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PubMed1993

Ossification of the hyoid bone during childhood.

Normal ossification of the hyoid bone was studied on the basis of postpartum radiographs of 10 stillborn children and radiographs of the cervical spine or the lateral neck of 86 children ranging in age from newborn to 16 years old. None of the patients was suspected of having any abnormality of skeletal ossification. Ossification of the hyoid was seen only after 30 weeks' gestation. The body of the hyoid was ossified in all infants older than 4 months, and the greater cornua were ossified in all those older than 6 months. Ossification of the lesser cornua did not appear in children less than 15 years of age. Normal measurements for the body of the hyoid and the greater cornua were determined.

Adolescent↗
PubMedDate not supplied

Effects of caffeine and nicotine administration on growth and ossification of the ICR mouse fetus.

The objective of this study was to determine how fetal effects are altered when nicotine (N) and caffeine (CA) are administered concurrently at dosages that individually produce minimal effects to the fetus. Female ICR mice were bred overnight and were assigned to four groups: CA (125 mg/kg), N (12mg/kg), CA plus N (125 mg/kg plus 12 mg/kg, respectively) treated, and control (distilled water) groups. Dams were intubated with these dosages three times daily during gestational days (GD) 6-18 and were euthanized on GD 18. Live fetuses were sexed, weighed, and examined for external malformations. One-half of the fetuses were fixed in 10% formalin and examined for internal malformations using Wilson's method. The remaining half was fixed in 95% ethanol (ETOH), stained, and cleared (Inouye's method) for skeletal examinations. Ossification was assessed by staging and measuring craniofacial bones, and counting ossification centra in sternbrae and in cervical and sacrococcygeal vertebrae. Data were analyzed by analysis of variance (ANOVA) followed by Student-Newman-Keuls post-hoc tests set at p < .05 significance level. The litter was used as the unit of measure and the ANOVA main effects were CA, N, and an interaction term (CA+N). In comparison to controls, CA treatment resulted in reduced bone measurements or reduced ossification scores in 5 of the 19 parameters examined, whereas for N only five parameters were significant. The main effects for interaction of CA+N were significant for seven parameters measured. Although it is difficult to assign the specific type of drug interaction that occurred because results were not completely consistent for all parameters measured, it may be concluded that in most parameters measured both CA and CA+N were different from controls, but CA was not different from CA+N. Under the experimental conditions of this study, we found that of the two drugs, caffeine had a significantly greater effect on fetal growth and ossification than nicotine.

Animals↗
PubMed1996

[Lack of ossification of the skull after surgery for craniosynostosis. A study of risk factors apropos of 592 cases].

The Center for Craniofacial Anomalies of Necker-Enfants-Malades Hospital presents a retrospective study of the outcome of 592 patients who were operated for craniosynostosis between 1976 and 1991. The quality of ossification one year after operation is reported with a focus on influencing factors. The lack of ossification rate is 5% (30/592). Three parameters are identified as increasing the risk of poor osseous wound healing: local postoperative infection, forehead advancement especially when accomplished with resorbable osteosynthesis, and brachycephaly. On the contrary, repaired tears of the dura mater do not seem to pose a risk. Seventy five per cent of patients with local infection and 12.4% of forehead advancement presented a lack of ossification which is statistically significant (p < 0.001). Lack of ossification can compromise aesthetic and functional results. Decreasing postoperative infection and stable fixation may help to avoid it.

Child, Preschool↗
PubMed1998

Apparent primary ossification of the menisci in a dog.

A 2-year-old Collie was examined after it developed acute lameness in the right hind limb. Palpation of the right stifle elicited signs of pain, but a cranial drawer sign could not be elicited during palpation of the joint. Radiography revealed mineralized opacities in the craniolateral and caudal portions of the right stifle joint. Exploratory arthrotomy of the right stifle joint revealed a firm mass in the cranial horn of the lateral meniscus, which was characterized as osseous metaplasia in the cranial and caudal menisceal horns on histologic examination. Other abnormalities were not identified during surgery. Results of histologic examination, radiologic evidence, and observations during exploratory surgery supported a diagnosis of primary lateral meniscal ossification of the right stifle joint. Radiographs were obtained of the contralateral stifle joint when the dog was clinically normal (5 weeks after arthrotomy), and mineralized opacities were found in the lateral meniscus of this limb as well. Clinical signs may not be associated with primary intrameniscal ossification initially; type and location of ossification may affect likelihood and severity of clinical signs and secondary joint damage. Initial treatment for menisceal ossification is conservative (anti-inflammatory medications) unless there is a concurrent pathologic process that requires surgical repair.

