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Chronic spontaneous diploic hematoma.

The authors report the case of a 23-year-old woman with café-au-lait spots and axillary and inguinal freckling who presented with a diploic chronic spontaneous hematoma of the left parietal bone. To the authors' knowledge, this case represents the first description of a diploic hematoma in a patient with stigmata of neurofibromatosis Type 1 unrelated to head trauma. Plain skull radiography showed an osteolytic lesion with well-circumscribed margins, corresponding to the hematoma, together with exuberant perilesional vascular markings. Angiography demonstrated an incidental aneurysm of the left

Subungual exostosis of the great toe: a case report and tumor overview.

UNLABELLED: Subungual exostosis is an acquired, benign, and solitary bone tumor of the distal phalanx occurring beneath or adjacent to nail. A 18-year-old man presented with a lump, ulceration, and pain on his right big toe. This complaint was present for the past 2 years. Initially, lump and pain were present, and since the past 6 months ulceration and superadded infection occurred. Plain radiograph showed a calcified lesion that was continuous with the phalangeal cortical surface in the distal dorsal aspect of the big toe. Excisional biopsy with complete nail removal and reconstruction of th

Cushing's syndrome in pregnancy with a severe maternal complication: a case report.

Cushing's syndrome (CS) in pregnancy may be confused with a complication of pregnancy, such as pre-eclampsia or gestational diabetes. We managed a case of CS in pregnancy that was considered to be severe pre-eclampsia due to uncontrolled hypertension. The fetus was delivered via emergency cesarean section at 31 weeks' gestation because of severe pre-eclampsia and pulmonary edema. The parturient was admitted to the intensive care unit for severe maternal complications, including pulmonary hemorrhage, acute renal failure, disseminated intravascular coagulopathy, and congestive heart failure. A s

Association between surgical steps and intraoperative auditory brainstem response and electrocochleography waveforms during hearing preservation vestibular schwannoma surgery.

Intraoperative monitoring of the auditory pathway by means of either electrocochleography or auditory brainstem response audiometry is valuable during hearing preservation vestibular schwannoma (VS) surgery. A more than 75% intraoperative reduction of the amplitude of these evoked auditory potentials was thought to be related with clear hearing compromise of hearing. We identified 22 patients who satisfied this intraoperative criterion in a cohort of 86 consecutive patients who had attempted hearing preservation VS surgery. The surgical step that temporally coincided with the above event was c

Paget disease of the humerus mimicking metastatic disease in a patient with metastatic malignant mesothelioma on whole body F-18 FDG PET/CT.

A 71-year-old man with newly diagnosed malignant mesothelioma was referred for an F-18 FDG PET/CT study to evaluate the extent of disease. PET showed mild FDG uptake in the right chest, corresponding to a lobulated, mass-like right pleural effusion versus thickening involving the entire right pleural space, and some mediastinal involvement, on the accompanying CT scan. In addition, marked FDG uptake was seen in the proximal left humerus, suspicious for an osseous metastasis. The corresponding CT scan findings of cortical thickening and a "Swiss cheese" appearance were most consistent with Page

"Sandwich technique" in the surgical treatment of primary complex fractures of the femur and humerus.

In this prospective study, our aim was to determine the clinical and radiographic outcomes of the surgical treatment of primary complex problem femoral and humeral shaft fractures treated by a new technique called "sandwich technique." A total of 45 patients with comminuted, complex and/or osteopoenic fractures of the femur or humerus (30 femoral and 15 humeral fractures) were treated using this technique. The patients were followed up for a mean of 25 months. In 24 (85.7%) of 28 patients with femoral fractures and in 14 (93.3%) of 15 patients with humeral fractures, union was achieved within

Clinical application of double dorsal plates for the distal radius fractures.

The purpose of this study was to develop plates that fit the contour of the distal radius of the Japanese and can be inserted less invasively. Three-dimensional models of 36 radii of 18 volunteers were prepared. Using these models, the shape of the cortical bone on the radial margin of the distal radius and just below the dorsal fourth compartment of the wrist, to which the plates were expected to be applied, was measured, and the curves of the plates were determined. The functions of approximated curves of the plates were: [y = -2 x 10(-8) x5 - 2 x 10(-6) x(4) + 0.0006 x3 - 0.0312 x2 + 0.3274…

Chondrosarcoma of the short tubular bones of the hands and feet.

