Intramuscular haemangioma adjacent to the bone surface with periosteal reaction. Report of three cases and review of the literature.
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We present three cases of intramuscular haemangioma adjacent to bone in the lower limb. All patients had local pain during the third decade. Plain radiographs showed an irregular or hypertrophic periosteal reaction on the shaft of the fibula and an intramuscular mass adjacent to the bone with inhomogeneous high signal intensity on MRI. These lesions mimic periosteal or parosteal tumours. (+info)
Temporal trends in demographic profiles and stress levels in medieval (6th-13th century) population samples from continental Croatia.
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AIM: To analyze and compare the demographic profiles and disease frequencies of early (6th-9th century) and late (10th-13th century) medieval skeletal series from continental Croatia. METHODS: Age and sex distributions in three early (n=277) and six late (n=175) medieval skeletal series were compared. All skeletons were analyzed for the presence of dental enamel hypoplasia, periostitis, trauma, and presence of Schmorl s depressions in vertebral bodies. RESULTS: Data collected from the skeletal series suggested significantly higher stress in the late medieval period. This stress may have affected mortality, as evidenced by significantly higher subadult mortality and shorter adult average life span. Men in the late medieval series, in particular, seem to have been under greater stress. They exhibited significantly higher mortality in the 21-25 years age category, and significantly higher frequencies of periosteal lesions, cranial and postcranial trauma, and Schmorl s depressions. CONCLUSION: The frequencies of all skeletal indicators of stress increased significantly during the late medieval period. This was accompanied by a significant increase in subadult mortality and shortening of the average life span of adult men and women. (+info)
Painful soft-tissue reaction to injectable Norian SRS calcium phosphate cement after curettage of enchondromas.
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A prospective single-cohort study was designed to include 20 patients with enchondromas but was stopped because of poor early results. Four patients with an enchondroma, three in the proximal humerus and one in the distal femur, were treated by curettage and filling of the defect with Norian SRS cement. Clinical and radiological follow-up including CT and MRI was carried out for 18 months. All three patients with lesions in the proximal humerus had severe pain and limited movement of the shoulder. The radiological and CT appearances of the cement were unchanged at follow-up. There were characteristic appearances of synovitis and periosteitis on MRI in two patients. Since the cement induces a soft-tissue reaction the bony cavity should be sealed with the curetted and burred bone after curettage and introduction of Norian cement, especially in sites where a tourniquet cannot be applied. (+info)
Ankylosing enthesitis, dactylitis, and onychoperiostitis in male DBA/1 mice: a model of psoriatic arthritis.
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OBJECTIVES: To further characterise spontaneous arthritis in aging male DBA/1 mice as a model of spondyloarthropathy and psoriatic arthritis with particular attention to signs of inflammation and nail involvement. MATERIALS AND METHODS: Aging male DBA/1 mice from different litters were caged together (4-6 mice per cage) at the age of 12 weeks, checked twice a week for signs of arthritis, and killed at different times. Hind paws were dissected and processed for histology. RESULTS: Disease incidence varied between 50% and 100% in four different experiments. Besides clinical signs of arthritis, nail abnormalities were noticed. Pathological examination showed the occurrence of dactylitis characterised by diffuse neutrophil infiltration in 6 of 50 paws examined. Onycho-periostitis with progressive destruction of the nail bed and the underlying distal phalanx was seen in 5 of 50 paws examined. CONCLUSIONS: Although dactylitis and onychoperiostitis are rare manifestations of the disease process, these data strongly suggest that spontaneous arthritis in aging male DBA/1 mice shares important features with human psoriatic arthritis. This model may therefore be an important tool to study links between stress, sex, inflammation, and new bone formation with particular relevance to human psoriatic arthritis. (+info)
Successful treatment of psoriatic onycho-pachydermo periostitis (POPP) with adalimumab.
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Psoriatic onycho-pachydermo periostitis (POPP) is recognized as a rare subset of psoriatic arthritis, characterized by psoriatic onychodystrophy, connective tissue thickening above the distal phalanx, and a periosteal reaction. Therapy for this rare disease is based on treatments used for psoriatic arthritis, but traditional disease-modifying antirheumatic drugs, such as sulfasalazine and methotrexate, have shown inconsistent and unsatisfactory results. We report herein a successful therapeutic approach for POPP using the fully human anti-tumor necrosis factor (TNF) antibody adalimumab in a 42-year-old male patient. After 4 months of anti-TNF treatment, a remarkable normalization of the clinical appearance was achieved and magnetic resonance imaging showed complete resolution of the initial inflammatory lesions. Therefore, we consider a TNF-blocking strategy as promising for treatment of POPP. (+info)
[Acute mastoiditis: increase of incidence and controversies in antibiotic treatment].
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An important complication of acute otitis media is acute mastoiditis which responds to antibiotic therapy and myringotomy. Patients with acute mastoiditis were reviewed during 1996-2005 in the tertiary University Children's Hospital in Madrid. The number of patients with acute mastoiditis increased by about 2-fold during this period. Of 205 children with mastoiditis, ranging from 0.6-17 years of age, surgical treatment was needed in about 4.3% in 1996 and in 70% in 2005. In spite of 80% of the children having received antibiotics at the pediatric visit, the number of complications increased (periostitis, subperiosteal abscess), and the number of surgical interventions increased by 8-fold. Etiological agents were Streptococcus pneumoniae (28.5%) and Staphylococcus aureus (16.3%). Negative cultures were obtained in 53.6% of cases. Lack of response to conventional therapy may require more tympanocentesis procedures for a middle ear culture, and surgical therapy may be necessary more often, as is the tendency in our hospital. (+info)
Psoriatic onycho-pachydermo periostitis.
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A 46-year-old woman presented with onycholysis and swollen, painful digits. No other stigmata of psoriasis were present. Magnetic resonance imaging of the hands showed an extensive periosteal reaction of the phalangeal tuft. Psoriatic onycho-pachydermo periostitis (POPP) is a rare subset of psoriatic arthritis that is characterized by psoriatic onychodystrophy, connective-tissue thickening above the distal phalanx, and a periosteal reaction. Treatment of POPP is difficult; however, low-dose methotrexate and anti-TNF-alpha agents may be beneficial. In patients who are unresponsive or intolerant of these medications, other biologic and non-biologic disease modifying anti-rheumatic drugs need to be considered. (+info)
Early congenital syphilis with isolated bone involvement: a case report.
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Congenital syphilis is the oldest recognized congenital infection and still represents a serious healthcare problem in the 21st century. It is important to be fully informed regarding the early diagnosis and treatment of congenital syphilis to prevent its devastating complications leading to death. In this manuscript, we report a newborn infant with unusual clinical findings of congenital syphilis such as a non-fluctuant mass surrounding the left calf. She did not have any additional system involvement such as hepatic or skin involvement or lymph nodes. To our best knowledge, there are only a few case reports presented with isolated bone involvement. This case demonstrates that congenital syphilis should be considered in neonates with bone fractures, lytic bone lesions and periostitis. (+info)