Metaphyseal dysplasia due to lead poisoning in children.
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A new association between multicentric fibromatosis and a bone dysplasia is reported. Three patients are described, each of whom had multicentric fibromatosis of the lower extremity and a skeletal dysplasia. One of the patients had dysplastic changes restricted to the involved extremity. The other two had dysplastic changes of all the long bones. The dysplasia consisted predominantly of undertubulation reminiscent of the findings seen in Pyle disease. No clinical or radiographic abnormalities of the marrow were found in any of these patients. It is believed that this association represents mesenchyme that is predisposed to develop both dysplastic bone changes and tumor.
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A case of chronic, multifocal hematogenous osteomyelitis in a child is descirbed. It represents a special, well-defined clinical variant of this disease, which obviously reflects a more or less balanced relationship between the bacterial aggressor and the defense mechanisms. Exacerbations of old processes, and spread to new sites, can be ascribed to a temporary imbalance.
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Eight children with short stature and GH deficiency were studied with 99mTc-methylene diphosphate before, during (occasionally), and after 4 months of GH therapy. Using digital images of the femoral shaft and distal metaphysis, the percent change in metaphysis-to-shaft, metaphysis-to-background (muscle), and metaphysis-to-injected dose ratios were calculated and compared to percent change in growth velocity over 4 months. The percent change in metaphysis-to-shaft and metaphysis-to-background ratios showed no significant correlation with percent change in growth velocity. The percent change in metaphysis-to-dose ratio demonstrated a significant correlation with change in growth velocity (r = 0.66; P less than 0.05). In addition, five of six patient studies before 4 months (after 1-68 days of GH therapy) demonstrated an increased metaphysis-to-dose ratio compared to baseline. In conclusion, GH therapy in GH-deficient children appears to increase the uptake of 9mmTc-methylene diphosphonate in the metaphysis, shaft, and muscle to a similar extent, and this increase appears to occur in most patients early after initiation of therapy.
Development and morphology of the epiphyses of the long bones were investigated in 93 adult rats of 7 different strains (BDIX/Han, BDE/Han, BN/Han, DA/Han, LEW/Han, AVN/IpcV/Wistar/Rehbrücke, Shoe: WIST) from the age of 14 weeks up to the age of 78 weeks. Strain-related differences were found in the development of the secondary centre of ossification, which was retarded in the BDIX/Han rats. Furthermore, closure of the growth plate started earlier in the BDIX/Han rats. In addition various regressive changes were detected in the growth plates of long bones of all rats, but not of the ribs. The frequency and extent of these changes varied between individuals and strains. Degeneration of the matrix and necrosis were already observed at 14 weeks of age.