with high cumulative methotrexate-doses. Both factors may favor intracellular accumulation of methotrexate and formation of methotrexate-polyglutamates and may be responsible for bone toxicity. Apparently the susceptibility of the rapidly growing skeletal structures of infants under three years of age to this toxic side effect of methotrexate is remarkably high.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1982

Nonosteomalacic osteopathy associated with chronic hypophosphatemia.

We studied bone histomorphometry in 19 patients with chronic hypophosphatemia related to an idiopathic renal phosphate wasting and without histological osteomalacia. Nine patients had renal lithiasis (group 1), three had radiological osteoporosis (group 2), and seven had lumbar pain (group 3). In the whole group of 19 patients, serum phosphate levels were low (24.9 +/- 2.1 mg/l), calcium in blood was normal, calcium in urine was increased, and iPTH was low. Histomorphometric data showed decreased osteoblastic surfaces with normal resorption surfaces, normal osteoid volume and calcification front. There was no correlation between serum phosphate level and histomorphometric parameters. There was no statistical difference between the data of the 3 groups of hypophosphatemic patients. We concluded that chronic hypophosphatemia in the adult doses not always lead to osteomalacia but to an unusual osteopathy characterized by an osteopenia due to an isolated decrease in bone formation. The respective importance of phosphate deficiency and of decreased iPTH level in the pathogenesis of this osteopathy is uncertain.

Adult↗