1/572. Bone cyst of a fishy origin: from an old catfish spine puncture wound to the foot. A rare first metatarsal unicameral-type bone cyst with a deceptive radiographic appearance and size and an unusual pathological etiology was identified in a female patient. This eccentric cyst was observed only postoperatively by radiograph. review of the patient's history documented a foot injury from a catfish spine as the etiology of this chronically inflamed cyst. ( info) |
2/572. Chondrodiatasis in a patient with spondyloepimetaphyseal dysplasia using the ilizarov technique: successful correction of an angular deformity with ensuing ossification of a large metaphyseal lesion. A case report. Distraction through the physis (chondrodiatasis) is a controversial technique with unpredictable results. However, it has been used in the past for the lengthening and correction of angular deformities of long bones. We report the case of an 11-year-old patient with spondyloepimetaphyseal dysplasia (SEMD) who presented with a severe recurvatum deformity of the left proximal tibia secondary to collapse of the tibial plateau into a large metaphyseal cystic lesion. Using the chondrodiatasis technique with a percutaneously applied Ilizarov circular frame, we were able to correct this deformity. Surprisingly, healing and ossification of the metaphyseal lesion was simultaneously observed at the end of the treatment, a finding which, to the best of our knowledge, has not been previously reported. ( info) |
3/572. Tibial and pretibial cyst formation after anterior cruciate ligament reconstruction with bioabsorbable interference screw fixation. We report a case of an osteolytic tibial enlargement in association with a pretibial cyst formation 8 months after successful anterior cruciate ligament reconstruction with autologous bone-patellar tendon-bone graft and tibial graft fixation with a bioabsorbable interference screw. No joint inflammatory reaction or graft insufficiency was detected. The patient underwent cyst excision and curettage of the tibial tunnel with full recovery and return to preinjury level of activity 2 months after the revision surgery. To our knowledge, the reported complication is the first obvious adverse reaction to a poly-D,L-lactide interference screw in anterior cruciate ligament surgery. ( info) |
4/572. A simple bone cyst containing secretory cells in its lining membrane in a patient with polyostotic fibrous dysplasia. An 11-year-old boy, severely affected with polyostotic fibrous dysplasia, showed radiographically rapid expansion of a cystic lesion in his right humerus. At biopsy, there was an extraordinarily thin shell of bone and a cavity encapsulated by a hypertrophic fibrous membrane and filled with yellow serous fluid. Histologically, in addition to typical features of fibrous dysplasia, the fibrous capsule membrane was composed of proliferated mesenchymal cells characteristic of the affected bone. Ultrastructurally, many secretory granules were observed in numerous cytoplasmic vacuoles in the capsular cells as well as in the cultured cells isolated from the evacuated fluid. ( info) |
5/572. Intraosseous ganglion cysts of the ankle: a report of three cases with long-term follow-up. Three cases of intraosseous ganglion cysts of the ankle are presented with an average follow-up of 68 months (range, 48-78 months). review of the literature revealed 251 cases of intraosseous ganglion cysts, with 75 located in the ankle and a recurrence rate of 6.1%. In the three cases presented, a satisfactory long-term result was obtained with bone graft and curettage in two cases and currettage alone in one case. No recurrences or complications occurred. ( info) |
6/572. Unusual finding after contrast injection of a solitary bone cyst. A case report. Injection of radiopaque contrast into a solitary bone cyst (SBC) prior to methylprednisolone acetate (MPA) injection has been previously reported. We report an unusual finding during the injection of radiopaque contrast in the treatment of one case of SBC of the femur: a bicameral appearance of the cyst was observed; no filling of the proximal cavity occurred and immediate perfusion of the femoral vein with contrast was noted. In cases of SBC such as this one, percutaneous autologous marrow or corticosteroid injection may fail to be effective. Furthermore there exists the potential risk of fat embolus secondary to bone marrow injection. Based on these findings in the case reported, we suggest that contrast injection should be performed prior to bone marrow or corticosteroid injection in order to evaluate both the venous drainage of the cyst and its degree of loculation. ( info) |
7/572. Painful intraosseous ganglion of the scaphoid overshadowed by thoracic outlet syndrome. Case report. We present a case of a woman diagnosed several years previously with thoracic outlet syndrome who had a 2-3 month history of worsening wrist pain. After an intraosseous ganglion was discovered, curettage and bone grafting successfully relieved her symptoms. ( info) |
8/572. 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. ( info) |
9/572. Subperiosteal ganglion cyst of the tibia. A communication with the knee demonstrated by delayed arthrography. We report a patient with a subperiosteal ganglion cyst of the tibia which was imaged by radiography, arthrography, CT and MRI. The images were correlated with the arthroscopic surgical and histological findings. Spiculated formation of periosteal new bone on plain radiographs led to the initial suspicion of a malignant tumour. Demonstration of the cystic nature of the tumour using cross-sectional imaging was important for the precise diagnosis. communication between the ganglion cyst and the knee was shown by a delayed arthrographic technique, and the presence of this communication was confirmed at arthroscopy and surgically. ( info) |
10/572. Intraosseous ganglion of the trapezium in communication with the flexor carpi radialis tendon sheath. We report a case of an intraosseous ganglion of the trapezium that communicated with the flexor carpi radialis tendon sheath. The findings support the hypothesis that intraosseous ganglia arise from penetration of bone by synovial tissue or fluid. ( info) |