Hemorrhage into the ischiorectal fossa--a complication of anticoagulant therapy: report of a case.
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Abscess↗
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Results for “Ischium”
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[The regenerative ability of the iliac crest following spongiosa removal in man--induction by phosphate ceramics? I].
The starting point for the investigation of calcium phosphate ceramics is given by the bone regeneration, including osteoconduction, osteostimulation and osteoinduction. The amount of the autogeneic bone, which can be used for transplantation to induce the organo typical regeneration, is a small one. Calcium phosphate ceramics are used as bone substitute. The basic knowledge of clinical employment is summarized. A new model for investigation of bone regeneration is introduced. In part II the results will be discussed.
Biocompatible Materials↗
A controlled study comparing the conventional treatment of idiopathic anorectal abcess with that of incision, curettage and primary suture under systemic antibiotic cover.
The treatment of anorectal abscess by deroofing and packing on an initial inpatient basis has been compared in a controlled trial with that of incision, curettage and primary suture under systemic antibiotic cover in the Accident and Emergency Department. Over a three-year period 219 patients with anorectal abscess were randomly allocated to one or other treatment and subsequently followed up in a rectal clinic. In terms of the time taken for complete healing and the periods lost from work postoperatively, the method of incision, curettage and primary suture under systemic antibiotic cover was found to be significantly superior, without any increased risk of recurrence of the abscess or of subsequent fistula formation.
Abscess↗
Leiomyoma of the ischioanal region: report of a case.
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Aged↗
An unusual case of ischio rectal abscess presenting as acute urinary retention.
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Abscess↗
[Complete rupture of the proximal semimembranosus tendon. Minimally invasive surgical repair by use of a suture anchor in a rare but often underestimated injury].
Complete rupture of the proximal semimembranosus tendon is a rare injury associated with significant functional loss. Conservative treatment has proven inadequate in returning patients to their previous activity level. However, diagnosis is often delayed because of underestimation of the severity of this injury. Satisfactory results can be achieved with both early and late surgical tendon repair in the majority of cases. However, repair delayed by more than 4 weeks post trauma usually requires extended mobilisation of the injured muscle and neurolysis of the sciatic nerve. Therefore, we recommend surgical repair as early as possible. We report on the successful minimally invasive surgical repair of a complete rupture of the proximal semimembranosus tendon by use of a suture anchor 18 days after injury.
Bone Screws↗
[Osseous avulsion of the ischio-crural muscle group with concomitant sciatica].
Avulsion fractures of the ischial tuberosity are rare. They are often caused by a typical "splits"-like accident. In general the patients feel sudden severe pain in the buttock with localized tenderness in the region of the ischial tuberosity, rarely in combination with sciatic nerve irritation. According to the functional anatomy, flexion of the knee and extension of the hip may be impaired. Roentgenograms often reveal no abnormality and show no evidence of fracture. Therefore, inadequate therapy because of missed diagnosis can result in avoidable persistent pain. We report on a 42-year-old man with an avulsion fracture of the ischial tuberosity. The epidemiology, symptoms, including irritation of the sciatic nerve, differential diagnoses, diagnostic procedures and therapy are presented in detail.
Adult↗
Comments on the ischio-pubic-patellar syndrome.
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Adolescent↗
Ischio-pubic-patellar hypoplasia: is it a new syndrome?
Aplasia/hypoplasia of the patella has been described as an isolated finding or, more commonly, as a part of congenital syndromes. We describe here bilateral absence of the patella in an 11-year-old girl with absence of the ischial and inferior pubic rami bilaterally. Other associated skeletal and soft-tissue deformities are also reported. To our knowledge, the constellation of these findings has not been described previously and represents a unique syndrome.
Child↗
Ischial hypoplasia, tibial hypoplasia and facial abnormalities: a new syndrome?
