Cases reported "Exostoses"

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1/17. 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.
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2/17. Autosomal dominant osteosclerosis.

    Two cases of a craniotubular hyperostosis are presented. The radiographic features closely resemble Van Buchem disease (hyperostosis corticalis generalisata; endosteal hyperostosis, recessive type), including symmetrical and bilateral diaphyseal cortical thickening of the long and short tubular bones as well as sclerosis and thickening of the calvaria, mandible, shoulder and pelvic girdles, and thoracic cage. Unlike Van Buchem disease, no periosteal excresences are observed, alkaline phosphatase is normal, no basal foramina encroachment of the skull is present, and the genetic pattern is dominant inheritance. These cases possibly represent a separate disorder rather than a variant of Van Buchem disease.
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3/17. Craniofacial characteristics of proteus syndrome: two modes of abnormal growth.

    The dysmorphic growth patterns of the craniofacial skeleton are summarized in five patients with the proteus syndrome. Two different modes of abnormal growth are present. One mode involves focal overgrowth of membrane bones, producing multiple hyperostoses which result in progressive craniofacial disfigurement and asymmetry. The second mode involves overgrowth of cartilage in the condyle, resulting in dentofacial asymmetry. The phenotype of the craniofacial skeleton results from both processes. In terms of appearance, the mode involving hyperostosis seems more dramatic in most cases than the mode involving cartilage.
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4/17. Reactive fibromatosis in pustulotic arthro-osteitis.

    Sterno-costo-hyperostosis is an inflammatory rheumatic disease which is associated to pustulosis palmaris et plantaris. The origin of this disorder is unknown. We described the appearance as a "reactive" fibromatosis in connection with a hyperostosis of a clavicle, which could be demonstrated in a biopsy-probe and by NMR-technique.
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5/17. Intraosseous lipoma of the skull: a report of two cases.

    Case histories of a 12-year-old boy and a 20-year-old woman with hyperostosis of the frontoparietal bones are presented. Microscopical examination of the lesions showed intraosseous lipoma with hyperostosis of diploe. In both cases, only the prominent part of the tumor was removed for cosmetic reasons. The results were satisfactory, and there was no evidence of recurrence over a period of six years.
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6/17. Resolution of prostaglandin-induced cortical hyperostosis in an infant.

    Prostaglandin E1 (PGE1) has been used to preserve patency of the ductus arteriosus in various forms of congenital heart disease. Long-term PGE1 therapy often leads to the roentgenographic findings of cortical hyperostosis, similar to those seen in infectious or metabolic diseases. These periosteal reactions regress after cessation of PGE1 therapy and should not prompt further diagnostic evaluation.
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7/17. Odontoid fracture complicating ankylosing hyperostosis of the spine.

    Ankylosing hyperostosis of the spine (Forestier's disease) is a distinct clinical entity which must be differentiated from ankylosing spondylitis (Marie-Strumpell's disease) and hypertrophic spondylosis. In the case presented, the distinction was made by clinical, roentgenographic, and postmortem pathologic findings. This case had the unique and previously unreported feature of complication by a fracture of the odontoid. The patient's particular circumstances led to the decision to treat the fracture by posterior arthrodesis, though this is not necessarily recommended for all spinal fractures occuring in this disease.
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8/17. confusion of roentgenographic differential diagnosis between ankylosing hyperostosis (Forestier's disease) and ankylosing spondylitis.

    A patient with ankylosing hyperostosis (Forestier's disease) initially diagnosed elsewhere as a case of ankylosing spondylitis with bamboo spine, is presented. The characteristic roentgenographic findings of Forestier's disease in the axial skeleton of this patient are described, including computerized tomography of the lower lumbar spine and sacroiliac joints. Major clinical and radiological distinguishing features of Forestier's disease and ankylosing spondylitis are discussed.
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9/17. Cervical ankylosing hyperostosis and airway obstruction.

    Forestier's disease, or ankylosing hyperostosis of the cervical spine, has been described to cause dysphagia, foreign body sensation, and aspiration. We report two patients with ankylosing hyperostosis producing ulceration of the posterior plate of the cricoid cartilage, inflammatory edema, and secondary bilateral vocal cord paralysis with airway obstruction. This disease initially produces minimal dysphagia when the primary location of the osteophyte is just above and posterior to the cricoid, then, progressive airway obstruction. The pathogenesis is infection superimposed on ulceration of the cricoid produced by laryngeal movement over a large, sharp osteophyte. Management included tracheostomy for airway management, endoscopy to rule out malignancy, intravenous antibiotic therapy, and surgical excision of the osteophyte.
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10/17. Diffuse posterior hyperostosis of the cervical spine with cord compression: a Forestier (DISH) variant.

    A patient presented with signs and symptoms of cervical spinal cord compression. Computed tomography (CT) scan showed diffuse idiopathic hyperostosis of the posterior vertebral border of C4, C5, C6, and C7 cervical vertebrae, with severe spinal stenosis at C5 and C6 level. Computed tomography scan is the single most useful instrument for demonstrating the extent of bony proliferation and severity of spinal stenosis.
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