1/75. Polycystic bone disease: A new, autosomal dominant disorder.We describe a new heritable bone disease characterized radiographically by increasingly numerous and enlarging cyst-like lesions throughout the skeleton. Beginning in early childhood, a father, son, and daughter all suffered from progressively frequent pathological fractures involving such radiolucencies. Healing occurred uneventfully and with little residual pain or deformity. Biochemical parameters of mineral homeostasis and skeletal turnover were normal. Bone scanning showed increased radioisotope uptake primarily in fractures and in the largest collections of the lesions. The histopathology is uncertain, but may reflect a form of intraosseous lipomatosis. This unique condition, which we have provisionally named polycystic bone disease, is inherited as an autosomal dominant trait with a high degree of penetrance.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/75. Intraosseous ganglion of the metatarsal bone.We describe a rare case of intraosseous ganglion arising in the metatarsal bone. Radiographs revealed an osteolytic lesion with a fracture in the third metatarsal bone. A biopsied specimen exhibited hyaline fibrous tissue with marked myxoid change. gadolinium-enhanced MRI, which revealed the network-like enhancement of the rim of the lesion and polycystic lesions adjacent to the joint, was helpful in making a diagnosis of intraosseous ganglion.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
3/75. Giant distal humeral geode.We describe the imaging features of a giant geode of the distal humerus in a patient with rheumatoid arthritis, which presented initially as a pathological fracture. The value of magnetic resonance imaging in establishing this diagnosis is emphasized.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
4/75. Transient posttraumatic cystlike lesions of bone.Cystlike cortical defects appearing after minor greenstick fractures in children have occasionally been described. These lesions are typically asymptomatic and appear just proximal to the fracture line within the area of subperiosteal new bone formation. Although the pathogenesis of these lesions remains in doubt, complete resolution is the rule, with no adverse effect on fracture healing. Only 18 cases of these transient postfracture cysts have previously been reported in the English-language literature. We present two additional cases of cyst formation after greenstick fracture of the distal radius in children aged 2.5 and 5.5 years. The natural history of such lesions is discussed and the current theories on their pathogenesis are reviewed.- - - - - - - - - - ranking = 2.5keywords = fracture (Clic here for more details about this article) |
5/75. Benign calcaneal bone cyst and pathologic fracture--surgical treatment with injectable calcium-phosphate bone cement (Norian): a case report.Solitary calcaneal bone cysts are uncommon. Usually they measure 1/3 to 1/2 of the calcaneal length. Symptomatic calcaneal bone cysts are generally treated with open debridement and autologous bone grafting. We report a case of a patient with a displaced intra-articular calcaneal fracture who presents with a large benign calcaneal bone cyst. This patient was treated with debridement and filling of defect with injectable calcium-phosphate bone cement (Norian) and open reduction and internal fixation of the calcaneal fracture.- - - - - - - - - - ranking = 3keywords = fracture (Clic here for more details about this article) |
6/75. Unicameral bone cyst of a cervical vertebral body and lateral mass with associated pathological fracture in a child. Case report and review of the literature.The authors present the case of a 10-year-old girl with a history of cervical trauma in whom a cystic lesion was found to involve all three columns of C-7 with evidence of pathological fracture. Computerized tomography scanning revealed a lytic lesion with sclerotic margins involving the left vertebral body, pedicle, lateral mass, and lamina of C-7 with an associated pathological compression fracture. magnetic resonance imaging demonstrated mixed signal on both T1- and T2-weighted sequences, with cystic and enhancing solid portions. magnetic resonance angiography demonstrated anterior displacement of the left vertebral artery at C-7. The patient underwent C-7 subtotal corpectomy and posterior resection of the tumor mass; anterior and posterior fusion were performed in which instrumentation was placed. Histological examination disclosed cystic areas lined by fibromembranous tissue with calcification and osteoid deposits consistent with unicameral bone cyst. Of the four previously reported cases of unicameral bone cysts in the cervical spine, none involved all three columns simultaneously or was associated with pathological fracture. The most common differential diagnostic considerations for cystic lesions in the spine are aneurysmal bone cyst, osteoblastoma, or giant cell tumor of bone. Unicameral bone cyst, in this location, although rare, must be considered in the differential diagnosis and may require resection and spinal reconstruction.- - - - - - - - - - ranking = 3.5keywords = fracture (Clic here for more details about this article) |
