Epiphyses Of Long Bones Research Articles

Multiscale design of artificial bones with biomimetic elastic microstructures

Cancellous bone is a highly porous, heterogeneous, and anisotropic material which can be found at the epiphyses of long bones and in the vertebral bodies. The hierarchical architecture makes cancellous bone a prime example of a lightweight natural material that combines strength with toughness. Better understanding the mechanics of cancellous bone is of interest for the diagnosis of bone diseases, the evaluation of the risk of fracture, and for the design of artificial bones and bone scaffolds for tissue engineering. A multiscale optimization method to maximize the stiffness of artificial bones using biomimetic cellular microstructures described by a finite set of geometrical micro-parameters is presented here. The most outstanding characteristics of its implementation are the use of: an interior point optimization algorithm, a precalculated response surface methodology for the evaluation of the elastic tensor of the microstructure as an analytical function of the micro-parameters, and the adjoint method for the computation of the sensitivity of the macroscopic mechanical response to the variation of the micro-parameters. The performance and effectiveness of the tool are evaluated by solving a problem that consists in finding the optimal distribution of the microstructures for a proximal end of a femur subjected to physiological loads. Two strategies for the specification of the solid volume fraction constraints are assessed. The results are compared with data of a computed tomography study of an actual human bone. The model successfully predicts the main features of the spatial arrangement of the trabecular and cortical microstructures of the natural bone.

Chondroblastoma of lower end of radius: A case report

Chondroblastoma is a tumor occurring in the epiphyses of long bones on immature skeletons commonly. Chondroblastoms of metaphysis leading to loss of Physeal activity is very rare finding leading shortening. We present a rare case of Chondroblastoma of the lower end radius metaphysis treated by curettage and bone grafting followed by ulnar shortening done after 2 years of follow up. It was concluded at early detection and prompt treatment lead of reduced need for repeated surgeries.

Clinical outcomes of chondroblastoma treated using synthetic bone substitute: risk factors for developing radiographic joint degeneration

BackgroundChondroblastoma (CB) is a rare locally aggressive bone tumor that commonly occurs in the epiphysis or apophysis of long bones. Although surgical treatment of CB carries potential risk for physeal or articular cartilage damage, risk factors for joint degeneration have not been well described. In addition, we have mainly used synthetic bone substitute (SBS) to fill the bone defect after intralesional curettage as treatment for CB. This study thus aimed to evaluate the incidence of and risk factors for adjacent-joint radiographic degeneration after SBS treatment for CB.MethodsWe retrospectively reviewed 48 patients treated for CB at our institutions between 1996 and 2017. Clinical data, radiographic images, treatments, and local recurrence were analyzed.ResultsWe identified 40 patients [29 males and 11 females with a mean age of 19 years (range, 8–35 years)] who received SBS to fill the defect after curettage with a minimum follow-up of 1 year. The mean follow-up period was 71 months (range, 13–239 months). A total of 8 patients (20%) developed local recurrence. Radiographic analysis showed that 5 patients (16.7%) developed radiographic joint degeneration. Joint degeneration was significantly associated with the affected joint (p = 0.004).ConclusionsCurettage and SBS filling had been found to be a reasonable treatment method for CB, which commonly occurs in the epiphysis or apophysis. Radiographic joint degeneration was not uncommon after CB treatment, especially in the talus and proximal humerus.

Giant cell tumor of the cervico-dorsal junction with compressive myelopathy: A rare presentation with review of literature

Giant cell tumor (GCT) of bone, although benign in its nature, is aggressive in its course. It has a predilection for the epiphysis of long bones. Although it can affect any vertebra in the body, it has propensity to affect the fixed spine more than the mobile segments. It occurs infrequently above the sacrum, and involvement of the cervical spine is still rarer. However, sparse case reports of upper cervical spine GCT have been reported in literature. We report a case of GCT involving the C7 and D1 vertebrae in a 50-year-old woman who presented with the features of compressive myelopathy. She underwent corpectomy of C7–D1 with cage fixation and cervical plating via an anterior approach. The patient showed significant neurological improvement postoperatively.

