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PubMed2000

Does ethanol affect the reliability of pelvic bone examination in blunt trauma?

STUDY OBJECTIVE: We sought to determine whether the reliability of clinical evaluation for pelvic bone fracture after trauma is compromised by a serum ethanol level of 100 mg/dL or greater. METHODS: This is a retrospective case control study of trauma registry patients presenting from October 1, 1995, to March 31, 1997, to an urban level I trauma center. Inclusion criteria were as follows: blunt trauma, age 13 years or older, and Glasgow Coma Scale score of 13 or greater. Exclusion criteria were as follows: isolated penetrating injury and suspected spinal injury. Patients were separated into 2 groups: those with an ethanol level of 100 mg/dL or greater, and those with an ethanol level of less than 100 mg/dL. Physician performance in clinical identification of pelvic bone fracture by using a complaint of pain, pelvic tenderness, with or without deformity, was compared between the 2 groups. RESULTS: Seven hundred sixty-three patients met inclusion criteria. Fifty-five (7. 2%) patients had a pelvic fracture, 75% of which were isolated acetabulum or pubic ramus fractures. Two hundred six control patients without pelvic fractures were randomly selected. The sensitivity and specificity of the complaint of pain and tenderness, deformity, or both for identification of a pelvic fracture was not significantly different between the ethanol groups. Five (9%) of 55 patients with pelvic fractures had neither a complaint of pain nor bony tenderness or deformity on examination. This was not statistically associated with an ethanol level of 100 mg/dL or greater (P =1.000). CONCLUSION: In our study, clinical evaluation for pelvic fracture in trauma patients with a Glasgow Coma Scale score of 13 or greater was not compromised by an ethanol level of 100 mg/dL or greater. The most common reason for clinically missed pelvic fractures was the presence of additional painful distracting injuries.

Adolescent↗
PubMed1998

[The use of computed and magnetic resonance tomography in the diagnosis of neoplasms of the pelvic bones and sacrum].

The experience of the computed tomography (CT) application in the pelvic bones and sacrum tumors diagnosis in 46 patients was summarized. The data obtained were defined more precisely using magnet-resonance tomography (MRT). MRT in contradistinction to permits to differentiate the soft tissues and reveal the tumoral invasion of dura mater and the spinal cord substance, the spinal cord nerves affection. Using CT it is possible to estimate more accurately the bone structure and tumoral elements, containing calcium.

Bone Neoplasms↗
PubMed1981

Conservative operations for pelvic bone tumours.

This paper outlines our experience of partial pelvic resection for benign tumours or those of low grade malignancy. The entire half of the pelvis may be removed with preservation of the limb. Pelvic resection must only be undertaken when the surgeon is sure that the removal of the tumour will be as radical as in an inter-ilio abdominal amputation. Various methods of creating rest for the superior end of the femur against the remaining parts of the pelvic bones are shown. Special attention is devoted to preservation of the limb movement and restoration of the locomotor function of the leg.

Acetabulum↗
PubMed1984

[Pelvic bone angiomas].

Three patients were seen with angiomas of the pelvic bones; the radiological and clinical features are described and the literature reviewed. The patients had been observed for four to six years. The differential diagnosis includes infiltrating mesenchymal neoplasms and the histologically similar, but rare, Gorham-Stout syndrome. Recommended treatment is irradiation, which is effective up to a point.

Adult↗
PubMed2006

A case of pelvic bone hydatidosis--diagnosis and treatment.

INTRODUCTION: Echinococcosis is a frequent helminthiasis in Bulgaria. Hydatid cysts commonly affect the liver and the lung. Echinococcosis rarely involves bones (0.5 to 2.5%) and vertebral column is affected in 50% of the cases. PATIENTS AND METHODS: We report a case of a 67-year-old female with echinococcosis of the pelvic bone clinically manifested by pain and swelling of the right iliac region and complicated by abscess of the surrounding soft tissue. The patient underwent surgery at the Department of Orthopedics and Traumatology, University hospital "St. George", Medical University, Plovdiv. Diagnosis was based on imaging findings, serologic and histological methods. Biopsy material was investigated by standard histological methods hematoxilin-eosin (H-E),PAS and hydrargyrum impregnation after Gommori, which presented both chitin and germinative membranes of the hydatid cyst. RESULTS: The patient underwent complete resection of the bone lesion along with the surrounding soft tissue. Purulent collection of 1200 ml was evacuated. A six months follow-up of the patient revealed no pathology of the cyst and other organs. She walked unaided. No echinococcosis recurrence was observed on control examinations. CONCLUSIONS: Hydatid bone disease is usually difficult to diagnose. Its treatment includes excision of bone lesion, curettage and oral therapy. It is not always possible to fully remove all the affected bone fragments especially when cysts are located in the femoral and pelvic bones. In the reported case the hydatid cyst was fully removed by resection of the right iliac ala and the patient's mobility was preserved.

Aged↗
PubMed1985

[Pelvic bone fractures in children].

An analysis of the treatment of fractures of pelvic bones in 158 children has shown that the conservative method of treatment is quite justified. Good and satisfactory results were achieved in 116 patients followed-up.

Adolescent↗
PubMed2000

A multidisciplinary approach to the treatment of malignant pelvic bone tumors: results with eight consecutive patients.

