Palpable Bone Research Articles

Bone marrow biopsy from the flipper of a dolphin

To find macroscopically palpable bone marrow cavities in dolphins is difficult because of their extremely retrogressive limbs and pelvis and because they do not contain abundant modular cavities (as in terrestrial mammals) that can serve as sites for bone marrow biopsies. Three-dimensional computed tomography analysis of dolphin skeletons suggests that bone marrow could be harvested from the humerus and radius. In this report, post-mortem paracentesis of the humerus from a captive rough-toothed dolphin using a biopsy needle provided a marrow preparation containing myelocytes, erythroblasts and megakaryocytes. This type of bone marrow collection from the flipper might be useful for clinical diagnostic work in cetaceans.

EXTENSOR CARPI RADIALIS LONGUS AVULSION: A LITERATURE REVIEW AND CASE REPORT

Extensor Carpi Radialis Longus (ECRL) avulsion is a rare injury which follows resisted wrist hyperflexion. Treatment of this condition with open reduction and internal fixation is not previously described in the literature, and treatment with plaster immobilisation or k-wire fixation requires a prolonged period of immobilisation. We believe that open reduction and internal fixation of these fractures with early mobilisation will result in the best possible wrist function. We describe a sign to raise the index of suspicion for this injury: a palpable bone lump on the dorsum of the hand in the presence of wrist extensor pain or weakness after wrist hyperflexion injury is a sign of wrist extensor avulsion.

Spinal hamartomas: a distinct clinical entity.

Congenital spinal hamartomas are defined as tumors of well-differentiated mature elements situated in an abnormal location. In this report, the authors document the clinical and pathological features of spinal hamartomas in 10 patients. Ten patients presented with midline dorsal malformations at birth, initially diagnosed as teratomas or myelomeningoceles. The locations of the masses were variable: two were located in the thoracic region, four at the thoracolumbar junction, two in the lumbar region, one at the lumbosacral junction, and one in the sacral region. The results of the neurological examination were normal in nine patients. All but one mass had intact skin and seven had palpable bone components. Neuroimaging studies revealed widening of the spinal canal, heterotopic bone located dorsally in some patients, and varying degrees of involvement of the intraspinal contents. During surgery, six patients were found to have involvement of the spinal cord or cauda equina. The pathological characteristics of the masses included three or more of the following: bone, cartilage, synovial membrane, urinary tract tissue, cyst wall, yellow or brown fat, and nerves. The well-differentiated cellular elements, which formed mature structures, along with the absence of primitive cellular components and neoplastic characteristics are more consistent with a diagnosis of hamartoma than teratoma. In this series, the authors describe a lesion that is overt on physical examination, yet can have occult spinal canal involvement. Complete neurosurgical evaluation is essential to provide appropriate treatment and prognosis.

Mandibular reconstruction with transforming growth factor-beta1.

Transforming growth factor-beta1 (TGF-beta1) plus demineralized bone matrix (DBM) will reconstruct a critical mandibular defect devoid of periosteum in a canine model. Randomized, blinded, placebo-controlled, prospective animal pilot study. Canine critical mandibular defects devoid of periosteum were reconstructed with DBM (group 1, n = 3) and DBM plus TGF-beta1 (250 microg TGF-beta1/g DBM) (group 2, n = 3). Radiologic, histologic, and biomechanical testing was performed on the test group and control group specimens at 12 weeks after implantation. A palpable bone bridge was present in the group 2 subjects 5 to 6 weeks after implantation and was never present in the group 1 subjects. Radiologic and histologic examination at the time of harvest (12 weeks after implantation) demonstrated a solid bone bridge in the group 2 subjects and a fibrous union in the group 1 subjects. Group 2 specimens demonstrated failure in four-point bending testing at an average maximum moment of 9.9 +/- 2.2 N-m. This value was 9.4% of the maximum moment of the contralateral nonoperated side. Group 1 specimens were palpably flexible on plate removal and had a biomechanical strength of 0. The difference in strength between group 1 and group 2 was statistically significant (P < 0.02), supporting the hypothesis that the addition of TGF-beta1 to the DBM carrier resulted in the formation of significantly stronger bone in the critical gap. The addition of TGF-beta1 to DBM results in healing of a critical bone defect devoid of periosteum in a higher mammalian model.

The identification of palpable bone in diabetic pedal ulcers by blunt sterile probe was indicative of osteomyelitis

Source Citation Grayson ML, Gibbons GW, Balogh K, Levin E, Karchmer AW. Probing to bone in infected pedal ulcers. A clinical sign of underlying osteomyelitis in diabetic patients. JAMA. 1995 Mar 1;273:721-3.

Immunopathology of chickens infected in ovo and at hatching with the avian osteopetrosis virus MAV.2-0.

AbstractThe immunological capacity of chickens infected with MAV.2–0, an avian osteopetrosis virus, was studied both morphologically and functionally. Infection of 11 to 12‐day‐old embryos with a high (0.58 × 106‐1.2 × 106 plaque‐forming units; PFU) and an intermediate (5.8 × 104 PFU) dose of virus resulted in severe stunting, as manifested by lower body and lymphoid organs (bursa, thymus and spleen) weights. The bursa and spleen of osteopetrotic chickens were poorly developed, the thymus partially necrotized; all lymphoid organs had fewer lymphocytes than controls, and there were far fewer germinal centers in the spleen of infected birds, as compared to controls. The humoral and cellular immunity of these osteopetrotic chickens was significantly suppressed, as assessed by (a) the plaque‐forming cell response against sheep red blood cells (SRBC) in the spleen; (b) circulating antibody responses against SRBC, Brucella abortus and human γ‐globulins (HGG); (c) the delayed hypersen‐sitivity reaction against HGG; and (d) mitogenic responsiveness of peripheral blood and spleen lymphocytes to concanavalin A, phytohemagglutinin M and pokeweed mitogen. A few birds, infected as 11‐day embryos with the lowest concentration of virus (2.9 × 104 PFU) had no palpable bone lesions, the lymphoid organs had normal histology, and immune responses were quite similar to those in uninfected control birds. Osteopetrotic chickens, infected within 48 h after hatching (5.8 × 105 PFU), had normal IgM‐class antibody responses against all antigens studied (SRBC, Brucella, HGG), whereas IgG and/or IgA responses tended to be lower than those observed in the normal controls. These findings, together with the regularly organized small lymphoid follicles in the bursa, indicate a late affection of B cell development, whereas in the birds infected at 11–12 days of incubation, an almost total arrest of B cell development was observed. T cell functions of birds infected at hatching were suppressed to the same extent as those of in ovo infected birds indicating susceptibility of the T cell lineage to MAV.2–0 also at later stages of development.

Tortuous innominate arteries simulating aneurysms.

THE PURPOSE of this presentation is to review the clinical picture of the seemingly expansile supraclavicular or superior mediastinal pulsating mass. While to physical examination or chest fluoroscopy, pulsating masses may seem to be aneurysmal, aneurysms in the innominate-carotid-subclavian vessels are rare.1,2In this area aneurysmectomy carries a high morbidity and mortality. Occasionally all doubt of diagnosis is removed by visible or palpable aneurysmal bone erosion in the area of the clavicle or upper sternum. More often, careful palpation reveals a tortuous course of one of the large arteries of the area which accounts for the swelling and establishes a diagnosis (Fig 1). In the group between these extremes definite diagnosis by physical examination is impossible because of the heavy skeleto-muscular structures shielding the area. Angiography to confirm aneurysm becomes mandatory. By clinical or fluoroscopic examination, each of the following patients was thought to have an innominate aneurysm. Each