Sample records for bone joints

  1. Bones and joints

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    Runge, M.


    This exercise book guides the student and the radiologist wishing to review his knowledge to rapid and correct analysis and interpretation of radiologic findings in bone and joint disorders. The first part of the volume demonstrates the radiologic findings without going into the clinical and pathological aspects. In the second part, the reader then learns to analyse and diagnose systematically the case examples by means of a complete description of the X-ray images. Contents: Introduction; iconography; commentary with corresponding schemata; references and subject index.

  2. Joint prosthesis and method of bone fixation

    NARCIS (Netherlands)

    Oosterom, R.; Van der Pijl, A.J; Bersee, H.E.N.; Van der Helm, F.C.; Herder, J.L


    The invention relates to a joint prosthesis (10), for example, a knee joint or shoulder joint prosthesis comprising a first, socket-holding prosthesis part (11) for attachment to a first bone (12) and a second, ball-holding prosthesis part (13) for attachment to a second bone (14) that intermates wi

  3. Joint and long-bone gunshot injuries. (United States)

    Dougherty, Paul J; Vaidya, Rahul; Silverton, Craig D; Bartlett, Craig S; Najibi, Soheil


    Gunshot wounds remain a major clinical problem, with the number of nonfatal gunshot wounds reported as 60,000 to 80,000 per year in the United States. Bone or joint injuries comprise a major portion of gunshot wound injuries. It is paramount for orthopaedic surgeons to be thorough in their treatment of patients with these injuries. Intra-articular injuries remain a source of significant clinical morbidity because of joint stiffness, arthritis, and the risk of infection. Treatment of long-bone fractures is a challenging clinical problem, and further studies are needed to investigate modern treatment methods. Lead toxicity is a potential risk for patients with gunshot injuries, particular for those with joint injuries. The clinician's recognition of the signs and symptoms of lead toxicity is important to achieve the best care for these patients.

  4. Men and women have similarly shaped carpometacarpal joint bones. (United States)

    Schneider, M T Y; Zhang, J; Crisco, J J; Weiss, A P C; Ladd, A L; Nielsen, P; Besier, T


    Characterizing the morphology of the carpometacarpal (CMC) joint bones and how they vary across the population is important for understanding the functional anatomy and pathology of the thumb. The purpose of this paper was to develop a statistical shape model of the trapezium and first metacarpal bones to characterize the size and shape of the whole bones across a cohort of 50. We used this shape model to investigate the effects of sex and age on the size and shape of the CMC joint bones and the articulating surface area of the CMC joint. We hypothesized that women have similar shape trapezium and first metacarpal bones compared to men, following scaling for overall size. We also hypothesized that age would be a significant predictor variable for CMC joint bone changes. CT image data and segmented point clouds of 50 CMC bones from healthy adult men and women were obtained from an ongoing study and used to generate two statistical shape models. Statistical analysis of the principal component weights of both models was performed to investigate morphological sex and age differences. We observed sex differences, but were unable to detect any age differences. Between men and women the only difference in morphology of the trapezia and first metacarpal bones was size. These findings confirm our first hypothesis, and suggest that the women have similarly shaped trapezium and first metacarpal bones compared to men. Furthermore, our results reject our second hypothesis, indicating that age is a poor predictor of CMC joint morphology.

  5. Bone and joint changes following electrical burn: plain radiographic findings

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    Kim, Uk Jung; Lee, Eil Seong; Shim, Ya Seong; Kim, Seon Bok; Lee, Shin Ho; Jung, Hae Kyoung; Hwang, Dae Hyun; Kang, Ik Won [Hallym Univ. College of Medicine, Seoul (Korea, Republic of)


    To evaluate the plain radiographic findings of bone and joint changes following electrical burn. This study involved 19 patients with 27 bone and joints regions which had suffered electrical injury. The most common input and output sites were, respectively, the hand(7/14) and foot (6/10). Three other sites were involved. Four cases involved osteomyelitis, and in four, amputation was performed. We observed bone and joint changes, changes following osteomyelitis and changes in the amputation stump. We analyzed the difference between input and output changes, and when this was interesting, the average time of onset was assessed. In bone and joint changes following electrical burn, the most frequent radiographic finding was joint contracture(n=3D16). Other findings included osteolysis(n=3D8), articular abnormalites (n=3D6), periostitis(n=3D5), fracture(n=3D5), acro-osteolysis(n=3D2), and heterotopic bone formation(n=3D2). In cases involving osteomyelitis(n=3D4), aggravation of underlying bone changes was noted. In electrical burn, various changes were noted in bone and joints, and input injury was more severe than that of output.=20.

  6. Transcriptional regulation of bone and joint remodeling by NFAT



    Osteoporosis and arthritis are highly prevalent diseases and a significant cause of morbidity and mortality worldwide. These diseases result from aberrant tissue remodeling leading to weak, fracture-prone bones or painful, dysfunctional joints. The nuclear factor of activated T cells (NFAT) transcription factor family controls diverse biologic processes in vertebrates. Here, we review the scientific evidence that links NFAT-regulated gene transcription to bone and joint pathology. A particula...

  7. Combined scintigraphic and radiographic diagnosis of bone and joint diseases

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    Bahk, Yong Whee (Catholic Medical Coll., Seoul (Korea, Republic of). Dept. of Radiology and Nuclear Medicine)


    This book is intended to emphasize the tremendous value of pinhole scintigraphy in diagnosing nearly the whole spectrum of bone and joint diseases. Pinhole scintigraphy discloses anatomic and pathologic as well as chemical alterations in greater detail, permitting analytical interpretation and raising the sensitivity as well. Infections, nonspecific bone inflammation, rheumatic disorders, metabolic and endocrine bone diseases, trauma, and both primary tumors and metastasis can be effectively and specifically examined. By improving sensitivity, many false negative readings can be avoided in early bone metastasis, synovitis, enthesopathies, bone contusion, etc. (orig.)

  8. Transarticular invasion of joints by bone tumors: Hypothesis

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    Abdelwahab, I.F.; Miller, T.T.; Hermann, G. (Dept. of Radiology, Mount Sinai Medical Center, New York, NY (USA)); Klein, M.J. (Dept. of Pathology, Mount Sinai Medical Center, New York, NY (USA)); Kenan, S.; Lewis, M.M. (Dept. of Orthopedic Surgery, Mount Sinai Medical Center, New York, NY (USA))


    Eight bone tumors with associated transarticular invasion of the sacroiliac joints are described. All invaded the true synovial joint and spread to the opposing bone. One tumor was benign, and the other seven were malignant. Five of the seven were primary and two were metastatic cancer. One, a myeloma, invaded the disc spaces between the fourth and fifth lumbar vertebrae and the fifth lumbar vertebra and sacrum as well as the sacroiliac joint. The right facet joints of the two vertebrae were also invaded. After a thorough search of the literature, we find that the sacroiliac joints is the most common joint to be invaded by tumors. This is followed by the vertebral disc spaces and, last, the facet joints. Apart from these joints we were unable to find any radiographic documentation of other joints being transarticularly invaded by tumors. We noted that there is a direct relation between transarticular tumor spread and joints that lack mobility and that certain tumors, benign and malignant, tend to invade these joints. (orig.).

  9. Bone dynamic study. Evaluation for factor analysis of hip joint

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    Nakajima, Kotaro; Toyama, Hinako; Ishikawa, Nobuyoshi; Hatakeyama, Rokuro; Akisada, Masayoshi; Miyagawa, Shunpei


    Factor analysis was applied to dynamic study of Tc-99m MDP for the evaluation of hip joint disorders. Fifteen patients were examined; eight were normal, six was osteoarthritis in which one accompanied synovitis was included, and one was aseptic necrosis on the head of the femur. In normals, according to the Tc-99m MDP kinetics, three factor images and time-activity curves were obtained which were named as blood vessel, soft tissue, and bone factor images and curves. In the patient with osteoarthritis, increased accumulation of the hip joint was shown in bone factor image only. But in one patient, who took osteoarthritis with synovitis, marked accumulations of the Tc-99m MDP appeared not only on the bone factor image but also on the soft tissue. Operation revealed thickening synovial tissue around the hip joint, caused by inflammatory process. In follow-up studies of the patient with aseptic necrosis on the head of the left femur, exessive accumulations, which were seemed in his left hip joint on both bone and soft tissue factor images at first, were decreased respondently to the treatment of this lesion. In conclusion, the factor analysis was useful for differential diagnosis of the hip joint disorders and observation of the clinical course of the hip joint disorders.

  10. Bone and Joint Problems Associated with Diabetes (United States)

    ... treated? Better management of blood glucose levels and physical therapy can slow the progress of this condition, but the limited mobility may not be reversible. What is it? Osteoporosis is a disorder that causes bones to become ...

  11. Transarticular invasion of bone tumours across the sacroiliac joint

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    Chhaya, S. [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto (Canada); University of Texas Health Science Centre, Department of Radiology, San Antonio, TX (United States); White, L.M. [University of Toronto, Department of Medical Imaging, Mount Sinai Hospital and the University Health Network, Toronto (Canada); Kandel, R. [University of Toronto, Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto (Canada); Wunder, J.S.; Ferguson, P. [Univeristy of Toronto, University Musculoskeletal Oncology Unit, Department of Orthopedic Surgery, Mount Sinai Hospital, Toronto (Canada); Agur, A. [University of Toronto, Division of Anatomy, Department of Surgery, Toronto (Canada)


    The purpose of this study was to evaluate the pattern of tumour spread across the SI articulation, correlating with cadaveric anatomic observations, in order to better understand the local spread of tumour and to assist in the assessment of local staging. Twenty-four consecutive patients (14 male, 10 female; age range 22-89 years, mean 52 years) with primary bone tumours of the iliac bone or sacrum abutting the SI joint, in whom surgical resection of the SI joint was performed, were studied following institutional ethics approval. In all patients, preoperative magnetic resonance (MR) imaging studies of the pelvis and SI joint were reviewed for imaging evidence of transarticular extension across the SI joint. Gross pathologic and histologic assessment of possible transarticular SI joint tumour extension was performed in all patients. Nine cadaveric pelvic specimens without pelvic neoplastic disease (4 male, 5 female; age range 20-84 years, mean 59 years, median 58 years) were anatomically dissected and the articular anatomy of the SI joint examined macroscopically. Twelve of the twenty-four patients demonstrated imaging and histological evidence of transarticular SI joint invasion. Eight tumours infiltrated only the interosseous ligamentous aspect of the SI joint. In the remaining four cases, extensive tumour infiltrated both the cartilaginous and ligamentous aspects of the joint. No case showed tumour involvement isolated to the cartilaginous aspect of the joint. Among the cadaveric specimens studied, degenerative changes were found involving the majority of cases (6/9), with cartilage thinning and fibrillation and antero-superior marginal osteophytes seen involving the cartilaginous portion of the SI joint articulation. Four of the nine specimens demonstrated central ossification bridging the iliac and sacral aspects of the ligamentous (interosseous) SI joint. (orig.)

  12. Preceding trauma in childhood hematogenous bone and joint infections. (United States)

    Pääkkönen, Markus; Kallio, Markku J T; Lankinen, Petteri; Peltola, Heikki; Kallio, Pentti E


    Preceding trauma may play a role in the etiology and pathogenesis of hematogenous bone and joint infections. Among 345 children with an acute hematogenous bone and/or joint infection, 20% reported trauma during a 2-week period leading to infection. Blunt impact, bruises, or excoriations were commonly reported. The rate was similar to that in the general pediatric population obtained from the literature. In the study group, patients with and without trauma were similar in age, serum C-reactive protein and erythrocyte sedimentation rate, length of hospitalization, and late sequelae. Preceding minor trauma did not prove to be significant as an etiological or as a prognostic factor.

  13. Nano-material aspects of shock absorption in bone joints. (United States)

    Tributsch, H; Copf, F; Copf, P; Hindenlang, U; Niethard, F U; Schneider, R


    This theoretical study is based on a nano-technological evaluation of the effect of pressure on the composite bone fine structure. It turned out, that the well known macroscopic mechano-elastic performance of bones in combination with muscles and tendons is just one functional aspect which is critically supported by additional micro- and nano- shock damping technology aimed at minimising local bone material damage within the joints and supporting spongy bone material. The identified mechanisms comprise essentially three phenomena localised within the three-dimensional spongy structure with channels and so called perforated flexible tensulae membranes of different dimensions intersecting and linking them. Kinetic energy of a mechanical shock may be dissipated within the solid-liquid composite bone structure into heat via the generation of quasi-chaotic hydromechanic micro-turbulence. It may generate electro-kinetic energy in terms of electric currents and potentials. And the resulting specific structural and surface electrochemical changes may induce the compressible intra-osseal liquid to build up pressure dependent free chemical energy. Innovative bone joint prostheses will have to consider and to be adapted to the nano-material aspects of shock absorption in the operated bones.

  14. Occlusal effects on longitudinal bone alterations of the temporomandibular joint. (United States)

    Zhang, J; Jiao, K; Zhang, M; Zhou, T; Liu, X-D; Yu, S-B; Lu, L; Jing, L; Yang, T; Zhang, Y; Chen, D; Wang, M-Q


    The pathological changes of subchondral bone during osteoarthritis (OA) development in the temporomandibular joint (TMJ) are poorly understood. In the present study, we investigated the longitudinal alterations of subchondral bone using a rat TMJ-OA model developed in our laboratory. Changes in bone mass were examined by micro-CT, and changes in osteoblast and osteoclast activities were analyzed by real-time PCR, immunohistochemistry, and TRAP staining. Subchondral bone loss was detected from 8 weeks after dental occlusion alteration and reached the maximum at 12 weeks, followed by a repair phase until 32 weeks. Although bone mass increased at late stages, poor mechanical structure and lower bone mineral density (BMD) were found in these rats. The numbers of TRAP-positive cells were increased at 12 weeks, while the numbers of osteocalcin-expressing cells were increased at both 12 and 32 weeks. Levels of mRNA expression of TRAP and cathepsin K were increased at 12 weeks, while levels of ALP and osteocalcin were increased at both 12 and 32 weeks. These findings demonstrated that there is an active bone remodeling in subchondral bone in TMJs in response to alteration in occlusion, although new bone was formed with lower BMD and poor mechanical properties.

  15. [Ankle joint prosthesis for bone defects]. (United States)

    Lampert, C


    Large defects of the talus, i.e. due to tumors, large areas of osteolysis in total ankle replacement (TAR) and posttraumatic talus body necrosis are difficult to manage. The gold standard in these circumstances is still tibiocalcaneal arthrodesis with all the negative aspects of a completely rigid hindfoot. We started 10 years ago to replace the talus by a custom-made, all cobalt-chrome implant (laser sintering). The first patient with a giant cell tumor did very well but the following patients showed all subsidence of the metal talus into the tibia due to missing bony edges. Therefore, we constructed a custom-made talus (mirrored from the healthy side) and combined it with a well functioning total ankle prosthesis (Hintegra). So far we have implanted this custom-made implant into 3 patients: the first had a chondrosarcoma of the talus (1 year follow-up), the second had massive osteolysis/necrosis of unknown origin (6 months follow-up) and the third massive osteolysis following a correct TAR (2 months follow-up). The results are very encouraging as all of the patients are practically pain free and have a good range of movement (ROM): D-P flexion 15°-0-20° but less motion in the lower ankle joint: ROM P-S 5°-0-5°. No subsidence was detected in the tibia or the calcaneus. The custom-made talus combined with the Hintegra total ankle replacement will probably be an interesting alternative to a tibiocalcaneal arthrodesis in selected cases with massive defects of the talus.

  16. Bone reaction in temporomandibular joint dysfunction. An investigation with bone scintigraphy and gamma imaging

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    Kirveskari, P.; Alanen, P.; Kuusela, T.; Ruotsalainen, P. (Turku Univ. (Finland))


    Scintigraphy was used in eight patients with temporomandibular joint dysfunction to detect changes in bone metabolism assumed to be responses to altered activity of the masticatory muscles. Asymmetry in clinical signs and symptoms coincided with the asymmetry observed in the computed horizontal tomograms.

  17. Imaging technologies for preclinical models of bone and joint disorders. (United States)

    Tremoleda, Jordi L; Khalil, Magdy; Gompels, Luke L; Wylezinska-Arridge, Marzena; Vincent, Tonia; Gsell, Willy


    Preclinical models for musculoskeletal disorders are critical for understanding the pathogenesis of bone and joint disorders in humans and the development of effective therapies. The assessment of these models primarily relies on morphological analysis which remains time consuming and costly, requiring large numbers of animals to be tested through different stages of the disease. The implementation of preclinical imaging represents a keystone in the refinement of animal models allowing longitudinal studies and enabling a powerful, non-invasive and clinically translatable way for monitoring disease progression in real time. Our aim is to highlight examples that demonstrate the advantages and limitations of different imaging modalities including magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), single-photon emission computed tomography (SPECT) and optical imaging. All of which are in current use in preclinical skeletal research. MRI can provide high resolution of soft tissue structures, but imaging requires comparatively long acquisition times; hence, animals require long-term anaesthesia. CT is extensively used in bone and joint disorders providing excellent spatial resolution and good contrast for bone imaging. Despite its excellent structural assessment of mineralized structures, CT does not provide in vivo functional information of ongoing biological processes. Nuclear medicine is a very promising tool for investigating functional and molecular processes in vivo with new tracers becoming available as biomarkers. The combined use of imaging modalities also holds significant potential for the assessment of disease pathogenesis in animal models of musculoskeletal disorders, minimising the use of conventional invasive methods and animal redundancy.

  18. Improved Therapeutic Efficacy in Bone and Joint Disorders by Targeted Drug Delivery to Bone. (United States)

    Takahashi, Tatsuo


     Site-specific drug delivery to bone is considered achievable using acidic amino acid (L-Asp or L-Glu) homopeptides known as acidic oligopeptides. We found that fluorescence-labeled acidic oligopeptides containing six or more residues bound strongly to hydroxyapatite, which is a major component of bone, and were selectively delivered to and retained in bone after systemic administration. We explored the applicability of this result for drug delivery by conjugation of estradiol and levofloxacin with an L-Asp hexapeptide. We also similarly tagged enzymes (tissue-nonspecific alkaline phosphatase, β-glucuronidase, and N-acetylgalactosamine-6-sulfate sulfatase) and decoy receptors (endogenous secretory receptor for advanced glycation end products and etanercept) to assess whether these would improve therapeutic efficacy. The L-Asp hexapeptide-tagged drugs, including enzymes and decoy receptors, were efficiently delivered to bone in comparison with the untagged drugs. An in vivo experiment confirmed the efficacy of L-Asp hexapeptide-tagged drugs on bone and joint disorders, although there was some loss of bioactivity of estradiol and levofloxacin in vitro, suggesting that the acidic hexapeptide was partly removed by hydrolysis in the body after delivery to bone. It was expected that the ester linkage to the hexapeptide would be susceptible to hydrolysis in situ, releasing the drug from the acidic oligopeptide. These results support the usefulness of acidic oligopeptides as bone-targeting carriers for therapeutic agents. We present some pharmacokinetic and pharmacological properties of the L-Asp hexapeptide-tagged drugs.

  19. Bone and Joint Decade 2000-2010 in Neplease Perspective

    Directory of Open Access Journals (Sweden)

    B P Paudyal


    Full Text Available The Bone and Joint Decade is a worldwide multi-disciplinary initiative targeting the care of people with musculoskeletal disorders. It focuses on improving the quality of life of these people through advances in the understanding and treatment through education, research, and prevention strategies. Though the epidemiological data in Nepal are very scanty, worldwide statistics have shown that musculoskeletal conditions represent more than half of all chronic diseases, and are the most common cause of severe long-term pain and disability. There is acute shortage of specialist manpower that care for people with these disorders. Furthermore the teaching in musculoskeletal disorders in health institutions is very minimal. All of these problems highlight the need for expanding the teaching of musculoskeletal disorders at all levels of medical education; promotion of clinical research; improving diagnostic, treatment, and rehabilitative facilities; and implementation of preventive strategies to reduce the burden of these chronic debilitating conditions in the society. Keywords: bone and joint decade, musculoskeletal and rheumatic diseases, Nepal.

  20. Statistical analysis of vibration-induced bone and joint damages. (United States)

    Schenk, T


    Vibration-induced damages to bones and joints are still occupational diseases with insufficient knowledge about causing and moderating factors and resulting damages. For a better understanding of these relationships also retrospective analyses of already acknowledged occupational diseases may be used. Already recorded detailed data for 203 in 1970 to 1979 acknowledged occupational diseases in the building industry and the building material industry of the GDR are the basis for the here described investigations. The data were gathered from the original documents of the occupational diseases and scaled in cooperation of an industrial engineer and an industrial physician. For the purposes of this investigations the data are to distinguish between data which describe the conditions of the work place (e.g. material, tools and posture), the exposure parameters (e.g. beginning of exposure and latency period) and the disease (e.g. anamnestical and radiological data). These data are treated for the use with sophisticated computerized statistical methods. The following analyses were carried out. Investigation of the connections between the several characteristics, which describe the occupational disease (health damages), including the comparison of the severity of the damages at the individual joints. Investigation of the side dependence of the damages. Investigation of the influence of the age at the beginning of the exposure and the age at the acknowledgement of the occupational disease and herewith of the exposure duration. Investigation of the effect of different occupational and exposure conditions.

  1. Template-based automatic extraction of the joint space of foot bones from CT scan (United States)

    Park, Eunbi; Kim, Taeho; Park, Jinah


    Clean bone segmentation is critical in studying the joint anatomy for measuring the spacing between the bones. However, separation of the coupled bones in CT images is sometimes difficult due to ambiguous gray values coming from the noise and the heterogeneity of bone materials as well as narrowing of the joint space. For fine reconstruction of the individual local boundaries, manual operation is a common practice where the segmentation remains to be a bottleneck. In this paper, we present an automatic method for extracting the joint space by applying graph cut on Markov random field model to the region of interest (ROI) which is identified by a template of 3D bone structures. The template includes encoded articular surface which identifies the tight region of the high-intensity bone boundaries together with the fuzzy joint area of interest. The localized shape information from the template model within the ROI effectively separates the bones nearby. By narrowing the ROI down to the region including two types of tissue, the object extraction problem was reduced to binary segmentation and solved via graph cut. Based on the shape of a joint space marked by the template, the hard constraint was set by the initial seeds which were automatically generated from thresholding and morphological operations. The performance and the robustness of the proposed method are evaluated on 12 volumes of ankle CT data, where each volume includes a set of 4 tarsal bones (calcaneus, talus, navicular and cuboid).

  2. Transarticular invasion of the sacroiliac joints by malignant pelvic bone tumors

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    Lee, Hwang Woo; Huh, Jin Do; Kim, Seong Min; Cho, Young Duk [College of Medicine, Kosin Univ., Pusan (Korea, Republic of); Cho, Kil Ho [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)


    To describe modes of transarticular invasion, with reference to the size and location of a tumor, the anatomic characteristics of invaded cartilage,and the existence of ankylosis in SI joint. Eleven histologically confirmed malignant pelvic bone tumors involving transarticular invasion of sacroiliac joints, were retrospectively analysed. Transarticular invasion of a joint was defined as involvement of its opposing bones. The anatomic site and size of the tumors were analysed, and invaded sacroiliac joint was divided into upper, middle and lower parts on the basis of the anatomic characteristics of the intervening cartilage: synovial hyaline or fibrous ligamentous. the existence of ankylosis was determined, and transarticular invasion directly across a joint was classified as direct invasion. Extension of tumors around a joint from its periphery to the opposing bone were considered as indirect invasion. All tumors were located near the sacroiliac joint, eight at the ilium and three at the sacrum. Six invasions were indirect and five were direct. Average tumor area was larger in indirect cases than in direct: 191.8 cm{sup 2} vs. 69.6 cm{sup 2}. In all indirect invasions, a huge soft tissue mass abutted onto the peripheral portion of the sacroiliac joint. In five of six cases of indirect transarticular invasion, the upper part of the joint posteriorly located fibrous ligamentous cartilage. In the other, the lower part was invaded, and this involved a detour around the joint space, avoiding the invasion of intervening cartilage. Ankylosis occurred in one of the indirect cases. Among the five cases of direct invasion, there was invasion of the posteriorly located ligamentous fibrous cartilage in three without ankylosis. In the other two cases, involving ankylosis, the synovial hyaline cartilage was invaded directly at the lower part of the joint. Transarticular invasions of sacroiliac joint via fibrous cartilage are most common. Ankylosis of the sacroiliac joint

  3. Patient and implant survival following joint replacement because of metastatic bone disease

    DEFF Research Database (Denmark)

    Sørensen, Michala S; Gregersen, Kristine G; Grum-Schwensen, Tomas


    Patients suffering from a pathological fracture or painful bony lesion because of metastatic bone disease often benefit from a total joint replacement. However, these are large operations in patients who are often weak. We examined the patient survival and complication rates after total joint...


    Directory of Open Access Journals (Sweden)

    Sri Nithisa H


    Full Text Available BACKGROUND Giant cell-rich lesions constitute a group of biologically and morphologically diverse bone and joint tumours. The common feature is presence of numerous multinucleated osteoclast-like giant cells. However, they differ from each other by in terms of clinical and radiographic features and in many cases by their distinct morphological features. METHODS All the bone and joint specimens with giant cell-rich lesions received in the period of one year were studied along with clinical and radiological data available. Gross and microscopic findings were noted. RESULTS In a period of one year, 10 cases of giant cell-rich lesions of bone and joints have been studied, which were and correlated with clinical and radiological findings. Five were lesions from bone and two were from joints, which are chondroblastoma, chondromyxoid fibroma, osteoclastoma, aneurysmal bone cyst, pigmented villonodular synovitis, giant cell lesion of tendon sheath, and tendinous xanthoma. CONCLUSION In the present study, variety of giant cell lesions of bone and joints are studied. Of which, the mean age in young patients being 20 years and in elderly patients being 50 years. The common site being lower end of femur.

  5. Model-based 3D segmentation of the bones of joints in medical images (United States)

    Liu, Jiamin; Udupa, Jayaram K.; Saha, Punam K.; Odhner, Dewey; Hirsch, Bruce E.; Siegler, Sorin; Simon, Scott; Winkelstein, Beth A.


    There are several medical application areas that require the segmentation and separation of the component bones of joints in a sequence of acquired images of the joint under various loading conditions, our own target area being joint motion analysis. This is a challenging problem due to the proximity of bones at the joint, partial volume effects, and other imaging modality-specific factors that confound boundary contrast. A model-based strategy is proposed in this paper wherein a rigid model of the bone is generated from a segmentation of the bone in the image corresponding to one position of the joint by using the live wire method. In other images of the joint, this model is used to search for the same bone by minimizing an energy functional that utilizes both boundary- and region-based information. An evaluation of the method by utilizing a total of 60 data sets on MR and CT images of the ankle complex and cervical spine indicates that the segmentations agree very closely with the live wire segmentations yielding true positive and false positive volume fractions in the range 89-97% and 0.2-0.7%. The method requires 1-2 minutes of operator time and 6-7 minutes of computer time, which makes it significantly more efficient than live wire - the only method currently available for the task.

  6. Bone and Joint Infections in Children: Septic Arthritis. (United States)

    Agarwal, Anil; Aggarwal, Aditya N


    The pathological invasion of a joint and subsequent inflammation is known as septic arthritis. The knee and hip are the most frequently involved joints. Staphylococcus aureus is the most common cause of septic arthritis in children. An acute onset of illness with an inflamed painful joint and restricted movements and inability to use joint (pseudoparalysis) clinically indicates septic arthritis. The diagnosis is difficult in a neonate or young child where refusal to feed, crying, discomfort during change of diaper (if hip is involved) or attempted joint movement may be the only findings. Fever and other systemic signs may also be absent in neonates. Septic arthritis is diagnosed clinically, supported by appropriate radiological and laboratory investigations. The peripheral blood white cell count is frequently raised with a predominance of polymorphonuclear cells. The acute phase reactants such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are often markedly raised. Ultrasonography and MRI are preferred investigations in pediatric septic arthritis. Determination of infecting organism in septic arthritis is the key to the correct antibiotic choice, treatment duration and overall management. Joint aspirate and/or blood culture should be obtained before starting antibiotic treatment. Several effective antibiotic regimes are available for managing septic arthritis in children. Presence of large collections, thick pus, joint loculations and pus evacuating into surrounding soft tissues are main indications for surgical drainage. Joint aspiration can be a practical alternative in case the lesion is diagnosed early, with uncomplicated presentations and superficial joints.

  7. Radiotherapy of rheumatic diseases of the bone joints

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    Makoski, H.B.; Stroetges, M.W.; Rau, R.; Schuette, H.


    Treatment of rheumatoid arthritis can be either systemic or local. 'Synoviorthesis', the intraarticular injection of radio-colloids, has shown to be very effective in withholding persistent synovitis, even compared with synovectomy. For large joints, e.g. knees, favourable results can be anticipated, with smaller joints results are poorer. Physical and biological data, indications and results are presented.

  8. Three-dimensional helical CT imaging of bone and joint diseases in the trunk and the hip joints. Pt. 1

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    Gong Hohghan [Jangxi Medical Coll. (China). First Affiliated Hospital; Hiraishi, Kumiko; Doi, Miwako; Matsui, Ritsuo; Simizu, Tadafumi; Sueyoshi, Kouzou; Narabayashi, Isamu


    To confirm the utility of CT scan images for orthopedic surgeons managing patients with complex disorders, we have produced and studied three-dimensional images from helical CT scans of 28 patients with various bone and joint disorders in the trunk and the hip joint. The CT scanner employed was a Toshiba X-force, and the 3D-CT images were constructed on an X-link50. The 3D images obtained could be observed from various projections. Congenital vertebral malformations, spondylosis, OPLL, osteonecrosis, fractures, and bone tumors were examined, and the 3D helical CT images brought useful information to bear on the spatial location and extent of the lesions. Therefore, 3D helical CT should become an indispensable tool for both preoperative examination and post-operative follow-up studies in orthopedic surgery. (author)

  9. Preliminary results of automated removal of degenerative joint disease in bone scan lesion segmentation (United States)

    Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Auerbach, Martin; Goldin, Jonathan; Henkel, Keith; Banola, Ashley; Morris, Darren; Coy, Heidi; Brown, Matthew S.


    Whole-body bone scintigraphy (or bone scan) is a highly sensitive method for visualizing bone metastases and is the accepted standard imaging modality for detection of metastases and assessment of treatment outcomes. The development of a quantitative biomarker using computer-aided detection on bone scans for treatment response assessment may have a significant impact on the evaluation of novel oncologic drugs directed at bone metastases. One of the challenges to lesion segmentation on bone scans is the non-specificity of the radiotracer, manifesting as high activity related to non-malignant processes like degenerative joint disease, sinuses, kidneys, thyroid and bladder. In this paper, we developed an automated bone scan lesion segmentation method that implements intensity normalization, a two-threshold model, and automated detection and removal of areas consistent with non-malignant processes from the segmentation. The two-threshold model serves to account for outlier bone scans with elevated and diffuse intensity distributions. Parameters to remove degenerative joint disease were trained using a multi-start Nelder-Mead simplex optimization scheme. The segmentation reference standard was constructed manually by a panel of physicians. We compared the performance of the proposed method against a previously published method. The results of a two-fold cross validation show that the overlap ratio improved in 67.0% of scans, with an average improvement of 5.1% points.


    Institute of Scientific and Technical Information of China (English)

    徐荣辉; 柴本甫


    Seven female patients (mean age of 56 years) with advanced hip joint osteoarthritis underwent total hip replacement. Four days before operation they were given oral tetracycline for two days. During operation specimens were taken from the white articular cartilage, the yellowish articular cartilage and the ivory bone together with their subchondral bone tissues. The undecalcified specimens were cut into 10 μm sections and observed under the fluorescence microscope. In all the specimens the following findings could be observed. 1. The osteoarthritic articular cartilage became thinner, with uneven surface and fissures. 2. The superficial and deep surfaces and the central part of the subchondral bone plate showed bright golden yellow fluorescence. It reflected extensive new bone formation. 3. The subchondral bone trabeculae also revealed bright golden yellow fluorescence on their peripheral borders, so trabeculae turned thicker obviously. 4. The marrow tissues between the bone trabeculae exhibited particulate or spherical bright golden yellow fluorescence, reflecting new bone formation in the marrow. The particulate and spherical bright golden yellow fluorescent materials might aggregate, enlarge and merge into large piece of new bone and they also fused with the neighbouring bone trabeculae. The aforementioned changes in the structure of the subchondral bone tissues increased greatly the mass in the osteoarthritic femoral head.

  11. [Combined treatment of long tubular bone fractures and false joints using the bioplastic material collapan (Russia)]. (United States)

    Kesian, G A; Berchenko, G N; Urazgil'deev, R Z; Arsen'ev, I G; Mikelaishvili, D S; Karapetian, G S


    This experimental morphological study on 32 dogs was designed to evaluate the efficiency of hydroxyapatite containing preparation collapan used to promote healing of segmented femur defects. Implantation of collapan was shown to greatly contribute to the formation, maturation and remodelling of bone callus. Combined treatment of 165 patients with comminuted fractures and 148 ones with false joints of long tubular bones using collapan implants proved to efficaciously promote bone consolidation in 99.4% of the total 313 subjects. Collapan activated reparative osteogenesis, reduced the duration of hospitalization, the frequency of inflammatory complications, and the requirement of secondary inpatient care.

  12. Septic arthritis of a lumbar facet joint: Detection with bone SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Swayne, L.C.; Dorsky, S.; Caruana, V.; Kaplan, I.L. (Morristown Memorial Hospital, NJ (USA))


    We present a rare case of septic arthritis of a lumbar facet joint with an associated epidural abscess resulting from Staphylococcus aureus. The infection was initially detected with planar bone scintigraphy and precisely localized with single photon emission computed tomography bone scintigraphy, despite an initially negative radiologic evaluation that included radiographs of the lumbar spine, lumbar myelography, and a postmyelography x-ray computed tomography scan. In the appropriate clinical setting, a bone scan demonstrating unilateral increased activity within the spine should raise the suspicion of inflammatory involvement of the posterior elements.

  13. Diagnosis of bone and joint disorders. Second edition

    Energy Technology Data Exchange (ETDEWEB)

    Resnick, D.; Niwayama, G.


    This book features descriptions of the anatomy, histology, radiography, radiology, biomechanics, and pathology of individual joints. It includes fresh new perspectives and contemporary coverage on important areas of musculoskeletal imaging not covered in the 1981 edition: iatrogenic, endocrine, infections, and oncologic disorders.

  14. Bone shape difference between control and osteochondral defect groups of the ankle joint

    NARCIS (Netherlands)

    Tümer, N; Blankevoort, L; van de Giessen, M; Terra, M P; de Jong, P.A.; Weinans, H; Tuijthof, G J M; Zadpoor, A A


    OBJECTIVE: The etiology of osteochondral defects (OCDs), for which the ankle (talocrural) joint is one of the common sites, is not yet fully understood. In this study, we hypothesized that bone shape plays a role in development of OCDs. Therefore, we quantitatively compared the morphology of the tal

  15. Direct comparison of conventional radiography and cone-beam CT in small bone and joint trauma

    Energy Technology Data Exchange (ETDEWEB)

    Smet, E. de [Antwerp University Hospital, Department of Radiology, Edegem (Belgium); Praeter, G. de [Sint-Maartenziekenhuis, Department of Radiology, Duffel (Belgium); Verstraete, K.L.A. [Ghent University Hospital, Department of Radiology, Ghent (Belgium); Wouters, K. [Antwerp University Hospital, Department of Scientific Coordination and Biostatistics, Edegem (Belgium); Beuckeleer, Luc de [GZA Sint-Augustinus, Department of Radiology, Wilrijk (Belgium); Vanhoenacker, F.M.H.M. [Antwerp University Hospital, Department of Radiology, Edegem (Belgium); Sint-Maartenziekenhuis, Department of Radiology, Duffel (Belgium); Ghent University Hospital, Department of Radiology, Ghent (Belgium)


    To compare the diagnostic value of cone-beam computed tomography (CBCT) and conventional radiography (CR) after acute small bone or joint trauma. Between March 2013 and January 2014, 231 patients with recent small bone or joint trauma underwent CR and subsequent CBCT. CR and CBCT examinations were independently assessed by two readers, blinded to the result of the other modality. The total number of fractures as well as the number of complex fractures were compared, and inter- and intraobserver agreement for CBCT was calculated. In addition, radiation doses and evaluation times for both modalities were noted and statistically compared. Fracture detection on CBCT increased by 35 % and 37 % for reader 1 and reader 2, respectively, and identification of complex fractures increased by 236 % and 185 %. Interobserver agreement for CBCT was almost perfect, as was intraobserver agreement for reader 1. The intraobserver agreement for reader 2 was substantial. Radiation doses and evaluation time were significantly higher for CBCT. CBCT detects significantly more small bone and joint fractures, in particular complex fractures, than CR. In the majority of cases, the clinical implication of the additionally detected fractures is limited, but in some patients (e.g., fracture-dislocations), the management is significantly influenced by these findings. As the radiation dose for CBCT substantially exceeds that of CR, we suggest adhering to CR as the first-line examination after small bone and joint trauma and keeping CBCT for patients with clinical-radiographic discordance or suspected complex fractures in need of further (preoperative) assessment. (orig.)

  16. Characteristics and Clinical Outcome of Bone and Joint Tuberculosis From 1994 to 2011

    DEFF Research Database (Denmark)

    Johansen, Isik S; Nielsen, Stig L; Hove, Malene;


    Background. Most information on bone-joint (BJ)-tuberculosis is based on data from high-incidence areas. We conducted a nationwide register-based analysis of BJ-tuberculosis in Denmark from 1994 to 2011. Methods. We linked data from the national tuberculosis surveillance system on BJ-tuberculosis...

  17. A history of osteomyelitis from the Journal of Bone and Joint Surgery: 1948 TO 2006. (United States)

    Klenerman, L


    Osteomyelitis is one of the oldest diseases known. It took many years before the acute infection could be brought under control with antibiotics and chronic osteomyelitis remains difficult to manage. The modern history of the disease is reflected in the pages of the Journal of Bone and Joint Surgery.

  18. Combined scintigraphic and radiographic diagnosis of bone and joint diseases. 3. rev. and enl. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong-Whee [Sung Ae General Hospital, Seoul (Korea). Dept. of Nuclear Medicine and Radiology


    The third edition of Combined Scintigraphic and Radiographic Diagnosis of Bone and Joint Diseases has been comprehensively rewritten and rearranged. It now encompasses, in addition to the bone and joint diseases described in the two earlier editions, hitherto unpublished novel applications of pinhole scanning to the diagnosis of a broader spectrum of skeletal disorders than ever before, including those of the soft tissues. A large number of state-of-the-art scans and corroboratory images obtained using CT, MRI and/or sonography are presented side by side. The book has been considerably expanded to discuss five new themes: Normal Variants and Artifacts, Drug-Induced Osteoporosis, Soft-Tissue Tumors and Tumor-like Conditions, PET/CT in Bone and Joint Diseases and A Genetic Consideration of Skeletal Disorders. Topical chapters on rheumatic skeletal disorders, malignant tumors of bone, benign tumors of bone and traumatic diseases have also been thoroughly rewritten and are complemented by the addition of some 90 recently acquired cases. (orig.)

  19. Temporomandibular joint disc repositioning using bone anchors: an immediate post surgical evaluation by Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Haddad Majd S


    Full Text Available Abstract Background Open joint procedures using bone anchors have shown clinical and radiograph good success, but post surgical disc position has not been documented with MRI imaging. We have designed a modified technique of using two bone anchors and 2 sutures to reposition the articular discs. This MRI study evaluates the post surgical success of this technique to reposition and stabilize the TMJ articular discs. Methods Consecutive 81 patients with unilateral TMJ internal derangement (ID (81 TMJs were treated between December 1, 2003, and December 1, 2006, at the Department of Oral and Maxillofacial Surgery, Ninth Peoples Hospital, Shanghai, Jiao Tong University School of Medicine. All patients were subjected to magnetic resonance imaging before and one to seven days post surgery to determine disc position using the modified bone anchor technique. Results Postoperative MRIs (one to seven days confirm that 77 of 81 joints were identified as excellent results and one joint was considered good for an overall effective rate of 96.3% (78 of 81 joints. Only 3.7% (3 of 81 of the joints were designated as poor results requiring a second open surgery. Conclusions This procedure has provided successful repositioning of the articular discs in unilateral TMJ ID at one to seven days post surgery.

  20. Does Metaphyseal Cement Augmentation in Fracture Management Influence the Adjacent Subchondral Bone and Joint Cartilage? (United States)

    Goetzen, Michael; Hofmann-Fliri, Ladina; Arens, Daniel; Zeiter, Stephan; Stadelmann, Vincent; Nehrbass, Dirk; Richards, R. Geoff; Blauth, Michael


    Abstract Augmentation of implants with polymethylmethacrylate (PMMA) bone cement in osteoporotic fractures is a promising approach to increase implant purchase. Side effects of PMMA for the metaphyseal bone, particularly for the adjacent subchondral bone plate and joint cartilage, have not yet been studied. The following experimental study investigates whether subchondral PMMA injection compromises the homeostasis of the subchondral bone and/or the joint cartilage. Ten mature sheep were used to simulate subchondral PMMA injection. Follow-ups of 2 (4 animals) and 4 (6 animals) months were chosen to investigate possible cartilage damage and subchondral plate alterations in the knee. Evaluation was completed by means of high-resolution peripheral quantitative computed tomography (HRpQCT) imaging, histopathological osteoarthritis scoring, and determination of glycosaminoglycan content in the joint cartilage. Results were compared with the untreated contralateral knee and statistically analyzed using nonparametric tests. Evaluation of the histological osteoarthritis score revealed no obvious cartilage damage for the treated knee; median histological score after 2 months 0 (range 4), after 4 months 1 (range 5). There was no significant difference when compared with the untreated control site after 2 and 4 months (P = 0.23 and 0.76, respectively). HRpQCT imaging showed no damage to the metaphyseal trabeculae. Glycosaminoglycan measurements of the treated joint cartilage after 4 months revealed no significant difference compared with the untreated cartilage (P = 0.24). The findings of this study support initial clinical observation that PMMA implant augmentation of metaphyseal fractures appears to be a safe procedure for fixation without harming the subchondral bone plate and adjacent joint cartilage. PMID:25621690

  1. Concomitant treatment of mandibular ameloblastoma and bilateral temporomandibular joint osteoarthritis with bone graft and total joint prostheses. (United States)

    Rodrigues, Daniel B; Wolford, Larry M; Malaquias, Pietry; Campos, Paulo S F


    Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease that can create clinical problems in the masticatory musculature, jaws, occlusion, and other associated structures and is commonly accompanied by inflammatory changes and pain. Many cases of TMJ dysfunction can be managed with nonsurgical therapies, but patients with irreversible TMJ damage may require surgical intervention for repair or reconstruction. Despite various methods of TMJ reconstruction, the patient-fitted total joint prostheses may be the best option to achieve good outcomes. Multicystic ameloblastoma is a benign odontogenic neoplasm of the jaws that is found most often in the mandible, in the region of the molars, and the ramus. Ameloblastomas usually progress slowly, but are locally invasive and may cause significant morbidity and sometimes death. This report describes a case of concomitant treatment of recurrent mandibular ameloblastoma and severe bilateral TMJ osteoarthritis treated by resection of the tumor, reconstruction with bone grafting, and bilateral TMJ reconstruction in a 63-year-old woman.

  2. Bone bruise, lipohemarthrosis, and joint effusion in CT of non-displaced hip fracture

    Energy Technology Data Exchange (ETDEWEB)

    Geijer, Mats (Center for Medical Imaging and Physiology, Skaane University Hospital, Lund University, Lund (Sweden)), Email:; Dunker, Dennis; Collin, David; Goethlin, Jan H. (Department of Radiology, Sahlgrenska University Hospital, Moelndal (Sweden))


    Background. A suspected occult hip fracture after normal radiography is not uncommon in an elderly person after a fall. Despite a lack of robust validation in the literature, computed tomography (CT) is often used as secondary imaging. Purpose. To assess the frequency and clinical utility of non-cortical skeletal and soft tissue lesions as ancillary fracture signs in CT diagnosis of occult hip fractures. Material and Methods. All fracture signs (cortical and trabecular fractures, bone bruise, joint effusion, and lipohemarthrosis) were recorded in 231 hip low-energy trauma cases with CT performed after normal or equivocal radiography in two trauma centers. Results. There were no fracture signs in 110 patients. Twelve of these had a joint effusion. In 121 patients with 46 cervical hip fractures and 75 trochanteric fractures one or more fracture signs were present. Cortical fractures were found in 115 patients. Bone bruise was found in 119 patients, joint effusion in 35, and lipohemarthrosis in 20 patients. Conclusion. Ancillary signs such as bone bruise and lipohemarthrosis can strengthen and sometimes indicate the diagnosis in CT of occult hip fractures. Joint effusion is a non-specific sign

  3. Bone marrow edema of the knee joint; Differenzialdiagnosen des Knochenmarkoedems am Kniegelenk

    Energy Technology Data Exchange (ETDEWEB)

    Breitenseher, M.J. [Waldviertelklinikum Horn (Austria). Institut fuer Radiologie; Universitaetsklinik fuer Radiodiagnostik Wien (Austria). Abteilung Osteologie; Kramer, J. [Institut fuer CT- und MRT-Diagnostik, Linz (Austria); Mayerhoefer, M.E. [Universitaetsklinik fuer Radiodiagnostik Wien (Austria). Abteilung Osteologie; Aigner, N. [Orthopaedisches Krankenhaus Speising, Erste Orthopaedische Abteilung, Wien (Austria); Hofmann, S. [LKH Stolzalpe (Austria). Orthopaedische Abteilung


    Bone marrow edema of the knee joint is a frequent clinical picture in MR diagnostics. It can be accompanied by symptoms and pain in the joint. Diseases that are associated with bone marrow edema can be classified into different groups. Group 1 includes vascular ischemic bone marrow edema with osteonecrosis (synonyms: SONK or Ahlbaeck's disease), osteochondrosis dissecans, and bone marrow edema syndrome. Group 2 comprises traumatic or mechanical bone marrow edema. Group 3 encompasses reactive bone marrow edemas such as those occurring in gonarthrosis, postoperative bone marrow edemas, and reactive edemas in tumors or tumorlike diseases. Evidence for bone marrow edema is effectively provided by MRI, but purely morphological MR information is often unspecific so that anamnestic and clinical details are necessary in most cases for definitive disease classification. (orig.) [German] Das Knochenmarkoedem des Kniegelenks ist ein haeufiges Erscheinungsbild in der MR-Diagnostik. Es kann mit Symptomen und Schmerzen des Gelenks einhergehen. Erkrankungen, die mit einem Knochenmarkoedem vergesellschaftet sind, koennen in verschiedene Gruppen eingeteilt werden. Zur 1. Gruppe gehoeren das vaskulaer-ischaemische Knochenmarkoedem mit Osteonekrose (Synonyme SONK oder Morbus Ahlbaeck), die Osteochondrosis dissecans und das Knochenmarkoedemsyndrom, zur 2. Gruppe das traumatologische oder mechanische Knochenmarkoedem. In der 3. Gruppe werden reaktive Knochenmarkoedeme zusammengefasst wie bei Gonarthrose, postoperative Knochenmarkoedeme und reaktive Oedeme bei Tumor oder tumoraehnlichen Erkrankungen. Der Nachweis eines Knochenmarkoedems gelingt mit der MRT sehr sensitiv, die rein morphologische MR-Information ist jedoch oft unspezifisch, sodass anamnestische und klinische Informationen fuer die sichere Zuordnung einer Erkrankung in den meisten Faellen notwendig sind. (orig.)

  4. Analysis and design of rolling-contact joints for evaluating bone plate performance. (United States)

    Slocum, Alexander H; Cervantes, Thomas M; Seldin, Edward B; Varanasi, Kripa K


    An apparatus for testing maxillofacial bone plates has been designed using a rolling contact joint. First, a free-body representation of the fracture fixation techniques utilizing bone plates is used to illustrate how rolling contact joints accurately simulate in vivo biomechanics. Next, a deterministic description of machine functional requirements is given, and is then used to drive the subsequent selection and design of machine elements. Hertz contact stress and fatigue analysis for two elements are used to ensure that the machine will both withstand loads required to deform different plates, and maintain a high cycle lifetime for testing large numbers of plates. Additionally, clinically relevant deformations are presented to illustrate how stiffness is affected after a deformation is applied, and to highlight improvements made by the machine over current testing standards, which do not adequately re-create in vivo loading conditions. The machine performed as expected and allowed for analysis of bone plates in both deformed and un-deformed configurations to be conducted. Data for deformation experiments is presented to show that the rolling-contact testing machine leads to improved loading configurations, and thus a more accurate description of plate performance. A machine for evaluation of maxillofacial bone plates has been designed, manufactured, and used to accurately simulate in vivo loading conditions to more effectively evaluate the performance of both new and existing bone plates.

  5. Experiment K-314: Fetal and neonatal rat bone and joint development following in Utero spaceflight (United States)

    Sabelman, E. E.; Holton, E. M.; Arnaud, C. D.


    Infant rat limb specimens from Soviet and U.S. ground-based studies were examined by radiography, macrophotography, histologic sectioning and staining and scanning electron microscopy. A comparison was conducted between vivarium and flight-type diets suggesting that nutritional obesity may adversely affect pregnancy. Data were obtained on maturation of ossification centers, orientation of collagen fibers in bone, tendon and ligaments, joint surface texture and spatial relationships of bones of the hind limb. Computer reconstructions of the knee and hip show promise as a means of investigating the etiology of congenital hip dislocation.

  6. Bone mineral density in patients with destructive arthrosis of the hip joint. (United States)

    Okano, Kunihiko; Aoyagi, Kiyoshi; Enomoto, Hiroshi; Osaki, Makoto; Chiba, Ko; Yamaguchi, Kazumasa


    Recent reports have shown the existence of subchondral insufficiency fracture in rapidly destructive arthrosis of the hip joint (RDA), and the findings suggest that osteopenia is related to the pathogenesis of the rapid progression of this disease. Therefore, we measured bone mineral density (BMD) in RDA patients. We measured BMD of the lumbar spine, radius, and calcaneus using dual-energy X-ray absorptiometry in 19 patients with RDA and 75 with osteoarthritis of the hip (OA) and compared BMD at different skeletal sites between RDA and OA patients. No significant differences were observed in BMD of the lumbar spine, ultradistal radius, mid-radius, and calcaneous between the RDA and OA groups. Our data suggest that RDA is not accompanied by generalized osteoporosis. Factors other than generalized bone status, for example, BMD around the affected hip joint before destruction, need to be analyzed to elucidate the pathophysiological mechanism of RDA.

  7. Closed rupture of the flexor tendons caused by carpal bone and joint disorders. (United States)

    Yamazaki, H; Kato, H; Hata, Y; Nakatsuchi, Y; Tsuchikane, A


    We analysed 21 patients with closed rupture of the flexor tendons caused by carpal bone and joint disorders. The tendon that ruptured depended on the location of the bone perforation into the carpal tunnel. Radiocarpal arthrography was performed in 13 patients and capsular perforation was demonstrated by contrast medium leakage into the carpal canal in 11 patients. This proved a useful diagnostic test. The flexor tendon(s) were reconstructed with free tendon graft in 17 patients, cross-over transfer of flexor tendons from adjacent digits in two and buddying to an adjacent flexor tendon in one patient. Postoperative total active range of motion in the fingers after 13 free tendon graft reconstructions averaged 213 degrees (range 170-265 degrees ). The active range of motion of the thumb-interphalangeal joint after free tendon graft reconstruction in three cases improved from 0 degrees to 33 degrees on average (range 10 degrees -40 degrees ).

  8. [Antibiotic therapy of bone and joint infections in children: recent changes]. (United States)

    Lorrot, M; Doit, C; Ilharreborde, B; Vitoux, C; Le Henaff, L; Sebag, G; Pennecot, G; Grimprel, E; Bingen, É


    Management of bone and joint infections in children associates early appropriate antibiotic therapy against Staphylococcus aureus and Kingella kingae and, if necessary, surgical drainage of abscess or septic arthritis. In 2007, the Paediatric Infectious Diseases Group of the French Society of Paediatrics (GPIP) proposed guidelines for antibiotherapy in acute and non-complicated cases, with an intravenous therapy during 4 to 7 days followed by oral therapy during 3 weeks.

  9. A brief history of the Journal of Bone and Joint Surgery. (United States)

    Cowell, H R


    The Journal of Bone and Joint Surgery had its origins in the Transactions of the American Orthopedic Association, which first were published in 1889. In 1903, the Transactions of the American Orthopedic Association, Volume 16, became the first volume of the American Journal of Orthopedic Surgery, still under the sponsorship of the American Orthopedic Association. In 1919, the word American was dropped from the title and the Journal of Orthopaedic Surgery became the official publication of the newly formed British Orthopaedic Association and the American Orthopedic Association. The name was changed to The Journal of Bone and Joint Surgery in 1921. Shortly after the founding of the American Academy of Orthopaedic Surgeons in 1933, The Journal became the official organ of the academy; however, ownership of The Journal remained with the American Orthopaedic Association. The British volume appeared in 1948. The Journal of Bone and Joint Surgery became an independent, not-for-profit corporation in 1954. The Journal, which continues to be a leader in the area of orthopaedic publication, began publishing the full text on compact disk in January 1992, the full text in electronic form through BRS/Saunders in 1995, and the full text on The Journal's website in December 1999.

  10. The effects of mechanical forces on bones and joints. Experimental study on the rat tail. (United States)

    Pazzaglia, U E; Andrini, L; Di Nucci, A


    We have used an experimental model employing the bent tail of rats to investigate the effects of mechanical forces on bones and joints. Mechanical strain could be applied to the bones and joints of the tail without direct surgical exposure or the application of pins and wires. The intervertebral disc showed stretched annular lamellae on the convex side, while the annulus fibrosus on the concave side was pinched between the inner corners of the vertebral epiphysis. In young rats with an active growth plate, a transverse fissure appeared at the level of the hypertrophic cell layer or the primary metaphyseal trabecular zone. Metaphyseal and epiphyseal trabeculae on the compressed side were thicker and more dense than those of the distracted part of the vertebra. In growing animals, morphometric analysis of hemiepiphyseal and hemimetaphyseal areas, and the corresponding trabecular bone density, showed significant differences between the compressed and distracted sides. No differences were observed in adult rats. We found no significant differences in osteoclast number between compressed and distracted sides in either age group. Our results provide quantitative evidence of the working of 'Wolff's law'. The differences in trabecular density are examples of remodelling by osteoclasts and osteoblasts; our finding of no significant difference in osteoclast numbers between the hemiepiphyses in the experimental and control groups suggests that the response of living bone to altered strain is mediated by osteoblasts.

  11. [Structural and functional characteristics of bone tissue and blood cytokines in health and disease of the joints]. (United States)

    Kariakina, E V; Norkin, I A; Gladkova, E V; Persova, E A; Matveeva, O V; Puchin'ian, D M


    Change of structural and functional state of bone in patients with primary osteoarthrosis of the hip joint compared to healthy individuals is characterized by decreased bone formation with a relative predominance of resorption. Osteopenic syndrome develops in the background of evident imbalance of a blood cytokine profile with increasing the level of proinflammatory and the variability of the level of anti-inflammatory cytokines.

  12. Rigid model-based 3D segmentation of the bones of joints in MR and CT images for motion analysis. (United States)

    Liu, Jiamin; Udupa, Jayaram K; Saha, Punam K; Odhner, Dewey; Hirsch, Bruce E; Siegler, Sorin; Simon, Scott; Winkelstein, Beth A


    There are several medical application areas that require the segmentation and separation of the component bones of joints in a sequence of images of the joint acquired under various loading conditions, our own target area being joint motion analysis. This is a challenging problem due to the proximity of bones at the joint, partial volume effects, and other imaging modality-specific factors that confound boundary contrast. In this article, a two-step model-based segmentation strategy is proposed that utilizes the unique context of the current application wherein the shape of each individual bone is preserved in all scans of a particular joint while the spatial arrangement of the bones alters significantly among bones and scans. In the first step, a rigid deterministic model of the bone is generated from a segmentation of the bone in the image corresponding to one position of the joint by using the live wire method. Subsequently, in other images of the same joint, this model is used to search for the same bone by minimizing an energy function that utilizes both boundary- and region-based information. An evaluation of the method by utilizing a total of 60 data sets on MR and CT images of the ankle complex and cervical spine indicates that the segmentations agree very closely with the live wire segmentations, yielding true positive and false positive volume fractions in the range 89%-97% and 0.2%-0.7%. The method requires 1-2 minutes of operator time and 6-7 min of computer time per data set, which makes it significantly more efficient than live wire-the method currently available for the task that can be used routinely.