Case report of giant cell tumor of proximal tibia-managed in a rural tertiary care hospital

Giant cell tumour is seen in 4% of all bone tumours and it constitutes approximately 10% of all malignant bone tumours. Preponderance is greatest between the age groups of 20 to 55 years. It is more common in females than in males [1, 2]. Tumour is known to have high post excision recurrence rate & its activity ranges from borderline to malignant lesion. It is a locally aggressive destructive lesion. Since tumour has high recurrence rates after it is treated by combination of various modalities available to reduce the recurrence rates. Tumours treated with multiple modalities have proven to have a lower recurrence rate than those tumours treated with single modalities [3, 4]. Tumour arises from the epiphyses of long bones. Most common sites are proximal tibia, distal femur, and distal radius. Radiographically, these tumours are often seen as an expansile exophytic mass. Following the multiple treatment modality in the management of Giant cell tumours, this is one case scenario.

Large giant cell tumor of the posterior iliac bone – an atypical location. A case report and literature review

Giant cell tumor (GCT) is a locally aggressive tumor but with benignity features, representing approximately 18% of non-malignant bone tumors in European countries, with slight female predominance. Malignancy in GCT is rare, about <2% of cases and is more common at older ages. Is known that usually occurs at the epiphyses of long bones, but extremely rare may have another location, such as the pelvic bone. An atypical location – the posterior iliac bone, found at a 34-year-old male –, is the case report we studied and described. Starting from the patient’s complains, like a mass in the left buttock region described as “recently appeared”, firm, not-mobile, with no distinctive borders and no tenderness at palpation, and a recent history trauma, multiple investigations have been performed, which have highlighted an osteolytic lesion, close to the sacroiliac joint, only with infiltration of the gluteal, iliac and paravertebral muscles. The treatment of choice was hemi-pelvectomy, with wide tumoral resection, and selective embolization of the nutrient vessels 24 hours prior to the surgical procedure. At two years postoperative, we found a good functional result and the computed tomography (CT) scan revealed no signs of recurrence.

Universality of indeterminate growth in lizards rejected: the micro-CT reveals contrasting timing of growth cartilage persistence in iguanas, agamas, and chameleons

Squamate reptiles are considered to exhibit indeterminate growth. Nevertheless, current literature disputes the available definitions of this growth type, presents new theoretical models, and questions its universality in cold-blooded vertebrates. We have followed up on our previous research employing micro-CT to explore growth plate cartilage (GPC) in the epiphysis of long bones, which is responsible for longitudinal skeletal growth by the endochondral ossification process. We focused on numerous and highly diversified group of the Iguania clade comprising Acrodonta (agamas and chameleons) and Pleurodonta (“iguanas”). We recorded the absence of GPC in most of the examined adult Pleurodonta specimens and interpret it as an irreversible arrest of skeletal growth. This finding clearly rejects the universality of indeterminate growth in lizards. On the other hand, we found apparent GPC preservation in most of the adult specimens belonging to Acrodonta. This suggests a preserved ability to continue body growth throughout most of their life. We discuss the uncovered disparity between Acrodonta and Pleurodonta and emphasize the importance of GPC degradation timing.

Use and forget: Contribution to the discussion about the bone tools called “machacadores” (pounders), Patagonia, South America

• Features identified on epiphysis of guanaco long bones from Patagonian are discussed. • Experimental tools were made in Lama guanicoe long bones. • The replicas were used to crush and hammer soft and hard materials. • Our work sustains that “ machacadores ” were opportunistic artifacts. • “ Machacadores ” are not a fracture technique to provoke a transversal fracture.

RECESSIVE MULTIPLE EPIPHYSEAL DYSPLASIA: A CASE REPORT

Multiple epiphyseal dysplasia (MED) is characterized by abnormal bone and cartilage development particularly affecting epiphysis of long bones. Individuals with MED present during childhood presents with hip pain, knee pain and waddling gait. The autosomal recessive MED is differentiated from the dominant type by the presence of hands, knees and feet malformations with scoliosis. We present here, a case of autosomal recessive MED, an eleven and half years old boy who presented with pain in knees, difficulty walking, abnormal fingers and abnormal toes. The radiographs of hands, knees and pelvis were suggestive of an abnormal epiphyseal development. After diagnosis, patient was counseled and he was advised analgesics and different exercises.

