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PubMed1983

Pathogenesis and treatment of osteochondritis dissecans--an experimental study on chondral and osteochondral fractures in adult and young rabbits.

To observe the natural history of chondral injury and clarify the genesis of osteochondritis dissecans, various types of experimental osteochondral or chondral injuries were made on the articular surface of femoral condyles of adult and young rabbits. Pathological features resembling osteochondritis dissecans were frequently observed in young rabbits, especially in the groups in which the injured part was most unstable (58% in rabbits aged from 7 to 14 days, 24% in those aged from 3 to 7 weeks). Therefore, a neglected chondral injury in early childhood and following ossification disturbances may relate to this disease.

Animals↗
PubMed1978

Osteochondrosis in the horse. II. Pathology.

An investigation was made of the pathology of osteochondritis dissecans of young foals and horses with clinical signs of the lesion. A randomly selected material of fetuses and young foals without clinical signs was also examined. It was demonstrated that osteochondritis dissecans is primarily a cartilaginous disease, as previously described in pigs and dogs. Thickening, disturbance of endochondral ossification, degeneration and necrosis of the cartilage were the four main features of osteochondritis dissecans. Cracks and fissures occurred in the degenerated and necrotic parts of the cartilage. This led to formation of cartilage flaps and eventually to loose bodies. It was shown that small pieces of subchondral bone could be ripped off when a cartilage flap was formed. This was one explanation as to why many flaps and loose bodies contained bone in contrast to the findings in pigs and dogs. Endochondral ossification could also take place in the thickened joint cartilage in some cases. Even some loose bodies could undergo endochondral ossification if they were well nourished. Osteochondritis dissecans was often found bilaterally in the knee and hock joint and this was interpreted as an indication that osteochondritis dissecans is a manifestation of a generalized condition called osteochondrosis. Simultaneous occurrence of lesions in joints other than the knee and hock and in several metaphyseal growth plates was another indication of the generalized nature.

Animals↗
PubMed1999

Choroid plexus papilloma: a clinicopathological study of 23 cases.

BACKGROUND: Choroid plexus papillomas (CPPs) are rare, accounting for less than 1% of all intracranial tumors in adults. However, they are relatively more common in childhood and constitute 1.5 to 4% of intracranial tumors. DESCRIPTION: They are most often located in the lateral ventricle, followed by the fourth and third ventricles and, rarely, in the cerebellopontine angle. The radiological appearance of a CPP as a cyst with a mural nodule is a curiosity. Bone formation is rare in CPPs and only 6 cases have been described in the literature. Neuromelanin production is also extremely rare and only 2 cases have been reported to date. CONCLUSION: In the present communication, 23 cases of CPP are analyzed and rare clinical, pathological, and radiological features are described.

Adolescent↗
PubMed1998

[Spondarthritis hyperostotica pustulo-psoriatica: nosologic study with clinical and radiologic presentation in relation to the SAPHO syndrome].

Spondarthritis hyperostotica pustulo-psoriatica (Spond.hyp.pp-Schilling), corresponding nosologically to pustulotic arthroosteitis, is a dermato-skeletal "double system" disease of adults. It consists of the triad (a) palmo-plantar pustulosis (Ppp) or, alternatively, Königsbeck-Barber-type psoriasis, (b) sternocostoclavicular hyperostosis (SCCH), and (c) truncal-skeletal changes with syndesmophite-like, hyperostotic and/or parasyndesmophite-like ossifications of layers of the anterior vertebral ligament taken together in the sense of a desmophytal hyperostosis. There is also a potential for sclerosing inflammatory arthritis of the sacro-iliac joints and "dry" inflammatory arthritis of peripheral joints. Thus, the pustulo-psoriatic terrain seems to have a decisive influence on osseous pathology. A total of 38 cases from a study during the years 1982 to 1992 is analysed with regard to morphological characteristics. Rare cases with diaphyseal and pelvic hyperostotic lesions subsequent to bland sclerosing osteomyelitis constitute an overlapping region to chronic recurrent multifocal osteomyelitis (CRMO) and illustrate the relationship between hyperostotic spondarthritis and CRMO. The syndromes of "acquired hyperostosis" and "SAPHO", the former more radiologically oriented and the latter more clinically oriented, together with mainly CRMO and hyperostotic spondarthritis and its forms, constitute the "Spond.hyp.pp.". Although hyperostosis is a guidepost for the radiologist and SAPHO symptoms are one for the clinician, the syndrome does not represent a diagnosis by itself and requires further differentiation. In this report the entity "Spond.hyp. pp." is considered and required contributions from rheumatologically and osteologically oriented radiologist.