  13. Current concepts in the management of recurrent anterior gleno-humeral joint instability with bone loss (United States)

    Ramhamadany, Eamon; Modi, Chetan S


    The management of recurrent anterior gleno-humeral joint instability is challenging in the presence of bone loss. It is often seen in young athletic patients and dislocations related to epileptic seizures and may involve glenoid bone deficiency, humeral bone deficiency or combined bipolar lesions. It is critical to accurately identify and assess the amount and position of bone loss in order to select the most appropriate treatment and reduce the risk of recurrent instability after surgery. The current literature suggests that coracoid and iliac crest bone block transfers are reliable for treating glenoid defects. The treatment of humeral defects is more controversial, however, although good early results have been reported after arthroscopic Remplissage for small defects. Larger humeral defects may require complex reconstruction or partial resurfacing. There is currently very limited evidence to support treatment strategies when dealing with bipolar lesions. The aim of this review is to summarise the current evidence regarding the best imaging modalities and treatment strategies in managing this complex problem relating particularly to contact athletes and dislocations related to epileptic seizures. PMID:27335809

  14. Clinical correlates and treatment of bone/joint pain and difficulty with sexual arousal in patients on maintenance hemodialysis. (United States)

    Carreon, Myra; Fried, Linda F; Palevsky, Paul M; Kimmel, Paul L; Arnold, Robert M; Weisbord, Steven D


    Bone/joint pain and difficulty with sexual arousal are prevalent, frequently severe, and potentially treatable in patients on maintenance hemodialysis. However, the mediators and adequacy of treatment for these symptoms have been less well studied. We sought to assess the clinical correlates and treatment of these symptoms in patients receiving chronic hemodialysis. Using the Dialysis Symptom Index, we assessed the presence and severity of bone/joint pain and difficulty with sexual arousal in 75 patients on chronic hemodialysis. Associations of demographic and clinical variables with these 2 symptoms were assessed. We also recorded the use of analgesics for bone/joint pain and, among men, phosphodiesterase-5 inhibitors for difficulty with sexual arousal. Twenty-eight patients (37%) reported bone/joint pain, of whom 20 (71%) described it as moderate to severe. Nineteen of 50 male patients (38%) reported difficulty with sexual arousal, which was described as moderate to severe by 15 (79%). Patients' demographic and clinical characteristics were not correlated with bone/joint pain. Among men, there were no correlations between patients' demographic and clinical characteristics and difficulty with sexual arousal. Only 48% of patients with bone/joint pain were receiving analgesics, while 21% of men who described difficulty with sexual arousal were receiving phosphodiesterase-5 inhibitors. Demographic, clinical, and dialysis-related variables are poorly correlated with bone/joint pain and difficulty with sexual arousal. However, these symptoms are prevalent and under-treated, which should spur efforts to assess the impact of improving provider assessment and treatment of these symptoms on patient outcomes, including health-related quality of life.

  15. Successful function-preserving therapy for chondroblastoma of the temporal bone involving the temporomandibular joint. (United States)

    Yokoyama, Junkichi; Yoshimoto, Hitoshi; Ito, Shin; Ohba, Shinichi; Fujimaki, Mitsuhisa; Ikeda, Katsuhisa; Yazawa, Masaki; Fujimiya, Nozomi; Hanaguri, Makoto


    We present a case involving a late diagnosis of chondroblastoma of the temporal skull base involving the temporomandibular joint (TMJ). Following an initial misdiagnosis and unsuccessful treatment over a period of 5 years, the patient was referred to our department for further evaluation and possible surgical intervention for occlusal abnormalities, trismus, clicking of the TMJ, and hearing impairment. Based on preoperative immunochemical studies showing positive reaction of multinucleated giant cells for S-100 protein, the final diagnosis was chondroblastoma. The surgical approach - postauricular incision and total parotidectomy, with complete removal of the temporal bone, including the TMJ via the extended middle fossa - was successful in preserving facial nerves and diminishing clinical manifestations. This study highlights a misdiagnosed case in an effort to underline the importance of medical examinations and accurate differential diagnosis in cases involving any tumor mass in the temporal bone.

  16. Successful Function-Preserving Therapy for Chondroblastoma of the Temporal Bone Involving the Temporomandibular Joint

    Directory of Open Access Journals (Sweden)

    Junkichi Yokoyama


    Full Text Available We present a case involving a late diagnosis of chondroblastoma of the temporal skull base involving the temporomandibular joint (TMJ. Following an initial misdiagnosis and unsuccessful treatment over a period of 5 years, the patient was referred to our department for further evaluation and possible surgical intervention for occlusal abnormalities, trismus, clicking of the TMJ, and hearing impairment. Based on preoperative immunochemical studies showing positive reaction of multinucleated giant cells for S-100 protein, the final diagnosis was chondroblastoma. The surgical approach – postauricular incision and total parotidectomy, with complete removal of the temporal bone, including the TMJ via the extended middle fossa – was successful in preserving facial nerves and diminishing clinical manifestations. This study highlights a misdiagnosed case in an effort to underline the importance of medical examinations and accurate differential diagnosis in cases involving any tumor mass in the temporal bone.


    Neverov, V A; Egorov, K S


    A case report presents the experience of application of compression pileateless mini-screws (Gerbert's screws) in treatment of intra-articular fractures, which formed the elbow joint (44 cases). There were performed 32 operations concerning fracture of head of radius, 10 operations on the occasion of fractures of distal section of the humerus and 2 operations on the coronoid process. Long-term treatment results were followed-up in 31 patients during more than 6 months. On basis of analysis of treatment results the authors made a conclusion that the application of mini-screws in case of bone fractures, which formed the elbow joint, allowed realization of stable osteosynthesis after anatomic reposition of articular surfaces, obtaining good anatomical and functional result and shortened the terms of patient's treatment.

  18. Bones - joints - soft tissues II. 7. rev. ed. Knochen - Gelenke - Weichteile II

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    Dihlmann, W. (Roentgeninstitut, Allgemeines Krankenhaus Barmbek, Hamburg (Germany)); Frommhold, W. (Radiologische Klinik, Tuebingen Univ. (Germany)) (eds.)


    With the publication of the 2nd part to Volume VI, 'Bones - joints - soft tissues', the 7th edition of 'Diagnostic radiology in the hospital and medical practice' is complete. The advances made particularly during the past decade in the field of diagnostic radiology have made it neccesary for all the individual sections to be completely revised. Recently developed methods of imaging like sonography, computed tomography and magnetic resonance tomography are increasingly used as a replacement for or, at least, an adjunct to conventional X-ray procedures. Owing to the development and continuous refinement of related methods of intervention the gap between mere diagnostic applications and therapeutic uses of radiology could eventually be closed. The issues mainly discussed in this volume are bone fractures and healing, bone transplantation, osteopathy and osteoarthropathy, fibrous dyplasia or Albright's disease, Pagetoid osteitis, genetically transmitted constitutional disorders of the skeleton and soft tissue changes. While in the key sections on bone fractures and healing, osteopathy and osteoarthropathy as well as constitutional genetic disorders X-ray techniques are still described as the prevailing method of diagnosis, diseases of soft tissues now are much more commonly diagnosed using magnetic resonance imaging. (orig./MG) With 2248 figs., 59 tabs.

  19. Bone and Joint Infections due to Haemophilus parainfluenzae: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Conar R. O’Neil


    Full Text Available Haemophilus parainfluenzae is a normal inhabitant of the human respiratory tract. However it is an increasingly recognized pathogen in invasive infections, particularly in the immunocompromised host and where there is disruption of the normal skin or mucosal barriers. We present a case of a 56-year-old female with a history of asplenia who developed H. parainfluenzae septic arthritis of the hip following an intra-articular steroid injection. We also summarize previously reported cases of bone and joint infections caused by H. parainfluenzae.

  20. A statistical study of papers in the Journal of Bone and Joint Surgery [BR] 1984. (United States)

    Morris, R W


    The statistical quality of 103 original articles published in The Journal of Bone and Joint Surgery (British Volume) in 1984 was assessed. Some papers were found to be deficient: thus, it was not always clear how series were selected and sometimes neither the data nor the results were clearly presented. Sample sizes were frequently inadequate for the conclusions reached and statistical techniques should have been used more frequently. A majority of papers were descriptions of case series for which no comparative data were made available. It is suggested that collaborative research would best advance knowledge about the relative benefits of various managements, and that statistical advice could make a substantial contribution.

  1. Fixation of trapezial implants in a trapeziometacarpal total joint prosthesis tested in a model of porcine bone. (United States)

    Hansen, Torben Bæk; Hengst, David; Mortensen, Jesper; Amstrup, Anders Læssøe


    High aseptic loosening rates have been reported in total joint prostheses of the carpometacarpal joint of the thumb, particularly in the trapezial component. The primary fixation of new implants may be tested in cadaver bones, but the anatomy of the pig is in many ways similar to that of the human, so we compared the central carpal bone from the forefoot of 6-month-old pigs, which has a saddle joint surface similar to the trapezium, to the trapezium in patients with carpometacarpal osteoarthritis. The mean (SD) bone mineral density of the 13 pig forefoot bones was 0.88 (0.12) g/cm(2) compared with 0.63 (0.16) g/cm(2) in the 31 human trapeziums. The measured size of the porcine bones was slightly larger than that of the human trapeziums. The similarity in form, size, and bone mineral density means that the central bone of the forefoot of 6-month-old pigs may be used for fixation tests in trapezial implants.

  2. Long-Term Symptoms Onset and Heterotopic Bone Formation around a Total Temporomandibular Joint Prosthesis: a Case Report

    Directory of Open Access Journals (Sweden)

    Luca Guarda-Nardini


    Full Text Available Background: The literature on total alloplastic temporomandibular joint (TMJ reconstructions is encouraging, and studies on total alloplastic TMJ replacements outcomes showed acceptable improvements in terms of both pain levels and jaw function. Nevertheless, some adverse events, such as heterotopic bone formation around the implanted prosthesis, may occur. In consideration of that, the present manuscript describes a case of heterotopic bone formation around a total temporomandibular joint prosthesis, which occurred several years after the implant. Methods: The present manuscript describes a case of heterotopic bone formation around a total TMJ prosthesis, which occurred several years after the implant in patients, who previously underwent multiple failed TMJ surgeries. Results: Ten years after the surgical TMJ replacement to solve an ankylotic bone block, the patient came to our attention again referring a progressive limitation in mouth opening. A computerized tomography showed evidence of marked heterotopic bone formation in the medial aspects of the joint, where a new-born ankylotic block occupied most part of the gap created by resecting the coronoid process at the time of the TMJ prosthesis insertion. Conclusions: Despite this adverse event has been sometimes described in the literature, this is the first case in which its occurrence happened several years after the temporomandibular joint replacement. It can be suggested that an accurate assessment of pre-operative risk factors for re-ankylosis (e.g., patients with multiple failed temporomandibular joint surgeries and within-intervention prevention (e.g., strategies to keep the bone interfaces around the implant separated should be better standardized and define in future studies.

  3. The ENCCA-WP7/EuroSarc/EEC/PROVABES/EURAMOS 3rd European Bone Sarcoma Networking Meeting/Joint Workshop of EU Bone Sarcoma Translational Research Networks; Vienna, Austria, September 24-25, 2015. Workshop Report

    NARCIS (Netherlands)

    Kager, L.; Whelan, J.; Dirksen, U.; Hassan, B.; Anninga, J.; Bennister, L.; Bovee, J.V.; Brennan, B.; Broto, J.M.; Brugieres, L.; Cleton-Jansen, A.M.; Copland, C.; Dutour, A.; Fagioli, F.; Ferrari, S.; Fiocco, M.; Fleuren, E.D.; Gaspar, N.; Gelderblom, H.; Gerrand, C.; Gerss, J.; Gonzato, O.; Graaf, W. van der; Hecker-Nolting, S.; Herrero-Martin, D.; Klco-Brosius, S.; Kovar, H.; Ladenstein, R.; Lancia, C.; Ledeley, M.C.; McCabe, M.G.; Metzler, M.; Myklebost, O.; Nathrath, M.; Picci, P.; Potratz, J.; Redini, F.; Richter, G.H.; Reinke, D.; Rutkowski, P.; Scotlandi, K.; Strauss, S.; Thomas, D; Tirado, O.M.; Tirode, F.; Vassal, G.; Bielack, S.S.


    This report summarizes the results of the 3rd Joint ENCCA-WP7, EuroSarc, EEC, PROVABES, and EURAMOS European Bone Sarcoma Network Meeting, which was held at the Children's Cancer Research Institute in Vienna, Austria on September 24-25, 2015. The joint bone sarcoma network meetings bring together Eu

  4. Simplifying the treatment of acute bacterial bone and joint infections in children. (United States)

    Pääkkönen, Markus; Peltola, Heikki


    The treatment of acute hematogenous bone and joint infections of children - osteomyelitis (OM), septic arthritis (SA) and OM-SA combination (OM+SA) - has simplified over the past years. The old approach included months-long antibiotic treatment, started intravenously for at least a week, followed by oral completion of the course. Recent prospective randomized trials show that most cases heal with a total course of 3 weeks (OM, OM+SA) or 2 weeks (SA) of an appropriate antibiotic, provided the clinical response is good and C-reactive protein level has normalized. If the prevalence of methicillin-resistant Staphylococcus aureus and Kingella kingae is low, clindamycin and a first-generation cephalosporin are safe, inexpensive and effective alternatives. They should be administered in large doses and four times a day. Clindamycin, vancomycin and expensive linezolid are options against methicillin-resistant Staphylococcus aureus. Extensive surgery beyond a diagnostic sample by aspiration is rarely needed in uncomplicated cases.

  5. How can we assess the burden of muscle, bone and joint conditions in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Myburgh, Corrie; Hartvigsen, Jan


    BACKGROUND: Musculoskeletal diseases are the most common causes of long-term pain and disability worldwide and a growing international public health concern. However, the everyday burden and impact of musculoskeletal conditions are not well understood, especially among people living in low......- and middle-income countries in Africa. Since 2011, World Spine Care, a nongovernmental organisation, has collaborated with the Botswana Ministry of Health to open spine care centres and to conduct research. The broad aim of the Muscle, Bone and Joint (MuBoJo) research project is to examine the sociocultural....../DESIGN: This focused ethnography is based on eight months (November 2011, April 2013, October 2013-March 2014) of fieldwork in Botswana. The project was theoretically informed by the concepts of explanatory models of illness, social suffering, and biographical disruption. Data collection included fieldnotes, non...

  6. Bone, joint and tooth development in mucopolysaccharidoses: relevance to therapeutic options. (United States)

    Oussoren, E; Brands, M M M G; Ruijter, G J G; der Ploeg, A T van; Reuser, A J J


    The mucopolysaccharidoses (MPS) are prominent among the lysosomal storage diseases. The intra-lysosomal accumulation of glycosaminoglycans (GAGs) in this group of diseases, which are caused by several different enzyme deficiencies, induces a cascade of responses that affect cellular functions and maintenance of the extra-cellular matrix. Against the background of normal tissue-specific processes, this review summarizes and discusses the histological and biochemical abnormalities reported in the bones, joints, teeth and extracellular matrix of MPS patients and animal models. With an eye to the possibilities and limitations of reversing the pathological changes in the various tissues, we address therapeutic challenges, and present a model in which the cascade of pathologic events is depicted in terms of primary and secondary events.

  7. Anatomic relationships of the distal and proximal radioulnar joints articulating surface areas, and of the radius and ulna bone volumes – implications for biomechanical studies of the distal and proximal radioulnar joints and forearm bones

    Directory of Open Access Journals (Sweden)

    Paul S C Malone


    Full Text Available BackgroundPrevious work from this laboratory has evidenced the biomechanical role of forearm osseoligamentous structures in load transfer of applied forces. It has shown that transmitted forces across the distal radioulnar joint (DRUJ and proximal radioulnar joint (PRUJ are similar though not identical under axial loading conditions. The purpose of the study was to assess the articulating surface areas of the radioulnar joints and the volumes of the forearm bones addressing the hypothesis that there may be anatomic adaptations that reflect the biomechanical function of the integrated forearm unit.MethodsThe articulating surface areas of PRUJ and DRUJ were assessed using a laser scanner in 24 cadaver forearms. The articulating joint surfaces were additionally delineated from standardized photographs assessed by three observers. The surface areas of matched pairs of joints were compared on the null hypothesis that these were the same within a given forearm specimen. An additional 44 pairs of matched forearm bone volumes were measured using water displacement technique and again compared through statistical analysis (paired sample t-test, and Bland Altman analysis.ResultsThe findings of this study are that the articulating surface areas of the DRUJ and PRUJ as well as the bone volumes are significantly different and yet strongly correlated. The paired sample t-test showed a significant difference between the surface areas of the DRUJ and PRUJ (p<0.05. The PRUJ articulating surface area was marginally larger than the DRUJ with a PRUJ : DRUJ ratio of 1.02. Paired sample t-test showed a significant difference between the two bone volumes (p<0.01 with a radius to ulna bone volume ratio of 0.81. When the olecranon was disregarded, radius volume was on average 4% greater than ulna volume.ConclusionsThis study demonstrated defines the anatomical relationships between the two forearm bones and their articulating joints when matched for specimen. The data

  8. Systematic mapping of the subchondral bone 3D microarchitecture in the human tibial plateau: Variations with joint alignment. (United States)

    Roberts, Bryant C; Thewlis, Dominic; Solomon, Lucian B; Mercer, Graham; Reynolds, Karen J; Perilli, Egon


    Tibial subchondral bone plays an important role in knee osteoarthritis (OA). Microarchitectural characterization of subchondral bone plate (SBP), underlying subchondral trabecular bone (STB) and relationships between these compartments, however, is limited. The aim of this study was to characterize the spatial distribution of SBP thickness, SBP porosity and STB microarchitecture, and relationships among them, in OA tibiae of varying joint alignment. Twenty-five tibial plateaus from end-stage knee-OA patients, with varus (n = 17) or non-varus (n = 8) alignment were micro-CT scanned (17 μm/voxel). SBP and STB microarchitecture was quantified via a systematic mapping in 22 volumes of interest per knee (11 medial, 11 lateral). Significant within-condylar and between-condylar (medial vs. lateral) differences (p volume fraction (BV/TV) was consistently high throughout the medial condyle, whereas in non-varus, medially, it was more heterogeneously distributed. Regions of high SBP thickness were co-located with regions of high STB BV/TV underneath. In varus, BV/TV was significantly higher medially than laterally, however, not so in non-varus. Moreover, region-specific significant associations between the SBP thickness and SBP porosity and the underlying STB microarchitecture were detected, which in general were not captured when considering the values averaged for each condyle. As subchondral bone changes reflect responses to local mechanical and biochemical factors within the joint, our results suggest that joint alignment influences both the medial-to-lateral and the within-condyle distribution of force across the tibia, generating corresponding local bony responses (adaptation) of both the subchondral bone plate and underlying subchondral trabecular bone microarchitecture. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  9. Persistent bone marrow edema after osteochondral autograft transplantation in the knee joint

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    Nemec, Stefan Franz [MR Centre of Excellence, Department of Radiology, Medical University Vienna, Lazarettgasse 14, 1090 Vienna (Austria)], E-mail:; Marlovits, Stefan [Department of Traumatology, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna (Austria); Trattnig, Siegfried [MR Centre of Excellence, Department of Radiology, Medical University Vienna, Lazarettgasse 14, 1090 Vienna (Austria)


    Background and objective: The assessment of bone marrow edema-like signal intensity in magnetic resonance imaging (MRI) in patients after osteochondral autograft transplantation (OCT) in the knee joint is a parameter of yet indefinite value. This study determines the prevalence of persistent edema-like signal intensity in OCT patients and evaluates the correlation between edema and morphological imaging findings of the graft and clinical pain symptoms. Materials and methods: In this longitudinal observational study, 10 patients after OCT were followed by MRI prospectively 1 month, 3 months, 6 months, 12 months, and 24 months post-operatively. All MR examinations were performed on a 1.0 T MR unit with the same protocol using a modified scoring system (magnetic resonance observation of cartilage repair tissue-MOCART) for evaluation. Edema-like signal intensity in and beneath the osteochondral graft was assessed in its prevalence and graded using a coronal short tau inversion recovery fast spin echo (STIR-FSE) sequence: grade 1, normal; grade 2, moderate (diameter <2 cm); grade 3, severe (diameter >2 cm). The finding of edema-like signal intensity was correlated with graded parameters describing the morphology of the repair tissue assessed in a sagittal dual FSE sequence including: (a) surface of repair tissue: grade 1, intact; grade 2, damaged. (b) Cartilage interface: grade 1, complete; grade 2, incomplete. (c) Bone interface: grade 1, complete; grade 2, delamination. The finding of edema-like signal intensity was also correlated with the KOOS pain score assessing knee pain after 12 months. Results: Initially, after 1 month the prevalence of edema-like signal intensity was 70% (7/10 patients) and finally after 24 months 60% (6/10 patients). We found no significant relationship between the prevalence and degree of edema-like signal intensity and parameters describing the morphology of the repair tissue. Also the clinical pain score did not show significant

  10. Stereomicroscopic evaluation of the joint cartilage and bone tissue in osteoporosis (United States)

    Vasile, Liliana; Torok, Rodica; Deleanu, Bogdan; Marchese, Cristian; Valeanu, Adina; Bodea, Rodica


    Aim of the study. Assessment by stereomicroscopy of the severity of lesions in osteoporotic bone at both sexes and to correlate micro-and macro-bone fracture due to low bone density values with the disease evolution. Material and method: The study material consists of fragments of bone from the femoral head, vertebral bone, costal and iliac crest biopsy obtained from patients aged over 70 years, female and male, treated in the County Hospital of Timisoara, Department of Orthopedics. For the purpose of studying the samples in stereomicroscopy and trough polarized light it has been used the Olympus Microscope SZ ×7 and an Olympus camera with 2,5 × digital zoom and a 3× optical zoom in the Vest Politechnic Univesity. Results and discussions: Subchondral bone presents osteolysis associated with a osteoporotic bone transformation. Pseudocystic chondrolisis was noted in the osteoarticular cartilage, in addition with areas of hemorrhagic postfractural necrosis. The osteoporotic bone exhibits ischemic necrosis and focal hemorrhagic necrosis adjacent fracture. Microporosity pattern of the bone observed by stereomicroscopy correspond to the spongy bone osteoporosis images. Morphometry of the bone spiculi reveals length of 154.88 and 498.32 μ. In men we found a greater thickness of bone trabeculi compared with bone texture porosity in women. The subchondral bone supports and fulfills an important role in transmitting forces from the overlying articular cartilage inducing the bone resorbtion. The femoral head fracture may be the final event of many accumulated bone microcracks. Conclusions: Bone fragility depends not only of the spongy bone but also of the cortical bone properties. Osteolysis produced by loss of balance in the process of remodeling in favor of bone resorption leads to the thinning of the subchondral bone at both sexes.

  11. Adipose, Bone Marrow and Synovial Joint-Derived Mesenchymal Stem Cells for Cartilage Repair (United States)

    Fellows, Christopher R.; Matta, Csaba; Zakany, Roza; Khan, Ilyas M.; Mobasheri, Ali


    Current cell-based repair strategies have proven unsuccessful for treating cartilage defects and osteoarthritic lesions, consequently advances in innovative therapeutics are required and mesenchymal stem cell-based (MSC) therapies are an expanding area of investigation. MSCs are capable of differentiating into multiple cell lineages and exerting paracrine effects. Due to their easy isolation, expansion, and low immunogenicity, MSCs are an attractive option for regenerative medicine for joint repair. Recent studies have identified several MSC tissue reservoirs including in adipose tissue, bone marrow, cartilage, periosteum, and muscle. MSCs isolated from these discrete tissue niches exhibit distinct biological activities, and have enhanced regenerative potentials for different tissue types. Each MSC type has advantages and disadvantages for cartilage repair and their use in a clinical setting is a balance between expediency and effectiveness. In this review we explore the challenges associated with cartilage repair and regeneration using MSC-based cell therapies and provide an overview of phenotype, biological activities, and functional properties for each MSC population. This paper also specifically explores the therapeutic potential of each type of MSC, particularly focusing on which cells are capable of producing stratified hyaline-like articular cartilage regeneration. Finally we highlight areas for future investigation. Given that patients present with a variety of problems it is unlikely that cartilage regeneration will be a simple “one size fits all,” but more likely an array of solutions that need to be applied systematically to achieve regeneration of a biomechanically competent repair tissue. PMID:28066501

  12. Exploration of computerized image processing in underexposed and overexposed X-rays of bones and joints

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhao-chen; ZHANG You-jun; FENG Cheng-qiang; ZHU Yuan-zhong; YAN Shi-yi; LIU Yu-jin


    Objective: To study the effective computerized image processing of underexposed and overexposed X-rays of bones and joints. Methods: Ninety-nine conventional X-ray images (82 were overexposed and 17 were underexposed),scanned by an UMAX Astra 4000U Scanner, were converted into digital images on the basis of their analog images. A computerized imaging processing program consisting of five functional modules such as Contrast Stretch, Fast Flourier Transform (FFT), Image Smoothing Modules, Inverse Fast Flourier Transform (IFFT) and Nonlinear Transform performed image contrast stretch and smoothing. Three senior doctors from hospital image sections made their evaluation of all the processed images. Results: Of 82 overexposed films, 71 met the clinical requirements after image processing, and 11 were unable to be applied to clinical diagnosis, accounting for 87% and 13% respectively. Of the other 17 underexposed X-ray images, 11 met the clinical requirements while 6 were not, making a percentage of 64 and 35. Conclusion: Image contrast stretch and smoothing processing are significantly effective on conventional X-ray images which were inappropriately exposed, and can avoid more X-ray radiation caused by handling of radiological photograph again. This method can decrease hospital cost and provide acute and effective X-ray examinations for the treatment and cure for critical patients.

  13. Skeletal muscle contraction in protecting joints and bones by absorbing mechanical impacts (United States)

    Rudenko, O. V.; Tsyuryupa, S.; Sarvazyan, A.


    We have previously hypothesized that the dissipation of mechanical energy of external impact is a fundamental function of skeletal muscle in addition to its primary function to convert chemical energy into mechanical energy. In this paper, a mathematical justification of this hypothesis is presented. First, a simple mechanical model, in which the muscle is considered as a simple Hookean spring, is considered. This analysis serves as an introduction to the consideration of a biomechanical model taking into account the molecular mechanism of muscle contraction, kinetics of myosin bridges, sarcomere dynamics, and tension of muscle fibers. It is shown that a muscle behaves like a nonlinear and adaptive spring tempering the force of impact and increasing the duration of the collision. The temporal profiles of muscle reaction to the impact as functions of the levels of muscle contraction, durations of the impact front, and the time constants of myosin bridges closing, are obtained. The absorption of mechanical shock energy is achieved due to the increased viscoelasticity of the contracting skeletal muscle. Controlling the contraction level allows for the optimization of the stiffness and viscosity of the muscle necessary for the protection of the joints and bones.

  14. Are bone erosions detected by magnetic resonance imaging and ultrasonography true erosions? A comparison with computed tomography in rheumatoid arthritis metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Møller Døhn, Uffe; Ejbjerg, B.; Court-Payen, M.;


    The objective of the study was, with multidetector computed tomography (CT) as the reference method, to determine whether bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) joints detected with magnetic resonance imaging (MRI) and ultrasonography (US), but not with radiography...

  15. Bone scan and joint scan of hands and feet in rheumatoid arthritis; Scintigraphie osseuse et articulaire des mains et des pieds dans la polyarthrite rhumatoide

    Energy Technology Data Exchange (ETDEWEB)

    Carpentier, N.; Verbeke, S.; Perdrisot, R.; Grilo, R.M.; Quenesson, E.; Bonnet, C.; Vergne, P.; Treves, R.; Bertin, P.; Boutros-Toni, F. [Centre Hospitalier Universitaire Dupuytren, Faculte de Medecine, 87 - Limoges (France)


    The aim of this study was to determine the ability of joint scan and bone scan of hands and feet, in patients with rheumatoid arthritis, to localize the altered joints. The sensitivity, the specificity, the positive predictive value (PPV) and the negative predictive value (NPV) of joint scan were determined in comparison with clinical joint assessment. Fifteen patients (780 joints) were clinically examined (pain and synovitis); during the same day, a bone scan and a joint scan were realized by oxidronate {sup 99m}Tc intravenous injection. Patients were scanned 5 minutes (tissual time, T{sub t}) and 3 hours 1/4 (bone time, T{sub 0}) after the administration. The uptake of the bi-phosphonate was evaluated with a qualitative method using a grey scale. The uptake of {sup 99m}Tc oxidronate was quantitated using an extra-articular region of interest. The sensitivity, specificity, PPV and NPV of the scan at Tt were 46%, 96%, 85% et 78%. The same parameters were 75%, 66%, 53% and 84% for the scan realized at T{sub 0}. The joint scan has showed 22% of false positive. These false positives could be a consequence of an earlier detection of joint alterations by scan. The joint scan should forecast the evolution of joints in patients with rheumatoid arthritis. (author)

  16. N-acylated glucosamines for bone and joint disorders: effects of N-butyryl glucosamine on ovariectomized rat bone. (United States)

    Anastassiades, Tassos; Rees-Milton, Karen; Xiao, Hao; Yang, Xiaojing; Willett, Thomas; Grynpas, Marc


    The benefit of glucosamine (GlcN) in bone and joint disorders remains controversial. N-acetylation and other N-acylations of GlcN alter its biological properties fundamentally. We have shown previously that N-butyryl glucosamine (GlcNBu) preserved strikingly the subchondral bone structure in a destructive arthritis rat model. Here, we examine whether GlcNBu preserves bone in the ovariectomized (OVX) rat, a model for postmenopausal osteoporosis. Rats were randomized into 4 groups: group 1, sham OVX glucose (Glc) fed; group 2, sham OVX GlcNBu fed; group 3, OVX Glc fed; and group 4, OVX GlcNBu fed. A single, oral, 200-mg/kg dose of GlcNBu or Glc was administered daily for 6 months. Bone mineral content (BMC) and bone mineral density, and biomechanical properties of the femurs and spines were determined by standardized techniques. Two-way analysis of variance with a Bonferroni post hoc test was used for statistical analysis. Ovariectomy in group 3 resulted either in significant or highly significant effects in a number of the tests. For spinal BMCs the interaction between GlcNBu and OVX was significant. For the femurs, this interaction was also seen in energy to failure, and ultimate displacement and ultimate strain tests. In general, ovariectomy was necessary to show significant preventive effects of GlcNBu on mineral content and some biomechanical properties. We conclude that GlcNBu feeding in the OVX rat preserves bone mineral and some biomechanical properties. Translationally, GlcNBu can be positioned between nutriceuticals and pharmaceuticals for the prevention and treatment of osteoporosis. Advantages include low production costs and a favorable safety profile.

  17. Prospective analysis of a first MTP total joint replacement. Evaluation by bone mineral densitometry, pedobarography, and visual analogue score for pain

    DEFF Research Database (Denmark)

    Wetke, Eva; Zerahn, Bo; Kofoed, Hakon


    We hypothesized that a total replacement of the first metatarsophalangeal joint (MTP-1) would alter the walking pattern with medialisation of the ground reaction force (GRF) of the foot and subsequently cause an increase in bone mineral density (BMD) in the medial metatarsal bones and a decline...

  18. Levofloxacin at the usual dosage to treat bone and joint infections: a cohort analysis. (United States)

    Asseray, N; Bourigault, C; Boutoille, D; Happi, L; Touchais, S; Corvec, S; Bemer, P; Navas, D


    Fluoroquinolones are recommended for the treatment of bone and joint infections (BJIs), and levofloxacin is commonly used in this setting. However, no pre-marketing clinical study has supported its use, especially its dosage, for treating BJIs. This study aimed to assess the benefit-risk ratio of levofloxacin administered orally at a standard dosage of 500 mg once daily (OD) in a cohort of patients with BJIs. The medical records of patients admitted to a large French teaching hospital for BJI over a 1-year period and managed by a multidisciplinary team were reviewed. Patient data were recorded on a standardised form and the outcome was assessed at the end of antibiotic treatment and after 1-year of follow-up. A total of 230 patients were included, of whom 79 were treated with an antibiotic regimen including levofloxacin (34%). Most BJIs (97%) were surgically treated by wound debridement and/or removal or replacement of the infected device. Adverse drug reactions to levofloxacin leading to treatment discontinuation occurred in three patients (4%). The antibiotic treatment duration was significantly longer in patients treated with levofloxacin compared with other antibiotic regimens (median, 13 weeks vs. 6 weeks). Post-treatment outcomes were considered favourable (total or partial recovery, including orthopaedics aftermath) in 89-93% of patients, with no significant difference between treatment groups. In conclusion, oral levofloxacin at 500 mg OD is a well-tolerated and efficacious antibiotic treatment for BJIs. Our approach of following-up all treated patients is a useful way to validate specific clinical practices.

  19. Combined scintigraphic and radiographic diagnosis of bone and joint diseases. Including gamma correction interpretation. 4. rev. and enl. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Yong-Whee [Sung Ae General Hospital, Seoul (Korea, Republic of). Dept. of Nuclear Medicine and Radiology


    In this fourth edition of Combined Scintigraphic and Radiographic Diagnosis of Bone and Joint Diseases, the text has been thoroughly amended, updated, and partially rearranged to reflect the latest advances. In addition to discussing the role of pinhole imaging in the range of disorders previously covered, the new edition pays detailed attention to the novel diagnostic use of gamma correction pinhole bone scan in a broad spectrum of skeletal disorders, including physical, traumatic, and sports injuries, infectious and non-infectious bone diseases, benign and malignant bone tumors, and soft tissue diseases. A large number of state of the art pinhole scans and corroborative CT, MRI, and/or ultrasound images are presented side by side. The book has been enlarged to encompass various new topics, including occult fractures; cervical sprain and whiplash trauma; bone marrow edema; microfractures of trabeculae; evident, gaping, and stress fractures; and differential diagnosis. This new edition will be essential reading for practitioners and researchers in not only nuclear medicine but also radiology, orthopedic surgery, and pathology.

  20. Implants composed of carbon fiber mesh and bone-marrow-derived, chondrocyte-enriched cultures for joint surface reconstruction. (United States)

    Robinson, D; Efrat, M; Mendes, D G; Halperin, N; Nevo, Z


    The current study integrates two distinct approaches in joint resurfacing into a combined type of implant, composed of carbon fiber mesh impregnated and coated with a hyaluronic-acid-based delivery substance containing cultured cells. Rabbit autogeneic chondrocyte-enriched cultures obtained from mesenchymal stem cells (chondroprogenitor cells) derived from adult rabbit bone marrow were grown in vitro under conditions favoring chondrogenesis. The improvement in quality of repair when a combined implant containing both cells and a carbon scaffold was used, in comparison to the utilization of carbon fiber mesh alone, was clearly demonstrated using clinical, histological, biochemical, and biomechanical examinations. Evaluations of the joints were performed at 6 weeks and 6 months after implantation. The repair tissue in the cell-implanted joints consisted of a typical hyaline cartilage, which was more cellular and thicker than the repair tissue in the hyaluronic-acid-impregnated carbon-fiber-implanted control joints. The hyaline cartilage in the experimental group formed a superficial layer above the carbon fibers, flush with the joint surface. In the controls, in which carbon fiber and the delivery substance alone were implanted, a histologically and biochemically fibrous tissue that was inferior biomechanically to the new cartilage was formed by the cells containing implants.

  1. Low bone mineral density is associated with reduced hip joint space width in women: results from the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Jensen, Trine W; Bach-Mortensen, Pernille;


    OBJECTIVE: Since estrogen receptors (ER-alpha/ER-beta) were identified in human chondrocytes, animal and experimental studies have demonstrated the importance of continued estrogen production for the integrity of articular cartilage. However, human epidemiological support of the hypothesis has been...... inconclusive. The present cross-sectional study investigated the relationship between reduced bone mineral density (BMD), as a surrogate parameter of endogenous estrogen status assessed by digital x-ray radiogrammetry, and reduced minimum hip joint space width (JSW). DESIGN: Standardized hand radiographs...

  2. Low bone mineral density is associated with reduced hip joint space width in women: results from the Copenhagen Osteoarthritis Study

    DEFF Research Database (Denmark)

    Jacobsen, Steffen; Jensen, Trine W; Bach-Mortensen, Pernille;


    inconclusive. The present cross-sectional study investigated the relationship between reduced bone mineral density (BMD), as a surrogate parameter of endogenous estrogen status assessed by digital x-ray radiogrammetry, and reduced minimum hip joint space width (JSW). DESIGN: Standardized hand radiographs......OBJECTIVE: Since estrogen receptors (ER-alpha/ER-beta) were identified in human chondrocytes, animal and experimental studies have demonstrated the importance of continued estrogen production for the integrity of articular cartilage. However, human epidemiological support of the hypothesis has been...

  3. Analysis by computed tomography of bone changes in the mandibular head and mandibular fossa in relation to clinical findings in patients with temporomandibular joint (TMJ) disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hamamoto, Yoshioki; Nakajima, Tamio; Hayashi, Takafumi [Niigata Univ. (Japan). School of Dentistry


    Bone changes in the mandibular head and mandibular fossa in 33 patients with temporomandibular joint (TMJ) disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain, crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa. (author).

  4. Human bones obtained from routine joint replacement surgery as a tool for studies of plutonium, americium and {sup 90}Sr body-burden in general public

    Energy Technology Data Exchange (ETDEWEB)

    Mietelski, Jerzy W., E-mail: [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Edward B. [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Department of Physical Therapy Basics, Faculty of Physical Therapy, Administration College, Bielsko-Biala (Poland); Tomankiewicz, Ewa [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland); Golec, Joanna [Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Nowak, Sebastian [Traumatology and Orthopaedic Clinic, 5th Military Clinical Hospital and Polyclinic, Independent Public Healthcare Facility, Wroclawska 1-3, 30-901 Cracow (Poland); Orthopaedic Rehabilitation Department, Chair of Clinical Rehabilitation, Faculty of Motor of the Bronislaw Czech' s Academy of Physical Education, Cracow (Poland); Szczygiel, Elzbieta [Physical Therapy Department, Institute of Physical Therapy, Faculty of Heath Science, Jagiellonian University, Medical College, Cracow (Poland); Brudecki, Kamil [Henryk Niewodniczanski Institute of Nuclear Physics, Polish Academy of Sciences, Radzikowskiego 152, 31-342 Cracow (Poland)


    The paper presents a new sampling method for studying in-body radioactive contamination by bone-seeking radionuclides such as {sup 90}Sr, {sup 239+240}Pu, {sup 238}Pu, {sup 241}Am and selected gamma-emitters, in human bones. The presented results were obtained for samples retrieved from routine surgeries, namely knee or hip joints replacements with implants, performed on individuals from Southern Poland. This allowed to collect representative sets of general public samples. The applied analytical radiochemical procedure for bone matrix is described in details. Due to low concentrations of {sup 238}Pu the ratio of Pu isotopes which might be used for Pu source identification is obtained only as upper limits other then global fallout (for example Chernobyl) origin of Pu. Calculated concentrations of radioisotopes are comparable to the existing data from post-mortem studies on human bones retrieved from autopsy or exhumations. Human bones removed during knee or hip joint surgery provide a simple and ethical way for obtaining samples for plutonium, americium and {sup 90}Sr in-body contamination studies in general public. - Highlights: > Surgery for joint replacement as novel sampling method for studying in-body radioactive contamination. > Proposed way of sampling is not causing ethic doubts. > It is a convenient way of collecting human bone samples from global population. > The applied analytical radiochemical procedure for bone matrix is described in details. > The opposite patient age correlations trends were found for 90Sr (negative) and Pu, Am (positive).

  5. Features of radiological and anatomical changes in bone of the hip joint due to injuries



    Objective: To conduct a retrospective analysis of radiographs and CT scans for studying of typical changes in acetabulum (A) and proximal femur (F) in patients with the consequences of injuries in the area of the hip joint.Methods: We analyzed radiographs and CT scans in 106 patients. Patients were divided into groups: I — false joint of F neck, II – false joint at the level of per-, inter- and subtrochanteric area of F, III — post-traumatic avascular necrosis of F head, IV — posttraumatic co...

  6. Application of comparative imaging in bone and joint imaging teaching%比较影像学在骨关节影像教学中的应用

    Institute of Scientific and Technical Information of China (English)

    刘连生; 王芳军; 李栩薇; 陈志强


    从骨关节影像教学现状及现代医学影像学的特点出发,阐述了在骨关节影像教学中引入比较影像学理念的必要性,从教学方法应用、教学效果评价及展望等方面探讨比较影像学在骨关节影像教学中的应用.%This article expounds on the necessity of the introduction of comparative imaging in bone and joint imaging teaching according to the bone and joint imaging teaching situation and modern medical radiographic features.Meanwhile,it discusses the application of comparative imaging in bone and joint imaging teaching from aspects of teaching method,teaching effect evaluation and prospects of the comparative imaging.

  7. Radionuclide bone scintigraphy in the detection of significant complications after total knee joint replacement

    Energy Technology Data Exchange (ETDEWEB)

    Smith, S.L.; Wastie, M.L.; Forster, I


    AIM: Post-arthroplasty knee pain is common and clinically it can be difficult to identify those patients with complications requiring active treatment. The aim of this study was to determine the usefulness of{sup 99}Tc{sup m}-MDP bone scintigraphy. METHOD: A retrospective study of all patients having a{sup 99}Tc{sup m}-MDP bone scintigram for a painful knee arthroplasty between 1993 and 1999 was performed. Bone scintigrams were classified as normal or abnormal by a single observer. The results of these investigations were correlated with clinical outcome. RESULTS: Seventy-five patients with painful knee arthroplasties were referred for investigation. A total of 80 bone scintigrams were performed. The average patient age was 66.2 years (42 female and 33 male). The mean time period between surgery and onset of knee pain was 3 years. A final clinical diagnosis based on arthroscopy, open surgery, and extended clinical follow-up was available for all patients. Forty-three (53.8%) of the scintigrams were normal and 37 (46.3%) abnormal. Two patients with a normal bone scintigram has loose prostheses. Thirteen patients with an abnormal study had normal prostheses on follow-up and these tended to be patients scanned less than a year after surgery. The sensitivity, specificity, positive predictive value and negative predictive value of an unequivocally normal or abnormal bone scintigram was 92.3, 75.9, 64.9 and 95.0%, respectively. The pattern of isotope uptake in the abnormal studies was not specific enough to reliably differentiate aseptic from septic loosening. CONCLUSION: Radionuclide bone scintigraphy is useful in the assessment of the painful knee arthroplasty. A negative bone scintigram is reassuring and makes loosening or infection unlikely. Smith, S.L. et al. (2001)

  8. Joint Beamforming and Feature Detection for Enhanced Visualization of Spinal Bone Surfaces in Ultrasound Images

    CERN Document Server

    Mehdizadeh, Saeed; Kiss, Gabriel; Johansen, Tonni F; Holm, Sverre


    We propose a framework for extracting the bone surface from B-mode images employing the eigenspace minimum variance (ESMV) beamformer and a ridge detection method. We show that an ESMV beamformer with a rank-1 signal subspace can preserve the bone anatomy and enhance the edges, despite an image which is less visually appealing due to some speckle pattern distortion. The beamformed images are post-processed using the phase symmetry (PS) technique. We validate this framework by registering the ultrasound images of a vertebra (in a water bath) against the corresponding Computed Tomography (CT) dataset. The results show a bone localization error in the same order of magnitude as the standard delay-and-sum (DAS) technique, but with approximately 20% smaller standard deviation (STD) of the image intensity distribution around the bone surface. This indicates a sharper bone surface detection. Further, the noise level inside the bone shadow is reduced by 60%. In in-vivo experiments, this framework is used for imaging ...

  9. Bone (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  10. The analysis of application of MRI in the knee joint bone contusion%MRI在膝关节骨挫伤中的应用分析

    Institute of Scientific and Technical Information of China (English)



    MRI可以对膝关节的骨挫伤的病理变化予以揭示,并且能够对关节周围的韧带以及软组织的损伤情况进行准确的判断。本文通过对膝关节骨挫伤的病理基础与MRI信号特点、MRI诊断骨挫伤的价值与临床意义、骨挫伤的MRI鉴别诊断等进行了系统的阐述,对MRI在膝关节骨挫伤中的应用进行分析。%MRI can reveal to the pathological changes of the bone contusion of knee joint. And around the joints of the ligaments and soft tissue injury of accurate judgment. This article through to the pathogenesis of knee joint bone contusion of MRI signal characteristics, and MRI diagnostic value and clinical significance of bone contusion, bone contusion of MRI diagnosis of the system, the application of MRI in the knee joint bone contusion were analyzed.

  11. Progression of cartilage degradation, bone resorption and pain in rat temporomandibular joint osteoarthritis induced by injection of iodoacetate.

    Directory of Open Access Journals (Sweden)

    Xue-Dong Wang

    Full Text Available BACKGROUND: Osteoarthritis (OA is an important subtype of temporomandibular disorders. A simple and reproducible animal model that mimics the histopathologic changes, both in the cartilage and subchondral bone, and clinical symptoms of temporomandibular joint osteoarthritis (TMJOA would help in our understanding of its process and underlying mechanism. OBJECTIVE: To explore whether injection of monosodium iodoacetate (MIA into the upper compartment of rat TMJ could induce OA-like lesions. METHODS: Female rats were injected with varied doses of MIA into the upper compartment and observed for up to 12 weeks. Histologic, radiographic, behavioral, and molecular changes in the TMJ were evaluated by light and electron microscopy, MicroCT scanning, head withdrawal threshold test, real-time PCR, immunohistochemistry, and TUNEL assay. RESULTS: The intermediate zone of the disc loosened by 1 day post-MIA injection and thinned thereafter. Injection of an MIA dose of 0.5 mg or higher induced typical OA-like lesions in the TMJ within 4 weeks. Condylar destruction presented in a time-dependent manner, including chondrocyte apoptosis in the early stages, subsequent cartilage matrix disorganization and subchondral bone erosion, fibrosis, subchondral bone sclerosis, and osteophyte formation in the late stages. Nociceptive responses increased in the early stages, corresponding to severe synovitis. Furthermore, chondrocyte apoptosis and an imbalance between anabolism and catabolism of cartilage and subchondral bone might account for the condylar destruction. CONCLUSIONS: Multi-level data demonstrated a reliable and convenient rat model of TMJOA could be induced by MIA injection into the upper compartment. The model might facilitate TMJOA related researches.

  12. Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Harris, S.A.; Rood, J.P.; Testa, H.J.


    13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed.

  13. One in 13 'original' articles in the Journal of Bone and Joint Surgery are duplicate or fragmented publications. (United States)

    Gwilym, S E; Swan, M C; Giele, H


    Duplicate publication in orthopaedic journals may further an author's academic career but this is at the cost of both scientific integrity and knowledge. Multiple publications of the same work increase the workload of editorial boards, misguide the reader and affect the process of meta-analysis. We found that of 343 'original' articles published in the Journal of Bone and Joint Surgery in 1999, 26 (7.6%) had some degree of redundancy. The prevalence of duplicate publications in the orthopaedic literature appears to be less than that in other surgical specialties but it is still a matter of concern. It is the author's responsibility to notify the editor of any duality when submitting a paper for publication.

  14. CAD - CAM Procedures Used for Rapid Prototyping of Prosthetic Hip Joint Bone (United States)

    Popa, Luminita I.; Popa, Vasile N.


    The article addresses the issue of rapid prototyping CAD/ CAM procedures, based on CT imaging, for custom implants dedicated to hip arthroplasty and the correlation study to be achieved between femoral canal shape, valued by modern imaging methods, and the prosthesis form. A set of CT images is transformed into a digital model using one of several software packages available for conversion. The purpose of research is to obtain prosthesis with compatible characteristics as close to the physiological, with an optimal adjustment of the prosthesis to the bone in which it is implanted, allowing the recovery of the patient physically, mentally and socially.

  15. The performance of MRI in detecting subarticular bone erosion of sacroiliac joint in patients with spondyloarthropathy: A comparison with X-ray and CT

    Energy Technology Data Exchange (ETDEWEB)

    Hu, Libin [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Huang, Zhenguo, E-mail: [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Zhang, Xuezhe [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Chan, Queenie [Philips Healthcare, Hong Kong (China); Xu, Yanyan [Department of Radiology, China-Japan Friendship Hospital, Beijing (China); Wang, Guochun [Department of Rheumatology, China-Japan Friendship Hospital, Beijing (China); Wang, Wu [Department of Radiology, China-Japan Friendship Hospital, Beijing (China)


    Highlights: • MRI 3D-WS-bSSFP sequence has high spatial resolution and short scanning time. • This is the first time this sequence was applied to detect bone erosion of SI joint. • Its performance was compared with other commonly used diagnostic methods. • Result shows that this sequence is better than X-ray and T1W in the detection of bone erosion. • This sequence can be considered an alternative to CT in showing erosion in SpA patients. - Abstract: Objective: To assess the sensitivity and specificity of detecting subarticular bone erosion of sacroiliac (SI) joint in patients with spondyloarthritis (SpA) using MRI three-dimensional water selective balanced steady-state free precession sequence (3D-WS-bSSFP) and T1-weighted (T1W) sequence. Materials and methods: Radiography, CT and MRI of SI joint from 43 SpA patients were retrospectively analyzed. MRI examination sequences include T1W, short tau inversion recovery (STIR) and 3D-WS-bSSFP. Two radiologists, blinded to clinical data, independently determined bone erosion at bilateral sacral and iliac sides of the SI joint on radiography, CT, T1W and 3D-WS-bSSFP respectively. X{sup 2} test was used to compare the sensitivity of detecting bone erosion among different diagnostic methods. Results: Of the 86 sacral and 86 iliac articular surfaces from the 43 cases, radiography, CT, MRI T1W and 3D-WS-bSSFP showed the presence of bone erosion in 40, 74, 50 and 71 articular surfaces respectively. CT and MRI 3D-WS-bSSFP demonstrated similar sensitivity (x{sup 2} = 0.11, P = 0.74), and both were superior to radiography (x{sup 2} = 15.17, P < 0.01 and x{sup 2} = 12.78, P < 0.01, respectively) and T1W (x{sup 2} = 7.26, P < 0.01 and x{sup 2} = 5.62, P < 0.05). Using CT diagnosis as the gold standard, the sensitivity and specificity of detecting bone erosion for MRI 3D-WS-bSSFP and T1W sequences were 91.8%, 96.9%, and 60.8%, 94.9% respectively. Conclusion: MRI 3D-WS-bSSFP sequence is associated with short scanning time

  16. A 3D lower limb musculoskeletal model for simultaneous estimation of musculo-tendon, joint contact, ligament and bone forces during gait. (United States)

    Moissenet, Florent; Chèze, Laurence; Dumas, Raphaël


    Musculo-tendon forces and joint reaction forces are typically estimated using a two-step method, computing first the musculo-tendon forces by a static optimization procedure and then deducing the joint reaction forces from the force equilibrium. However, this method does not allow studying the interactions between musculo-tendon forces and joint reaction forces in establishing this equilibrium and the joint reaction forces are usually overestimated. This study introduces a new 3D lower limb musculoskeletal model based on a one-step static optimization procedure allowing simultaneous musculo-tendon, joint contact, ligament and bone forces estimation during gait. It is postulated that this approach, by giving access to the forces transmitted by these musculoskeletal structures at hip, tibiofemoral, patellofemoral and ankle joints, modeled using anatomically consistent kinematic models, should ease the validation of the model using joint contact forces measured with instrumented prostheses. A blinded validation based on four datasets was made under two different minimization conditions (i.e., C1 - only musculo-tendon forces are minimized, and C2 - musculo-tendon, joint contact, ligament and bone forces are minimized while focusing more specifically on tibiofemoral joint contacts). The results show that the model is able to estimate in most cases the correct timing of musculo-tendon forces during normal gait (i.e., the mean coefficient of active/inactive state concordance between estimated musculo-tendon force and measured EMG envelopes was C1: 65.87% and C2: 60.46%). The results also showed that the model is potentially able to well estimate joint contact, ligament and bone forces and more specifically medial (i.e., the mean RMSE between estimated joint contact force and in vivo measurement was C1: 1.14BW and C2: 0.39BW) and lateral (i.e., C1: 0.65BW and C2: 0.28BW) tibiofemoral contact forces during normal gait. However, the results remain highly influenced by the

  17. Novel Lesions of Bones and Joints Associated with Chikungunya Virus Infection in Two Mouse Models of Disease: New Insights into Disease Pathogenesis.

    Directory of Open Access Journals (Sweden)

    Brad A Goupil

    Full Text Available Chikungunya virus is an arbovirus spread predominantly by Aedes aegypti and Ae. albopictus mosquitoes, and causes debilitating arthralgia and arthritis. While these are common manifestations during acute infection and it has been suggested they can recur in patients chronically, gaps in knowledge regarding the pathogenesis still exist. Two established mouse models were utilized (adult IRF 3/7 -/- -/- and wild-type C57BL/6J mice to evaluate disease manifestations in bones and joints at various timepoints. Novel lesions in C57BL/6J mice consisted of periostitis (91% and foci of cartilage of necrosis (50% of mice at 21 DPI. Additionally, at 21 DPI, 50% and 75% of mice exhibited periosteal bone proliferation affecting the metatarsal bones, apparent via histology and μCT, respectively. μCT analysis did not reveal any alterations in trabecular bone volume measurements in C57BL/6J mice. Novel lesions demonstrated in IRF 3/7 -/- -/- mice at 5 DPI included focal regions of cartilage necrosis (20%, periosteal necrosis (66%, and multifocal ischemic bone marrow necrosis (100%. Contralateral feet in 100% of mice of both strains had similar, though milder lesions. Additionally, comparison of control IRF 3/7 -/- -/- and wild-type C57BL/6J mice demonstrated differences in cortical bone. These experiments demonstrate novel manifestations of disease similar to those occurring in humans, adding insight into disease pathogenesis, and representing new potential targets for therapeutic interventions. Additionally, results demonstrate the utility of μCT in studies of bone and joint pathology and illustrate differences in bone dynamics between mouse strains.

  18. Novel Lesions of Bones and Joints Associated with Chikungunya Virus Infection in Two Mouse Models of Disease: New Insights into Disease Pathogenesis (United States)

    Goupil, Brad A.; McNulty, Margaret A.; Martin, Matthew J.; McCracken, Michael K.; Christofferson, Rebecca C.; Mores, Christopher N.


    Chikungunya virus is an arbovirus spread predominantly by Aedes aegypti and Ae. albopictus mosquitoes, and causes debilitating arthralgia and arthritis. While these are common manifestations during acute infection and it has been suggested they can recur in patients chronically, gaps in knowledge regarding the pathogenesis still exist. Two established mouse models were utilized (adult IRF 3/7 -/- -/- and wild-type C57BL/6J mice) to evaluate disease manifestations in bones and joints at various timepoints. Novel lesions in C57BL/6J mice consisted of periostitis (91%) and foci of cartilage of necrosis (50% of mice at 21 DPI). Additionally, at 21 DPI, 50% and 75% of mice exhibited periosteal bone proliferation affecting the metatarsal bones, apparent via histology and μCT, respectively. μCT analysis did not reveal any alterations in trabecular bone volume measurements in C57BL/6J mice. Novel lesions demonstrated in IRF 3/7 -/- -/- mice at 5 DPI included focal regions of cartilage necrosis (20%), periosteal necrosis (66%), and multifocal ischemic bone marrow necrosis (100%). Contralateral feet in 100% of mice of both strains had similar, though milder lesions. Additionally, comparison of control IRF 3/7 -/- -/- and wild-type C57BL/6J mice demonstrated differences in cortical bone. These experiments demonstrate novel manifestations of disease similar to those occurring in humans, adding insight into disease pathogenesis, and representing new potential targets for therapeutic interventions. Additionally, results demonstrate the utility of μCT in studies of bone and joint pathology and illustrate differences in bone dynamics between mouse strains. PMID:27182740

  19. Bone marrow oedema assessment by magnetic resonance imaging in rheumatoid arthritis wrist and metacarpophalangeal joints

    DEFF Research Database (Denmark)

    Krabbe, Simon; Eshed, Iris; Pedersen, Susanne Juhl


    OBJECTIVE: The aim of this study was to examine the influence of different MRI unit field strengths, coil types and image resolutions on the OMERACT RA MRI scoring system (RAMRIS) of bone marrow oedema (BME) and image quality. METHODS: Forty-one patients and 12 healthy controls participated...... STIR image sets were anonymized and scored according to RAMRIS and parameters of image quality were measured. RESULTS: The BME sum scores were similar overall when comparing the different MRI units, coil types and voxel sizes, yet significantly higher at the higher resolution of 1.5T Extr compared......-88%]. The smallest detectable difference was better at 0.6, 1.5 and 3T (9-29% of maximum value) than at 0.23T (40%). Image quality was lowest at 0.23T. CONCLUSION: No major, consistent differences were found between BME scores using STIR sequences obtained at different field strengths, coil types and image...

