-
IDCases 2024Brodie's abscess is a manifestation of subacute to chronic osteomyelitis, characterized as intraosseous abscess formation, usually on the metaphysis of the long tubular...
Brodie's abscess is a manifestation of subacute to chronic osteomyelitis, characterized as intraosseous abscess formation, usually on the metaphysis of the long tubular bones in the lower extremities of male pediatric patients. Clinically, Brodie's abscess presents with atraumatic bone pain of an insidious onset, with absence of systemic findings. Delay in diagnosis is common, as diagnostic imaging, followed by biopsy for culture and histologic examination are generally required to secure a diagnosis of Brodie's abscess. Treatment of Brodie's abscess is non-standardized, and usually consists of surgical debridement and antibacterial therapy. Despite the variability in therapeutic approaches, outcomes of Brodie's abscess treated with surgery and antibiotics are favourable. Herein we report a case of a delayed diagnosis of Brodie's abscess in the upper extremity of an adult female. While she improved with treatment of Brodie's abscess, the case serves to remind clinicians to consider this entity in adult individuals who present with atraumatic bone pain.
PubMed: 38711946
DOI: 10.1016/j.idcr.2024.e01977 -
Zhongguo Yi Xue Ke Xue Yuan Xue Bao.... Apr 2024Bone infarction has a low incidence in clinical practice and mostly occurs in the metaphysis and diaphysis.Few studies report the advanced imaging technique for bone...
Bone infarction has a low incidence in clinical practice and mostly occurs in the metaphysis and diaphysis.Few studies report the advanced imaging technique for bone infarction.Here we reported the fast field echo resembling a CT using restricted echo-spacing and calcium-suppressed spectral CT imaging for a case of multifocal bone infarcts in both lower extremities,aiming to provide diagnostic experience for clinical practice.
Topics: Humans; Male; Calcium; Infarction; Lower Extremity; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Adult
PubMed: 38686729
DOI: 10.3881/j.issn.1000-503X.15724 -
Bone Reports Jun 2024Osteoporosis occurs in every third individual after simultaneous pancreas kidney transplantation (SPKT). Currently used bone measures insufficiently predict their...
Osteoporosis occurs in every third individual after simultaneous pancreas kidney transplantation (SPKT). Currently used bone measures insufficiently predict their fracture risk. Lumbar spine Trabecular bone score (TBS) and distal radius areal and volumetric bone mineral density (BMD) were monitored for the first time in patients with type 1 diabetes and chronic renal failure after SPKT with steroid-sparing protocol. In 33 subjects (mean age 43.4 ± 9.8 years), dual-energy X-ray absorptiometry and peripheral quantitative computed tomography were performed just after SPKT (baseline) and one and three years later. While TBS -scores increased (-1.1 ± 1.2 and -0.3 ± 1.0; p˂0.001, at baseline and year three, respectively), trabecular volumetric BMD -scores at distal radius metaphysis did not change during the study (-1.3 ± 1.3 and -1.3 ± 1.0; = 0.38). Similarly, areal BMD -scores increased at lumbar spine, total hip and femoral neck (all < 0.01), but not at the distal radius. SPKT induced bone measures' improvement at lumbar spine and hip but not at distal radius. Before suggesting changes in current clinical care, predictive value of individual bone measures or its combination for fracture risk assessment remains to be elucidated.
PubMed: 38681747
DOI: 10.1016/j.bonr.2024.101764 -
Cureus Mar 2024Osteosarcoma is a malignant mesenchymal tumour. This primarily manifests in the formation of immature osteoid cells by tumour cells. Osteosarcoma is the most common...
Osteosarcoma is a malignant mesenchymal tumour. This primarily manifests in the formation of immature osteoid cells by tumour cells. Osteosarcoma is the most common primary bone tumour in children and adolescents. It tends to occur in the metaphysis of long shafts, shows osteoblastic differentiation, and produces malignant osteoid material. We present the case of a 17-year-old male who presented to our clinic who had left knee pain for a few days. An initial radiograph of the knee joint revealed a lytic lesion in the proximal tibia and further imaging was advised. During a follow-up visit, the patient had worsening pain and had a computerized tomography scan of the left knee, confirming osteosarcoma on the lateral side of the left tibia. He was referred to the orthopaedic department, where a biopsy was performed, to confirm the diagnosis of osteosarcoma. The patient was commenced on chemotherapy due to metastatic disease and has so far tolerated therapy well.