OBJECTIVE: To report 12 cases of chondrosarcoma in a rare location, the short tubular bones of the hands and feet, as well as 12 cases of enchondroma in similar locations, emphasizing the radiologic and histopathologic features. DESIGN AND PATIENTS: All relevant cases that had both histologic slides and radiographs available were taken from the files of one orthopedic referral hospital and the personal files of one of the authors. A similar number of enchondroma cases was selected at random from the files. RESULTS AND CONCLUSIONS: One malignancy arose in a background of enchondromatosis, wit

The treatment of primary vertebral tumors by radical resection and prosthetic vertebral replacement.

The basic principles for the treatment of primary vertebral tumors include radical resection of the tumor, insertion of a prosthetic vertebral body, and bone grafting within and around the prosthetic vertebral body. Since 1970, the authors have treated 12 cases with this procedure. In order to improve the vertebral prosthesis, 94 dried adult vertebral column specimens were studied. The anterior cortex of each vertebral body was thicker than the posterior cortex. The thickness of the anterior cortex of the dorsolumbar vertebral bodies progressively increases from the proximal to caudal vertebra

The use of allograft stapes.

Since 1981, we have used the stapes allograft, singly or in combination with homograft incus, in 20 cases of tympanoplasty and in 7 cases of … es were attempted: (1) the allograft stapes was placed in the normal position and a shaped incus or cortical bone or tragal cartilage was placed on the top of the stapedial head and connected and (2) the allograft stapes was placed in the upside-down position and the columella was placed on the stapes footplate. Better results were obtained with the allograft s …

Lymphocytic choriomeningitis virus-induced immunosuppression: evidence for viral interference with T-cell maturation.

Acute lymphocytic choriomeningitis virus (LCMV) infection is associated with general immunosuppression which develops during the second week of the infection and persists for several weeks. In the present study, the ability of LCMV-infected mice to mount a cytotoxic T-lymphocyte response was investigated in a transplantation assay, using LCMV-immunized mice as recipients. By this means it was possible to evaluate the T-cell responsiveness of the acutely infected mice separately. Our results revealed a marked depression of the T-cell function temporally related to immunosuppression in the intac

Diagnosis and Guided Surgical Management of a Mandibular Buccal Bifurcation Cyst: A Case Report.

Mandibular buccal bifurcation cyst (MBBC) is a rare inflammatory odontogenic cyst that frequently mimics chronic periapical pathosis, leading to potential misdiagnosis and unnecessary endodontic treatment. This case report describes the diagnosis and management of an MBBC associated with a vital mandibular left second molar (#18) in a healthy 16-year-old female, highlighting the value of pulp vitality testing, cone beam computed tomography (CBCT), and a custom 3D-printed surgical guide for conservative management. The patient presented with buccal bony expansion and a 12-mm periodontal probing

Conservative Management of a Large Periapical Lesion Using Decompression Technique: A Case Report.

The management of extensive periapical lesions poses a significant challenge in endodontic therapy due to their potential cystic nature, anatomical proximity to critical structures, risk of cortical perforation, and complex infection dynamics. This report presents a successful case of a large through-and-through periapical lesion managed conservatively via decompression. Initial periapical radiographs revealed poor-quality root canal therapy and a large radiolucent lesion associated with a maxillary lateral incisor. Cone-beam computed tomography (CBCT) imaging confirmed a through-and-through l

Mechanical alterations of the bone-cartilage unit in a rabbit model of early osteoarthrosis.

OBJECTIVE: The purpose of this study was to assess mechanical properties along with microstructural modifications of the hyaline cartilage (HC), calcified cartilage (CC) and cortical plate (Ct.Pt), in an anterior cruciate ligament transection (ACLT) model. Medial femoral condyles of six healthy rabbits (control group) and of six ACLT rabbits 6 weeks after OA induction were explanted. The zone of interest (ZOI) for all experiments was defined as the weight bearing areas of the samples. Biomechanical properties were measured using nanoindentation and morphological changes were evaluated using bi

Giant cell tumours of the mobile spine: characteristic imaging features and differential diagnosis.