  20. 多学科协同治疗骨关节疾病%Multidisciplinary treatment of bone and joint diseases

    Institute of Scientific and Technical Information of China (English)



    The bone and joint diseases are very common, have chronic, recurrent characteristics and often lead to discomfort and disability in China. These diseases affect human health seriously. The etiology and pathogenesis are unknown. They may be related with genetic, environmental factors and autoimmune reaction. Rehabilitation exercise, health education, medical treatment and operation are the main methods in the treatment of the diseases. The expected benefits of the treatment are pain relief, improvement or prevention of further deterioration, and prevention of deformity. The types of treatments are different for various diseases. Short-term or long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs) can relive the pain of bone and joint. Disease-modifying antirheumatic drugs (DMARDs) are selected in the first-line treatment as soon as possible in rheumatoid arthritis, and seronegative spondylo-arthropathies can be treated with SASP and symptoms of some patients are relieved. Advances in the understanding of the pathogenesis of the disease have fostered the development of new therapeutics (biological drugs such as TNF-a inhibitors and rituximab), with improved outcomes. However, operation for advanced stage or medicine ineffective patients is also very important. Rheumatology is very young in China, which is still facing the lack of the rheumatology physician after more than 20 years' development. The cooperation of surgeons and rheumatology physicians is very important, but it has not been recognized and emphasized so far. We should pay more attention to the cooperation in the clinical work in the future.%@@ 一、概述 世界卫生组织将2000年至2010年定为"骨与关节的十年",这一项以"增进患有肌肉与骨骼疾病患者的健康,进一步改善他们的生活质量"作为目标的活动意义重大.骨关节病的范围广泛,除了骨关节炎、类风湿关节炎等各种关节疾病外,还包括脊柱疾病、骨质疏松症以

  1. Evaluation of the correlation between disc displacements and degenerative bone changes of the temporomandibular joint by means of magnetic resonance images. (United States)

    Dias, Isabela Maddalena; Coelho, Patrícia Rocha; Picorelli Assis, Neuza Maria Souza; Pereira Leite, Fabiola Pessôa; Devito, Karina Lopes


    The aim was to evaluate the correlation between disc displacements and degenerative bone changes in magnetic resonance images (MRI) of 112 patients of both genders, with signs and symptoms of temporomandibular disorder. For this purpose, a calibrated examiner evaluated 224 MRI by assigning scores for the displacement of the disc and degenerative bone changes. Disc displacement was found in 58.42% of the temporomandibular joints (TMJs) evaluated. Anterior displacement of the disc with reduction was the most common, occurring in 67.18% cases of joints with disc displacement. Degenerative bone changes were observed in 53.94% of the TMJs analysed. There was significant correlation between disc displacement with reduction and condylar flattening, disc displacement without reduction and condylar flattening, disc displacement without reduction, and associated degenerative bone changes (flattening and erosion, flattening, osteophyte and erosion; flattening and osteophytes, erosion and sclerosis, flattening and sclerosis, flattening, osteophytes and sclerosis). The correlation between advanced cases of disc displacement and the occurrence of degenerative bone changes emphasises the importance of MRI for an accurate diagnosis and development of an appropriate treatment plan and in cases in which clinical examination is not sufficient for these purposes.


    Fraser, J


    The all important point revealed by the investigation is the fact that a large proportion of bone and joint tuberculosis occurring in children in Edinburgh owes its origin to infection by the bovine bacillus. The bovine bacillus is introduced into the system practically by one route only, that of ingestion, and the medium with which it is ingested is cow's milk. It is not my intention to criticize in any way the existing conditions of milk supply. I have furnished proof of what is actually occurring and no one will deny that the evil is a remediable one. In those cases in which the human bacillus was present, a considerable proportion showed a definite history of pulmonary tuberculosis affecting a co-resident, and every fact went to prove that the infection had been a direct one from patient to child. A complete distinction can be drawn between human and bovine bacilli, and the distinction is best secured by subjecting the organism to a series of tests such as I have detailed. The subject is one which ought to be investigated in a series of different localities. It is possible that the locus may be a factor in the explanation of the difference between the above results and those of other observers.

  3. Digital film viewer conventional view boxes in the identification of bone and joint disorders; Diafanoscopio digitale vs tradizionale nell'identificazione delle malattie osteo-articolari

    Energy Technology Data Exchange (ETDEWEB)

    Magarelli, N. [Chieti Univ. G. D' Annunzio, Chieti (Italy). Ist. di Scienze Radiologiche e Formazione dell' Immagine; Guglielmi, G. [IRRCCS Ospedale Casa Sollievo della Sofferenza, S. Giovanni Rotondo, FG (Italy); Mattei, P.A. [Chieti Univ. G. D' Annunzio, Chieti (Italy). Facolta' di Medicina e Chirurgia; Mattioli, M.G.; Riario Sforza, A.


    The aim of this report is to compare the diagnostic accuracy of a digital film viewer (Smartlight 2000 Plus) versus a conventional view box for the identification of bone and joint disorders. [Italian] Scopo di questo studio e' confrontare l'accuratezza del diafanoscopio digitale (Smartlight 2000 Plus) con quella del diafanoscopio tradizionale nell'identificazione delle lesioni osteo-articolari.

  4. Tne bone density distribution of the sacroiliac joint measured by computer assisted tomography%骶髂关节面应力分布规律的CT测量

    Institute of Scientific and Technical Information of China (English)

    钱齐荣; 贾连顺; 周伟明


    目的了解骶髂关节面应力分布的规律。方法选取健康尸体5具,将标本以CT同样参数扫描各层面骶髂关节两侧骨及关节腔内固定的测量点,计算其CT值。结果骶髂关节的骨CT值及每个层面的CT值呈一类似于波谷样的分布规律。结论人体骨的密度与其所受到的应力直接相关,以此可推测骶髂关节面应力分布应该呈相似的分布特点。这一结论正与我们以三维有限元方法研究骶髂关节周围应力分布特点的结果极其相似。%Objective To find out the character of the its strain distribution. Methods We use five fresh cadaver sacroiliac joints of male adults. We fixed the samples in the CT. We chose the same point of the joints and measure the CT values . Result The bone CT values of the sacroiliac joints and the same slide distributes in a curve from the anterior of the joint to the posterior. Conclusion The density of the bones are directly related with the strains. So the strain distribution on the sacroiliac joint surface is similar to the CT value distribution. This is similar to the result we get with tri- dimentional finite elements study of the sacroiliac joint.

  5. Antibiotic bone cement and renovation after artificial joint replacement%抗生素骨水泥与人工关节置换后的翻修

    Institute of Scientific and Technical Information of China (English)



    BACKGROUND:Antibiotic bone cement is the important method for the prevention and treatment of infection after artificial hip replacement and renovation. OBJECTIVE:To review the research progress of antibiotic bone cement. METHODS:A computer-based online search was performed in PubMed database, CNKI database, Chinese Biomedical Literature database, VIP database and Wanfang database for the literatures from 1978 to 2012. The key words were“bone cement, antibiotic bone cement, infection, joint replacement”in English and Chinese. RESUTLS AND CONCLUSION:A total of 335 literatures were screened out. Final y, 29 literatures were included for in-depth analysis after the primary screen through reading the title, abstract and ful-text. Antibiotic bone cement has been widely used in the treatment of infection after artificial joint replacement and renovation as it can reduce the risk of infection after initial joint replacement and renovation. The material properties and mechanical properties wil not change after bone cement mixed with appropriate amount of antibiotic. Different antibiotics in the bone cement have different release rates, which were closely related with the porosity of bone cement. Adding the additive that used for increasing the porosity of bone cement can increase the antibiotic release.%  背景:抗生素骨水泥是预防和治疗人工关节置换以及翻修后感染的重要方法。目的:综述抗生素骨水泥的研究进展以及人工关节置换后翻修。方法:通过计算机检索Pubmed数据库、中国知网数据库、中国生物医学文献数据库、维普期刊全文数据库、万方数据库,时间范围在1978年至2012年,中文检索词“骨水泥”、“抗生素骨水泥”、“感染”、“关节置换”;英文检索词“bone cement”、“antibiotic bone cement”、“infection”、“joint replacement”。结果与结论:共检索到相关文献335篇。通过阅读标题、摘要以及全

  6. Pathophysiological Mechanisms of Staphylococcus Non-aureus Bone and Joint Infection: Interspecies Homogeneity and Specific Behavior of S. pseudintermedius. (United States)

    Maali, Yousef; Martins-Simões, Patrícia; Valour, Florent; Bouvard, Daniel; Rasigade, Jean-Philippe; Bes, Michele; Haenni, Marisa; Ferry, Tristan; Laurent, Frédéric; Trouillet-Assant, Sophie


    Implicated in more than 60% of bone and joint infections (BJIs), Staphylococci have a particular tropism for osteoarticular tissue and lead to difficult-to-treat clinical infections. To date, Staphylococcus aureus internalization in non-professional phagocytic cells (NPPCs) is a well-explored virulence mechanism involved in BJI chronicity. Conversely, the pathophysiological pathways associated with Staphylococcus non-aureus (SNA) BJIs have scarcely been studied despite their high prevalence. In this study, 15 reference strains from 15 different SNA species were compared in terms of (i) adhesion to human fibronectin based on adhesion microplate assays and (ii) internalization ability, intracellular persistence and cytotoxicity based on an in vitro infection model using human osteoblasts. Compared to S. aureus, S. pseudintermedius was the only species that significantly adhered to human fibronectin. This species was also associated with high (even superior to S. aureus) internalization ability, intracellular persistence and cytotoxicity. These findings were confirmed using a panel of 17 different S. pseudintermedius isolates. Additionally, S. pseudintermedius internalization by osteoblasts was completely abolished in β1 integrin-deficient murine osteoblasts. These results suggest the involvement of β1 integrin in the invasion process, although this mechanism was previously restricted to S. aureus. In summary, our results suggest that internalization into NPPCs is not a classical pathophysiologic mechanism of SNA BJIs. S. pseudintermedius appears to be an exception, and its ability to invade and subsequently induce cytotoxicity in NPPCs could explain its severe and necrotic forms of infection, notably in dogs, which exhibit a high prevalence of S. pseudintermedius infection.

  7. Pathophysiological mechanisms of Staphylococcus non-aureus bone and joint infection: interspecies homogeneity and specific behaviour of S. pseudintermedius

    Directory of Open Access Journals (Sweden)

    Yousef Maali


    Full Text Available Implicated in more than 60% of bone and joint infections (BJIs, Staphylococci have a particular tropism for osteoarticular tissue and lead to difficult-to-treat clinical infections. To date, Staphylococcus aureus internalization in non-professional phagocytic cells (NPPCs is a well-explored virulence mechanism involved in BJI chronicity. Conversely, the pathophysiological pathways associated with Staphylococcus non-aureus (SNA BJIs have scarcely been studied despite their high prevalence. In this study, fifteen reference strains from 15 different SNA species were compared in terms of (i adhesion to human fibronectin based on adhesion microplate assays and (ii internalization ability, intracellular persistence and cytotoxicity based on an in vitro infection model using human osteoblasts. Compared to S. aureus, Staphylococcus pseudintermedius was the only species that significantly adhered to human fibronectin. This species was also associated with high (even superior to S. aureus internalization ability, intracellular persistence and cytotoxicity. These findings were confirmed using a panel of 17 different S. pseudintermedius isolates. Additionally, S. pseudintermedius internalization by osteoblasts was completely abolished in β1 integrin-deficient murine osteoblasts. These results suggest the involvement of β1 integrin in the invasion process, although this mechanism was previously restricted to S. aureus. In summary, our results suggest that internalization into NPPCs is not a classical pathophysiologic mechanism of SNA BJIs. S. pseudintermedius appears to be an exception, and its ability to invade and subsequently induce cytotoxicity in NPPCs could explain its severe and necrotic forms of infection, notably in dogs, which exhibit a high prevalence of S. pseudintermedius infection.

  8. Characterization of Staphylococcus caprae Clinical Isolates Involved in Human Bone and Joint Infections, Compared with Goat Mastitis Isolates. (United States)

    d'Ersu, J; Aubin, G G; Mercier, P; Nicollet, P; Bémer, P; Corvec, S


    Staphylococcus caprae is an emerging microorganism in human bone and joint infections (BJI). The aim of this study is to describe the features of S. caprae isolates involved in BJI (H for human) compared with those of isolates recovered in goat mastitis (A for animal). Fourteen isolates of each origin were included. Identifications were performed using a Vitek 2 GP ID card, tuf gene sequencing, and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) Vitek MS. Molecular typing was carried out using pulsed-field gel electrophoresis (PFGE) and DiversiLab technology. The crystal violet method was used to determine biofilm-forming ability. Virulence factors were searched by PCR. Vitek MS technology provides an accurate identification for the two types of isolates compared to that of gold-standard sequencing (sensitivity, 96.4%), whereas the Vitek 2 GP ID card was more effective for H isolates. Molecular typing methods revealed two distinct lineages corresponding to the origin despite few overlaps: H and A. In our experimental conditions, no significant difference was observed in biofilm production ability between H and A isolates. Nine isolates (5 H isolates and 4 A isolates) behaved as weak producers while one A isolate was a strong producer. Concerning virulence factors, the autolysin atlC and the serine aspartate adhesin (sdrZ) genes were detected in 24 isolates (86%), whereas the lipase gene was always detected, except in one H isolate (96%). The ica operon was present in 23 isolates (82%). Fibrinogen-binding (fbe) or collagen-binding (cna) genes were not detected by using primers designed for Staphylococcus aureus or Staphylococcus epidermidis, even in low stringency conditions. Although S. caprae probably remains underestimated in human infections, further studies are needed to better understand the evolution and the adaptation of this species to its host.

  9. Analysis of Clinical Treatment of Multiple Injuries of Bone and Joint%多发性骨与关节损伤的临床治疗分析

    Institute of Scientific and Technical Information of China (English)



    目的:对多发性骨于关节损伤的临床治疗进行探讨分析,了解多发性骨与关节损伤的特点和治疗方法。方法此次根据我院接收的100例骨与关节损伤患者来进行研究分析,根据其临床治疗资料进行回顾。结果经过治疗共有5例患者死亡,主要是失血休克、脂肪栓塞综合征、急性肾衰的导致的,临床死亡率5%,后期有6例接收二次手术,4例漏诊,有68例完全康复,愈合延迟8例,2例截肢,4例漏诊,7例膝关节功能减退。结论多发性骨和关节损伤在院前急救时需要提供比较好的处理,为院内急救提供基础,对该类患者的漏诊原因进行分析,提升诊断准确率,引导患者的术后功能锻炼,提升康复几率。%Objective To analyze the clinical treatment of multiple bone to joint injury, understand the characteristics and treatment of multiple injuries of bone and joint.Methods the according to our hospital received 100 patients with bone and joint injuries to study and analyze, review according to the clinical treatment data.Resultsafter treatment for a total of 5 patients died, mainly hemorrhagic shock, fat embolism syndrome, acute renal failure causes, clinical mortality was 5%, and later 6 cases received two times operation, 4 cases of misdiagnosis, 68 cases recovered completely, 8 cases of delayed healing, 2 cases of amputation, 4 cases were missed, 7 cases of knee joint dysfunction.Conclusion multiple bone and joint injuries need to provide better handling in pre hospital ifrst aid, and provides a basis for the treatment in hospital, the causes of misdiagnosis of the patients analyzed, improve the accuracy rate of diagnosis, patients with postoperative functional exercise guidance, enhance the chance of recovery.

  10. Technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy for the diagnosis of bone and joint infections: a retrospective study in 116 patients

    Energy Technology Data Exchange (ETDEWEB)

    Devillers, A. [Dept. of Nuclear Medicine, Centre Eugene Marquis, Rennes (France); Moisan, A. [Dept. of Nuclear Medicine, Centre Eugene Marquis, Rennes (France); Jean, S. [Dept. of Rheumatology, Pontchaillou CHU, Rennes (France); Arvieux, C. [Dept. of Infectious Diseases, Pontchaillou CHU, Rennes (France); Bourguet, P. [Dept. of Nuclear Medicine, Centre Eugene Marquis, Rennes (France)


    The aim of this study was to evaluate the diagnostic value of technetium-99m hexamethylpropylene amine oxime leucocyte scintigraphy (HMPAO-LS) by means of a retrospective review of 116 patients divided into three groups of bone and joint infection. One hundred and thirty-one LS examinations were performed, and 143 sites analysed. The final diagnosis of infection was based on surgical, histological and bacteriological data and follow-up. Ninety-four suspected localizations were examined in group 1, which included 74 patients with an infection suspected to involve orthopaedic implants. In this group, there were 38 true-positives, 1 false-negative, 49 true-negatives and 6 false-positives. Surgical confirmation was obtained in 34 cases. In group 2 (24 patients with suspected osteomyelitis), there were 27 localizations of which 14 were true-positives and 13 were true-negatives (including seven surgical confirmations). In group 3 (18 patients suspected of septic arthritis) there were eight true-positives, two false-negatives, ten true-negatives and two false-positives. Overall sensitivity of {sup 99m}Tc-HMPAO-LS for the detection of bone and joint infection was 95%, with a specificity of 90% (group 1: sensitivity 97%, specificity 89%; group 2: 100% and 100%; group 3: 80% and 83%). It may be concluded that HMPAO-LS is an effective tool for the diagnosis of both bone infection involving implants and chronic osteomyelitis. (orig.)

  11. Effects of Low-Impact Dance on Blood Biochemistry, Bone Mineral Density, the Joint Range of Motion of Lower Extremities, Knee Extension Torque, and Fall in Females. (United States)

    Wu, Hui Ying; Tu, Jui Hung; Hsu, Chin Hsing; Tsao, Te Hung


    The effect of low-impact dance on blood metabolites, the joint range of motion (ROM) of the lower extremities, knee extension torque, bone mass density (BMD), the number of falls, and the confidence to perform daily activities (Modified Falls Efficacy Scale [MFES]) was examined in older sedentary women (age: 59 ± 4 years) before and after a 16-week intervention. Results showed that the average score for the MFES, some parameters of blood chemistry, and joint ROM were significantly improved after low-impact intervention. In addition to improvements in blood lipids and body fat percentages, the increases shown in the parameters regarding the lower extremities may contribute to confidence in performing common daily activities in older women, although the number of falls did not significantly differ between the two groups during the 16-week period.

  12. The Influence of Oblique Angle Forced Exercise in Surgically Destabilized Stifle Joints Is Synergistic with Bone, but Antagonistic with Cartilage in an Ovine Model of Osteoarthritis. (United States)

    Hill, Rachel J; Mason, Holly M; Yeip, Gavin; Merchant, Samer S; Olsen, Aaron L; Stott, Rusty D; Van Wettere, Arnaud J; Bressel, Eadric; Mason, Jeffrey B


    Large animal models of osteoarthritis are a necessary testing ground for FDA approval of human medicine applications. Sheep models have advantages over other available large animals, but development and progression of osteoarthritis in sheep is exceedingly slow, which handicaps progress in development of potential treatments. We combined oblique angle forced exercise to increase stress on the stifle, with surgical destabilization to hasten the development of osteoarthritis in ewes. Methods for early detection of clinical signs included radiography, urine, and serum biomarker assays and gait analysis and ex vivo we used microcomputed tomography and macroscopic joint analysis. Our model was able to produce clinically detectable signs of osteoarthritis in a relatively short period (14 weeks). Changes in bone were highly correlated between microcomputed tomography and radiographic analysis and changes in cartilage correlated well between urinary glycosaminoglycan levels and serum aggrecanase analyses. Exercise improved the negative effects of destabilization in bone but exacerbated the negative effects of destabilization in cartilage. These observations suggest that we may need to consider treatments for bone and cartilage separately. These results represent an improved large animal model of osteoarthritis with rapid onset of disease and superior detection of bone and soft tissue changes.

  13. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... your doctor to view and assess bone fractures, injuries and joint abnormalities. This exam requires little to ... fusion, joint replacement and fracture reductions. look for injury, infection, arthritis , abnormal bone growths and bony changes ...

  14. Abnormal joint and bone wound healing in hemophilia mice is improved by extending factor IX activity after hemarthrosis. (United States)

    Sun, Junjiang; Hua, Baolai; Livingston, Eric W; Taves, Sarah; Johansen, Peter B; Hoffman, Maureane; Ezban, Mirella; Monroe, Dougald M; Bateman, Ted A; Monahan, Paul E


    Wound healing requires interactions between coagulation, inflammation, angiogenesis, cellular migration, and proliferation. Healing in dermal wounds of hemophilia B mice is delayed when compared to hemostatically normal wild type (WT) mice, with abnormal persistence of iron deposition, inflammation, and neovascularity. We observed healing following induced joint hemorrhage in WT and factor IX (FIX) knockout (FIX(-/-)) mice, examining also parameters previously studied in an excisional skin wound model. Hemostatically normal mice tolerated this joint bleeding challenge, cleared blood from the joint, and healed with minimal pathology, even if additional autologous blood was injected intra-articularly at the time of wounding. Following hemarthrosis, joint wound healing in hemophilia B mice was impaired and demonstrated similar abnormal histologic features as previously described in hemophilic dermal wounds. Therefore, studies of pathophysiology and therapy of hemophilic joint bleeding performed in hemostatically normal animals are not likely to accurately reflect the healing defect of hemophilia. We additionally explored the hypothesis that the use of a FIX replacement protein with extended circulating FIX activity could improve synovial and osteochondral wound healing in hemophilic mice, when compared to treatment with unmodified recombinant FIX (rFIX) in the established joint bleeding model. Significantly improved synovial wound healing and preservation of normal osteochondral architecture are achieved by extending FIX activity after hemarthrosis using glycoPEGylated FIX when compared to an equivalent dose of rFIX. These results suggest that treating joint bleeding only until hemostasis is achieved may not result in optimal joint healing, which is improved by extending factor activity.

  15. Retrospective Analysis of Multiple Bone and Joint Injuries%多发性骨与关节损伤病例回顾分析

    Institute of Scientific and Technical Information of China (English)



    Objective Analysis of multiple injuries of bone and joint were diagnosed by clinical features, diagnosis and treatment of purpose.Methods Multiple injuries of bone and joint and related mat ers needing at ention. Clinical data of our hospital has treated 100 cases of bone and joint injury were analyzed. Results The treatment results showed, 5 patients died, the cause of death was hemor hagic shock, fat embolism syndrome (FES) and acute renal failure (ARF), treatment rate 5%, later, need a two operation in patients with 6 cases (6%), the occur ence of missed 4 cases (4%), the function of knee joint in 7 cases (7%), do amputation operation was 2 cases (2%), delayed wound healing in 8 cases (8%), 68 cases recovered completely (68%). Conclusion First aid at ention of multiple injuries of bone and joint pre hospital, strengthen the emergency personnel and medical staf training, analysis of the multiple injuries of bone and joint the cause of missed diagnosis, reduce misdiagnosis, adhering to the operation principle of treatment, to actively guide the postoperative functional exercise. Improve patients recovery rate.%目的:通过分析讨论多发性骨与关节损伤病例,研究多发性骨与关节损伤的临床特点、诊治方法及相关注意事项。方法对我院近期收治的100例骨与关节损伤患者的临床治疗资料进行分析。结果治疗结果显示,有5例患者死亡,死亡原因分别是失血性休克、脂肪栓塞综合征(FES)以及急性肾功能衰竭(ARF),死亡率5%,后期治疗,需要二次手术的患者有6例(6%),发生漏诊的患者有4例(4%),膝关节功能下降7例(7%),做截肢手术的有2例(2%),愈合延迟8例(8%),完全康复68例(68%)。结论重视多发性骨与关节损伤的院前急救,强化对急救人员以及门诊医护人员的培训,分析多发性骨与关节损伤漏诊原因,减少漏诊、坚持手术治疗原则,要积极引导患者术后功能锻炼。提高患者的康复率。

  16. 骨关节结核模型的动物选择研究进展%The progress of choosing animals of bone and joint tuberculosis model

    Institute of Scientific and Technical Information of China (English)

    乔永杰; 张吕丹; 李杜鹏; 曹雪飞; 甄平


    Tuberculosis (TB) is still the major infectious diseases which cause serious damage to the human health,since application specification and development of anti-TB drugs,human tuberculosis morbidity and mortality have dropped to the lowest ever,even some people say that TB will be extinct as smallpox.Since the 1980s,with the growth of drug-resistant mycobacterium tuberculosis,originally lower tuberculosis epidemic in developed countries and heavier in developing countries,are obviously improved and showing a worsening trend.Especially multi-drug resistant tuberculosis (MDR-TB) and the increasing of the tuberculosis cases with human immune virus (HIV),making the treatment of anti-tuberculosis to meet the challenge.Bone and joint TB is the highest incidence of extra pulmonary tuberculosis except for lymphoid tuberculosis,and spinal tuberculosis has more than 50% of total bone and joint tuberculosis,which will cause serious disability and sequelae,seriously affect the life and quality of patients.Throughout the history,there are a lot of domestic and foreign scholars studying pulmonary tuberculosis,but few research of bone and joint tuberculosis.Bone and joint tuberculosis mainly through local blood vessels injection and local drilling plant mycobacterium tuberculosis to build,but mycobacterium tuberculosis mainly in the aerobic environment grow well.The construction of bone and joint tuberculosis mainly in oxygen and even less anaerobic environment,so a large part of the experimental animals after planting mycobacterium tuberculosis tuberculosis are forming pulmonary tuberculosis by the circulation of the blood,which lead to high rate of animal' s mortality and low success rate.Given the huge damage that bone and joint tuberculosis to patients and low success rate of animal model,there' s an urgent need to choose a suitable animal model in order to establish a solid foundation for treatment and research of bone and joint tuberculosis.In this paper,by selecting

  17. [Imaging of the elbow joint with focused MRI. Part 1: examination techniques and sequences for bone and ligaments]. (United States)

    Rehm, J; Zeifang, F; Weber, M-A


    Imaging of the elbow joint places high demands on the quality of imaging due to the challenging anatomy and the sometimes subtle findings. For the diagnosis of periarticular soft tissues, ligamentous structures and in individual cases for fracture and tumor diagnosis, magnetic resonance imaging (MRI) is mostly groundbreaking and allows a reliable diagnosis in most cases. This review article discusses the complex imaging anatomy and anatomical variants of this joint and the most common osseous and ligamentous injuries of the elbow joint are presented. The typical MRI findings and indications are illustrated and discussed and possible pitfalls are pointed out. The various examination techniques and MRI sequences are also addressed.

  18. 骨关节型严重多发伤的救治%Treatment of severe polytrauma complicated by bone and joint injury

    Institute of Scientific and Technical Information of China (English)

    张旭鸣; 邱美光; 林世水; 许志贤; 陈曙光; 施爱平; 于荣国


    Objective To investigate the curative effect of damage control theory in treating severe polytrauma patients combined with bone and joint injury. Methods A retrospective study was done on data including complication, death rate, fracture healing and joint function recovery of 63 patients with severe polytrauma combined with bone and joint injury( average ISS ≥27 points) admitted to our hospital from January 2006 to June 2009. Results Of all the patients, 57 shock patients were cured,three died of hemorrhagic shock within two hours after admission and one patient died of severe traumatic brain injury 11 hours after admission. One patient died of ARDS at 24 hours postoperatively and one died of multiple organ failure at day 6 after injury. Fracture healing was achieved in 52 patients, with satisfactory recovery of the limb function. Amputation was performed in two patients and three patients had mild claudication and pain walking. Conclusion Damage control strategy has great clinical significance in guidance of treatment of severe polytrauma combined with bone and joint injury.%目的 探讨如何提高基于损伤控制外科理论的治疗在骨关节型严重多发伤中的效果.方法回顾性分析2006年1月-2009年6月应用损伤控制性手术治疗骨关节损伤为主的严重多发伤63例(平均ISS≥27分)的并发症、死亡率及骨折愈合关节功能恢复.结果61例创伤性休克中57例得到纠正,3例因失血性休克死于入院后2 h内,1例因严重颅脑外伤死于人院后11 h;1例因ARDS死于术后24 h;1例于伤后6 d因多器官功能衰竭死亡.52例骨折愈合,肢体功能恢复满意;2例行截肢术;3例轻度跛行,行走痛.结论损伤控制手术有助于骨关节型严重多发伤的救治,对临床救治严重创伤患者具很大指导意义.

  19. Detection of bone erosions in rheumatoid arthritis wrist joints with magnetic resonance imaging, computed tomography and radiography

    DEFF Research Database (Denmark)

    Døhn, Uffe Møller; Ejbjerg, Bo J; Hasselquist, Maria


    BACKGROUND: The objectives of the present study were, with multidetector computed tomography (CT) as the reference method, to determine the performance of magnetic resonance imaging (MRI) and radiography for the detection of bone erosions in rheumatoid arthritis wrist bones, and to test whether...... on the same day. CT was performed on a Philips Mx8000IDT unit (voxel size 0.4 mm x 0.4 mm x 1 mm) and MRI was performed on a Philips Panorama 0.6T unit (voxel size 0.4 mm x 0.4 mm x 0.4 mm). Images were evaluated separately for erosions in all wrist bones and were scored according to the principles.......90 (both P persons' total erosion volume and total score (all P

  20. 长期血液透析患者骨关节影像表现%Imaging appearance of bone and joint in long-term dialysis recipients

    Institute of Scientific and Technical Information of China (English)

    刘家袆; 王武; 洪闻; 黄振国; 任安; 张雪哲


    Objective To analyze the MRI characters of hemodialysis-related osteoarthropathy in long-term dialysis recipients, and to evaluate the diagnostic value of X-ray, CT, and MRI on hemodialysis-related osteoarthropathy. Methods The shoulders, hips, wrists and lumbar vertebraes of 32 patients underwent X-ray and CT examinations. Twenty-six of them received MRI examinations. Results In X-ray of 32 patients, 28 appeared osteoporosis, 11 showed bone resorption, 6 had cystic lesions, 11 had bone sclerosis, 1 had joint swelling, and 19 had soft tissue calcification. In CT of 32 patients, 32 appeared osteoporosis, 9 showed bone resorption, 12 had cystic lesions, 11 had bone sclerosis, 3 had joint swelling, and 19 had soft tissue calcification. In MRI of 26 patients, 6 appeared osteoporosis, 2 showed bone resorption, 14 showed cystic lesions, 5 had bone sclerosis, 15 had joint swelling, and 1 showed soft tissue calcification. Conclusions X-rays plain film is the first choice for the diagnosis of hemadialysis-related osteopathy, and MRI is the first choice for the diagnosis of hemedialysis-related arthropathy. CT and MRI is pretty useful in the diagnosis of hemodialysis-related osteoarthropathy.%目的 分析长期血液透析患者骨关节改变的MRI表现,探讨X线平片、CT及MRI对透析患者相关骨关节病的诊断价值.方法 对32例长期血液透析患者的肩、髋、手腕关节及腰椎进行X线平片、CT检查,其中26例行MR检查.结果 32例患者X线检查见骨质疏松28例,骨吸收11例,囊性骨质破坏6例,骨质硬化11例,关节肿胀1例,软组织内钙化19例;32例患者CT见骨质疏松32例,骨吸收9例,囊性骨质破坏12例,骨质硬化11例,关节肿胀3例,软组织内钙化19例;26例患者MRI见骨质疏松6例,骨吸收2例,囊性骨质破坏14例,骨质硬化5例,关节肿胀15例,软组织内钙化1例.结论 X线平片是观察血液透析患者骨改变的首选诊断手段;MRI是观察血液透析患者关节改变的

  1. Quality of life in young patients after bone tumor surgery around the knee joint and comparison with healthy controls.

    NARCIS (Netherlands)

    Bekkering, W.P.; Vliet Vlieland, T.P.M.; Koopman, H.M.; Schaap, G.R.; Schreuder, H.W.B.; Beishuizen, A.; Tissing, W.J.; Hoogerbrugge, P.M.; Anninga, J.K.; Taminiau, A.H.M.


    BACKGROUND: This study aimed to compare the health related quality of life (HRQoL) of children and adolescents after malignant bone tumor surgery of the leg with healthy controls. PROCEDURE: Patients between 8 and 25 years old were cross-sectional recruited. Patients under 16 years of age received t

  2. Quality of Life in Young Patients After Bone Tumor Surgery Around the Knee Joint and Comparison With Healthy Controls

    NARCIS (Netherlands)

    Bekkering, W. Peter; Vlieland, Theodora P. M. Vliet; Koopman, Hendrik M.; Schaap, Gerard R.; Schreuder, H. W. Bart; Beishuizen, Auke; Tissing, Wim J. E.; Hoogerbrugge, Peter M.; Anninga, Jacob K.; Taminiau, Antonie H. M.


    Background. This study aimed to compare the health related quality of life (HRQoL) of children and adolescents after malignant bone tumor surgery of the leg with healthy controls. Procedure. Patients between 8 and 25 years old were cross-sectional recruited. Patients under 16 years of age received t

  3. The acutely ACL injured knee assessed by MRI: changes in joint fluid, bone marrow lesions, and cartilage during the first year

    DEFF Research Database (Denmark)

    Frobell, R B; Le Graverand, M-P; Buck, R;


    OBJECTIVES: To investigate changes in the knee during the first year after acute rupture of the anterior cruciate ligament (ACL) of volumes of joint fluid (JF), bone marrow lesions (BMLs), and cartilage volume (VC), and cartilage thickness (ThCcAB) and cartilage surface area (AC). To identify...... factors associated with these changes. METHODS: Fifty-eight subjects (mean age 26 years, 16 women) with an ACL rupture to a previously un-injured knee were followed prospectively using a 1.5T MR imager at baseline (within 5 weeks from injury), 3 months, 6 months, and 1 year. Thirty-four subjects were...... treated with ACL reconstruction followed by a structured rehabilitation program and 24 subjects were treated with structured rehabilitation only. Morphometric data were acquired from computer-assisted segmentation of MR images. Morphometric cartilage change was reported as mean change divided...

  4. [Joint reconstruction with autologous bone cylinder and locked intramedullary nail: proximal humeral shaft fracture with ipsilateral reverse Hill-Sachs lesion]. (United States)

    Osterhoff, G; Hepp, P; Engel, T; Josten, C


    The case of a 51-year-old patient is presented, with a humeral shaft fracture in combination with an ipsilateral reverse Hill-Sachs lesion, presumably after posterior shoulder dislocation as a result of an electrical accident followed by a fall from a ladder. After corresponding diagnostics, osteosynthesis of the shaft fracture was performed with a locked antegrade intramedullary nail. Simultaneously the reverse Hill-Sachs lesion was elevated und supplemented with the bone core that accrues during drilling of the nail entrance. In the follow-up period good fragment alignment, persistent joint stability and freedom of pain could be observed. On the basis of this case and the current literature the injury mechanism and potential therapy alternatives are discussed.

  5. 膝关节骨性关节炎21例临床分析%An Analysis of 21 Cases for Knee Joint Bone Arthritis

    Institute of Scientific and Technical Information of China (English)

    肖文玖; 袁序


    采用关节腔内注射透明质酸钠治疗膝关节骨性关节炎患者21例,有效率86.7%,优良率65.3%,无效率12.4%。结果显示,用透明质酸钠注射液进行关节腔注射,是治疗膝关节骨性关节炎比较有效的方法。%The authors have treated 21 cases of knee joint bone arthritis byinjection.It has shown good cure results:Excellent,86.7%,good,65.3%,poor,12.4%.

  6. 人工全膝关节置换临床研究%Clinic analysis of the effect of total knee arthoplasty in treatment of bone and joint disease

    Institute of Scientific and Technical Information of China (English)

    张孝轩; 周政


    目的 探讨人工全膝关节表面置换术对骨关节疾病治疗疗效.方法 2008年1月~2010年12月,对某院骨科纳入的89例病例,包括男性55例,女性34例,进行人工膝关节置换术.采用HSS评分评价治疗后的疗效.结果 全部患者经过人工膝关节置换术治疗后,置换后于置换前比较总评分以及HSS评分均优于置换后,差异有统计学意义(P<0.001).结论 人工全膝关节表面置换术对骨关节病疗效显著,对治疗膝关节骨关节炎和类风湿性关节炎等疾病效果显著.%OBJECTIVE To explore the effect of total knee arthoplasty in treatment of bone and joint disease. METHODS From Jan. 2008 to Dec. 2010, a total of 89 cases were included in our hospital, including 32 males and 18 females. All the patients were taken knee arthoplasty. The HSS were used to analyze the effect of treatment. RESULTS After receiving total knee arthoplasty, the scores of patients before and after surgery were compared, the HSS after surgery was significantly better than that before surgery. There was significant difference between them (P < 0.001). CONCLUSION The total knee arthoplasty showed effective to the bone and joint disease, especially for the osteoarthritis and rheumatoid arthritis.

  7. Antimicrobial-Loaded Bone Cement Does Not Negatively Influence Sonicate Fluid Culture Positivity for Diagnosis of Prosthetic Joint Infection. (United States)

    Park, Kyung-Hwa; Greenwood-Quaintance, Kerryl E; Hanssen, Arlen D; Abdel, Matthew P; Patel, Robin


    We compared culture results to investigate the influence of antimicrobial-loaded cement on sonicate fluid culture positivity for the diagnosis of prosthetic joint infection. Fifty-four subjects were assessed. The sensitivities of sonicate fluid culture were 77.8% (14 of 18) in subjects with an antimicrobial-loaded cemented prosthesis and 58.3% (21 of 36) in subjects with an antimicrobial-free prosthesis.


    Institute of Scientific and Technical Information of China (English)

    王臻; 马真胜; 黄耀添; 刘继中; 于会东; 张毅; 胡蕴玉


    Objective To analyze the indications for revision surgery after limb salvage procedure of malignant bone tumor and summarize the experiences in revision surgery. Methods From January 1994 to December 1997, 8 cases were re-operated after primary limb salvage procedure. The average survival period with no-tumor occurrence was 8 years. The common causes for the revision were traumatic osteoarthritis, fracture, and bone resorption. The main difficulties in revision were soft tissue contracture and limb discrepancy from limb shortening. Results In this study, there was total hip replacement in 1 case, large segmental allograft for reconstruction of distal femur in 3 cases, total knee replacement upon composite of previously transplanted allograft in 3 cases, removing of intramedullary nail and re-internally fixed with intramedullary nail in 1 cases. The isotopic bone scan before the revision showed active bone metabolism in all 4 transplanted segmental allograft. The pathologic study of the transplanted allograft after revision confirmed new bone formation in allograft. The revision procedure reduced the pain, and improved the limb function. Conclusion The main causes of revision surgery after limb salvage procedure of malignant bone tumor are fracture of transplanted allograft segment or devitalized tumor segment, and poor function of the affected joint. Constrained knee prostheses with rotating hinges or semi-constrained ball-axis resurfacing knee prostheses improve the function of knee joint postoperatively.%目的 分析四肢恶性骨肿瘤保肢手术后进行返修术的原因及手术治疗经验。方法 1994年1月~1997年12月进行保肢手术后骨关节返修术8例,平均无瘤生存时间8年。主要返修原因是严重的创伤性骨关节炎、骨折、骨吸收。影响返修手术的主要困难是软组织挛缩和肢体短缩。结果 行全髋返修1例,股骨下端长段同种异体骨移植再建3例,在原移植物

  9. The use of osteochondral allograft with bone marrow-derived mesenchymal cells and hinge joint distraction in the treatment of post-collapse stage of osteonecrosis of the femoral head. (United States)

    Gagala, J; Tarczynska, M; Gaweda, K; Matuszewski, L


    Osteonecrosis of the femoral head is an entity which occurs mainly in young and active patients aged between 20 and 50. The success of hip joint preserving treatments ranges from 15% to 50% depending on the stage and amount of osteonecrotic lesion. Total hip replacement is indicated in late post-collapse hips but it has unsatisfactory survival because of the wear and osteolysis in young and active patients. Osteochondral allografts have been reported in the treatment of large articular lesions with defects in underlying bone in knee, talus and shoulder. By combining osteoconductive properties of osteochondral allograft with osteogenic abilities of bone marrow-derived mesenchymal cells it has a potential to be an alternative to an autologous graft. The adjunct of hinged joint distraction should minimize stresses in subchondral bone to promote creeping substitution and prevent femoral head collapse. Unlike current treatment modalities, it would provide both structural support and allow bony and articular substitution.

  10. The value of MRI in the diagnosis of bone contusion of the knee joint%膝关节骨挫伤的MRI诊断价值

    Institute of Scientific and Technical Information of China (English)

    郑汉朋; 邱乾德


    目的:探讨MRI对膝关节骨挫伤的诊断价值.方法:搜集本院2006年1月~2010年4月间经MRI检查确诊的膝关节骨挫伤70例进行回顾性分析.70例中男45例,女25例,年龄10~69岁,平均35岁;70例行MRI检查时间自外伤后5h~20天,平均8天;70例患者外伤后局部均出现疼痛、压痛和(或)软组织肿胀及功能障碍;临床采用保守和对症治疗.结果:70例共显示134个病灶,其中股骨下端67个,胫骨上端(包括胫骨平台)54个,髌骨8个,腓骨上端5个;MRI表现为不规则斑片状或地图样T1WI低信号、T2WI等或略高信号,STIR脂肪抑制序列均呈明显高信号.伴半月板撕裂25例,侧付韧带损伤21例,前交叉韧带损伤11例.结论:MRI能揭示膝部骨挫伤的病理改变,并准确判断关节周围韧带及软组织的损伤情况,常规MRI检查并行脂肪抑制序列是诊断外伤性骨挫伤最佳的方法.%Objective: To investigate the value of MRI in the diagnosis of bone contusion of the knee joint. Methods: A retrospective analysis of 70 cases of knee bone bruise with the performance of MRI in our hospital from 2006. l to 2010. 4,including 45 males and 25 females, aged from 10 to 69 years, in averaged of 35 years old. 70 patients suffered from posttraumatic localized pain, tenderness and (or) soft swelling and dysfunction. The time interval between the accident and the MRI examination ranged from 5 h to 20 days. in averaged of 8 days. The patients with only bone contusion were treated with conservative and symptomatic treatment. Results: A total of 134 lesions in 70 cases. including 67 distal femur, 54proximal tibia (including the tibial plateau) . 8 patella, 5 fibula top* MRI showed irregular patchy or map-like in T1 WI low signal and T2 WI etc or slightly higher than the signal shadow and STIR fat suppression sequence is obvious hyperintensity,Associated with meniscal tears in 25 cases. lateral ligament injury in 21 cases . anterior cruciate ligament injury in

  11. MRI of the temporo-mandibular joint: which sequence is best suited to assess the cortical bone of the mandibular condyle? A cadaveric study using micro-CT as the standard of reference

    Energy Technology Data Exchange (ETDEWEB)

    Karlo, Christoph A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Patcas, Raphael; Signorelli, Luca; Mueller, Lukas [University of Zurich, Clinic for Orthodontics and Pediatric Dentistry, Center of Dental Medicine, Zurich (Switzerland); Kau, Thomas; Watzal, Helmut; Kellenberger, Christian J. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Ullrich, Oliver [University of Zurich, Institute of Anatomy, Faculty of Medicine, Zurich (Switzerland); Luder, Hans-Ulrich [University of Zurich, Section of Orofacial Structures and Development, Center of Dental Medicine, Zurich (Switzerland)


    To determine the best suited sagittal MRI sequence out of a standard temporo-mandibular joint (TMJ) imaging protocol for the assessment of the cortical bone of the mandibular condyles of cadaveric specimens using micro-CT as the standard of reference. Sixteen TMJs in 8 human cadaveric heads (mean age, 81 years) were examined by MRI. Upon all sagittal sequences, two observers measured the cortical bone thickness (CBT) of the anterior, superior and posterior portions of the mandibular condyles (i.e. objective analysis), and assessed for the presence of cortical bone thinning, erosions or surface irregularities as well as subcortical bone cysts and anterior osteophytes (i.e. subjective analysis). Micro-CT of the condyles was performed to serve as the standard of reference for statistical analysis. Inter-observer agreements for objective (r = 0.83-0.99, P < 0.01) and subjective ({kappa} = 0.67-0.88) analyses were very good. Mean CBT measurements were most accurate, and cortical bone thinning, erosions, surface irregularities and subcortical bone cysts were best depicted on the 3D fast spoiled gradient echo recalled sequence (3D FSPGR). The most reliable MRI sequence to assess the cortical bone of the mandibular condyles on sagittal imaging planes is the 3D FSPGR sequence. (orig.)

  12. Chondrogenic co-culture of allogenic decalcified bone matrix and bone marrow mesenchymal stem cells in the joint cavity:comparison of cartilage traits in the same joint cavity%同种异体脱钙骨与骨髓间充质干细胞关节腔内共培养:与同腔软骨性状的对比

    Institute of Scientific and Technical Information of China (English)

    徐斌; 周亮; 王英明; 钱三祥


    BACKGROUND:Loose bodies in the knee are found to survive for a long term and maintain certain histophysiological properties of cartilage tissue. Therefore, a bold hypothesis is proposed that the joint cavity may be a preferred environment for chondrocyte growth and development, supporting the concept of “intracavitary culture and intracavitary transplantation”. OBJECTIVE:To observe the trait difference of chondrogenic culture with alogenic decalcified bone matrix and bone marrow mesenchymal stem cels in the joint cavity orin vitro versus cartilage in the same cavity. METHODS:There were three groups in this experiment: inin vitro culture group, bone marrow mesenchymal stem cels from newborn rabbits undergoing chondrogenic culture were co-cultured with decalcified bone matrix from adult rabbitsin vitro; in intracavitary culture group, bone marrow mesenchymal stem cels from newborn rabbits undergoing chondrogenic culture were co-cultured with decalcified bone matrix from adult rabbits in the joint cavity; normal cartilage in the same cavity served as control group. RESULTS AND CONCLUSION: (1) After 12 weeks of culture, in the in vitro culture group, hematoxylin-eosin staining showed a smal amount of chondrocytes proliferated, with blue-stained nuclei; toluidine blue staining showed chondrocytes arranged disorderly, surrounded by a smal amount of matrix; Masson staining showed a smal positive area and irregular cellarrangement; type II colagen immunohistochemistry staining showed a few of yelow particles in the cytoplasm and extracelular matrix. (2) After 12 weeks of culture, in the intracavitary culture group, hematoxylin-eosin staining showed proliferation of chondrocytes with blue-stained nuclei; toluidine blue staining showed cluster-shaped arrangement of chondrocytes surrounded by the matrix with lacuna formation; Masson staining showed there were many positive cels with blue-stained matrix that arranged in a certain stress direction; immunohistochemical

  13. Activation of Natural Killer Cells in Patients with Chronic Bone and Joint Infection due to Staphylococci Expressing or Not the Small Colony Variant Phenotype

    Directory of Open Access Journals (Sweden)

    Sébastien Viel


    Full Text Available Chronic bone and joint infections (BJI are devastating diseases. Relapses are frequently observed, as some pathogens, especially staphylococci, can persist intracellularly by expressing a particular phenotype called small colony variant (SCV. As natural killer (NK cells are lymphocytes specialized in the killing of host cells infected by intracellular pathogens, we studied NK cells of patients with chronic BJI due to staphylococci expressing or not SCVs (10 patients in both groups. Controls were patients infected with other bacteria without detectable expression of SCVs, and healthy volunteers. NK cell phenotype was evaluated from PBMCs by flow cytometry. Degranulation capacity was evaluated after stimulation with K562 cells in vitro. We found that NK cells were activated in terms of CD69 expression, loss of CD16 and perforin, in all infected patients in comparison with healthy volunteers, independently of the SCV phenotype. Peripheral NK cells in patients with chronic BJI display signs of recent activation and degranulation in vivo in response to CD16-mediated signals, regardless of the type of bacteria involved. This could involve a universal capacity of isolates responsible for chronic BJI to produce undetectable SCVs in vivo, which might be a target of future intervention.

  14. First experience of a multicenter external quality assessment of molecular 16S rRNA gene detection in bone and joint infections. (United States)

    Plouzeau, Chloé; Bémer, Pascale; Valentin, Anne Sophie; Héry-Arnaud, Geneviève; Tandé, Didier; Jolivet-Gougeon, Anne; Vincent, Pascal; Kempf, Marie; Lemarié, Carole; Guinard, Jérôme; Bret, Laurent; Cognée, Anne Sophie; Gibaud, Sophie; Burucoa, Christophe; Corvec, Stéphane


    The objective of this study was to assess the performance of seven French laboratories for 16S rRNA gene detection by real-time PCR in the diagnosis of bone and joint infection (BJI) to validate a large multicenter study. External quality control (QC) was required owing to the differences in extraction procedures and the molecular equipment used in the different laboratories. Three proficiency sets were organized, including four bacterial DNA extracts and four bead mill-pretreated osteoarticular specimens. Extraction volumes, 16S rRNA gene primers, and sequencing interpretation rules were standardized. In order to assess each laboratory's ability to achieve the best results, scores were assigned, and each QC series was classified as optimal, acceptable, or to be improved. A total of 168 QCs were sent, and 160 responses were analyzed. The expected results were obtained for 93.8%, with the same proportion for extracts (75/80) and clinical specimens (75/80). For the specimens, there was no significant difference between manual and automated extraction. This QC demonstrated the ability to achieve good and homogeneous results using the same 16S rRNA gene PCR with different equipment and validates the possibility of high-quality multicenter studies using molecular diagnosis for BJI.

  15. Evaluation of Lo"wenstein-Jensen Medium Culture,MGIT 960 Culture and Different Specimen Types inDiagnosis of Bone and Joint Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    Guirong Wang[1; Weijie Dong[2; Liping Zhao[1; Xia Yu[1; Suting Chen[1; Yuhong Fu[1; Shibing Qin[1; Hairong Huang[1


    Objective: The aim of this study was to evaluate L-J (Lo"wenstein-Jensen) medium culture, MGIT 960 culture anddifferent specimen types in diagnosis of BJTB (bone and joint tuberculosis). Methods:: Specimens of pus, caseous necrosis,tuberculous granuloma and sequestrum were collected from 52 BJTB patients. All specimens were cultured using both MGIT 960system and L-J medium; and all pus were amplified using real-time PCR to detect the presence of M. tuberculosis DNA. KeyFindings: A total of 191 specimens were collected. Granuloma had better chance to produce positive outcomes by L-J mediumculture, while for sequestrum MGIT 960 culture had higher yield, but there was no significant difference in the recovery rates amongdifferent types of specimen either by L-J culture (Z2 = 0.638, P = 0.888) or by MGIT960 culture (Z2 = 1.399, P = 0.706). MGIT960culture had significantly higher recovery rate than L-J culture, With a combined culture and PCR-based test, the recovery rate of pusspecimen was significantly higher than that of either method alone (P 〈 0.05). Conclusion: MGIT 960 culture is superior to L-Jculture in BJTB diagnosis; pus, sequestrum, granuloma and caseous necrosis are usable specimen for mycobacterial culture;combination of culture and molecular techniques can provide a better diagnostic significance.

  16. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography

    DEFF Research Database (Denmark)

    Ejbjerg, B.J; Narvestad, E; Jacobsen, S;


    of the wrist and 2nd-5th MCP joints was performed on a low field MRI unit (0.2 T Esaote Artoscan) and a high field MRI unit (1.0 T Siemens Impact) on 2 subsequent days. MRI was performed and evaluated according to OMERACT recommendations. Additionally, conventional x ray, clinical, and biochemical examinations......OBJECTIVE: To evaluate a low field dedicated extremity MRI unit for detection of bone erosions, synovitis, and bone marrow oedema in wrist and metacarpophalangeal (MCP) joints, with a high field MRI unit as the standard reference. METHODS: In 37 patients with RA and 28 healthy controls MRI...... were performed. In an initial low field MRI 'sequence selection phase', based on a subset of 10 patients and 10 controls, sequences for comparison with high field MRI were selected. RESULTS: With high field, spin echo MRI considered as the reference method, the sensitivity, specificity, and accuracy...

  17. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... little information about muscles, tendons or joints. An MRI may be more useful in identifying bone and ... bones and the spinal cord can be evaluated). MRI can also detect subtle or occult fractures or ...

  18. The Establishment of Anatomy Database of Chinese Normal Lower Limb Bones and Joints%国人下肢正常骨与关节周围解剖数据库的建立

    Institute of Scientific and Technical Information of China (English)

    李钧; 陈爱民; 郭清河; 江曦; 郭永飞; 叶添文; 赵良瑜


    Objective To acquire the anatomic parameters of Chinese normal lower limb bones and joints, and then establish the database, so as to provide reference for designing orthopedic fixations of the lower limb bones. Methods One hundred and fifty volunteers' anteroposterior and lateral X-ray plain film of the lower limb bones were obtained, and the three-dimensional images of lower limb joints were setted up by mimics 10.01. Finally, the parameters of limb bone (the length of femur, the width of tibial plateau and the diameter of talus on tibial astragaloid joint etc) were measured and the data were inputted into database software. Results When taken the measured value of TP-TSA and PS which were compared with westerner's for example (P <0.05), there was significant deviation between them. Conclusion Because the morphology and anatomic feature of Chinese lower limb bones are different from westerner's, establishing the database of normal lower limb bones and joints is of great significance for designing domestic orthopedic fixations of the lower limb bones.%目的 初步获得国人下肢正常骨与关节解剖学参数,并建立数据库,为国产下肢接骨板和螺钉的设计提供参考依据.方法 对150例志愿者.行下肢骨骼全长正侧位X线平片及关节周围CT平扫,利用Mimics 10.01软件将原始CT扫描图像重建关节周围骨骼三维图像,并测量下肢骨骼参数(股骨长度、胫骨平台宽度、胫距关节面距骨横径等),将数据输入数据库软件中.结果 以胫骨平台内翻角及后倾角测得值为例与西方人比较,有统计学差异(P<0.05).结论 国人下肢骨骼形态及解剖特点与西方人有明显区别,国人下肢正常骨与关节周围数据库的建立对国产下肢接骨板和螺钉的设计有重要意义.

  19. 宣痹合剂治疗腰椎退行性骨关节病疼痛的临床研究%Clinical Study on Xuanbi Mixture in the Treatment of Lumbar Degenerative Bone Joint Disease Pain

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the effect Xuanbi mixture in the treatment of lumbar degenerative bone joint disease pain symptoms. Methods The control group received routine clinical. The research group used Xuanbi mixture on the basis of the Western medicine. The improvement of lumbar degenerative bone joint disease pain before and after treatment was recorded, and the resulting data were implemented statistical test. Results The two groups had no significant difference in pain intensity ( P >0. 05 ) . After corresponding treatment, the improvement of lumbar degenerative bone joint disease pain of the two groups was significantly improved, the research group was better than the control group, and the difference was statistically significant (P0.05);治疗后两组疼痛程度均较之前显著改善,且研究组改善效果优于对照组,对比结果具有统计学意义(P<0.05)。结论对腰椎退行性骨关节病患者给予常规治疗联合宣痹合剂可获得更为理想的临床疗效,有利于保障患者生活质量及身心健康。

  20. 带血管蒂腓骨移植及人工关节置换修复邻近关节良性骨肿瘤所致骨缺损%Operative treatment of benign bone tumor defects in proximal joint by fibula transplantation with vascular and artificial joint replacement.

    Institute of Scientific and Technical Information of China (English)

    傅晨; 周巧玲; 时代; 潘晓瑾; 徐饶; 崔后春; 张明建; 王汝渔


    Objective To explore the reconstructive methods of benign bone tumor defects in proximal joint. Methods Operative treatment was performed in 11 cases with benign bone tumor defects in proximal joint, a-mong whom 4 cases were treated by curettage,cauterization of wall and bone grafting,3 cases were treated by filling branch through segment fibula transplantation with vascular,2 cases were treated by fibula head transplantation with vascular to reconstruct the glenohumeral joint and rediocarpal joint, and 2 cases were treated by artificial joint re-placement. Results The follow-up ranged from 1.5 to 6 years. All of cases got excellent bone unioned without re-lapse and 2 cases of them developed with little limitation in joint function. Conclusion The importance and recon-structive achievement of fibula transplantation in treating the benign bone tumor defects in proximal joint should be thought fully. The indication of artificial tumor prosthesis replacement should be strictly mastered.%目的 探讨邻近关节良性骨肿瘤所致骨缺损的修复方法 .方法 对11例邻近关节之良性骨肿瘤所致骨缺损进行手术处理,其中4例行肿瘤刮除、瘤壁烧灼加植骨术,3例行带血管节段性腓骨移植充填支撑加植骨术,2例行带血管腓骨小头移植重建盂肱及桡腕关节术,2例行人工肿瘤型假体置换术.结果 经1.5~6年随访,所有病例骨愈合均满意,肿瘤无复发,其中2例关节功能轻度障碍.结论 处理邻近关节的良性骨肿瘤所致骨缺损的修复,应充分考虑腓骨作为移植材料的重要性和修复能力.行人工肿瘤型假体置换应严格掌握适应证.

  1. 人胎儿骨骼和关节RACE cDNA文库的构建%The construction of rapid amplification of cDNA ends cDNA libraries from human fetal bone and joint

    Institute of Scientific and Technical Information of China (English)

    梁晓媛; 龚瑶琴; 刘奇迹; 李江夏; 陈丙玺; 郭辰虹


    目的 建立人胎儿骨骼和关节快速扩增cDNA末端(rapid amplification of cDNA ends,RACE cDNA)文库,为分离骨骼和关节发育相关基因奠定基础。方法 采用改进的异硫氰酸胍-酚-氯仿-异戊醇一步法提取骨骼和关节总RNA,用TaKaRa公司生产的cDNA合成试剂盒合成平末端的双链cDNA,然后与衔接子连接。再用位于双链cDNA末端的通用引物扩增全部cDNA。结果 建立了从骨骼和关节构建RACE cDNA文库的方法,并用该方法成功地构建了人胎儿骨骼和关节RACE cDNA文库。结论 所构建的的利用少量总RNA构建RACE cDNA文库方法切实可行,所构建的文库适用于用RACE方法从中分离骨骼和关节发育相关基因。%Objective To construct rapid amplification cDNA ends(RACE) cDNA libraries from human fetal bone and joint and provide resources for isolation of bone- and joint- specific development-related genes.Methods Total RNA of bone and joint were extracted with the modified single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. The double-stranded end-blunted cDNA were synthesized using TaKaRa's cDNA synthesis kit and ligated to cassette adaptors. All of the cDNA molecules were amplified by a pair of common primers.Results A protocol for RACE cDNA library construction from bone and joint was established and two RACE cDNA libraries from human fetal bone and joint were successfully constructed.Conclusion The protocol of RACE cDNA library construction from limited materials proved to be simple and efficient and the library was suitable for RACE to isolate tissue-specific genes.