A child with facial abnormalities, short stature and a variety of skeletal alterations is reported. The facial abnormalities comprised low-set ears, short nose with a long philtrum, micrognathia and cleft palate. The skeletal alterations included ischial hypoplasia, malformations of the cervical spine, hypoplasia of the lesser trochanters, tibial hypoplasia with bowing of the lower legs, tibio-fibular diastasis with malformed distal tibial epiphyses, clubfeet and brachymesophalangy. The constellation of clinical and radiological findings in the present patient do not fit any known malformation syndrome.
Abnormalities, Multiple↗
Ischio-vertebral dysplasia: a distinct entity.
BACKGROUND: Kyphoscoliosis is a complication of some bone dysplasias, including cleidocranial dysplasia. OBJECTIVES: We report a distinct disorder with defective ossification of the ischial rami, severe kyphoscoliosis and normal clavicles. Early recognition of this syndrome allows prevention of complications. MATERIALS AND METHODS: All patient cases (aged 1 day to 33 years) were selected according to the above criteria, with special attention to radiological findings, family history and follow-up (5-30 years). RESULTS: In all eight patients, we observed the following: (a) Severe thoracic scoliosis of early onset and rapid progression, leading to rotatory dislocation. Spinal cord compression occurred in four cases with respiratory problems related to chest deformity. (b) Bilateral and symmetrical incomplete ossification of the ischial rami. (c) Peculiar facies with retrognathia. (d) Normal clavicles. Three patients were from the same family (grandmother, mother and daughter). CONCLUSION: Ischio-vertebral dysplasia seems to represent a true entity, with radiological and genetic findings that make it distinct from cleidocranial dysostosis. The association of kyphoscoliosis and these pelvic abnormalities is specific for this condition. Neurological and respiratory complications can be avoided if the condition is recognised early and early treatment is instituted.
Abnormalities, Multiple↗
Ischio-spinal dysostosis: a previously unrecognised combination of malformations.
BACKGROUND: Ischial hypoplasia is an extremely rare malformation, both as an isolated anomaly and as a syndromic constituent. OBJECTIVE: To elucidate the clinical and radiological characteristics in five patients with the combination of ischial hypoplasia and spinal malformations. MATERIALS AND METHODS: The clinical records and radiographs of two females and three males, ranging in age from 3 months to 38 years, were evaluated. RESULTS: Ossification defects of the ischial rami were symmetrical and total in four patients, whereas the right ischial ramus was partly ossified in the other patient. All patients possessed multiple segmental defects of the spine, with rib anomalies of varying severity. One patient characteristically showed multiple rib gaps, resulting in respiratory distress. Severe anomalies of the cervical spine were evident in two patients. Four patients exhibited lumbosacral hypoplasia, which ultimately led to cauda equina syndrome in three older patients. One patient had mild facial dysmorphism and another had a diversity of anomalies, including ichthyosiform skin changes. Four patients were sporadic cases, whereas the other patient was born to consanguineous parents. CONCLUSIONS: The combination of anomalies in these patients constitutes a recognisable pattern of malformations but may represent a heterogeneous group of disorders.
Abnormalities, Multiple↗
Imaging features of ischial bursitis with an emphasis on ultrasonography.
OBJECTIVE: The aim of this study was to evaluate the imaging features of ischial bursitis with an emphasis on ultrasonography (US). DESIGN AND PATIENTS: Our study included 31 patients with a painful mass or tenderness in their buttock who underwent US (n=27), CT (n=1), or MR imaging (n=4). A needle aspiration (n=6) or a bursal excision (n=5) was performed in those patients who had no clinical improvement in spite of the conservative treatment. Evaluation included lesion location, size, wall of the bursae, and intrinsic characteristics on US, CT and MR imaging. RESULTS: Ischial bursitis was superficial to the ischial tuberosity in all patients (n=31). The lesion ranged from 1.5 cm to 7 cm (average 3.8 cm) in diameter. The bursal wall was identifiable in 25 cases (81%). Internal septa and mural nodules were seen in 12 (39%) and 17 cases (55%), respectively. Sonography showed that fluid within the bursa was hypoechoic (59%), hyperechoic (26%), or of mixed echogenicity (15%). The bursae were compressible by the transducer. Power Doppler examination (n=7) showed hypervascularity of the bursal wall. All lesions imaged with contrast-enhanced CT and MR imaging had an enhancing thin wall and mural nodule. CONCLUSIONS: Ischial bursitis, superficial to the ischial tuberosity, can be clearly demonstrated on sonography and appears as a thin-walled cystic lesion, with or without internal septa and mural nodules.
