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International Journal of Legal Medicine Mar 2021The evaluation of epiphyseal areas by magnetic resonance imaging (MRI) for forensic age estimation is an important supportive diagnostic method to prevent repeated...
The evaluation of epiphyseal areas by magnetic resonance imaging (MRI) for forensic age estimation is an important supportive diagnostic method to prevent repeated radiation exposure without a valid medical reason. There are still not enough individuals being analyzed with MRI for age estimation. The aim of this study was to investigate the utility of T1-weighted turbo spin echo (T1-TSE) MRI sequences in determining the degree of ossification of the distal femoral and proximal tibial epiphyses in a Turkish population. In this study, images from 649 patients (335 males and 314 females) aged 10-30 years were retrospectively evaluated with sagittal T1-weighted turbo spin echo (T1-TSE) MRI sequences of the knee. Proximal tibial and distal femoral epiphysis were scored by two different observers twice using the combined staging system described by Schmeling and Kellinghaus. Spearman's rank correlation analysis indicated a significant positive relationship between age and ossification stages of the distal femoral and proximal tibial epiphyses (p < 0.001). The intra- and inter-observer reliabilities in evaluating the femur and tibia were separately determined and gave promising results and Cohen's kappa statistics ranged from κ = 0.886 and κ = 0.961. The minimal ages of patients with stage 4 ossification were 15.1 years for females and 15.8 years for males for the distal tibial epiphysis and 15.4 years for females and 17 years for males for the distal femoral epiphysis. This study show that (T1-TSE) MRI and the applicability and Schmeling and Kellinghaus staging method of the knee can be performed for living 14- to 17-year-old individuals in need of a supportive noninvasive method for estimating forensic age.
Topics: Adolescent; Adult; Age Determination by Skeleton; Child; Epiphyses; Female; Femur; Humans; Knee; Magnetic Resonance Imaging; Male; Osteogenesis; Tibia; Turkey; Young Adult
PubMed: 32839871
DOI: 10.1007/s00414-020-02402-0 -
BMC Musculoskeletal Disorders Jun 2018Epiphyseal-preservation surgery for osteosarcoma is an alternative method which has been indicated carefully to selected patients. The tumor-devitalised autograft...
BACKGROUND
Epiphyseal-preservation surgery for osteosarcoma is an alternative method which has been indicated carefully to selected patients. The tumor-devitalised autograft treated with liquid nitrogen procedure is one of the biological reconstruction method to reconstruct the defect after tumor excision. The limb length discrepancy is usually appeared in children with their growth after limb-sparing surgery. This study was aimed to investigated the growth of residual epiphysis following epiphyseal-preservation surgery for childhood osteosarcoma around the knee joint.
METHODS
We retrospectively reviewed 12 patients with osteosarcoma who underwent epiphysis preserving tumor excision (8 in distal femur and 4 in proximal tibia) and reconstructed by using tumor-devitalized autograft treated with liquid nitrogen. The mean patient age was 11 (range, 6 to 14) years. The mean follow-up period were 63 (range, 41 to 90) months. Epiphysis transverse growth rate, epiphysis-width discrepancy (EWD) and collapse of epiphysis were evaluated by using pre- and post-operative whole standing leg radiographs. A retrospective chart review was performed to investigate functional outcome, complications and oncological status.
RESULTS
The mean growth of epiphysis rate was 12.6% (range, 3.3 to 28.0%) of affected side and 12.7% (range, 3.8 to 28.9%) of contralateral side, mean EWD was 0.1 mm (range, - 1.0 to 1.7 mm), mean LLD was + 26.1 mm (range, + 1 to + 48 mm) and two patients with distal femoral reconstruction underwent limb lengthening of tibia. There was no collapse of the residual epiphysis. The mean MSTS score was 27.7 (range, 18 to 30).
CONCLUSIONS
Epiphysis transverse growth was not diminished, and there was absence of epiphyseal collapse even after epiphyseal-preservation surgery in this small series of childhood osteosarcoma around the knee. With careful assessment for epiphyseal tumor involvement, epiphyseal-preservation surgery shall be possible, and could be an alternative method worth considering.