Islands of bone within bone

A 17-year-old boy presented with a 2-month history of pain in his right wrist. Physical examination did not reveal any local swelling, redness, tenderness or deformity. Radiograph of both wrists...

Evaluation of Local Recurrence in Giant-Cell Tumor of Bone Treated by Neoadjuvant Denosumab.

BackgroundGiant-cell tumor of bone (GCTB) is a locally aggressive primary benign tumor presenting as an expansile osteolytic lesion affecting the epiphysis of long bones. Denosumab halts the osteolysis by giant cells thereby downstaging the tumor, helping in performing less morbid procedures to remove the tumor. Our aim was to report the incidence of local recurrence (LR) in patients operated following neoadjuvant denosumab, to investigate factors associated with LR following extended curettage for GCTB, and to compare the postoperative functional and oncological outcome of patients operated with and without neoadjuvant denosumab.MethodsA total of 123 patients with a mean age of 29.6 years undergoing extended curettage for GCTB were retrospectively divided into group 1 receiving neoadjuvant denosumab and group 2 operated without denosumab. The mean follow-up period was 35 months. The perioperative characteristics and outcome were compared between the two groups and the factors for LR of GCTB were analyzed.ResultsThe incidence of LR among patients operated after neoadjuvant denosumab therapy was 42.8% and was significantly high compared to that in patients without denosumab (p < 0.001). On multivariate logistic regression analysis, use of denosumab as a neoadjuvant was the only factor independently associated with LR following surgery (p = 0.002). Patients treated with denosumab had a lower LR-free survival rate (log-rank, p = 0.018).ConclusionsDenosumab was independently associated with increased LR following surgery for GCTB. Denosumab has to be used cautiously in patients in whom the burden of downstaging the disease outweighs the possible chance of LR.

Innervation of the tibial epiphysis through the intercondylar foramen

The periosteum and mineralized bone are innervated by nerves that sense pain. These include both myelinated and unmyelinated neurons with either free nerve endings or bearing nociceptors. Parasympathetic and sympathetic autonomic nerves also innervate bone. However, little is known about the route sensory nerves take leaving the epiphyses of long bones at the adult knee joint. Here, we used transgenic mice that express fluorescent Venus protein in Schwann cells (Sox10-Venus mice) to visualize myelinated and unmyelinated nerves in the tibial epiphysis. Immunofluorescence to detect a pan-neuronal marker and the sensory neuron markers calcitonin gene-related peptide (CGRP) and tropomyosin receptor kinase A (TrkA) also revealed Schwann cell-associated sensory neurons. Foramina in the intercondylar area of the tibia were conserved between rodents and primates. Venus-labeled fibers were detected within bone marrow of the proximal epiphysis, exited through foramina along with blood vessels in the intercondylar area of the tibia, and joined Venus-labeled fibers of the synovial membrane and meniscus. These data suggest that innervation of the subchondral plate and trabecular bone within the tibial epiphysis carries pain signals from the knee joint to the brain through intercondylar foramina.

Norcantharidin modulates the miR-30a/Metadherin/AKT signaling axis to suppress proliferation and metastasis of stromal tumor cells in giant cell tumor of bone

