1/31. adult onset of multifocal eosinophilic granuloma of bone: a long-term follow-up with evaluation of various treatment options and spontaneous healing.We report a case of multifocal-monosystemic Langerhans cell histiocytosis (LCH), formerly usually referred to as eosinophilic granuloma (EG) of bone. The condition developed in a 36-year-old man. A notable infrequent thoracic spine location and two successive distinct costal lesions were observed. Both the first costal site and the vertebral location healed spontaneously; the second costal lesion underwent biopsy resection. The patient's disease course with an 8-year follow-up is discussed with reference to various treatment options, emphasising in selected cases a watchful conservative approach, in view of the widely documented potential for spontaneous healing.- - - - - - - - - - ranking = 1keywords = bone (Clic here for more details about this article) |
2/31. reflex sympathetic dystrophy in hypophosphataemic osteomalacia with femoral neck fracture: a case report.We report a male patient who presented with suspicion of skeletal metastases based upon an abnormal 99-mTc bone scan, which showed increased uptake at both femoral heads, left femoral neck, and several ribs. The images also suggested reflex sympathetic dystrophy, subcapital fracture of the left femur, and rib fractures. A diagnosis of hypophosphataemic osteomalacia was finally made.- - - - - - - - - - ranking = 0.2keywords = bone (Clic here for more details about this article) |
3/31. Chest compressions in an infant with osteogenesis imperfecta type II: No new rib fractures.The case report of a newborn female with osteogenesis imperfecta type II who underwent cardiopulmonary resuscitation (CPR) with manual chest compressions for several minutes is presented. Chest radiographs taken before and after the chest compressions were administered were reviewed by several radiologists from 3 different hospitals and demonstrated no new radiographically visible rib fractures. collagen analysis, the patient's clinical appearance, and clinical course, as well as a consultant's opinion aided in confirmation of the diagnosis of osteogenesis imperfecta type II. A review of 4 previous studies concerning rib fractures and CPR is included. This unique case supports previous articles that have concluded that rib fractures rarely, if ever, result from CPR in pediatrics, even in children with a lethal underlying bone disease, such as osteogenesis imperfecta type II. cardiopulmonary resuscitation, chest compressions, osteogenesis imperfecta, rib fractures, bone disease.- - - - - - - - - - ranking = 62.681109799792keywords = bone disease, bone (Clic here for more details about this article) |
4/31. Refractory empyema caused by an intraoperative rib fracture sustained during esophagectomy: report of a case.A 57-year-old woman underwent esophagectomy with three-field lymphadenectomy for lower esophageal cancer, followed by gastric roll reconstruction through the posterior mediastinum. A laparotomy and right thoracotomy with partial resection of the right fifth rib were performed. A purulent discharge requiring drainage developed postoperatively and continued for 3 months despite anastomotic integrity and the absence of a bronchopleural fistula. An empyema developed 3 months after drain removal, and a thoracostomy tube was reinserted. A displaced fragment of the right fifth rib was identified within the abscess cavity. drainage and irrigation were not curative, and removal of the bone fragment was performed 18 months after the initial procedure. The patient has been symptom-free during 1 year of follow-up. We believe that the rib fragment functioned as a foreign body, which complicated treatment of the patient's postoperative infection.- - - - - - - - - - ranking = 0.2keywords = bone (Clic here for more details about this article) |
5/31. Effect of liver transplantation on multiple bone fractures in an infant with end-stage biliary atresia: a case report.Osteodystrophy is frequently found in children with chronic cholestatic liver disease. We herein report an end-stage case of biliary atresia that was associated with multiple bone fractures and severe growth retardation. The patient, an 8-month-old female, underwent a living-related liver transplantation and thereafter showed a dramatic improvement in growth and decrease in bone fractures. A correction of the liver function is therefore considered to be a key factor in treating osteodystrophy that is related to chronic cholestatic liver disease. It is also essential to perform liver transplantation at the most appropriate time to enhance and support the growth of these patients.- - - - - - - - - - ranking = 1.2keywords = bone (Clic here for more details about this article) |