PubMed: 38633972
DOI: 10.7759/cureus.56366 -
International Journal of Implant... Apr 2024Osteoporotic individuals who have dental implants usually require a prolonged healing time for osseointegration due to the shortage of bone mass and the lack of initial...
PURPOSE
Osteoporotic individuals who have dental implants usually require a prolonged healing time for osseointegration due to the shortage of bone mass and the lack of initial stability. Although studies have shown that intermittent teriparatide administration can promote osseointegration, there is little data to support the idea that pre-implantation administration is necessary and beneficial.
METHODS
Sixty-four titanium implants were placed in the bilateral proximal tibial metaphysis in 32 female SD rats. Bilateral ovariectomy (OVX) was used to induce osteoporosis. Four major groups (n = 8) were created: PRE (OVX + pre-implantation teriparatide administration), POST (OVX + post-implantation administration), OP (OVX + normal saline (NS)) and SHAM (sham rats + NS). Half of rats (n = 4) in each group were euthanized respectively at 4 weeks or 8 weeks after implantation surgery, and four major groups were divided into eight subgroups (PRE4 to SHAM8). Tibiae were collected for micro-CT morphometry, biomechanical test and undecalcified sections analysis.
RESULTS
Compared to OP group, rats in PRE and SHAM groups had a higher value of insertion torque (p < 0.05). The micro-CT analysis, biomechanical test, and histological data showed that peri-implant trabecular growth, implants fixation and bone-implant contact (BIC) were increased after 4 or 8 weeks of teriparatide treatment (p < 0.05). There was no statistically difference in those parameters between PRE4 and POST8 subgroups (p > 0.05).
CONCLUSIONS
In osteoporotic rats, post-implantation administration of teriparatide enhanced peri-implant bone formation and this effect was stronger as the medicine was taken longer. Pre-implantation teriparatide treatment improved primary implant stability and accelerated the osseointegration process.
Topics: Female; Animals; Rats; Rats, Sprague-Dawley; Teriparatide; Osseointegration; Dental Implants; Embryo Implantation; Saline Solution
PubMed: 38625587
DOI: 10.1186/s40729-024-00536-z -
Cureus Apr 2024Background Rotational deformities in children are currently treated with an osteotomy, acute de-rotation, and surgical fixation. Meanwhile, guided growth is now the gold...
Background Rotational deformities in children are currently treated with an osteotomy, acute de-rotation, and surgical fixation. Meanwhile, guided growth is now the gold standard in pediatric coronal deformity correction. This study aimed to evaluate the feasibility of a novel implant intended for rotational guided growth (RotOs Plate) in a large porcine animal model. Methodology A submuscular plate was inserted on the medial and lateral aspect of the distal femoral physis of the left femur in 6 pigs. Each plate was anchored with a screw in the metaphysis and epiphysis respectively. The plates were expected to rotate the femur externally. The right femur acted as a control in a paired design. The animals were housed for 12 weeks after surgery. MRI scanning of both femora was performed before euthanasia after 12 weeks. Rotation was determined as the difference in the femoral version on MRI between the operated and non-operated femur after 12 weeks. Results External rotation in all operated femurs was observed. The mean difference in the femoral version on MRI between operated and non-operated femurs was 12.5° (range 9°-16°). No significant changes in axial growth were detected. Conclusions This study shows encouraging results regarding rotational guided growth, which may replace current invasive surgical treatment options for malrotation in children. However, further studies addressing potential secondary deformities are paramount and should be carried out.
PubMed: 38616978
DOI: 10.7759/cureus.58169 -
Journal of Nanobiotechnology Apr 2024Early-onset bone dysplasia is a common manifestation of hypophosphatasia (HPP), an autosomal inherited disease caused by ALPL mutation. ALPL ablation induces...
