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Radiological criteria of industrial fluorosis.

The bone radiographs of 43 potroom workers in an aluminium factory, on whom the diagnosis of industrial fluorosis had been confirmed by bone biopsy, are compared with radiographs from 18 control subjects. A higher frequency of ossification of ligament, tendon, and muscle attachments is observed among the fluoride exposed subjects. These changes increase with the bone fluoride content. The presence of hyperostosis is an important aid in the diagnosis of skeletal fluorosis. However, this radiological sign has to be complemented by clinical data and estimation of the concentration of urinary fluoride. Final confirmation of the diagnosis is obtained by bone biopsy.

Bone and Bones↗

Sclerotic changes of the manubrium sterni.

Six females with nearly identical sclerotic and hyperostotic changes of the manubrium sterni are reported. Malignancies, bacterial inflammatory processes, and Paget disease, which were first suspected, could be excluded. The youngest patients also had sclerotic changes of other bones, including the lumbar spine, the pubic bone, and the clavicle, and may be classified as having "chronic recurrent multifocal osteomyelitis" (CRMO). The two oldest patients had ossification of the costoclavicular ligament(s) and may be classified as having "inter-sterno-costo-clavicular ossification" (ISCCO). One had only hyperostotic and sclerotic changes as seen in "sterno-costo-clavicular hyperostosis" (SCCH). The pathogenesis of these uncommon diseases is unknown, but they are all frequently associated with pustulosis palmo-plantaris and have similar clinical courses and laboratory abnormalities. None of the present patients had HLA-B27. The similarity of the radiological abnormalities of the manubrium sterni suggests that the diseases themselves may be similar, but with different courses depending on age, CRMO being present in children and young adults and ISCCO or SCCH in older adults.

Adult↗

Hypertrophy of the talar beak.

Hypertrophy of the talar beak is the product of traction of the insertion of the joint capsule. It is commonly seen in athletes and may be entirely asymptomatic despite its size. It should not be mistaken for spurring of the articular margin of the talus which is seen in tarsal coalition.

Bone Diseases↗

Ulnar variance in children--standard measurements for evaluation of ulnar shortening in juvenile rheumatoid arthritis, hereditary multiple exostosis and other bone or joint disorders in childhood.

Measurements for radioulnar variance in adults cannot be used in children because the epiphyses are not fully ossified. We describe a method of determining ulnar variance in children by using the distance from the distal metaphysis of the radius to the distal metaphysis of the ulna. Standards for this measurement are presented for ages 1.5 to 15.5 years in boys and girls. These measurements change little with age and may be helpful in establishing shortening of the ulna which may been seen in juvenile rheumatoid arthritis, hereditary multiple exostosis, or other bone and joint diseases with childhood onset.

Adolescent↗

A radiographic analysis on human lumbar vertebrae in the aged.

Radiographic analysis was made on human lumbar vertebrae (1st to 3rd) from 101 autopsy cases (54 males, 47 females) without primary and secondary osteopathy. The materials consisted with 11 control cases (28-59yr) and 90 cases of the aged subjects (60-92yr). The aged subjects were divided into four groups by decades. One vertebral body was removed from the column and three bone specimens, one mid-sagittal (Plane A) and two mid-horizontal (plane BL and BR) sections, of about 10 mm in thickness were prepared by a hand saw. Contact radiographs taken on films by a radiographic apparatus were analyzed. Radiographic images of Plane A in control showed a typical checker pattern consisting of vertical and horizontal trabeculae within a rim of a transversely elongated square. Planes B showed a uniform ring pattern of about 1.0 to 1.3 mm in diameter within a semi-circular dense cortical margin. The trabecular image of the male was somewhat denser and wider than those of the female. Radiographically the aged vertebrae were classified into four types. Type I wass a trabecular pattern indistinguishable from that of the control. Type IV was the most advanced from of vertebral atrophy. Type II and III were intermediate forms between previous two types. Early trabecular atrophy, which was characterized by slight decrease in trabecular density in Plane A and widened ring pattern in Planes B, was seen in Type II. In type TTT, these features were further exaggerated. Horizontal trabeculae in Plane A became indiscernible and the ring pattern in Planes B widened more significantly. In Type IV, the typical trabecular pattern was no longer seen...

Adult↗

Ankylosing spinal hyperostosis (ASH) and ossification of the posterior longitudinal ligament (OPLL).

The clinical and radiological features of 70 patients with ankylosing spinal hyperostosis are presented. Pain in some region of the back was found in 49 patients. No significant deviations were found in HLA typing. Radiologically, the most characteristic features were bony spurs or bridges in the dorsal spine, where they predominated on the right and anterior aspects of the spine, especially in the lower dorsal region. Ossification of the posterior longitudinal ligament was found in 21 patients.

Adult↗

Sclerosis and hyperostosis of the manubrium sterni.

Seven females and one male with almost identical sclerotic and hyperostotic changes of the manubrium sterni are reported. The clinical course was prolonged and characterized by intermittent periods of exacerbation followed by improvement. Malignancies, bacterial inflammatory processes, and Paget disease, which were first suspected, could be excluded. Pustulosis-palmoplantaris was present in four patients and one had psoriasis vulgaris. None of the patients had sacroiliitis or peripheral joint changes, but the three youngest patients had sclerotic changes of other bones, including the lumbar spine, the pubic bone, and the clavicle. This may indicate that this is an adult disease analogous to "chronic recurrent multifocal osteomyelitis", a disease mainly present in children and adolescents.

Adult↗

Hereditary spinal osteochondromas in diaphyseal aclasia.

We present cases of cervical cord compression in father and son with diaphyseal aclasia. Both patients were investigated with plain radiography, CT and MRI. We believe this to be the first report of spinal cord compression in first-degree relatives with diaphyseal aclasia.

Adolescent↗

The widened spectrum of multiple cartilaginous exostosis (MCE).

2 brothers with possible homozygous multiple cartilaginous exostosis (MCE) are reported. The MCE-PD-(Peripheral Dysostosis) syndrome is discussed. A family (father, daughter and son) with Metachondromatosis is presented, and the tendency to spontaneous remission in this condition is emphasized. A "second thought", when considering the diagnosis of mce, seems worthwhile.

Child↗

Exostosis of the posterior clinoid process.

We report an unusual case of exostosis arising from the lateral aspect of the posterior clinoid process. Its presence should be considered in approaching the parasellar regions.

Arteries↗