Epiphyseal Lesions Research Articles

Intra-osseous ganglion. Report of four cases and review of the literature.

Intraosseous ganglia are histologically identical to their soft tissue counterparts. Most commonly seen adjacent to the hip, ankles, knee, or wrist, they are often mistaken for other neoplasms occurring in the epiphysis. We discuss the characteristic clinical, radiological, and pathologic features of four cases of intraosseous ganglia. Intraosseous ganglia should be included in the differential diagnosis of well-demarcated lucent epiphyseal lesions of bone.

Epiphyseal lesions of the femur and tibia in rats following oral chronic administration of zinc dimethyldithiocarbamate (ziram)

A 24-month chronic feeding toxicity study with zinc dimethyldithiocarbamate (ziram) was performed on Fischer 344 rats of both sexes (80 animals/sex per group) at dietary levels of 0, 20, 200, or 2000 ppm. Eight animals of either sex from each group were sacrificed after 26, 52 and 78 weeks, and all surviving animals were killed after 104 weeks. Epiphyseal abnormalities in the long bones of the hind legs were observed in both sexes at 2000 ppm. Clinically, 3 male rats showed partial paralysis of the hind legs. At necropsy, marked curvature of the proximal end of the crus which could cause a restricted extension of the tibio-femoral joint was seen in 11 of 34 males killed at terminal sacrifice. While females had either clinical signs nor gross abnormalities during the study, histopathological examination revealed retarded epiphyseal closure of the proximal end of the tibia in both sexes. Females also showed the epiphyseal lesion at the distal end of the femur. In severely affected rats marked proliferation of epiphyseal cartilaginous. tissue was also noted together with the irregular arrangement of chondrocytes. These changes were evident only in aged animals. The incidence of the lesions in all males and females examined in this group was 22 77 (29%) and 13 73 (18%), respectively. The occurence of the lesions appeared to be caused by impaired regulation of epiphyseal closure which moght be related to the treatment with ziram.

Solitary lucent epiphyseal lesions in children.

We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. Forty percent of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyxoid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

The site of focal osteomyelitis lesions in foals.

The long bone ends of foals with infectious disease were sawn into sagittal slabs, washed and inspected. Tissue suspected to be abnormal on the basis of change of colour and consistency was radiographed, and then decalcified and examined histologically. The exact site of 140 focal osteomyelitis lesions from 18 foals was determined. There were more lesions in the epiphysis than the metaphysis. Epiphyseal lesions were in specific sites within a given epiphysis, and in most epiphyses the lesions were at the site of thickest cartilage. Metaphyseal lesions in the metacarpal, metatarsal and distal radial growth plates tended to be on the more inclined parts of the growth plate.

Limited Posterolateral Surgical Approach to the Knee for Excision of Osteoid Osteoma

An 18-year-old man suffered four years of undiagnosed knee pain until a CAT scan revealed an epiphyseal osteoid osteoma of the tibia located subchondrally, just medial to the proximal tibiofibular joint. A nidus in this location is not easily accessible, and its proximity to the joint surface raised concerns about damage to the tibial plateau. To facilitate excision of the tumor, cadaveric dissections were performed to develop a limited posterior approach to the proximal, lateral portion of the tibia. The CAT scan was used to calculate the precise dimensions of the tumor and its relation to the posterior tibial cortex and the proximal tibiofibular joint. With the use of the exposure developed in the laboratory and the calculations derived from the CAT scan, the tumor could be excised by removing a single block of bone 15 mm3. Intraoperative radiographs confirmed the presence of the nidus within the excised block of bone. This case report reaffirms the frequent difficulties and tardiness in diagnosing osteoid osteomas and the need to include these tumors in the differential diagnosis of knee pain and epiphyseal lesions. Before CAT scans were used, the working diagnoses were torn meniscus, juvenile rheumatoid arthritis, and bone hemangiomatosis.

Classification of ankle fractures in children

The roentgenograms of 310 children treated for ankle fractures were evaluated for grouping according to the classifications of Ashhurst-Bromer-Weber, Lauge-Hansen, and Salter-Harris. The mean age of the children at the time of injury was 11.1 years (range 2-14 years). Two hundred twenty-one (71.3%) children had malleolar fractures, 71 (22.9%) had tibial epiphyseal fractures, and 18 (5.8%) had syndesmotic lesions. The age distribution of fractures was typical: malleolar fractures predominated among the younger children, epiphyseal fractures among the older. Only the oldest children had avulsion fractures of the syndesmosis. Grouping of the fractures according to Lauge-Hansen and Ashhurst-Bromer-Weber, classifications suited to adults was largely unsuccessful. Epiphyseal fractures, moreover, were easily classified according to Salter-Harris. In spite of their complexity, ankle fractures in children can be roughly divided into avulsional and epiphyseal fractures. Adequately reduced avulsional fractures can be expected to heal well; epiphyseal fractures, however, may five rise to late complications. We propose, therefore, that ankle fractures in children be classified on the basis of roentgenological findings with respect primarily to epiphyseal lesions as well as on an additional simple grouping as to risk for clinical purposes: Group I, low risk, avulsional fractures and epiphyseal separations; Group II, high risk, fractures through the epiphyseal plate.