Topics: Adolescent; Bone Development; Bone Neoplasms; Child; Cryopreservation; Epiphyses; Female; Humans; Internal Fixators; Knee Joint; Male; Osteosarcoma; Osteotomy; Retrospective Studies; Transplantation, Autologous
PubMed: 29875014
DOI: 10.1186/s12891-018-2109-4 -
The Yale Journal of Biology and Medicine 1993Skeletal tissues from children sustaining acute skeletal trauma were analyzed with detailed radiologic and histologic techniques to assess the failure patterns of the... (Review)
Review
Skeletal tissues from children sustaining acute skeletal trauma were analyzed with detailed radiologic and histologic techniques to assess the failure patterns of the developing skeleton. In the physis- and epiphysis-specific fracture propagation varied, usually going through the portion of the hypertrophic zone adjacent to the metaphysis. However, the physeal fracture in types 1 and 2 sometimes involved the germinal zone. There may also be microscopic propagation at oblique angles from the primary fracture plane, splitting cell columns apart longitudinally. The cartilage canals supplying the germinal zone appear to be "weak" areas into which the fracture may propagate, especially in infancy. Incomplete type 1 physeal fractures, which cannot be detected by routine radiography, may occur. Types 1, 2, and 4 physeal injuries may be comminuted. In type 3 injuries, discrete segments of physis that include the germinal zone may "adhere" to the metaphysis, separating the cells from their normal vascularity. In types 2 and 3, comminution may occur at the site of fracture redirection from the physis. Direct type 5 crushing of the physeal germinal zone does not occur, even in the presence of significant pressure-related changes within other areas of the epiphysis. Type 7 separation between cartilage and bone at any chondro-osseous epiphyseal interface may occur, but is similarly impossible to diagnose radiographically. In the metaphysis torus, fractures result from plastic deformation of the cortex, coupled with a partial microfracturing that may be difficult to visualize with clinical radiography. Some of the energy absorption may also be transmitted to the physis, causing metaphyseal hemorrhage adjacent to the growth plate and variable microscopic damage within the physis. In the diaphysis, the greenstick fracture is associated with longitudinal tensile failure through the developing osteons of the "intact" cortex. The inability of these failure patterns to "narrow" after the fracture force dissipates is the probable cause of retained bowing (plastic deformation). In both torus and greenstick fractures, the fractured bone ends show micro-splitting through the osteoid seams. In the diaphysis, metaphysis, and epiphyseal ossification center there may be areas of focal hemorrhage and microfracture that correlate with the reported MRI phenomenon of "bone bruising." Again, such injury cannot be diagnosed during routine radiography.
Topics: Animals; Bone Development; Bone and Bones; Cartilage; Child; Child, Preschool; Contusions; Disease Susceptibility; Epiphyses; Fractures, Bone; Fractures, Cartilage; Humans; Infant; Rabbits; Radiography; Rats
PubMed: 8209558
DOI: No ID Found -
Clinical Orthopaedics and Related... May 2021
Topics: Epiphyses; Epiphyses, Slipped; Humans; Rotation; Slipped Capital Femoral Epiphyses
PubMed: 33560677
DOI: 10.1097/CORR.0000000000001656 -
Fa Yi Xue Za Zhi Aug 2016People aged 18 years could be punished lightly or diminished criminal responsibility, even be spared the death sentence, which has important meaning in Chinese... (Review)
Review
People aged 18 years could be punished lightly or diminished criminal responsibility, even be spared the death sentence, which has important meaning in Chinese judicatory adjudication. The epiphysis of long bones from human limbs and the secondary sexual characteristics almost have developed completely before 18 years old. Clavicle epiphysis is one of the articular metaphysis which has a late epiphyseal closure. The recent studies in exploring the rule of clavicle epiphyseal by multi-imaging technology shows that the development of clavicle epiphysis has some value in age estimation of 18 years old. CT, especially thin-section CT, is widely used at present. However, thin-section CT scanning has great net radiation, which is not ethically acceptable if it is not for diagnosis and treatment. MRI is nonradioactive tomographic imaging and easy to evaluate, which is one of the future research directions in forensic age estimation using the medial clavicle. This paper summarizes the progress on the rule of clavicle epiphyseal closure, and analyzes and summarizes the feasibility of rule of clavicle epiphyseal closure applies on age estimation.