BACKGROUND
Early-onset bone dysplasia is a common manifestation of hypophosphatasia (HPP), an autosomal inherited disease caused by ALPL mutation. ALPL ablation induces prototypical premature bone ageing characteristics, resulting in impaired osteogenic differentiation capacity of human bone marrow mesenchymal stem cells (hBMMSCs). As angiogenesis is tightly coupled with osteogenesis, it also plays a necessary role in sustaining bone homeostasis. We have previously observed a decrease in expression of angiogenesis marker gene CD31 in the metaphysis of long bone in Alpl mice. However, the role of ALPL in regulation of angiogenesis in bone has remained largely unknown.
METHODS
Exosomes derived from Normal and HPP hBMMSCs were isolated and identified by ultracentrifugation, transmission electron microscopy, and nanoparticle size measurement. The effects of ALPL on the angiogenic capacity of hBMMSCs from HPP patients were assessed by immunofluorescence, tube formation, wound healing and migration assay. exo-ELISA and Western Blot were used to evaluate the exosomes secretion of hBMMSCs from HPP, and the protein expression of VEGF, PDGFBB, Angiostatin and Endostatin in exosomes respectively.
RESULTS
We verified that ALPL ablation resulted in impaired pro-angiogenic capacity of hBMMSCs, accounting for reduced migration and tube formation of human umbilical vein endothelial cells, as the quantities and proteins composition of exosomes varied with ALPL expression. Mechanistically, loss of function of ALPL enhanced ATP release. Additional ATP, in turn, led to markedly elevated level of ATP receptor P2X7, which consequently promoted exosomes secretion, resulting in a decreased capacity to promote angiogenesis. Conversely, inhibition of P2X7 increased the angiogenic induction capacity by preventing excessive release of anti-angiogenic exosomes in ALPL deficient-hBMMSCs.
CONCLUSION
The ALPL-ATP axis regulates the pro-angiogenic ability of hBMMSCs by controlling exosomes secretion through the P2X7 receptor. Thus, P2X7 may be proved as an effective therapeutic target for accelerating neovascularization in ALPL-deficient bone defects.
Topics: Humans; Animals; Mice; Endothelial Cells; Exosomes; Osteogenesis; Mesenchymal Stem Cells; Adenosine Triphosphate; Alkaline Phosphatase
PubMed: 38609899
DOI: 10.1186/s12951-024-02396-6 -
Journal of Orthopaedic Case Reports Mar 2024Non-ossifying fibroma (NOF) is a common benign fibrogenic bone lesion commonly found in the metaphysis of long bones. While small NOFs are typically asymptomatic and...
INTRODUCTION
Non-ossifying fibroma (NOF) is a common benign fibrogenic bone lesion commonly found in the metaphysis of long bones. While small NOFs are typically asymptomatic and left untreated, large NOFs are often associated with pathologic fractures that can be treated conservatively or operatively. To our knowledge, the NOF presented in this case report is one of the largest reported in the literature.
CASE REPORT
We present a case of a 12-year-old Hispanic female who presented to our institution after falling off a horse and landing on her right leg and wrist. Radiographs revealed a right distal femur fracture through an unusually large lytic bone lesion. The patient was treated with curettage, grafting, open reduction, and internal fixation, given the unstable and pathological nature of the fracture.
CONCLUSION
This case substantiates the literature that large fractures through a NOF can be appropriately managed operatively. However, orthopedic surgeons should be aware of the risks of surgery, including infection, when considering operative management of patients who present with large unstable pathologic fractures through a NOF.
PubMed: 38560297
DOI: 10.13107/jocr.2024.v14.i03.4282 -
Quantitative Imaging in Medicine and... Mar 2024The hand skeletal features of children and adolescents at different growth statuses and development periods, and the correlation between these skeletal features and hand...
BACKGROUND
The hand skeletal features of children and adolescents at different growth statuses and development periods, and the correlation between these skeletal features and hand asymmetric force are currently unclear. Thus, this study sought to investigate the hand skeletal features of children and adolescents at different growth statuses and at different periods of development, and the correlation between these skeletal features and asymmetric force in hands.