PURPOSE: The aim of this study was to investigate the characteristic imaging features of giant cell tumours (GCTs) of the mobile spine. MATERIALS AND METHODS: Thirty pathologically proven GCTs of the mobile spine were reviewed. X-ray (n = 18), computed tomography (CT) (n = 24) and magnetic resonance (MR) (n = 21) images were retrospectively evaluated. RESULTS: Five tumours were located in the cervical spine, 15 tumours were located in the thoracic spine and 10 tumours in the lumbar spine. The characteristic X-ray findings included an osteolytic and expansile lesion with a "soap bubble" or pu

Scaphoid fractures: evaluation with high-spatial-resolution US initial results.

PURPOSE: To evaluate the diagnostic accuracy of high-spatial-resolution ultrasonography (US) in the diagnosis of scaphoid fractures. MATERIALS AND METHODS: In 72 hours after acute wrist trauma, 15 consecutive patients were examined for possible scaphoid fractures clinically and with conventional radiographs, including scaphoid views. Thereafter, high-spatial-resolution US was performed by two experienced radiologists blinded to the results of the previously performed investigations. High-spatial-resolution US of the scaphoid bones was performed from the palmar, lateral, and dorsal directions

Oral mucosal wound healing: A photograph-based prospective study.

BACKGROUND: Oral mucosa heals with minimal scar formation compared with other tissues. The aim of this study was to explore the differential healing properties between keratinized gingiva and non-keratinized alveolar mucosa, and to analyze the healing dynamic of these tissues through a clinical photograph-based prospective study. METHODS: Fourteen patients received 26 interdental piezocisions as part of orthodontic therapy. Piezocisions penetrated through the oral mucosa, the periosteum, and the cortical bone. They overlapped both keratinized gingiva and non-keratinized alveolar mucosa. Wound…

Adding a protective K-wire during opening high tibial osteotomy increases lateral hinge resistance to fracture.

PURPOSE: It was hypothesized in this in-vitro study that positioning a K-wire intersecting the cutting plane at the theoretical lateral hing … d to the control group. A mean distance of 10 ± 1 mm between cut-bone (saw-print) and lateral hinge cortical bone was found post-performing the osteotomy and the hinge failing. CONCLUSION: The maximum load to breakage and the maximum permissible displacement were, respectively, 880% and 260% higher during the opening of the OWHTO in using K-wires compared to t …

Bone cross-sectional geometry is not associated with atypical femoral fractures in Asian female chronic bisphosphonate users.

INTRODUCTION: Atypical femoral fractures (AFF) tend to occur in Asian women with prolonged bisphosphonate exposure. Hip geometry is thought to contribute to the risk of AFF formation. We examined the hip structural geometry parameters in Asian female chronic bisphosphonate users who sustained an AFF and compared them to chronic bisphosphonate users who did not sustain any femoral fracture (NFF) and bisphosphonate-naïve patients who sustained an osteoporotic femoral fracture (OFF). MATERIALS & METHODS: Thirty-one patients with AFFs were gender and age-matched to 31 patients with NFFs and 49 pa

Predicting Pathological Fractures at Metastatic Humeral Lesions.

UNLABELLED: The humerus is the second most common site of metastatic disease involving long bones, yet it is still unclear which patients are at high risk for a fracture and may require prophylactic surgical fixation. The goal of this study was to assess the validity of the Mirels score to predict fractures of metastatic lesions in the humerus. METHODS: We performed a retrospective electronic chart review of patients with humeral metastases at our institution (2005 to 2021), with 188 patients meeting the inclusion criteria. Sixty-one of the patients developed a fracture during follow-up. The

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… It was defined as a lesion involving >50% of the cortical bone. However, the Harrington criteria have limitations: they apply only to the proximal femur, and they have yet to be validated. Use of the Harrington criteria is still debated. …