The prognosis for malignant pelvic bone tumors is worse than that for malignant bone tumors of the extremities because definitive surgery in the pelvis is often difficult to accomplish. The results for eight patients who were treated consecutively with a multidisciplinary approach, from 1990, were analyzed. The histologic diagnosis was osteosarcoma in five patients, chondrosarcoma in two, and Ewing's sarcoma in one. Five lesions arose in the ilium and three in the pubis. The extraosseous tumors decreased in size and/or were encapsulated as a result of preoperative chemotherapy in six patients, four of these achieving a wide surgical margin. With respect to tumor location and surgical margin, all five lesions in the ilium involved the sacrum, four of these being resected with an inadequate margin. The three lesions in the pubis were resected with an adequate margin. Local recurrence was observed in two patients who had been treated with an inappropriate margin. During the period between 18 and 57 months after the first operation, five patients were continuously free of disease and one was still alive but had lung metastases. Our results indicate that a patient's chances of definitive surgery may be enhanced by a multidisciplinary approach, although the management of sacroiliac involvement remains challenging.

Adult↗
PubMed2001

[Echinococcosis of the pelvic bone: four cases].

We report four cases of echinococcosis of the pelvic bone in 3 women and a man aged 30 to 55 years. Disease spread was wide, involving the entire hemipelvis in one case and the sacrum in another making surgical excision difficult. In two cases, computed tomography was highly contributive to diagnosis and assessment of local extension. We used surgical excision and hydrogen peroxide sterilization for the first two case. For the two last cases, we used albendazole in four 4-week cures at a 2-week interval before and after surgery. The clinical course was favorable to these two cases at 3 and 4 years. The albendazole-surgery combination appears to be the best therapeutic option.

Adult↗
PubMed1997

[Age-related changes in the goniometric indices of the pelvic bones in children].

The present research was aimed to study changes of angular parameters of pelvic bones in children depending on age and sex. The following are angular parameters studied: 1) pubic arch angle; 2) ischiadic angle; 3) angle of pubic bone rami inclination; 4) angle of anterior pelvic semicircle; 5) angle of symphysis inclination; 6) angle of pelvic inclination. To assess the results obtained and reveal variability regularities variation-statistical processing was performed.

Aging↗
PubMed1994

The potential use of I-123 IMP scintigraphy for pelvic bone metastases in hepatocellular carcinoma. A comparison with Ga-67 scintigraphy.

Conventional bone scintigraphy is often inconclusive in detecting bone metastases of hepatocellular carcinoma, suggesting the necessity of alternative scintigraphic agents. In this study, the diagnostic value of I-123 IMP scintigraphy was evaluated in 8 patients with 12 pelvic bone metastases from hepatocellular carcinoma, then compared with Ga-67 scintigraphy. Eleven of 12 lesions (91.7%) were detected by I-123 IMP scintigraphy; Ga-67 scintigraphy visualized 8 lesions (66.7%) in the same patient population. I-123 IMP scintigraphy is useful for detecting pelvic bone metastases of hepatocellular carcinoma with less physiologic accumulation in the intestine as compared with Ga-67 scintigraphy.

Aged↗
PubMed2004

[A case of osteosarcoma in pelvic bone following radiation therapy for prostate cancer].

A case of osteosarcoma in pelvic bone following radiation therapy for prostate cancer is reported. A 74-year-old patient was diagnosed with prostate cancer 10 years ago and started on the endocrine therapy with LH-RH agonist. He had no apparent distant metastasis, and received radiation therapy 8 years ago. He has complained of low back pain since several months ago. A high uptake on bone scintigram and osteolytic and osteoblastic damages on CT were noted in pubic bone and sacrum. The PSA level was less than 0.2 ng/ml. Pathohistological diagnosis by biopsy of the pubic bone was chondroblastic type osteosarcoma, showing an atypical cell proliferation with osteoid. Immunostaining for nonepithelial marker vimentin was positive. He underwent heavy ion radiation therapy for osteosarcoma at the National Institute of Radiological Sciences. Osteosarcoma is one of the rare delayed complications after radiation therapy and requires biopsy for correct diagnosis.

Aged↗
PubMed2000

[Radiologic diagnosis of malignant tumors of the pelvic bones in children].

An analysis of the data on radiodiagnosis of malignancies of pelvic bones in 50 patients, aged 10-15, is presented. Diagnosis was morphologically confirmed in all the cases: Ewing's sarcoma (41)--82%, primitive neuroectodermal tumor (6)--12% and chondrosarcoma (3)--6%. The leading clinical syndrome was pain in the loin. The significantly most frequent site was the iliac bone. X-ray imaging of tumor site and adjacent areas using standard direct, lateral and oblique projections, ultrasonography, X-ray contrast tomography, radioisotope examination, puncture and open biopsy (when indicated) proved useful.

Adolescent↗
PubMed2002

Pseudomonas aeruginosa sacroiliitis and osteomyelitis of pelvic bones after radical prostatectomy.

A 66-year-old diabetic man presented with acute incapacitating pelvic pain 6 weeks after radical prostatectomy. Symphysis pubis biopsy showed chronic osteomyelitis, and culture grew Pseudomonas aeruginosa. Despite a 7-week course of intravenous piperacillin and ceftazidime, he returned 6 months later with the same symptoms. Imaging studies and biopsy indicated right sacroiliitis and persistent pseudomonas osteomyelitis of the pelvic bones. He refused surgical debridement and was successfully treated with the same antibiotics for 8 more weeks. We emphasize the importance of bone biopsy and culture to expedite effective intravenous antibiotic therapy.

Aged↗