Adult↗
Cyclic sciatica caused by infiltrative endometriosis: MRI findings.
Endometriosis, an important gynecological disorder of reproductive women, affects most commonly the ovaries and less frequently the gastrointestinal tract, chest, urinary tract, and soft tissues. Endometriosis classically appears on MRI as a mass with a large cystic component and variable signal intensities on T1- and T2-weighted images due to the presence of variable degradation of hemorrhagic products. Endometriosis in an atypical location, an infiltrative appearance and without cystic-hemorrhagic components has rarely been described. We report on a 33-year-old woman with cyclic sciatica due to histologically documented infiltrative endometriosis involving the area of the left sciatic notch.
Adult↗
Osteomyelitis of the ischiopubic synchondrosis: imaging findings.
Osteomyelitis of the ischiopubic synchondrosis in children is not rare and presents a diagnostic problem because of the diversity of presentation and the deceptive nature of symptoms. Radiological assessment is extremely difficult because of the variation in normal ossification on radiography and normal physiological uptake on radioisotope bone scan. We present two cases of osteomyelitis of the ischiopubic synchondrosis and describe findings on radiographs, isotope bone scan, computed tomography (CT) and magnetic resonance imaging (MRI). MRI changes have not been described in any of the case reports in the English literature. Aspiration and biopsy remain the gold standard for diagnosis. However, MRI appearances can significantly increase diagnostic confidence prior to intervention.
Acute Disease↗
Apophysitis of the ischial tuberosity mimicking a neoplasm on magnetic resonance imaging.
We present multimodality imaging features of an ischial tuberosity apophysitis in a 13-year-old boy who was an active baseball pitcher. Roentgenography of the pelvis and computed tomography showed mild irregularity in the inferior margin of the left ischial tuberosity. T1-weighted MRI showed a wide area with low signal intensity in the left ischial body; T2-weighted fat-suppression images showed areas with markedly high signal intensity in the ischial apophysis and body and the surrounding periosteum; contrast-enhanced T1-weighted fat-suppression MRI showed that the ischial body, surrounding periosteum, and origin of the hamstring muscles strongly enhanced; technetium-99m scintigraphic scans showed increased isotope uptake in the entire ischial body. Histological specimens obtained from the bone showed increased osteoblastic activity, edema, and proliferation of benign spindle cells and small vessels in the bone marrow spaces. In the present case, because MR imaging demonstrated extensive signal abnormalities involving the apophysis, periosteum, and intramedullary portion of bone, a neoplasm could not be excluded, and a biopsy was undertaken.
Athletic Injuries↗
A novel form of ischio-vertebral syndrome.
We report a boy with ischial hypoplasia, vertebral malsegmentation and multiple other skeletal anomalies which do not fit well with any previously-described disorder. The proband's brother and mother were also slightly affected. We review the pertinent literature, discuss the differential diagnosis and suggest that this may be a previously unreported autosomal dominant disorder, with variable penetrance.We believe that the clinical and radiological features of various syndromes with ischial aplasia/hypoplasia and vertebral malsegmentation are not sufficiently different to justify the current separate categories of "ischio-vertebral dysplasia" and "ischio-spinal dysostosis". We suggest that the term "ischio-vertebral syndrome" should be used until identification of genes affecting ischial and axial morphogenesis is completed.
Adolescent↗
The pelvic digit: five new examples of an unusual anomaly.
Five new cases of a rare congenital anomaly known as the "pelvic digit", were each discovered incidentally on a radiographic examination of the pelvis. The features are described, using tomograms in some cases to show the most important and typical radiographic signs of this anomaly. We review the cases previously reported in the literature and discuss the features in the differential diagnosis between the pelvic digit, myositis ossificans, avulsion injury of the pelvis and the pelvic rib.
Adult↗