Cortical Breaks Research Articles

AB1303 Ability of ultrasound in B mode and PD (PDUS) to detect erosions in mechanically strained area in healthy individuals (HI) and rheumatoid arthritis (RA): Comparison with micro computed tomography scan (μCT)

BackgroundBoth clinical studies and practice require exact detection of bone erosions in RA patients. Yet especially in mechanically strained areas such as the wrist (WR) and the metatarsophalangeal joints (MTPJ)...

AB1302 Evaluation of physiological and abnormal cortical breaks in healthy individuals (HI) and rheumatoid arthritis (RA) patients by ultrasound in B-and PD-mode (PDUS) in comparison with micro computed tomography scan (μCT)

BackgroundAccurate detection of bone erosions in RA patients is important both for clinical studies and practice. US has been demonstrated to be more sensitive than x rays for detecting erosions.(1)Yet...

SAT0386 The structural basis of MRI bone erosions- an assessment by micro computed tomography

BackgroundMicro-CT (μCT) allows to directly measure the volume of individual erosions and thus exactly defines the extent of structural damage. Based on our experience with high resolution μCT scanning we...

The structural basis of MRI bone erosions: an assessment by microCT

ObjectiveTo determine whether erosions appearing in MRI in patients with rheumatoid arthritis (RA) represent true erosions.Methods50 RA patients received 1.5 T MRI and microCT (μCT) of the dominant hand. Erosion...

Intra-Osseous Lipoma of the Talus: A Case Report

Intra-osseous lipomas are rare benign tumours. We report one such case in the talus of a 60-year-old man. The patient underwent curettage and bone grafting. At the 22-month follow-up, radiographs of the talus showed dense sclerosis with multiple cortical breaks in the anterior process and no evidence of local recurrence or avascular necrosis. The patient had a painless ankle joint with normal range of movement.

A detailed comparative study of high‐resolution ultrasound and micro–computed tomography for detection of arthritic bone erosions

To test whether bony lesions appearing on ultrasound (US) imaging are cortical breaks detectable by micro-computed tomography (micro-CT). Twenty-six subjects (14 with rheumatoid arthritis, 6 with psoriatic arthritis, and 6 healthy controls) were assessed for bone erosions at the radial, palmar, and dorsal regions of the second metacarpophalangeal (MCP) joint and the palmar and dorsal regions of the third and fourth MCP joints. All patients underwent US and, for validation of the results, micro-CT scanning. The prevalence and severity of bone erosions as determined by US and by micro-CT were recorded and compared. Overall there was a good correlation between the severity of erosions as assessed by US and by micro-CT (r = 0.463, P < 0.0001). False-negative results (US negative/micro-CT positive) were obtained in only 9.9% of the joint regions and were mostly due to small erosive lesions at the dorsal sides of the MCP joints. False-positive results (US positive/micro-CT negative) were more frequent (28.6%) and were primarily based on vascular bone channels at the palmar sides of the MCP joints as well pseudo-erosions created by osteophytes. These data show that the majority of bone lesions appearing on US are indeed bone erosions with a cortical break. The sensitivity of US for detecting bone erosions was high and there was a good correlation between the severity of bone erosions as assessed by US and as assessed by micro-CT. Specificity of US for bone erosions was substantially lower, suggesting that smaller lesions seen on US do not always represent breaks in the cortical bone surface.

Periarticular bone structure in rheumatoid arthritis patients and healthy individuals assessed by high‐resolution computed tomography

To define the nature of structural bone changes in patients with rheumatoid arthritis (RA) compared with those in healthy individuals by using the novel technique of high-resolution microfocal computed tomography (micro-CT). Fifty-eight RA patients and 30 healthy individuals underwent a micro-CT scan of the proximal wrist and metacarpophalangeal joints. Bone lesions such as cortical breaks, osteophytes, and surface changes were quantified on 2-dimensional (2-D) slices as well as by using 3-D reconstruction images, and exact localization of lesions was recorded. Micro-CT scans could detect bone lesions <0.5 mm in width or depth. Small erosions could be observed in healthy individuals and RA patients, whereas lesions >1.9 mm in diameter were highly specific for RA. Cortical breaks were mostly found along the radial sites of the metacarpal heads. No significant difference in the presence of osteophytes between healthy individuals and RA patients was found. Cortical surface changes, presumably cortical thinning and fenestration, became evident from 3-D reconstructions and were more pronounced in RA patients. Micro-CT allows exact detection of morphologic changes of juxtaarticular bone in healthy individuals and RA patients. Even healthy individuals occasionally show bone changes, but the severity of these lesions, with the exception of osteophytes, is greater in RA patients. Thus, micro-CT allows accurate differentiation among physiologic bone changes in joints and among types of pathologic bone damage resulting from RA.

Solitary enchondromas of long bones: pattern of referral and outcome

Enchondromas are benign cartilaginous tumors, often found incidentally and diagnosed by the radiographic appearance. Active growing enchondromas/low grade chondrosarcomas are diagnosed by clinical symptoms and possibly an aggressive appearance on the radiographs. This study aimed to answer the following questions: Who requests a referral? The radiologist reporting a possibility of sarcoma or the referring physician? What is the outcome of these patients? We retrospectively reviewed the medical records of 115 patients with final diagnosis of enchondroma over three consecutive years and recorded the radiological diagnosis on report, patients' symptoms, our initial diagnosis, follow-up, and any decision for a biopsy/surgical management, as well as the histological final diagnosis. Nearly 80% of patients were referred from an orthopedic surgeon. About half of the imaging reports mentioned a malignancy in the differential diagnosis of enchondroma. Very few had the classic signs of an aggressive/growing cartilage tumor. In radiological evaluation, we found scalloping/cortical erosion, lytic areas, cortical breaks, soft tissue extension in only 12 cases of which 8 underwent a biopsy. Of the study patients, 65% were diagnosed with adjacent joint problems. Enchondromas are mostly diagnosed incidentally. They are frequently associated with adjacent joint or soft tissue pathologies, which are main source of the symptoms. Even small, well-defined lesions are often confused with a sarcoma or other malignancies, which may be due to the lack of education on bone tumors for both the radiologists and general orthopedists.

Drop out: a third chromosome maternal-effect locus required for formation of the Drosophila cellular blastoderm.

drop out (dop) is a recessive maternal-effect locus identified in a screen for female-sterile mutations in Drosophila polytene region 71C-F. Phenotypic analyses of the dop mutation indicate that the gene is required for proper formation of the cellular blastoderm. In embryos derived from either homozygous or hemizygous dop mothers, cytoplasmic clearing, nuclear migration and division, and pole cell formation appear normal. However, developmental defects are observed prior to and during cellularization of the blastoderm. At the beginning of nuclear cycle 14, the distinct separation of the internal yolk mass and the cortical cytoplasm breaks down. Subsequently, a population of somatic nuclei located at the periphery of the syncytial blastoderm becomes irregularly spaced and nonuniform in their distribution. Despite a somewhat regular formation of the cortical actin network, cellularization in mutant embryos is extremely variable. Such embryos fail to gastrulate normally and produce variable amounts of defective cuticle. Overall, our analyses suggest that the dop gene functions in maintaining the separation of yolk and cortical cytoplasm and in stabilizing the distribution of somatic nuclei in the Drosophila syncytial blastoderm.