  2. Delta-toxin production deficiency in Staphylococcus aureus: a diagnostic marker of bone and joint infection chronicity linked with osteoblast invasion and biofilm formation. (United States)

    Valour, F; Rasigade, J-P; Trouillet-Assant, S; Gagnaire, J; Bouaziz, A; Karsenty, J; Lacour, C; Bes, M; Lustig, S; Bénet, T; Chidiac, C; Etienne, J; Vandenesch, F; Ferry, T; Laurent, F


    Biofilm formation, intra-osteoblastic persistence, small-colony variants (SCVs) and the dysregulation of agr, the major virulence regulon, are possibly involved in staphylococcal bone and joint infection (BJI) pathogenesis. We aimed to investigate the contributions of these mechanisms among a collection of 95 Staphylococcus aureus clinical isolates from 64 acute (67.4%) and 31 chronic (32.6%) first episodes of BJI. The included isolates were compared for internalization rate, cell damage and SCV intracellular emergence using an ex vivo model of human osteoblast infection. Biofilm formation was assessed in a microbead immobilization assay (BioFilm Ring test). Virulence gene profiles were assessed by DNA microarray. Seventeen different clonal complexes were identified among the screened collection. The staphylococcal internalization rate in osteoblasts was significantly higher for chronic than acute BJI isolates, regardless of the genetic background. Conversely, no differences regarding cytotoxicity, SCV emergence, biofilm formation and virulence gene distribution were observed. Additionally, agr dysfunction, detected by the lack of delta-toxin production using whole-cell matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) analysis (n = 15; 15.8%), was significantly associated with BJI chronicity, osteoblast invasion and biofilm formation. These findings provide new insights into MSSA BJI pathogenesis, suggesting the correlation between chronicity and staphylococcal osteoblast invasion. This adaptive mechanism, along with biofilm formation, is associated with agr dysfunction, which can be routinely assessed by delta-toxin detection using MALDI-TOF spectrum analysis, possibly providing clinicians with a diagnostic marker of BJI chronicity at the time of diagnosis.

  3. Imaging of low-grade bone infection with a technetium-99m labelled monoclonal anti-NCA-90 Fab' fragment in patients with previous joint surgery

    Energy Technology Data Exchange (ETDEWEB)

    Ivaneeviae, V.; Sandrock, D.; Munz, D.L. [Clinic for Nuclear Medicine, University Hospital Charite, Humboldt University of Berlin (Germany); Perka, C.; Hasart, O. [Orthopaedic Clinic, University Hospital Charite, Humboldt University of Berlin (Germany)


    or 7, infection was verified and scintigraphic outcome was accordingly true positive, while the remaining patient was true negative. In conclusion, MN3 Fab' scintigraphy proved to be highly sensitive but not specific in diagnosing low-grade infections of the hip and knee regions in patients with previous joint surgery. The method seems reliable in excluding but not in proving the presence of infection. MN3 Fab' scintigraphy should not be applied in patients with Girdlestone situations. Assessment of infection using the Zimmerli score was more reliable than MN3 Fab' scintigraphy in this group of patients without rheumatoid arthritis as the underlying disease. Considering results from the literature concerning leucocyte scintigraphy, MN3 Fab' scintigraphy may be clinically useful in evaluating low-grade bone infection in THA and TKA patients with Zimmerli scores above 5 and concomitant rheumatoid arthritis or other inflammatory diseases. (orig.)

  4. TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

    Energy Technology Data Exchange (ETDEWEB)

    Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R [University of Wisconsin, Madison, Wisconsin (United States); Meyer, E [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)


    Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

  5. Efficacy Observation on Long's Bone-Setting Manipulation for Thoracic Joint Disorder%龙氏正骨手法治疗胸椎关节紊乱的疗效观察

    Institute of Scientific and Technical Information of China (English)



    Objective:To observe the efficacy of Long's bone-setting manipulation in treatment of thoracic joint disorder. Methods:128 cases of pa-tients with thoracic joint disorder who were accepted from Mar 2010 to Mar 2016 in our department were randomly divided into treatment group (64 cases) and control group (64 cases), the treatment group treated by Long's bone-setting manipulation, while control group by medication, compared the efficacy of the two groups. Results:The overall response rate of treatment group was significantly higher than that of control group, which had statistical significance (P<0.05). Conclusion:Long's bone-setting manipulation which can significantly improve the clinical symptoms of patients has a significant curative effect on thoracic joint disorder, deserves promotion.%目的:观察龙氏正骨手法治疗胸椎关节紊乱的治疗效果。方法:选取2010年3月~2016年3月我科收治的胸椎关节紊乱的患者128例,随机分成治疗组和对照组各64例,治疗组用龙氏正骨手法治疗,对照组用药物治疗,对比两组临床治疗效果。结果:治疗组总有效率显著高于对照组,差异有统计学意义(P<0.05)。结论:龙氏正骨手法治疗胸椎关节紊乱疗效确切,能够显著改善患者临床症状,值得推广。

  6. 酶联免疫斑点试验在骨关节结核诊断中的价值%Diagnosis value of enzyme-linked immunospot assay in bone and joint tuberculosis

    Institute of Scientific and Technical Information of China (English)

    陈芳; 魏毅; 王媛; 赵玮; 李晓娟; 王效娅


    Objective To study the diagnostic value of enzyme-linked immuno-spot assay(ELISPOT) in bone and joint tuberculosis. Methods A total of 54 patients with bones and joints diseases were underwent the enzyme-linked immuno-spot assay to detect fleck and to estimate the positive results of joint tuberculosis. Results In 54 patients , 20 cases were diagnosed as bone and joint tuberculosis by surgical pathology. The sensitivity, specificity, accuracy and Kappa value of ELISPOT antigen A test were 80.00%, 91.18%, 87.04% and 0.72 respectively. The sensitivity, specificity, accuracy and Kappa value of ELISPOT antigen B test were 80.00%, 97.06%, 90.74%and 0.80 respectively. The areas under of ROC of A and B antigen were 0.99 and 0.87 respectively and their cut off were 4.5. Conclusions The enzyme-linked immuno-spot method had a higher sensitivity and specificity for detecting tuberculosis infection technique which can be used for the auxiliary diagnosis of bone tuberculosis.%目的研究酶联免疫斑点试验(ELISPOT)在骨关节结核临床诊断中的应用价值。方法对54例骨关节病患者进行ELISPOT试验,并进行斑点阅读与统计,判定骨关节结核阳性结果。结果54例患者中20例经手术病理诊断明确为骨关节结核,ELISPOT A抗原试验灵敏度80.00%,特异度91.18%,正确率87.04%,Kappa值0.72。 ELISPOT B抗原试验灵敏度80.00%,特异度97.06%,正确率90.74%,Kappa值0.80。A抗原ROC曲线下面积0.99,B抗原曲线下面积0.87,最佳临界值均为4.5。结论 ELISPOT是一种具有较高敏感性和特异性的检测结核感染的技术,可用于骨结核的辅助诊断。

  7. Surgery for Bone Cancer (United States)

    ... be amputated mid-thigh, the lower leg and foot can be rotated and attached to the thigh bone. The old ankle joint becomes the new knee joint. This surgery is called rotationplasty (roh-TAY-shun-PLAS-tee). A prosthesis is used to make the new leg the ...

  8. SPECT/CT 骨显像对颞下颌关节紊乱综合征的临床研究%Clinical research of SPECT/CT bone imaging on temporo-mandibular joint dysfunction syndrome

    Institute of Scientific and Technical Information of China (English)

    史聪翀; 刘超


    目的:研究放射性核素骨显像对颞下颌关节紊乱综合征的诊断价值。方法对36例颞下颌关节综合征患者行 SPECT/ CT 骨显像,对颞下颌关节的髁状突、下颌升支、下颌角图像进行冠状面、矢状面、横断面采集重建,并计算放射性计数比值。结果骨显像患侧颞下颌关节髁状突、下颌升支、下颌角放射性计数比值分别为6.23±0.59,3.42±0.14,2.75±0.63,与健侧比较差异均有统计学意义(P <0.05)。结论放射性核素骨扫描对颞下颌关节紊乱病的早期器质性病变是很好的检测手段,可以早期发现骨质的细小破坏,从而为选择治疗方法提供参考。%Objective To study the diagnostic value of radionuclide bone imaging on temporo-mandibular joint dysfunction syndrome(TMJD). Methods Conducted SPECT/ CT bone imaging on 36 TMJD patients,gathered and rebuilt coronal plane, vertical plane and transaction of temporal-mandibular joint,mandibular ramus,angle of mandible images,and calculated the ra-dioactive count ratios. Results The radioactive count ratios of bone imaging affected side’s temporal-mandibular joint,mandibu-lar ramus,angle of mandible were 6. 23 ±0. 59,3. 42 ±0. 14 and 2. 75 ±0. 63 respectively,and they had significant difference than those of uninjured side(P <0. 05). Conclusion Radionuclide bone scanning is a good detection method for early temporomandib-ular disorders,so it can early detection of bone damage and provide reference evidence for the choice of treatment method.

  9. Bone tumor (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor; Bone tumor - benign ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  10. Anti-RANKL treatment inhibits erosive joint destruction and lowers inflammation but has no effect on bone formation in the delayed-type hypersensitivity arthritis (DTHA) model

    DEFF Research Database (Denmark)

    Atkinson, Sara Marie; Bleil, Janine; Maier, Rene;


    . Periarticular bone formation was observed from day 10. Induction of new bone formation indicated by enhanced Runx2, collagen X, osteocalcin, MMP2, MMP9, and MMP13 mRNA expression was observed only between days 8 and 11. Anti-RANKL treatment resulted in a modest reduction in paw and ankle swelling...

  11. Evaluation the limb and joint function after treatment the pelvic bone tumors by the microwave hyperthermia%骨盆骨肿瘤原位分离微波高温治疗后肢体关节功能的评价

    Institute of Scientific and Technical Information of China (English)


    Objective To evaluate the limb and joint function after treatment the pelvic bone tumors by the microwave hyperthermia inserted antenna arrays.Methods 51 patients were treated by inserted microwave antenna arrays induced hyperthermia. All patient limb and joint functions were observed and analyzed from oncology, function and complications.Results There were 9 recurred cases and 7 of them died. Among the remaining 42 patients,36 patients had excellent and good limb and joint function,6 patients had fair function.Conclusions By the method of inserted microwave antenna arrays induced hyperthermia to treat the pelvic tumors the limb and joint function was excellent.

  12. Three cases report of connective tissue disease complicated with knee joint bone infarction%结缔组织病合并膝关节骨梗死三例报道

    Institute of Scientific and Technical Information of China (English)

    郑桂敏; 王磊; 贾秀川; 张风肖; 高建霞


    Bone infarction is often found in patients with connective tissue disease due to long-term application of large amount of corticosteroids. For these patients, bone infarction more commonly occurs in hip joints rather than in knee joints. Aching joints and arthritis are routine presentations of connective tissue disease, which may easily result in the misdiagnosis of bone infarction in knee joints. Likewise, bone infarction may hinder the tracking of the development of connective tissue disease. The clinical manifestations, immunological characteristics and course of diagnosis and treatment of 3 cases of connective tissue disease complicated with bone infarction are retrospectively described in this paper. All are females, 2 of whom suffers from systemic lupus erythematosus, and the other Sjogren's syndrome. All of them are treated with corticosteroids and immunodepressants in a long term, exhibit Raynaud's phenomenon, and are complicated with multiple or single bone infarction. Management of anti-osteoporosis, blood circulation activation and bone metabolism promotion yields definite effect, and magnetic resonance imaging has a high value in diagnosis. A clinical comprehensive analysis on the basis of symptoms, laboratory results and imaging findings should be carried out to avoid the misdiagnosis.%结缔组织病患者因为长期大量应用激素,骨梗死并不少见,但多发生于髋关节,发生在膝关节较少见.由于结缔组织病常表现有关节疼或关节炎,发生在膝关节的骨梗死容易被误诊;同样,骨梗死的诊断也可能掩盖结缔组织病的病情活动.作者回顾性分析了3例结缔组织病合并膝关节骨梗死患者的临床表现、免疫学特征以及诊疗过程.患者均为年轻女性,其中2例为系统性红斑狼疮,1例为干燥综合征;均有长期应用激素和免疫抑制剂史,均有雷诺现象,骨梗死为多发或单发,抗骨质疏松和活血、改善骨代谢有一定的疗效,磁共振成

  13. 核素骨显像对骶髂关节、髋关节及 脊柱关节病的诊断%Bone scintigraphic imaging of sacroiliac joint, hip joint and spondyloarthritis

    Institute of Scientific and Technical Information of China (English)


    Objective To establish normal reference value of radioactivity ratio of sacroiliac joint /soft tissue,sacroiliac joint/sacrum, hip joint/soft tissue and hip joint/thighbone in Chinese, and discuss its diagnostic value in spondyloarthritis (SpA). Methods 260 joints from 130 normal individuals were divided into 4 groups according to ages: 15~19 years, ~24 years, ~39 years and ≥40 years. They have exhibited no waist-leg symptom and a normal CT exam in sacroiliac joint. SPECT was performed on whole body skeleton as well as sacroiliac joint and hip joint to measure the radioactivity ratio in these joints respectively. In the same time, SPECT was also undertaken in 45 patients with SpA to calculate the radioactivity ratio of sacroiliac joint/soft tissue and sacroiliac joint/sacum. Results After statistical processing, a normal reference value of all radioactivity ratio in four groups was obtained. Analysis on the data in 4 groups showed that the variant coefficient of sacroiliac joint/sacrum is minimal, and thus to be used as a judgment for sacroiliac joint/sacrum osteometabolism. In 45 patients with SpA, 23 cases were undifferentiated spondyloarthritis. The radioactivity ratio of sacroiliac joint/sacrum increased in 20 cases (86.9%), while other joint disorders occurred in 21 cases. Conclusion The radioactivity ratio of sacroiliac joint/sacrum is of important value in early diagnosis for SpA.%目的 建立国人骶髂关节/软组织、骶髂关节/骶骨、髋关节/软组织、髋关节/股骨放射性比值的正常参考值,探讨其在脊柱关节病(SpA)中的诊断价值。方法 对无腰腿症状、CT检查骶髂关节正常的不同年龄者130例260组关节分为4组:15~19岁,~24岁,~39岁,≥40岁,进行全身骨骼及骶髂关节、髋关节周围结构的SPECT显像,取得4组不同部位放射性比值。同时对临床诊断为SpA的45例患者进行骨显像,计算其左右骶髂关节/软组织、骶髂关节/骶骨放射

  14. A Simplified Method for the Aspiration of Bone Marrow from Patients Undergoing Hip and Knee Joint Replacement for Isolating Mesenchymal Stem Cells and In Vitro Chondrogenesis

    Directory of Open Access Journals (Sweden)

    Subhash C. Juneja


    Full Text Available The procedure for aspiration of bone marrow from the femur of patients undergoing total knee arthroplasty (TKA or total hip arthroplasty (THA may vary from an OR (operating room to OR based on the surgeon’s skill and may lead to varied extent of clotting of the marrow and this, in turn, presents difficulty in the isolation of mesenchymal stem cells (MSCs from such clotted bone marrow. We present a simple detailed protocol for aspirating bone marrow from such patients, isolation, and characterization of MSCs from the aspirated bone marrow specimens and show that the bone marrow presented no clotting or exhibited minimal clotting. This represents an economical source and convenient source of MSCs from bone marrow for use in regenerative medicine. Also, we presented the detailed protocol and showed that the MSCs derived from such bone marrow specimens exhibited MSCs characteristics and generated micromass cartilages, the recipe for regenerative medicine for osteoarthritis. The protocols we presented can be used as standard operating procedures (SOPs by researchers and clinicians.

  15. A Simplified Method for the Aspiration of Bone Marrow from Patients Undergoing Hip and Knee Joint Replacement for Isolating Mesenchymal Stem Cells and In Vitro Chondrogenesis. (United States)

    Juneja, Subhash C; Viswanathan, Sowmya; Ganguly, Milan; Veillette, Christian


    The procedure for aspiration of bone marrow from the femur of patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA) may vary from an OR (operating room) to OR based on the surgeon's skill and may lead to varied extent of clotting of the marrow and this, in turn, presents difficulty in the isolation of mesenchymal stem cells (MSCs) from such clotted bone marrow. We present a simple detailed protocol for aspirating bone marrow from such patients, isolation, and characterization of MSCs from the aspirated bone marrow specimens and show that the bone marrow presented no clotting or exhibited minimal clotting. This represents an economical source and convenient source of MSCs from bone marrow for use in regenerative medicine. Also, we presented the detailed protocol and showed that the MSCs derived from such bone marrow specimens exhibited MSCs characteristics and generated micromass cartilages, the recipe for regenerative medicine for osteoarthritis. The protocols we presented can be used as standard operating procedures (SOPs) by researchers and clinicians.

  16. 99m-Tc HMDP bone scintigraphic findings of gouty arthropathy of both hands. Extending soft tissue uptake adjacent to the joints

    Energy Technology Data Exchange (ETDEWEB)

    Shih, Wei-Jen; Domstad, P.A.; Purcell, M.; DeLand, F.H.

    The /sup 99m/Tc hydroxy methylene diphosphonate scintigraphic findings of both hands are correlated to the radiographic findings in a patient with a 30-year history of gouty arthropathy. Scintigraphic differentiation of the type of arthritis on the basis of uptake pattern is difficult. However, the findings of rheumatoid arthritis are confined to the joints and usually the involvement is symmetrical. With gout there is a tendency toward asymmetrical, bilateral, multifocal joint involvement with areas of intense abnormal uptake; because of the associated soft tissue swelling, the intense uptake usually extends beyond the involved joints.

  17. Osteoblastoma crossing the sacro-iliac joint

    Energy Technology Data Exchange (ETDEWEB)

    Whittingham-Jones, Paul; Lehovsky, Jan [Royal National Orthopaedic Hospital, Spinal Surgery, London (United Kingdom); Hughes, Richard; Saifuddin, Asif [Royal National Orthopaedic Hospital, Radiology, London (United Kingdom); Fajinmi, Matilda [Royal National Orthopaedic Hospital, Histopathology, London (United Kingdom)


    Osteoblastoma is a rare primary bone tumour which is well-described in the spine and sacrum. We report a case of histologically confirmed osteoblastoma in a 20-year-old male which crossed the sacroiliac joint. This has not previously been described to our knowledge. The imaging features of osteoblastoma and sacroiliac joint involvement by bone tumours are reviewed. (orig.)

  18. Effects of ground and joint reaction force exercise on lumbar spine and femoral neck bone mineral density in postmenopausal women: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Kelley George A


    Full Text Available Abstract Background Low bone mineral density (BMD and subsequent fractures are a major public health problem in postmenopausal women. The purpose of this study was to use the aggregate data meta-analytic approach to examine the effects of ground (for example, walking and/or joint reaction (for example, strength training exercise on femoral neck (FN and lumbar spine (LS BMD in postmenopausal women. Methods The a priori inclusion criteria were: (1 randomized controlled trials, (2 exercise intervention ≥ 24 weeks, (3 comparative control group, (4 postmenopausal women, (5 participants not regularly active, i.e., less than 150 minutes of moderate intensity (3.0 to 5.9 metabolic equivalents weight bearing endurance activity per week, less than 75 minutes of vigorous intensity (> 6.0 metabolic equivalents weight bearing endurance activity per week, resistance training g was calculated for each FN and LS BMD result and pooled using random-effects models. Z-score alpha values, 95%confidence intervals (CI and number-needed-to-treat (NNT were calculated for pooled results. Heterogeneity was examined using Q and I2. Mixed-effects ANOVA and simple meta-regression were used to examine changes in FN and LS BMD according to selected categorical and continuous variables. Statistical significance was set at an alpha value ≤0.05 and a trend at >0.05 to ≤ 0.10. Results Small, statistically significant exercise minus control group improvements were found for both FN (28 g’s, 1632 participants, g = 0.288, 95% CI = 0.102, 0.474, p = 0.002, Q = 90.5, p I2 = 70.1%, NNT = 6 and LS (28 g’s, 1504 participants, g = 0.179, 95% CI = −0.003, 0.361, p = 0.05, Q = 77.7, p I2 = 65.3%, NNT = 6 BMD. Clinically, it was estimated that the overall changes in FN and LS would reduce the 20-year relative risk of osteoporotic fracture at any site by approximately 11% and 10%, respectively. None of the mixed

  19. Radiological and clinical features of bone and joint disease in patients with congenital insensitivity to pain and anhidrosis%先天性无痛无汗症骨关节病的临床与X线表现特征

    Institute of Scientific and Technical Information of China (English)

    潘阿善; 陈庆东; 林浒衡; 邱乾德


    目的:探讨先天性无痛无汗症骨关节病的临床及X线表现特点。方法回顾性分析8例先天性无痛无汗症骨关节病患者的临床及X线表现,总结其特征。8例均拍摄X线片,主要观察病灶部位、范围、形态、周边骨质硬化、关节及软组织改变。结果临床主要表现为无痛、无汗、发热、智力发育迟缓和感染。8例共累及166块骨,其中跖、趾骨115块,指骨29块。整根骨完全或大部分骨质溶解缺失113块,骨质呈小斑片状溶解40块,溶解的骨质仅残留小斑片状骨质影7块,残留骨端呈“图钉征”、“平截征”、“笔尖征”6块。周边骨质硬化12块,伴病理性骨折2块。关节脱位3个、关节变形3个、夏科关节3个。软组织溃烂4例,指端或趾端软组织完全缺如4例,软组织内见斑点状钙化3例。结论先天性无痛无汗症骨关节病具有一定的临床与X线特征。%Objective To investigate the radiological and clinical features of osteoarthrosis in congenital insensitivity to pain with anhidrosis (CIPA).Methods The clinical and radiological features in 8 cases of CIPA diseases were retrospectively analyzed. There were five males and three females,age ranged from 11 to 18 years with a median age of (14±3) years. X-ray plain film findings in eight cases were analyzed for the location, extent and contour of the lesions, surrounding bony sclerosis, as well as joint and soft tissue changes. Results The main clinical presentations were insensitivity to pain, anhydrosis, fever, mental retardation and infection. In these eight cases, a total of 166 pieces of bone were involved, including the plantar and phalanges (n=115),phalanx (n=29).The radiological findings include dissolution of the entire bone or most of the bone (n=113), dissolution of a few small areas of the bone (n=40), dissolution of the bone with only residual punctate areas (n=7), the“pushpin sign”and“pencil tip sign

  20. Identifying compositional and structural changes in spongy and subchondral bone from the hip joints of patients with osteoarthritis using Raman spectroscopy (United States)

    Buchwald, Tomasz; Niciejewski, Krzysztof; Kozielski, Marek; Szybowicz, Mirosław; Siatkowski, Marcin; Krauss, Hanna


    Raman microspectroscopy was used to examine the biochemical composition and molecular structure of extracellular matrix in spongy and subchondral bone collected from patients with clinical and radiological evidence of idiopathic osteoarthritis of the hip and from patients who underwent a femoral neck fracture, as a result of trauma, without previous clinical and radiological evidence of osteoarthritis. The objectives of the study were to determine the levels of mineralization, carbonate accumulation and collagen quality in bone tissue. The subchondral bone from osteoarthritis patients in comparison with control subject is less mineralized due to a decrease in the hydroxyapatite concentration. However, the extent of carbonate accumulation in the apatite crystal lattice increases, most likely due to deficient mineralization. The alpha helix to random coil band area ratio reveals that collagen matrix in subchondral bone is more ordered in osteoarthritis disease. The hydroxyapatite to collagen, carbonate apatite to hydroxyapatite and alpha helix to random coil band area ratios are not significantly changed in the differently loaded sites of femoral head. The significant differences also are not visible in mineral and organic constituents' content in spongy bone beneath the subchondral bone in osteoarthritis disease.

  1. Bone scintiscanning updated. (United States)

    Lentle, B C; Russell, A S; Percy, J S; Scott, J R; Jackson, F I


    Use of modern materials and methods has given bone scintiscanning a larger role in clinical medicine, The safety and ready availability of newer agents have led to its greater use in investigating both benign and malignant disease of bone and joint. Present evidence suggests that abnormal accumulation of 99mTc-polyphosphate and its analogues results from ionic deposition at crystal surfaces in immature bone, this process being facilitated by an increase in bone vascularity. There is, also, a component of matrix localization. These factors are in keeping with the concept that abnormal scintiscan sites represent areas of increased osteoblastic activity, although this may be an oversimplification. Increasing evidence shows that the bone scintiscan is more sensitive than conventional radiography in detecting focal disease of bone, and its ability to reflect the immediate status of bone further complements radiographic findings. The main limitation of this method relates to nonspecificity of the results obtained.

  2. 《骨与关节杂志》(美国版)(J Bone Joint Surg Am)2001年第83卷第5期目录

    Institute of Scientific and Technical Information of China (English)


    Reverse Obliquity Fractures of the Intertrochanteric Region of the Femur George J Haidukewych, et al. 643 Fluorine-18 Fluorodeoxyglucose-Positron Emission Tomography:A Highly Accurate Imaging Modality for the Diagnosis of Chronic Musculoskeletal Infections F De Winter, et al. 651 Position of Immobilization After Dislocation of the Glenohumeral Joint: A Study with Use of Magnetic Resonance Imaging Eiji Itoi, et al. 661 Impact of Smoking on the Outcome of Anterior Cervical Arthrodesis with Interbody or Strut-Grafting Alan S Hilibrand, et al. 668 Radiation Exposure With Use Of the Inverted-C-Arm Technique in Upper-Extremity Surgery Michael R Tremains, et al. 674 Clinical Determinants of the Outcome of Manual Stretching in the Treatment of Congenital Muscular Torticollis in Infants : A Prospective Study of Eight Hundred and Twenty-one Cases JCY Cheng, et al. 679 Histopathologic Changes in Growth-Plate Cartilage Following Ischemic Necrosis of the Capital Femoral Epiphysis: An Experimental Investigation in Immature Pigs Harry KW Kim, et al. 688 Arthroscopically Assisted Treatment of Avulsion Fractures of the Posterior Cruciate Ligament from the Tibia Sung-Jae Kim, et al. 698 Influence of Metacarpophalangeal Joint Position on Basal Joint-Loading in the Thumb Mark JR Moulton, et al. 709 Improvement of the Bone-Pin Interface Strength in Osteoporotic Bone with Use of Hydroxyapatite-Coated Tapered External-Fixation Pins: A Prospective, Randomized Clinical Study of Wrist Fractures Antonio Moroni, et al. 719 A Brief Note. Ask Yourself, Why?: A Cost-Effective Look at Routine Pathologic Examination of Specimens Using the Trapezium Jeffrey A Culp, et al. 722 The Effect of Placing a Tensioned Graft Across Open Growth Plates: A Gross and Histologic Analysis T Bradley Edwards, et al. 725 Operative Treatment of Supracondylar Fractures of the Humerus in Children: The Consequences of Pin Placement David L Skaggs, et al. 735

  3. How does joint remodeling work?: new insights in the molecular regulation of the architecture of joints. (United States)

    Schett, Georg


    Remodeling of joints is a key feature of inflammatory and degenerative joint disease. Bone erosion, cartilage degeneration and growth of bony spurs termed osteophytes are key features of structural joint pathology in the course of arthritis, which lead to impairment of joint function. Understanding their molecular mechanisms is essential to tailor targeted therapeutic approaches to protect joint architecture from inflammatory and mechanical stress. This addendum summarizes the new insights in the molecular regulation of bone formation in the joint and its relation to bone resorption. It describes how inflammatory cytokines impair bone formation and block the repair response of joints towards inflammatory stimuli. It particularly points out the key role of Dickkopf-1 protein, a regulator of the Wingless signaling and inhibitor of bone formation. This new link between inflammation and bone formation is also crucial for explaining the generation of osteophytes, bony spurs along joints, which are characterized by new bone and cartilage formation. This mechanism is largely dependent on an activation of wingless protein signaling and can lead to complete joint fusion. This addendum summarized the current concepts of joint remodeling in the limelight of these new findings.

  4. 闭合性双踝骨折合并踝关节向外半脱位中医治疗%Clinical treatment of Chinese traditional treatment on double malleolus bone fracture and malleolus joint half dislocation

    Institute of Scientific and Technical Information of China (English)

    袁海升; 赵育刚; 屈平; 周跃辉; 李武


    目的:探讨闭合性双踝骨折合并踝关节向外半脱位中医治疗的临床疗效,明确手法整复适应症,提高复位成功率,减少治疗中后期双踝骨折及踝关节半脱位再移位情况,保证患者踝关节功能.方法:所有患者采用手法整复,超踝夹板及中立位托板固定,后期进行功能锻炼.结果:对2010~2013我院收治的206例患者进行疗效评估,临床愈合199例,骨性愈合141例,总愈合率96.6%.3例复位失败后进行手术治疗,4例在14天内因过早下地导致骨折移位,进行手术治疗.无效率3.39%.对本组剩余199例进行1年随访,随访采用Olerud和Molander踝关节骨折标准进行疗效评定,优172例,良27例,无一般及差评分.结论:中医改进疗法治疗闭合性双踝骨折合并踝关节向外半脱位,有效的改善了治疗效果.%AIM: To discuss the clinical efficacy on Chinese traditional treatment on double malleolus bone fracture and malleolus joint half dislocation; To clarify the indications of the treatment method in order to improve the efficacy of clinical treatment of Chinese traditional treatment on double malleolus bone fracture and malleolus joint half dislocation,and decrease the risk of bone fracture dislocation in the treatment; To make the function exercise as early as possible to protect the function of malleolus joint. METHODS:All patients performed the manipulative reduction, and the malleolus bone were fixed by the deck, as well as the exercises should be received. RESULTS: A total of 206 cases admitted into our hospital from 2010 to 2013 were taken into the clinical assessment, with 199 cases of clinical healing and 141 cases of fracture healing, and the total healing rate was 96.6%. A total of 3 cases underwent surgical treatment after replace ment failure, while 4 cases suffered fracture displacement due to early walking within 14 days. Failure rate was 3.39%. During 1 year

  5. Bone pathology inpsoriatic arthritis

    Directory of Open Access Journals (Sweden)

    V. V. Badokin


    Full Text Available Objective. To study different variants of osteolysis in pts with psoriatic arthritis (PA and to reveal their relationship with other clinico-radiological features of joint damage. Material and methods. 370 pts with definite PA having different variants of joint damage were included. Radiological examination of bones and joints (in some cases large picture frame was performed. Morphological evaluation of synovial biopsies was done in 34 pts with PA and 10 pts with rheumatoid arthritis (RA. Results. Different types of osteolysis were revealed in 80 (21,6% pts. Osteolytic variant of joint damage was present in 29 pts. 33 pts had acral, 48 — intra-articular osteolysis and 16 - true bone atrophy. Frequency and intensity of bone resorption were associated with severity of PA. Acral osteolysis correlated with arthritis of distal interphalangeal joints and onychodystrophy. Intra-articular osteolysis was most often present in distal interphalangeal joints of hands and metacarpophalangeal joints (39,6% and 41,7% respectively. Characteristic feature of PA was combination of prominent resorption with formation of bone ankylosis and periosteal reaction. Ankylosis was present in 33,3% of pts with intra-articular osteolysis and in 60% of pts with combination of different osteolysis variants. Systemic reaction of microcirculation in synovial biopsies was most prominent in osteolytic variant: marked thickening of capillary and venule basal membrane with high level of acid phosphatase, increased capillary and precapillary blood flow with stasis features, vascular lymphocyte and macrophage infiltration, productive vasculitis with annular wall thickening, thrombovasculitis and villi deep layer sclerosis. Conclusion. Different variants of osteolysis show bone involvement in PA. Acral and intra- articular osteolysis association with bone ankylosis and periostitis proves their common pathogenetic entity.

  6. Customized artificial prosthesis replacement for treatment of giant cell tumors of bone near the joints%定制人工假体置换治疗近关节部位骨巨细胞瘤

    Institute of Scientific and Technical Information of China (English)

    陈飚; 王全; 赵春和


    目的:评价定制人工假体置换治疗近关节部位骨巨细胞瘤的疗效。方法对近关节部位骨巨细胞瘤42例行瘤段切除、定制人工假体置换治疗。其中37例行旋转铰链型人工膝关节假体置换,3例行人工肱骨头置换,2例行加长柄双动性股骨头置换。结果42例患者均获随访,时间12~96个月,无局部复发或远处转移。术后6个月MSTS评分为16~28(24.0±2.34)分,肢体功能优31例,良8例,中3例,优良率为92.8%。结论定制人工假体置换是治疗近关节部位骨巨细胞瘤的有效方法,能减少局部复发,提高临床效果。%Objective To evaluate the clinical effect of customized artificial prosthesis replacement for treatment of gi-ant cell tumors of bone near the joints. Methods 42 patients with giant cell tumors of bone near the joints were trea-ted with en block excision and reconstruction with customized artificial prosthesis. The type of the prostheses was as follow:37 rotating hinge knee prosthesis, 3 artificial humeral head, 2 long stem femoral head. Results According to the follow-up for 12~96 months, 42 patients had no local recurrence or metastasis. The Musculoskeletal Tumor So-ciety (MSTS) score was 16~28(24. 0 ± 2. 34), with an excellent limb function in 31 patients, good in 8, fair in 3. The excellent and good rate was 92. 8%. Conclusions Customized artificial prosthesis replacement is an effective method for treatment of giant cell tumors of bone near the joints. It also can reduce the local recurrence and provide better outcomes.

  7. Effect of indomethacin on regulation of juxta-articular bone blood-flow during joint tamponade. An experimental study in puppies

    DEFF Research Database (Denmark)

    Ewald, Henrik Lykke; Holm, I E; Bülow, J;


    ) and regional blood flow (RBF) measurements in the distal femoral epiphysis (DFE), aspects of vascular control mechanisms in the distal femoral epiphysis were investigated during knee joint tamponade (50% of mean arterial pressure) before and after administration of indomethacin 7.5 mg/kg. Six dogs aged 3......-4 months were investigated in fentanyl anaesthesia. Knee joint tamponade resulted in a significant increase in IOP and calculated venous resistance in the DFE, while no significant changes in regional blood-flow or arterial resistance were encountered. Administration of indomethacin did not affect...

  8. MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage

    DEFF Research Database (Denmark)

    Tan, Yu M; Østergaard, Mikkel; Doyle, Anthony;


    INTRODUCTION: The aim of this study was to investigate the magnetic resonance imaging (MRI) features of bone disease in the arthritis mutilans (AM) form of psoriatic arthritis (PsA). METHODS: Twenty-eight patients with erosive PsA were enrolled (median disease duration of 14 years). Using x...

  9. Ultrasound Doppler Score Correlates with OMERACT RAMRIS Bone Marrow Oedema and Synovitis Score in the Wrist Joint of Patients with Rheumatoid Arthritis

    DEFF Research Database (Denmark)

    Boesen, M; Ellegaard, K; Boesen, L;


    PURPOSE: MRI is considered the standard of reference for advanced imaging in rheumatoid arthritis (RA). However, in daily clinical practice ultrasound (US) imaging with Doppler information is more versatile and often used for fast and dynamic assessment of joint inflammation. The aim was to compa...

  10. Transfer of lumbosacral load to iliac bones and legs Part 2: Loading of the sacroiliac joints when lifting in a stooped posture

    NARCIS (Netherlands)

    C.J. Snijders (Chris); A. Vleeming (Andry); R. Stoeckart (Rob)


    textabstractWe developed a biomechanical model of load transfer by the sacroiliac joints in relation to posture. A description is given of two ways in which the transfer of lumbar load to the pelvis in a stooped posture can take place. One way concerns ligament and muscle forces that act on the sacr

  11. Transfer of lumbosacral load to iliac bones and legs Part 1: Biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise

    NARCIS (Netherlands)

    C.J. Snijders (Chris); A. Vleeming (Andry); R. Stoeckart (Rob)


    textabstractThis study deals primarily with the stability of the base of the spine. The sacroiliac joints are vulnerable to shear loading on account of their predominantly flat surfaces. This raises the question of what mechanisms are brought into action to prevent dislocation of the sacroiliac join

  12. 膝关节周围骨折术后早期康复训练的临床分析%Clinical analysis of early rehabilitation treatment after operation of bone fractures around the knee joint

    Institute of Scientific and Technical Information of China (English)



    Objective: To Investigate the effect of early rehabilitation treatment after operation of bone fractures around the knee joint. Methods: 80 cases after operation of bone fractures around the knee joint clinical data were collected, which were randomly divided into control group and observation group, 40 cases in each group. The traditional methods of rehabilitation was given in the control group, while early rehabilitation training was given in observation group. Then, the curative effect, knee-joint ROM and Lysholm score were compared. Results: In the control group, 20 cases were excellent, 10 cases were good, the excellent and good rate was 75.0%; In the observation group, 32 cases were excellent, 7 cases were good, the excellent and good rate was 97.5%, there was a significant difference between the two groups (P<0.05). The knee-joint ROM and Lysholm score in observation group were higher than the control group, there were significant, differences between the two groups (P<0.01). Conclusion: Early rehabilitation treatment after operation of bone fractures around the knee joint can improve the efficacy of operation, which is helpful for recoveiy of knee function in patients. It is worthy of popularization.%目的:探讨膝关节周围骨折术后早期康复训练的临床疗效.方法:收集本院80例膝关节周围骨折术后患者的临床资料,将其随机分为对照组和观察组,每组各40例,对照组给予传统的康复方法,观察组给予早期康复训练,比较两组患者的疗效、膝关节活动范围(ROM)和Lysholm评分.结果:对照组优20例,良10例,优良率为75.0%;观察组优32例,良7例,优良率为97.5%,两组间比较差异有统计学意义(P<0.05);观察组患者的膝关节ROM和Lysholm评分明显好于对照组,两组间比较差异有高度统计学意义(P<0.01).结论:膝关节周围骨折术后进行早期康复训练能提高手术疗效,有利于患者膝关节功能的恢复,值得推广应用.

  13. Bone Biopsy (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  14. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... view and assess bone fractures, injuries and joint abnormalities. This exam requires little to no special preparation. ... follow-up exam is done because a potential abnormality needs further evaluation with additional views or a ...

  15. Bone scintigraphy in ankylosing spondylitis

    Energy Technology Data Exchange (ETDEWEB)

    Otsuka, Nobuaki; Fukunaga, Masao; Tomomitsu, Tatsushi (Kawasaki Medical School, Kurashiki, Okayama (Japan)); Morita, Rikushi


    Twelve patients with ankylosing spondylitis (11 males and one female) were examined by both bone scintigraphy and dual energy X-ray absorptiometry (DEXA). Bone scintigraphy revealed increased accumulation in the sacroiliac joint in 6 patients, the spines in 10, and the other joints, including the sternoclavicular joint, in 8 patients. Each one patient had an intense tracer uptake in the finger and toe joints. In 4 patients in whom DEXA was concurrently performed at the level of 2nd to 4th lumbar vertebrae, there was no consistent tendency for mean bone mineral density. In 2 of 3 patients receiving DEXA for the radius, bone marrow density was within the normal range. (N.K.).

  16. Changes of distal joint after the femoral medullary cavity is blocked with bone cement%骨水泥阻塞兔骨干髓腔后远侧关节的改变

    Institute of Scientific and Technical Information of China (English)

    李宏宇; 安洪; 梁斌; 李荣祝; 田文; 韦敏克


    进行组织学观察,同时采用透射电镜观察左侧股骨远端关节软骨、软骨下骨标本组织学变化.主要观察指标:①苏木精-伊红染色、甲苯胺蓝染色、免疫组织化学检测实验兔实验侧远侧关节软骨、软骨下骨和滑膜组织学观察结果.②透射电镜下左侧股骨远端关节软骨、软骨下骨标本组织学变化.结果:①苏木精-伊红染色显示模型组实验兔关节软骨、软骨下骨和关节滑膜组织损害随时间呈进行性加重,造模后16周关节软骨破坏,骨组织结构损害,滑膜组织增生、肿胀;甲苯胺蓝染色显示造模后16周实验兔关节软骨全层失染;免疫组织化学结果:造模后16周软骨细胞Ⅱ型胶原染色阳性.关节滑膜细胞及软骨细胞TGF-β1染色阳性.②透射电镜下模型组实验兔关节软骨和骨细胞损害随时间呈进行性加重,造模16周部分软骨细胞和骨细胞坏死、崩解.结论:骨水泥阻塞股骨近中段骨干髓腔后导致股骨远端血循环障碍,使股骨远端骨代谢发生紊乱,最终造成远侧关节骨、软骨和滑膜组织发生了退行性病变或坏死.%BACKGROUND:There are so many researches on the complication of artificial joint of bone cement on clinics, but the effect of implanting artificial joint of bone cement on the structure of distal joint is unclear.OBJECTIVE:To explore the structural changes of distal joint after blocking the proximal and middle femoral medullary cavity with bone cement.DESIGN:Controlled observation.SETTING:The People's Hospital of Guangxi Zhuang Autonomous Region.MATERIALS:A total of 26 healthy adult New Zealand rabbits, of clean grade and both genders,weighing 2.6-3.5 kg,were offered by the Experimental Animal Center of Chongqing Medical University.Polymethyl methacrylate (PMMA) TJ bone cement,16# antrum needle for puncture (outer diameter 1.6 mm,inner diameter 1.05 mm,length 80 mm), light microscope of Japan Olympus Company (BH-2), and

  17. Load transfer through the radiocarpal joint and the effects of partial wrist arthrodesis on carpal bone behaviour: a finite element study. (United States)

    Gíslason, M K; Stansfield, B; Bransby-Zachary, M; Hems, T; Nash, D H


    A finite element model of the wrist was developed to simulate mechanical changes that occur after surgery of the wrist. After partial arthrodesis, the wrist will experience altered force transmission during loading. Three different types of partial arthrodesis were investigated - radiolunate, radioscaphoid, and radioscapholunate - and compared with the healthy untreated wrist. The results showed that the compressive forces on the radiocarpal joint decreased compared with the untreated wrist with both radiolunate and radioscaphoid fusions. The load transmission through the midcarpal joints varied depending on arthrodesis type. The forces in the extrinsic ligaments decreased with the fusion, most noticeably in the dorsal radiotriquetral ligament, but increased in the dorsal scaphotriquetral ligament. From the results of the study it can be concluded that the radioscapholunate fusion shows the most biomechanically similar behaviour out of the three fusion types compared with the healthy wrist. The modelling described in this paper may be a useful approach to pre-operative planning in wrist surgery.

  18. Bone Densitometry (Bone Density Scan) (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Densitometry (DEXA) Bone densitometry, also called dual-energy ... limitations of DEXA Bone Densitometry? What is a Bone Density Scan (DEXA)? Bone density scanning, also called ...

  19. 膝关节周围动脉为蒂骨膜(骨)瓣的应用解剖及临床意义%Anatomical study and clinical application of the periosteal (bone ) flaps pedicled with arteries around knee joint

    Institute of Scientific and Technical Information of China (English)

    祝少博; 陈振光; 谭金海; 方成; 张发惠; 郑和平


    Objective To provide anatomical basis for repairing nonunion and defect around knee joint. Methods The origin, course, branches, distribution and anastomosis of the vessel netwo rk around knee joint were observed and measured in 30 adult cadaver lower limb specimens infused with red dye via artery. Results There were abundant vessel network around knee joint, which was composed of the end b ranches and communicating branches of femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery, etc. Conclusion  The periosteal (bone) flaps pedicled with arteries around knee is one of the mos t important donors.%目的 为带蒂骨膜(骨)瓣移位治疗膝关节周围骨不连、骨缺损提供解剖学依据。方法 在30侧经动脉灌注的成人下肢标本上,观察并测量膝关节周围动脉网有关血管的起始、走行、口径、分布及其吻合情况。结果 膝关节周围存在着丰富的血供,其主要由月 国动脉、股动脉、胫前动脉、胫后动脉的终末支及相互间的交通支和吻合网恒定构成。结论 以膝关节周围动脉为蒂的骨膜(骨)瓣,是进行局部转位和吻合血管游离移植的重要供区之一。

  20. 儿童双骨肢体单骨骨折对关节的影响%Influence on Joints Due to Fracture of Single Bone on Double Bone Extremities in Children

    Institute of Scientific and Technical Information of China (English)

    俞志涛; 王承武; 范源


    Objective:To observe the overgrowth after the fracture of a single bone in double bone extremities in children.Methods:179 cases of forearm fracture and 123 of lower leg fracture (excluding Monteggia fracture,Galeazzi fracture or physeal injuries)were reviewed.The time of follow-up was 5~8 years(mean 7.5 years).Comparative assessments of bilateral extremities on X-ray examination included length of ulna and radius,radioulnar angle,anteversion of the radius,radiocapitular line,position of the capitellium,length of the tibia and fibula,and anteroposteriorproject of the ankle.Ranges of motion of the wrist,elbow,forearm and ankle were examined.Results:Overgrowth of affected bones With 2~4 mm in length were found only in 4 cases of forearm fracture and in 7 cases of lower leg fracture.Conclusions:In most cases of fracture of singlebone on double bone extremities,overgrowth of affected bone has been rarely observed.%目的:为了观察儿童双骨肢体单骨骨折后的过度生长.方法:对前臂单骨骨折179例(不包括孟氏骨折、盖氏骨折及骨骺损伤),小腿单骨骨折123例(不包括骨骺损伤),进行了5~6年的随访,平均7.5年.对比测量了双侧X线片中的尺、桡骨长度、胫腓骨长度、桡尺角、桡骨内倾角、桡骨头线、肱骨小头的位置以及踝关节正位片,并对腕、肘关节、踝关节活动进行了对比.结果:前臂有4例,小腿有7例较对侧长2~4 mm.前臂、腕、肘关节及踝关节活动无异常.结论:前臂是双骨均衡支撑肢体,小腿虽以胫骨负重为主,但单骨骨折后另一骨同样可起支撑作用,因此均不会出现明显的过度生长.

  1. Efficacy observation on treating 65 cases of ceruical uertebra small joint disorder with bone-setting manipulation%正骨手法治疗65例颈椎小关节紊乱疗效观察

    Institute of Scientific and Technical Information of China (English)



    To investigate the clinical efficacy in treating small joint disorder with bone-setting manipulation. Methods: 130 patients were randomly divided into two groups, 65 patients in each group. The control group was treated with ceruical uertebra traction and medium frequency, while the treated group was treated with bone-setting manipulation. Results: The cure rate in the treated group 83.08%was higher than that in the control group 49.23%, and the total effective rate in the treated group 98.46% was higher than that in the control group 81.54%, all with significant differences (P<0.01). No severe adverse effects were detected in both groups. Conclusion: Bone-setting manipulation was convenient in manipulation and effective and in treating ceruical uertebra small joint disorder, worth a wide clinical application.%  目的:探讨正骨手法治疗颈椎小关节紊乱的临床疗效.方法:将130例颈椎小关节紊乱患者随机分为对照组和观察组各65例,对照组给予颈椎牵引和中频治疗,观察组给予正骨手法治疗,对比两组疗效.结果:观察组治愈率83.08%优于对照组的49.23%,总有效率98.46%优于对照组的81.54%,差异均有显著性统计学意义(P<0.01),两组治疗期间均未出现严重不良反应.结论:正骨手法治疗颈椎小关节紊乱操作简便,疗效确切,安全可靠,值得临床推广应用.

  2. 医用骨水泥和人工韧带在犬髋关节脱位治疗中的应用%Application of Medical Bone Cement and Artificial Ligament in Treatment of Canine Hip Joint Dislocation

    Institute of Scientific and Technical Information of China (English)

    毛典荣; 刘汉文; 江颖; 李浓; 周庆国


    为了探索人工圆韧带植入术治疗犬髋关节脱位远期疗效降低的解决办法,选择体重6.5 kg~7.5 kg、年龄1岁左右的3只本地家犬,在使用外科丝线替代圆韧带植入髋关节后,使用医用骨水泥填充和封闭髋臼和股骨孔道,术后通过运动姿态观察、负重力测试、常规 X 线摄片、血清生化项目检测和病理剖检几个方面,分析评估人工圆韧带植入术使用医用骨水泥的效果。结果显示,随着犬肢运动状态逐渐改善,术肢负重力增加;但随着丝线断开或出现退行性关节病,术肢运动肢势改变和负重力降低;骨水泥填充、封闭人工圆韧带孔道效果可靠,关节滑液保持良好,血清重要生化指标均在参考范围。在动物试验基础上,选择医用人工韧带植入和将骨水泥用于犬髋关节脱位临床病例1例,经过9个月的动态观察,术肢运动状态、负重力和髋关节 X 线影像与健肢相比无任何异常。动物试验与临床疗效表明,联合使用医用骨水泥和人工韧带能够很好地重建髋关节结构和功能,维持人工圆韧带植入术治疗犬髋关节脱位的远期疗效。%To explore the solution for the lower long-term effects of the ligamentum teres implantation for canine hip joint dislocation,three hybrid dogs of about 1 year old,6.5 kg~7.5 kg body weight were select-ed.After surgical silk thread instead of the ligamentum teres was implanted into a hip joint,the acetabular and femoral holes were filled and closed with medical bone cement.Effect of the bone cement was analysed and evaluated by the observation of motion state,weight-bearing gravity test,conventional X-ray radio-graph,detection of serum biochemical items and pathological dissection.The results showed that the limb weight-bearing gravity increased with motion state gradually improved.But as the silk thread was discon-nected or degenerative joint disease appeared,the limb

  3. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. II. Juxtacortical cartilage tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brien, E.W. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)]|[Musculoskeletal Tumor Service, Orthopaedic Hospital, Los Angeles, CA (United States); Mirra, J.M.; Luck, J.V. Jr. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)


    In part I, we reviewed the varied clinical presentations, pathogenesis, histologic findings, radiologic findings, and treatment of intramedullary cartilaginous lesions of bone. In this section, we will evaluate our cases and consultations of juxtacortical cartilaginous tumors. Radiographic differential diagnosis includes the numerous juxtacortical lesions particularly osteochondroma, parosteal chondroma, Trevor`s disease, trauma (fracture and periostitis ossificans), and the low- and high-grade surface osteosarcomas. By emphasizing pathogenesis in conjunction with radiographic and histologic findings, pitfalls in diagnosis and subsequent treatment can be avoided in such cases. (orig.) With 32 figs., 2 tabs., 32 refs.

  4. Antimicrobial susceptibility pattern and epidemiology of bacteria isolated from bone and joint in China, 2012%2012年中国骨及关节标本分离细菌分布及耐药状况

    Institute of Scientific and Technical Information of China (English)

    郑波; 吕媛; 潘义生; 刘玉村


    Objective To investigate the bacterial distribution and resist-ance to antibiotic of bone and joint infection in China, 2012.Methods The bacteria isolated from bone and joint in the tertiary hospitals were routinely identified.Disc diffusion test, minimum inhibitory concentra-tion ( MIC) test and E-test were used to detect the antimicrobial sensi-tivity.Results All the clinical stains isolated from 557 tertiary hospi-tals.2636 pathogenic strains were collected from bone and joint speci-men, which included Klebsiella pneumonia 370 strains (14.0%), Esche-richia coli 348 strains ( 13.2%) , Acinetobacter baumannii 319 strains (12.1%), Staphylococcus aureus 252 strains (9.6%) and Pseudomonas aeruginosa 167 strains ( 6.3%).The resistant rate of Staphylococcus aureus strains to oxacillin were 36.0%, no vancomycin and linezolid re-sistant isolate were found.The resistant rate of Escherichia coli, Klebsiella pneumonia and Enterobacter cloaecae strains to ceftriaxone were 64.6%, 33.0%and 37.4%, respectively, the resistant rate to imipenem were<2%.The resistant rate of Pseudomonas aeruginosa to carbapenem, ceftazidime and cefepime were <20%, the resistant rate to quinolone were <10%.The resistant of Acinetobacter buamannii to cabarpenem were <40%, the resistant rate to amikacin were 18.8%.The resistant rate of Acinetobacter lwoffii to cabarpenem were <1%, and the resistant rate to pipercillin and cefepime were <10%.Conclusion Gram negative bacteria were predominant organism in bone and joint infections in China, it may be related to the initial em-piric therapy always cover Staphylococcus.There were some difference in bacterial resistance to different antibiotics.These data present information for the proper treatment of bone and joint infections.%目的:了解我国2012年骨关节标本来源细菌分布及耐药状况。方法常规方法培养分离骨及关节标本中的细菌,用纸片扩散法、微量稀释法或E-test法测定

  5. Bone marrow mesenchymal stem cell transplantation for the treatment of temporomandibular joint osteoarthrosis%骨髓间充质干细胞移植治疗颞下颌关节骨关节病*★

    Institute of Scientific and Technical Information of China (English)

    杨兴华; 彭琳; 刘云生; 邢再臣; 李海峰; 李玉庆; 刘敏


      背景:随着干细胞技术的发展,利用组织工程技术修复软骨损伤成为一种可能,而骨髓间充质干细胞由于其优良的特性成为研究重点。目的:通过体外培养骨髓间充质干细胞,注入兔颞下颌关节紊乱病动物模型,观察干细胞对兔颞下颌关节紊乱病的治疗效果。方法:通过体外全血贴壁法培养骨髓间充质干细胞并进行鉴定;细胞在体外扩增,诱导成软骨细胞后待用。以Ⅱ型胶原酶进行颞下颌关节腔内注射,建立颞下颌关节紊乱病动物模型,关节腔内注射诱导后成软骨细胞设为实验组,对照组注射未进行诱导的细胞进行比较,通过观察动物咀嚼和组织切片观察治疗效果。结果与结论:实验分离的细胞7-14 d可见少量集落形成,20 d时观察见细胞基本铺满瓶底。经stro-1+、CD44+流式细胞及免疫组化测定细胞表达间充质干细胞特性;细胞在诱导成软骨细胞后Ⅱ型胶原免疫组化染色强阳性。兔颞下颌关节注射胶原酶可在2周时出现偏侧咀嚼症状,骨髓间充质干细胞诱导的成软骨细胞关节腔注入动物模型后,实验组明显弱于对照组。组织切片显示诱导的成软骨细胞可促进关节损伤的修复,软骨及胶原生成多于对照组。说明骨髓间充质诱导的成软骨细胞关节腔注入后可促进兔颞下颌关节骨关节病愈合。%BACKGROUND:With the development of stem cel technology, it is possible to repair cartilage injury using tissue engineering technology, and bone marrow mesenchymal stem cel s have become the research focus because of their advantages. OBJECTIVE:To observe the treatment effect of stem cel s on rabbit temporomandibular joint disorders through injection of bone marrow mesenchymal stem cel s cultured in vitro into a rabbit model of temporomandibular joint disorder. METHODS:The bone marrow mesenchymal stem cel s were cultured and identified

  6. Clinical Analysis of 127 Cases of Lung Cancer with Bone and Joint Symptoms as the Initial Manifestation%127例以骨关节症状为首发表现的肺癌临床分析

    Institute of Scientific and Technical Information of China (English)

    张现伟; 李富林; 赵文召; 李向宇; 贺会江


    Objective:To improve the diagnostic accuracy of lung cancer with bone and joint symptoms as the initial manifestation and reduce the rate of misdiagnosis and missed diagnosis in order to get early diagnosis and treatment and reduce loss and pain of patients.Methods:The data of 127 cases of lung cancer with bone and joint symptoms as the initial manifestation were retrospectively analyzed to find the clinical characteristics of lung cancer,the relationship between initial manifestation and tumor location and types,and the causes of misdiagnosis.Results:Most of the researched were 50 to 79 years old with a long history of smoking,who mostly suffered from adenocarcinoma,squamous carcinoma and small cell lung cancer.Osteoarticular manifestations of primary lung cancer were mostly joint swelling and clubbing ifnger(toe).Bone metastasis of lung cancer manifested as pain in many parts of the body and pain in spine(back,waist and neck).Clubbing ifnger(toe)was commonly seen in squamous carcinoma,accounting for 72.22%.Multi-joint swelling and multi-part pain were common in adenocarcinoma.Above lung cancer was often misdiagnosed as ostarthritis,reactive arthritis,rheumatoid arthritis,osteomyelitis,scapulohumeral periarthritis,clubbing ifnger(toe)and hypertrophic osteoarthropathy.Bone metastasis of lung cancer was often misdiagnosed as ostarthritis,sciatica,costal chondritis,cervical spondylosis,muscle fascia ifbrositis,chronic lumbar muscle strain,intercostal neuritis,lumbar disc herniation and spinal tuberculosis.In 47.24% of the patients,the diagnosis was conifrmed by 1 ~ 6 months,and the combined application of X-ray,CT and biopsy helped get a high diagnostic rate.Conclusion:When patients more than 50 years old have a long history of smoking,clubbing ifnger (toe),multiple bone and joint swelling and pain,pain in many parts of the body,radiating pain,rest pain and pain aggravated at night,they may suffer from lung cancer.It is important for them to take a comprehensive

  7. Grafting of iliac bone flap with deep iliac circumflex vessel in treatment of femoral head ischemic necrosis and long dated hip joint function observation%旋髂深血管髂骨瓣移植治疗中青年股骨头缺血性坏死远期髋关节功能观察

    Institute of Scientific and Technical Information of China (English)

    奉成斌; 杜全印


    Objective To retrospect the long dated curative effect of grafting of iliac bone flap with deep iliac circumflex vessel in treatment of femoral head ischemic necrosis.Methods 79 cases of femoral head ischemic necrosis treated by promoted Smith Petersen incision, neck of femur notch, focus cleaning decompression,grafting of iliac bone flap with deep iliac circumflex vessel and screw fixation. 13 cases treated by transplanting granular bone after decompression. Results Grafting of iliac bone flap with deep iliac circumflex vessel treatment group were followed up from 3 to 9 years,the planting bone healed 3 to 6 months averagely.Two cases suffered femoral head ischemic necrosis continuously.Other cases received good results.Transplanting granular bone after decompression group were followed up 3 to 9 years, 3 cases suffered femoral head ischemic necrosis continuously, hip joint function was limited,patients received hip replacement finally. Conclusion Place of iliac bone flap with deep iliac circumflex vessel is fixed, curative effects are credible, which can become the first choice therapy to femoral head ischemic necrosis of middle age and young people (Ficat I~ III stage).

