Особливості клініко-рентгенологічного перебігу різних форм фіброзної дисплазії

Abstract

The aim of the study: to improve the diagnosis of forms of fibrous dysplasia by investigating clinical and radiological features, depending on the disease form, age and sex of the patient. Materials and methods. The research was conducted by analyzing results of examination and treatment of 80 patients with different forms of fibrous dysplasia at Kyiv Institute of Traumatology and Orthopedics by NAMS of Ukraine from 2000 to 2019. The diagnosis was made on the basis of studying features of the medical history of the disease, its clinical course and radiological examination method. There were 56 patients with monoosal disorder, 14 with polyosal, and 10 with Albright syndrome. Clinical-radiological method of the research was used to clarify the diagnosis of the disease and to study features of the disease. The radiological examination was performed on the Multix UP in the department of functional diagnostics «ITO NAMSU» according to the standard technique in direct posterior and lateral projections with capture of adjacent joints. Localization, volume of lesion and condition of cortical layer at pathological dysplastic process of long bones of lower extremities were evaluated. Results . The article specifies clinical-radiological features revealed in various forms of fibrous dysplasia and shows that pathological fractures of the long bones and their deformation depend on the form of the disease, age and sex of patients. The incidence of pathological fractures of long bones of lower extremities was determined depending on the localization, form of the disease and sex of patients with different forms of fibrous dysplasia: femur – 72.3% (proximal part – 76.7%); tibia bones – 27.3% (diaphyseal part – 78.3%); it was found that the number of fractures was significantly greater (49.4%) with the monoosal form of fibrous dysplasia than with the polyosal form (30.1%, p<0.05) and Albright syndrome (20.5%, p<0,5); in males with monoosal form and Albright syndrome, the number of fractures was significantly greater (p<0.05) than in females. Conclusions . Features of the course of clinical and radiological manifestations depending on the form of the disease, age and sex of the patient have been covered in the article, which will allow reducing and eliminating diagnostic errors related to this pathology and create a basis for improvement of the system of orthopedic treatment of this nosology. The research was conducted in accordance with principles of the Declaration of Helsinki. The research protocol was approved by institution’s Local Ethics Committee. Informed consent was obtained from parents of children (or their guardians) for the research.