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Arthroplasty Today Aug 2022Patients with hereditary multiple exostosis develop several benign osseocartilaginous bulge lesions throughout the body. A 62-year-old woman presented for evaluation of... (Review)
Review
Patients with hereditary multiple exostosis develop several benign osseocartilaginous bulge lesions throughout the body. A 62-year-old woman presented for evaluation of worsening left knee valgus deformity, and left knee pain. She had been diagnosed with hereditary multiple exostosis at the age of 12 years. Radiographic evaluation of the left knee revealed exostoses that caused continuous bulges from cortical bone at the metaphyseal regions of the femur and tibia as well as extra-articular deformity. We used patient-specific instrumentation to indicate the direction of the stem into curved metaphyseal bone regions and then corrected the patient's left knee deformity by performing total knee arthroplasty with titanium-constrained prostheses. Soft tissue release was performed with only complete iliotibial band release at a minimum, and stability was obtained.
PubMed: 35789783
DOI: 10.1016/j.artd.2022.04.017 -
Korean Journal of Radiology 2002To evaluate the radiographic and MR appearance of idiopathic synovial osteochondromatosis of the hip.
OBJECTIVE
To evaluate the radiographic and MR appearance of idiopathic synovial osteochondromatosis of the hip.
MATERIALS AND METHODS
Radiographs and MR images of 15 patients with idiopathic synovial osteochondromatosis of the hip were assessed. The former were analysed in terms of the presence of 1) juxta-articular calcified and/ or ossified bodies, 2) osteophytes, 3) bone erosion, 4) juxta-articular osteopenia, and 5) joint space narrowing, while for the latter, analysis focused on 1) the configuration of intra-articular bodies, 2) bone erosion, 3) synovial thickening, 4) conglomeration of intra-articular bodies, and 5) extra-articular extension.
RESULTS
At hip radiography, juxta-articular calcified and/ or ossified bodies were seen in 12 of the 15 patients (80%), bone erosion in eight (53%), osteophytes in seven (47%), juxta-articular osteopenia in five (33%) and joint space narrowing in five (33%). In eight patients (53%), MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, and areas of isointensity at T1WI and hyperintensity at T2WI. In three (20%), intra-articular bodies of focal low signal intensity and areas of hyperintensity at all pulse sequences were observed, with areas of iso-intensity at T1WI and hyperintensity at T2WI, while in four (27%), intra-articular bodies of only focal low signal intensity at all pulse sequences were apparent. Synovial thickening was present in 13 patients (87%), bone erosion in 11 (73%), conglomeration of the intra-articular bodies in 11 (73%), and an extra-articular herniation sac in six (40%).
CONCLUSION
The most common radiographic finding of synovial osteochondromatosis of the hip was the presence of juxta-articular calcified and/ or ossified bodies. MR imaging depicted intra-articular bodies of focal low signal intensity at all pulse sequences, with areas of iso-intensity at T1WI and hyperintensity at T2WI. In addition, the presence of an extra-articular herniation sac was not uncommon.
Topics: Adult; Chondromatosis, Synovial; Female; Hip Joint; Humans; Magnetic Resonance Imaging; Male; Radiography
PubMed: 12514343
DOI: 10.3348/kjr.2002.3.4.254 -
Diagnostic and Interventional Imaging Apr 2013Cartilaginous tumours of the extremities are commonly seen in radiographs. Enchondroma is the most frequently encountered tumour. Since the vast majority of enchondromas... (Review)
Review
Cartilaginous tumours of the extremities are commonly seen in radiographs. Enchondroma is the most frequently encountered tumour. Since the vast majority of enchondromas are asymptomatic, they are typically discovered as incidental findings or along with a pathologic fracture. The authors propose a pictorial review to illustrate the imaging features of cartilaginous bone lesions of the hand and their specificities, and discuss the main differential diagnoses.
Topics: Bone Neoplasms; Calcinosis; Cartilage; Chondroma; Chondrosarcoma; Diagnosis, Differential; Enchondromatosis; Finger Phalanges; Fractures, Spontaneous; Gout; Hand Bones; Humans; Magnetic Resonance Imaging; Osteochondromatosis; Periosteum; Tomography, X-Ray Computed
PubMed: 23478067
DOI: 10.1016/j.diii.2013.01.012 -
BMJ Case Reports Sep 2021Ischiofemoral impingement (IFI) has been described in the medical literature as a cause of hip pain. IFI occurs due to an abnormal contact or reduced space between the...
