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PubMed2006

Heterotopic ossification: Pathophysiology, clinical features, and the role of radiotherapy for prophylaxis.

Heterotopic ossification (HO) is a benign condition of abnormal formation of bone in soft tissue. HO is frequently asymptomatic, though when it is more severe it typically manifests as decreased range of motion at a nearby joint. HO has been recognized to occur in three distinct contexts-trauma, neurologic injury, and genetic abnormalities. The etiology of HO is incompletely understood. A posited theory is that HO results from the presence of osteoprogenitor cells pathologically induced by an imbalance in local or systemic factors. Individuals at high risk for HO development frequently undergo prophylaxis to prevent HO formation. The two most commonly employed modalities for prophylaxis are nonsteroidal anti-inflammatory drugs and radiation therapy. This review discusses HO pathophysiology, clinical features, and the role of radiotherapy for prophylaxis.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1992

Prenatal ultrasound semiography of anencephaly: sonographic-pathological correlations.

A better understanding of the ultrasound findings in each of the different types of fetal anencephaly can help to reduce the number of false-negative diagnoses of this condition during the prenatal period. Errors in the estimation of the remaining cerebral tissue (angiomatous stroma, area cerebrovasculosa) can cause false-negative diagnoses or diagnostic confusion with cases of microcephaly or incomplete ossification of the cranial vault. In a retrospective study, 30 fetuses with anencephaly (diagnosed at 13-38 weeks of gestation) were grouped, in terms of their ultrasound results, according to the Nanagas classification. The ultrasound diagnoses were then correlated with those found through autopsy, to identify any errors in the ultrasound classification.

Journal Article↗
PubMed2005

[Oral pathology in a denture practice].

An 86-year-old edentulous patient visits a denturist for the provision of a new set of dentures. In the region 36/37 of the lower denture base extension is a bony like structure apparent, that does really not bother the patient. The denturist refers the patient for further diagnosis. It appeared to be a benign condition (traumatic periosteal ossification) that did not require surgical intervention. The responsibilities and capabilities of the denturist with regard to the treatment of edentulous patients are discussed in light of the current Dutch legislation.

Aged, 80 and over↗
PubMed1990

Chondrolipoangioma. A cartilage-containing benign mesenchymoma of soft tissue.

The clinical and pathologic features of four cases of benign mesenchymoma in which mature cartilage represented the predominant component are reported. The distinctive histologic feature in all four cases was a lobular proliferation of cartilaginous tissue exhibiting a spectrum of hyaline cartilage, fibrocartilage, myxoid cartilage, and cartilage with ossification and even bone marrow formation, intimately associated with mature adipose tissue and vascular elements. The localization of these tumors was in the proximity of a bone, but not attached to the periosteum or in continuity with a joint. Because these lesions may be mistaken for other cartilaginous neoplasms of soft tissue, recognition of this entity has potentially important diagnostic and therapeutic implications in that mutilating surgery may be avoided.

Adipose Tissue↗
PubMed1981

Radiation-induced meningeal and pituitary tumors in the rat after prenatal application of strontium-90.

Strontium-90 was inject i.v. into pregnant rats on day 18 post conception (p.c.). This caused a remarkable transplacental radioactivity uptake and accumulation in the ossification centers of the skull basis. The total radiation dose within the surface of these regions was consequently calculated to be 0.6-1.2 Gy within the entire lifespan. About 50% of it was delivered during the 7 days following the injection of the isotope. The pathologic examination of the offspring throughout their lifetime revealed a pituitary tumor frequency in the exposed groups which was about tenfold in the males and threefold in the females in comparison to the controls. A very outstanding result in the animals treated was the occurrence of metastasizing meningeal sarcomas in about 6% of all cases. In four cases (= 2%) the simultaneous occurrence of a pituitary adenoma and of a meningeal sarcoma could be observed.

Adenoma, Chromophobe↗
PubMed1996

Accessory ossifications in the ulno-carpal wrist region.

Accessory ossifications in the ulno-carpal transition such as ossa styloidea or triangularia represent a rare finding, especially among younger individuals. The present results of radiological and morphological investigations show that up to 50% of the ossa are located palmar to the styloid process. Most of them have a sharply bordered contour and are less than 10 mm in length. An aetiological classification of accessory ossifications in the distal epiphyseal region is only possible when an obvious case history is available. Accessory skeletal elements are present among elderly individuals as a result of sclerotic alterations of the ulno-carpal joint elements. Among younger individuals, however, they point to a pathological aetiology and can therefore assume clinical and diagnostic relevance in cases involving inflammatory rheumatic and traumatic alterations accompanied by vague discomfort in the proximal wrist region.