Acquired Hyperostosis Syndrome↗
PubMed2006

Extraskeletal osteochondroma in the nape of the neck: a case report.

Extraskeletal osteochondroma in the nape of the neck is rare and its pathological diagnosis is based on radiological and histopathological examination. It is vital that such a diagnosis be considered when a discrete, ossified mass is localised in soft tissues, even at atypical sites. Differential diagnoses include myositis ossificans, a lipomatous lesion, a pseudomalignant osseous tumour, an ossifying fibromyxoid tumour, an extraskeletal chondroma with endochondral ossification, synovial (osteo) chondromatosis, tumoural calcinosis, a synovial sarcoma, and an extraskeletal osteosarcoma. Clinical awareness of this benign entity is important as no malignant transformation or metastasis has been reported. Marginal excision with histopathological identification is the treatment of choice.

Adult↗
PubMed1979

Osseous lesions and pathologic fractures in congenital cytomegalic inclusion disease: report of a case.

A newborn infant with congenital cytomegalic inclusion disease had spontaneous fractures of the distal radii bilaterally, and involvement of the metaphyseal portions of the humeri, ulnas, femurs, and tibias. The fractures healed promptly without complications under ordinary management. At the present time, one can only speculate on the cause of these lesions. Viral osteomyelitis, osteomalacia secondary to hepatitis and malabsorption and a disturbance of endochondral ossification are all possibilities. There is a need for additional cases with histologic and biochemical studies of the bone lesions in congenital cytomegalic inclusion disease.

Bone Diseases↗
PubMed1989

Pulmonary hypoplasia and osteogenesis imperfecta type II with defective synthesis of alpha I(1) procollagen.

Perinatal lethal osteogenesis imperfecta (OI type II), a heritable disorder of connective tissue occurs approximately once in 60,000 live births. Phenotypic characteristics include defective cranial ossification and severe skeletal deformity due to intrauterine rib and long bone fractures. Lethal OI may be associated with intracranial hemorrhage or severe respiratory insufficiency. Pulmonary hypoplasia has been previously observed in OI type II, but has not been defined clinically. The infant described herein was born with OI type II and pulmonary hypoplasia. Pathological examination of airway branching patterns indicated that lung development had progressed to only the 10 week stage with immature acinar development. Investigation type I collagen synthesis by cultured dermal fibroblasts revealed the presence of electrophoretically abnormal alpha 1(I) polypeptides. These findings suggest that biochemically regulated processes, as well as mechanical factors, may impeded pulmonary development in similar cases of OI type II.

Culture Techniques↗
PubMedDate not supplied

[Magnetic resonance tomography in therapy follow-up after repositioning treatment of congenital hip dislocation].

INTRODUCTION: After treatment of infantile hip dislocation in terms of reduction and retention in plaster casts or splints a problem of therapy controlling exists. To assess if the femoral head is in correct position centered in the socket ultrasound is not possible, because one cannot achieve the necessary standard position. Computertomograms are associated with a hereditary taint of radiation and plain roentgenograms lack of presentation of the important cartilaginous structures. METHOD: To control infantile hips after open or closed reduction from 1990 until 1996, 43 examinations by MR imaging were performed in 34 children. RESULTS: In our series MRI was able to provide exact information about the position of the femoral head independently of its state of ossification. Also, a clearly visualisation of the different structures of the acetabular fossa, particular acetabulum, pulvinar, bony and cartilaginous acetabular rim and limbus was possible. Furthermore the MR images showed interpositioned soft tissue, intraarticular effusion and displayed cartilaginous parts of the acetabular rim. CONCLUSIONS: MRI is an exact method to assess the anatomical and pathological conditions of the childlike hip joint. Because of the disadvantages of CT and X-ray, MRI is superior in terms of controlling the results after treatment of infantile hip dislocation.