The effect of Solanum malacoxylon on rachitic bone lesions in the rat

The plant Solanum malacoxylon (S.M.) is known to cause severe soft tissue calcifications in cattle and sheep and has recently become of special interest since it exerts biological actions which resemble those of vitamin D. In order to investigate whether S.M. is capable to improve the rachitic bone changes in vitamin D and phosphate deficient rats, a watery extract of 50, 100 and 200 mg S.M. was fed daily to these animals over a period of 10 days. The width of epiphyseal plates was compared after the time with those of rats treates with 0, 0.225, 0.45, and 0.9 IU of vitamin D3 daily. There was a dose related curative effect of S.M. on the epiphyseal lesions very similar to that of vitamin D3. The hypercalcemic and hyperphosphatemic effect of S.M. was identical to that of vitamin D3. The 25-hydroxy-vitamin D serum levels remained almost undetectable in the S.M. treated rats as well as in the vitamin D3 treated animals.

Mobile Mass in a Pulmonary Cavity or Air Meniscus Sign

In introducing the Gamut 1,2 as a regular feature ofTopics in Radiology, it is hoped that each case will prove challenging to the radiologist and clinician alike, since only by working together can the correct diagnosis be established in difficult cases. The gamut approach to roentgenographic diagnosis rests on the following triangulation concept. Successful roentgenographic interpretation begins with a detailed analysis of all the indexes of disturbed morphology and pathophysiology seen on the roentgenogram. The radiologist can usually fit the visualized abnormalities into a specific pattern of disturbed morphology, such as honeycomb lung, bull's-eye lesion of the gastrointestinal tract, or solitary epiphyseal lesion of bone. For each pattern there is a specific gamut or comprehensive list of differential possibilities. This list can be narrowed to one or several reasonable possibilities for a given patient, based on age, symptoms, and knowledge of pertinent clinical and laboratory data

Lesions of the epiphyses

Disturbances of the epiphyses result from many causes other than trauma. As much or more information can be obtained from the radiologic appearance of a joint as can be obtained from metabolism studies in certain endocrine disorders. Skeletal disturbances characterize retardation phenomena such as are found in dyschrondroplasia. Much can be gained by studying the normal joint appearance before one attempts to treat epiphyseal lesions.

EXPERIMENTAL SYPHILIS IN THE RABBIT

A systematic study was made of the affections of bone, cartilage, tendons, and synovial membranes which occurred in a series of rabbits with generalized syphilis. Localized infection of this group of structures was found to be of very frequent occurrence. The parts involved were, in the order of their frequency, the facial and cranial bones and cartilages, the bones, tendons, and joints of the feet and legs, the cervical and caudal vertebrae, the ribs, and the sternum. These infections often gave rise to characteristic manifestations of disease which could be detected without difficulty by inspection or palpation of the part. In many instances, however, clinical manifestations were so slight that the presence of lesions could be detected only by radiographic or pathological examination. Detailed descriptions of various clinical types of disease were given and the clinical manifestations correlated with the pathological process. It was pointed out that bone lesions exhibited a decided predilection for certain exposed bony prominences, for lines of bony union, and for epiphyseal lines in particular. A study of the clinical history of bone lesions brought out the fact that they were among the earliest of the generalized forms of disease; they tended to pursue a comparatively rapid course, and relapse was never observed. Especial emphasis was laid upon three aspects of the experimental infection: the analogy existing between certain forms of the animal and human affections, the relation of syphilis of the osseous system to other evidences of disease, and the occurrence of obscure bone lesions. In this connection, it was pointed out that the nasal and epiphyseal lesions of the rabbit presented a striking analogy to those of congenital syphilis in man. It was also pointed out that syphilis of the osseous system occupied a definite position in the scheme of defensive reactions such that lesions of these tissues might be favored or inhibited according to the experimental conditions employed. Finally, the frequency with which infections occurred which were not accompanied by sufficiently distinctive signs even to suggest the possibility of their existence was interpreted as evidence that some cases of latent or obscure infection in man might find their explanation in the presence of a similar group of affections.