Animals↗
PubMed2004

Ossification of the transverse atlantal ligament associated with fluorosis: a report of two cases and review of the literature.

STUDY DESIGN: Two cases of ossification of the transverse atlantal ligament (OTAL) are reported, and the literature is reviewed. OBJECTIVE: To report two cases of OTAL, which share fluorosis as a possible etiologic link. SUMMARY OF BACKGROUND DATA: OTAL, a rare phenomenon, may cause upper cervical canal stenosis and spastic quadriparesis. However, the incidence, etiology, and the best therapeutic options are currently unclear. METHODS: Two cases are reported. Included are pertinent history, physical examination, radiographic evaluation, nonsurgical interventions, and outcomes. The available literature is also reviewed. RESULTS: On systemic examination, these two cases were found to have ossification of many ligaments and interosseous membranes, i.e., the atlantal transverse ligament, posterior longitudinal ligament, and interosseous membranes of ribs, forearm, and leg. These findings were coupled with a history of high fluoride intake and dental fluorosis; the diagnosis of fluorosis was made. After 2 weeks of treatment with halo ring traction, and protection and stabilization with a hard cervical collar, the clinical symptoms significantly improved. CONCLUSION: The incidence of OTAL may be not as rare as has been thought. Although the complete etiology of OTAL is not known, fluorosis may be one of the etiologic factors related to OTAL, as well as the ossification of other ligaments and interosseous membranes. Nonsurgical treatment may be safe and effective.

Aged↗
PubMed2006

Core binding factor beta (CBFB) haploinsufficiency due to an interstitial deletion at 16q21q22 resulting in delayed cranial ossification, cleft palate, congenital heart anomalies, and feeding difficulties but favorable outcome.

The core binding factor beta gene (CBFB), essential to bone morphogenesis, is located at 16q22.1. Homozygous deficiency of CBFB leads to ossification defects in mice. CBFB forms a heterodimer with RUNX2 (CBFA1) during embryonic bone development. RUNX2 mutations lead to cleidocranial dysplasia in humans. We describe an infant boy with an interstitial deletion of 16q21q22, delayed skull ossification, cleft palate, and heart anomalies who had a difficult course in infancy but eventually improved and is healthy. He was found to have CBFB haploinsufficiency, but did not have mutations in RUNX2. We suggest that 16q21q22 deletion be considered when there are antenatal or postnatal findings of enlarged cranial sutures with or without cleft palate. The finding of CBFB haploinsufficiency in our case and the similarity of cranial ossification defects with a mouse model of CBFB deletion suggest a role for CBFB in cranial bone development in humans.

Abnormalities, Multiple↗
PubMed2002

Morphological influence of ascorbic acid deficiency on endochondral ossification in osteogenic disorder Shionogi rat.

The influences of chronic deficiency of L-ascorbic acid (AsA) on the differentiation of osteo-chondrogenic cells and the process of endochondral ossification were examined in the mandibular condyle and the tibial epiphysis and metaphysis by using Osteogenic Disorder Shionogi (ODS) rats that bear an inborn deficiency of L-gulonolactone oxidase. Weanling male rats were kept on an AsA-free diet for up to 4 weeks, until the symptoms of scurvy became evident. The tibiae and condylar processes of scorbutic rats displayed undersized and distorted profiles with thin cortical and scanty cancellous bones. In these scorbutic bones, the osteoblasts showed characteristic expanded round profiles of rough endoplasmic reticulum, and lay on the bone surface where the osteoid layer was missing. Trabeculae formation was deadlocked, although calcification of the cartilage matrix proceeded in both types of bone. Scorbutic condylar cartilage showed severe disorganization of cell zones, such as unusual thickening of the calcification zone, whereas the tibial cartilage showed no particular alterations (except for a moderately decreased population of chondrocytes). In condylar cartilage, hypertrophic chondrocytes were encased in a thickened calcification zone, and groups of nonhypertrophic chondrocytes occasionally formed cell nests surrounded by a metachromatic matrix in the hypertrophic cell zone. These results indicate that during endochondral ossification, chronic AsA deficiency depresses osteoblast function and disturbs the differentiation pathway of chondrocytes. The influence of scurvy on mandibular condyle cartilage is different from that on articular and epiphyseal cartilage of the tibia, suggesting that AsA plays different roles in endochondral ossification in the mandibular condyle and long bones.

Animals↗
PubMed1983

The effect of diphosphonates on heterotopic ossification in regenerating Achilles tendon of the mouse.