  8. The Application of AO Collar Bone Hook Titanium Plate in the Treatment of Rockwood Ⅲ°-Ⅵ° Acromioclavicular Joint Disorder%AO锁骨钩钛板在RockwoodⅢ°~Ⅵ°肩锁关节损伤中的应用

    Institute of Scientific and Technical Information of China (English)

    刘伟; 赖茂松; 熊浩; 林伟文; 区彩琼; 艾合买提江·玉素甫


    目的 总结AO锁骨钩钛板治疗RockwoodⅢ°~Ⅵ°肩锁关节损伤的临床疗效.方法 采用AO锁骨钩钛板治疗RockwoodⅢ°~Ⅵ°肩锁关节损伤27例.术中,于肩锁关节复位后放置钛板,并修补关节囊及肩锁、喙锁韧带.结果 患者术后切口均Ⅰ期愈合,肩锁关节脱位得到纠正,无血管、神经损伤等并发症发生.本组患者术后随访6~15个月.术后3~6个月取出锁骨钩钛板.术后6个月疗效评价,优23例,良3例,差1例,优良率为96.8%.结论 AO锁骨钩钛板治疗RockwoodⅢ°~Ⅵ°肩锁关节损伤具有创伤小,可早期锻炼等优点,值得临床推广.%Objective To explore the application of AO collar bone hook titanium plate in treating Rockwood Ⅲ°Ⅳ°acromioclavicular joint disorder. Methods Twenty-seven patients with Rockwood Ⅲ°Ⅳ° acromioclavicular joint disorder were treated using AO collar bone hook titanium plate. After the replacement of acromioclavicular joint fixed by AO collar bone hook titanium plate, the joint capsule, shoulder lock ligament and beak lock ligament were also fixed. Results All the patients were healed by first intension, the acromioclavicular joint disorder were corrected and no complications occurred. All the patients were followed for 6-15 months. The AO collar bone hook titanium plate were taken out 3-6 months after surgery. Function of the acromioclavicular joint was estimated by Karlsson criteria: the results were excellent in 23 cases, good in 3 cases and poor in 1 case. Choiceness rate was 96.8%. Conclusion Using AO collar bone hook titanium plate in treating Rockwood Ⅲ°Ⅳ° acromioclavicular joint disorder could minimize the surgical trauma, and early functional exercise could be performed. It should be advocated.

  9. Bone within a bone

    Energy Technology Data Exchange (ETDEWEB)

    Williams, H.J.; Davies, A.M. E-mail:; Chapman, S


    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  10. Joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  11. Joint swelling (United States)

    ... chap 275. Raftery AT, Lim E, Ostor AJK. Joint disorders. In: Raftery AT, Lim E, Ostor AJK, eds. ... A.M. Editorial team. Related MedlinePlus Health Topics Joint Disorders Browse the Encyclopedia A.D.A.M., Inc. ...

  12. Porous surface modified bioactive bone cement for enhanced bone bonding.

    Directory of Open Access Journals (Sweden)

    Qiang He

    defect. CONCLUSIONS: Our findings suggested a new bioactive bone cement for prosthetic fixation in total joint replacement.

  13. Bone scanning in otolaryngology. (United States)

    Noyek, A M


    Modern radionuclide bone scanning has introduced a new concept in physiologic and anatomic diagnostic imaging to general medicine. As otolaryngologists must diagnose and treat disease in relation to the bony and/or cartilaginous supporting structures of the neurocranium and upper airway, this modality should be included in the otolaryngologist's diagnostic armamentarium. It is the purpose of this manuscript to study the specific applications of bone scanning to our specialty at this time, based on clinical experience over the past three years. This thesis describes the development of bone scanning in general (history of nuclear medicine and nuclear physics; history of bone scanning in particular). General concepts in nuclear medicine are then presented; these include a discussion of nuclear semantics, principles of radioactive emmissions, the properties 99mTc as a radionuclide, and the tracer principle. On the basis of these general concepts, specific concepts in bone scanning are then brought forth. The physiology of bone and the action of the bone scan agents is presented. Further discussion considers the availability and production of the bone scan agent, patient factors, the gamma camera, the triphasic bone scan and the ultimate diagnostic principle of the bone scan. Clinical applications of bone scanning in otolaryngology are then presented in three sections. Proven areas of application include the evaluation of malignant tumors of the head and neck, the diagnosis of temporomandibular joint disorders, the diagnosis of facial fractures, the evaluation of osteomyelitis, nuclear medicine imaging of the larynx, and the assessment of systemic disease. Areas of adjunctive or supplementary value are also noted, such as diagnostic imaging of meningioma. Finally, areas of marginal value in the application of bone scanning are described.

  14. Osteoma of temporomandibular joint: a rarity. (United States)

    Misra, Neeta; Srivastava, Saurabh; Bodade, Pankaj R; Rastogi, Vikalp


    Osteoma is a benign tumour consisting of mature bone tissue. It is an uncommon lesion that occurs in the bones of the craniofacial complex. Only a few cases involving the temporomandibular joint have been reported. An osteoma of the left temporomandibular joint causing limited mouth opening in a 22-year-old man with CT findings revealing the unusual possibility in differential diagnosis of trismus.

  15. Joint ventures

    NARCIS (Netherlands)

    M.N. Hoogendoorn (Martin)


    textabstractEen veel voorkomende wijze van samenwerking tussen ondernemingen is het uitvoeren van activiteiten in de vorm van een joint venture. Een joint venture is bijna altijd een afzonderlijke juridische entiteit. De partners in de joint venture voeren gezamenlijk de zeggenschap uit. In internat

  16. 《骨与关节杂志》(美国版)(J Bone Joint Surg Am)2000年第82卷第11期目录

    Institute of Scientific and Technical Information of China (English)


    The Millennium Enigma: More is Less Henry R Cowell 1509 Syme Amputation for the Treatment of Fibular Deficiency. An Evaluation of Long Term Physical and Psychological Functional Status John G Birch, et al 1511 Complications Associated with Pedicle Screws John E Lonstein, et al 1519 Evaluation of Intraoperative Nerve Monitoring During Insertion of an Iliosacral Implant in an Animal Model Berton R Moed, et al 1529 Immediate Weight Bearing After Treatment of a Comminuted Fracture of the Femoral Shaft with a Statically Locked Intramedullary Nail Robert J Brumback,et al 1538 Complex Reconstruction for the Treatment of Dorsolateral Peritalar Subluxation of the Foot. Early Results After Distraction Arthrodesis of the Calcaneocuboid Joint in Conjunction with Stabilization of, and Transfer of the Flexor Digitorum Longus Tendon to, the Midfoot to Treat Acquired Pes Planovalgus in Adults Brian C Toolan, et al 1545 Factors Associated with Bone Regrowth Following Diabetes Related Partial Amputation of the Foot D G Armstrong,et al 1561 Megavoltage Radiation Therapy for Axial and Inoperable Giant Cell Tumor of Bone Arnab Chakravarti,et al 1566 High Rate of Failure of Allograft Reconstruction of the Extensor Mechanism After Total Knee Arthroplasty Major Seth S Leopold,et al 1574 The Use of Fibrin Tissue Adhesive to Reduce Blood Loss and the Need for Blood Transfusion After Total Knee Arthroplasty. A Prospective, Randomized, Multicenter Study Ofer Levy, et al 1580 Symptomatic Ganglioneuroma of Bone. A Case Report Kai Mith fer, et al 1589 Pericapsular Fistula of the Hip After Radiation Therapy and Resection of a Rectal Carcinoma. A Case Report P Justin Tortolani, et al 1596 Pathophysiology of Nerve Compression Syndromes: Response of Peripheral Nerves to Loading David Rempel, et al 1600 Instructional Course Lectures, The American Academy of Orthopaedic Surgeons Tendon Transfers About the Shoulder and Elbow in Obstetrical Brachial Plexus Palsy James B Bennett, et

  17. Evaluation of antibiotic resistance to orally administrable antibiotics in staphylococcal bone and joint infections in one of the largest university hospitals in Germany: is there a role for fusidic acid? (United States)

    Klein, Sabrina; Nurjadi, Dennis; Eigenbrod, Tatjana; Bode, Konrad A


    Bone and joint infections (BJIs) are often difficult to treat. Staphylococcus spp. is the major pathogen causing these infections, which is often associated with biofilm formation on prosthetic materials. Therapeutic measures are complex, ranging from surgical intervention to initial intravenous and supportive long-term oral antibiotic therapy. The options for oral antimicrobial therapy are limited, mainly due to the resistance profile of the causative pathogen and the unfavourable pharmacodynamic and pharmacokinetic properties of most antibiotics in biofilm. Data analysis over a 5-year period was performed on staphylococci isolated from BJI patients in the Orthopaedic Department of the University Hospital Heidelberg (Heidelberg, Germany) to assess the plausibility of fusidic acid (FA)-based alternative oral treatment regimens. Six percent of BJIs were caused by meticillin-resistant Staphylococcus aureus (MRSA), and multiresistance was common. Over 75% of MRSA in BJIs were resistant to the commonly used rifampicin (RIF)-based combinations. Resistance to FA-based combinations was high. However, over 80% were susceptible to the combination RIF+FA. In coagulase-negative staphylococci, resistance to RIF-based combinations was similar to FA-based combinations. Almost two-thirds of the isolates tested were susceptible to RIF+FA. These data suggest FA as a possible option as a substitution for RIF or as a combination companion in case of resistance or unavailability.

  18. Measurement of knee joint gaps without bone resection: "physiologic" extension and flexion gaps in total knee arthroplasty are asymmetric and unequal and anterior and posterior cruciate ligament resections produce different gap changes. (United States)

    Nowakowski, Andrej Maria; Majewski, Martin; Müller-Gerbl, Magdalena; Valderrabano, Victor


    General agreement is that flexion and extension gaps should be equal and symmetrical in total knee arthroplasty (TKA) procedures. However, comparisons using a standard TKA approach to normal knee joints that have not undergone bone resection are currently unavailable. Since bony preparation can influence capsule and ligament tension, our purpose was to perform measurements without this influence. Ten normal cadaveric knees were assessed using a standard medial parapatellar TKA approach with patellar subluxation. Gap measurements were carried out twice each alternating 100 and 200 N per compartment using a prototypical force-determining ligament balancer without the need for bony resection. Initial measurements were performed in extension, followed by 908 of flexion. The ACL was then resected, and finally the PCL was resected, and measurements were carried out in an analogous fashion. In general, the lateral compartment could be stretched further than the medial compartment, and the corresponding flexion gap values were significantly larger. ACL resection predominantly increased extension gaps, while PCL resection increased flexion gaps. Distraction force of 100 N per compartment appeared adequate; increasing to 200 N did not improve the results.

  19. Positive modulator of bone morphogenic protein-2 (United States)

    Zamora, Paul O.; Pena, Louis A.; Lin, Xinhua; Takahashi, Kazuyuki


    Compounds of the present invention of formula I and formula II are disclosed in the specification and wherein the compounds are modulators of Bone Morphogenic Protein activity. Compounds are synthetic peptides having a non-growth factor heparin binding region, a linker, and sequences that bind specifically to a receptor for Bone Morphogenic Protein. Uses of compounds of the present invention in the treatment of bone lesions, degenerative joint disease and to enhance bone formation are disclosed.

  20. Distal radioulnar joint injuries

    Directory of Open Access Journals (Sweden)

    Binu P Thomas


    Full Text Available Distal radioulnar joint is a trochoid joint relatively new in evolution. Along with proximal radioulnar joint , forearm bones and interosseous membrane, it allows pronosupination and load transmission across the wrist. Injuries around distal radioulnar joint are not uncommon, and are usually associated with distal radius fractures,fractures of the ulnar styloid and with the eponymous Galeazzi or Essex_Lopresti fractures. The injury can be purely involving the soft tissue especially the triangular fibrocartilage or the radioulnar ligaments.The patients usually present with ulnar sided wrist pain, features of instability, or restriction of rotation. Difficulty in carrying loads in the hand is a major constraint for these patients. Thorough clinical examination to localize point of tenderness and appropriate provocative tests help in diagnosis. Radiology and MRI are extremely useful, while arthroscopy is the gold standard for evaluation. The treatment protocols are continuously evolving and range from conservative, arthroscopic to open surgical methods. Isolated dislocation are uncommon. Basal fractures of the ulnar styloid tend to make the joint unstable and may require operative intervention. Chronic instability requires reconstruction of the stabilizing ligaments to avoid onset of arthritis. Prosthetic replacement in arthritis is gaining acceptance in the management of arthritis.


    Directory of Open Access Journals (Sweden)

    V. G. Fedorov


    Full Text Available The usage of bone plastics by cylindrical autotransplant in cases of posttraumatic changes of knee joint is described. Knee joint arthrodesis is supposed to be used as alternate in term of replacement impossibility (for example, high-grade deformity, the age (osteoporosis, concomitant diseases that can lead to complicate operation.

  2. 同种异体半关节移植治疗股骨远端恶性骨肿瘤手术后骨缺损%Femoral malignant bone tumor salvage limb treatment with allogeneic heterotopic half-joint trasplantation

    Institute of Scientific and Technical Information of China (English)

    赵志坚; 陈坤峰


    目的 探讨股骨远端恶性骨肿瘤的保肢治疗及同种异体半关节和股骨髁上带锁髓内钉的应用.方法 对11例股骨远端恶性骨肿瘤患者进行肿瘤切除、同种异体骨半关节移植、股骨髁上带锁髓内钉固定.结果 11例患者中9例得到随访,无一例出现感染、排异或异体骨骨折,术后6周均可扶拐行走,根据Mankin标准评价术后效果,优3例,良4例,差2例.结论 保肢治疗恶性骨肿瘤手术后骨缺损可提高患者生活质量,且同种异体骨来源丰富,具有可接受的关节面,是治疗骨肿瘤切除后骨缺损较好的移植物.%Objective To study far femoral malignant bone tumor salvage limb treatment with allogeneic heterotopic half-joint transplantation and the use of GSH nail Methods Eleven cases with far femoral malignant bone tumor were administered tumor resection,transplanted with allogeneic heterotoeic bone half-joint,and fixed with GSH nail Results Nine out of the 11 cases were followed up.None of them had infection,rejection or heterotopic bone fracture.All of them can move with walking after 6 months.The effects of surgery was rated as "excellent" for 3 cases,"fine" for 4 cases and " bad" for 2 cases according to Mankin's rating criteria.Conclusion Salvage limb treatment for bone tumor can improve patients' quality of life.Allogeneic heterotopic bone,with rich source and acceptable joint surface,is a good graft for the treatment of bone defect after bone tumor resection.

  3. Systemic alendronate prevents resorption of necrotic bone during revascularization. A bone chamber study in rats

    Directory of Open Access Journals (Sweden)

    Aspenberg Per


    Full Text Available Abstract Background Avascular necrosis of bone (osteonecrosis can cause structural failure and subsequent deformation, leading to joint dysfunction and pain. Structural failure is the result of resorption of necrotic bone during revascularization, before new bone has formed or consolidated enough for loadbearing. Bone resorption can be reduced by bisphosphonates. If resorption of the necrotic bone could be reduced during the revascularization phase until sufficient new bone has formed, it would appear that structural failure could be avoided. Methods To test whether resorption of necrotic bone can be prevented, structural grafts were subjected to new bone ingrowth during systemic bisphosphonate treatment in a rat model. Results In rats treated with alendronate the necrotic bone was not resorbed, whereas it was almost entirely resorbed in the controls. Conclusion Systemic alendronate treatment prevents resorption of necrotic bone during revascularization. In patients with osteonecrosis, bisphosphonates may therefore prevent collapse of the necrotic bone.

  4. Bone Markers (United States)

    ... markers may be seen in conditions such as: Osteoporosis Paget disease Cancer that has spread to the bone (metastatic bone disease) Hyperparathyroidism Hyperthyroidism Osteomalacia in adults and rickets in children—lack of bone mineralization, ...

  5. Bone scan (United States)

    ... legs, or spine fractures) Diagnose a bone infection (osteomyelitis) Diagnose or determine the cause of bone pain, ... 2015:chap 43. Read More Broken bone Metabolism Osteomyelitis Review Date 12/10/2015 Updated by: Jatin ...

  6. Bone Cancer (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  7. Bone Diseases (United States)

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  8. Bone-seeking therapeutic radiopharmaceuticals

    Directory of Open Access Journals (Sweden)

    Srivastava Suresh C.


    Full Text Available Bone-seeking therapeutic radiopharmaceuticals are utilized on the basis of the radionuclide?s particulate emissions (primarily low to intermediate beta emission. The requirements therefore are different from those of bone imaging agents that consist mainly of short-lived single photon emitters. Lately, the therapeutic bone seeking radiopharmaceuticals have attained increasing importance due to their potential role in alleviating pain from osseous metastases in cancer patients, for the treatment of joint pain resulting from inflamed synovium (radiosynoviorthesis, or radiosynovectomy, or from various other forms of arthritic disease. There is, however, a paucity of published data on the bio-pharmacokinetics of these agents when used following intravenous administration for bone pain palliation. This paper will briefly review and summarize the presently available chemical and biopharmacokinetic information on the various clinically approved as well as experimental bone-localizing therapeutic radiopharmaceuticals, and make projections on their clinical application for the treatment of primary/metastatic cancer in bone.

  9. Joint Interdiction (United States)


    exercise of authority by combatant commanders and other joint force commanders (JFCs), and prescribes joint doctrine for operations and training. It...interdiction requirements and dependable, interoperable, and secure communications architecture to exercise control. The JFC exercises C2 through...moving across open desert terrain were more vulnerable to interdiction by coalition airpower than dispersed Serbian forces that benefited from trees

  10. Bone Mineral Density Assessment in Ankylosing Spondylitis and Characteristics of Bone Turnover Parameters

    Directory of Open Access Journals (Sweden)

    Füsun Şahin


    Full Text Available Ankylosing spondylitis, characterised with excessive new bone formation and calcification in spine and peripheral joints, causes osteoporosis which is a general component of inflammatory arthritis. Since is excessive bone formation affects bone mineral density, there are problems in diagnosis and follow-up of osteoporosis efforts made for finding the right diagnostic tool. Besides bone metabolism and turn-over in inflammatory diseases should be known in detail, because it has a place in diagnosis and follow-up. In this review, bone mineral density in ankylosing spondylitis, the importance and usage of bone turn-over parameters are discussed in the light of literature data.

  11. Bone marrow edema in sports: General concepts

    Energy Technology Data Exchange (ETDEWEB)

    Vanhoenacker, F.M. [AZ Sint-Maarten Duffel-Mechelen, Department of Radiology, Rooienberg 25, B-2570 Duffel (Belgium) and University Hospital Antwerp, Department of Radiology, Wilrijkstraat 10, B-2650 Edegem (Belgium)]. E-mail:; Snoeckx, A. [AZ Sint-Maarten Duffel-Mechelen, Department of Radiology, Rooienberg 25, B-2570 Duffel (Belgium); University Hospital Antwerp, Department of Radiology, Wilrijkstraat 10, B-2650 Edegem (Belgium)


    This paper will discuss the value of medical imaging in the detection and follow-up of bone marrow edema (BME), resulting from acute and chronic trauma in sports. MR imaging is the only imaging technique that allows direct evaluation of bone marrow edema in sports medicine. The use of fat suppressed T2-weighted or STIR images is particularly appropriate to detect bone marrow edema. The extent of bone marrow edema reflects the biomechanics of trauma. Compressive forces between two bony structures will result in extensive areas of bone marrow edema, whereas distraction forces provoke more subtle areas of bone marrow edema at the insertion of supporting structures of joints. In most clinical situations, a combination of compression and distraction forces is present, causing a complex pattern of bone marrow edema. A meticulous pattern approach of the distribution of these bone marrow changes around a joint can reveal in most instances the underlying mechanism of trauma. This may be helpful to analyze which joint supporting structures may be at risk. In the acute setting, plain radiography and CT scan may have an additional role in the detection of small avulsion fractures occurring at the site of minor areas of bone marrow edema. The clinical significance and natural history of bone marrow edema is still a matter of debate.

  12. Bone scintigraphy in psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.


    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

  13. Bone Densitometry (Bone Density Scan) (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  14. Surgical management of temporomandibular joint ankylosis in ankylosing spondylitis. (United States)

    Felstead, Andrew M; Revington, Peter J


    Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.

  15. Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Andrew M. Felstead


    Full Text Available Relatively few patients develop such severe degenerative temporomandibular joint (TMJ disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic. Ankylosis of the temporomandibular joint (TMJ secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.

  16. Bone marrow aspiration (United States)

    Iliac crest tap; Sternal tap; Leukemia - bone marrow aspiration; Aplastic anemia - bone marrow aspiration; Myelodysplastic syndrome - bone marrow aspiration; Thrombocytopenia - bone marrow aspiration; Myelofibrosis - bone marrow aspiration

  17. Review article: Paediatric bone and joint infection. (United States)

    Stott, N Susan


    Paediatric musculoskeletal infection remains an important cause of morbidity. Methicillin sensitive Staphylococcus aureus is still the most common organism although the incidence of methicillin resistant S. aureus in the community is rising. Osteomyelitis and septic arthritis due to Haemophilus influenzae is decreasing in incidence secondary to immunisation and in some units has been replaced by infections with the gram negative bacillus, Kingella kingae. Recent prospective studies indicate that uncomplicated osteomyelitis can be treated by three to four weeks of antibiotics. However, there is still a small group of children who will have overwhelming disseminated infection. These children require aggressive surgical and medical intervention. Two recent reports have identified an increased incidence of septic arthritis in children who have hemophilia and are HIV positive.

  18. Aging changes in the bones - muscles - joints (United States)

    ... because of changes in the muscle tissue and normal aging changes in the nervous system . Muscles may become rigid ... knee jerk or ankle jerk can occur. Some changes, such as a positive ... Involuntary movements (muscle tremors and fine movements called ...

  19. Bones, Muscles, and Joints: The Musculoskeletal System (United States)

    ... parts of the body. The amounts of certain vitamins and minerals that you eat, especially vitamin D and calcium , directly affects how much calcium ... known as juvenile rheumatoid arthritis, or JRA), lupus , Lyme disease , and septic arthritis (a bacterial infection of a ...

  20. [Bone and joint diseases in children. Rickets]. (United States)

    Tanaka, Hiroyuki


    Rickets is a disorder of growth plate chondrocytes. Its basic pathophysiology has been revealed as a defect in apoptosis of hypertrophic chondrocytes induced by low phosphate concentration in the body fluid. This review summarized recent topics in two major forms of rickets, vitamin D deficient rickets and hereditary hypophosphatemic rickets. Vitamin D deficient rickets reappeared all over the world due to environmental change. The knowledge in basic pathophysiology of the hereditary hypophosphatemic rickets is increasing rapidly after the discovery of fibroblast growth factor 23 and the responsible genes have been revealed. The finding may support to uncover the whole truth of phosphate metabolism.

  1. Bone and Joint Disorders in Acromegaly. (United States)

    Claessen, Kim M J A; Mazziotti, Gherardo; Biermasz, Nienke R; Giustina, Andrea


    Acromegaly is a chronic, progressive disease caused by a growth hormone (GH)-producing pituitary adenoma, resulting in elevated GH and insulin-like growth factor 1 concentrations. Following appropriate therapy (surgery, radiotherapy and/or medical treatment), many systemic GH-induced comorbid conditions improve considerably. Unfortunately, despite biochemical control, acromegaly patients suffer from a high prevalence of late manifestations of transient GH excess, significantly impairing their quality of life. In this overview article, we summarize the pathophysiology, diagnosis, clinical picture, disease course and management of skeletal complications of acromegaly, focusing on vertebral fractures and arthropathy.

  2. Bones, Muscles, and Joints: The Musculoskeletal System (United States)

    ... decide to move, the motor cortex sends an electrical signal through the spinal cord and peripheral nerves to the muscles, causing them to contract. The motor cortex on the right side of the brain controls the muscles on the left side of the body and vice versa. The cerebellum coordinates the muscle ...

  3. The warm sacroiliac joint. A finding in pelvic abscess

    Energy Technology Data Exchange (ETDEWEB)

    Slavin, J.D. Jr.; Epstein, N.; Negrin, J.A.; Spencer, R.P. (Saint Francis Hospital and Medical Center, Hartford, CT (USA))


    Two patients with pain referable to the low back and sacroiliac regions had bone scans with similar findings. In each, one sacroiliac joint was warm (uptake on that side was slightly greater than that in the contralateral area). Ga-67 imaging also demonstrated increased uptake in the same locale. Subsequent CT scanning revealed pelvic abscesses adjacent to the affected joints. Asymmetric uptake of bone imaging agent may have been related to hyperemia and heating of the sacroiliac joint. Rapid defervescence with antibiotics and drainage (and no CT evidence of bone involvement) suggested that osteomyelitis was not involved in these cases.

  4. Symptomatic carpal coalition: scaphotrapezial joint. (United States)

    Campaigniac, Erin; Eskander, Mark; Jones, Marci


    Carpal coalition is an uncommon congenital abnormality that arises from incomplete cavitation of the common cartilaginous precursor that forms the carpal bones. When carpal coalition is discovered, it is typically an asymptomatic incidental radiographic finding, and is often bilateral. We present a case of symptomatic unilateral carpal coalition of the scaphotrapezial joint, which was treated by excising the fibrous coalition and placing an interposition fat graft. This treatment was effective in alleviating the patient's symptoms.

  5. Bone Scintigraphic Findings in MRSA Osteomyelitis. (United States)

    Cornejo, Patricia; Mandell, Gerald A


    Methicillin-resistant Staphylococcus aureus osteomyelitis is a severe form of infection characterized by multifocal or multiple segmental osseous involvement and subperiosteal abscess formation with increased frequency of extraosseous complications including pyomyositis, septic thrombus, and septic arthritis. Bone scan showed long segment and/or multifocal involvement in 4 of 5 patients with areas of abnormal increased and decreased uptake. The clinical presentations included limp and/or pain. Joint involvement was seen in 4 cases. Bone scan abnormalities correlated well with MRI findings of severe and extensive bone disease, abscess formation, muscle, as well as joint and soft tissue involvement.

  6. Patterns of magnetic resonance imaging bone erosion in rheumatoid arthritis--which bones are most frequently involved and show the most change?

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Møller Døhn, Uffe; Duer-Jensen, A


    To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA).......To investigate by magnetic resonance imaging (MRI) which bones in wrists and metacarpophalangeal (MCP) joints most frequently show bone erosions, and which most frequently demonstrate erosive progression, in early and established rheumatoid arthritis (RA)....

  7. Joint purpose?

    DEFF Research Database (Denmark)

    Pristed Nielsen, Helene


    Starting from Crenshaw´s point that antiracism often fails to interrogate patriarchy and that feminism often reproduces racist practices (1991: 1252), this paper asks: What are the theoretical reasons for believing that feminism and anti-racism can be regarded as fighting for the joint purpose of...

  8. Remoção da cartilagem articular associada ou não a implante homógeno ou enxerto autógeno de osso esponjoso em cães submetidos à artrodese atlantoaxial Joint cartilage removal associated or not to homologous implant or autologous cancellous bone graft in dogs submitted to atlantoaxial arthrodesis

    Directory of Open Access Journals (Sweden)

    Rafael Festugatto


    Full Text Available O objetivo deste estudo foi avaliar o grau de fusão articular e formação óssea na articulação atlantoaxial de cães submetidos à artrodese após a remoção da cartilagem articular associada ou não ao implante homógeno ou enxerto autógeno de osso esponjoso. Foram utilizados 12 cães, adultos, distribuídos aleatoriamente em três grupos iguais. Grupo I (GI: realizada apenas a remoção da cartilagem articular e imobilização articular com pinos e resina acrílica. Grupo II (GII: feita a remoção da cartilagem articular e imobilização da articulação, seguida da colocação e modelagem do implante ósseo esponjoso homógeno entre as superfícies articulares. Grupo III (GIII: foi realizado o mesmo procedimento do GII, mais o enxerto ósseo esponjoso autógeno no local determinado. Realizaram-se exames radiográficos em todos os animais aos 30, 60 e 90 dias de pós-operatório (PO. Aos 90 dias de PO foi feita a eutanásia para o emprego do teste de palpação manual, avaliação tomográfica e histopatológica. Para análise estatística da associação entre o grau de fusão articular, aplicou-se o Teste Qui-quadrado de independência. Os resultados dos testes foram avaliados pela significância exata e considerados significantes a 5% (PThe aim of this study was to evaluate the degree of joint fusion and bone formation in dogs undergoing atlantoaxial arthrodesis after removal of articular cartilage associated or not to implant homogenous or autogenous cancellous bone. Twelve dogs, weighing between 8 and 12kg were randomly divided into three groups. Group I (GI performed only the removal of joint cartilage and joint immobilization with acrylic resin and pins. Group II (GII: after removel of joint cartilage and articular immobilization was performed modeling and placement of homogenous cancellous bone at the given location. The volume of homograft placed in the joint was measured using a precision balance and all animals received the

  9. Bone scintigraphy and osteo-articular tuberculosis in transplant patients: a study of 50 bone scans

    Energy Technology Data Exchange (ETDEWEB)

    Coulaud, J.P.; Mechali, D.; Morau, G. (Hopital Claude-Bernard, Paris (France))


    Bone scintigraphy with 99 m technecium labelled phosphorus compounds was achieved in 50 west Africans migrant workers in Paris. Bone and joint tuberculosis was assumed in 20 cases. In 5 of these 20 cases, bone scan, but not X-ray, showed abnormalities, and in 4, bone scan disclosed more localisations than X-rays. In 7 cases, yet, bone scan was normal, with major osteolytic X-rays lesions in 3 cases, minor in 2 cases, and isolated cold abcesses in two more cases: these means 7 false-negative results. Among the 30 other cases, 29 were considered as mechanical vertebral pathology, and 1 sacro-iliitis Brucellosis. Bone scan was normal in 28 cases the 2 others are unexplained false-positive. Although non-specific and not completely reliable, we think that bone-scanning is useful in bone-tuberculosis check-up, especially to obtain early diagnosis and detect multifocal localisations.

  10. The peroneocuboid joint: morphogenesis and anatomical study. (United States)

    Guimerá, V; Lafuente, A; Zambrana, L; Rodriguez-Niedenführ, M; Sañudo, J R; Vazquez, T


    The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been anatomically well-defined and no embryological study has been published. Furthermore, the ossification of the os peroneum (a sesamoid inside the peroneus longus tendon) and its associated pathology has been considered to be generated by orthostatic and/or mechanical loads. A light microscopy analysis of serially sectioned human embryonic and fetal feet, the analysis of human adult feet by means of standard macroscopic dissection, X-ray and histological techniques have been carried out. The peroneus longus tendon was fully visible until its insertion in the 1st metatarsal bone already at embryonic stage 23 (56-57 days). The peroneocuboid joint cavity appeared at the transition of the embryonic to the fetal period (8-9th week of gestation) and was independent of the proximal synovial sheath. The joint cavity extended from the level of the calcaneocuboid joint all the way to the insertion of the peroneus longus tendon in the 1st metatarsal bone. The frenular ligaments, fixing the peroneus longus tendon to the 5th metatarsal bone or the long calcaneocuboid ligament, developed in the embryonic period. The peroneus longus tendon presented a thickening in the area surrounding the cuboid bone as early as the fetal period. This thickening may be considered the precursor of the os peroneum and was similar in shape and in size relation to the tendon, to the os peroneum observed in adults. To the best of our knowledge, this is the first study to show that the os peroneum, articular facets of the peroneus longus tendon and cuboid bone, the peroneocuboid joint and the frenular ligaments appear during the embryonic/fetal development period and therefore they can not be generated exclusively by orthostatic and mechanical forces or pathological processes.

  11. Value of the Joint Detection of PSA and ALP in the Early Diagnosis of Prostate Cancer Bone Metastasis%前列腺特异抗原和碱性磷酸酶联合检测在早期诊断前列腺癌骨转移中的应用

    Institute of Scientific and Technical Information of China (English)

    郭枫; 陈琳; 李运柱; 彭松; 李国灏; 朱晨曦; 余家俊; 王勇; 万志华


    Objective: To investigate the role and significance of the joint detection of prostatic specific antigen (PSA) and alkaline phosphatase (ALP) in the early diagnosis of prostate cancer bone metastasis. Methods: By radionuclide bone imaging, 98 cases of prostate cancer were divided into bone metastasis group and non-metastasis group. Serum levels of PSA and the ALP were detected in all patients, and the results were analyzed and compared statistically between the two groups in relation to metastasis status. Radionuclide bone scintigraphy were adopted to find radioactive foci. Results: The serum PSA and ALP levels were higher in bone metastasis group than in non-metastasis group (P0. 05). The sensitivity (specificity) of joint detection were significantly different from that of ALP or PSA alone. The radionuclide bone scintigra-phy positive rate was 58. 2% , and abnormal radioactive dense foci were located in the thoracic and lumbar parts. Conclusion: PAS and ALP joint detection is useful for the early diagnosis of prostate cancer bone metastases, and can improve the diagnostic rate.%目的:探讨前列腺特异抗原(PSA)和碱性磷酸酶(ALP)联合检测在早期诊断前列腺癌骨转移中的作用及意义.方法:经核素骨显像将98例前列腺癌患者分为骨转移组和非骨转移组,所有患者均检测PSA和ALP,对比分析两组患者PSA和ALP检测结果、阳性率及与骨转移关系,分析二者联合检测与单项检测对前列腺癌骨转移的敏感度与特异度,以及核素骨显像异常放射性浓聚灶分布情况.结果:骨转移组血清PSA和ALP水平均高于非骨转移组,相比均有显著性差异(P<0.05);PSA单项检测结果骨转移组与非骨转移组阳性率相比无显著性差异(P>0.05),ALP相比有显著性差异(P<0.05);目PSA和ALP值随着骨转移分级增加而增加,呈正相关;PSA和ALLP联合检测与单项检测敏感度相比有显著性差异(P<0.05),特异度有极显著性差异(P<0

  12. Versican Expression during Synovial Joint Morphogenesis

    Directory of Open Access Journals (Sweden)

    John B. Shepard, Heidi A. Krug, Brooklynn A. LaFoon, Stanley Hoffman, Anthony A. Capehart


    Full Text Available The extracellular matrix (ECM plays a critical role in governing cell behavior and phenotype during limb skeletogenesis. Chondroitin sulfate proteoglycans (Cspgs are highly expressed in the ECM of precartilage mesenchymal condensations and are important to limb chondrogenesis and cartilage structure, but little is known regarding their involvement in formation of synovial joints in the embryonic limb. Matrix versican Cspg expression has previously been reported in the epiphysis of developing long bones and presumptive joint; however, detailed analysis has not yet been conducted. In the present study we immunolocalized versican and aggrecan Cspgs during chick elbow joint morphogenesis between HH st25-41 of development. In this study we show that versican and aggrecan expression initially overlapped in the incipient cartilage model of long bones in the wing, but versican was also highly expressed in the perichondrium and presumptive joint interzone during early stages of morphogenesis (HH st25-34. By HH st36-41 versican localization was restricted to the future articular surfaces of the developing joint and surrounding joint capsule while aggrecan localized in an immediately adjacent and predominately non-overlapping region of chondrogenic cells at the epiphyses. These results suggest a potential role for versican proteoglycan in development and maintenance of the synovial joint interzone.

  13. Bridging osteophyte of the anterosuperior sacroiliac joint as a cause of lumbar back pain. (United States)

    Parmar, K A; Solomon, M; Loefler, A; Dalton, S


    A case report is presented of a patient with an anterosuperior osteophytic bone bridge of the sacroiliac joint causing lumbar back pain. After prolonged physiotherapy, the bone bridge was excised, with complete resolution of the symptoms. Excision should only be considered in cases of symptomatic sacroiliac joint pain that does not respond to rehabilitation programmes and conservative treatment.

  14. How many joints does the 5th toe have? A review of 606 patients of 655 foot radiographs.

    LENUS (Irish Health Repository)

    Moulton, Lawrence Stephen


    It is a common understanding that the fifth toe has three bones with two interphalangeal joints. However, our experience shows that a significant number have only two phalanges with one interphalangeal joint.

  15. Bone cutting. (United States)

    Giraud, J Y; Villemin, S; Darmana, R; Cahuzac, J P; Autefage, A; Morucci, J P


    Bone cutting has always been a problem for surgeons because bone is a hard living material, and many osteotomes are still very crude tools. Technical improvement of these surgical tools has first been their motorization. Studies of the bone cutting process have indicated better features for conventional tools. Several non-conventional osteotomes, particularly ultrasonic osteotomes are described. Some studies on the possible use of lasers for bone cutting are also reported. Use of a pressurised water jet is also briefly examined. Despite their advantages, non-conventional tools still require improvement if they are to be used by surgeons.

  16. Bone infarction - A rare complication of pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Lundberg, T.M.; Jesspo, J.F.; Wong, J.C.H. [Royal Brisbane Hospital, Herston, QLD (Australia). Department of Nuclear Medicine


    Full text: In this study a combination of a {sup 99m}Tc MDP Bone scan and {sup 67}Ga scan was used to help in the diagnosis of bone infarction, in a patient with known pancreatitis. A 40-year-old male patient presented to hospital with a history of abdominal epigastric pain and generalised joint pains especially in his left knee and foot. He was recovering after a diagnosis four months earlier of hypertension and pancreatitis. On examination, he was febrile, and had scattered erythematous nodules on both legs. There were joint effusions involving his elbows, knees and ankles. (A series of tests, seemed to suggest either an inflammatory process or osteomyelitis.) At this stage, a two phase bone scan was performed which showed several areas of marked hyperaemia on the blood pools and intense abnormal uptake in the delayed images. Differential diagnosis was bone infarcts or multifocal osteomyelitis. A gallium scan was performed. The combined bone and gallium studies were more in keeping with bone infarcts. Conservative treatment was instituted and a repeat bone scan one year later showed marked improvement. Since pancreatitis is rarely complicated by bone infarction, the diagnosis is often delayed. In this case, nuclear medicine imaging played a very decisive role in excluding osteomyelitis and diagnosing the presence of widespread bone infarction-a rare sequela of pancreatitis.

  17. Life Estimation of Hip Joint Prosthesis (United States)

    Desai, C.; Hirani, H.; Chawla, A.


    Hip joint is one of the largest weight-bearing structures in the human body. In the event of a failure of the natural hip joint, it is replaced with an artificial hip joint, known as hip joint prosthesis. The design of hip joint prosthesis must be such so as to resist fatigue failure of hip joint stem as well as bone cement, and minimize wear caused by sliding present between its head and socket. In the present paper an attempt is made to consider both fatigue and wear effects simultaneously in estimating functional-life of the hip joint prosthesis. The finite element modeling of hip joint prosthesis using HyperMesh™ (version 9) has been reported. The static analysis (load due to the dead weight of the body) and dynamic analysis (load due to walking cycle) have been described. Fatigue life is estimated by using the S-N curve of individual materials. To account for progressive wear of hip joint prosthesis, Archard's wear law, modifications in socket geometry and dynamic analysis have been used in a sequential manner. Using such sequential programming reduction in peak stress has been observed with increase in wear. Finally life is estimated on the basis of socket wear.

  18. Temporomandibular joint: true sagittal computed tomography with meniscus visualization

    Energy Technology Data Exchange (ETDEWEB)

    Sartorix, D.J.; Neumann, C.H.; Riley, R.W.


    Accessory patient support equipment was constructed that allows patient positioning for true sagittal projection of the temporomandibular joint using a GE 8800 CT/T scanner. Range of motion abnormalities, osseous alterations of the mandibular condyle and temporal bone, joint-space narrowing, and meniscal configuration may be demonstrated. The technique has potential advantages over other CT projections and sagittal reconstruction for evaluation of temporomandibular joint dysfunction.

  19. Osteomyelitis and pyogenic infection of the sacroiliac joint. MRI findings and review

    Energy Technology Data Exchange (ETDEWEB)

    Haliloglu, M. [Dept. of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States); Kleiman, M.B. [Dept. of Pediatrics, Indiana University School of Medicine, Indianapolis, IN (United States); Siddiqui, A.R. [Division of Nuclear Medicine, Indiana University School of Medicine, Indianapolis, IN (United States); Cohen, M.D. [Dept. of Radiology, Indiana University School of Medicine, Indianapolis, IN (United States)


    Acute pyogenic sacroiliac joint infection and osteomyelitis of adjacent bones often present with severe, poorly localized lower back, pelvic of hip pain. Five cases of sacroiliac joint infection or sacroiliac bone osteomyelitis were evaluated by MRI. MRI may be a helpful diagnostic tool to evaluate early changes of infection in the sacroiliac area. It is very sensitive for detecting bone marrow abnormalities; however, it is non-specific and can not accurately differentiate osteomyelitis from sacroiliitis. (orig.)

  20. Limb bone morphology, bone strength, and cursoriality in lagomorphs. (United States)

    Young, Jesse W; Danczak, Robert; Russo, Gabrielle A; Fellmann, Connie D


    The primary aim of this study is to broadly evaluate the relationship between cursoriality (i.e. anatomical and physiological specialization for running) and limb bone morphology in lagomorphs. Relative to most previous studies of cursoriality, our focus on a size-restricted, taxonomically narrow group of mammals permits us to evaluate the degree to which 'cursorial specialization' affects locomotor anatomy independently of broader allometric and phylogenetic trends that might obscure such a relationship. We collected linear morphometrics and μCT data on 737 limb bones covering three lagomorph species that differ in degree of cursoriality: pikas (Ochotona princeps, non-cursorial), jackrabbits (Lepus californicus, highly cursorial), and rabbits (Sylvilagus bachmani, level of cursoriality intermediate between pikas and jackrabbits). We evaluated two hypotheses: cursoriality should be associated with (i) lower limb joint mechanical advantage (i.e. high 'displacement advantage', permitting more cursorial species to cycle their limbs more quickly) and (ii) longer, more gracile limb bones, particularly at the distal segments (as a means of decreasing rotational inertia). As predicted, highly cursorial jackrabbits are typically marked by the lowest mechanical advantage and the longest distal segments, non-cursorial pikas display the highest mechanical advantage and the shortest distal segments, and rabbits generally display intermediate values for these variables. Variation in long bone robusticity followed a proximodistal gradient. Whereas proximal limb bone robusticity declined with cursoriality, distal limb bone robusticity generally remained constant across the three species. The association between long, structurally gracile limb bones and decreased maximal bending strength suggests that the more cursorial lagomorphs compromise proximal limb bone integrity to improve locomotor economy. In contrast, the integrity of distal limb bones is maintained with increasing

  1. 兔关节盘、髁突及软骨下骨的年龄相关性改变组织学研究%Age-related Changes of Condyle, Articular Disc, and Subchondral Bone:a Histomorphometric Study in Rabbit Temporomandibular Joint

    Institute of Scientific and Technical Information of China (English)

    黄林剑; 蔡协艺; 李辉; 盛夏涵; 杨驰


    目的:探究不同年龄段兔颞下颌关节(TMJ)关节盘、髁突和软骨下骨的生理特征的变化。方法:选取1、4、12和32周龄健康雌性新西兰大白兔各3只,取材TMJ,经脱钙处理后进行5μm 连续切片,苏木精-伊红染色。分别对关节盘大小、髁突前后径,以及关节盘所对应软骨下骨的形态结构和骨密度进行测量分析。采用SPSS19.0软件包对数据进行统计学分析。结果:关节盘大小比较,4周组明显大于1周组(P=0.039),12周组明显大于4周组(P=0.007);髁突前后径在4周和12周组间(P=0.003)显著增加;软骨下骨的形态结构和骨密度在4~32周内(P<0.05)显著改变。结论:兔颞下颌关节关节盘和髁突在青春期前生长发育明显;髁突软骨下骨的形态结构和骨密度在4周时开始出现明显改变。虽然青少年期和成年期兔髁突大小没有统计学差异,但是两者软骨下骨的骨质密度差异明显。%Objective:To study the age-related changes of articular disc, condyle and subchondral bone in rabbit temporo-mandibular joint (TMJ). Methods:Three New Zealand rabbit in each group were obtained at the ages of 1-,4-,12-and 32-week, respectively. Animals were sacrificed and TMJ specimen was subjected to histolgical assessment to evaluate about the length of articular disc and condyle and the architecture of subchondral bone. One-way ANOVA using SPSS 19.0 soft-ware package was performed. Results:Articular disc significant elongated from 1-week to 4-week rabbits (P=0.039) and 4-week to 12-week rabbits (P=0.007). The increase of subchondral bone density (P<0.05) occurred from 1- week to 4-week and 4- week to 32- week rabbits respectively. The significant enlargement of condyle length occurred from 4- week to 12-week rabbits (P=0.003). Conclusion:The growth and development potential of the articular disc and the mandibular condyle were promintly before the adolesence. The morphology

  2. Bone x-ray (United States)

    ... or broken bone Bone tumors Degenerative bone conditions Osteomyelitis (inflammation of the bone caused by an infection) ... Multiple myeloma Osgood-Schlatter disease Osteogenesis imperfecta Osteomalacia Osteomyelitis Paget disease of the bone Rickets X-ray ...

  3. MRI of joint fluid in femoral head osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Chan, W.P. [Chief in Department of Radiology, Taipei Medical University, Municipal Wan Fang Hospital, 111 Hsing-Long Road, Section 3, Taipei 116 (Taiwan); Liu, Y.-J. [Institute of Electric Engineering, National Taiwan University, 1 Roosevelt Road, Section 4, Taipei 106 (Taiwan); Huang, G.-S. [Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, 325 Cheng-Kung Road, Section 2, Taipei 114 (Taiwan); Jiang, C.-C.; Huang, S. [Department of Orthopedic Surgery, National Taiwan University Hospital, 7 Chung-San S. Road, Taipei 100 (Taiwan); Chang, Y.-C. [Department of Mathematics, Tamkang University, 151 Ying-Chuan Road, Tamsui, Taipei 251 (Taiwan)


    To evaluate the relationship between joint fluid, intramedullary pressure (IMP), bone marrow edema, and stages of osteonecrosis of the femoral head (ONFH). Material and methods: We reviewed the magnetic resonance (MR) images of 28 patients with 40 documented ONFHs. IMP was measured in 16 symptomatic hips. The amount of joint fluid was graded as 0 (no fluid), 1 (fluid <5 mm in width), or 2 (fluid {>=} 5 mm in width) adjacent to the entire length of the femoral neck. Associated focal and diffuse bone marrow abnormalities were evaluated. A control group of 29 recruited individuals without symptoms related to hip disease were examined. Follow-up MR images were obtained in four patients (five affected hips) 6-10 months after core decompression. Results: Of the 40 affected hips, the severity of ONFH was divided into stages 0 (n=4), I (n=28), and II (n=8 hips) on MR findings. The correlation of joint fluid to IMP and to the presence of bone marrow edema was poor. The amount of joint fluid correlated significantly with the stage of ONFH. None of the five affected hips showed decreased joint fluid on follow-up MR images. Conclusion: The amount of joint fluid correlates well with the stage of ONFH. The amount of joint fluid does not correlate with IMP or bone marrow edema. (orig.)

  4. Joint x-ray (United States)

    ... show: Arthritis Fractures Bone tumors Degenerative bone conditions Osteomyelitis (inflammation of the bone caused by an infection) ... dysplasia of the hip Fungal arthritis Gout Osteoarthritis Osteomyelitis Psoriatic arthritis Reactive arthritis Rheumatoid arthritis Septic arthritis ...

  5. Virtual temporal bone

    Institute of Scientific and Technical Information of China (English)

    QIU Ming-guo; ZHANG Shao-xiang; LIU Zheng-jin; TAN Li-wen; WANG Yu-su; DENG Jun-hui; TANG Ze-sheng


    Objective:To provide the virtual model of the temporal bone for improving 3-dimension (3D) visualization of the inner ear. Methods: Plastination technique was used to make equidistant serial thin sections 1.0 mm in thickness. On SGI workstation, a Contours+Marching Cubes algorithm was selected to reconstruct the temporal bone and intratemporal structures in 3D, then to view the middle ear, inner ear, and intratemporal structures which imitate the scenes observed by the traditional endoscopy. Results: The virtual model of the temporal bone was successfully constructed, with all reconstructed structures being represented individually or jointly and being rotated continuously in any plane. Virtual endoscopy improved 3D visualization of the middle ear, inner ear, and intratemporal structures. Conclusion: The reconstructed model can be used for the medical students to rehearse or review the surgeries on this part and for the surgeons to develop a new approach for operation. Virtual otoscopy stands as a promising new visualization technique for elucidating the structure and relation of the middle ear, inner ear, and intratemporal structures.

  6. Finite element stress analysis of some ankle joint prostheses. (United States)

    Falsig, J; Hvid, I; Jensen, N C


    A three-dimensional finite element stress analysis was employed to calculate stresses in a distal tibia modelled with three simple total ankle joint replacement tibial components. The bone was modelled as a composite structure consisting of cortical and trabecular bone in which the trabecular bone was either homogeneous with a constant modulus of elasticity or heterogenous with experimentally determined heterogeneity. The results were sensitive to variations in trabecular bone material property distributions, with lower stresses being calculated in the heterogeneous model. An anterolateral application of load, which proved the least favourable, was used in comparing the prosthetic variants. Normal and shear stresses at the trabecular bone-cement interface and supporting trabecular bone were slightly reduced by addition of metal backing to the polyethylene articular surface, and a further reduction to very low values was obtained by addition of a long intramedullary peg bypassing stresses to the cortical bone.

  7. Bone pain

    DEFF Research Database (Denmark)

    Frost, Charlotte Ørsted; Hansen, Rikke Rie; Heegaard, Anne-Marie


    Skeletal conditions are common causes of chronic pain and there is an unmet medical need for improved treatment options. Bone pain is currently managed with disease modifying agents and/or analgesics depending on the condition. Disease modifying agents affect the underlying pathophysiology...... of the disease and reduce as a secondary effect bone pain. Antiresorptive and anabolic agents, such as bisphosphonates and intermittent parathyroid hormone (1-34), respectively, have proven effective as pain relieving agents. Cathepsin K inhibitors and anti-sclerostin antibodies hold, due to their disease...... modifying effects, promise of a pain relieving effect. NSAIDs and opioids are widely employed in the treatment of bone pain. However, recent preclinical findings demonstrating a unique neuronal innervation of bone tissue and sprouting of sensory nerve fibers open for new treatment possibilities....

  8. Bone graft (United States)

    ... around the area. The bone graft can be held in place with pins, plates, or screws. Why ... Orthopaedic Surgery, San Francosco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the ...

  9. Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system. (United States)

    Miller, Larry E; Block, Jon E


    Chronic sacroiliac (SI) joint-related low back pain (LBP) is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry(®) SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed.

  10. Anatomy and biomechanics of the elbow joint. (United States)

    Martin, Silvia; Sanchez, Eugenia


    Magnetic resonance (MR) imaging provides clinically useful information in assessing the elbow joint. Superior depiction of muscles, ligaments and tendons as well as the ability to directly visualize nerves, bone marrow and hyaline cartilage, are advantages of MR imaging relative to conventional imaging techniques. As the elbow is located superficially, clinical examination is easier for the orthopedic surgeon and only a few cases need a diagnosis for the radiologist, for this reason the elbow joint is little known for the radiologist. To better understand the injuries that occur in the elbow during the sport activities, we need a better understanding of the biomechanics of the joint. And for understanding the biomechanics, it is necessary to know the exact anatomy of the elbow joint and to be able to identify each anatomic structure in the different imaging planes and pulse sequences. This is especially important in MR as the imaging tool that shows a highest soft tissue resolution among other imaging techniques.

  11. Control Study of Treatment of Salmon Calcitonin for Hip Joint Fracture on Postoperative Affect of Determination of Ultrasound Bone Density%鲑鱼降钙素治疗对髋关节骨折术后患者超声骨密度测定影响的对照研究

    Institute of Scientific and Technical Information of China (English)

    王志; 张秀花; 陈庆法; 蒋娴; 倪宏伟


    目的结探讨鲑鱼降钙素治疗对髋关节骨折术后患者超声骨密度测定的影响。方法选取2013年1月~2015年1月来我院进行诊治的髋关节骨折患者60例,随机分为对照组和观察组,每组30例,对照组给予常规和促进骨折愈合治疗,观察组在此基础上加用鲑鱼降钙素喷鼻剂治疗,比较两组患者治疗前后超声骨密度测定结果。结果治疗前,两组患者使用超声骨密度仪测定骨密度,结果相比无显著性差异(>0.05);治疗后,观察组患者超声传播速度、骨硬度指数、超声波振幅衰减值均明显增高,与对照组和同组治疗前相比,差异具有统计学意义(0.05); After treatment, the ultrasonic velocity, bone stif ness index and ultrasonic amplitude at enuation' value al obviously increased, compared with control group and the same group before treatment, the dif erence had statistical significance ( <0.05).Conclusion Salmon calcitonin could increase the bone density of patients who with hip joint fracture, and prevent bone lose in patients with fracture.

  12. Reliability of Tubular Joints

    DEFF Research Database (Denmark)

    Sørensen, John Dalsgaard; Thoft-Christensen, Palle

    In this paper the preliminary results obtained by tests on tubular joints are presented. The joints are T-joints and the loading is static. It is the intention in continuation of these tests to perform tests on other types of joints (e.g. Y-joints) and also with dynamic loading. The purpose...... of the test is partly to obtain empirical data for the ultimate load-carrying capacity of tubular T-joints and partly to obtain some experience in performing tests with tubular joints. It is well known that tubular joints are usually designed in offshore engineering on the basis of empirical formulas obtained...

  13. Spacesuit mobility knee joints (United States)

    Vykukal, H. C. (Inventor)


    Pressure suit mobility joints are for use in interconnecting adjacent segments of an hermetically sealed spacesuit in which low torques, low leakage and a high degree of reliability are required. Each of the joints is a special purpose joint characterized by substantially constant volume and low torque characteristics and includes linkages which restrain the joint from longitudinal distension and includes a flexible, substantially impermeable diaphragm of tubular configuration spanning the distance between pivotally supported annuli. The diaphragms of selected joints include rolling convolutions for balancing the joints, while various joints include wedge-shaped sections which enhance the range of motion for the joints.

  14. Low Bone Density (United States)

    ... Information › Bone Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your ... compared to people with normal bone density. Detecting Low Bone Density A bone density test will determine ...

  15. Bone graft materials in fixation of orthopaedic implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan


    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...... bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA...

  16. Bone marrow transplant (United States)

    Transplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical ...

  17. Chromium Content in the Human Hip Joint Tissues

    Institute of Scientific and Technical Information of China (English)

    Barbara Brodziak-Dopiera; Jerzy Kwapuliski; Krzysztof Sobczyk; Danuta Wiechua


    Objective Chromium has many important functions in the human body. For the osseous tissue, its role has not been clearly defined. This study was aimed at determining chromium content in hip joint tissues. Methods A total of 91 hip joint samples were taken in this study, including 66 from females and 25 from males. The sample tissues were separated according to their anatomical parts. The chromium content was determined by the AAS method. The statistical analysis was performed with U Mann-Whitney's non-parametric test, P≤0.05. Results The overall chromium content in tissues of the hip joint in the study subjects was as follows:5.73 µg/g in the articular cartilage, 5.33 µg/g in the cortical bone, 17.86 µg/g in the cancellous bone, 5.95 µg/g in the fragment of the cancellous bone from the intertrochanteric region, and 1.28 µg/g in the joint capsule. The chromium contents were observed in 2 group patients, it was 7.04 µg/g in people with osteoarthritis and 12.59 µg/g in people with fractures. Conclusion The observed chromium content was highest in the cancellous bone and the lowest in the joint capsule. Chromium content was significantly different between the people with hip joint osteoarthritis and the people with femoral neck fractures.

