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At least 163 records · Page 9Linked to original sources
PubMed2004

Hydatidosis of the pelvis: a case report with a 25-year follow-up.

INTRODUCTION: Hydatid disease involves mainly the liver (66% of the cases) and the lungs (22%), with skeletal involvement being reported in 0.5-2.5% of cases. CASE REPORT: Herein is reported a case of hydatidosis of the hip and pelvis with a follow-up of 25 years. The diagnosis was first done in April 1975 following the local excision of a single hydatid cyst from the ischium of a 25-year-old man complaining of increasing pain and swelling of the left thigh. Histology confirmed hydatid disease of the bone. Local excision was repeated four more times for recurrence of the hydatid cysts in the bone or soft tissues. Antiparasitic medical therapy (albendazole 10 mg/kg daily) was attempted in 1991 but suspended after 2 days due to systemic adverse effects (abdominal pain, diarrhea). The patient had a 12-year relapse-free period with complete absence of any symptoms. CONCLUSION: Such a long symptom-free period confirms that it is not possible to consider bone hydatidosis as being completely healed without the confirmation of a long term follow-up.

Adult↗
PubMed2000

Solitary osseous hemangioma outside the spinal and craniofacial bones.

Bone hemangioma is mainly seen in the skull and spine, and rarely occurs in other bones. We report herein four cases of osseous hemangioma arising in rare sites: In two cases, on a rib; a faintly painful mass in one case located on the scapula; and progressive pain in one case located on the ischium. The tumors presented clinically as incidental lesions on radiographs. All cases had an aggressive appearance, such as defect of the cortex, a soft-tissue mass, and a sunburst-like appearance. Markedly high signal intensity on T2-weighted magnetic resonance images was a characteristic finding. Open biopsy resulted in severe blood loss, but needle biopsy was performed safely under computed tomography guidance. It is important to note that bone hemangiomas may be misdiagnosed as malignant tumors.

Adolescent↗
PubMed2006

Desmoplastic fibroma of bone with extensive cartilaginous metaplasia.

Desmoplastic fibroma of bone is a rare tumor demonstrating the same histologic and biologic features of its soft tissue counterpart, aggressive fibromatosis. We report the second case of desmoplastic fibroma of bone with extensive chondroid metaplasia. The tumor arose in the left ischium of a 51-year-old male, with extension into adjacent musculature as a pseudoencapsulated mass. The infiltrating growth and quality of the fibrous component are characteristic of desmoplastic fibroma, and in addition, abrupt transitions into bland hyalin cartilage were frequent. Discriminating features of this lesion from other bone tumors capable of biphasic expression of fibrous and chondroid elements are discussed.

Bone Neoplasms↗
PubMed1997

Ischial pressure sore coverage: a rationale for flap selection.

The role of wound debridement and flap coverage in treating pressure sores is clearly established. However, criteria and supportive clinical data for specific flap selection and the sequence of flaps for coverage of the ischium remain ill-defined. From 1979-1995, 114 consecutive patients underwent flap coverage of 139 ischial pressure sores. Preoperative risk factors, prior flap history, defect size, flap success, complication rates, and the length of hospitalization were retrospectively evaluated and compared for 112 flaps in 87 patients. Flap success was defined as a completely healed wound. Average follow-up was 10 months (range: 1 month-9 years). Overall, 83% (93/112) of the flaps healed. In the majority of cases (75%, 84/112), wound debridement and flap reconstruction was achieved in a single stage. However, there were significant differences in the healing rates among the various flaps used. The inferior gluteus maximus island flap and the inferior gluteal thigh flap had the highest success rates, 94% (32/34) and 93% (25/27), respectively, while the V-Y hamstring flap and the tensor fascia lata flap had the poorest healing rates, 58% (7/12) and 50% (6/12), respectively. Flap success was not significantly affected by the age of the patient or the prior number of flaps used and preoperative risk factors were equally distributed across all types of flaps. The overall complication rate was 37% (41/112), most commonly from a slight wound edge dehiscence (n = 16) that healed with local wound care within one month postoperatively. Results of this study show that proper flap selection and the appropriate sequence of flap use significantly improve success rates for ischial pressure sore coverage in both the short- and long-term. Based upon flap reliability (successful healing rates), reusability, and the need to preserve as many future flap options as possible, a rationale for flap selection is presented which can be individualized to any patient.

Adolescent↗
PubMed2003

Fetal bony pelvis in the bladder exstrophy complex: normal potential for growth?