Midpoint tenotomy of the mouse Achilles tendon is followed by regeneration with heterotopic ossification at the junction of tendon stump and the regenerated segment. This heterotopic bone formation occurs through a process of endochondral ossification and the cartilage cells appear to arise by a process of fibroblast transformation. Five weeks after tenotomy 60 per cent. of specimens show cartilage and bone formation whilst the remaining 40 per cent. show chondrification only. After 10 weeks all specimens showed bone formation with trabecular bone and haemopoietic marrow. The treatment of tenotomised animals with either disodium ethane-1, 1-diphosphonate (EHDP) or disodium dichloromethylene diphosphonate (Cl2MDP) has no effect on the process of heterotopic ossification which can be detected at the radiological or light microscopical level.

Achilles Tendon↗
PubMed1992

Ossification of the ligamentum flavum in the thoracolumbar spine of young adults report of two cases.

Ossification of the ligamentum flavum in the thoracolumbar spine is rare in young adults. We report two cases in 22 year old males who required surgical treatment. The first patient was obese and hyperinsulinaemic. He had a compression myelopathy below T11 due to extensive posterior ossification. The second patient had an osteoid osteoma of the right pedicle of T11 with ossification of the adjacent ligamenta flava. Both patients benefited from surgical decompression of the spine.

Adult↗
PubMed1993

Anatomical and radiological observations concerning ossification of the sacrotuberous ligament: is there a relation to spinal diffuse idiopathic skeletal hyperostosis (DISH)?

In a collection of 101 anatomical preparations of the human pelvis, ossification of the sacrotuberous ligament was found in 8 cases. In 7 of these, the ossification showed a characteristic intraligamentous morphology, with a broad-based origin at the ischial tuberosity and tapering off craniomedially. The length varied between 1.1 and 7.2 cm. The surface of the bone formations appeared fasciculated, except in one case which had a wax-like flowing bone formation lying upon the sacrotuberous ligament. Careful anatomical and radiological examination of the spine, the ulnae, the calcanei and the iliac crests in these 8 cases, revealed in only one case any findings (spurs at the olecranon) that could be attributed to extraspinal manifestations of diffuse idiopathic skeletal hyperostosis (DISH). Indeed, in no case were the most widely accepted diagnostic criteria of DISH, the spinal alterations, seen. We therefore suggest that ossification of the sacrotuberous ligament is an autonomous finding and not a good indicator of the presence of spinal DISH.

Adult↗
PubMed1984

Spontaneous regression of neurogenic heterotopic ossification.

A description is given of an unusual case of a 13 year old girl who showed complete regression of neurogenically induced heterotopic ossification following recovery from her head injury. The case report indicates that heterotopic ossification is not necessarily permanent following neurological disturbance, but may be a reversible condition resulting from temporary neurological stress. The cause of heterotopic ossification is not known and the detrimental effect of misapplied physiotherapy is considered.

Adolescent↗
PubMed1980

The effects of intervertebral fusion in patients with myelopathy due to ossification of the posterior longitudinal ligament of the cervical spine.

Fifty patients with ossification of the posterior longitudinal ligament of the cervical spine were treated by anterior intervertebral body fusion and compared with 30 other patients treated conservatively. We found that patients with narrowing of the cervical canal to 0.5 of the normal diameter were improved by simple intervertebral fusion without excision of the ossified ligament. Patients with more extensive ossification and narrowing of the spinal canal to less than 0.4 of the normal diameter might have either severe symptoms or unexpectedly minor symptoms and the latter were attributed to the spontaneous fusion and loss of mobility that had occurred. Conversely, patients with less severe ossification but abnormally increased intervertebral mobility often had severe symptoms but were greatly improved following intervertebral fusion. It was concluded that narrowing of the spinal canal in the presence of mobility of the neck produced unfavourable dynamic compression of the spinal cord and that reduction in the mobility of the spine was effective in reversing many of the signs of cervical myelopathy.

Adult↗
PubMed1976

Ossification in cancer of the stomach: an experimental study.

In rats with Nitrosoguanidine induced carcinomas of the gastric stump, heterotopic ossifications are found freqently. The following stages of differentiation during the desmal ossification in the stump carcinomas are demonstrated: 1. Osteoblasts, 2. Osteoid, 3. Woven bone, 4. Lamellar bone. --The islands of metaplastic bone cells are predominantly located in the invasive marginal zone of the carcinoma of the gastric stump. The histology of the heterotopic ossification in the gastric stump of the rat is similar to that one seen in stomach cancer of men. The model here described seems to be suitable for further study of metaplastic bone formation in the gastrointestinal tract.