Ischiofemoral impingement (IFI) has been described in the medical literature as a cause of hip pain. IFI occurs due to an abnormal contact or reduced space between the lesser trochanter and the lateral border of the ischium and is an often unrecognised cause of pain and snapping in the hip. Association of multiple exostoses and a skeletal dysplasia characterised by an abnormal modelling of bone metaphysis and osseous deformities is highly characteristic of this disease. Consequently, multiple exostoses may narrow the ischiofemoral space and cause impingement and pain, even in the absence of malignant transformation. Surgical excision of exostosis of the lesser trochanter is a safe and effective method of treatment for patients with IFI. We present a case of left hip pain with incidental finding of hereditary multiple osteochondroma causing IFI and discuss the predisposing factors and review of literature.
Topics: Adult; Bone Neoplasms; Exostoses, Multiple Hereditary; Femoracetabular Impingement; Hip Joint; Humans; Incidental Findings; Ischium
PubMed: 34518173
DOI: 10.1136/bcr-2021-241840 -
BMC Musculoskeletal Disorders Feb 2021This study aimed to investigate the characteristic deformities of the hip in multiple hereditary exostoses patients (MHE) and its association with the hip impingement...
BACKGROUNDS
This study aimed to investigate the characteristic deformities of the hip in multiple hereditary exostoses patients (MHE) and its association with the hip impingement syndrome.
MATERIALS AND METHODS
Between 2001 and 2019, total 51 patients (102 hips) were evaluated in this study. Patients with MHE were classified to femoro-acetabular impingement (FAI) symptom group, ischio-femoral impingement (IFI) symptom group and non-impingement symptom group by comparing the symptoms, clinical signs and imaging studies. To assess the morphometry of the hip in patients with MHE, the femoral neck-shaft angle, Sharp's acetabular angle and center-edge (CE) angle were evaluated. Alpha angle was further evaluated to investigate the FAI using radiographs, and the minimum ischio-femoral distance was further measured to investigate the IFI using computed-tomographic (CT) study.
RESULTS
On hip impingement symptom analysis, FAI symptom and IFI symptom were confirmed in 14 hip joints and 18 hip joints, respectively. Unlike general population, the number of the hip with IFI-symptom was higher than those with FAI symptom in this study. In morphometric evaluation of MHE hips, coxa valga was most prominent deformity with occasional tendency of mild acetabular dysplasia. In a comparison of morphometric study between the impingement symptom group and non-symptom group, the FAI symptom showed significant differences of morphometric measure values than those of the non-symptom group (FAI symptom group vs. Non-FAI symptom group; Femoral neck-shaft angle (153.9 vs 142.6), Sharp's angle (45.0 vs 41.5), CE angle (21.1 vs 28.8) and alpha angle (76.7 vs 57.9)). Similarly, the IFI symptom group also showed significant differences of morphometric measure values than those of the non-symptom group (IFI-symptom vs. Non-IFI symptom; Femoral neck-shaft angle (150.9 vs 142.7), Sharp's angle (44.7 vs 41.4), CE angle (21.1 vs 29.3) and alpha angle (73.3 vs 56.8)). In addition, the minimum ischio-femoral distance measured using CT was significantly decreased in the IFI symptom group (IFI symptom group: 6.6, Non-IFI symptom group: 16.4).
CONCLUSION
The results suggest that the characteristic deformities represented by coxa valga in the MHE hip act as an offset for FAI symptoms, on the contrary, act as a trigger for IFI symptoms.
LEVEL OF EVIDENCE
Level III.
Topics: Exostoses, Multiple Hereditary; Femoracetabular Impingement; Hip Dislocation; Hip Dislocation, Congenital; Hip Joint; Humans
PubMed: 33549073
DOI: 10.1186/s12891-021-04021-1 -
Anales de Pediatria (Barcelona, Spain :... Nov 2006
Topics: Child; Exostoses, Multiple Hereditary; Humans; Male; Pedigree
PubMed: 17184612
DOI: 10.1157/13094252 -
Boletin Medico Del Hospital Infantil de... 2016Multiple hereditary osteochondromatosis is characterized by the growing of benign cartilaginous tumors in form of exostosis, predominately in the metaphysis of long...
BACKGROUND
Multiple hereditary osteochondromatosis is characterized by the growing of benign cartilaginous tumors in form of exostosis, predominately in the metaphysis of long bones. It is described with a prevalence of 1/50,000 individuals.
CASE REPORTS
This article presents the clinical information and its autosomal dominant inheritance pattern where exotoxin genes (EXT gene family) were affected in a three-member family with multiple hereditary osteochondromatosis. The three patients showed altered arcs of movement of wrists, shoulders and ankles. Clinical diagnosis was confirmed with radiology and malignancy was ruled out in all patients.