Adult↗
PubMed2006

Metaplastic breast carcinoma with osseous differentiation: a case report.

Metaplastic breast carcinoma is a rare entity with the distinguishing feature of having epithelial and mesenchymal tissue types incorporated within one tumor. This is a case report of a patient found to have a rare metaplastic breast carcinoma with prominent osseous differentiation. Radiologic and pathologic correlation is provided.

Breast↗
PubMed1977

[Structural changes in the tibial bones from an excessive load].

80 cases of pathological reconstruction of the tibia in young men at the age of 18--20 are described. The pathology developed as a result of intense regular physical exercise. In 53 patients the process was localized in the upper third of the tibia, in 20--in the middle third and in 7--in the lower third of the bone. In 6 cases the fracture of the tibial proximal metaphysis happened against the background of pathological reconstruction of the tibia; 3 of them sustained simultaneously a fracture of the fibular head. Some recommendations of practical importance are suggested.

Adolescent↗
PubMedDate not supplied

The role of trauma in the pathogenesis of the osteochondroses.

Compression fracture of the secondary centers of ossification is an important factor in the pathogenesis of Perthes' disease and osteochondrosis dissecans. Avulsion fracture produces osteochondrosis affecting the non-articular epiphyses, e.g., Osgood-Schlatter disease. Some of these injuries appear to be produced solely by repetitive trauma and others may represent pathologic insult to constitutionally vulnerable or revascularizing bone, e.g., the femoral head in Perthes' disease.

Animals↗
PubMed1991

[Ultrasonography of the borderline between normal and pathological state of the hip in newborn infants (borderline hip)].

Infant hips are classified, according to Graf, in 4 US types on the basis of the morphologic changes in both the cartilaginous and the bony roofs (type I, II, III, IV). Out of 6,000 examined hips, 170 (2.8%) were considered, which could be classified neither as type I (mature) nor as type II (delayed/immature ossification). These hips were called borderline hips. They exhibited some characteristic US features: good bone modeling, rounded cotyle, and alpha angle 60 degrees +/- 2. They were always observed during the first month of the patients' life. Anamnestic data were not specific (27.5% breech delivery, and 13% oligohydramnios); clinics sometimes overestimated the actual anatomic development (64/170 cases with positivity of Ortolani's sign and/or restricted abduction; 25% of patients presented with no suspicious signs). Dynamic hip examination showed only physiological cranial deflection of the cartilaginous roof. Finally, borderline hips developed into type I hips in 99% of cases, within the third month of the patients' life.

Follow-Up Studies↗
PubMed1998

Acquired spinal cord lesion associated with os odontoideum causing deterioration in dystonic cerebral palsy: case report and review of the literature.

A boy with a dystonic quadriparesis presented with acquired paralysis, spasticity, and a feeding disorder. Spinal MRI revealed a cervical cord lesion and os odontoideum. Excessive movement of the neck, leading to failure of ossification of the dens and then to cervical cord trauma was the likely mechanism. The poor outcome of this subject is described, emphasising the need to pay careful attention to neurological changes in children with extrapyramidal cerebral palsy, who may be at particular risk of cord pathology. The management issues are discussed.

Atrophy↗
PubMedDate not supplied

[Arachnoiditis ossificans].

Arachnoiditis ossificans is a uncommon disorder, is generally associated with neurologic deficits, but patients could be only mild sintomatic, regardless of the degree of ossification. Unenhanced CT has been well show to be sensitive for the disorder, useful to evaluate the full extenstion of the ossified mass and their remotion if surgical intervention is needed. On MRI imaging the manifestations could be minimal and variable, being important to access another pathologic conditions (arachnoid cysts, intramedullary cysts and syringomyelia).

Aged↗
PubMed1986

Sternocostoclavicular hyperostosis. Radiological and pathological study of a specimen with ununited clavicular fracture.