Acetabulum↗
PubMed1998

Anatomy and pathology of the aging spine.

The vertebral column is a complicated anatomical structure which is composed of the intervertebral discs and the vertebrae. Both components develop special degenerative changes and morphologic features during life. This paper first reviews the anatomical fundamentals and then describes the morphological features of the aging intervertebral disc and the subsequent osseous changes of the vertebral bodies and the zygapophyseal joints. The aging intervertebral disc is characterised by processes which are labeled as intervertebral chondrosis and intervertebral osteochondrosis. Often these processes are combined with typical dislocations of intervertebral disc tissue in an anterior or dorsolateral direction. The well known Schmorl's nodules must also be mentioned in this context. Furthermore calcification and ossification of the intervertebral disc tissue can take place. More severe processes lead to osseous changes of the vertebral bodies. In particular, an osteophytosis of the vertebral bodies can be established. These sturdy osteophytes are able to stiffen the vertebral column. Furthermore the arthrotic changes of the zygapophyseal joints are delineated in this paper. The special appearances of these changes are discussed according to the different and specialised regions of the vertebral column. The advanced degenerative changes of the zygapophyseal and uncovertebral joints of the cervical spine are of essential clinical interest because the compression of the vertebral artery or the narrowing of the intervertebral foramina by these processes may cause severe neurological symptoms. The arthrotic changes of the medial atlantoaxial joint, which lead to the crowned odontoid, and the pseudospondylolisthesis (so called M. Junghanns) of the lumbar spine must also be mentioned. It is the aim of this paper, not only to explain and review the degenerative changes, but to illustrate the anatomy and pathology of the aging spine on the basis of macerated osseous specimens in order to make radiological investigations and pictures more understandable and clear.

Aged↗
PubMed2005

Expression of mouse HtrA1 serine protease in normal bone and cartilage and its upregulation in joint cartilage damaged by experimental arthritis.

Levels of HtrA1 protein in cartilage have been reported to elevate in joints of human osteoarthritis patients. To understand roles of HtrA1 in normal osteogenesis as well as in pathogenesis of arthritis, we examine HtrA1 expression pattern during bone and cartilage development and in articular cartilage affected by experimental arthritis. HtrA1 is not expressed in mesenchymal or cartilage condensations before initiation of ossification. When ossification begins in the condensations, the expression of HtrA1 starts in chondrocytes undergoing hypertrophic differentiation near the ossification center. Hypertrophic chondrocytes found in adult articular cartilage and epiphyseal growth plates also express HtrA1. When arthritis is induced by injection of anti-collagen antibodies and lipopolysaccharide, resting chondrocytes proceed to terminal hypertrophic differentiation and start expressing HtrA1. These data suggest that hypertrophic change induces HtrA1 expression in chondrocytes both in normal and pathological conditions. HtrA1 has been reported to inhibit TGF-beta signaling. We show that HtrA1 digests major components of cartilage, such as aggrecan, decorin, fibromodulin, and soluble type II collagen. HtrA1 may, therefore, promote degeneration of cartilage by inducing terminal hypertrophic chondrocyte differentiation and by digesting cartilage matrix though its TGF-beta inhibitory activity and protease activity, respectively. In bone, active cuboidal osteoblasts barely express HtrA1, but osteoblasts which flatten and adhere to the bone matrix and osteocytes embedded in bone are strongly positive for HtrA1 production. The bone matrix shows a high level of HtrA1 protein deposition akin to that of TGF-beta, suggesting a close functional interaction between TGF-beta and HtrA1.

Aging↗
PubMedDate not supplied

[Results of radium 224 therapy in ankylosing spondylitis (Strümpell-Marie-Bechterew disease)].