OBJECTIVES: To provide the first look at the bony histologic features of fetuses with the exstrophy complex, specifically evaluating the endochondral ossification, stage of development, and microscopic potential for normal growth. METHODS: Three fetuses between 28 and 30 weeks of gestation, one with classic bladder exstrophy, one with cloacal exstrophy, and one control, were obtained from France. The bony pelves were dissected and preserved in formalin, and multiple representative sections were sliced from all pelvic areas: pubis, ischium, ilium, and sacrum. These slices were sequentially processed as slides, stained with hematoxylin-eosin, and evaluated microscopically for histologic changes, developmental stage, and degree of endochondral ossification. RESULTS: All slides from the three specimens showed cartilage analogue with endochondral ossification. Histologically the exstrophy specimens were identical to the control and appeared completely normal; bone development was occurring at an expected rate with the potential for continued normal growth. CONCLUSIONS: These new findings illustrate that fetal bone in the exstrophy complex displays normal microscopic growth patterns and unhindered endochondral ossification at 28 weeks of gestation, well beyond the embryologic period. With no evident microscopic bony defect, the gross bony anomalies in exstrophy should be surgically correctable, leading us to conclude that early reapproximation of the physiologic shape of the pelvis could lead to more normal gross bone growth, decreased shortage of bone, and a more appropriate distribution of the mechanical and developmental forces on a closed, normally functioning pelvic ring.

Abortion, Legal↗
PubMed1992

Pelvic osteotomy for axial rotation of the acetabular segment in dogs with hip dysplasia.

Pelvic osteotomy has provided normal function and activity to dogs with hip dysplasia. Physical and radiographic examination and palpation under anesthesia permit evaluation of the degenerative process and provide the specific amount of axial rotation of the pelvis necessary for each dog. The technique consists of an osteotomy of the pubis, ischium, and ilium to reestablish acetabular support of the femoral head.

Animals↗
PubMed2002

Anatomical basis of chronic pelvic pain syndrome: the ischial spine and pudendal nerve entrapment.

Chronic pelvic pain syndrome is a conundrum that may be explained partly by pudendal nerve entrapment (PNE), which causes neuropathic pain. In men with PNE, aberrant development and subsequent malpositioning of the ischial spine appear to be associated with athletic activities during their youth. The changes occur during the period of development and ossification of the spinous process of the ischium.

Adolescent↗
PubMedDate not supplied

MR image and CT scan of a tuberculous abscess in the gluteus maximus muscle.

A 77-year-old man had rapidly increased intramuscular tuberculous abscess in his left buttock. Radiographs showed a bone defect in the left ischium. Postcontrast CT scanning revealed marginal enhancement. MR imaging showed low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. T1-weighted MR images with Gd-DTPA enhancement showed enhancement of the wall. Bone defect and marginal enhancement on postcontrast MR images and on postcontrast CT images are image character of the intramuscular tuberculous abscess.

Abscess↗
PubMed1979

Using warning devices to improve pressure-relief training.

A training and monitoring system has been developed to train spinal cord injured patients to relieve pressure intermittently from ischium while sitting in wheelchairs. The system automates the training of wheelchair push-ups based on certain conditioning principles. The system reminds the patient to do a push-up of a specified duration and at specified intervals. The frequency and the duration of the push-ups are monitored providing information about performance of the patients, especially when the alarms to remind the patients are disconnected. A long-term study is in hand to assess the effectiveness of the system.

Adolescent↗
PubMed1980

Pre-ischiatic silicone implants.

A silicone prosthesis for pre-ischiatic implantation is presented and described; it is used in operations of pressure sores in this area. It has been placed in nine cases, with satisfactory results. The use of this prosthesis is recommended when the patient's psychic, social and economic conditions are precarious and when the fibrosis close to ulceration may be eliminated in the operation, but the transfer on the ischium of the adjacent musculature is problematic. The author suggests to increase the use of this prosthesis prescription, implanting it as a usual restoration procedure and as a prophylactic method in special cases.

Humans↗
PubMed2005

Pelvic insufficiency fracture related to autosomal dominant polycystic kidney disease.

We report the case of a patient with autosomal dominant polycystic kidney disease (ADPKD) and an insufficiency-type fracture of the pelvis. A 60-year-old Japanese woman was admitted because of pain in the right ischium and pubis that began suddenly with no precipitating cause. Computed tomography showed the bony pelvis to be compressed by enlarged dependent kidneys and an enlarged liver. We relieved compression on the pelvic bones by means of transarterial embolization (TAE) to the kidneys and liver after initiation of hemodialysis therapy. The fracture healed gradually after TAE, and the patient could walk 4 months later. In an iliac bone specimen obtained before TAE, cancellous bone was intact, but periosteal and endosteal surfaces of cortical bone showed marked resorption and were irregular. Normally, many ligaments are connected tightly to the periosteal surface, supporting the cortical bone. However, because of extensive surface resorption associated with pressure from enlarged kidneys, connections between ligaments and the periosteal surface presumably became fragile, promoting an insufficiency fracture from unapparent external forces. Thus, ADPKD is a potential cause of insufficiency fracture owing to abnormalities of cortical bone.

Bone Density↗
PubMed1990

Buried inferiorly based gluteus maximus musculocutaneous flap for reconstruction of large, recurrent ischiopubic pressure sores.

The ischium is the most common site for recurrence of pressure sores in the paraplegic population. Successful reconstruction of these wounds depends on the total excision of ulcer, soft tissue debris, bony prominence, and the durability of the soft tissue repair. The V-Y gluteus maximum musculocutaneous flap based on the inferior gluteal vessels can be advanced medially, deepithelialized, and buried to fill large, deep soft tissue ischial wounds. Local rotational flaps close the superficial wound. This buried flap, although not previously described, is useful for the reconstruction of large ischiopubic pressure sores initially or at the time of recurrence.