METHODS
A retrospective study was performed on subjects aged 4-20 years with good growth status (group A) or short stature (group B). Additional subjects aged 4-20, 21-40, and >40 years were enrolled in groups C, D, and E, respectively. All the subjects underwent left-hand posteroanterior X-ray radiography. Brachymesophalangia-V (BMP-V), conical epiphysis, epiphysis/metaphysis symmetry of the proximal phalanx (ESP), and the angle of the metacarpal-phalangeal axis were analyzed.
RESULTS
Of the 654 children and teenagers aged 4-20 years (median: 11 years) enrolled in the study, 432 were allocated to group A, of whom 237 (54.9%) were male and 195 (45.1%) were female, and 222 matched cases were allocated to group B, of whom 112 (50.5%) were male and 110 (49.5%) were female. The first to third ESPs were significantly (P<0.05) greater in group A than in group B, while the first to third angles of the metacarpal-phalangeal axis were significantly (P<0.05) smaller in group A than in group B. The correlation analysis revealed a highly significant (P<0.01) negative correlation between the ESP and angle of the metacarpal-phalangeal axis (r=-0.948, -0.926, -0.940, -0.885, and -0.848, respectively). The incidence of BMP-V was 15.4% in all patients, while that of conical epiphysis was 19.5%. The incidence of BMP-V and conical epiphysis was significantly (P<0.05) smaller in group A than in group B (11.1% 23.8% for BMP-V and 16.6% 25.2% for conical epiphysis, respectively). Additionally, 216 subjects were enrolled in group C (108 male and 108 female), 185 subjects were enrolled in in group D (93 male and 92 female), and 176 subjects were enrolled in in group E (104 male and 72 female). The second to fifth ESPs in group C were significantly (P<0.05) smaller than those in both groups D and E, while the second to fifth angles of the metacarpal-phalangeal axis were significantly (P<0.05) larger in group C than in both groups D and E. A BMP-V was present in 35 (16.2%) patients in group C, 8 (4.3%) in group D, and 2 (1.1%) in group E, and the difference among the three groups was statistically significant (P<0.05).
CONCLUSIONS
The epiphyseal symmetry of the proximal phalanges is poor in short stature children and adolescents, and the angle between the metacarpal and phalangeal axes is larger in children and adolescents with short stature than those with normal height and good growth status. A negative correlation was found between the epiphyseal symmetry of the proximal phalanges and asymmetrical stress.
PubMed: 38545069
DOI: 10.21037/qims-23-26 -
Animals : An Open Access Journal From... Mar 2024This study investigated the effects of dietary methionine (Met) levels on the bone quality of broilers challenged with coccidia. A total of 600 fourteen-day-old male...
Effects of Methionine Supplementation Levels in Normal or Reduced Protein Diets on the Body Composition and Femur Bone Characteristics of Broilers Challenged with Coccidia.
This study investigated the effects of dietary methionine (Met) levels on the bone quality of broilers challenged with coccidia. A total of 600 fourteen-day-old male Cobb500 broilers were gavaged with mixed spp. and randomly allocated into 10 treatment groups by a 2 × 5 factorial arrangement. Birds received normal protein diets (NCP) or reduced-protein diets (LCP), containing 2.8, 4.4, 6.0, 7.6, and 9.2 g/kg of Met. Data were analyzed via two-way ANOVA and orthogonal polynomial contrast. At 9 days post-inoculation (DPI), whole body bone mineral density (BMD) and bone mineral content (BMC) linearly decreased as Met levels increased ( < 0.05). For the femoral metaphysis bone quality at 9 DPI, BMD linearly decreased, and porosity linearly increased as Met levels increased ( < 0.05) in the cortical bone. The increased Met levels linearly improved trabecular bone quality in LCP groups ( < 0.05) while not in NCP groups. For the femoral diaphysis cortical bone at 6 DPI, LCP groups had higher BMD and BMC than NCP groups ( < 0.05). Bone volume linearly increased as Met levels increased in LCP groups ( < 0.05) while not in NCP groups. In summary, the results suggested that increased Met levels decreased the cortical bone quality. However, in the context of reduced-protein diets, the increased Met levels improved trabecular bone quality.
PubMed: 38540016
DOI: 10.3390/ani14060917