After an average of 5 years following therapy with Ra224, the concentration of Tc99m methyl diphosphonate (MDP) in the region of the sacroiliac joints and lumbar spine was measured in 15 patients with ankylosing spondylitis. The findings were supplemented by those of clinical, pathological, and roentgenological examinations. The concentration of MDP was normal in the sacroiliac joints in almost all the patients, but was raised in the lumbar spine in two-thirds. This is to be interpreted as indicating enhanced bone turnover, the difference from that in healthy subjects being highly significant (p less than 1). Increased ossification of the lumbar spine could be demonstrated roentgenologically in two-thirds of the patients. Differential blood count, blood sedimentation rate, and electrophoresis remained unchanged after therapy. However, in 60% of patients the mobility of the spine was the same or even improved; 46% felt better after Ra224 treatment than before it.

Adult↗
PubMed2003

Apoptosis of terminal hypertrophic chondrocytes in an in vitro model of endochondral ossification.

It is widely accepted that growth plate chondrocytes undergo apoptosis when they reach the terminal hypertrophic stage of their differentiation during the process of endochondral ossification in vivo. In this report, an established chondrocyte cell culture model of mammalian endochondral ossification was utilized to investigate the fate of chondrocytes after they had entered hypertrophy in vitro. Fetal bovine epiphyseal chondrocytes were treated with the demethylating agent, 5-azacytidine, for 48 h and then cultured under azacytidine-depleted conditions. There was evidence for apoptosis in azacytidine-treated cells, as demonstrated by nuclear condensation and fragmentation (days 27 and 35) using transmission electron microscopy, and the detection of exposed phosphatidylserine on the plasma membrane surface of apoptotic chondrocytes (day 27) using fluorescence-labelled annexin V. Treated cultures on days 10 and 20 and untreated cultures at all corresponding time-points showed no morphological characteristics of apoptosis. In situ hybridization studies of treated cultures revealed that expression of the apoptotic suppressor, bcl-2, remained consistently high throughout the culture period, whilst the apoptotic inducer, bax, was not expressed until day 23. Quantification of these data showed a gradual shift in the ratio of the expression level of bcl-2 and bax in favour of bax with time in culture, particularly from day 23 onwards. Taken together, the results indicate that azacytidine-treated epiphyseal chondrocytes entered terminal hypertrophy from day 23 onwards in culture and died by apoptosis. This study confirms this culture system as a successful recapitulation of the entire mammalian chondrocyte differentiation pathway, including apoptosis. The culture model will prove valuable for studies of the apoptotic fate of terminally differentiated chondrocytes in the growth plate with a view to providing a better understanding of the underlying mechanisms of skeletal malformations and other pathological disorders such as osteoarthritis.

Animals↗
PubMed1991

Magnetic resonance imaging study on spinal cord plasticity in patients with cervical compression myelopathy.

Spinal cord plasticity in 55 patients with cervical compression myelopathy was assessed with magnetic resonance imaging, by which the transverse area of the spinal cord was measured at the site of maximum compression before and after surgery and compared with the conventional modalities of computed tomographic myelography. A high correlation (r = 0.901, P less than 0.01) was observed between the preoperative measurements of magnetic resonance imaging and computed tomographic myelography. The preoperative transverse area was in good correlation with the preoperative Japanese Orthopaedic Association score (r = 0.466, P less than 0.01). In most patients with a spinal cord area of less than 0.45 cm2, the clinical results were poor despite considerable morphologic restoration of the spinal canal obtained after decompression surgery, reflecting an irreversible pathology developed in the spinal cord.

Adult↗
PubMed2006

[Bony fragments in the uterus cavity].

A rare kind of uterine pathology is considered in the article--the presence of bony fragments in the uterine cavity. Three cases with such findings are cited. Pathogenesis, clinical symptoms, diagnostic and therapeutic methods are discussed.

Adult↗
PubMed1979

Sprengel's deformity. Radiology of the pathologic deformation.

A unique specimen of unilateral Sprengel's deformity, and contralateral normal pectoral girdle, were studied morphologically and roentgenographically. The cervical spine exhibited multiple abnormalities involving both the vertebral centra as well as the posterior elements (Klippel-Feil abnormality). A small spina bifida involving C5 and C6 was present. Abnormalities of the spinous processes included an articulation with a well-formed omovertebral bone that also articulated with the vertebral (infraspinatus) margin of the scapula. Secondary (presumed epiphyseal) ossification was present in the omovertebral bone at the distal end. The scapula was deformed, especially in the supraspinatus portion. The clavicle was shorter and had a different contour.