Adolescent↗
PubMed2002

Endometrial endometrioid adenocarcinoma in a premenopausal woman presenting with metastasis to bone: a case report and review of the literature.

We describe the clinicopathologic and immunohistochemical features and microsatellite instability analysis of a rare case of endometrial endometrioid adenocarcinoma presenting as a metastasis to the ischium in a 39-year-old premenopausal woman. The patient was treated with a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic and para-aortic lymphadenectomy. One month later, she underwent an ischial resection followed by radiotherapy. After a follow-up of 3 years, the patient shows no evidence of disease.

Adaptor Proteins, Signal Transducing↗
PubMedDate not supplied

Adductor transfers in cerebral palsy: long-term results studied by gait analysis.

Thirty-three ambulatory patients with spastic cerebral palsy underwent evaluation and gait analysis an average of 9.6 years after bilateral posterior adductor transfers to the ischium. All patients showed functional improvement postoperatively, which was maintained at long-term follow-up in 94%. Gait analysis, however, documented pelvic obliquity in 85% of this group of patients. Associated with pelvic obliquity was a 36% incidence of unilateral hip subluxation. These complications of posterior adductor transfers have been difficult to treat and have resulted in the abandonment of this procedure at our institution.

Cerebral Palsy↗
PubMed1978

Complications of total ischiectomy for the treatment of ischial pressure sores.

Five patients are reported, 4 of whom had total ischiectomies and the other an extensive partial ischiectomy. In each, recurrent ulcers, extending into the perineum, developed subsequently. One patient had a urethrocutaneous fistula as a result of his perineal ulcer, and he had to undergo an ileal loop diversion. Following a unilateral ischiectomy, the pressure is shifted to the opposite ischium, and this favors the development of another ischial pressure sore on the opposite side. After bilateral ischiectomy there is much more pressure on the perineum, and these patients may go on to develop a perineal pressure sore--particularly if there is a dislocated hip. Recurrent pressure sores which extend into the perineum are difficult to treat, and usually they appear to be related to a previous extensive removal of the ischia.

Adult↗
PubMed2003

Sitting with adjustable ischial and back supports: biomechanical changes.

STUDY DESIGN: The seat and back contact force, pressure distribution, lumbar lordosis, and low back muscle activities associated with a new seat design with adjustable ischial support and backrest were investigated using kinematic, kinetic, electromyographic, and radiographic measurements. OBJECTIVES: To investigate the biomechanical effects of adjusting ischial and backrest supports during sitting. SUMMARY OF THE BACKGROUND DATA: Sitting may induce posterior rotation of the pelvis, reduction of lumbar lordosis, and increases in muscle tension, disc pressure, and pressure on the ischium and coccyx, which may be associated with low back pain. A device that reduces the ischial load and maintains lumbar lordosis may help increase seating comfort and reduce low back pain. METHODS: Fifteen office workers with no known low back pain history were tested. Contact pressure distributions, reaction forces between the buttock-thighs and seat and between the back and backrest, load carried by the seat pan and backrest, sacral inclination, lumbar lordosis, intervertebral space of lumbar spine, and muscular activity in stabilizing the trunk were measured for sitting with and without ischial support and with adjustable back support. RESULTS: When the ischial support was relieved, the center of the force on the seat and on the legs of the chair, and the peak center of pressure on the seat, were significantly (P < 0.002) shifted forward toward the thighs. The total contact area on the seat pan and on the backrest was significantly decreased and increased, respectively (P < 0.001). The sacral inclination, total and segmental lumbar lordosis, and lumbar spine disc height were significantly increased for sitting upright with backrest, with the lumbar curve close to that during standing. CONCLUSIONS: Sitting with reduced ischial support and fitted backrest to the lower spine altered the contact area, reduced peak pressure under the ischia, reduced muscular activity, maintained total and segmental lumbar lordosis, rotated the sacrum forward, and increased lumbar intervertebral disc heights, which could potentially reduce low back pain.

Adult↗
PubMed2000

Clinical findings associated with chronic ischial fracture in a gelding.

An 8-year-old show-jumper gelding was referred for examination as a result of a purchase dispute for reported back pain. Clinical examination identified back pain and atrophy of the left semimembranosus and semitendinosus muscles, but no lameness. Standing pelvic radiography demonstrated a chronic nonunion fracture of the left ischium, the clinical significance of which was uncertain. The apparent back pain was thought to be probably unrelated to the pelvic lesion. We conclude that chronic ischial fracture in the horse can lead to specific atrophy of the semimembranosus and semitendinosus muscles, which originate from this bone.

Animals↗
PubMed1983

Ischial stress fracture.

A single report of a very unusual stress fracture in the ischium of a fourteen year old athlete. The mechanism and the more usual lesion of ischial apophysiolysis is discussed.

Adolescent↗