  18. Quality of Bone Healing: Perspectives and Assessment Techniques (United States)


    uniquely restricted to appositional growth; therefore, all activities occur on bone surfaces, either the outer periosteal or marrow- oriented...Standardized scoring systems such as the radio- graphic union score for tibial fractures39 allow for a reduction in the variability of assessing fracture...O’Connor B, Kenwright J. Measuring stiffness can define healing of tibial fractures. J Bone Joint Surg 1994; 76-B: 389–94. Guda et al. Bone healing

  19. The role of MRI in early ankylosing spondylitis: emphasis on the sacroiliac and hip joints

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chul Min; Kang, Moo Song; Kim, Chang Soo; Chung, Chun Phil [Maryknoll Hospital, Busan (Korea, Republic of)


    In clinically suspected ankylosing spondylitis of sacroiliac (SIJ) and hip joints with normal or minimal secondary bone change in simple X-ray films, we evaluated the role of MRI in sacroiliac and hip joints. Authors evaluated 11 cases (36 joints; SIJ 14 hip 22) confirmed as ankylosing spondylitis by clinical, laboratory, and radiologic findings, and compared the detectability of involvement of joints by simple X-ray film and MRI. Authors analysed MR findings for the presence of pannus and its signal intensities (SI), change of articular cartilage, bony erosion and sclerosis, subchondral bone cysts, osteophytosis, bone marrow edema, joint effusion, adjacent soft tissue change, and contrast enhancement of pannus. MRI detected not only 20 joints (SIJ 11, hip 9) detected in simple X-ray, but also additional 7 joints (SIJ 3, hip 4). MRI depicted simultaneous involvement of SIJ and hip joints in 5 of 11 cases (SIJ 10 joints, hip 9 joints), and bilateral involvement of SIJ and hip joints in 4 among the 5 cases. MRI also demonstrated pannus, which were not detected in conventional films, as intermediate SI on T1WI and high SI on T2WI, in all 27 joints (SIJ 14, hip 13). Gd-DTPA enhanced T1WI revealed enhancement of pannus in 7 cases (17 joints). MRI was a valuable modality in evaluation of clinically suspected ankylosing spondylitis of SIJ or hip joints with normal or minimal secondary bone change in simple X-ray. Simultaneous evaluation of SIJ and hip joints is suggested in clinically suspected ankylosing spondylitis or other joint diseases.

  20. Cannabinoids and bone: friend or foe? (United States)

    Idris, Aymen I; Ralston, Stuart H


    The endocannabinoid system is recognized to play an important role in regulating a variety of physiological processes, including appetite control and energy balance, pain perception, and immune responses. The endocannabinoid system has also recently been implicated in the regulation of bone metabolism. Endogenously produced cannabinoids are hydrophobic molecules derived from hydrolysis of membrane phospholipids. These substances, along with plant-derived and synthetic cannabinoids, interact with the type 1 (CB(1)) and 2 (CB(2)) cannabinoid receptors and the GPR55 receptor to regulate cellular function through a variety of signaling pathways. Endocannabinoids are produced in bone, but the mechanisms that regulate their production are unclear. Skeletal phenotyping of mice with targeted inactivation of cannabinoid receptors and pharmacological studies have shown that cannabinoids play a key role in the regulation of bone metabolism. Mice with CB(1) deficiency have high peak bone mass as a result of an osteoclast defect but develop age-related osteoporosis as a result of impaired bone formation and accumulation of bone marrow fat. Mice with CB(2) deficiency have relatively normal peak bone mass but develop age-related osteoporosis as a result of increased bone turnover with uncoupling of bone resorption from bone formation. Mice with GPR55 deficiency have increased bone mass as a result of a defect in the resorptive activity of osteoclasts, but bone formation is unaffected. Cannabinoids are also produced within synovial tissues, and preclinical studies have shown that cannabinoid receptor ligands are effective in the treatment of inflammatory arthritis. These data indicate that cannabinoid receptors and the enzymes responsible for ligand synthesis and breakdown play important roles in bone remodeling and in the pathogenesis of joint disease.

  1. 《中国骨与关节杂志》2012年度常务编委扩大会会议纪要%Chinese Journal of Bone and Joint Minutes of the Board Member Meeting 2012

    Institute of Scientific and Technical Information of China (English)


    Summary The Board Member Meeting of “Chinese Journal of Bone and Joint” was held in Chengdu Mingyu Shangya Hotel with more than 30 participants under the support of the orthopedic department in the West China Hospital of Sichuan University on December 29, 2012. The meeting was presided by professor Hou Shuxun, the deputy editor-in-chief. Professor Xu Wanpeng, the editor-in-chief, reviewed the course of development of the“Chinese Journal of Bone Tumor and Bone Diseases”, which is the predecessor of the“Chinese Journal of Bone and Joint”. The annual report was made by professor Wu Wenwen, the editorial director. It was concluded as follows:the tendency of more qualified articles submitted urged the conversion of the journal from bimonthly to monthly. In order to raise its international influence, the journal expanded the scope and length of the English to form a full structure and added English introductions to all the main points of short essays, reviews, case reports, meeting minutes, top expert’s notes, and expert’s commentaries. The journal also invited foreign editorial board members from the United States, Britain, the Netherlands, Japan, Korea and other countries to catch the latest progress in the related fields and improve the quality of original articles and English abstract. Ma Zheng, director of the Chinese Ministry of Science and Technology Information Institute, addressed a lecture entitled“Evaluation and Competition of Academic Journals”. In his lecture, he described the basic role of “quantitation” in the measurement and analysis of scientific issues, and emphasized its importance in the research design, experimental analysis and thesis writing. Professor Pei Fuxing, the deputy editor-in-chief, delivered a lecture entitled “Suggestions on the Improvement of Academic Influence”. He stressed the innovativeness, scientificalness and orientation. Many valuable suggestions and opinions were expressed by other participating

  2. Benign and malignant cartilage tumors of bone and joint: their anatomic and theoretical basis with an emphasis on radiology, pathology and clinical biology. Pt. 1. The intramedullary cartilage tumors

    Energy Technology Data Exchange (ETDEWEB)

    Brien, E.W. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)]|[Musculoskeletal Tumor Service, Orthopaedic Hospital, Los Angeles, CA (United States); Mirra, J.M. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States); Kerr, R. [Orthopaedic Oncology Service, Orthopaedic Hospital, Los Angeles, CA (United States)


    We reviewed 845 cases of benign and 356 cases of malignant cartilaginous tumors from a total of 3067 primary bone tumors in our database. Benign cartilaginous lesions are unique because the epiphyseal plate has been implicated in the etiology of osteochondroma, enchondroma (single or multiple), periosteal chondromas and chondroblastoma. In the first part of this paper, we will review important clinical, radiologic and histologic features of intramedullary cartilaginous lesions in an attempt to support theories related to anatomic considerations and pathogenesis. (orig.). With 44 figs., 2 tabs.

  3. Bone mineral content and bone metabolism in young adults with severe periodontitis

    DEFF Research Database (Denmark)

    Wowern von, N.; Westergaard, J.; Kollerup, G.


    Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis......Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis...

  4. International joint ventures

    DEFF Research Database (Denmark)

    Sørensen, Karsten Engsig


    The article analysis problems connected with corporate joint ventures. Among others the possible conflicts between the joint venture agreement and the statutes of the companies is examined, as well as certain problems connected to the fact that the joint venture partners have created commen control...... over their joint company....

  5. [Numerical variants and congenital fusions of carpal bones]. (United States)

    Senecail, B; Perruez, H; Colin, D


    The number of carpal bones may be increased or decreased by the fact of anatomical variants or true congenital anomalies. Numerical increment arises from additional or from split bones. Over twenty accessory carpal bones have been described but the commonest are the os centrale carpi, the os radiale externum, the triangular bone and the styloideum bone. Additional carpal bones usually result from a failure of fusion of their ossification centers. A congenital origin is not clearly established for all these ossicles. The scaphoid and lunate may split into two or three bones and several cases of bipartite hamulus of the hamatum have been reported. A carpus with only seven bones results from the congenital absence of a normal bone, which mainly affects the scaphoid, lunate and triquetrum, or from a synostosis between two carpal bones, usually the lunate and triquetrum. Congenital fusions originate from an absence of joint cavitation into the embryo and chondrification of the joint interzone. Numerical carpal variants are uncommon as independent entities but occur with a relative high frequency in association with complex malformations of the hand. These anomalies are detectable on plain radiographs of the wrist, but CT-scan and MR-Imaging are useful to differentiate bipartite and accessory bones from carpal fractures or posttraumatic injuries, carpal fusions having to be distinguished from bony ankylosis.

  6. Backgrounds of antibiotic-loaded bone cement and prosthesis-related infection

    NARCIS (Netherlands)

    Hendriks, JGE; van Horn, [No Value; van der Mei, HC; Busscher, HJ


    Antibiotic-loaded bone cement has been in use for over 30 years for the fixation of total joint arthroplasties, although its mechanism of action is still poorly understood. This review presents the backgrounds of bone cements, prosthesis-related infection and antibiotic-loaded bone cements. It is sh

  7. [Bone transplant]. (United States)

    San Julián, M; Valentí, A


    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands.

  8. Bone marrow scan evaluation of arthropathy in sickle cell disorders

    Energy Technology Data Exchange (ETDEWEB)

    Alavi, A.; Schumacher, H.R.; Dorwart, B.; Kuhl, D.E.


    Twelve patients with sickle cell hemoglobinopathies and arthropathy were studied, using technetium Tc 99m sulfur colloid bone marrow scans. Eight of 12 had decreased marrow radionuclide activity adjacent to painful joints, suggesting obliteration of vessels supplying bone marrow. Four patients without marrow defects on scanning had causes other than infarction for their joint symptoms, viz, small fractures, postinfectious synovitis, degenerative arthritis, and osteochondromas. Roentgenograms never showed bony abnormalities in five patients with marrow infarctions, and, in three others, showed defects several months later than did the marrow scans. Bone marrow scans offer a sensitive and early diagnostic aid in sickle cell hemoglobinopathies with arthropathy.

  9. Chronic sclerosing osteomyelitis of the iliac bone. Etiological possibilities

    Energy Technology Data Exchange (ETDEWEB)

    Jurik, A.G.; Moeller, S.H.; Mosekilde, L.


    An adolescent with chronic recurrent multifocal osteomyelitis located to both iliac bones and an adult with pustulotic arthro-osteitis, involving the left iliac bone, an invertebral space, and the sternoclavicular, first sternocostal, manubriosternal and single peripheral joints are described. Their iliac bone changes were identical, except for the occurrence of bilateral changes in the adolescent, and ankylosis of the sacroiliac joint in the adult. It is suggested that chronic recurrent multifocal osteomyelitis and pustulotic arthro-osteitis may be related diseases with age-dependent differences.

  10. Effect of a treat-to-target strategy based on methotrexate and intra-articular betamethasone with or without additional cyclosporin on MRI-assessed synovitis, osteitis, tenosynovitis, bone erosion, and joint space narrowing in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Møller-Bisgaard, S; Ejbjerg, B J; Eshed, I;


    OBJECTIVES: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients, and to i......OBJECTIVES: To investigate whether a treat-to-target strategy based on methotrexate (MTX) and intra-articular (IA) betamethasone suppresses magnetic resonance imaging (MRI)-determined measures of disease activity and reduces joint destruction in early rheumatoid arthritis (eRA) patients......, and to investigate whether concomitant cyclosporin A (CyA) provides an additional effect. METHOD: In the 2-year randomized, double-blind, treat-to-target trial CIMESTRA, 160 patients with eRA (... no consistent statistically significant differences between treatment groups. CONCLUSIONS: In this eRA treat-to-target trial, MTX and intra-articular glucocorticoids markedly reduced, but did not eliminate, MRI osteitis, synovitis, and tenosynovitis. Accordingly, minimal but statistically significant increases...

  11. Bone biopsy (image) (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  12. Bone lesion biopsy (United States)

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  13. Facts about Broken Bones (United States)

    ... Room? What Happens in the Operating Room? Broken Bones KidsHealth > For Kids > Broken Bones Print A A ... sticking through the skin . What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  14. Calcium and bones (United States)

    Bone strength and calcium ... calcium (as well as phosphorus) to make healthy bones. Bones are the main storage site of calcium in ... your body does not absorb enough calcium, your bones can get weak or will not grow properly. ...

  15. Broken Bones (For Parents) (United States)

    ... Feeding Your 1- to 2-Year-Old Broken Bones KidsHealth > For Parents > Broken Bones Print A A ... bone fragments in place. When Will a Broken Bone Heal? Fractures heal at different rates, depending upon ...

  16. Radiographic analysis of temporomandibular joint arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)


    The author analysed the bone changes, the positional relationships between condylar head and articular fossa, and the interrelationship between the bone changes and the abnormal position of condylar head, from 1,036 radiographs of 259 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and orthopantomograms. The results were as follows: 1. Among the radiographic bone changes of the temporomandibular joint arthrosis, deformity was 36..90% (217 cases), sclerosis 34.18% (201 cases), erosive change 25.58% (152 cases) and marginal proliferation 3.06% (18 cases) respectively. 2. In the positional changes between condylar head and articular fossa, the downward positioning of condylar head in centric occlusion was most frequent (36.90%), of which frequency was significantly higher than forward positioning (11.22%) and backward positioning (4.76%) in same condition. Also, radiographs showed that the enlargement of articular space showed higher frequency than its narrowing. In the opening position of mouth, the restrict ed movement of condylar head within articular fossa was most frequent (35.03%). The forward positioning and the downward positioning was 15.65% and 9.52% respectively. Also, radiographs revealed that the incomplete movement or no positional change of condylar head was most frequent. 3. In the interrelationship between bone changes and abnormal position of condylar head, deformity was 42.79% in the cases of downward positioning of condylar head in centric occlusion and 37.50% in those of normal positioning of condylar head in same condition. This revealed that deformity was most frequent bone change in above condylar positionings. However, erosive change was 34.62% in the cases of downward positioning of condylar head in centric occlusion and 33 .33% in those of forward positioning. In opening position of condylar head, and deformity in the cases of norma l positioning, forward positioning and

  17. 耳针干预乳腺癌芳香化酶抑制剂所致肌肉骨关节疼痛的临床研究%Clinical Study of Acupuncture Intervention in Muscle, Bone and Joint Pain Caused by Aromatase Inhibitors in the Treatment of Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    叶荆; 王蓓; 吕晓皑; 孙占玲


    目的:观察耳针干预乳腺癌芳香化酶抑制剂治疗所致肌肉骨关节疼痛的临床疗效。方法将140例接受芳香化酶抑制剂治疗所致肌肉骨关节疼痛的乳腺癌患者随机分为A组、B组、C组和D组,每组35例。A组采用耳针配合唑来膦酸静脉滴注治疗,B组采用单纯耳针治疗,C组采用单纯唑来膦酸静脉滴注治疗,D组采用口服碳酸钙D3咀嚼片和阿法骨化醇软胶囊治疗。观察各组治疗前后简明疼痛量表评分,并比较各组治疗前后腰椎骨密度。结果 A组和B组治疗3、6、12星期后及治疗后6星期疼痛干扰评分与同组治疗前比较,差异均具有统计学意义(P<0.01)。A组和B组治疗3、6、12星期后及治疗后6星期疼痛干扰评分与C组和D组比较,差异均具有统计学意义(P<0.01)。A组和B组治疗3、6、12星期后最严重时的疼痛评分与同组治疗前比较,差异均具有统计学意义(P<0.05)。A组和B组治疗6、12星期后最严重时的疼痛评分与C组和D组比较,差异均具有统计学意义(P<0.05)。B组治疗3星期后最严重时的疼痛评分与C组和D组比较,差异均具有统计学意义(P<0.05)。各组治疗12星期及治疗后6星期BMD T-Score与同组治疗前比较,差异均无统计学意义(P>0.05)。结论耳针能明显缓解芳香化酶抑制剂引起的肌肉骨关节疼痛,且疼痛改善与骨密度无关,但停止治疗后患者肌肉骨关节疼痛症状再次出现。唑来膦酸不能缓解疼痛,耳针配合唑来膦酸对缓解疼痛的疗效并不优于单独耳针治疗。%Objective To investigate the clinical efficacy of acupuncture intervention in muscle, bone and joint pain caused by aromatase inhibitors in the treatment of breast cancer. Method One hundred and forty breast cancer patients with aromatase inhibitors-caused muscle, bone and joint pain were randomly allocated to groups A, B, C and D, 35 cases each. group A received ear acupuncture plus the

  18. Treatment of multiple base unstable fractures of metatarsal bone combined with tarsometatarsal joint injury by open reduction and internal fixation%切开复位内固定治疗多发跖骨基底部不稳定骨折合并跖跗关节损伤

    Institute of Scientific and Technical Information of China (English)

    张海波; 李勇; 蔡友芳


    [Objective] To explore the therapy and the clinical effectiveness of open reduction and internal fixation in the treatment of multiple base unstable fractures of metatarsal bone combined with tarsometatarsal joint injury. [ Method] From January 2003 to July 2001,35 patients with multiple base unstable fractures of metatarsal bone combined with tarsometatarsal joint injuries underwent open reduction and internal fixation. There were 22 males and 13 females with an average age of 37.4 years (range,20 -58 years) ,with total of 89 base fractures. There were 9 cases in the second to third metatarsal bone,7 in the third to fourth metatarsal bone and 19 in the second to fourth metatarsal bone. The classification of tarsometatarsal joint injury showed that there were 2 case of simple middle column ,7 cases of inner and middle columns, 10 cases of lateral and middle colums ,16 cases of three columns. The second and third base fractures of metatarsal bone were treated with transarticular fixation by miniplate. [Result]All the patients were followed up,the duration ranged from 12 to 30 months (averaged 22. 5 months). No complications such as wound infection, skin necrosis and fixture breakage were found postoperatively. The clinical fracture healing time was 8 to 17 weeks (mean ,13.9 weeks). The results were excellent in 11 cases, good in 18 cases, fair in 4 cases, and poor in 2 cases according to American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score system,with excellent and good result rate of 82. 9%. [ Conclusion ] The anatomical reduction and stable fixation of tarsometatarsal joint and metatarsal base are also important to rebuild the function of foot, can reduce incidence rate of osteoarthritis at midfoot and obtain very good clinical effect. Reasonable internal fixation should be selected according to injury type.%[目的]探讨切开复位内固定治疗多发跖骨基底部不稳定骨折合并跖跗关节损伤的方法及临床疗效.[方法]2003年1

  19. Bone densitometry

    DEFF Research Database (Denmark)

    Ravn, Pernille; Alexandersen, P; Møllgaard, A


    The bisphosphonates have been introduced as alternatives to hormone replacement therapy (HRT) for the treatment and prevention of postmenopausal osteoporosis. The expected increasing application in at clinical practice demands cost-effective and easily handled methods to monitor the effect on bone...

  20. Histopathological perspective on bone marrow oedema, reactive bone change and haemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Thiryayi, W.A.; Thiryayi, S.A. [Department of Histopathology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL (United Kingdom); Freemont, A.J. [Division of Regenerative Medicine, University of Manchester, Oxford Road, Manchester M13 9PT (United Kingdom)], E-mail:


    This article presents a systematic review of the current biomedical literature surrounding the aetiopathogenesis and histopathological features of bone marrow oedema, reactive bone change and haemorrhage. Bone marrow oedema is generally demonstrated as a non-specific finding on magnetic resonance imaging in association with infections, tumours and avascular necrosis. When it occurs in isolation as a primary event not triggered by any obvious bony pathology in the clinical setting of debilitating joint pain, it constitutes the 'bone marrow oedema syndrome'. Although the latter diagnosis is based on magnetic resonance (MR) imaging, showing the lesion as areas of signal hyperintensity within the marrow, recent radiology-histology correlational studies have shown variably interstitial marrow oedema, necrosis, fibrosis and trabecular bone abnormalities. In light of these facts, the use of the term bone marrow oedema syndrome in a radiological context might be considered questionable, but histopathological techniques are not sensitive in detecting increased extracellular fluid. Reactive bone changes may be focal or diffuse and usually amount to increased bone formation. Bone marrow haemorrhage, due to trauma, results in bone bruising, a condition in which the size of the bruise and associated osteochondral injury determines the outcome, although the natural history of these lesions is still being researched.

  1. Early treatment of severe polytrauma complicated by bone and joint injuries in hospital%骨关节型严重多发伤的院内早期救治

    Institute of Scientific and Technical Information of China (English)

    张旭鸣; 邱美光; 林世水; 庄颖峰; 何武兵; 陈曙光; 施爱平


    目的 探讨骨关节型严重多发伤的院内早期救治方法.方法 回顾性分析我科2006年1月~2010年6月治疗骨关节损伤为主的严重多发伤73例(平均ISS≥27分)临床资料,早期采用控制出血、骨折临时固定、手术优先解决危及生命的损伤等损害控制措施救治.结果 73例患者中,1例因严重颅脑外伤死于入院后11h,1例因ARDS死于术后24h,2例因伤后第3、6天多器官功能衰竭死亡,3例因未予以早期积极救治死于入院后2h内;66例存活 (90.4%),死亡7例(9.6%).结论 及时控制出血、早期骨折固定、手术优先解决危及生命的损伤、合理应用损害控制外科(damage control surgery,DCS)等措施有助于骨关节型严重多发伤的早期救治,对临床救治严重创伤伤员有很大指导意义.%Objective To discuss the correlation between clinical manifestation and findings on imaging provided by multislice computed tomography ( MSCT) in craniocerebral injury patients with aural trauma. Methods rilgh-resolution CT scanning and three-dimensional reconstruction had been performed in 53 patients with suspec-ted temporal bone fracture. The features of MSCT three - dimensional imagings of temporal bone fracture and the correlation between CT findings and clinical symptoms were analyzed. Results CT showed temporal bone fracture in 53 patients. Among them, longitudinal fractures were detected in 34 patients, transverse fractures in 5 patients and mixed fractures in 14 patients. Totally 48 patients had good inner ear and 5 patients had inner ear damaged. Contusions of brain and/or intracerebral hematomas were detected in 21 patients; unilateral temporal lobe injuries in 11 patients,bilateral in 5 patients,diffuse axonal injury and brain stem injury in 1 patient, respectively jepidural and/ or subdural hematomas in 8 patients,subarachnoid space haematocele in 6 patients. Conclusion MSCT three-di-mensional imagings can clearly display complex anatomic structures

  2. 多发伤与多发骨关节损伤的诊治进展%Research progress in diagnosis and treatment of polytrauma and multiple bone joint injury

    Institute of Scientific and Technical Information of China (English)



    多发伤(multiple injuries or polytrauma)是指同一致伤因素所致2个或2个以上解剖部位的严重损伤。多发骨关节损伤(multiple bone and ioint injury)又常称为多发骨折(poly fractures)或多肢体骨关节损伤(multiple extremity injury,MEI)。严格地讲,多肢体骨关节损伤系指2个以上的上、下肢长管状骨折及关节损伤,含脱位、骨与软骨损伤、

  3. TKA 术中螺钉附加骨水泥结合髓内延长杆修复胫骨平台骨缺损重建关节稳定性%Supporing Screws and Bbone Cement Filling Combined with Intramedullary Stem for Reconstruc-ting Tibial Bone Defect and Joint Stability in Total Knee Arthroplasty

    Institute of Scientific and Technical Information of China (English)

    潘文杰; 贺艳; 马建兵; 肖琳; 卿忠; 王曦; 姚舒馨; 武淑芳


    Objective To observe the early clinical effect of Supporing screws and bone cement filling combined with intr-amedullary stem for reconstructing tibial noncontained bone defect and joint stability in primary total knee arthroplasty. Meth-ods From May 2012 to October 2015,16 patients(21 knees)with tibial plateau noncontained bone defects including 4 men (5knees)and12 women(16 knees)underwent primary total knee arthmplasty. The average age of the patients was 70. 5 years old ranging from 65 to 76 years. The average weight was 75. 6 kg ranging from 68. 5 kg to 92 kg,and the average body height was 171. 1 cm ranging from 155 cm to 180 cm. The diagnoses of the patients were osteoarthritis in 13 cases(16 knees)and rheumatoid arthritis in 2 cases(4 knees),Kashin-Bek syndrome in 1 case(1 knee). The preoperative range of movement (ROM)was(69. 8 ± 9. 8)°. According to Knee Society score(KSS)criterion,the clinical score of preoperation was(31. 9 ± 8. 8)and functional score was(33. 1 ± 9. 1)During operation,the average depth of tibial plateau defect was 19. 8 mm before tibial osteotomy. The conventional tibial osteotomy of 10. 0 mm was performed,the average depth of the residual bone defect was10. 5 mm. Sclerotic bone was thoroughly removed,2 or 3 pieces of supporting screws were inserted according to bone defect area and morphology,and bone cement was pressurely filled,and then the tibial prosthesis with stem was installed. Results All the cases were followed up of 26. 5 months(range,3 to 36months). All the patients can walk without crutch and self-care 1 month after operation,The enstrophy or ecstrophy or contraction anisotrophy were completely rectified right after operation,and the pain of knee was totally reliefed,At the latest follow-up,the KSS clinical score was knee score(90. 3 ± 9. 0)and functional score was(91. 4 ± 8. 3). The ROM of the knee joint was(115 ± 8. 8)°. In the final follow-up through the X-ray measurement, the position of the prosthesis was good

  4. MR imaging of the temporomandibular joint in patient with acute mandibular condylar fracture

    Energy Technology Data Exchange (ETDEWEB)

    Park, Il Soon; Na, Jae Boem; Kang, Su Jin; Kim, Jae Hyoung; You, Jin Jong; Lee, Sang Hwy; Kim, Il Hyun [Gyeongsang National Univ. College of Medicine, Seoul (Korea, Republic of)


    To analyze various MR imaging findings and thus evaluate the usefulness of MR imaging of the temporomandibular joint in patient with acute mandibular condylar fracture. MR imaging was performed within 1 week after trauma in 25 patients (total joints studied = 31) in whom condylar fracture had been diagnosed by simple radiographs. We analyzed the signal intensity of bone marrow and disk, displacement of bone fragment and disk, deformity. In addition, MRI findings of retrodiskal tissue, joint capsule and joint effusion were evaluated. No abnormal signal intensity was noted in bone marrow or disk. Displacement of a condylar fracture fragment was observed in 24 joints(77 %) (anteromedial, 63 %; medial, 25 %; anterior, 4 %; anterolateral, 4 %; and lateral, 4 %). Disk displacement occurred in 23 joints(74 %) (anteromedial, 65 %; medial, 9 %; anterior, 18 %; anterolateral, 4 %; and lateral, 4%). In 17 joints (55 %) the disk was displaced along with the fractured condylar fragment, and disk deformity was noted in five joints(16 %). MR imaging (T2WI) revealed a capsular tear(n=1), joint effusion(n=26), and high signal intensity in the retrodiskal tissue(n=6). MR imaging provided information concerning condylar fragments, disk, retrodiskal tissue, capsules, and joint effusion. In patients with acute mandibular condylar fracture, MRI is therefore useful for evaluation of the temporomandibular joint.

  5. Radiographic study of bone changes on TMJ arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo [Dept. of Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)


    The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

  6. Use of Bioresorbable Hydrogels and Genetic Engineering to Accomplish Rapid Stabilization and Healing in Segmental Long Bone Defects (United States)


    also suggests that the lymphatics play a critical role in fracture repair. With normal healing of tibial fracture, foci of ossification are...Effectiveness in segmental tibial defects in rats. Tissue Eng 12:489–497. Finkemeier CG. 2002. Bone-grafting and bone-graft substitutes. J Bone Joint...Vogelin E, Brekke JH, Jones NF. 2000. Heterotopic and orthotopic bone formation with a vascularized periosteal flap, a matrix and rh-BMP- 2 (bone

  7. The Hedgehog signalling pathway in bone formation

    Institute of Scientific and Technical Information of China (English)

    Jing Yang; Philipp Andre; Ling Ye; Ying-Zi Yang


    The Hedgehog (Hh) signalling pathway plays many important roles in development, homeostasis and tumorigenesis. The critical function of Hh signalling in bone formation has been identified in the past two decades. Here, we review the evolutionarily conserved Hh signalling mechanisms with an emphasis on the functions of the Hh signalling pathway in bone development, homeostasis and diseases. In the early stages of embryonic limb development, Sonic Hedgehog (Shh) acts as a major morphogen in patterning the limb buds. Indian Hedgehog (Ihh) has an essential function in endochondral ossification and induces osteoblast differentiation in the perichondrium. Hh signalling is also involved intramembrane ossification. Interactions between Hh and Wnt signalling regulate cartilage development, endochondral bone formation and synovial joint formation. Hh also plays an important role in bone homeostasis, and reducing Hh signalling protects against age-related bone loss. Disruption of Hh signalling regulation leads to multiple bone diseases, such as progressive osseous heteroplasia. Therefore, understanding the signalling mechanisms and functions of Hh signalling in bone development, homeostasis and diseases will provide important insights into bone disease prevention, diagnoses and therapeutics.

  8. MR tomography of the elbow joint

    Energy Technology Data Exchange (ETDEWEB)

    Zwaan, M.; Rinast, E.; Weiss, H.D.; Pressler, M.; Vogel, H.


    MR examinations of the elbow joint of three healthy subjects and a comparison with corresponding sections of anatomical preparations show that MR tomography enables not only an excellent differentiation of muscles, tendons and of the articular capsule, but will also visualise vessels and nerve tracts. MR tomography proved superior to the conventional methods in demonstration of separate fragments and inflammatory changes in the bone on examining 11 pathological elbow joints: congenital malformation, osteochondritis dissecans, ostitis, ulnar and radial nerve lesions, completely healed radius fracture and epicondylitis of the radial and ulnar humerus. Epicondylitis could not be demonstrated by MR. Magnetic resonance tomography seems to be the only method that enables direct visualisation of the nerve paths at the elbow joint.

  9. Modeling of Human Joint Structures. (United States)


    Radial Lateral " epicondyle Olecranon Radius Ulna Figure 3. Lateral aspect of the right elbow joint. -17- Annular Ligament This strong band encircles... elbow joint, knee joint, human joints, shoulder joint, ankle joint, joint models, hip joint, ligaments. 20. ABSTRACT (Continue on reverse side If...ligaments. -A rather extended discussion of the articulations and anatomical descriptions of the elbow , shoulder, hip, knee and ankle joints are

  10. The impact of joint line restoration on functional results after hinged knee prosthesis

    Directory of Open Access Journals (Sweden)

    Serdar Yilmaz


    Conclusion: RHKA is an effective salvage procedure for serious instability and large bone defects. Restoration of the joint line improves the patellar score although it had no effect on the clinical outcome.

  11. Transverse morphology of the sacroiliac joint: effect of angulation and implications for fluoroscopically guided sacroiliac joint injection

    Energy Technology Data Exchange (ETDEWEB)

    Ling, B.C.; Lee, J.W.; Man, H.S.J.; Grace, M.G.A.; Lambert, R.G.W. [Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, Edmonton (Canada); Jhangri, G.S. [Department of Public Health Sciences, University of Alberta Hospital, Edmonton (Canada)


    Effects of angulation of computed tomography (CT) reconstruction plane on sacroiliac (SI) joint morphology were studied, and factors influencing the approach to fluoroscopically guided SI joint injection were assessed. CT scans of pelvises were reformatted on 41 subjects, aged 51.7 ({+-}15.1) years. Transverse images were reconstructed at the caudal 3 cm of the SI joint tilting plane of reconstruction from -30 to +30 at 15 increments. Anteroposterior diameter of joint (depth), angle from sagittal plane (orientation angle), and distance from skin were measured. Joint contour was classified, and presence of bone blocking access to the joint was recorded. Comparison between angles were analysed by t-test. Relationships between variables were assessed by a Pearson correlation test. Depth was shorter with angulation in the inferior direction (P<0.01). Orientation angle increased with superior angulation (P<0.01). Distance from skin increased (P<0.01) with angulation in either direction. Joint contour was significantly different from baseline at each angle (P<0.001) but highly variable. Inferior angulation resulted in interposition of ilium between skin and SI joint, and superior angulation caused bone block due to the lower sacrum. None of these features was identified without tilting of the reconstruction plane, and effects were more pronounced with steeper angulation.

  12. Disk abnormality coexists with any degree of synovial and osseous abnormality in the temporomandibular joints of children with juvenile idiopathic arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kirkhus, Eva; Smith, Hans-Joergen [Oslo University Hospital, Rikshospitalet, Department of Radiology and Nuclear Medicine, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Oslo (Norway); Arvidsson, Linda Z.; Larheim, Tore A. [University of Oslo, Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Oslo (Norway); Flatoe, Berit; Hetlevik, Siri O. [Oslo University Hospital, Rikshospitalet, Department of Rheumatology, Oslo (Norway); University of Oslo, Institute of Clinical Medicine, Oslo (Norway)


    MRI manifestation of temporomandibular joint arthritis is frequently reported in children with juvenile idiopathic arthritis. However, little attention has been paid to temporomandibular joint disk abnormalities. To assess combinations of MRI findings in the symptomatic temporomandibular joint in children with juvenile idiopathic arthritis with focus on disk abnormalities. This was a retrospective study of 46 patients with juvenile idiopathic arthritis, mean age 12 years (range: 5-17 years). Mean disease duration was 70 months (standard deviation: 61 months). MR images of 92 temporomandibular joints were scored for thickness of abnormally enhancing synovium (synovitis), joint effusion, bone marrow oedema, abnormal bone shape, bone erosion and disk abnormalities. The 92 temporomandibular joints were categorized as A: No synovitis and normal bone shape (30/92; 33%), B: Synovitis and normal bone shape (14/92: 15%), C: Synovitis and abnormal bone shape (38/92; 41%) and D: No synovitis but abnormal bone shape (10/92; 11%). Thirty-six of the 46 patients (78%) had synovitis and 33/46 (72%) had abnormal bone shape, most frequently in combination (30/46; 65%). Disk abnormalities (flat disk, fragmented disk, adherent disk and displaced disk) were found in 29/46 patients (63%). Disk abnormalities were found in all categories of juvenile idiopathic arthritis involved temporomandibular joints (B: 8/14 [57%]; C: 25/38 [66%] and D: 7/10 [70%]). Disk displacement was found in half of the joints (7/14) in category B. Synovitis was most pronounced in this category. Disk abnormalities were frequent. Disk displacement also occurred in joints with early temporomandibular joint arthritis, i.e., with normal bone shape. Other disk abnormalities were found in joints with bone abnormalities. Attention should be paid to disk abnormalities both in early and long-standing temporomandibular joint arthritis in children with juvenile idiopathic arthritis. (orig.)

  13. Role of Scaphoid in the Abduction and Adduction Movements of Wrist Joint

    Directory of Open Access Journals (Sweden)

    Sadik I Shaikh


    Full Text Available Background: Being a carpal bone scaphoid has an important role in wrist movements. Wrist joint is a synovial modified ellipsoid joint where movements like flexion, extension and adduction, abduction take place around two axes (transverse and antero-posterior. These movements at the wrist joint are associated with considerable range of movements at the mid carpal joint, as same group of muscles act on both of these joints. Methodology: A study has been done amongst 120 persons at the tertiary care hospital during the period from 2006-07 to detect the important movements of scaphoid bone specially during the abduction and adduction of wrist joint (which occur in association with the intercarpal joints and also to detect whether such movements have any speciality in the population. Results: In fully abducted position, it was 45o among 53.3% subjects and the average among all the subjects was 60o. So, the degree of abduction was 30o. The extent of movement was more in adduction (ie, 1.90 cm - 1.03 cm = 0.87 cm than in abduction (ie, 1.03 cm - 0.72 cm = 0.31cm. Conclusion: It was found in this study that the scaphoid acts as a link bone between the two rows of carpal bones and prevents the buckling of midcarpal joint especially of the capitato- lunate joint interface. [Natl J Med Res 2013; 3(3.000: 253-256

  14. 个性化假体三维设计及其在恶性骨肿瘤初次置换与翻修术中的应用%Personalized prosthesis with three-dimensional design in joint replacement and renovation for malignant bone tumor

    Institute of Scientific and Technical Information of China (English)

    尹知训; 白波; 余楠生; 董伟强; 严广斌


    Objective To discuss computer-assisted three-dementional(3-D) design of personalized hip or knee prosthesis, which is bassed on CT scan of patients with bone tumor and assess its efficacy in operation. Methods Patients with malignant bone tumor were selected to undergo CT scan, 3 D reconstruction, computer-aided preoperative planning, simulated operation and prosthesis designs. The STL files of the designs were sent to customise personalized prosthesis. The limb salvage operation was carried out based on preoperative planning. The operation effects were observed. Results An artificial femoral tumor prosthesis with a positioning mark and a hinged type knee tumor prosthesis were successfully designed and custom made. The operations were successful in tumor bone resection, prosthesis installation; the limb length of prosthesis side was equal to the healthy side. Conclusions The individualized artificial joint tumor prosthesis with positioning mark can be designed based on CT scan and reconstruction. It can benefit limb salvage operation in accurate restoration of limb length and precise installation of prosthesis.%目的 探讨基于骨肿瘤患者CT扫描的人工髋、膝关节假体计算机辅助三维个性化设计方法和手术效果.方法 选取股骨恶性骨肿瘤患者,进行CT扫描,三维重建,计算机辅助术前规划、模拟手术和假体三维设计,发送STL文件定制个性化假体.依据术前规划进行保肢手术,观察手术效果.结果 设计并定制了带定位标识的个性化人工股骨柄肿瘤假体和人工膝关节铰连式肿瘤假体,手术瘤骨切除彻底、假体安装顺利、位置合适,术后双下肢等长.结论 基于CT重建能设计出带标识个性化人工关节肿瘤假体,有利于保肢手术精确恢复下肢长度和精确安装假体位置.

  15. 骨髓基质细胞诱导分化修复髁突软骨面缺失的实验研究%An experimental study of bone marrow stromal cells differentiating to chondrocytes for repairing temporomandibular joint condylar cartilage defects

    Institute of Scientific and Technical Information of China (English)

    黄跃; 沈国芳; 王旭东; 杨辛; 张秀丽; 蒋欣泉


    PURPOSE: To repair the temporomandibular joint condylar cartilaginous defects by the differentiated bone marrow stroma cells combined with chondrocytes. METHODS: Fifteen goats were randomly divided into 2 groups.The experimental group included 9 goats, autologous BMSCs combined with chondrocytes were mixed with pluronic F-127 and implanted into goat temporomandibular joint condylar articular cartilage defects. The control group included 6 goats, pluronic F-127 gel was implanted into their temporomandibular joint condylar articular cartilage defects.The goats were killed 4,8,12 weeks postoperatively.The reconstructive articular cartilage was evaluated by HE staining and immunostaining of type Ⅱ collagen. RESULTS: The experimental group could reconstruct the articular cartilage after 4 weeks. 12 weeks later the articular cartilage did not degenerate. The control group could not reconstruct the articular cartilage. CONCLUSIONS: BMSCs can be differentiated into chondrocytes and play an important role in repairing articular cartilage defects. Supported by Phosphor Program of Science and Technology Commission of Shanghai Municipality (04QMX1424) and Key Project in Social Development Sponsored by Fujian Provincial Department of Science and Technology (2009Y0016).%目的:采用骨髓基质细胞(BMSCs)体内修复髁突软骨全层缺失.方法:15只山羊,9只作为实验组,将BMSCs和少量软骨细胞(7∶3比例混合)按5×107/mL与生物可降解材料复合后,植入山羊髁突软骨全层缺失处;对照组6只山羊,髁突软骨全层缺失区植入支架材料,分别于术后4、8、12周每个时间段取材3只实验动物,2只对照组动物;2组分别用HE染色、Ⅱ型胶原分泌的免疫组化法进行评价.结果:实验组术后4周,山羊髁突软骨缺失区能形成成熟的软骨组织,12周时软骨未退变.对照组不能形成成熟的软骨组织.结论:骨髓基质细胞在自体软骨细胞基质的诱导下,可以修复山羊颞下

  16. Culture - joint fluid (United States)

    Joint fluid culture ... fungi, or viruses grow. This is called a culture. If these germs are detected, other tests may ... is no special preparation needed for the lab culture. How to prepare for the removal of joint ...

  17. Sacroiliac joint pain - aftercare (United States)

    ... this page: // Sacroiliac joint pain - aftercare To use the sharing features on this page, please enable JavaScript. The sacroiliac joint (SIJ) is a term used to describe the ...

  18. Knee joint replacement - slideshow (United States)

    ... this page: // Knee joint replacement - series—Normal anatomy To use the ... to slide 4 out of 4 Overview The knee is a complex joint. It contains the distal ...

  19. 氟铝联合中毒对小鼠骨代谢生物标志物的影响%Joint effects of fluoride and aluminum on biomarkers of bone metabolism in mice

    Institute of Scientific and Technical Information of China (English)

    杨莉萍; 王克跃; 石修权; 李红


    Objective To explore the interaction characters of fluoride and aluminum by analyzing the changes of bone metabolism in mice. Methods Kunming mice were randomly divided into nine groups according to the factorial experiment, design of two factors and three levels. The animals in different groups were fed with various doses of fluoride(NaF, 0,50,150 mg/L) and/or aluminum(AlCl3, 0,200,600 mg/L) in drinking water for 24 weeks. Serum calcium, phosphor, magnesium, alkaline phosphatase, osteoealine, parathyroid, and urinary calcium and phosphor were tested. Results We found interaetians of fluoride and aluminum with serum calcium, osteoealine and urine calcium(F=17.370,4.399,9.448, P<0.01), but not with serum phosphor, magnesium, alkaline phosphatase, parathyroid or urinary phospbor(F=0.416,0.415,1.921,1.362, 1.630, P 0.05). The serum levels of calcium and osteoealine in high fluoride group were (1.13±0.27)mmol/L and (6.56±5.74)μg/L, respectively, which were lower than in the control group[ (1.82±0.37)mmol/L and (23.45±15.40)laeJL, respectively], but the levels were elevated to (1.76±0.36)mmol/L and (10.57±4.28)μg/L when high fluoride was combined with low aluminum, and further elevated to (2.10±0.51)mmol/L and (15.73±3.15)μg/L when high fluoride was combined with high aluminum. The urinary calcium level in low fluoride group [ (6.24±2.61)retool/retool Cr] was higher than that in the control group[ (3.12±2.04)retool/retool Cr], but it was decreased in low fluoride and aluminum groups[ (0.81±0.44), (1.23± 0.41)mmol/mmoi Cr, respectively]. On the other hand, the levels of serum ealeium and osteocaline in high aluminum group were (1.07±0.68)mmol/L and (7.21±5.22)μg/L, elevated to (1.47±0.18)mmol/L and (10.98±4.35) μg/L when low fluoride was combined wth high aluminum, and further elevated to (2.10±0.51)mmol/L and (15.73± 3.15)μg/L when high fluoride was.combined with high aluminum, respectively, and the combined effects showed the same trend of

  20. ANA deficiency enhances bone morphogenetic protein-induced ectopic bone formation via transcriptional events. (United States)

    Miyai, Kentaro; Yoneda, Mitsuhiro; Hasegawa, Urara; Toita, Sayaka; Izu, Yayoi; Hemmi, Hiroaki; Hayata, Tadayoshi; Ezura, Yoichi; Mizutani, Shuki; Miyazono, Kohei; Akiyoshi, Kazunari; Yamamoto, Tadashi; Noda, Masaki


    Ectopic bone formation after joint replacement or brain injury in humans is a serious complication that causes immobility of joints and severe pain. However, mechanisms underlying such ectopic bone formation are not fully understood. Bone morphogenetic protein (BMPs) are defined as inducers of ectopic bone formation, and they are regulated by several types of inhibitors. ANA is an antiproliferative molecule that belongs to Tob/BTG family, but its activity in bone metabolism has not been known. Here, we examined the role of ANA on ectopic bone formation activity of BMP. In ANA-deficient and wild-type mice, BMP2 was implanted to induce ectopic bone formation in muscle. ANA deficiency increased mass of newly formed bone in vivo compared with wild-type based on 3D-muCT analyses. ANA mRNA was expressed in bone in vivo as well as in osteoblastic cells in vitro. Such ANA mRNA levels were increased by BMP2 treatment in MC3T3-E1 osteoblastic cells. Overexpression of ANA suppressed BMP-induced expression of luciferase reporter gene linked to BMP response elements in these cells. Conversely, ANA mRNA knockdown by small interference RNA enhanced the BMP-dependent BMP response element reporter expression. It also enhanced BMP-induced osteoblastic differentiation in muscle-derived C2C12 cells. Immunoprecipitation assay indicated that ANA interacts with Smad8. Thus, ANA is a suppressor of ectopic bone formation induced by BMP, and this inhibitory ANA activity is a part of the negative feedback regulation of BMP function.

  1. Heterotopic bone formation following total shoulder arthroplasty

    DEFF Research Database (Denmark)

    Kjaersgaard-Andersen, P.; Frich, Lars Henrik; Sjøbjerg, J.O.


    The incidence and location of heterotopic bone formation following total shoulder arthroplasty were evaluated in 58 Neer Mark-II total shoulder replacements. One year after surgery, 45% had developed some ectopic ossification. In six shoulders (10%) the ossifications roentgenographically bridged...... the glenohumeral and/or the glenoacromial space. There was no correlation between shoulder pain and the development of ossification. Shoulders with grade III heterotopic bone formation had a limited range of active elevation compared with shoulders without or with only a milder lesion. Men and patients...... with osteoarthritis of the shoulder joint were significantly disposed to the development of heterotopic bone. Heterotopic bone formation following total shoulder arthroplasty is frequent, but disabling heterotopic ossifications seem to be rare....

  2. Chondroblastoma of the patella with aneurysmal bone cyst. (United States)

    Tan, Honglue; Yan, Mengning; Yue, Bing; Zeng, Yiming; Wang, You


    Chondroblastoma of the patella is rare. Aneurysmal bone cysts, which develop from a prior lesion such as a chondroblastoma, are seldom seen in the patella. The authors report a case of a 36-year-old man who presented with 2 years of right knee pain without calor, erythema, pain on palpation, or abnormal range of motion. Radiological studies suggested aneurysmal bone cyst. The lesion was excised with curettage and the residual cavity filled with autogenous bone graft. Histopathology revealed chondroblastoma associated with a secondary aneurysmal bone cyst. In the follow-up period, the patient demonstrated normal joint activities with no pain. Normal configuration of the patella and bone union were shown on plain radiographs. The authors present a review of the literature of all cases of patellar chondroblastoma with aneurysmal bone cyst. This case is the 14th report of aneurysmal bone cyst arising in a chondroblastoma of the patella. According to the literature, computed tomography and magnetic resonance imaging are useful in the study of these lesions. The pathologic diagnosis is based on the presence of chondroblastoma and aneurysmal bone cyst. Treatment of this lesion includes patellectomy, curettage alone, and curettage with bone grafting. Despite the risk of recurrence of this lesion in the patella, the authors first recommend curettage followed by filling the cavity with bone graft. To protect the anterior tension of the patella intraoperatively, the bone window should be made at the medial edge of the patella to perform the curettage and bone grafting.

  3. Observation on the Therapeutic Effect of Chinese Medicine Combined Physical Therapy in the Treatment of Knee Joint Bone Hyperplasia%中药配合物理疗法治疗膝关节骨质增生的疗效观察

    Institute of Scientific and Technical Information of China (English)



    Objective To explore the effect of Chinese medicine combined physical therapy on the treatment of knee joint bone hyperplasia. Methods 80 patients were divided into two groups, control group used physical therapy, and observation group used Chinese medicine on the basis of control group. Results The total effective rate, HSS score, excellent rate, knee motion of observation group was significantly better than control group (P<0.05). Conclusion The effect of Chinese medicine combined physical therapy is ideal.%目的:探讨中药配合物理疗法治疗膝关节骨质增生的效果。方法随机将80例膝关节骨质增生患者平均分为两组,对照组给予物理疗法,观察组在对照组的基础上行中药治疗。结果观察组总有效率、HHS 评分及优良率、膝关节活动度等均明显优于对照组(P <0.05)。结论中药配合物理疗法治疗膝关节骨质增生效果理想。

  4. Interesting bone scans - unusual findings

    Energy Technology Data Exchange (ETDEWEB)

    Dobson, M.; Wadhwa, S.S.; Mansberg, R.; Fernandes, V.B. [Wollongong Hospital, Wollongong, NSW (Australia)


    A 59-year-old female with carcinoma of the colon and known liver metastatic disease was referred for bone scan to evaluate for bone metastases. Although no bone metastases were found, there was abnormal uptake noted in the liver corresponding to a metastatic calcified lesion. The only other findings were of degenerative disease in the cervical spine, right shoulder and small joints of the hands. A 69-year-old male with carcinoma of the prostate and right side low back pain was referred for bone scan. No focal abnormalities to suggest metastatic disease were identified; findings within the cervical spine, lumber spine and knees were presumed secondary to degenerative disease. Intermittent pain persisted and the patient was referred for a repeat bone scan six months later. Previous scan findings of degenerative disease and no metastatic disease were confirmed; however, closer inspection revealed an enlarged right kidney with significant retention of tracer in the pelvicalyceal system suggesting possible obstruction. A Retrograde pyelogram was performed, and no obvious obstruction demonstrated. As bone scan findings were very suggestive of obstruction, a DTPA scan with lasix was performed showing a dilated right collecting system with no functional obstruction. Given the degree of dilation, it is possible that the patient experiences intermittent PUJ obstruction causing his symptoms. A 33-year-old male with insulin dependent diabetes mellitus and viral arthritis was referred for a bone scan. A three phase revealed increased uptake in the region of the knee and leR proximal tibia. Delayed whole body images revealed multiple focal areas of osteoblastic activity in the leR tibia. Abnormal uptake was also seen in the upper third of the leR femur. The remainder of the skeletal survey was normal. X-ray correlation of the leR tibia and femoral findings was undertaken. Combinating unilateral changes on bone scan and X-ray although very suggestive of sclerotic polyostotic

  5. Osteonecrosis in the knee joint

    Energy Technology Data Exchange (ETDEWEB)

    Poeschl, M.


    The following forms are discussed: spontaneous osteonecrosis (Ahlbaeck's necrosis), which extends subchondrally into one of the femur condyles. It usually occurs in older patients, especially females. Blunt trauma may cause similar lesions. These often occur with cartilage and bone avulsions (flake fractures), which are often diagnosed much later (arthroscopy). Patellar chondropathy is increasing in frequency due to more intensive participation in sports. Pain localized at the apex of the patella (patellar apex syndrome) can develop from chondropathy, tendon lesions or primary juvenile necrosis of the patellar apex. Gas emboli occur near the knee joint during deep sea diving. Similar cartilage infarctions are seen in many hemoglobinopathies. The incidence of this is increasing due to the increased number of people immigrating from regions where these diseases are common. We have also observed vascular juvenile lesions of the epi- and metaphyses in Klippel-Trenaunay-Weber's syndrome. Their radiological appearance is similar to that of necroses.

  6. Dating of cremated bones

    NARCIS (Netherlands)

    Lanting, JN; Aerts-Bijma, AT; van der Plicht, J; Boaretto, E.; Carmi, I.


    When dating unburnt bone, bone collagen, the organic fraction of the bone, is used. Collagen does not survive the heat of the cremation pyre, so dating of cremated bone has been considered impossible. Structural carbonate in the mineral fraction of the bone, however, survives the cremation process.

  7. Clinical Observation on Early Treatment of Multiple Injuries of Bone and Joint with the Combination of Xue Fu Zhu Yu Tang and Injury Control%血府逐瘀汤联合损伤控制技术早期救治骨关节多发伤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    王旭光; 初海滨; 鞠传宝


    Objective To sum up the curative effect of the early treatment of bone and joint injury by the combination of Xue Fu Zhu Yu Tang and injury control technology. Methods Our hospital between January 2014 and December 2015 were treated 112 cases of joint multiple trauma patients as the research object of this experiment, according to the double blind method will be involved in the study of patients, divided into two different groups, two groups of patients the appellation of the control group respectively, and the team, each group of 56 patients, control group patients use the conventional methods for treatment, the team is to provide patients with therapeutic and the combined treatment of damage control technology. Results After the operation, the team with the total effective was 96.43%, signiifcantly higher than control group in patients with 85.71%, the comparison between the two groups, data signiifcant difference (P<0.05).Patients in the study group were pain stop time, swelling clearance time and hospitalization time were less than the control group patients, the difference between the groups was signiifcant. Conclusion The combination of Xue Fu Zhu Yu Tang and the therapeutic joint damage control technology in the early treatment polytrauma curative effect is obvious, bone can be promoted.%目的:总结血府逐瘀汤联合损伤控制技术早期救治骨关节多发伤的疗效。方法选取本院2014年1月至2015年12月收治的112例骨关节多发伤患者作为本次实验的研究对象,根据双盲法将参与研究的患者,分为两个不同的组别,两组患者的称谓分别为对照组以及研究组,每组各56例患者,对照组的患者使用常规的方法进行治疗,研究组则为患者提供血府逐瘀汤以及损伤控制技术的联合治疗。结果手术后,研究组患者的总有效为96.43%,明显高于对照组患者的85.71%,两组间比较,数据差异显著,(P<0.05)。研究组患者疼痛停止时

  8. 肿瘤型假体置换治疗近关节部位骨巨细胞瘤37例临床分析%Tumor-type prosthesis replacement for treatment of giant cell tumors of bone near the joints

    Institute of Scientific and Technical Information of China (English)

    陈飚; 王全; 赵春和; 张长明; 李勇; 蒋曦


    目的 评价肿瘤型假体置换治疗近关节部位骨巨细胞瘤(GCT)的疗效.方法 1998年1月至2008年1月收治近关节部位GCT 37例.股骨远端23例,胫骨近端10例,肱骨近端3例,股骨近端1例.Companacci分级,Ⅱ级9例,Ⅲ级28例.所有患者行瘤段切除、肿瘤型假体置换治疗.术后采用MsTS 93评分系统进行功能评价.结果 随访2~9年,1例术后2年3个月肿瘤局部复发,1例接受截肢手术.1例假体感染,2例假体松动.术后3年MSTS 93评分系统评分平均为(22.49±5.16)分.肢体功能评估优良率为89.2%(33/37).结论 肿瘤型假体置换是近关节部位GCT减少复发、重建功能的一种有效方法.%Objective To assess the clinical effect of tumor-type prosthesis replacement for treatment of giant cell tumors of bone near the joints. Methods Thirty-seven patients with giant cell tumors of bone near the joints from January 1998 to January 2008 were reviewed. 18 were males and 19 were females. The ages ranged from 19 to 64 and the median age was 32 years old. The anatomic site of the lesions spreaded at distal femur(23 cases) , proximal tibia(10 cases),proximal humerus(3 cases) and proximal femur(1 case). According to Companacci's staging system: 9 patients were classified as grade II and 28 as grade Ⅲ. All patients had been treated with block excision and reconstruction with prosthesis. The functional outcomes were evaluated by MSTS 93 score. Results According to the follow-up for 2 -9 years,1 patient (4. 3% ) had local recurrence and underwent amputation of the diseased limb. As for the complications, periprosthesis infection occurred in 1 patient, prosthesis loosening in 2 patients. The average MSTS 93 score was 22. 49 ±5. 16 in 3 years after surgery. The evaluated functional result revealed excellent or good performance in 89. 2% of the patients. Conclusions Tumor-type prosthesis replacement is an effective procedure to reduce the local recurrence,and to restore joint function.

  9. Iliacus pyomyositis mimicking septic arthritis of the hip joint. (United States)

    Chen W-S; Wan Y-L


    The iliacus muscle is closely associated with the psoas muscle, femoral nerve, hip joint, pelvic and intraabdominal structures; thus, its disorders may present as lower abdominal pain, hip pain, or femoral neuropathy. Iliacus pyomyositis, a primary bacterial infection of the skeletal muscle not secondary to a contiguous skin, bone, or soft-tissue infection, presenting as hip pain, femoral neuropathy, and sympathetic effusion of the hip joint in an 8-year-old boy mimicked septic arthritis of the hip joint. Computed tomography was helpful in delineating the accurate location of the lesion. Surgical drainage and appropriate antibiotic therapy led to complete resolution and full functional recovery.

  10. Cytokine-Mediated Bone Destruction in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Seung Min Jung


    Full Text Available Bone homeostasis, which involves formation and resorption, is an important process for maintaining adequate bone mass in humans. Rheumatoid arthritis (RA is an autoimmune disease characterized by inflammation and bone loss, leading to joint destruction and deformity, and is a representative disease of disrupted bone homeostasis. The bone loss and joint destruction are mediated by immunological insults by proinflammatory cytokines and various immune cells. The connection between bone and immunity has been intensely studied and comprises the emerging field of osteoimmunology. Osteoimmunology is an interdisciplinary science investigating the interplay between the skeletal and the immune systems. The main contributors in osteoimmunology are the bone effector cells, such as osteoclasts or osteoblasts, and the immune cells, particularly lymphocytes and monocytes. Physiologically, osteoclasts originate from immune cells, and immune cells regulate osteoblasts and vice versa. Pathological conditions such as RA might affect these interactions, thereby altering bone homeostasis, resulting in the unfavorable outcome of bone destruction. In this review, we describe the osteoclastogenic roles of the proinflammatory cytokines and immune cells that are important in the pathophysiology of RA.

  11. Results of Chiari pelvic osteotomy for acetabular dysplasia in adults; Association with bone scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Nobuo; Ozono, Kenji; Sugano, Nobuhiko; Takaoka, Kunio; Ono, Hiroo (Osaka Univ. (Japan). Faculty of Medicine)


    In an attempt to determine indications of Chiari pelvic osteotomy in acetabular dysplasia, postoperative outcome of hip joint (64 joints) was examined on the basis of findings of bone scintigraphy. The subjects were 61 patients with osteoarthrosis of hip joint who underwent preoperative bone scintigraphy. The follow-up period ranged from 2 years to 9 years and 7 months with a mean of 4 years and 9 months. According to X-ray findings, 37 osteoarthrosis joints were staged as early and 27 as progressive. Preoperative bone scintigraphic findings fell into three: (I) normal or slight hot type (33 joints), (II) hot type at the weighting part (16 joints), and (III) double hot type in the weighting part and inside part (15 joints). None of the patients had severe surgical complications such as deep-seated infection, neuroparalysis and pseudojoint. According to the clinical staging for hip joint function, 7 (47%) of 64 joints were judged as poor after osteotomy, belonging to type III. Deterioration of osteoarthrosis was seen in 11 joints (41%) on X-ray films. Of these, 9 had type III. In conclusion, Chiari pelvic osteotomy should not be indicated when type III is shown on bone scintigrams. (N.K.).