Abnormalities, Multiple↗
PubMed2004

Chondroid syringoma. Cytokeratin 20 immunolocalization of Merkel cells and reappraisal of apocrine folliculo-sebaceous differentiation.

CONTEXT: Chondroid syringoma (CS) is a benign cutaneous adnexal tumor with epithelial and stromal components. Epithelial components derived from folliculo-sebaceous-apocrine germ are evident in apocrine but not in eccrine CS. OBJECTIVES: To further characterize pilosebaceous differentiation and to identify the presence of Merkel cells in the areas of follicular differentiation. DESIGN: Histologic type, folliculo-sebaceous differentiation, character of stroma, and presence or absence of Merkel cells by cytokeratin (CK) 20 immunoreactivity were evaluated in 25 CSs (22 apocrine and 3 eccrine) from the surgical pathology files of Henry Ford Hospital (Detroit, Mich). RESULTS: Most CSs occurred in the head and neck region of patients aged 40 years or older. We found no significant difference in sex, age, or location between apocrine and eccrine types. The stroma varied from myxoid (100%) to chondroid (59%), with various amounts of fat (59%) and ossification identified in 2 cases (9%) of apocrine type, but was homogeneously myxoid in the eccrine type. Follicular and sebaceous differentiation was found in 64% and 32% of apocrine CSs, respectively. Only 2 (14%) apocrine CSs with follicular differentiation were positive for CK20 (a few scattered cells in one case and numerous grouped cells in the other in association with follicular epithelium). No correlation was found between type of stroma and the presence of Merkel cells. Scattered Merkel cells were identified in 83% of normal hair follicles and in 33.3% of normal epidermis. CONCLUSION: A high proportion of apocrine CSs show folliculo-sebaceous differentiation. The presence of Merkel cells in foci of follicular differentiation of CS supports the hypothesis that Merkel cells may be an integral constituent of follicles. To our knowledge, the presence of Merkel cells in CS, particularly in proliferative form, has not been described previously in the literature.

Adenoma, Pleomorphic↗
PubMed1987

Reactive endosteal bone formation.

The microstructure of reactive endosteal new bone was examined using undecalcified ground sections in five pathologic conditions (bone metastasis from prostate cancer in seven cases, intervertebral osteochondrosis in five, Paget disease in four, chronic suppurative osteomyelitis in two, and fracture healing in one). To determine a basic form of rapid intramembranous bone formation, fetal rat calvaria and primitive bones made in clonal osteogenic cell culture were also observed. In slow bone-forming conditions, lamellar new bone was deposited on pre-existing trabecular surface and caused trabecular thickening on radiographs. In contrast, in rapid bone-forming conditions, woven bone was deposited as spicules extending from trabecular surface so as to form new networks in intertrabecular space. This causes obscurity of trabecular margins radiographically. Reactive endosteal bone formation may be nonspecific and have a significance for assessing the virulence of underlying pathologic conditions like periosteal reactions.

Aged↗
PubMed1995

Incidental asymptomatic orbital calcifications.

OBJECTIVE: To use modern computed tomography (CT) imaging to quantify the incidence of asymptomatic incidental orbital calcifications and describe their histological features. MATERIALS AND METHODS: One hundred orbital CT scans were reviewed. In addition, patients who had orbital calcification(s) detected on a brain CT scan were examined by the ophthalmology service. RESULTS: Of the orbital CT scans, 2% had bilateral drusen of the optic nerve head, 3% had calcified scleral plaques anterior to the medial or lateral rectus muscles, and 3% had bilateral ossification of the trochlear apparatus. Routine brain CT scans detected asymptomatic calcifications of the sclera and dura surrounding the proximal optic nerves. CONCLUSION: Incidental asymptomatic orbital calcifications are commonly encountered on modern high-resolution CT images of the brain and orbit. This article should help the clinician to confidently distinguish these densities from foreign bodies or pathological calcifications.

Adolescent↗