7/75. Complication of linear skull fracture in young children.The development of a leptomeningeal cyst following an otherwise uncomplicated linear skull fracture in a young child may result in a sizable cranial defect and irreversible neurological deficit months or years later. This complication most often follows parietal fractures but is also seen after occipital fractures or traumatic suture diastases. An underlying dural tear is a prerequisite to its subsequent development. Neurological deficit may be avoided by early diagnosis, surgical excision, dural closure, and cranioplasty. early diagnosis depends on obtaining a skull roentgenogram four to six months following the original injury in any child where examination of the scalp and skull suggests and underlying expanding fracture.- - - - - - - - - - ranking = 4keywords = fracture (Clic here for more details about this article) |
8/75. Large geodes in rheumatoid arthritis without joint destruction.Although subchondral geodes are a well-known radiological feature of rheumatoid arthritis (RA), large geodes are uncommon. Progressive bone damage with pathological fractures has been reported. We report the case of a 49-year-old man with seropositive RA in whom large, rapidly progressive geodes in the wrists, hands, and feet contrasted with the absence of joint destruction, good functional tolerance, and moderate abnormalities of markers for inflammation. The location and rapid progression of the cyst-like lesions in this patient were highly unusual.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
9/75. Elastic stable intramedullary nailing for the treatment of complicated juvenile bone cysts of the humerus.Juvenile bone cysts usually are asymptomatic and may manifest as pathological fractures. Since the new method of flexible intramedullary nailing (" Elastic Stable Intramedullary Nailing" - ESIN or " Embrochage Centro- Medullaire Elastique Stable" - ECMES) has demonstrated superb results in the treatment of non-pathologic fractures of the long bones in childhood, this method is rapidly gaining popularity for the treatment of spontaneous or pathological fractures. Given the self-limiting natural history of juvenile bone cysts with eventual spontaneous healing, our goal is to stabilise the pathological fracture and the biomechanically weakened humerus. We treated 15 patients with 16 pathological fractures (one re-fracture) due to juvenile bone cysts of the proximal humerus. All fractures healed completely without pseudarthrosis. Complications were a secondary fracture in otherwise correctly positioned nails. Five of the 15 implants remain in situ, in 6 cases a repeat osteosynthesis was necessary, in one case the nails had to be changed because of the re-fracture. Ten of the 15 juvenile bone cysts healed over a period of 3 years, the nails were removed and so far there have been no further fractures in this group. In the other 5 cases, the juvenile bone cysts have progressively filled with sclerotic bone, and the nails remain in situ.- - - - - - - - - - ranking = 5keywords = fracture (Clic here for more details about this article) |
10/75. Simple bone cyst with pathologic lumbar pedicle fracture: a case report.STUDY DESIGN: A case report and review of the literature are presented. OBJECTIVE: To describe an unusual simple bone cyst involving the pedicle of lumbar spine. SUMMARY OF BACKGROUND DATA: To the authors' knowledge, only nine cases of a simple bone cyst involving the spine have been reported. Most of these reports have described mild back or neck pain because the presenting symptoms or cysts were found incidentally. In the reported case, acute severe back pain with radiating pain developed. Therefore, the study focus was on the unusual location, the presenting symptoms, and its spinal involvement. methods: A cystic lesion involving the left pedicle of the first lumber vertebra was identified in a 53-year-old woman with sudden-onset severe back pain with pain radiating to the left leg. Surgical resection was undertaken along with review of the patient's medical record, imaging studies, microscopic findings of the lesion, and the related literature. RESULTS: Microscopic examination of the cystic lesion corresponded with the findings of a simple bone cyst. A thin fibrous membrane with reactive bone formation was identified without evidence of hemorrhage. A favorable result was achieved by surgical resection. CONCLUSIONS: This case study suggests that a simple bone cyst may be found in any portion of the spine, including the pedicle. Severe resting pain would be elicited by a pathologic fracture of the pedicle. Direct nerve compression by the fractured fragment and chemical irritation by cystic fluid would be compatible with the observed clinical manifestations.- - - - - - - - - - ranking = 3keywords = fracture (Clic here for more details about this article) |
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