Giant cell tumor of bone (GCTB) is a benign but locally aggressive tumor, which can cause significant bone destruction at the epiphysis of long bones. Recent studies have demonstrated that norcantharidin (NCTD) can inhibit the proliferation and migration of various human cancer cells, but the role of NCTD in GCTB has not previously been evaluated. The aim of this study was to explore the nature of the anti-cancer effects of NCTD in GCTB and to elucidate the biomolecular mechanisms responsible for these effects. Primary stromal cell cultures, representing the main neoplastic component of GCTB, were used for cell-based experiments. Firstly, the anti-cancer effects of NCTD on GCTB stromal tumor cells were investigated by CCK-8 assay, flow cytometry and transwell invasion assay. Next, microRNA (miRNA) microarray and quantitative reverse transcription PCR (qRT-PCR) analyses were performed to examine and verify altered expression of miRNAs associated with NCTD treatment. Subsequently, the GCTB stromal cells were transfected with miR-30a inhibitor to confirm its involvement in the observed anti-cancer effects of NCTD. Luciferase reporter assays were carried out to identify the target gene of miR-30a. Moreover, changes in the expression of protein markers of AKT signaling were measured by Western Blot analysis. The results demonstrated that NCTD treatment could inhibit cell proliferation, block the cell cycle process and induce cell apoptosis in GCTB stromal cells. An inhibitory effect of NCTD on GCTB stromal cell invasion through inhibition of epithelial mesenchymal transition (EMT) was also observed. Expression of miR-30a was significantly upregulated by NCTD treatment and miR-30a knockdown significantly reversed the anti-tumor effects of NCTD against GCTB stromal cells. Of note, metadherin (MTDH), a novel oncogene which modulates the AKT pathway, was identified as a direct target of miR-30a in GCTB stromal cells. Further data showed that miR-30a could negatively regulate the expression of MTDH and the AKT pathway in GCTB stromal cells. Importantly, MTDH expression was found to be inversely correlated with miR-30a expression in clinical GCTB specimens. Moreover, NCTD treatment effectively suppressed the AKT signaling pathway as demonstrated by downregulation of phosphorylated-Akt S473 (p-Akt S473), p-Akt (T308), phosphorylated-glycogen synthase kinase (GSK)3β (p-GSK3β) and c-Myc, whilst miR-30a inhibition re-activated the AKT signaling pathway in GCTB stromal cells. Our findings demonstrate that NCTD can inhibit cell proliferation and metastasis of GCTB stromal cells in vitro, via modulating the miR-30a/MTDH/AKT signaling axis. This suggests that NCTD has potential as a novel therapeutic treatment for GCTB.

Automatic segmentation of chondroblastoma from X-ray images using active contour and levelset method

Chondroblastoma is a benign but locally aggressive bone tumor found usually in the age below 25 years. Chondroblastoma is a destructive type of lesion with a thin radio dense border which is normally seen in the epiphysis of long bones. The benign tumors have similarities in pathology and could be related with histogenic similarity. This tumor reduces the strength of affected bone and may leads to death if not treated early. Chondroblastoma can be diagnosed from X-ray/CT/MRI images and the treatment is its removal by surgical methods. Diagnosis of Chondroblastoma is difficult due to the similarities with other benign tumors like chondromyxoid fibroma. To reduce diagnostic errors, computer aided methods can adopt. This work focuses on automatic segmentation of Chondroblastoma using active contour and level set method which gives better segmentation results and a mild stone to CAD design.

The most pronounced constitutional differences between healthy and sick with pyoderma in men or women in the western region of Ukraine

