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The pattern of shortening of the bones of the hand in PHP and PPHP--A comparison with brachydactyly E, Turner Syndrome, and acrodysostosis.

The patterns of length alterations in the hand bones in cases of pseudohypoparathyroidism (PHP), pseudopseudohypoparathyroidism (PPHP), and acrodysostosis were evaluated. The length of each of the hand bones was measured and compared to appropriate means for age and sex. The pattern profiles thus generated showed that those for PHP and PPHP are almost identical, and are similar to that seen in acrodysostosis, except for the much smaller size of the bones seen in the latter condition. PHP and PPHP are probably differend manifestations of the same entity, and acrodysostosis may also be related to them. Brachydactyly E is indistinguishable radiologically from the PHP-PPHP syndrome.

Abnormalities, Multiple↗

Upper extremity radionuclide bone imaging: the wrist and hand.

Bone scintigraphy of the hands and wrists represents an important adjunct imaging technique that complements plain film radiographic examination. The use of the three-phase bone scan provides clinical information not only regarding osseous uptake but the blood flow and extravascular distribution of the radiotracer as well. Scintigraphic evaluation of the hands and wrists is employed in acute and chronic conditions. In the event of an equivocal or negative plain film, the bone scan can identify occult fractures. Of particular concern is the identification of scaphoid fractures due to the higher incidence of osteonecrosis. Work related injuries represent a significant health issue. The bone scan can be a part of the algorithm for evaluating chronic pain syndromes including reflex sympathetic dystrophy. The complimentary roles of bone scanning and imaging with gallium-67 citrate or radiolabeled leukocytes has proven useful in the evaluation of acute or chronic osteomyelitis. In addition, the diphosphonates are useful in identifying solitary and multiple primary bone tumors. In the case of primary bone tumor, thallium-201 can be used to evaluate response to therapy. Although uncommon in the hand and wrist, the bone scan can identify metastatic tumors or tumor-related conditions such as hypertrophic osteoarthropathy. Finally, bone scintigraphy may be useful in identifying location and extent in a variety of conditions such as fibrous dysplasia, histiocytosis X, and Paget's disease.

Bone Diseases↗

The distribution of bone islands and juxta-articular bone cysts in the growing hand.

Bone islands and juxta-articular bone cysts are relatively common incidental findings when X-rays are taken for other purposes. We have identified that the incidence of bone islands in the hands of asymptomatic children between the ages of 5 and 13 years is 3.8% and the incidence of cysts in the same population is 2.8%. Bone islands were most common in the scaphoid, whilst juxta-articular bone cysts were most common in the capitate. The age at which they appear has not been reported previously. This study first identifies their presence in the hands of children of age 10 years and 2 months (bone islands) and 10 years 0 months (juxta-articular bone cysts). Most of the lesions were already present on the first radiograph taken. New bone islands appeared in five cases between the ages of 13 years and 1 month and 15 years and 3 months. New juxta-articular bone cysts were observed to appear in five cases between the ages of 10 years 10 months and 15 years 0 months. No island or cyst changed in size during the review period.

Adult↗

[A comparative evaluation of methods for treating the sequelae of fractures and dislocations of the bones of the hand].

A comparative clinical investigation of effectiveness of different methods of treatment of sequelae of injuries of the hand bones and joints in 159 patients was carried on. Traditional methods of treatment and devices for external fixation were used. An analysis of long-term results of treatment of 145 patients has shown that methods of external fixation by compressive-distraction and hinge-distraction devices are most effective.

Adult↗

Bone mineral density of the hand in rheumatoid arthritis.

OBJECTIVE: To determine the reproducibility, accuracy, and linearity of hand bone mineral content (BMC) measurements, and to evaluate the influence of hand posture; to determine the relationship of hand bone mineral density (BMD) to generalized osteopenia in rheumatoid arthritis (RA); and to determine the relationship between hand BMD and disease severity in early RA. METHODS: Hand BMD was measured by dual-energy x-ray absorptiometry (DXA). We studied 70 postmenopausal women with steroid-treated RA (established RA), ages 49-79, and 20 age-matched healthy controls to determine the relationship to generalized osteoporosis; we also studied 20 patients aged 23-74 years with early RA to determine the relationship between disease severity and hand BMD. RESULTS: Reproducibility of hand BMD was to within 1%. In established RA, there was a greater decrease in juxtaarticular BMD (23% at the hand) than in generalized BMD (16% at the femoral neck, 11% at the lumbar spine, and 11% total body) compared with that in age-matched controls. Hand BMD correlated with skeletal size and BMD at other skeletal sites. In established RA, there was no effect of disease duration, disability, or steroid therapy. In early RA, hand BMD correlated with age and disease activity. CONCLUSION: Measurement of hand BMD by DXA is accurate and precise. Hand BMD reflects BMD at other skeletal sites in patients with RA, and is a marker of disease severity in patients with early disease. It may be a sensitive marker of disease progression and response to therapeutic intervention.

Aged↗

Fracture healing: bone healing, fracture management, and current concepts related to the hand.

Bones fracture frequently and often result in significant impairments, functional limitations, and disabilities, especially when the hand is involved. When fractures occur, there is a disruption of the skeletal tissue organization and a loss of mechanical integrity. The goal of fracture healing is to regenerate mineralized tissue in the fracture area and restore mechanical strength to the bone. Of equal importance is the reconstitution of the normal soft tissue gliding and movement about the fracture site. This article briefly reviews the history of fracture healing and the advances in mechanics and cellular and molecular biology, which should help the reader better understand the current mechanisms related to bone healing (primarily and secondarily). Fracture fixation modes also are described along with the temporal sequencing as to when to protect or move the fractured region.

Bone and Bones↗