1/155. Pronounced palatal and mandibular tori observed in a patient with chronic phenytoin therapy: a case report. phenytoin, an anticonvulsant drug for epileptic patients, has many adverse effects, including calvarial thickening and coarsening of the facial features. Previous studies have demonstrated that phenytoin has an anabolic action on bone cells. This report describes pronounced palatal and mandibular tori found in a 45-year-old Japanese man undergoing chronic phenytoin therapy. The tori were extremely large, lobular, and symmetrical. A palatal torus appeared along the middle of the hard palate and mandibular tori consisted of 2 pairs of nodular masses extensively filling the lingual floor of the oral cavity. Pronounced osseous outgrowth occurred for the duration of a dose-increase of phenytoin from 1985 to 1997. His parents did not have any palatal or mandibular tori. These facts suggest that these unusual tori may have been the result of chronic phenytoin therapy, rather than association with the familial background. ( info) |
2/155. Stenosing tenosynovitis and impingement of the peroneal tendons associated with hypertrophy of the peroneal tubercle. We report three patients with lateral ankle and foot pain, with the diagnosis of stenosing tenosynovitis of the peroneus longus tendon associated with a markedly enlarged peroneal tubercle. Stenosing tenosynovitis of the peroneus longus tendon associated with an atraumatically enlarged peroneal tubercle has rarely been reported, and these reported cases were associated with an os peroneum. One of our patients had no demonstrable associated os peroneum but did have a bony tunnel enveloping the peroneus longus tendon. Our other two patients had an os peroneum, but were asymptomatic at the lateral outer border of the cuboid tunnel; one patient had involvement of the peroneus longus and brevis tendons. ( info) |
3/155. association of diffuse idiopathic skeletal hyperostosis (DISH) and calcification and ossification of the posterior longitudinal ligament. Diffuse idiopathic skeletal hyperostosis (DISH) is a common ossifying diathesis in middle-aged and elderly patients characterized by bone proliferation along the anterior aspect of the spine and at extraspinal sites of ligament and tendon attachment to bone. Four patients with DISH revealed extensive calcification and ossification of the posterior longitudinal ligament in the cervical spine. review of cervical spine radiographs in 74 additional patients with DISH demonstrated bony hyperostosis of the posterior aspect of the vertebrae in 41%, posterior spinal osteophytosis in 34%, and posterior longitudinal ligament calcification and ossification in 50%. These ligamentous findings, which have previously been described almost exclusively in Japanese people, appear to be an additional skeletal manifestation of DISH. ( info) |
| The authors present a case of atypical heel pain masquerading as plantar fasciitis. The patient was subsequently diagnosed with hyperparathyroidism-induced stress fracture of the calcaneus. The clinical entity of hyperparathyroidism and its manifestations in the skeletal system are presented, as well as a review of stress fractures and pertinent imaging studies. ( info) |
5/155. Solitary exostosis of the thoracic spine. early diagnosis and treatment. STUDY DESIGN: A case report. OBJECTIVE: To highlight the importance of early diagnosis and treatment of vertebral exostosis. SUMMARY OF BACKGROUND DATA: Few cases of spinal cord compression caused by solitary thoracic exostoses have been reported. METHOD: A solitary exostosis in the midline of the neural arch of the fifth thoracic vertebra, causing compression of the spinal cord documented on both magnetic resonance and computed tomographic examinations, is reported in a 51-year-old woman who had normal findings in a neurologic examination. RESULTS: The exostosis was successfully excised. CONCLUSION: Accurate preoperative diagnosis of vertebral exostoses is possible using magnetic resonance and computed tomography. Early excision avoids the development of a permanent neurologic deficit. ( info) |
6/155. Multiple maxillary and mandibular exostoses associated with multiple dermatofibromas: a case report. exostoses of the maxilla and mandible are nodular protuberances of mature bone that need to be accurately distinguished from other more diagnostically significant lesions, notably exosteal osteomas. Multiple dermatofibromas are rare and may be associated with altered immune function. We report the case of an otherwise healthy 47-year-old woman who was first seen with multiple maxillary and mandibular exostoses associated with multiple dermatofibromas. This association has not been previously reported. ( info) |
7/155. Surgical treatment for an unusual cause of localized bronchiectasis. A 17-year-old girl presented with recurrent episodes of pneumonia related to localized bronchiectasis in the lingula. On computed tomography and magnetic resonance imaging, the cause of this was found to be an inwardly projecting exostosis arising from the left fifth rib. The patient underwent thoracotomy and excision of the exostosis with the affected area of lung. We report here the unusual case of a rib exostosis presenting with localized bronchiectasis. ( info) |
8/155. Turret exostosis of the thumb. Eighteen cases of turret exostoses of the hand have been reported, all associated with dorsal injuries. We present a case of turret exostosis involving the volar aspect of the thumb. ( info) |
9/155. Complete denture covering mandibular tori using three base materials: a case report. The torus mandibularis presents many challenges when fabricating a complete denture. The mucosa tends to be thin and will not tolerate normal occlusal loads on a denture. Large mandibular tori can prevent complete seating of impression trays and denture. To address this problem, we fabricated a new mandibular complete denture incorporating a combination of soft acrylic flanges and liners. ( info) |
10/155. A rare case of enthesopathy of the bicipital tuberositas of the radius. We present a case of a patient with complaints in both elbows, due to a prominent bicipital tuberosity with an enlarged bursa, in which operative resection was successful. ( info) |