Anatomico-radiological study of a sternocostoclavicular mass taken post-mortem from a man whose clinical history had shown bilateral sternocostoclavicular hyperostosis (SCCH) with plantar pustulosis for 27 years. The clavicle showed an ununited fracture attributable to a trauma sustained five years earlier. Both clavicular segments showed active remodelling with intraosseous granulation tissue and periosteal metaplastic ossification. The sternocostoclavicular region was fused in a bony block in which there were no signs of remodelling activity. The first rib and the distal extremity of the clavicle were histologically normal. These observations support the conclusions of a previous study of another case of SCCH. The condition might be due to a bone infection caused by an--as yet--unknown germ. Bone remodelling would explain the periosteal hyperostosis and the fragility of the underlying bone. Furthermore, the possibility that the condition might also be a joint disease related to the group of rheumatic diseases called spondyloarthropathies should be considered.

Adult↗
PubMed1999

Radiological pathogenesis of cervical myelopathy in 60 consecutive patients with cervical ossification of the posterior longitudinal ligament.

STUDY DESIGN: The radiological pathogenetic factors for cervical myelopathy in 60 consecutive patients with cervical ossification of the posterior longitudinal ligament (OPLL) were investigated retrospectively. OBJECTIVE: To clarify which patients with OPLL will develop cervical myelopathy. METHODS: Sixty consecutive patients with OPLL were radiologically assessed comparing the myelopathic patient group (M group, n=41) and the mild or non-myelopathic patient group (non-M group, n=19). RESULTS: The narrowing ratio of the spinal canal in the M group (47.1%) was significantly greater (P=0.026) than that in the non-M group (38.3%). The two groups showed a significant difference (P=0.0016) with regard to the Pavlov ratio (M group, 0.73; non-M group, 0.84). The total range of motion of the cervical spine did not differ between the two groups but the per cent range of motion was significantly greater (P=0.037) in the M group than in the non-M group. CONCLUSION: This study suggests that factors important in the onset or aggravation of myelopathy are factors related to pathological compression by OPLL, cervical soft disc herniation, developmentally narrow spinal canal, and local or non-proportional hypermobility.

Adult↗
PubMed2000

Dural band pathology in syringomyelia with Chiari type I malformation.

Surgical material taken from the 'outer layer' of thickened dura mater (dural band) at the craniovertebral junction of eight cases of syringomyelia with Chiari type I malformation was histologically examined in comparison with four autopsy cases as controls. The dural band was thickened and there were increased numbers of collagen fibers which showed fiber splitting, hyalinous nodule, calcification and/or ossification. These changes were not observed in the four control cases. Thus, it is suggested that the thickening of the dura mater may be a causative factor of syringomyelia with Chiari type I malformation. In addition, the histology of the thickened dura mater suggests the condition may be a consequence of birth injury in these patients.

Adolescent↗
PubMed2001

A mathematical framework to study the effects of growth factor influences on fracture healing.

During fracture healing, multipotential stem cells differentiate into specialized cells responsible for producing the different tissues involved in the bone regeneration process. This cell differentiation has been shown to be regulated by locally expressed growth factors. The details of their regulatory mechanisms need to be understood. In this work, we present a two-dimensional mathematical model of the bone healing process for moderate fracture gap sizes and fracture stability. The inflammatory and tissue regeneration stages of healing are simulated by modeling mesenchymal cell migration; mesenchymal cell, chondrocyte and osteoblast proliferation and differentiation, and extracellular matrix synthesis and degradation over time. The effects of two generic growth factors on cell differentiation are based on the experimentally studied chondrogenic and osteogenic effects of bone morphogenetic proteins-2 and 4 and transforming growth factor-beta-1, respectively. The model successfully simulates the progression of healing and predicts that the rate of osteogenic growth factor production by osteoblasts and the duration of the initial release of growth factors upon injury are particularly important parameters for complete ossification and successful healing. This temporo-spatial model of fracture healing is the first model to consider the effects of growth factors. It will help us understand the regulatory mechanisms involved in bone regeneration and provides a mathematical framework with which to design experiments and understand pathological conditions.

Bone Morphogenetic Protein 2↗
PubMed1987

Computed tomography of benign mature teratomas of the mediastinum.

The computed tomography (CT) findings of five benign, mature teratomas of the anterior mediastinum collected during a ten-year period are described, and their case histories are reviewed. Three of the five were primarily cystic, with only small soft tissue components. One of the five contained equal cystic and solid elements. All cysts had a higher attenuation than water. Three tumors contained small foci of dense calcification or ossification. Only two contained fat. Computed tomography accurately predicted the presence of adherence to adjacent structures in all five. Four of five patients were less than 22 years of age, and benign teratoma of the mediastinum was not a common neoplasm at any age. The origin and pathology of germ cell tumors of the mediastinum are briefly reviewed.

Adolescent↗