Topics: Adolescent; Age Determination by Skeleton; Asian People; Clavicle; Death; Epiphyses; Forensic Anthropology; Humans; Magnetic Resonance Imaging; Osteogenesis; Tomography, X-Ray Computed
PubMed: 29188672
DOI: 10.3969/j.issn.1004-5619.2016.04.011 -
The Malaysian Journal of Pathology Apr 2017The relationship between the activity of the epiphysis and gonads in rats of different sex and age in different seasons of the year was determined by studying the levels...
The relationship between the activity of the epiphysis and gonads in rats of different sex and age in different seasons of the year was determined by studying the levels of melatonin and testosterone in the blood plasma. Determination of the levels of melatonin and testosterone in the serum of rats was carried out by enzyme-linked immunosorbent assay. To assess the relationship between the levels of melatonin and testosterone the correlation coefficient was calculated. Based on the study of the levels of melatonin and testosterone in serum the circannual relationship between the activity of the pineal gland and gonads in males of reproductive age has been determined. In females, the relationship between the levels of melatonin and testosterone without the circannual dependence has been determined. The strongest correlation between melatonin and testosterone is present in males at the age of 9 months in autumn, and it corresponds to the human age of 29-30 years.
Topics: Age Factors; Animals; Epiphyses; Female; Gonads; Humans; Male; Melatonin; Rats; Reproduction; Seasons; Sex Factors
PubMed: 28413204
DOI: No ID Found -
International Journal of Molecular... Jul 2022The cranial base contains a special type of growth plate termed the synchondrosis, which functions as the growth center of the skull. The synchondrosis is composed of...
The cranial base contains a special type of growth plate termed the synchondrosis, which functions as the growth center of the skull. The synchondrosis is composed of bidirectional opposite-facing layers of resting, proliferating, and hypertrophic chondrocytes, and lacks the secondary ossification center. In long bones, the resting zone of the epiphyseal growth plate houses a population of parathyroid hormone-related protein (PTHrP)-expressing chondrocytes that contribute to the formation of columnar chondrocytes. Whether PTHrP chondrocytes in the synchondrosis possess similar functions remains undefined. Using Pthrp-mCherry knock-in mice, we found that PTHrP chondrocytes predominantly occupied the lateral wedge-shaped area of the synchondrosis, unlike those in the femoral growth plate that reside in the resting zone within the epiphysis. In vivo cell-lineage analyses using a tamoxifen-inducible Pthrp-creER line revealed that PTHrP chondrocytes failed to establish columnar chondrocytes in the synchondrosis. Therefore, PTHrP chondrocytes in the synchondrosis do not possess column-forming capabilities, unlike those in the resting zone of the long bone growth plate. These findings support the importance of the secondary ossification center within the long bone epiphysis in establishing the stem cell niche for PTHrP chondrocytes, the absence of which may explain the lack of column-forming capabilities of PTHrP chondrocytes in the cranial base synchondrosis.
Topics: Animals; Cell Differentiation; Chondrocytes; Epiphyses; Growth Plate; Mice; Parathyroid Hormone-Related Protein; Skull Base
PubMed: 35887221
DOI: 10.3390/ijms23147873 -
Schweizer Archiv Fur Tierheilkunde Nov 2021The prevalence of osteochondral changes in the metatarsal growth plates of fattening bulls was investigated. Plantarodorsal radiographic views of the metatarsal region...