Adenoma↗
PubMed1979

Clinical features of 22 cases with "inter-sterno-costo-clavicular ossification". A new rheumatic syndrome.

We present 22 cases with inter-sterno-costoclavicular ossification. Clinical and pathological findings show that abnormal ossification observed in this situation is due to non-suppurative chronic inflammation of the soft tissues around the sterno-costo-clavicular region such as the costo-clavicular ligament. We have classified X-ray findings into three stages according to the extent of the ossification; localized, generalized, and hyperostotic, and show that the disease progressed in this sequence. A considerable number of the patients showed abnormal X-ray findings in the spine or the sacro-iliac joint. Frequent association of pustulosis palmaris et plantaris was noted in this disease. Most of the cases were treated effectively with anti-inflammatory drugs, but a few cases required surgical resection of the ossified mass with the clavicle or the first rib in order to relieve the severe pain.

Adult↗
PubMed1988

Prevention of periarticular heterotopic ossification following total hip arthroplasty. Clinical experience with indomethacin and ibuprofen.

Prophylactic treatment with indomethacin or ibuprofen to prevent periarticular heterotopic ossification (PHO) was investigated in a consecutive series of 200 total hip replacements (THR) performed for primary coxarthrosis in 170 patients. No widespread PHO (grades III and IV) occurred in 166 THR treated with indomethacin or ibuprofen from the 1st to the 21st postoperative day. Only one patient exhibited moderate (grade-II) ossification. In contrast, the incidence of PHO grades III and IV was found to be high (23%) in the 35 THR for which the patients did not receive prophylaxis according to intention. It was concluded that 3 weeks' postoperative treatment with indomethacin or ibuprofen is sufficient to prevent the development of clinically significant heterotopic ossification.

Aged↗
PubMed1996

A new classification for heterotopic ossifications in total hip arthroplasty considering the surgical approach.

We would like to introduce a new classification for heterotopic ossifications (HO) after total hip arthroplasty which also considers ossifications within the region of the surgical approach. Furthermore, we will point out the influence of the surgical approach on the rate of HO. We analyzed 75 cementless hip arthroplasties with consecutive HO in a prospective study. The operations were performed by three experienced orthopaedic surgeons using an identical stem and a standardized lateral approach. All patients followed an identical rehabilitation procedure. Clinical and radiological data were documented in a standardized way. We found a total of 40 HO. Only 24 could be exactly classified by the known methods. Our classification considers 3 regions and 4 grades and is relevant for all 40 HO. Electrocauterisation to dissect the muscles in the lateral approach reduced the rate of HO: overall 64.3% to 39.4%; clinically relevant ossifications were reduced to 3.0% from 16.7%. Our new classification considers all HO concerned with total hip arthroplasty, especially those localized in the intertrochanteric region. The rate of HO can be reduced by using electrocauterisation for muscle dissection in the lateral approach.

Electrocoagulation↗
PubMed1990

Nonsteroid anti-inflammatory drugs prevent the recurrence of heterotopic ossification after excision.

The prophylactic effect of nonsteroid anti-inflammatory drugs on the recurrence of high-grade periarticular heterotopic ossification after resection was studied in ten patients operated on for loosening of one or both components of a cemented total hip prosthesis. These drugs, given at a standard dosage for 1-3 weeks after surgery, prevented the recurrence of heterotopic ossification. In some patients the range of motion of their joint increased following surgery, while it remained unaffected in the majority. At follow-up 2-5 years after surgery, all patients walked well and there were no clinical or radiographs signs of loosening of the prosthetic components. It is concluded that treatment with NSAIDs following resection of periarticular heterotopic ossification prevents recurrence.

Aged↗
PubMed1990

Neuroradiological examination of thoracic radiculomyelopathy due to ossification of the ligamentum flavum.

Sixteen cases of thoracic radiculomyelopathy due to ossification of the ligamentum flavum (OLF) were analyzed. The patients ranged in age from 39 to 78 years (average 57 years). There were 13 men and 3 women. A significant predilection of OLF for the lower thoracic spine (T9/10, T10/11, T11/12) was noticed. Plain X-ray of the thoracic spine and multidirectional tomography could give important information about the site of ossification. Computed tomography with the intrathecal injection of the water-soluble contrast material clearly demonstrated the ossification and the degree of compression of the spinal cord. The disadvantages of using computed tomography for diagnosing OLF included the necessity for the scan level to be previously decided by other methods because computed tomography of the entire spine was impractical. Magnetic resonance imaging was performed in 14 patients and gave important information about OLF and the compression of the spinal cord. The combination of MRI and computed tomography seems the most useful for the precise diagnosis of OLF.

Adult↗