  12. Acute neuropathic joint in diabetic foot: Plain radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Dae Young; Kang, Heung Sik; Sim, Jung Suk; Yoon, Yong Kyu; Kim, Chu Wan [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    To determine the plain film findings of acute neuropathic joint in diabetic foot. Acute neuropathic joint in diabetic foot was considered when fragmentation of the articular ends of bone and subluxation of the affected joint developed within eight weeks after clinical onset of diabetic gangrene. Eight toes of six diabetics were satisfactory to our criteria. We analyzed plain radiographic findings of the affected joint and soft tissue, interval changes in followed-up radiographs, and deformities after healing. The time interval between clinical onset of gangrene and bone destruction ranges from 2 weeks to 4 weeks(mean 2.6 weeks). Plane radiographs showed fragmentation of the articular ends, subluxation, and soft tissue swelling of the metatarsophalangeal joint or interphalangeal joint. The significant feature of these patients was rapid progression of the lesions. Clinically, all patients had diabetic gangrene in affected toes, however, there was no evidence of osteomyelitis in our series. Amputation was done in 2 cases, and lesions in 3 of the remaining 4 cases were repaired spontaneously with regression of gangrene, leaving radiological residua such as pointed-end, tapered-end, and ball and socket deformity. Rapid disorganisation of the joint with associated evidence of soft tissue gangrene in plain radiograph is believed to be valuable for the diagnosis of diabetic osteoarthropathy.

  13. Isolated Facet Joint Fracture as a Cause of Chronic Low Back Pain and Sciatica

    Directory of Open Access Journals (Sweden)

    Robert W Teasell


    Full Text Available A case of facet joint fracture following a rear-end motor vehicle accident who presented with chronic low back pain and sciatica is outlined. Diagnosis was made with 99Tc nuclear bone scan and was confirmed on computed tomographic scan after diagnosis with regular radiographs had failed. Facetectomy relieved pain but led to symptoms related to asymmetric load on the opposite facet joint. Symptoms were substantially relieved with a facet joint deinnervation procedure. Facet joint fracture was felt to occur as a consequence of compression forces on the facet joint at the time of impact.

  14. Distal interphalangeal joint implant arthroplasty in a musician. (United States)

    Schwartz, D A; Peimer, C A


    Degenerative joint disease commonly affects the distal interphalangeal (DIP) joints, causing articular destruction and marginal bone formation. Treatment for pain relief and function is most often done through arthrodesis. The case of a 70-year-old concert violinist with left index finger DIP joint osteoarthritis is presented. Arthritis in the involved joint caused pain and deformity and interfered with the patient's ability to play music. Trial arthrodesis with K-wires proved impossible because of the patient's need for continued mobility. Swanson hinge implant arthroplasty was performed on the affected DIP joint. The patient eventually achieved an excellent result and was able to return to playing the violin professionally. Treatment and therapy guidelines are presented.

  15. Smoking and Bone Health (United States)

    ... supported by your browser. Home Bone Basics Lifestyle Smoking and Bone Health Publication available in: PDF (85 ... late to adopt new habits for healthy bones. Smoking and Osteoporosis Cigarette smoking was first identified as ...

  16. 21 CFR 888.3790 - Wrist joint metal constrained cemented prosthesis. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint metal constrained cemented prosthesis... constrained cemented prosthesis. (a) Identification. A wrist joint metal constrained cemented prosthesis is a... as cobalt-chromium-molybdenum, and is limited to those prostheses intended for use with bone...

  17. Automatic joint alignment measurements from pre- and post-operative long leg standing radiographs

    NARCIS (Netherlands)

    Goossen, A.; Weber, G.M.; Dries, S.P.M.


    Objectives: For diagnosis or treatment assessment of knee joint osteoarthritis it is required to measure bone morphometry from radiographic images. We propose a method for automatic measurement of joint alignment from pre-operative as well as post-operative radiographs.Methods: In a two step approac

  18. Evidence of cartilage repair by joint distraction in a canine model of osteoarthritis

    NARCIS (Netherlands)

    Wiegant, Karen; Intema, Femke; Van Roermund, Peter M.; Barten-Van Rijbroek, Angelique D.; Doornebal, Arie; Hazewinkel, Herman A W; Lafeber, Floris P J G; Mastbergen, Simon C.


    Objective. Knee osteoarthritis (OA) is a degenerative joint disorder characterized by cartilage, bone, and synovial tissue changes that lead to pain and functional impairment. Joint distraction is a treatment that provides long-term improvement in pain and function accompanied by cartilage repair, a

  19. Diagnostic flowcharts in osteomyelitis, spondylodiscitis and prosthetic joint infection

    NARCIS (Netherlands)

    Jutte, P.; Lazzeri, E.; Sconfienza, L. M.; Cassar-Pullicino, V.; Trampuz, A.; Petrosillo, N.; Signore, A.


    Infections of the bone, spine and prosthetic joints are serious and complex conditions to diagnose and to treat. Structured diagnostic workup may very well improve the accuracy and speed of diagnosis, thereby improving the outcome since treatment may very well be more successful and less harmful if

  20. Current topics in the radiology of joint replacement surgery

    Energy Technology Data Exchange (ETDEWEB)

    Weissman, B.N. (Harvard Medical School, Boston, MA (USA))


    Several methods of total hip joint replacement are currently used. Radiographic appearances after cemented, bone ingrowth, press-fit, and bipolar hip prostheses are reviewed. The roles of nuclear medicine and arthrographic procedures for identifying complications are discussed. Total knee prostheses and, in particular, complications related to the patellar component are described.115 references.

  1. Adaptive scapula bone remodeling computational simulation: Relevance to regenerative medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Gulshan B., E-mail: [Emory University, Department of Radiology and Imaging Sciences, Spine and Orthopaedic Center, Atlanta, Georgia 30329 (United States); University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213 (United States); University of Calgary, Schulich School of Engineering, Department of Mechanical and Manufacturing Engineering, Calgary, Alberta T2N 1N4 (Canada); Robertson, Douglas D., E-mail: [Emory University, Department of Radiology and Imaging Sciences, Spine and Orthopaedic Center, Atlanta, Georgia 30329 (United States); University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213 (United States)


    Shoulder arthroplasty success has been attributed to many factors including, bone quality, soft tissue balancing, surgeon experience, and implant design. Improved long-term success is primarily limited by glenoid implant loosening. Prosthesis design examines materials and shape and determines whether the design should withstand a lifetime of use. Finite element (FE) analyses have been extensively used to study stresses and strains produced in implants and bone. However, these static analyses only measure a moment in time and not the adaptive response to the altered environment produced by the therapeutic intervention. Computational analyses that integrate remodeling rules predict how bone will respond over time. Recent work has shown that subject-specific two- and three dimensional adaptive bone remodeling models are feasible and valid. Feasibility and validation were achieved computationally, simulating bone remodeling using an intact human scapula, initially resetting the scapular bone material properties to be uniform, numerically simulating sequential loading, and comparing the bone remodeling simulation results to the actual scapula’s material properties. Three-dimensional scapula FE bone model was created using volumetric computed tomography images. Muscle and joint load and boundary conditions were applied based on values reported in the literature. Internal bone remodeling was based on element strain-energy density. Initially, all bone elements were assigned a homogeneous density. All loads were applied for 10 iterations. After every iteration, each bone element’s remodeling stimulus was compared to its corresponding reference stimulus and its material properties modified. The simulation achieved convergence. At the end of the simulation the predicted and actual specimen bone apparent density were plotted and compared. Location of high and low predicted bone density was comparable to the actual specimen. High predicted bone density was greater than

  2. Biologic resurfacing of the patella bone versus patellectomy

    Directory of Open Access Journals (Sweden)

    Motamedi M


    Full Text Available In the past years, there was a tendency to excise the patella in pathologic conditions affecting this bone. The patella has many critical effects in the function of the knee joint. For example, after its exicision the force of quadriceps muscle decreases by forty percent (40% and the knee joint becomes prone to early osteoarthritic changes. For these reasons, in the recent years the "biologic resurfacing of patella" has been used in pathologic conditions instead of its complete removal. In this new method after resection of the diseased part of the bone, the fascia of the quadriceps muscle, with its intact base, is used to cover the resected part of the bone. In practice, after pain relief, the active motion of the joint is started. Then the limb is placed in a splint or brace and after a period of 3 weeks, passive motion is begun.

  3. Bioreactor cultivation of anatomically shaped human bone grafts. (United States)

    Temple, Joshua P; Yeager, Keith; Bhumiratana, Sarindr; Vunjak-Novakovic, Gordana; Grayson, Warren L


    In this chapter, we describe a method for engineering bone grafts in vitro with the specific geometry of the temporomandibular joint (TMJ) condyle. The anatomical geometry of the bone grafts was segmented from computed tomography (CT) scans, converted to G-code, and used to machine decellularized trabecular bone scaffolds into the identical shape of the condyle. These scaffolds were seeded with human bone marrow-derived mesenchymal stem cells (MSCs) using spinner flasks and cultivated for up to 5 weeks in vitro using a custom-designed perfusion bioreactor system. The flow patterns through the complex geometry were modeled using the FloWorks module of SolidWorks to optimize bioreactor design. The perfused scaffolds exhibited significantly higher cellular content, better matrix production, and increased bone mineral deposition relative to non-perfused (static) controls after 5 weeks of in vitro cultivation. This technology is broadly applicable for creating patient-specific bone grafts of varying shapes and sizes.

  4. Percutaneous CT-Guided Treatment of Osteochondritis Dissecans of the Sacroiliac Joint

    Energy Technology Data Exchange (ETDEWEB)

    Becce, Fabio, E-mail: [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland); Mouhsine, Elyazid [Clinique Hirslanden Bois-Cerf, Department of Orthopaedic Surgery (Switzerland); Mosimann, Pascal John; Anaye, Anass [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland); Letovanec, Igor [University Institute of Pathology, Centre Hospitalier Universitaire Vaudois (Switzerland); Theumann, Nicolas [University of Lausanne, Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois (Switzerland)


    Osteochondritis dissecans (OCD) is a joint disorder that affects the articular cartilage and subchondral bone, most commonly at the knee. OCD of the sacroiliac joint is extremely rare. Management of OCD remains controversial, and surgery is often needed, especially when conservative treatment fails. We present a rare case of OCD involving the left sacroiliac joint successfully treated by percutaneous computed tomography-guided retrograde drilling and debridement.

  5. 18F-NaF PET-CT与血清肿瘤标志物联合检测对肺癌骨转移早期诊断的价值%Value of 18F-NaF PET-CT and serum tumor markers in the joint detection of bone metastases in recently diagnosed lung cancer patients

    Institute of Scientific and Technical Information of China (English)

    王明霜; 周凡; 甘西伦; 谭蓓蓓


    目的:探讨18F-NaF PET-CT与血清肿瘤标志物CEA、CYFRA21-1、NSE联合检测对肺癌骨转移患者早期诊断的临床意义。方法:选取46例来我院就诊,通过临床、CT、MRI等确诊为肺癌骨转移患者,分别于行18F-NaF PET-CT检查同时采取静脉血行血清CEA、CYFRA21-1、NSE检测,得到的最终诊断进行比较,分析两种检查联合检测在肺癌骨转移患者早期诊断中的临床意义。结果:46例患者18F-NaF PET-CT检查的SUVmax平均值为8.81±4.54,CEA平均值为37.45±42.57,CYFRA21-1平均值为32.30±42.66,NSE平均值为50.12±38.45。46例阳性患者,18F-NaF PET-CT检查出44例,灵敏度为93.40%,特异性为91.37%,准确性为93.50%;三种血清肿瘤标志物联合检测诊断肺癌的灵敏度分别为83.49%,特异性为70.52%,准确性为90.99%;两种检查联合诊断的灵敏度为96.85%,特异性为97.43%,准确性为98.33%。结论:18F-NaF PET-CT对肺癌骨转移早期患者诊断的灵敏度和准确性较血清CEA、CYFRA21-1、NSE检测高,但血清CEA、CYFRA21-1、NSE对其诊断也具有一定的价值,对前者检查可以起到协助补充的作用,两者联合应用对于肺癌骨转移早期患者的早期诊断具有重要的临床意义。%ObjectiveTo explore the joint detection value of 18F-NaF PET-CT and serum CEA,CYFRA21-1,and NSE in the diagnosis of bone metastases in recently diagnosed lung cancer patients. Methods46 cases of confirmed bone metastases of recently diagnosed lung cancer were selected, 18F-NaF PET-CT and serum CEA, CYFRA21-1,and NSE detection were performed at the same time, and their value in early detecting the bone metastasis was studied. Results In 46 cases, the SUV max of 18F-NaF PET-CT was 8.81 ± 4.54, serum CEA was 37.45±42.57,serum CYFRA21-1 was 32.30±42.66, seram NSE was 50.12±38.45. The sensitivity of 18F-NaF PET - CT examination was 93.40%, specificity was 91.37%, the diagnostic accuracy was 93

  6. Bone development

    DEFF Research Database (Denmark)

    Tatara, M.R.; Tygesen, Malin Plumhoff; Sawa-Wojtanowicz, B.


    The objective of this study was to determine the long-term effect of alpha-ketoglutarate (AKG) administration during early neonatal life on skeletal development and function, with emphasis on bone exposed to regular stress and used to serve for systemic changes monitoring, the rib. Shropshire ram...... lambs were randomly assigned to two weight-matched groups at birth. During the first 14 days of life AKG was administered orally to the experimental group (n=12) at the dosage of 0.1 g/kg body weight per day, while the control group (n=11) received an equal dose of the vehicle. Lambs were slaughtered...... has a long-term effect on skeletal development when given early in neonatal life, and that changes in rib properties serve to improve chest mechanics and functioning in young animals. Moreover, neonatal administration of AKG may be considered as an effective factor enhancing proper development...

  7. Managing Joint Production Motivation

    DEFF Research Database (Denmark)

    Lindenberg, Siegwart; Foss, Nicolai Juul


    We contribute to the microfoundations of organizational performance by proffering the construct of joint production motivation. Under such motivational conditions individuals see themselves as part of a joint endeavor, each with his or her own roles and responsibilities; generate shared represent...... representations of actions and tasks; cognitively coordinate cooperation; and choose their own behaviors in terms of joint goals. Using goal-framing theory, we explain how motivation for joint production can be managed by cognitive/symbolic management and organizational design.......We contribute to the microfoundations of organizational performance by proffering the construct of joint production motivation. Under such motivational conditions individuals see themselves as part of a joint endeavor, each with his or her own roles and responsibilities; generate shared...

  8. Chondromyxoid fibroma of the clavicle extending to the adjacent joint: a case report. (United States)

    Aggarwal, Aditya; Bachhal, Vikas; Soni, Ashwani; Rangdal, Sushil


    Chondromyxoid fibroma is a rare benign bone tumour usually involving bones of the lower extremity in young adults. We present a case of chondromyxoid fibroma of the left clavicle extending to the adjacent joint in a 84-year-old man. The tumour had breached the hyaline cartilage of acromioclavicular joint. The tumour was excised en bloc, and the humeral head was curetted and grafted with autogenous cancellous bone. Postoperatively, the patient had an uneventful recovery and regained excellent function of the left shoulder without any pain or stiffness. At the 18-month follow-up, there was no sign of recurrence.

  9. Jointly Poisson processes

    CERN Document Server

    Johnson, D H


    What constitutes jointly Poisson processes remains an unresolved issue. This report reviews the current state of the theory and indicates how the accepted but unproven model equals that resulting from the small time-interval limit of jointly Bernoulli processes. One intriguing consequence of these models is that jointly Poisson processes can only be positively correlated as measured by the correlation coefficient defined by cumulants of the probability generating functional.

  10. Joint Program Management Handbook (United States)


    the Engieermg and Manufacuring Devopment Phase. Nfilestoae HI- Develommen Annros Devopment approval marks a significant step for any program, but it review concept formulaton. Systems Engilneertn As with service programs, systems engineering in joint program management is an essential tool . I...MANAGEMENT HANDBOOK On=e wd Umawtaiutt As discussed in Chapter 7, systems analysis of relationships is a usef tool for joint program managers. The joint

  11. [Modelling of the knee joint loading conditions in the view of mechanics]. (United States)

    Pustovoĭt, K B; Karpins'kyĭ, M Iu


    The results of mathematic modelling of work of femoropatellar joint in normal conditions and in the presence of dysplastic deformity were adduced. There was established, that a knee joint (KJ) by its external appearance and function constitutes a classic cam mechanism. Biomechanical scheme of interaction between the femoral bone processus and patella was elaborated. In accordance to scheme of cam mechanism its experimental roentgenometric investigations were performed. According to statistical analysis performed, in conditions of dysplasia in femoropatellar joint the changes in the KJ occur, which may cause its blockade; the patella position in the KJ depends on peculiarities of anatomical structure of the femoral bone processuses.

  12. Temporal bone chondroblastoma totally invisible on MRI. (United States)

    Hiraumi, Harukazu; Arakawa, Yoshiki; Yamamoto, Norio; Sakamoto, Tatsunori; Ito, Juichi


    We report a case of temporal bone chondroblastoma that was totally invisible on MRI. The patient was a 64-year-old man who presented with several months history of vertigo. The CT scan with bone window setting showed destruction of the temporomandibular joint, the floor of the middle cranial fossa, and the superior semicircular canal. Calcific foci were seen within the tumor. On MR imaging, the tumor, situating mainly medial to the temporomandibular joint, showed no signal on both T1- and T2-weighted images. The tumor was not enhanced with gadolinium. In summary, the tumor was totally signal negative or "invisible" on pre- and postcontrast T1- and T2-weighted images. The tumor was resected through transpetrosal - transzygomatic approach.

  13. Surgical treatment and outcomes of temporal bone chondroblastoma. (United States)

    Moon, In Seok; Kim, Jin; Lee, Ho-Ki; Lee, Won-Sang


    Chondroblastoma is an uncommon primary benign bone tumor that usually arises in the epiphyses of the long bones. Temporal bone chondroblastoma is a rare primary bone tumor that affects the floor of the middle cranial fossa and temporomandibular joint (TMJ). The biological nature of temporal bone chondroblastoma is occasionally aggressive because of local invasion and is known to have a high recurrence after curettage. Therefore, complete resection is recommended. However, the literature provides little information regarding long-term surgical outcomes and complications after surgical resection. The authors have retrospectively analyzed four cases of temporal bone chondroblastoma that had been completely excised by a single surgeon with an eventual long-term follow-up. A single surgeon operated on four patients, two males and two females, with a mean age of 34 years, at the Department of Otorhinolaryngology, Severance Hospital. In all cases, the tumor involved the middle cranial fossa dura and the mandibular fossa with variable degree of infiltration. All patients have had no tumor recurrence to date (mean follow-up period of 5 years). Complete surgical resection of the temporal bone chondroblastoma is the gold standard for treatment. Precise preoperative image evaluation of tumor extension and proper management of the dura mater and temporomandibular joint (TMJ) are the major important features in complete surgical removal that minimize complications in temporal bone chondroblastoma treatment.

  14. The Effect of changes in the Temporomandibular joint blood supply on glyco saminoglycans of the rabbit condylar cartilage and development of bone and joint disease%颞下颌关节血供变化对软骨内氨基多糖及骨关节病发生的影响

    Institute of Scientific and Technical Information of China (English)

    丁桂聪; 李宏礼; 张国志


    目的观察颞下颌关节血流减少对关节软骨中氨基多糖(GAG)的影响。方法经兔一侧颈外动脉位注射硬化剂,减少该侧关节的血流量。应用组织化学方法观察关节软骨GAG的变化。结果血流减少使软骨GAG含量降低,随时间延长,GAG逐渐增加。结论颞下颌关节血流减少可引起软骨内GAG降低,这可能在颞下颌关节的骨关节病发生上起重要作用。%Objective The purpose of this study was to investigate the effect of blood supply decrease on glycosaminoglycans(GAG)of the cartilage in the temporomandibular joint(TMJ) . Method Four rabbits were used as controls, and 16 rabbits were injected 5% sodirm morrhumate through carotid artery unilaterlally. All specimens were examimined histochemically. Result A reduction in alcian(AB) blue staining was observed after operation, a gradual increase in AB staining with blood supply restoration of TMJ tissue was observed. Conclusion The result suggests that the decrease in blood supply of the temporomnandibular jorint leads to the loss of GAG in the condylar cartilage, which may play an important role in pathogenesis of osteoarthrosis.

  15. Combined bilateral idiopathic necrosis of the humerus and femur heads: Bone scan, X-ray, CT, and MRI findings. Kombinierte beidseitige idiopathische Nekrose der Humerus- und Femurkoepfe: Skelettszintigraphie, Roentgen-, CT- und MRT-Befunde

    Energy Technology Data Exchange (ETDEWEB)

    Piepenburg, R.; Hahn, K. (Mainz Univ. (Germany). Klinik fuer Nuklearmedizin); Doll, G. (Mainz Univ. (Germany). Klinik fuer Roentgendiagnostik); Grimm, J. (Mainz Univ. (Germany). Orthopaedische Klinik)


    Untreated aseptic bone necroses close to a joint commonly leads to severe secondary arthrosis and destruction of the joint within a short time. Therefore, only a diagnosis in an early stage of the disease offers the chance of a successful joint- preserving therapy. In cases of clinically suspected aseptic bone necrosis but still negative or doubtful X-ray findings, bone scans or MRI are reliable methods of verifying the diagnosis. (orig./MG).

  16. Human Bone Matrix Changes During Deep Saturation Dives (United States)


    agreement notwithstanding, much remains unknown about its pathogenesis, prevention, and treatment . DON is currently disqualifying for U.S. Navy divers...recourse for symptomatic treatment is surgical joint replacement.7 The principal mechanism of bone injury is generally accepted to be bubble formation...urine concentrations of Ntx have been demonstrated in bone diseases such as osteoporosis, primary hyperthyroidism , and Paget’s disease. Also

  17. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi


    Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

  18. Orchestration of bone remodeling

    NARCIS (Netherlands)

    Moester, Martiene Johanna Catharina


    In healthy individuals, a balance exists between bone formation and resorption. Disruption of this balance can lead to higher or lower bone mass, and disease such as osteoporosis. Treatment for osteoporosis generally inhibits bone resorption, but does not rebuild bone to a healthy strength. More kno

  19. Bone grafts in dentistry

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar


    Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

  20. Bone Marrow Diseases (United States)

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains stem cells. The stem cells can ... the platelets that help with blood clotting. With bone marrow disease, there are problems with the stem ...

  1. Mechanism of estrogen and estrogen-related compounds in osteoarthritis:joint protection and repair of bone cartilage cells%雌激素及相关化合物干预骨关节炎作用机制:关节保护与骨软骨细胞的修复

    Institute of Scientific and Technical Information of China (English)

    王健; 陶海荣


    背景:雌激素通过成骨细胞、破骨细胞、细胞分泌的因子,以及多条骨代谢调控途径参与了骨关节炎骨代谢的调控。  目的:综合阐述雌激素及雌激素相关化合物在关节保护、骨与软骨细胞的修复、滑膜炎症的抑制等方面对骨关节炎的作用。  方法:作者检索1992至2014年PubMed、Embase、Elseveir数据库文献。检索词为:“Osteoarthritis, Estrogens,Matrix Metal oproteinases,Interleukins,Tumor Necrosis Factor-alpha”。按照事先制定的标准逐一评价纳入研究的文献,提取有效资料进行综合分析。  结果与结论:雌激素可通过增加成骨细胞中骨保护素和核因子κB受体活化因子配体的表达,抑制破骨性骨吸收,防止骨关节炎的发生和进展。雌激素能上调抗破骨细胞的细胞因子,而下调亲破骨细胞的细胞因子,通过Wnt与骨形态发生蛋白信号系统也参与骨关节炎患者骨代谢的调控。雌激素可以通过下丘脑-垂体-肾上腺轴的作用促进肾上腺皮质分泌糖皮质激素,从而间接抑制基质金属蛋白酶类的产生,对关节软骨起到保护作用。外源性雌激素通过抑制骨的吸收可能会有助于延缓骨关节炎的发展。雌激素和雌激素相关的化合物在骨关节炎进展的后期阶段可能会抑制滑膜炎症和炎症递质导致的软骨流失。%BACKGROUND:The bone metabolism of osteoarthritis is regulated by estrogen with osteoblasts, osteoclasts and cytokines, as wel as a number of regulatory pathways. OBJECTIVE:To describe the role of estrogen and estrogen-related compounds for joint protection, repair of bone and cartilage cells, and inhibition of synovitis in osteoarthritis. METHODS:Author researched PubMed, Embase, Elseveir database from 1992 to 2014, with the key words of“osteoarthritis, estrogens, matrix metal oproteinases, interleukins, tumor necrosis factor-alpha”. After the quality

  2. Mechanics of Sheeting Joints (United States)

    Martel, S. J.


    Physical breakdown of rock across a broad scale spectrum involves fracturing. In many areas large fractures develop near the topographic surface, with sheeting joints being among the most impressive. Sheeting joints share many geometric, textural, and kinematic features with other joints (opening-mode fractures) but differ in that they are (a) discernibly curved, (b) open near the topographic surface, and (c) form subparallel to the topographic surface. Where sheeting joints are geologically young, the surface-parallel compressive stresses are typically several MPa or greater. Sheeting joints are best developed beneath domes, ridges, and saddles; they also are reported, albeit rarely, beneath valleys or bowls. A mechanism that accounts for all these associations has been sought for more than a century: neither erosion of overburden nor high lateral compressive stresses alone suffices. Sheeting joints are not accounted for by Mohr-Coulomb shear failure criteria. Principles of linear elastic fracture mechanics, together with the mechanical effect of a curved topographic surface, do provide a basis for understanding sheeting joint growth and the pattern sheeting joints form. Compressive stresses parallel to a singly or doubly convex topographic surface induce a tensile stress perpendicular to the surface at shallow depths; in some cases this alone could overcome the weight of overburden to open sheeting joints. If regional horizontal compressive stresses, augmented by thermal stresses, are an order of magnitude or so greater than a characteristic vertical stress that scales with topographic amplitude, then topographic stress perturbations can cause sheeting joints to open near the top of a ridge. This topographic effect can be augmented by pressure within sheeting joints arising from water, ice, or salt. Water pressure could be particularly important in helping drive sheeting joints downslope beneath valleys. Once sheeting joints have formed, the rock sheets between

  3. Bone Health and Osteoporosis. (United States)

    Lupsa, Beatrice C; Insogna, Karl


    Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitable consequence of the decrease in estrogen levels during and following menopause, but additional risk factors for bone loss can also contribute to osteoporosis in older women. A well-balanced diet, exercise, and smoking cessation are key to maintaining bone health as women age. Pharmacologic agents should be recommended in patients at high risk for fracture.

  4. Conversion of failed ankle arthroplasty to an arthrodesis. Technique using an arthrodesis nail and a cage filled with morsellized bone graft.

    NARCIS (Netherlands)

    Bullens, P.H.J.; Waal Malefijt, M.C. de; Louwerens, J.W.


    Arthrodesis of the ankle joint after a failed ankle prosthesis is most often demanding because of bone loss. The bone loss is also responsible for limb length discrepancy. Intramedullary nail fixation has been described to be successful for arthrodesis of the arthritic ankle joint. We report the use


    Directory of Open Access Journals (Sweden)



    Full Text Available Osteopetrosis, a generalized developmental bone disease due to genetic disturbances, characterized by failure of bone re sorption and continuous bone formation making the bone hard, dense and brittle. Bones of intramembranous ossification and enchondrial ossification are affected genetically and symmetrically. During the process of disease the excess bone formation obliterates the cranial foramina and presses the optic, auditory and facial nerves resulting in defective vision, impaired hearing and facial paralysis. The bone formation in osteopetrosis affects bone marrow function leading to severe anemia and deficient of blood cells. The bone devoid of blood supply due to compression of blood vessels by excess formation of bone are prone to osteomyelitic changes with suppuration and pathological fracture if exposed to infection. Though the condition is chronic progressive, it produces changes leading to fatal condition, it should be studied thoroughly by everyone and hence this article presents a classical case of osteopetrosis with detailed description and discussion for the benefit of readers

  6. MR diagnosis of temporomandibular joint. A study of joint effusion

    Energy Technology Data Exchange (ETDEWEB)

    Kaneda, Takashi; Yamashiro, Mitsuaki; Ozawa, Kaoru; Suzuki, Hiromi; Okada, Hiroyuki; Yamamoto, Hirotsugu [Nihon Univ., Matsudo, Chiba (Japan). School of Dentistry


    The purposes of this study were to evaluate the relationship between correlation of MR joint effusion of the temporomandibular joint and disk position, to evaluate the relationship between joint effusion and aging, and to assess the frequency of MR joint effusion of bilateral temporomandibular joints. The temporomandibular joints of 192 patients with clinical symptoms of temporomandibular joint disorders were imaged bilaterally using high field, surface-coil MR imaging. Oblique sagittal and coronal proton density-weighted and T2-weighted images were obtained. Imaging findings of joint effusion were correlated with disk position, aging, and bilateral temporomandibular joints. MR showed effusion in 4% of the joints with normal superior disk position, 36% of the joints with disk displacement with reduction, and 45% of the joints with disk displacement without reduction. There were significant differences in the incidence of joint effusion between normal disk position and anterior disk displacement with or without reduction. Younger patients less than 40 years were significant higher the incidence of joint effusion than those of older patients. A significant association was seen between joint effusion and aging. MR showed effusion in 17% of the unilateral temporomandibular joint, 24% of the bilateral temporomandibular joints. There was no significant difference between unilateral and bilateral case. These results indicated that joint effusion using MR imaging was associated with varied temporomandibular joint pathologic states. (author)

  7. Early arthrosis of the digital joints

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, E.


    Arthrosis of the digital joints begins predominantly on the volar joint surface and the volar-proximal margin of the head. Because of this localisation, and in order to obtain adequate contrast and definition, these early changes are best shown by means of low R.V. radiographs in three views. The early changes consist of the following local processes: intrachondral sclerosis, exomarginal and endomarginal subchondral sclerosis, discreet increase in the spongiosa; this leads to disrounding and hooklike form of the head; thickening or disappearance of the sub-marginal spongiosa and marginal defects. Artifacts produced by the projections or local bone variants must be recognised, as well as diffuse idiopathic skeletal hyperostosis. 21 figs.

  8. Acromioclavicular Joint Separations (United States)


    Published online: 16 December 2012 # Springer Science+Business Media New York 2012 Abstract Acromioclavicular (AC) joint separations are common...injuries. The sports most likely to cause AC joint dislocations are football, soccer , hockey, rugby, and skiing, among others [9, 28, 29]. The major cause

  9. Etiology, pathophysiology and conservative management of degenerative joint disease

    Directory of Open Access Journals (Sweden)

    Jandrić Slavica


    Full Text Available Etiology of degenerative joint diseases Etiology of degenerative joint diseases is still not clearly understood and there is no specific management for this group of diseases. Various pathological conditions cause damage of the articular cartilage and lead to clinically and radiographically recognized impairment. Biomechanical, metabolic, genetic factors inflammation and other risk factors contribute to development of osteoarthrosis. Pathophysiology of degenerative joint diseases Osteoarthrosis is characterized by progressive erosion of articular cartilage and bone overgrowth at the joint margins. Cartilage integrity requires balance between synthesis and degradation of matrix components. Chondrocytes react to various mechanical and chemical stresses in order to stabilize and restore the tissue. Failures in stabilizing and restoring the tissue lead to cartilage degeneration that may be irreversibile. For better understanding of conservative management of degenerative joint diseases it is important to know the impact of pathophysiology mechanisms on development of degenerative joint diseases. There is great variability in the rate of progression of erosive processes in articular cartilage in clinical radiographic signs and course of the disease. This is in relation with many factors, as well as with management and response to therapy. Treatment of degenerative joint diseases Treatment should vary depending on the severity of disease and patient's expectations and level of activity. Besides analgesic and anti-inflammatory drugs, conventional and not conventional treatment and techniques can be used for management of osteoarthrosis. Physical therapy and exercises are very important for maintaining muscle strength, joint stability and mobility, but should be closely monitored for optimal efficacy.

  10. In Vivo Measurement of Glenohumeral Joint Contact Patterns

    Directory of Open Access Journals (Sweden)

    Bey MichaelJ


    Full Text Available The objectives of this study were to describe a technique for measuring in-vivo glenohumeral joint contact patterns during dynamic activities and to demonstrate application of this technique. The experimental technique calculated joint contact patterns by combining CT-based 3D bone models with joint motion data that were accurately measured from biplane x-ray images. Joint contact patterns were calculated for the repaired and contralateral shoulders of 20 patients who had undergone rotator cuff repair. Significant differences in joint contact patterns were detected due to abduction angle and shoulder condition (i.e., repaired versus contralateral. Abduction angle had a significant effect on the superior/inferior contact center position, with the average joint contact center of the repaired shoulder 12.1% higher on the glenoid than the contralateral shoulder. This technique provides clinically relevant information by calculating in-vivo joint contact patterns during dynamic conditions and overcomes many limitations associated with conventional techniques for quantifying joint mechanics.

  11. In Vivo Measurement of Glenohumeral Joint Contact Patterns (United States)

    Bey, Michael J.; Kline, Stephanie K.; Zauel, Roger; Kolowich, Patricia A.; Lock, Terrence R.


    The objectives of this study were to describe a technique for measuring in-vivo glenohumeral joint contact patterns during dynamic activities and to demonstrate application of this technique. The experimental technique calculated joint contact patterns by combining CT-based 3D bone models with joint motion data that were accurately measured from biplane x-ray images. Joint contact patterns were calculated for the repaired and contralateral shoulders of 20 patients who had undergone rotator cuff repair. Significant differences in joint contact patterns were detected due to abduction angle and shoulder condition (i.e., repaired versus contralateral). Abduction angle had a significant effect on the superior/inferior contact center position, with the average joint contact center of the repaired shoulder 12.1% higher on the glenoid than the contralateral shoulder. This technique provides clinically relevant information by calculating in-vivo joint contact patterns during dynamic conditions and overcomes many limitations associated with conventional techniques for quantifying joint mechanics.

  12. Multiscale Modeling of Bone (United States)


    DISEASE Both age and disease can affect the structure of bone, the effects of which are often similar. The most common bone disease is osteoporosis ... Osteoporosis is a disease that results in reduced bone mass and density. This reduction of bone mass and density has a greater impact on trabecular...Bone loss in females is linked to a decrease in estrogen ; the decrease of estrogen associated with menopause increases osteoclast activity [89]. This

  13. MRI of the internal derangement of temporomandibular joint: Comparison with arthrographic and operation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Hye; Kim, Dong Ik; Kim, Hyung Gon; Suh, Jung Ho; Jung, Tae Sub [Yonsei University College of Medicine, Seoul (Korea, Republic of)


    We retrospectively reviewed the MRI findings of 100 temporomandibular joints in 78 patients who had complained temporomandibular joint dysfunction. MRI findings were classified according to Wilke's staging criteria. And these findings were compared with arthographic findings in 22 joint and surgical findings in 44 joints. According to Wilke's staging, they were classified into 6 stages of abnormality: stage 0 (33 cases), stage I (19 cases), stage II (10 cases), stage III (18 cases), stage IV (6 cases), stage V (14 cases). Among the 22 cases in which arthography and MRI were done, both studies were well correlated in 10 joints. In 7 joints, MRI was superior to arthography, which correctly demonstrated the meniscal displacement in 2 joints and meniscal deformity in 5 joints. In 5 joints, arthography was superior to MR, which demonstrated the perforation (1 joint), adhesion (2 joints) and recapture of meniscus (2 joints). Compared with surgical findings, MRI correctly demonstrated the displacement of meniscus in all 44 joints. However, in case of the 10 meniscal perforation, MRI demonstrated the meniscal discontinuity in only 4 joints. Retrospective MR findings in 10 proven cases were the defect in posterior attachment in 4, far anterior meniscal displacement without recapture in 8, condylar spur in 4, and close bone to bone contact in 1. In conclusion, MRI as a primary diagnostic modality of temporomandibular joint derangement, is superior for the grading of displacement and deformity of meniscus but inferior for the evaluation of perforation, adhesion and recapture of meniscus to conventional arthrography. In case of the suspected meniscal perforation, arthrographic correlation is recommended preoperatively.

  14. Biochemical Markers of Joint Tissue Turnover

    DEFF Research Database (Denmark)

    Bay-Jensen, Anne-Christine; Sondergaard, Bodil Cecilie; Christiansen, Claus;


    Recent disappointments in late stage developments of anti-osteoarthritic drugs have reinforced efforts to develop better biomarkers for application in both the drug development process as well as in the routine management of these patients. Here we provide a brief review of biochemical tests...... available for the study of tissue turnover in each of the three compartments of the articular joint, that is the bone, the cartilage, and the synovium. Finally, we provide some perspective to future developments in biomarker discovery and discuss the potential impact such technologies could have on the drug...

  15. Jointness for the Rest of Us: Reforming Joint Professional Development (United States)


    service members for joint employment . Similar to their enlisted counterparts, the training, education and professional development of DOD civilian...the U.S. Armed forces sought by Congressional legislators and Defense leaders is not possible as long as joint education and training are limited to a...SUBJECT TERMS joint training, joint education , Goldwater Nichols Act, jointness, joint development reform analytics 16. SECURITY CLASSIFICATION OF

  16. Bone cysts: unicameral and aneurysmal bone cyst. (United States)

    Mascard, E; Gomez-Brouchet, A; Lambot, K


    Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy.

  17. Effect of landing height on frontal plane kinematics, kinetics and energy dissipation at lower extremity joints. (United States)

    Yeow, C H; Lee, P V S; Goh, J C H


    Lack of the necessary magnitude of energy dissipation by lower extremity joint muscles may be implicated in elevated impact stresses present during landing from greater heights. These increased stresses are experienced by supporting tissues like cartilage, ligaments and bones, thus aggravating injury risk. This study sought to investigate frontal plane kinematics, kinetics and energetics of lower extremity joints during landing from different heights. Eighteen male recreational athletes were instructed to perform drop-landing tasks from 0.3- to 0.6-m heights. Force plates and motion-capture system were used to capture ground reaction force and kinematics data, respectively. Joint moment was calculated using inverse dynamics. Joint power was computed as a product of joint moment and angular velocity. Work was defined as joint power integrated over time. Hip and knee joints delivered significantly greater joint power and eccentric work (pheights. Substantial increase (pwork was noted at the hip joint in response to increasing landing height. Knee and hip joints acted as key contributors to total energy dissipation in the frontal plane with increase in peak ground reaction force (GRF). The hip joint was the top contributor to energy absorption, which indicated a hip-dominant strategy in the frontal plane in response to peak GRF during landing. Future studies should investigate joint motions that can maximize energy dissipation or reduce the need for energy dissipation in the frontal plane at the various joints, and to evaluate their effects on the attenuation of lower extremity injury risk during landing.

  18. Construcción de modelos computacionales para el análisis de esfuerzos mecánicos de piezas óseas utilizando imágenes de TC: aplicación a la articulación gleno-humeral Construction of computational models for the stress analysis of the bones using CT imaging: application in the gleno-humeral joint

    Directory of Open Access Journals (Sweden)

    Adrián Cisilino


    Full Text Available Se presenta en este trabajo una metodología para el procesamiento de imágenes de estudios de TC para la construcción de modelos computacionales de piezas óseas. Los modelos computacionales son utilizados para el análisis de esfuerzos utilizando el Método de los Elementos Finitos. Las constantes elásticas del tejido óseo son calculadas a partir de los datos de densidad de las TC. La metodología propuesta es aplicada en la construcción de un modelo para el análisis de la articulación gleno-humeral.A methodology for the construction of computational models from CT images is presented in this work. Computational models serve for the stress analysis of the bones using the Finite Element Method. The elastic constants of the bone tissue are calculated using the density data obtained in from the CTs. The proposed methodology is demonstrated in the construction of a model for the gleno-humeral joint.

  19. Minimally invasive arthrodesis for chronic sacroiliac joint dysfunction using the SImmetry SI Joint Fusion system

    Directory of Open Access Journals (Sweden)

    Miller LE


    Full Text Available Larry E Miller,1,2 Jon E Block21Miller Scientific Consulting, Inc., Asheville, NC, USA; 2The Jon Block Group, San Francisco, CA, USA Abstract: Chronic sacroiliac (SI joint-related low back pain (LBP is a common, yet under-diagnosed and undertreated condition due to difficulties in accurate diagnosis and highly variable treatment practices. In patients with debilitating SI-related LBP for at least 6 months duration who have failed conservative management, arthrodesis is a viable option. The SImmetry® SI Joint Fusion System is a novel therapy for SI joint fusion, not just fixation, which utilizes a minimally invasive surgical approach, instrumented fixation for immediate stability, and joint preparation with bone grafting for a secure construct in the long term. The purpose of this report is to describe the minimally invasive SI Joint Fusion System, including patient selection criteria, implant characteristics, surgical technique, postoperative recovery, and biomechanical testing results. Advantages and limitations of this system will be discussed. Keywords: arthrodesis, fusion, minimally invasive, sacroiliac, SImmetry

  20. The influence of cyclic loading on gentamicin release from acrylic bone cements

    NARCIS (Netherlands)

    Hendriks, JGE; Neut, D; Hazenberg, JG; Verkerke, GJ; van Horn, [No Value; van der Mei, HC; Busscher, HJ


    Antibiotic-loaded acrylic bone cement is widely used in total joint replacement to reduce infections. Walking results in cyclic loading, which has been suggested to stimulate antibiotic release. The goal of this study is to compare antibiotic release from cyclically loaded bone cement with the relea

  1. The specificity of ultrasound-detected bone erosions for rheumatoid arthritis

    DEFF Research Database (Denmark)

    Zayat, Ahmed S; Ellegaard, Karen; Conaghan, Philip G


    Bone erosion is one of the hallmarks of rheumatoid arthritis (RA), but also seen in other rheumatic diseases. The objective of this study was to determine the specificity of ultrasound (US)-detected bone erosions (including their size) in the classical 'target' joints for RA....

  2. Multi-axial fatigue of trabecular bone with respect to normal walking

    CERN Document Server

    Mostakhdemin, Mohammad; Syahrom, Ardiyansyah


    This book focuses on the analysis and treatment of osteoporotic bone based on drug administration, tracking fatigue behavior and taking into consideration the mechanical interaction of implants with trabecular bone. Weak trabeculae are one of the most important clinical features that need to be addressed in order to prevent hip joint fractures.

  3. Expression of metastasin S100A4 is essential for bone resorption and regulates osteoclast function

    DEFF Research Database (Denmark)

    Erlandsson, Malin C; Svensson, M; Jonsson, Ing-Marie


    S100A4 is a Ca-binding protein that regulates cell growth, survival, and motility. The abundant expression of S100A4 in rheumatiod arthritis contributes to the invasive growth of joint tissue and to bone damage. In the present study, we analysed the role of S100A4 in bone homeostasis....

  4. The release of gentamicin from acrylic bone cements in a simulated prosthesis-related interfacial gap

    NARCIS (Netherlands)

    Hendriks, JGE; Neut, D; van Horn, [No Value; van der Mei, HC; Busscher, HJ


    Gentamicin is added to polymethylmethacrylate bone cements in orthopedics as a measure against infection in total joint arthroplasties. Numerous studies have been published on gentamicin release from bone cements, but none have been able to estimate the local concentrations in the prosthesis-related

  5. MRI of the hip joint; MRT des Hueftgelenks

    Energy Technology Data Exchange (ETDEWEB)

    Czerny, C.; Noebauer-Huhmann, I.M.; Imhof, H. [Universitaetsklinik fuer Radiodiagnostik, Medizinische Univ. Wien (Austria)


    Magnetic resonance imaging (MRI) is performed to diagnose many pathologic conditions affecting the hip joint. Either conventional MRI (without contrast enhancement of the joint cavity) or MR arthrography is used to detect and most accurately differentiate hip joint pathologies. Conventional MRI is performed in cases of bone marrow edema, necrosis, arthrosis and especially the so-called ''activated arthrosis'', as well as in inflammatory and tumorous entities. MR arthography, which has only recently become available for use, is excellently suited for diagnosing lesions of the acetabular labrum, cartilage lesions, and free articular bodies. This article provides an overview about MRI characteristics and their accuracy of hip joint diseases and the impact on the therapeutic procedure. (orig.)

  6. Genetic Influences on Temporomandibular Joint Development and Growth. (United States)

    Hinton, Robert J; Jing, Junjun; Feng, Jian Q


    The temporomandibular joint (TMJ) is a small synovial joint at which the mandible articulates with the skull during movements involved in speaking and mastication. However, the secondary cartilage lining its joint surfaces is indicative of a very different developmental history than limb cartilages. This review summarizes our current knowledge of genes that regulate the formation of primary components of the TMJ, as well as genes that regulate postnatal growth of the TMJ. Although the TMJ is regulated by some of the same genes that are important in limb joints, others appear unique to the TMJ or have different actions. Runx2, Sox9, and members of the TGF-β/BMP family are critical drivers of chondrogenesis during condylar cartilage morphogenesis, and Indian hedgehog (Ihh) is important for formation of the articular disc and cavitation. Osterix (Osx) is a critical regulator of endochondral bone formation during postnatal TMJ growth.

  7. Septic arthritis of the distal interphalangeal joint in 12 horses. (United States)

    Honnas, C M; Welch, R D; Ford, T S; Vacek, J R; Watkins, J P


    The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (one horse), intraarticular injection of antimicrobial drugs (five horses), curettage of the distal phalanx (one horse), and cancellous bone grafting to promote fusion (one horse). Five horses were euthanatized. Ankylosis of the affected joint developed in five horses, four of which are pasture sound. Two horses treated medically are sound although one underwent subsequent palmar digital neurectomy for treatment of navicular syndrome.

  8. Estrogen effects on cartilage and bone changes in models for osteoarthritis

    NARCIS (Netherlands)

    Y.H. Sniekers (Yvonne)


    textabstractOsteoarthritis (OA) is a frequently occurring musculoskeletal disorder, leading to joint pain and disability. Although all tissues in the joint can be affected, the focus of this thesis is on changes in bone and cartilage. Evidence from literature suggests that estrogen may have an OA-pr

  9. Regulation of Bone Metabolism. (United States)

    Shahi, Maryam; Peymani, Amir; Sahmani, Mehdi


    Bone is formed through the processes of endochondral and intramembranous ossification. In endochondral ossification primary mesenchymal cells differentiate to chondrocytes and then are progressively substituted by bone, while in intramembranous ossification mesenchymal stem cells (MSCs) differentiate directly into osteoblasts to form bone. The steps of osteogenic proliferation, differentiation, and bone homeostasis are controlled by various markers and signaling pathways. Bone needs to be remodeled to maintain integrity with osteoblasts, which are bone-forming cells, and osteoclasts, which are bone-degrading cells.In this review we considered the major factors and signaling pathways in bone formation; these include fibroblast growth factors (FGFs), bone morphogenetic proteins (BMPs), wingless-type (Wnt) genes, runt-related transcription factor 2 (RUNX2) and osteoblast-specific transcription factor (osterix or OSX).

  10. Regulation of Bone Metabolism (United States)

    Shahi, Maryam; Peymani, Amir; Sahmani, Mehdi


    Bone is formed through the processes of endochondral and intramembranous ossification. In endochondral ossification primary mesenchymal cells differentiate to chondrocytes and then are progressively substituted by bone, while in intramembranous ossification mesenchymal stem cells (MSCs) differentiate directly into osteoblasts to form bone. The steps of osteogenic proliferation, differentiation, and bone homeostasis are controlled by various markers and signaling pathways. Bone needs to be remodeled to maintain integrity with osteoblasts, which are bone-forming cells, and osteoclasts, which are bone-degrading cells.In this review we considered the major factors and signaling pathways in bone formation; these include fibroblast growth factors (FGFs), bone morphogenetic proteins (BMPs), wingless-type (Wnt) genes, runt-related transcription factor 2 (RUNX2) and osteoblast-specific transcription factor (osterix or OSX). PMID:28367467

  11. MR imaging of osteosarcoma: emphasis on joint involvement

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Soo Jeong; Lee, Jeong Hoon; Kim, Kie Hwan; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)


    To evaluate MR imaging findings of joint involvement in patients with osteosarcoma Among 166 patients with osteosarcoma treated between January 1993 and July 1998, 67(44 men and 23 women, mean age 20 years) whose tumors had invaded the epiphysis were included in this study. Those with preserved normal bone marrow signal intensity between the tumor and cortical bone were excluded. Tumors were located around the knee (n=52), the hip (n=7), the shoulder (n=5), the ankle (n=2), or the wrist (n=1). For all patients, pre-operative spin echo pre-and post-contrast enhanced MR images were obtained. In all cases, we assessed the presence or abscence of intrasynovial mass, intraarticular disruption of cortical bone and articular cartilage, and joint effusion, and also evaluated the mass around the cruciate ligaments of the knee. All patients underwent surgery and MR findings were correlated with the results of pathologic examinations. In six patients the tumor was found to involve the knee joint. Sensitivity and specificity for the intrasynovial mass (n=6), intraarticular disruption of cortical bone and articular cartilage (n=19), mass around the cruciate ligaments (n=7), and joint effusion (n=12) were 83.3%, 100%, 83.3%, 33.3% and 98.4%, 78.7%, 95.6%, 83.6%, respectively, while accuracy for the intrasynovial mass and mass around the cruciate ligaments was 97% and 94.2% respectively. If MR imaging indicates the presence of a mass in the synovial cavity or around the cruciate ligaments, this is suggestive MR findings of joint involvement.

  12. Influence of Environmental Factors and Relationships between Vanadium, Chromium, and Calcium in Human Bone


    Natalia Lanocha-Arendarczyk; Kosik-Bogacka, Danuta I.; Elzbieta Kalisinska; Sebastian Sokolowski; Lukasz Kolodziej; Halina Budis; Krzysztof Safranow; Karolina Kot; Zaneta Ciosek; Natalia Tomska; Katarzyna Galant


    The aim of this study was to investigate the impact of environmental factors on the concentrations of vanadium (V), chromium (Cr), and calcium (Ca) and to examine the synergistic or antagonistic relationships between these metals, in cartilage (C), cortical bone (CB), and spongy bone (SB) samples obtained following hip joint surgery on patients with osteoarthritis in NW Poland. We found significantly higher concentrations of V and Cr in spongy bone in patients who consumed game meat and also ...

  13. Lessons from rare diseases of cartilage and bone. (United States)

    Gallagher, James A; Ranganath, Lakshminarayan R; Boyde, Alan


    Studying severe phenotypes of rare syndromes can elucidate disease mechanisms of more common disorders and identify potential therapeutic targets. Lessons from rare bone diseases contributed to the development of the most successful class of bone active agents, the bisphosphonates. More recent research on rare bone diseases has helped elucidate key pathways and identify new targets in bone resorption and bone formation including cathepsin K and sclerostin, for which drugs are now in clinical trials. By contrast, there has been much less focus on rare cartilage diseases and osteoarthritis (OA) remains a common disease with no effective therapy. Investigation of rare cartilage syndromes is identifying new potential targets in OA including GDF5 and lubricin. Research on the arthropathy of the ultra-rare disease alkaptonuria has identified several new features of the OA phenotype, including high density mineralized protrusions (HDMPs) which constitute a newly identified mechanism of joint destruction.

  14. 引导组织再生联合根内骨内种植对牙周病的临床实效性对照探究%Clinical effectiveness of patients with periodontal disease treated with guided tissue regeneration in the bone within the joint root planting

    Institute of Scientific and Technical Information of China (English)



    Objective:To investigate the clinical effectiveness of patients with periodontal disease treated with guided tissue regeneration in the bone within the joint root planting. Methods:50 cases of patients with periodontal disease were selected from January 2013 to January 2014, divided into observation group and control group with 25 patients respectively. Patients in observation group were first taken to the teeth with the inner bone implant surgery, then take guided tissue regeneration combined graft surgery. The control group of patients taking guided tissue regeneration combined graft surgery. Treatment effect was observed in both groups of patients. Results: Compared with the preoperative observation group and the control group of patients 6 months after the periodontal pocket probing depth, attachment loss were analyzed and found that periodontal pocket probing depth was significantly lighter, significantly improved attachment levels, etc, comparative analysis after, the difference was statistically significant ( t=6.394,7.289, P<0.05) . Compared with the control group of patients, patients in the observation group, probing pocket depth, attachment loss of comparative analysis, the difference was statistically sig-nificant ( t=9.242,10.432, P<0.05) . Patients in the observation group one month, three months, six months after loosening Ⅲ degree were 7.14%, 2.86% and 0.0%, patients in the control group one month, three months, Ⅲ degree after six months loose respectively 16.67%,13.33% and 8.33%. Con-clusion: Guided tissue regeneration and better cultivation methods for treatment of periodontal disease in the bone within the joint root, and then attached to the situation better and better postoperative re-covery, it is worth big.%目的:探讨引导组织再生联合根内骨内种植对牙周病的临床实效性对照研究。方法:选择2013年1月至2014年1月收治的50例牙周病患者,将患者按照简单随机方法分

  15. Total ankle joint replacement. (United States)


    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications.

  16. Joint Robotics Program (United States)


    Åèìáëáíáçå= oÉëÉ~êÅÜ=póãéçëáìã= JOINT ROBOTICS PROGRAM Published: 23 April 2008 by Joel Brown and Paul Varian 5th Annual Acquisition Research...3. DATES COVERED 00-00-2008 to 00-00-2008 4. TITLE AND SUBTITLE Joint Robotics Program 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM...ëóåÉêÖó=Ñçê=áåÑçêãÉÇ=ÅÜ~åÖÉ=======- 464 - = = Joint Robotics Program Presenter: Joel Brown, Defense Acquisition University Author: Paul Varian

  17. Joints in steel buildings

    Directory of Open Access Journals (Sweden)

    Gabriel F. Valencia Clement


    Full Text Available Masonry and steel components used in constructing buildings are in a constant state of motion. Volumetric changes are produced by temperature variation and deformation resulting from static or dynamic loading and in some materials, such as masonry, due to moisture content. This article addresses means of determining when expansion and seismic joints are required and how to proportion and design appropriate joints, specifically in steel buildings. It does not cover the study of expansion joints in concrete structures, in masonry construction or in non-structural (architectural elements.

  18. Stabilization of the sacroiliac joint. (United States)

    Shaffrey, Christopher I; Smith, Justin S


    Lower back pain and pain involving the area of the posterior iliac spine are extremely common. Degeneration of the sacroiliac joint (SIJ) is one potential cause for lower back pain and pain radiating into the groin or buttocks. Degenerative changes to the lumbar spine and sacroiliac joints are common. A recent study evaluating SIJ abnormalities in a primary low back pain population demonstrated 31.7% of patients demonstrated SI joint abnormalities. (4) As is the case for the evaluation and management of isolated lower back pain, the evaluation, management, and role for surgical intervention in SIJ pain is very controversial. Many patients have degenerative changes of the disc, facet joints, and SIJs. A recent systematic review performed to determine the diagnostic accuracy of tests available to clinicians to identify the disc, facet joint, or SIJ as the source of low back pain concluded that tests do exist that change the probability of the disc or SIJ (but not the facet joint) as the source of low back pain. (3) It was also concluded that the usefulness of these tests in clinical practice, particularly for guiding treatment selection, remains unclear. (3) Although there is general agreement that SIJ pathological changes are a potential cause of pain, there is far less agreement about the optimal management of these conditions. A variety of conditions can cause SIJ dysfunction including degenerative and inflammatory arthritis, trauma, prior lumbosacral fusion, hip arthritis, limb length inequality, infections, and neoplasia. (8) There is increasing evidence that image intensifier-guided single periarticular injection can correctly localize pain to the SIJ but the optimal management strategy remains controversial. Recent publications have compared surgical versus injection treatments and fusion versus denervation procedures. (1 , 8) A systematic review found improvement regardless of the treatment, with most studies reporting over 40% improvement in pain as measured

  19. [External femorotibial transfixation in femoral fracture with joint involvement in a child]. (United States)

    Nounla, J; Bennek, J; Bühligen, U; Rolle, U


    Long bone fractures combined with joint injuries run a high risk of destabilising the articulations. Remaining joints incongruence can lead to early arthosis especially in cases of severe injuries or not achieved anatomical reduction. A number of osteosynthesis methods are available for anatomical repair of the articular facet. This report presents a seven years old boy with an open comminuted fracture of the distal femur and consecutive joint instability, treated with a Transfixation (Orthofix) of the knee joint. The functional results suggest this method as an alternative treatment.