The prevalence of osteochondral changes in the metatarsal growth plates of fattening bulls was investigated. Plantarodorsal radiographic views of the metatarsal region of 204 hind legs from 102 slaughtered fattening bulls were taken. Radiographic lesions in metatarsal growth plates were confirmed in selected cases using computed tomography (n=14) and histology (n=6). Radiographic criteria for growth plate lesions were axis deviations between the metatarsal bones and the digit, radiolucencies in the growth plate, increased bone density in the metaphysis, irregularities of the growth plate and marginal osteophytes («lipping»). The individual lesions were categorised as present/absent or 1 = slight, 2 = distinct, and 3 = severe. A weighted sum of these radiographic changes was generated for each growth plate and for each animal, and used for statistical analysis of the associations between husbandry factors and the occurrence of lesions. Almost all of the metatarsal bones had signs of osteochondral changes on the radiographs of the growth plates. The most common lesions were lipping (99,5 %), increased bone density in the metaphysis (66,6 %) and radiolucencies in the growth plates (64,1 %). Computed tomography and histology revealed hyperplasia of the margins of the epiphysis and metaphysis, focal increase in bone deposits accompanied by incomplete ossification and irregular and widened cartilage columns of the growth plate. There were statistically significant associations between the weighted radiographic changes and slaughter weight, average daily weight gain, husbandry practices and production label. The prevalence of radiographic lesions indicative for osteochondrosis of the metatarsal growth plates of fattening bulls slaughtered at a local abattoir was high. The extent to which the distinct and severe lesions are associated with reduced production and obvious clinical lameness requires further study.
Topics: Animals; Cattle; Epiphyses; Growth Plate; Male; Metatarsal Bones; Prevalence; Switzerland
PubMed: 34758948
DOI: 10.17236/sat00322 -
The Journal of Bone and Joint Surgery.... Jan 2011Guiding growth by harnessing the ability of growing bone to undergo plastic deformation is one of the oldest orthopaedic principles. Correction of deformity remains a... (Review)
Review
Guiding growth by harnessing the ability of growing bone to undergo plastic deformation is one of the oldest orthopaedic principles. Correction of deformity remains a major part of the workload for paediatric orthopaedic surgeons and recently, along with developments in limb reconstruction and computer-directed frame correction, there has been renewed interest in surgical methods of physeal manipulation or 'guided growth'. Manipulating natural bone growth to correct a deformity is appealing, as it allows gradual correction by non- or minimally invasive methods. This paper reviews the techniques employed for guided growth in current orthopaedic practice, including the basic science and recent advances underlying mechanical physeal manipulation of both healthy and pathological physes.
Topics: Adolescent; Bone Diseases, Developmental; Child; Child, Preschool; Clubfoot; Epiphyses; Female; Hip Dislocation, Congenital; Humans; Infant; Male; Minimally Invasive Surgical Procedures; Orthopedic Fixation Devices; Radiography; Scoliosis
PubMed: 21196537
DOI: 10.1302/0301-620X.93B1.25181 -
The Pan African Medical Journal 2016This study aims to describe the epidemiological characteristics and the different anatomo-clinical entities of the fracture-separation of the medial clavicular epiphysis... (Review)
Review
This study aims to describe the epidemiological characteristics and the different anatomo-clinical entities of the fracture-separation of the medial clavicular epiphysis but also to relate the morphological and functional results of bloody reduction followed by osteosuture using non absorbable thread. Five boys and one girl (mean age 14 years) showed a closed and isolated shoulder girdle trauma. Clinical examination and medical imaging, especially CT scan, allowed the diagnosis of epiphyseal separation and to classify the degree of medial clavicular epiphysiseal ossification indicating the direction of displacement as well as the nature of displacement according to the Salter-Harris classification. Bloody reduction followed by osteosuture using non absorbable thread (No. 1 decimal) was performed in 3 patients. One patient underwent cross-pinning the two younger patients were treated orthopedically. The displacement of the clavicle stump was anterior in 3 patients and retro-sternal in 3 patients. Posterior forms were complicated by odynophagia (n = 2) and asymptomatic compression of the subclavian vein (n = 1). One of the posterior forms was associated with an ipsilateral fracture of the medial one third of the clavicle. Consolidation was achieved in all patients with preservation of shoulder mobility. The fracture-separation of the medial end of the clavicle mimes clinically and radiologically the sternoclavicular dislocation. It can be serious because of the risk of visceral and vascular compression in its posterior form. Tomdensitometry is irreplaceable for an accurate diagnosis. Our preference is for bloody reduction followed by osteosuture using non metallic thread.
Topics: Adolescent; Child, Preschool; Clavicle; Epiphyses; Female; Fracture Fixation, Internal; Fractures, Bone; Humans; Infant, Newborn; Joint Dislocations; Male; Sternoclavicular Joint; Suture Techniques; Tomography, X-Ray Computed; Young Adult
PubMed: 28154711
DOI: 10.11604/pamj.2016.25.19.8787