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[Paget's disease, ankylosing vertebral hyperostosis and hyperostosis frontalis interna].

Ankylosing vertebral hyperostosis and internal frontal hyperostosis have a frequency of 5% and 8% respectively. In Paget's disease, these two disorders are found with a frequency of 40% and 19.1% respectively. This frequency is not due to chance. There exists a link between the 3 diseases. Ankylosing vertebral hyperostosis is thusa new pathological association in Paget's disease. It is even the most frequent of these associations. It seems Paget's disease induces hyperostosis and not the contrary. The authors suggest the theory that cortical and periostal hypervascularisation in pagetoid bone favour the development of these hyperostoses.

Aged

[Lumbo-sacroiliac hyperostosis with retroperitoneal fibrosis in spondarthritis hyperostotical pustulo-psoriatica--with sternocostoclavicular hyperostosis and superior and inferior venous obstruction syndrome: pathogenetic hypothesis of fibro-osteopathia psoriatica].

We report two cases of retroperitoneal fibrosis which were found in 38 patients with "spondarthritis hyperostotica pustulo-psoriatica" (spond.hyp.p.-p.). Spond.hyp.p.-p. is associated with sternocosto-clavicular hyperostosis and resembles pustulotic arthroosteitis and SAPHO syndrome. However, as dermatologically and osteo-histopathologically documented, it is an enthesiopathic and hyperostotic form of spondarthritis psoriatica. Both cases show a lumbosacroiliac hyperostosis (LSIH) which is a rare analogue to sternocosto-clavicular hyperostosis (SCCH). Facultative paraosseous connective-tissue proliferation results in a new form of retroperitoneal fibrosis with sacroiliac origin. Mediastinal and pelvic masses cause superior and inferior vena caval obstruction syndromes. Because of proven psoriasis in pelvic bone with para-periostal

Arthritis, Psoriatic

[Vertebral hyperostosis and hyperostosis frontalis interna].

Routine roentgenographic examination of the spine was performed in 690 patients with rheumatologic disorders. Ankylosing hyperostosis was discovered in 124 patients (18 percent). Roentgenograms of the skull revealed hyperostosis frontalis interna in 63 percent of cases, especially in female patients. No common pathogenic mechanism, however, has been discovered in these two disorders.

Adult

[The acquired hyperostosis syndrome. Synthesis of 13 personal observations of sternocostoclavicular hyperostosis and 300 cases from the literature. 1].

Sterno-costo-clavicular hyperostosis (SCCH) is the most common manifestation of a syndrome, consisting of increased bone metabolism, mostly new bone formation and heterotopic ossification of fibrous tissue, which we have characterised as the acquired hyperostosis syndrome. In part I we discuss the terminology, radiological appearances, scintigraphy, clinical and laboratory findings, bacteriology, histology, nosology, complications, treatment and differential diagnosis of SCCH. Chronic recurrent multifocal osteomyelitis (CRMO) is regarded as a phenotype of SCCH, depending on the age. CRMO occurs in children, adolescents and young adults, SCCH predominantly in middle-aged and elderly adults.

Adult

Acquired hyperostosis syndrome--AHYS--(sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, SAPHO-syndrome): bone scintigraphy of the anterior chest wall.

The objective of this report is to provide a description of diagnostically significant scintigraphically recognizable sites and patterns of acquired hyperostosis syndrome (AHYS) on the anterior chest wall (ACW), which is involved in 82% of AHYS patients. In 49/90 of our own AHYS patients, planar bone scans of the ACW were performed with the gamma camera, applying an average of 650 MBq of 99mTc-phosphate complexes. In addition, 53 atraumatic patients with extrathoracic cancer were available for routine whole-body scintigraphy. None of these patients had increased uptake identifiable as metastasis clinically or by imaging modalities in either the ACW or the rest of the skeleton. The scintigraphic involvement of the various morphological ACW structures is described in AHYS. Moreover, attention is called to the diagnostic significance of focal hyperactivities at the anterior end of the 2nd-8th rib of adults, which are in the 5th place with respect to their frequency in AHYS. The diagnostic significance of sternocostal-joint involvement in AHYS can likewise be recognized by bone-scan scintigraphy and will be discussed. Bone scintigraphy is more sensitive than radiomorphological imaging in AHYS. This, however, only applies under three conditions. 1. The increased radiotracer uptake in the upper sternocostoclavicular region must be assessed on both the anterior and the posterior view of the ACW scan. 2. In addition to the anterior view of the routine scintiscan, further anterior scans with reduced scan time of the gamma camera are usually necessary. This ensures better visibility of the involvement of certain morphological structures that are important for AHYS diagnosis. Moreover, a statement can be made about the inflammatory ossifying activity/inactivity of the AHYS on ACW.3. Increased radionuclide uptake in the manubrium sterni and corpus sterni on the anterior scan should be verified by additional lateral or oblique scans of the thorax (sternum).

Acne Vulgaris

[Pelvic and skeletal hyperostosis (diffuse idiopathic skeletal hyperostosis, Forestier disease)].

Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by, among other things, spinal and extraspinal manifestations. Two studies on the prevalence and clinical significance of hyperostotic spurs and ectopic ossifications in the pelvic area are presented. Spinal DISH seems to be a risk factor for the development of ectopic ossification, particularly in the postoperative course after total hip arthroplasty. Pain and reduced range of motion, however, are not obligatory consequences of these phenomena.

Aged