6/31. Ewing sarcoma of the rib with normal blood flow and blood pool imagings on a 3-phase bone scan.Ewing sarcoma is the second most common pediatric malignant bone tumor. It usually presents as a hot spot on a 3-phase bone scan as a result of increased vascularity of the tumor and new bone formation. However, aggressive Ewing sarcoma can also appear as a cold lesion. We present the features of a Ewing sarcoma of the rib on a 3-phase bone scan in a child who was being investigated for rib fracture after trauma.- - - - - - - - - - ranking = 1.6keywords = bone (Clic here for more details about this article) |
7/31. flail chest in a neonate resulting from nonaccidental trauma.The authors present a 21-day-old infant who sustained a flail chest as a result of nonaccidental trauma. Initial treatment included endotracheal intubation and mechanical ventilation for hypoxemic respiratory failure followed by the administration of continuous positive airway pressure by nasal cannula. Further evaluation resulted in the identification of nonaccidental as the mechanism of injury. The pathophysiology of flail chest, its etiology, and treatment options are reviewed. In the absence of a documented history of significant thoracic injury or the presence of metabolic bone disease, nonaccidental trauma is the most likely diagnosis in infants and children with a flail chest.- - - - - - - - - - ranking = 31.340554899896keywords = bone disease, bone (Clic here for more details about this article) |
8/31. osteoporotic fractures and vitamin d deficiency.Case study: A caucasian woman aged 79 years, with a history of hypertension, hyperlipidaemia, and osteoarthritis, was referred for assessment of osteoporosis and generalised musculoskeletal pain after surgery for a right midshaft femoral fracture. Further history revealed she had suffered nonspecific musculoskeletal pain, particularly of the pelvic girdle, and unsteady gait for many weeks, but denied suffering any falls. She had limited mobility due to osteoarthritis of both knees. She had been mostly housebound and was on an animal product restricted diet in view of her history of hypercholesterolaemia. Initial x-rays confirmed an incomplete fracture of the midshaft of the right femur. She had an orthopaedic review, and subsequent bone scan and x-rays (Figure 1) revealed incomplete fractures of the midshaft of both femurs and the seventh rib. She was managed conservatively (alendronate 70 mg per week) and progress was closely monitored. Three weeks later, she presented to the emergency department with worsening right thigh pain and difficulty in weightbearing. x-rays revealed an extension of the right femoral fracture traversing the entire cortex that required surgery. physical examination revealed a mild thoracic kyphosis. There was no muscle or bone tenderness, proximal muscle weakness, or other significant abnormality. The plasma biochemistry revealed: mild hypocalcaemia (1.98 mmol/L), hypophoshataemia (0.7 mmol/L), raised alkaline phosphatase (ALP) (216 iu/L), low 25-hydroxyvitamin D (250HD) (22 nmol/L), and a mildly raised parathyroid hormone (PTH) level (8 pmol/L). Thyroid, renal, and liver functions were normal. The patient was treated with nine capsules of Ostelin 1000 per day, which was tapered over 8 weeks to one capsule. The repeat plasma 25OHD after 6 weeks was 56 nmol/L, and her musculoskeletal symptoms were completely resolved. There was normalisation of biochemical abnormalities and x-rays demonstrated healing of both femoral fractures. A bone biopsy taken at the time of surgery revealed an increased amount of osteoid. However, undecalcified bone sections were not examined, nor was quantitative histomorphometry performed. Dual energy X-ray absortiometry (DEXA) scan revealed a T-score of -3.32 at the hip and -1.38 at the lumbar spine. Corresponding Z-scores were -1.05 and -0.7.- - - - - - - - - - ranking = 0.8keywords = bone (Clic here for more details about this article) |
9/31. Hypocalciuric hypercalcemia presenting as neonatal rib fractures: a newly described mutation of the calcium-sensing receptor gene.A 2-week-old infant presented with bilateral rib fractures, hypercalcemia, and subperiosteal bone erosions. parathyroid hormone levels were elevated and urine calcium low. Her parent's laboratory test results were normal. Gene sequencing revealed a new mutation of the calcium-sensing receptor gene, causing severe neonatal hyperparathyroidism, a variant of hypocalciuric hypercalcemia. This is a rare cause of neonatal hyperparathyroidism and nonabusive fractures.- - - - - - - - - - ranking = 0.2keywords = bone (Clic here for more details about this article) |
10/31. Sonographically detected costo-chondral dislocation in an abused child. A new sonographic sign to the radiological spectrum of child abuse.A case of an abused child with fractures of the skull, ribs and long bones is presented. Sonographically a costochondral dislocation of the left lower ribs was detected, which has not been reported in the literature.- - - - - - - - - - ranking = 0.2keywords = bone (Clic here for more details about this article) |
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