1/203. Meniscal cysts causing bone erosion: retrospective analysis of seven cases. Meniscal cysts of the knee are common and well evaluated by magnetic resonance (MR) imaging, a method that also reveals the frequently associated meniscal tear. Diagnosis of meniscal cysts with routine radiography is difficult, although bone erosions are reported as a very rare manifestation of such cysts. Our retrospective study describes seven patients in whom meniscal cysts were associated with adjacent erosion of bone. ( info) |
2/203. Para-articular chondroma and osteochondroma of the infrapatellar fat pad: a report of three cases. We report three cases of para-articular chondroma and osteochondroma in the region of infrapatellar fat pad. All three lesions were resected and examined histologically. Two of them were primarily cartilaginous with a lobular pattern internally, and one uniformly osseous with peripheral cartilage. We conclude that these lesions are not the same. The former should be designated para-articular chondroma after Jaffe and the latter, osteochondroma. ( info) |
3/203. The role of arthroscopy in the diagnosis and management of cartilaginous lesions of the wrist. Articular cartilage lesions in the wrist are common. Diagnosis of these lesions is difficult, and the decision to operate may not be clear. A meticulous history and physical examination allows an accurate diagnosis. Appropriate surgical intervention can be useful in alleviating symptoms and returning the patient to normal activities. The origin, diagnosis, and treatment of cartilaginous lesions of the wrist are discussed in this article. ( info) |
4/203. dna analysis of a transplanted cryopreserved meniscal allograft. SUMMARY: Meniscal transplantation is frequently performed in young patients with a single meniscal-deficient compartment as a result of previous total meniscectomy. Indications, operative techniques, and preservation of meniscal allografts have been studied extensively. In this study we compared the dna profile of a meniscal allograft with that of the human recipient 1 year after transplantation. Applying techniques routinely used in forensic analysis, we were able to show that the dna profile of the meniscal allograft was 95% identical to that of the human recipient. These findings indicate that 1 year after transplantation the meniscal allograft is nearly completely repopulated by host cells. ( info) |
5/203. Cartilaginous hamartoma of the chest wall with secondary aneurysmal cyst-like areas in an infant: a case report. A case of a four-month-old infant diagnosed as cartilaginous hamartoma of the rib is presented. This rare tumor usually presents at birth. The patient had respiratory distress syndrome. Swelling of the ribs was palpable on physical examination and the infant underwent surgery for excision of the ribs. Histopathologically, the tumor showed benign focal overgrowth of normal skeletal elements with cartilaginous, vascular and primitive-appearing mesenchymal elements. Additionally, secondary aneurysmal cyst formation coexisted with the tumor. The diagnosis was infantile cartilaginous hamartoma of the rib. In this entity, primitive-appearing mesenchymal stroma may be mistaken for a malignant condition. Usually a benign clinical course is expected and treatment is by block excision. ( info) |
6/203. Chondritis attributable to lactobacillus after ear piercing. A diabetic patient was admitted with ear pain and purulent discharge after "high ear piercing" by a friend. After investigation she was found to have chondritis, complicated by an abscess. Wound cultures grew lactobacillus species. Patient responded to parenteral antibiotics without suffering cosmetic deformity. Sterile technique, adherence to post-piercing ear hygiene, and avoiding piercing the auricular cartilage may prevent complications associated with ear piercing. lactobacillus should be included in the differential of pathogens involved in post-piercing chondritis. ( info) |
7/203. Rapid chondrolysis after an intra-articular leak of bone cement in treatment of a benign acetabular subchondral cyst: an unusual complication of percutaneous injection of acrylic cement. Percutaneous injection of methylmethacrylate is now increasingly employed to treat bone lesions, both malignant and benign. However, the risks of this procedure are still to be fully established. In this report, we describe a case of rapid chondrolysis appearing after the intra-articular leakage of cement during injection of an acetabular subchondral cyst, resulting in hip replacement. Although the mechanism of such chondrolysis is unknown, this event suggests a chondrolytic effect of the acrylic cement. Thus, it is essential to systematically search for the presence of an intra-articular passage before injecting bone cement into a peri-articular cyst. This unusual complication highlights the need for rigorous evaluation of the benefits and risks of percutaneous injection of acrylic cement in the treatment of benign lesions, especially close to an articulation. ( info) |
8/203. Arthrodiatasis for chondrolysis with hinge abduction: a case report. A 13-year-old boy with bilateral chronic slipped capital femoral epiphysis was referred to the Nagoya University Hospital. Chondrolysis occurred on the left side 3 months after a subcapital wedge osteotomy and a concavity of the femoral head appeared, which formed hinge abduction. Increase of the joint space and resolution of the hinge were achieved by arthrodiatasis. As arthrodiatasis can resolve hinge abduction by distraction and reduce mechanical stress, it may be taken into consideration as an option for diseases with hinge abduction. ( info) |
9/203. Focal fibrocartilaginous dysplasia of long bones: report of eight additional cases and literature review. We report eight additional cases of focal fibrocartilaginous dysplasia (FFCD) in the proximal tibia (five), distal ulna (one), and distal femur (two). Spontaneous, complete resolution of the lesion was observed in two tibiae and one ulna. Three tibial lesions with genu varum deformity were managed with osteotomy. Two femoral FFCDs caused persistent or progressive deformity: one genu valgum with patellar dislocation, and one genu varum. These patients underwent concomitant deformity correction and lengthening by the Ilizarov method. The final results were satisfactory in all patients except one, who underwent valgus tibial osteotomy and developed mild postoperative genu valgum. The analysis of a total of 46 cases in the literature and our experience suggests that (a) FFCD has a wide histopathologic spectrum, ranging from purely dense, fibrous tendon-like tissue to benign fibrocartilaginous tissue; (b) at least 45% of tibial FFCD demonstrates progressive, spontaneous resolution; (c) in contrast, femoral and humeral FFCDs appear to have a slim possibility of spontaneous regression of the deformity; and (d) corrective osteotomy is indicated when the deformity is increasing or persistent, or when the existing deformity is severe enough to jeopardize adjacent joint mechanics and alignment. ( info) |
10/203. Postintubation interarytenoid adhesion. Interarytenoid fibrous adhesion is a poorly recognized complication of intubation and is frequently confused with bilateral vocal cord paralysis. early diagnosis and treatment is essential for optimal management. Otolaryngologists should constantly remain alert for interarytenoid fibrous scar to establish the diagnosis as early as possible, optimizing the probability of restoring normal breathing and quality of life and avoiding an unnecessary tracheotomy. Surgical laser reduction is appropriate in all cases when other miscellaneous laryngeal injury lesions are eliminated. Direct laryngoscopy with careful examination of the posterior commissure and laryngeal electromyography are the 2 main clinical diagnostic aids contributing to establish the diagnosis. ( info) |