Despite the significant progress made in the study of the problem of pyoderma, theclinical features of their course depending on the somatotype and their differences, ascompared with the healthy subjects, remain virtually unexplored. The purpose of thestudy is to establish the most pronounced discrepancies between the anthropometric,somatotypological and component components of body mass in men and women of theWestern region of Ukraine in norm and in patients with pyoderma. An anthropologicalexamination under the Bunak scheme of 45 patients with pyoderma men aged from 22to 35 years, and 48 patients with pyoderma women aged from 21 to 35 years, and 24healthy men and 43 healthy women of similar age, the third generation residents of theWest region of Ukraine was conducted. The somatotype is defined according to themathematical scheme of the Hit-Carter. For the calculation of the fat, bone and musclemass components of the body, Matiegka and the American Institute of Nutrition formulaswere used. With the help of the license package "STATISTICA 6.0", the statisticalprocessing of the obtained results was performed using parametric and non-parametricestimation methods. In healthy men, lower values of the thickness of skin and fat foldsare found, than in patients with acute and chronic pyoderma; as well as lower valuesof the endo- and mesomorphic components of the somatotype and the fatty componentof the body mass and the higher values of the ectomorphic component of the somatotypethan in the patients with the acute course of the disease; a lower percentage of endo-mesomorphic somatotype representatives than in patients with deep pyoderma. Inhealthy women found smaller than in female patients of different groups of the majorityof total, cross, girth body size, width of distal epiphysis of long bones of the extremitiesand mesomorphic somatotype component, muscle and bone components of bodyweight, and higher values ectomorphic somatotype component; a smaller percentageof the mesomorphic somatotype than those of the general group and with the acutecourse of pyoderma, as well as a higher percentage of the representatives of theectomorphic somatotype than patients with superficial pyoderma. In patients with chronicpyoderma men set lower than in patients with acute pyoderma men, meaning of crossmedium and lower thoracic sizes, thickness of skin-fat folds, endo- and mesomorphicsomatotype components and bone and fat components of body weight. In patients withchronic pyoderma women set less than women suffering from deep pyoderma, thevalue of total, half of the transverse dimensions of the pelvis, extremities, most girthsizes, width of distal epiphysis of the shoulder and hip, muscle and bone componentsof body weight and a higher percentage representatives of the ectomorphic somatotypethan patients with superficial pyoderma. Comparative study of anthropometric indicesand individual somatic sex groups and constitutional types showed individual variabilityof body structure and set typological features of patients with some form and degreeof manifestation of pyoderma

Chondroblastoma of the Patella: A Case Report

Chondroblastoma is a rare bone tumor of cartilaginous origin representing less than 1% of all the primitive bone tumors. This lesion usually develops in the epiphysis of long bones and occurs during the second decade of life. However, there are rare atypical localizations like the patella. We report an atypical case of chondroblastoma of the patella and discuss the clinical, radiological and therapeutic features of this rare location. A young 20-year-old patient consulted for right knee pain evolving for 2 months with a discreet knee effusion and pain on palpation of the patella. The radiological and CT showed lytic lesion of the distal half of the patella, lobulated, with sclerotic outlines and blowing the internal cortex. The patient underwent surgery with curettage and filling with autologous iliac cancellous bone graft. Histological examination led to the diagnosis of chondroblastoma. At last follow-up, 18 months, the patient had a normal function of his knee with no recurrence for radiological control. The location of chondroblastoma in the patella is exceptional but its radiological features resemble those of usual epiphyseal locations. The most popular treatment is curettage associated with cancellous bone grafting and thus to avoid the functional consequences of a patellectomy.

Trabecular architecture in the forelimb epiphyses of extant xenarthrans (Mammalia)

BackgroundBone structure has a crucial role in the functional adaptations that allow vertebrates to conduct their diverse lifestyles. Much has been documented regarding the diaphyseal structure of long bones of tetrapods. However, the architecture of trabecular bone, which is for instance found within the epiphyses of long bones, and which has been shown experimentally to be extremely plastic, has received little attention in the context of lifestyle adaptations (virtually only in primates). We therefore investigated the forelimb epiphyses of extant xenarthrans, the placental mammals including the sloths, anteaters, and armadillos. They are characterised by several lifestyles and degrees of fossoriality involving distinct uses of their forelimb. We used micro computed tomography data to acquire 3D trabecular parameters at regions of interest (ROIs) for all extant genera of xenarthrans (with replicates). Traditional, spherical, and phylogenetically informed statistics (including the consideration of size effects) were used to characterise the functional signal of these parameters.ResultsSeveral trabecular parameters yielded functional distinctions. The main direction of the trabeculae distinguished lifestyle categories for one ROI (the radial trochlea). Among the other trabecular parameters, it is the degree of anisotropy (i.e., a preferential alignment of the trabeculae) that yielded the clearest functional signal. For all ROIs, the armadillos, which represent the fully terrestrial and fossorial category, were found as characterised by a greater degree of anisotropy (i.e., more aligned trabeculae). Furthermore, the trabeculae of the humeral head of the most fossorial armadillos were also found to be more anisotropic than in the less fossorial species.ConclusionsMost parameters were marked by an important intraspecific variability and by a size effect, which could, at least partly, be masking the functional signal. But for some parameters, the degree of anisotropy in particular, a clear functional distinction was recovered. Along with data on primates, our findings suggest that a trabecular architecture characterised by a greater degree of anisotropy is to be expected in species in which the relevant epiphyses withstand a restricted range of load directions. Trabecular architecture therefore is a promising research avenue for the reconstruction of lifestyles in extinct or cryptic species.