CONCLUSIONS
This disease requires frequent medical evaluation, surgical bone correction when the normal function is involved, surveillance for malignant transformation, and genetic counseling.
PubMed: 29421192
DOI: 10.1016/j.bmhimx.2015.11.008 -
Journal of Orthopaedic Surgery (Hong... Jan 2017Surgical dislocation of the hip remains an important alternative in hip preservation surgery, especially when a dynamic access to the hip is needed and arthroscopy is...
BACKGROUND
Surgical dislocation of the hip remains an important alternative in hip preservation surgery, especially when a dynamic access to the hip is needed and arthroscopy is not a suitable option. We describe a novel technique for operative dislocation of the hip without trochanteric osteotomy and the clinical results of our patients.
METHODS
Surgical dislocation of the hip without trochanteric osteotomy was done through a modified lateral approach in all of the cases. A review of demographic, clinical, and radiological data was done in all of the patients operated with this technique between 2010 and 2015. Complications, walking aids, weight-bearing status, and modified Harris Hip Score (mHHS) were also recorded.
RESULTS
Six surgical dislocations of the hip were carried out. Indications were tumor resection in five and bulletectomy in one hip. There were two women (four hips) and two men. Mean age was 19 ± 3.8 years. Median follow-up was 2.5 years (range 2-4.5 years). Median mHHS was 92 (90-96). There were no intraoperative nor postoperative complications.
CONCLUSIONS
Surgical dislocation of the hip without trochanteric osteotomy through a modified lateral approach appears to be a safe, simpler, and effective alternative.
Topics: Adolescent; Adult; Arthroplasty; Bone Neoplasms; Cohort Studies; Exostoses, Multiple Hereditary; Female; Femur Head; Giant Cell Tumor of Bone; Hip Dislocation; Hip Fractures; Humans; Male; Middle Aged; Osteotomy; Treatment Outcome; Young Adult
PubMed: 29185379
DOI: 10.1177/2309499016684414 -
Medicina 2014
Topics: Child; Exostoses, Multiple Hereditary; Humans; Male; Radiography
PubMed: 24736254
DOI: No ID Found -
Orthopaedics & Traumatology, Surgery &... Oct 2022Spinal osteochondroma (or exostosis) is a rare benign tumour whose clinical manifestations are delayed due to their slow growth and location. Few studies have addressed... (Observational Study)
Observational Study
BACKGROUND
Spinal osteochondroma (or exostosis) is a rare benign tumour whose clinical manifestations are delayed due to their slow growth and location. Few studies have addressed the characteristics and the diagnostic and therapeutic peculiarities of spinal osteochondroma in children. The objective of this multicentre observational study was to assess the outcomes of a cohort of children after surgery for spinal osteochondroma.
HYPOTHESIS
Surgical excision of spinal osteochondroma in children is not followed by complications or recurrences.
MATERIAL AND METHODS
We included consecutive children who had surgery between 2010 and 2018 at any of eight participating centres to remove spinal osteochondromas. The cause, clinical manifestations, and location of the lesions were collected. The surgical outcomes were evaluated after at least 2 years' follow-up.
RESULTS
We identified 22 patients who had surgery to remove 26 spinal osteochondromas at a mean age of 12.8±2.6 years. Among them, 7 had a solitary osteochondroma (SO group) and 15 had hereditary multiple osteochondromas (HMO group). At diagnosis, 72% of patients had clinical signs (spinal pain, n=4; one or more lumps, n=5; and neurological manifestations, n=3). In the HMO group, the diagnosis was made during routine MRI screening for tumours involving the spinal canal. Most osteochondromas involved the cervical spine (n=13), with no difference between the two groups (p=0.9). The lamina was the most common location but 54% of the tumours were growing within the canal (92% in the HMO group). After a mean follow-up of 5.2±4.4 years, no patients had experienced any recurrences or complications related to the disease or treatment.
DISCUSSION
Surgical excision of spinal osteochondromas in children is effective, with no medium-term recurrences. Our results also confirm the low peri-operative morbidity, even when the canal is involved, and the absence of any effect at last follow-up on spinal alignment. All patients with neurological manifestations at diagnosis made a full recovery.
LEVEL OF EVIDENCE
IV, retrospective observational cohort study.
Topics: Adolescent; Cervical Vertebrae; Child; Humans; Osteochondroma; Retrospective Studies; Spinal Neoplasms; Treatment Outcome
PubMed: 35150927
DOI: 10.1016/j.otsr.2022.103239