A study of Giant Cell Lesions of Bone

Introduction: Giant cell lesions of bone include true giant cell tumors & numerous benign osteoclasts and pseudo-anaplastic-appearing giant cells containing variants.Many times it is difficult to differentiate between true giant cell tumor and other tumor like conditions. Aims: To study histopathology of various giant cell rich tumor and tumor like conditions of bone. Methods and Material: Retrospective analysis of 50 cases of giant-cell rich lesions of bone diagnosed and treated at Smt. N.H.L. Municipal Medical College Ahmedabad, Gujarat during 1 st January 2002 to 1 st January 2003 included in the study. Patients’ clinical, radiological details, histopathological examination were studied using structured proforma. The cases were classified in different categories according to age groups, types of tumour, benign versus malignant category. Results: The most common giant cell containing benign tumor is giant cell tumor (19 cases) followed by Aneurysmal bone cyst (5), Most of the giant cell containing tumors of bone are found in younger age group and are located in epiphysis The common giant cell containing malignant tumor is osteogenic sarcoma (7 cases) followed by Talangiectatic O.S (01). The majority of cases found in age between 15 - 28 years and most common sites are epiphysis of long bones. Conclusion: The most common giant cell rich benign bone tumor is giant cell tumor and most common giant cell rich malignant bone tumor is osteosarcoma commonly occurs in younger age groups in the epiphysis region long bones DOI:10.21276/APALM.1524

Giant cell tumor arising from anterior arc of rib

Giant cell tumor of bone also known as Osteoclastoma has only recently been included in the diagnostic purview of the cytopathologist. It is a benign but locally aggressive neoplasm most commonly found in the epiphysis or metaphyseal-epiphyseal region of long bones. Rarely, it can occur on the ribs, usually on the posterior aspect i.e. head and tubercle of the ribs. We, therefore report a case of giant cell tumor arising from the anterior arc of the rib, diagnosed on fine needle aspiration cytology.

A fast method for the quantification of fat fraction and relaxation times: Comparison of five sites of bone marrow

PurposeBone marrow is found either as red bone marrow, which mainly contains haematopoietic cells, or yellow bone marrow, which mainly contains adipocytes. In adults, red bone marrow is principally located in the axial skeleton. A recent study has introduced a method to simultaneously estimate the fat fraction (FF), the T1 and T2* relaxation times of water (T1w, T2*w) and fat (T1f and T2*f) in the vertebral bone marrow. The aim of the current study was to measure FF, T1w, T1f, T2*w and T2*f in five sites of bone marrow, and to assess the presence of regional variations. MethodsMRI experiments were performed at 1.5T on five healthy volunteers (31.6±15.6years) using a prototype chemical-shift-encoded 3D multi-gradient-echo sequence (VIBE) acquired with two flip angles. Acquisitions were performed in the shoulders, lumbar spine and pelvis, with acquisition times of <25seconds per sequence. Signal intensities of magnitude images of the individual echoes were used to fit the signal and compute FF, T1w, T1f, T2*w and T2*f in the humerus, sternum, vertebra, ilium and femur. ResultsRegional variations of fat fraction and relaxation times were observed in these sites, with higher fat fraction and longer T1w in the epiphyses of long bones. A high correlation between FF and T1w was measured in these bones (R=0.84 in the humerus and R=0.84 in the femur). In most sites, there was a significant difference between water and fat relaxation times, attesting the relevance of measuring these parameters separately. ConclusionThe method proposed in the current study allowed for measurements of FF, T1w, T1f, T2*w and T2*f in five sites of bone marrow. Regional variations of these parameters were observed and a strong negative correlation between the T1 of water and the fat fraction in bones with high fat fractions was found.