  20. Correlation between generalized joint hypermobility and hallux valgus

    Directory of Open Access Journals (Sweden)

    A. A. Kardanov


    Full Text Available Purpose: to evaluate correlation between generalized joint hypermobility, forefoot deformities and elasticity of the first ray of the foot. Material and methods. We examined 138 patients with complaints related with deformities at the forefoot level. During this study the medical history was obtained, the elasticity type of the feet was defined and the degree of motion of the medial metatarsal-cuneiform joint was evaluated. Forefoot elasticity was identified by bringing together the heads I and V metatarsal bones with fingers. If convergence occurred with little resistance, those feet were called hyperelastic. The convergence of the heads I and V metatarsal bones of the foot with an average type of elasticity occurred with resistance. It was impossible to converge the heads of I and V metatarsal bones. Due to the results of weight-bearing and non-weight bearing X-ray, analysis of the main radiographic angles of the foot was performed: between I and V metatarsal bones, between the first and second metatarsal bones and between the first metatarsal bone and proximal phalanx of the great toe. Calculation formula of the forefoot flatness index, showing the average ratios of basic radiographic angles of the foot on the x-ray images (weight-bearing and non-weight bearing was created. An assessment of total joint hypermobility using Beighton scale and evaluation of first ray deformity using DuPont scale were performed. Statistical analysis of obtained data was performed, as a result of which significantly strong correlation between total joint hypermobility, forefoot elasticity and valgus deviation of the great toe were revealed. Results. 11% of the feet were hyperelastic. Calculation of the index of forefoot flatness showed that forefoot flatness wasn’t significant for a rigid foot - 5.6 %, for the feet with an average degree of mobility it was 6.0% and it was expressed for hypemobile feet - 12.3 %. Strong correlation relation between the forefeet

  1. [Animal models for bone and joint disease. CIA, CAIA model]. (United States)

    Hirose, Jun; Tanaka, Sakae


    The collagen-induced arthritis (collagen-induced arthritis, CIA) is an autoimmune arthritis that resembles rheumatoid arthritis (RA) in many ways, therefore it has been used most commonly as a model of RA. CIA is induced by immunization with an emulsion of complete Freund's adjuvant (CFA) and type II collagen (C II ) . Collagen antibody-induced arthritis (CAIA) is induced by the administration of a cocktail of monoclonal antibodies recognizing conserved epitopes located within the CB11 fragment. CAIA offers several advantages over CIA, including rapid disease onset, high uptake rate, and the capacity to use genetically modified mice, such as transgenics and knockouts.

  2. Synovial desmoplastic fibroblastoma of hip joint with bone erosion

    Energy Technology Data Exchange (ETDEWEB)

    Beggs, I. [Department of Clinical Radiology, Royal Infirmary, Edinburgh (United Kingdom); Salter, D.S. [Department of Pathology, University of Edinburgh, Edinburgh (United Kingdom); Dorfman, H.D. [Department of Orthopaedic Surgery, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY (United States)


    A 78-year-old woman presented with pain at the left hip. Initial radiographs showed minimal age-related changes. Over the next 2 years she developed large erosions in the left femoral neck and proceeded to hip replacement. Histological examination showed bland spindle cells in a loose and hyalinised collagenous stroma considered to represent a desmoplastic fibroblastoma (collagenous fibroma). This is the first reported case of synovial desmoplastic fibroblastoma. (orig.) With 7 figs., 33 refs.

  3. Lubricin protects the temporomandibular joint surfaces from degeneration.

    Directory of Open Access Journals (Sweden)

    Adele Hill

    Full Text Available The temporomandibular joint (TMJ is a specialized synovial joint essential for the mobility and function of the mammalian jaw. The TMJ is composed of the mandibular condyle, the glenoid fossa of the temporal bone, and a fibrocartilagenous disc interposed between these bones. A fibrous capsule, lined on the luminal surface by the synovial membrane, links these bones and retains synovial fluid within the cavity. The major component of synovial fluid is lubricin, a glycoprotein encoded by the gene proteoglycan 4 (Prg4, which is synthesized by chondrocytes at the surface of the articular cartilage and by synovial lining cells. We previously showed that in the knee joint, Prg4 is crucial for maintenance of cartilage surfaces and for regulating proliferation of the intimal cells in the synovium. Consequently, the objective of this study was to determine the role of lubricin in the maintenance of the TMJ. We found that mice lacking lubricin have a normal TMJ at birth, but develop degeneration resembling TMJ osteoarthritis by 2 months, increasing in severity over time. Disease progression in Prg4-/- mice results in synovial hyperplasia, deterioration of cartilage in the condyle, disc and fossa with an increase in chondrocyte number and their redistribution in clusters with loss of superficial zone chondrocytes. All articular surfaces of the joint had a prominent layer of protein deposition. Compared to the knee joint, the osteoarthritis-like phenotype was more severe and manifested earlier in the TMJ. Taken together, the lack of lubricin in the TMJ causes osteoarthritis-like degeneration that affects the articular cartilage as well as the integrity of multiple joint tissues. Our results provide the first molecular evidence of the role of lubricin in the TMJ and suggest that Prg4-/- mice might provide a valuable new animal model for the study of the early events of TMJ osteoarthritis.

  4. Lubricin protects the temporomandibular joint surfaces from degeneration. (United States)

    Hill, Adele; Duran, Juanita; Purcell, Patricia


    The temporomandibular joint (TMJ) is a specialized synovial joint essential for the mobility and function of the mammalian jaw. The TMJ is composed of the mandibular condyle, the glenoid fossa of the temporal bone, and a fibrocartilagenous disc interposed between these bones. A fibrous capsule, lined on the luminal surface by the synovial membrane, links these bones and retains synovial fluid within the cavity. The major component of synovial fluid is lubricin, a glycoprotein encoded by the gene proteoglycan 4 (Prg4), which is synthesized by chondrocytes at the surface of the articular cartilage and by synovial lining cells. We previously showed that in the knee joint, Prg4 is crucial for maintenance of cartilage surfaces and for regulating proliferation of the intimal cells in the synovium. Consequently, the objective of this study was to determine the role of lubricin in the maintenance of the TMJ. We found that mice lacking lubricin have a normal TMJ at birth, but develop degeneration resembling TMJ osteoarthritis by 2 months, increasing in severity over time. Disease progression in Prg4-/- mice results in synovial hyperplasia, deterioration of cartilage in the condyle, disc and fossa with an increase in chondrocyte number and their redistribution in clusters with loss of superficial zone chondrocytes. All articular surfaces of the joint had a prominent layer of protein deposition. Compared to the knee joint, the osteoarthritis-like phenotype was more severe and manifested earlier in the TMJ. Taken together, the lack of lubricin in the TMJ causes osteoarthritis-like degeneration that affects the articular cartilage as well as the integrity of multiple joint tissues. Our results provide the first molecular evidence of the role of lubricin in the TMJ and suggest that Prg4-/- mice might provide a valuable new animal model for the study of the early events of TMJ osteoarthritis.

  5. Joint Quantum Institute (United States)

    Federal Laboratory Consortium — The Joint Quantum Institute (JQI) is pursuing that goal through the work of leading quantum scientists from the Department of Physics of the University of Maryland...

  6. Healthy Joints Matter (United States)

    ... my joints more healthy? Definitions What can go wrong? Although you might think arthritis affects only older ... Discovery Into Health ® Home | Health Information | Research | Funding | News & Events | About Us | Portal en español | Asian-Language ...

  7. Improved orthopedic arm joint (United States)

    Dane, D. H.


    Joint permits smooth and easy movement of disabled arm and is smaller, lighter and less expensive than previous models. Device is interchangeable and may be used on either arm at the shoulder or at the elbow.

  8. Biomechanical study of tarsometatarsal joint fusion using finite element analysis. (United States)

    Wang, Yan; Li, Zengyong; Zhang, Ming


    Complications of surgeries in foot and ankle bring patients with severe sufferings. Sufficient understanding of the internal biomechanical information such as stress distribution, contact pressure, and deformation is critical to estimate the effectiveness of surgical treatments and avoid complications. Foot and ankle is an intricate and synergetic system, and localized intervention may alter the functions to the adjacent components. The aim of this study was to estimate biomechanical effects of the TMT joint fusion using comprehensive finite element (FE) analysis. A foot and ankle model consists of 28 bones, 72 ligaments, and plantar fascia with soft tissues embracing all the segments. Kinematic information and ground reaction force during gait were obtained from motion analysis. Three gait instants namely the first peak, second peak and mid-stance were simulated in a normal foot and a foot with TMT joint fusion. It was found that contact pressure on plantar foot increased by 0.42%, 19% and 37%, respectively after TMT fusion compared with normal foot walking. Navico-cuneiform and fifth meta-cuboid joints sustained 27% and 40% increase in contact pressure at second peak, implying potential risk of joint problems such as arthritis. Von Mises stress in the second metatarsal bone increased by 22% at midstance, making it susceptible to stress fracture. This study provides biomechanical information for understanding the possible consequences of TMT joint fusion.

  9. Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome


    Naslund, J.; Odenbring, S; Naslund, U; Lundeberg, T


    Objectives: Painful disorders of the patellofemoral joint are one of the most frequent complaints in orthopaedic and sports medicine. The aims of this study were to determine whether bone scintigrams of patients suffering from patellofemoral pain syndrome (PFPS) show diffuse uptake and in what bony compartment of the knee uptake, if any, was localised.

  10. Degenerative changes of the sacroiliac auricular joint surface-validation of influential factors. (United States)

    Nishi, Keita; Saiki, Kazunobu; Imamura, Takeshi; Okamoto, Keishi; Wakebe, Tetsuaki; Ogami, Keiko; Hasegawa, Takashi; Moriuchi, Takefumi; Sakamoto, Junya; Manabe, Yoshitaka; Tsurumoto, Toshiyuki


    The purpose of this study was to clarify the relevance of degenerative changes in the sacroiliac joint (SIJ) and the joints in the lower limb and lumbar spine using age estimation methods. We also examined the shape of the auricular surface to determine the effect of degenerative changes on each joint. A total of 200 iliac auricular surfaces from 100 Japanese male skeletons were examined macroscopically in accordance with conventional methods of age estimation. From the obtained estimated age, we calculated the deflection values, which represented the degree of degenerative changes of the joints. For comparison, we used osteophyte score data of the hip, knee, and zygapophyseal joints in lumbar spines from previous studies which had used the same bone specimens. As a quantitative indicator of auricular surface morphology, we defined the constriction ratio (CR) of the auricular surface and compared the CR values obtained with various measured values. Degenerative changes in the SIJ were positively correlated with those in both the hip joint and zygapophyseal joint, but a correlation with knee joints was found only on the left side. In skeletons from individuals aged ≥60 years as time of death, the CR was significantly different between the group with high scores and those with low scores in both the hip and sacroiliac joints. It has been suggested that degenerative changes in SIJs interact with those in the hip joint and zygapophyseal joint. In addition, the shape of the auricular surface may also be a relevant factor for degenerative changes in these joints.

  11. Concrete Pavement Joint Deterioration



    Concrete pavements are an important part of our national infrastructure. In recent years the relatively small number of reported joints deteriorating prematurely in concrete pavements around Indiana has increased. Changes over the past 45 years in INDOT specification, pavement materials, designs and construction practices, and current de-icing materials were examined and related to the durability of concrete at the joints of existing pavements. A survey of concrete pavements across the state ...

  12. Epidemiologic and clinical profiles of bone and joint tuberculosis: observational study at hospital Universitario San Vicente de Paul, Medellín, Colombia, 1994-2004. Perfiles epidemiológico y clínico de la tuberculosis osteoarticular: estudio observacional en el Hospital Universitario San Vicente de Paúl, de Medellín, 1994-2004

    Directory of Open Access Journals (Sweden)

    Jorge Eduardo López Valencia


    Full Text Available An observational, retrospective study was performed at Hospital Universitario San Vicente de Paúl, in Medellín, Colombia, based on the clinical records of patients with bone and joint tuberculosis between January 1994 and December 2004; based on the findings, epidemiological, clinical, laboratory and therapeutic characteristics of 47 patients are described. These patients represented 3.4% of the total of tuberculosis cases found in this hospital during the studied period; 35 had spinal tuberculosis and in 12 the disease affected other bones; a history of pulmonary tuberculosis was found in only 7 patients; 23 were males and 24, females; their ages were between 1 and 71 years; 18 were younger than 12 years; cultures for Mycobacterium tuberculosis were positive in 14 patients (29.8% and biopsies were consistent with tuberculosis in 26 (55.3%. Eleven of the 12 patients with extraspinal disease had the radiological findings of Phemisther. Predominant symptoms of spinal tuberculosis were: pain, neurological manifestations and deformity, mostly kyphosis. From the radiological point of view, these patients had destruction of vertebral bodies and decrease of articular space in addition to osteopenia. Tomography was performed in 19 patients and revealed medullary compression in 5 of them; magnetic resonance carried out in 17 patients showed medullary compression in 8 and paravertebral abscesses in the 17. Results are discussed on the basis of reports from the world medical literature and in the context of the health situation of the Colombian population. Se llevó a cabo un estudio observacional retrospectivo en el Hospital Universitario San Vicente de Paúl, de Medellín, basado en la revisión de las historias de pacientes con tuberculosis osteoarticular, entre enero de 1994 y diciembre de 2004; con base en los hallazgos se describen las características demográficas, clínicas, de laboratorio y de tratamiento de 47 pacientes que correspondían al 3

  13. Magnetic resonance imaging and bone scintigraphy in the differential diagnosis of unclassified arthritis

    DEFF Research Database (Denmark)

    Duer, Anne; Østergaard, M; Hørslev-Petersen, K;


    OBJECTIVES: To investigate the value in clinical practice of hand magnetic resonance imaging (MRI) and whole body bone scintigraphy in the differential diagnosis of patients with unclassified arthritis. METHODS: 41 patients with arthritis (> or = 2 swollen joints, > 6 months' duration) which...... joints of the most symptomatic hand and whole body bone scintigraphy were performed. Two rheumatologists agreed on the most likely diagnosis and the patients were treated accordingly. A final diagnosis was made by another specialist review 2 years later. RESULTS: Tentative diagnoses after MRI and bone...

  14. The first metatarsal bone under loading conditions: a finite element analysis. (United States)

    Kristen, K-H; Berger, K; Berger, C; Kampla, W; Anzböck, W; Weitzel, S H


    An individual-based, three-dimensional finite element model of the first metatarsal (MT I) bone was created with fine CT. The three-dimensional model of the bone was fixed proximally at the metatarsocuneiform joint and load was applied on the metatarsal head. Loading conditions were simulated, including muscular forces as described for a normal metatarsophalangeal (MTP) joint during three typical phases of gait as the combination of the load in the contact areas of the sesamoid bones and the base of the proximal phalanx. The resultant strain and stress distributions within the loaded MT I were calculated and visualized with the MTP in different positions.

  15. Large-scale gene expression profiling data of bone marrow stromal cells from osteoarthritic donors. (United States)

    Stiehler, Maik; Rauh, Juliane; Bünger, Cody; Jacobi, Angela; Vater, Corina; Schildberg, Theresa; Liebers, Cornelia; Günther, Klaus-Peter; Bretschneider, Henriette


    This data article contains data related to the research article entitled, "in vitro characterization of bone marrow stromal cells from osteoarthritic donors" [1]. Osteoarthritis (OA) represents the main indication for total joint arthroplasty and is one of the most frequent degenerative joint disorders. However, the exact etiology of OA remains unknown. Bone marrow stromal cells (BMSCs) can be easily isolated from bone marrow aspirates and provide an excellent source of progenitor cells. The data shows the identification of pivotal genes and pathways involved in osteoarthritis by comparing gene expression patterns of BMSCs from osteoarthritic versus healthy donors using an array-based approach.

  16. Clinical efficacy of radiation synovectomy in digital joint osteoarthritis

    Energy Technology Data Exchange (ETDEWEB)

    Kampen, Willm Uwe; Hellweg, Leif; Massoudi-Nickel, Schirin; Czech, Norbert; Henze, Eberhard [University Hospital Schleswig-Holstein, Clinic of Nuclear Medicine, Kiel (Germany); Brenner, Winfried [University Hospital Hamburg-Eppendorf, Department of Nuclear Medicine (Germany)


    Radiation synovectomy was developed for local treatment of rheumatoid arthritis. In this study, the long-term efficacy of radiation synovectomy was retrospectively evaluated in patients with osteoarthritis (activated arthrosis) of the digital joints using an algofunctional score. Fifty-three digital joints in 29 patients (mean age 64.8 years) were treated by intra-articular injection of{sup 169}Er citrate. All joints were painful despite pharmacotherapy and showed an elevated blood pool pattern in a pretherapeutic three-phase bone scan, indicative for local synovitis. The patients were asked to classify their complaints with respect to different daily manual activities on a ten-step pain scale from 1 (total disability) to 10 (lack of any impairment) prior to and after treatment, with a mean follow-up of 41 months. Local signs of osteoarthritis such as joint swelling or pain were additionally evaluated and were scored from progression of complaints to excellent improvement based on patient self-evaluation. All patients reported a pronounced improvement in their manual activities. The mean total score of 4.73{+-}0.58 for all activities prior to treatment increased significantly to 6.79{+-}0.47 after radiation synovectomy (p<0.05). The best results were obtained in the thumb base joints, whereas distal interphalangeal joints were frequently resistant to therapy. Radiation synovectomy is highly effective in digital joint osteoarthritis with concomitant local synovitis. (orig.)

  17. En-block切除术联合结构性植骨治疗第1跖趾关节痛风性关节炎%Treatment of first metatarsophalangeal joint gouty arthritis by arthrodesis with En-block resection and structural bone graft

    Institute of Scientific and Technical Information of China (English)

    宋国勋; 高鹏; 余伟林; 顾文奇; 施忠民


    背景:痛风性关节炎最常累及第1跖趾关节关节,伴有肿痛、畸形及关节僵硬,严重影响患者的生活质量。目的:探讨采用En-block切除术结合结构性植骨关节融合治疗第1跖趾关节痛风性关节炎的手术技术及疗效。方法:2012年6月至2013年6月,我院共收治8例第1跖趾关节痛风性关节炎患者。男7例,女1例,年龄25~68岁,平均47.6岁。所有患者均采用En-block病灶切除结合结构性植骨第1跖趾关节融合术。术后定期复查,摄片明确愈合情况,并采用美国骨科足踝外科协会(AOFAS)前足评分及疼痛直观模拟量表(VAS)评价治疗效果,记录相关并发症。结果:所有患者伤口均一期愈合,未见伤口感染、皮肤坏死等软组织并发症。术后7例患者获得12~24个月随访,平均18个月。影像学检查明确术后平均10周融合端骨性愈合。AOFAS评分从术前平均(44.4±10.5)分提高至术后(80.0±10.8)分,而VAS评分从术前平均(7.0±2.0)分降至术后(1.1±0.9)分,其差异均有统计学意义(P<0.0001)。随访期间未见骨不连、畸形愈合及固定失效等并发症。结论:En-block切除结合结构性植骨融合治疗第1跖趾关节痛风性关节炎具有症状缓解明显、融合率高、并发症少等优势,可有效改善患者生活质量,是一种安全有效的治疗方式。%Background:Gouty arthritis most commonly involves the first metatarsophalangeal joint (MTPJ), causing pain, deformity and anchylosis and reducing patients' quality of life. Objective:To investigate the technique and clinical outcome of arthrodesis with En-block resection and structural bone graft to treat the 1st MTPJ gouty arthritis. Methods: From June 2012 to June 2013, 8 patients suffering from 1st MTPJ gouty arthritis were treated in our hospital. There were 7 men and 1 woman with an average age of 47.6 years (range 25-68 years). The first MTPJ

  18. Appendicular bone mass and knee and hand osteoarthritis in Japanese women: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Moji Kazuhiko


    Full Text Available Abstract Background It has been reported that there is an inverse association between osteoarthritis (OA and osteoporosis. However, the relationship of bone mass to OA in a Japanese population whose rates of OA are different from Caucasians remains uncertain. Methods We studied the association of appendicular bone mineral density (second metacarpal; mBMD and quantitative bone ultrasound (calcaneus; stiffness index with knee and hand OA among 567 Japanese community-dwelling women. Knee and hand radiographs were scored for OA using Kellgren-Lawrence (K/L scales. In addition, we evaluated the presence of osteophytes and of joint space narrowing. The hand joints were examined at the distal and proximal interphalangeal (DIP, PIP and first metacarpophalangeal/carpometacarpal (MCP/CMC joints. Results After adjusting for age and body mass index (BMI, stiffness index was significantly higher in women with K/L scale, grade 3 at CMC/MCP joint compared with those with no OA. Adjusted means of stiffness index and mBMD were significantly higher in women with definite osteophytes at the CMC/MCP joint compared to those without osteophytes, whereas there were no significant differences for knee, DIP and PIP joints. Stiffness index, but not mBMD, was higher in women with definite joint space narrowing at the CMC/MCP joint compared with those with no joint space narrowing. Conclusions Appendicular bone mass was increased with OA at the CMC/MCP joint, especially among women with osteophytes. Our findings suggest that the association of peripheral bone mass with OA for knee, DIP or PIP may be less clearcut in Japanese women than in other populations.

  19. Joint stiffness of the ankle and the knee in running. (United States)

    Günther, Michael; Blickhan, Reinhard


    The spring-mass model is a valid fundament to understand global dynamics of fast legged locomotion under gravity. The underlying concept of elasticity, implying leg stiffness as a crucial parameter, is also found on lower motor control levels, i.e. in muscle-reflex and muscle-tendon systems. Therefore, it seems reasonable that global leg stiffness emerges from local elasticity established by appropriate joint torques. A recently published model of an elastically operating, segmented leg predicts that proper adjustment of joint elasticities to the leg geometry and initial conditions of ground contact provides internal leg stability. Another recent study suggests that in turn the leg segmentation and the initial conditions may be a consequence of metabolic and bone stress constraints. In this study, the theoretical predictions were verified experimentally with respect to initial conditions and elastic joint characteristics in human running. Kinematics and kinetics were measured and the joint torques were estimated by inverse dynamics. Stiffnesses and elastic nonlinearities describing the resulting joint characteristics were extracted from parameter fits. Our results clearly support the theoretical predictions: the knee joint is always stiffer and more extended than the ankle joint. Moreover, the knee torque characteristic on the average shows the higher nonlinearity. According to literature, the leg geometry is a consequence of metabolic and material stress limitations. Adapted to this given geometry, the initial joint angle conditions in fast locomotion are a compromise between metabolic and control effort minimisation. Based on this adaptation, an appropriate joint stiffness ratio between ankle and knee passively safeguards the internal leg stability. The identified joint nonlinearities contribute to the linearisation of the leg spring.

  20. High pressure ceramic joint (United States)

    Ward, Michael E.; Harkins, Bruce D.


    Many recuperators have components which react to corrosive gases and are used in applications where the donor fluid includes highly corrosive gases. These recuperators have suffered reduced life, increased service or maintenance, and resulted in increased cost. The present joint when used with recuperators increases the use of ceramic components which do not react to highly corrosive gases. Thus, the present joint used with the present recuperator increases the life, reduces the service and maintenance, and reduces the increased cost associated with corrosive action of components used to manufacture recuperators. The present joint is comprised of a first ceramic member, a second ceramic member, a mechanical locking device having a groove defined in one of the first ceramic member and the second ceramic member. The joint and the mechanical locking device is further comprised of a refractory material disposed in the groove and contacting the first ceramic member and the second ceramic member. The present joint mechanically provides a high strength load bearing joint having good thermal cycling characteristics, good resistance to a corrosive environment and good steady state strength at elevated temperatures.

  1. What Is Bone Cancer? (United States)

    ... start in bone, muscle, fibrous tissue, blood vessels, fat tissue, as well as some other tissues. They can develop anywhere in the body. There are several different types of bone tumors. Their names are based on ...

  2. Osteochondroma (Bone Tumor) (United States)

    ... to be the most common benign bone tumor, accounting for 35% to 40% of all benign bone ... imaging scans. Doctors may also request computed tomography (CT) scans or magnetic resonance imaging (MRI) scans to ...

  3. What causes bone loss? (United States)

    ... bone biology. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, PA: Elsevier; 2016:chap 29. Maes C, Kronenberg HM. Bone development and remodeling. In: Jameson JL, ...

  4. Bone mineral density test (United States)

    BMD test; Bone density test; Bone densitometry; DEXA scan; DXA; Dual-energy x-ray absorptiometry; p-DEXA; Osteoporosis-BMD ... need to undress. This scan is the best test to predict your risk of fractures. Peripheral DEXA ( ...

  5. [Septic arthritis of the temporomandibular joint: report of one case]. (United States)

    Pintor, Fernanda; Carrasco, Rolando; Verdugo-Avello, Francisco; Landaeta, Mirtha


    Septic arthritis of the temporomandibular joint (TMJ) is an uncommon condition, caused by hematic bacterial migration or direct migration of other head and neck infections. We report a 41 year old female who presented a right temporomandibular joint involvement, with bone destruction of the mandibular condyle and an infectious process spreading to the temporal space, following a necrotizing medial and external otitis with associated mastoiditis. A septic arthritis of the TMJ by continuity was diagnosed and treated with antimicrobials, TMJ arthrocentesis and occlusal stabilization, with a positive evolution. However, the patient remains in control due a secondary TMJ osteoarthritis caused by the septic arthritis.

  6. Androgens and bone. (United States)

    Vanderschueren, Dirk; Vandenput, Liesbeth; Boonen, Steven; Lindberg, Marie K; Bouillon, Roger; Ohlsson, Claes


    Loss of estrogens or androgens increases the rate of bone remodeling by removing restraining effects on osteoblastogenesis and osteoclastogenesis, and also causes a focal imbalance between resorption and formation by prolonging the lifespan of osteoclasts and shortening the lifespan of osteoblasts. Conversely, androgens, as well as estrogens, maintain cancellous bone mass and integrity, regardless of age or sex. Although androgens, via the androgen receptor (AR), and estrogens, via the estrogen receptors (ERs), can exert these effects, their relative contribution remains uncertain. Recent studies suggest that androgen action on cancellous bone depends on (local) aromatization of androgens into estrogens. However, at least in rodents, androgen action on cancellous bone can be directly mediated via AR activation, even in the absence of ERs. Androgens also increase cortical bone size via stimulation of both longitudinal and radial growth. First, androgens, like estrogens, have a biphasic effect on endochondral bone formation: at the start of puberty, sex steroids stimulate endochondral bone formation, whereas they induce epiphyseal closure at the end of puberty. Androgen action on the growth plate is, however, clearly mediated via aromatization in estrogens and interaction with ERalpha. Androgens increase radial growth, whereas estrogens decrease periosteal bone formation. This effect of androgens may be important because bone strength in males seems to be determined by relatively higher periosteal bone formation and, therefore, greater bone dimensions, relative to muscle mass at older age. Experiments in mice again suggest that both the AR and ERalpha pathways are involved in androgen action on radial bone growth. ERbeta may mediate growth-limiting effects of estrogens in the female but does not seem to be involved in the regulation of bone size in males. In conclusion, androgens may protect men against osteoporosis via maintenance of cancellous bone mass and

  7. Gracile bone dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Kozlowski, Kazimierz [Department of Medical Imaging, The Children' s Hospital at Westmead, Locked Bag 4001, Westmead 2145, NSW (Australia); Masel, John [Department of Radiology, Royal Children' s Hospital, Brisbane (Australia); Sillence, David O. [Department of Paediatrics and Child Health, The University of Sydney (Australia); Arbuckle, Susan [Department of Anatomical Pathology, The Children' s Hospital at Westmead, NSW (Australia); Juttnerova, Vera [Oddeleni Lekarske Genetiky, Hradec Kralove (Czech Republic)


    Gracile bone dysplasias constitute a group of disorders characterised by extremely slender bones with or without fractures. We report four newborns, two of whom showed multiple fractures. Two babies had osteocraniostenosis and one had features of oligohydramnios sequence. The diagnosis in the fourth newborn, which showed thin long bones and clavicles and extremely thin, poorly ossified ribs, is uncertain. Exact diagnosis of a gracile bone dysplasia is important for genetic counselling and medico-legal reasons. (orig.)

  8. Proximal Tibiofibular Joint: An overview

    Directory of Open Access Journals (Sweden)

    Tze Wang Chan


    Full Text Available Proximal tibiofibular joint is a frequently neglected joint which can be a source of lateral knee pain. Open surgery is the current mainstay of surgical management of proximal tibiofibular joint disorders. The proximal tibiofibular arthroscopy allows access to the joint and adjacent important ligamentous structures. This forms the basis of further development of arthroscopic procedures for a variety of pathologies.

  9. of the stomach (ID 345), neutralisation of gastric acid (ID 345), contribution to normal formation of collagen and connective tissue (ID 287, 288, 333, 334, 335, 1405, 1652, 1718, 1719, 1945), maintenance of normal bone (ID 287, 335, 1652, 1718, 1945), maintenance of normal joints (ID 1405, 1652, 1945, ), maintenance of normal appearance and elasticity of the skin (ID 288, 333), and contribution to normal formation of hair and nails (ID 334, 1652, 1719) pursuant to Article 13(1) of Regulation (EC) No 1924/2006

    DEFF Research Database (Denmark)

    Tetens, Inge

    claims in relation to silicon and protection against aluminium accumulation in the brain, cardiovascular health, forming a protective coat on the mucous membrane of the stomach, neutralisation of gastric acid, contribution to normal formation of collagen and connective tissue, maintenance of normal bone......, maintenance of normal joints, maintenance of normal appearance and elasticity of the skin, and contribution to normal formation of hair and nails. The scientific substantiation is based on the information provided by the Member States in the consolidated list of Article 13 health claims and references...

  10. Enzymatic maceration of bone

    DEFF Research Database (Denmark)

    Uhre, Marie-Louise; Eriksen, Anne Marie; Simonsen, Kim Pilkjær;


    the bones. The DNA analysis showed that DNA was preserved on all the pieces of bones which were examined. Finally, the investigation suggests that enzyme maceration could be gentler on the bones, as the edges appeared less frayed. The enzyme maceration was also a quicker method; it took three hours compared...

  11. [Biomechanics of the ankle joint]. (United States)

    Zwipp, H


    According to Fick, the tree-dimensional patterns of foot motion are best characterized as jawlike movement. Anatomically and biomechanically, this process represents conjoined, synchronous motion within the three mobile segments of the hindfoot: the ankle joint, the posterior subtalar joint, and the anterior subtalar joint. Foot kinematics can be described more completely if the anterior subtalar joint is defined not only as the talocalcaneal navicular joint, but as including the calcaneocuboid joint, thus representing the transverse joint of the tarsus, i.e., the Chopart joint. The axes of these three joints can be defined precisely. In some parts they represent a screwlike motion, clockwise or counter-clockwise, around the central ligamentous structures (fibulotibial ligament, talocalcaneal interosseous ligament, bifurcate ligament). The individual anatomy and structure of these ligaments provide variations in the degree and direction of foot motion. A precise knowledge of foot kinematics is important in surgical ligament and joint reconstruction and in selective foot arthrodeses.

  12. The Digital Astronaut Project Computational Bone Remodeling Model (Beta Version) Bone Summit Summary Report (United States)

    Pennline, James; Mulugeta, Lealem


    prescriptions on preserving bone. More specifically, the model will accept loading history due to muscle and joint force on bone and produce quantified remodeling within the bone region under influence of the applied stress. Furthermore, because they tend to respond differently, the bone remodeling model includes both trabecular bone and cortical bone.

  13. Direct Joint Detection from Humanoid 3D Models without using Skeleton Information

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    Terumasa Aoki


    Full Text Available Skeletonization, or automatic skeleton extraction, is one of the most essential technologies in 3DCG. This technology makes it possible to automatically extract skeletons (i.e. bones, joints and their hierarchical structures from 3D models. Such skeletons are important shape and pose descriptors for object representation, object recognition etc. They are used in many applications such as 3D model search, virtual character's pose estimation and collision detection between two or more 3D models. However, existing skeletonization methods have some drawbacks. Most of the existing skeletonization methods have difficulties in correctly extracting the positions of joints. In most methods, bones are extracted from a 3D model first and joints are defined as the cross points of bones. However some errors always occur when bones are extracted. Hence joints cannot be found in this scheme so often. Furthermore, they are not allowing for controlling the number of bones/joints and their structure. Therefore applying motion data acquired from motion capture devices to 3D models still involves a lot of cumbersome manual work. In this paper, we propose a novel joint detection method suited for kinematic skeleton generation, skeleton rigging etc. Unlike the existing methods, the proposed method detects joint positions directly without using skeleton (bone information. So the proposed method can avoid propagating errors occurred by skeletonization process. Also, the proposed method is able to extract the same numbers of joints/bones and the same structure as in given motion data, i.e. one can directly apply existing motion data without the need of manual adjustment. In general, 3D models describe shape information and pose information simultaneously. Distinguishing one from the other seems to be very difficult. However, the proposed method solves this problem by extracting only the pose information of 3D models by using a vertex Gauss sphere representation and

  14. Oxytocin and bone (United States)

    Sun, Li; Zaidi, Mone; Zallone, Alberta


    One of the most meaningful results recently achieved in bone research has been to reveal that the pituitary hormones have profound effect on bone, so that the pituitary-bone axis has become one of the major topics in skeletal physiology. Here, we discuss the relevant evidence about the posterior pituitary hormone oxytocin (OT), previously thought to exclusively regulate parturition and breastfeeding, which has recently been established to directly regulate bone mass. Both osteoblasts and osteoclasts express OT receptors (OTR), whose stimulation enhances bone mass. Consistent with this, mice deficient in OT or OTR display profoundly impaired bone formation. In contrast, bone resorption remains unaffected in OT deficiency because, even while OT stimulates the genesis of osteoclasts, it inhibits their resorptive function. Furthermore, in addition to its origin from the pituitary, OT is also produced by bone marrow osteoblasts acting as paracrine-autocrine regulator of bone formation modulated by estrogens. In turn, the power of estrogen to increase bone mass is OTR-dependent. Therefore, OTR−/− mice injected with 17β-estradiol do not show any effects on bone formation parameters, while the same treatment increases bone mass in wild-type mice. These findings together provide evidence for an anabolic action of OT in regulating bone mass and suggest that bone marrow OT may enhance the bone-forming action of estrogen through an autocrine circuit. This established new physiological role for OT in the maintenance of skeletal integrity further suggests the potential use of this hormone for the treatment of osteoporosis. PMID:25209411

  15. Joint ventures in medical services. (United States)

    Rublee, D A


    This paper is an overview of joint-venture activity in healthcare, describing trends in joint ventures and raising issues for physicians. The purposes are to discuss the major current facets of joint-venture alliances in healthcare and to identify policy issues that arise from the trend to use joint ventures as an organizational tool. Speculation is made about the future role of joint ventures in the organization of healthcare.

  16. Development of a knee joint motion simulator to evaluate deep knee flexion of artificial knee joints. (United States)

    Takano, Y; Ueno, M; Kiguchi, K; Ito, J; Mawatari, M; Hotokebuchi, T


    A purpose of this study is to examine the effect that quadriceps femoris force gives to rotation angle and joint reaction force of total knee prosthesis during deep knee flexion such as a unique sitting style called 'seiza' in Japanese. For the evaluation, we developed the knee motion simulator which could bend to 180 degrees continually simulating the passive flexion performed by clinicians. A total knee prosthesis, which is a specially-devised posterior stabilized type and capable of flexion up to 180 degrees, was inserted into bone model. And this prosthesis pulled by three kinds of quadriceps femoris forces to perform parameter study. The results obtained in this study were showed the same tendency with those in the past cadaveric experiment. It is suggested that the rotation angle and joint reaction force of total knee prosthesis are affected by shape of prosthesis, a vector of quadriceps femoris force, and bony aliments during deep knee flexion.

  17. Microstimulation at the bone-implant interface upregulates osteoclast activation pathways. (United States)

    Stadelmann, Vincent A; Terrier, Alexandre; Pioletti, Dominique P


    Peri-implant bone resorption after total joint arthroplasty is a key parameter in aseptic loosening. Implant wear debris and biomechanical aspects have both been demonstrated to be part of the bone resorption process. However, neither of these two parameters has been clearly identified as the primary initiator of peri-implant bone resorption. For the biomechanical parameters, micromotions were measured at the bone-implant interface during normal gait cycles. The amplitude of the micromotions was shown to trigger differentiation of bone tissues. So far no data exists directly quantifying the effect of micromotion and compression on human bone. We hypothesize that micromotion and compression at the bone-implant interface may induce direct activation of bone resorption around the implant through osteoblasts-osteoclasts cell signaling in human bone. This hypothesis was tested with an ex vivo loading system developed to stimulate trabecular bone cores and mimic the micromotions arising at the bone-implant interface. Gene expression of RANKL, OPG, TGFB2, IFNG and CSF-1 was analyzed after no mechanical stimulation (control), exposure to compression or exposure to micromotions. We observed an 8-fold upregulation of RANKL after exposure to micromotions, and downregulation of OPG, IFNG and TGFB2. The RANKL:OPG ratio was upregulated 24-fold after micromotions. This suggests that the micromotions arising at the bone-implant interface during normal gait cycles induce a bone resorption response after only 1 h, which occurs before any wear debris particles enter the system.

  18. Bone regeneration with cultured human bone grafts

    Energy Technology Data Exchange (ETDEWEB)

    Yoshikawa, T.; Nakajima, H. [Nara Medical Univ., Kashihara City (Japan). Dept. of Pathology; Nara Medical Univ., Kashihara City (Japan). Dept. of Orthopedic Surgery; Ohgushi, H.; Ueda, Y.; Takakura, Y. [Nara Medical Univ., Kashihara City (Japan). Dept. of Orthopedic Surgery; Uemura, T.; Tateishi, T. [National Inst. for Advanced Interdisciplinary Research (NAIR), Ibaraki (Japan). Tsukuba Research Center; Enomoto, Y.; Ichijima, K. [Nara Medical Univ., Kashihara City (Japan). Dept. of Pathology


    From 73 year old female patient, 3 ml of bone marrow was collected from the ilium. The marrow was cultured to concentrate and expand the marrow mesenchymal cells on a culture dish. The cultured cells were then subculturedeither on another culture dish or in porous areas of hydroxyapatite ceramics in the presence of dexamethasone and beta-glycerophosphate (osteo genic medium). The subculturedtissues on the dishes were analyzed by scanning electron microscopy (SEM), and subculturedtissues in the ceramics were implanted intraperitoneally into athymic nude mice. Vigorous growth of spindle-shaped cells and a marked formation of bone matrix beneath the cell layers was observed on the subculture dishes by SEM. The intraperitoneally implanted ceramics with cultured tissues revealed thick layer of lamellar bone together with active osteoblasts lining in many pore areas of the ceramics after 8 weeks. The in vitro bone formations on the culture dishes and in vivo bone formation in porous ceramics were detected. These results indicate that we can assemble an in vitro bone/ceramic construct, and due to the porous framework of the ceramic, the construct has osteogenic potential similar to that of autologous cancellous bone. A significant benefit of this method is that the construct can be made with only a small amount of aspirated marrow cells from aged patients with little host morbidity. (orig.)

  19. Temporomandibular joint examination reviewed

    Directory of Open Access Journals (Sweden)

    L. Guarda Nardini


    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  20. Temporomandibular joint disorders. (United States)

    Buescher, Jennifer J


    Temporomandibular joint disorders are common in adults; as many as one third of adults report having one or more symptoms, which include jaw or neck pain, headache, and clicking or grating within the joint. Most symptoms improve without treatment, but various noninvasive therapies may reduce pain for patients who have not experienced relief from self-care therapies. Physical therapy modalities (e.g., iontophoresis, phonophoresis), psychological therapies (e.g., cognitive behavior therapy), relaxation techniques, and complementary therapies (e.g., acupuncture, hypnosis) are all used for the treatment of temporomandibular joint disorders; however, no therapies have been shown to be uniformly superior for the treatment of pain or oral dysfunction. Noninvasive therapies should be attempted before pursuing invasive, permanent, or semi-permanent treatments that have the potential to cause irreparable harm. Dental occlusion therapy (e.g., oral splinting) is a common treatment for temporomandibular joint disorders, but a recent systematic review found insufficient evidence for or against its use. Some patients with intractable temporomandibular joint disorders develop chronic pain syndrome and may benefit from treatment, including antidepressants or cognitive behavior therapy.

  1. Bone densitometry in dogs using gamma radiation

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, A.L.B.; Costa, V.E.; Rezende, M.A.; Grossklauss, D.B.B.F.; Oliveira, T.B. [UNESP, Botucatu, SP (Brazil)


    Full text. The purpose of this work came from the possibility of joining similar methodologies for determination of density, used in different areas, and provide more precise values of bone density by analyzing the mass attenuation coefficient. For over 20 years, The Applied Physics Laboratory, Department of Physics and Biophysics, IBB- UNESP, Botucatu campus, has been working in the determination of density in different areas, using the methods of immersion and gamma radiation attenuation. The results presented have excellent precision, due to the facility in obtaining and preparing samples, coupled to the large experience in the area. This study aims to determine the bone density of samples of mongrel dogs (dogs without defined breed) by the immersion method; to determine the mass attenuation coefficient of bones samples of mongrel dogs with a gamma radiation source; to discuss and to evaluate the methodological aspects involved in the optic densitometry used nowadays, presenting its advantages and disadvantages and, finally, to examine the effect of animal weight, age and sex on bone densitometry of medium-sized dogs. For this study, we use upper limbs samples, at the joint region humerus-radio-ulnar of after death mongrel dogs, assigned by the Department of Pathology, Faculty of Animal Science and Veterinary Medicine (UNESP-Botucatu) and by the Kennel of the city of Araras, Sao Paulo. This work is performed in three stages. In the first step is determined the density by the method of immersion in water, in the second step, is obtained the mass coefficient attenuation and, finally, in the third step are discussed the implemented methods and evaluate the density bone samples to establish correlations with the age, weight and sex parameters of each group of animals. Based on this methodology , we can find the average value for the mass attenuation coefficient of gamma radiation with energy 59,6, find variations in the values of bone densitometry in the same bone


    Directory of Open Access Journals (Sweden)

    Wijianto Wijianto


    Full Text Available This paper discuss about ceramics in application as bone implant. Bioceramics for instance Hydroxyapatite, usually is abbreviated with HA or HAp, is a mineral that is very good physical properties as bone replacement in human body. To produce Hydroxyapatite, coating process is used which have good potential as they can exploit the biocompatible and bone bonding properties of the ceramic. There are many advantages and disadvantages of bioceramics as bone implant. Advantages of hydroxyapatite as bone implant are rapidly integrated into the human body, and is most interesting property that will bond to bone forming indistinguishable unions. On contrary, disadvantages of hydroxyapatite as bone implant are poor mechanical properties (in particular fatigue properties mean that hydroxyapatite cannot be used in bulk form for load bearing applications such as orthopaedics and poor adhesion between the calcium phosphate coating and the material implant will occur.

  3. The usefulness of bone scintigraphy in SAPHO syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)


    SAPHO syndrome is well known to various disease entities including synovitis, acne, pustulosis, hyperostosis and polyarthritis. The purpose of this study is to evaluate sicntigraphic findings and to compare with radiologic findings in SAPHO syndrome. Five patients (M:F=5:0, Age 22.8{+-}4.78 yrs) with SAPHO syndrome were enrolled in our study. All patients underwent whole-body bone scintigraphy with intravenous administration of 740 MBq of Tc-99m MDP. Among them, two patients were additionally perfomed SPECT of the spine to evaluate the location and extent of spinal lesion. All patients were demonstrated abnormal increased uptakes in sternoclavicular joint (SC), sacroiliac joint (SI), and small joints of both hands. Among them, three patients were bilateral involvement (3/5) and two were unilateral (2/5) in SC. Involvement of SI showed bilateral in four patients (4/5) and unilateral in one (1/5). SPECT images demonstrate that the lesion sites of the lumbar spine are more likely facet joints than vertebral bodies or pedicles. As SAPHO syndrome is the disease entity involved polyarticular joints with various dermatologic manifestations, the bone scintigraphy may be a very useful method to evaluate the location and extent of joint involvement, and to avoid inadequate surgical management or ineffective antibiotic treatment.

  4. Diabetes, Biochemical Markers of Bone Turnover, Diabetes Control, and Bone


    Starup-Linde, Jakob


    Diabetes mellitus is known to have late complications including micro vascular and macro vascular disease. This review focuses on another possible area of complication regarding diabetes; bone. Diabetes may affect bone via bone structure, bone density, and biochemical markers of bone turnover. The aim of the present review is to examine in vivo from humans on biochemical markers of bone turnover in diabetics compared to non-diabetics. Furthermore, the effect of glycemic control on bone marker...

  5. Facet joint laser radiation: tissue effects of a new clinical laser application (United States)

    Werkmann, Klaus; Thal, Dietmar R.


    Chronic unilateral and bilateral back pain with pseudoradicular symptoms, is a common clinical syndrome, which in many cases can be related to the facet joint syndrome. The pain is caused by mechanical affection of synovial and capsular nerve terminals. Therefore, current therapeutical attempts including physical therapy, intra-articular injection of local anesthetics and steroids and thermocoagulation of the facet joint with a thermocoagulator, are performed. We confirmed laser coagulation of the facet joint. Porcine cadaveric spines were treated immediately after death by intra-articular facet joint laser radiation. With the pulsed Nd:YAG laser (1064 nm) altogether 600 J were applied in three different places 4 mm apart at the top of the facet joint. The results showed that facet joint laser radiation leads to a small (about 1 - 2 mm diameter) lesion restricted to the facet joint cavity and its synovia. Histologically, we found a central carbonization zone and necrosis, including almost the whole cartilage and approximately 0.2 mm of the adjacent bone. These changes are similar to Nd:Yag-laser applications in other skeletal regions. It is suggested that these changes may lead to facet joint denervation by coagulation of the synovial nerve terminals. Cicatration of the laser lesion might cause ankylosis of this joint. In sum, facet joint laser radiation could be an alternative therapeutical tool for lower back pain of the facet joint syndrome type. Therefore, future clinical application of this technique seems to be very promising.

  6. MRI of cystic collection of the three joint; Les collections kystiques du genou en IRM

    Energy Technology Data Exchange (ETDEWEB)

    Boutry, N.; Cotten, A.; Dewatre, F.; Chastanet, P.; Gougeon, F. [Hopital R. Salengro, C.H.U., 59 - Lille (France)


    We present the main MR features of cystic lesions around the knee joint. Popliteal cysts are the most frequently seen. The usually result from extrusion of joint fluid into the gastrocnemio-semimembranosus bursa but they can have an atypical location or extension. They are most often due to a meniscal, ligamentous, degenerative or inflammatory joint disease responsible for a chronic joint effusion. Meniscal cysts are always associated with a horizontal tear. Medial meniscal cysts are larger and can extend far from the joint. Bursitis occur as a result of inflammation or infection of a bursa. Their location is stereotyped and they do not communicate with the knee joint. Ganglion cysts or ganglia are benign cystic lesions which can affect peri-articular tissues as well as subchondral bone or cruciate ligaments. MRI is now a simple and noninvasive way of obtaining etiologic diagnosis and guiding therapy. (authors). 46 refs.

  7. RANK, RANKL and osteoprotegerin in arthritic bone loss

    Directory of Open Access Journals (Sweden)

    M.C. Bezerra


    Full Text Available Rheumatoid arthritis is characterized by the presence of inflammatory synovitis and destruction of joint cartilage and bone. Tissue proteinases released by synovia, chondrocytes and pannus can cause cartilage destruction and cytokine-activated osteoclasts have been implicated in bone erosions. Rheumatoid arthritis synovial tissues produce a variety of cytokines and growth factors that induce monocyte differentiation to osteoclasts and their proliferation, activation and longer survival in tissues. More recently, a major role in bone erosion has been attributed to the receptor activator of nuclear factor kappa B ligand (RANKL released by activated lymphocytes and osteoblasts. In fact, osteoclasts are markedly activated after RANKL binding to the cognate RANK expressed on the surface of these cells. RANKL expression can be upregulated by bone-resorbing factors such as glucocorticoids, vitamin D3, interleukin 1 (IL-1, IL-6, IL-11, IL-17, tumor necrosis factor-alpha, prostaglandin E2, or parathyroid hormone-related peptide. Supporting this idea, inhibition of RANKL by osteoprotegerin, a natural soluble RANKL receptor, prevents bone loss in experimental models. Tumor growth factor-ß released from bone during active bone resorption has been suggested as one feedback mechanism for upregulating osteoprotegerin and estrogen can increase its production on osteoblasts. Modulation of these systems provides the opportunity to inhibit bone loss and deformity in chronic arthritis.

  8. Use of Gamma Correction Pinhole Bone Scans in Trauma

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Youg Whee [Sung Ae Hospital, Seoul (Korea, Republic of); Chung, Youg An; Park, Jung Mee [Catholic Univ. of Korea, Seoul (Korea, Republic of)


    {sup 99}mTc hydroxydiphosphonate (HDP) bone scanning is a classic metabolic nuclear imaging method and the most frequently performed examination. Clinically, it has long been cherished as an indispensable diagnostic screening tool and for monitoring of patients with bone, joint, and soft tissue diseases. The HDP bone scan, the pinhole scan in particular, is known for its ability to detect increased, decreased, or defective tracer uptake along with magnified anatomy. Unfortunately, however, the findings of such uptake changes are not specific in many traumatic bone disorders, especially when lesions are minute and complex. This study discusses the recently introduced gamma correction pinhole bone scan (GCPBS), emphasizing its usefulness in the diagnosis of traumatic bone diseases including occult fractures; and fish vertebra. Indeed, GCPBS can remarkably enhance the diagnostic feasibility of HDP pinhole bone scans by refining the topography, pathologic anatomy, and altered chemical profile of the traumatic diseases in question. The fine and precise depiction of anatomic and metabolic changes in these diseases has been shown to be unique to GCPBS, and they are not appreciated on conventional radiographs, multiple detector CT, or ultrasonographs. It is true that MR imaging can portray proton change, but understandably, it is a manifestation that is common to any bone disease.

  9. Effect of thermodisinfection on mechanic parameters of cancellous bone. (United States)

    Fölsch, Christian; Kellotat, Andreas; Rickert, Markus; Ishaque, Bernd; Ahmed, Gafar; Pruss, Axel; Jahnke, Alexander


    Revision surgery of joint replacements is increasing and raises the demand for allograft bone since restoration of bone stock is crucial for longevity of implants. Proceedings of bone grafts influence the biological and mechanic properties differently. This study examines the effect of thermodisinfection on mechanic properties of cancellous bone. Bone cylinders from both femoral heads with length 45 mm were taken from twenty-three 6-8 months-old piglets, thermodisinfected at 82.5 °C according to bone bank guidelines and control remained native. The specimens were stored at -20 °C immediately and were put into 21 °C Ringer's solution for 3 h before testing. Shear and pressure modulus were tested since three point bending force was examined until destruction. Statistical analysis was done with non-parametric Wilcoxon, t test and SPSS since p mechanic properties of cancellous bone and the reduction of mechanic properties should not relevantly impair clinical use of thermodisinfected cancellous bone.

  10. Segmentation of multiple knee bones from CT for orthopedic knee surgery planning. (United States)

    Wu, Dijia; Sofka, Michal; Birkbeck, Neil; Zhou, S Kevin


    Patient-specific orthopedic knee surgery planning requires precisely segmenting from 3D CT images multiple knee bones, namely femur, tibia, fibula, and patella, around the knee joint with severe pathologies. In this work, we propose a fully automated, highly precise, and computationally efficient segmentation approach for multiple bones. First, each bone is initially segmented using a model-based marginal space learning framework for pose estimation followed by non-rigid boundary deformation. To recover shape details, we then refine the bone segmentation using graph cut that incorporates the shape priors derived from the initial segmentation. Finally we remove overlap between neighboring bones using multi-layer graph partition. In experiments, we achieve simultaneous segmentation of femur, tibia, patella, and fibula with an overall accuracy of less than 1mm surface-to-surface error in less than 90s on hundreds of 3D CT scans with pathological knee joints.

  11. Coralline hydroxyapatite is a suitable bone graft substitute in an intra-articular goat defect model. (United States)

    Koëter, S; Tigchelaar, S J; Farla, P; Driessen, L; van Kampen, A; Buma, P


    Intra-articular defects can be filled with an autologous bone graft taken from the iliac crest. This can be indicated after trauma or following correcting osteotomy. Patients may encounter donor site morbidity after this procedure. In this in vivo study, we studied if coralline hydroxyapatite (CHA) is a suitable material to replace autologous bone graft to fill a defect in the femoral trochlea of goats. CHA did not evoke any negative reaction in the synovium, and the articular cartilage was comparable to controls. In the bone graft group, we found scattered areas of (enchondral formed) bone. Most bone graft had been resorbed or remodeled, and the scarce remnants were incorporated into new bone. Resorption of CHA was limited or absent and most CHA was surrounded by new bone. In areas with fragmented CHA, close to the joint surface, numerous giant cells were found. The study shows that in this animal model, CHA inserted in a defect that directly communicates with the joint space incorporates into bone. This study did not show any negative effects of CHA in a joint environment.

  12. Combined use of bone and bone marrow scintigraphies for the diagnosis of active sacroiliitis. A new approach

    Energy Technology Data Exchange (ETDEWEB)

    Bozkurt, M.F.; Ugur, O.; Ertenli, I.; Caner, B. [Hacettepe Univ., Ankara (Turkey). Faculty of Medicine


    Diagnosis of sacroiliitis (SI) with bone scintigraphy may involve difficulties even with a quantitative approach. The aim of this study was to evaluate the combined use of bone and bone marrow scintigraphies for the diagnosis of active sacroiliitis. Thirty-one patients who were clinically suspected to have SI were included in the study. Bone and marrow scintigraphies were done after injections of 740 MBq of {sup 99m}Tc-MDP (MDP) and 370 MBq of {sup 99m}Tc-sulfur colloid (SC) respectively with a 2-day interval. Both visual and quantitative assessment of MDP uptake and visual assessment of SC uptake in sacroiliac joints were performed. Also sacroiliac joint radiographic findings for each patient were evaluated and graded from 0 to 4 according to the New York grading system. Patients were divided into 2 groups according to their x-ray findings (Group A: grade 0-2, Group B: grade 3-4). A total of 14 patients (10 bilateral, 4 unilateral) had increased MDP uptake with decreased/normal SC uptake. Twelve of 14 patients had grade 0-2 radiographic changes while only 2 patients had grade 3-4 radiographic changes. Increased MDP uptake with decreased/normal SC uptake is the most common scintigraphic pattern seen in acute phase SI in which radiographic findings are generally found to be normal or slightly changed. In at least in 8 patients the decreased bone marrow uptake of SC was demonstrated, supporting the diagnosis. Although our results did not reveal any significant superiority of bone marrow scintigraphy to bone scan for the detection of active sacroiliitis, combined use of bone and bone marrow scintigraphies was presented as an alternative method to characterize patients with active sacroiliitis. (author)

  13. Studies of welded joints

    Directory of Open Access Journals (Sweden)

    J. M. Krupa


    Full Text Available Studies of a welded joint were described. The joint was made as a result of the reconstruction of a truss and one of the possible means to make a repair. The studies were of a simulation character and were targeted at the detection of welding defects and imperfections thatshould be eliminated in a real structure. A model was designed and on this model the tests and examinations were carried out. The modelwas made under the same conditions as the conditions adopted for repair. It corresponded to the real object in shape and dimensions, and in the proposed technique of welding and welding parameters. The model was composed of five plates joined together with twelve beads.The destructive and non-destructive tests were carried out; the whole structure and the respective welds were also examined visually. Thedefects and imperfections in welds were detected by surface methods of inspection, penetration tests and magnetic particle flaw detection.The model of the welded joint was prepared by destructive methods, a technique that would never be permitted in the case of a realstructure. For the investigations it was necessary to cut out the specimens from the welded joint in direction transverse to the weld run. The specimens were subjected to metallographic examinations and hardness measurements. Additionally, the joint cross-section was examined by destructive testing methods to enable precise determination of the internal defects and imperfections. The surface methods were applied again, this time to determine the severity of welding defects. The analysis has proved that, fabricated under proper conditions and with parameters of the welding process duly observed, the welded joint has good properties and repairs of this type are possible in practice.

  14. Joint loads in marsupial ankles reflect habitual bipedalism versus quadrupedalism.

    Directory of Open Access Journals (Sweden)

    Kristian J Carlson

    Full Text Available Joint surfaces of limb bones are loaded in compression by reaction forces generated from body weight and musculotendon complexes bridging them. In general, joints of eutherian mammals have regions of high radiodensity subchondral bone that are better at resisting compressive forces than low radiodensity subchondral bone. Identifying similar form-function relationships between subchondral radiodensity distribution and joint load distribution within the marsupial postcranium, in addition to providing a richer understanding of marsupial functional morphology, can serve as a phylogenetic control in evaluating analogous relationships within eutherian mammals. Where commonalities are established across phylogenetic borders, unifying principles in mammalian physiology, morphology, and behavior can be identified. Here, we assess subchondral radiodensity patterns in distal tibiae of several marsupial taxa characterized by different habitual activities (e.g., locomotion. Computed tomography scanning, maximum intensity projection maps, and pixel counting were used to quantify radiodensity in 41 distal tibiae of bipedal (5 species, arboreal quadrupedal (4 species, and terrestrial quadrupedal (5 species marsupials. Bipeds (Macropus and Wallabia exhibit more expansive areas of high radiodensity in the distal tibia than arboreal (Dendrolagus, Phascolarctos, and Trichosurus or terrestrial quadrupeds (Sarcophilus, Thylacinus, Lasiorhinus, and Vombatus, which may reflect the former carrying body weight only through the hind limbs. Arboreal quadrupeds exhibit smallest areas of high radiodensity, though they differ non-significantly from terrestrial quadrupeds. This could indicate slightly more compliant gaits by arboreal quadrupeds compared to terrestrial quadrupeds. The observed radiodensity patterns in marsupial tibiae, though their statistical differences disappear when controlling for phylogeny, corroborate previously documented patterns in primates and

  15. Transversely Compressed Bonded Joints

    DEFF Research Database (Denmark)

    Hansen, Christian Skodborg; Schmidt, Jacob Wittrup; Stang, Henrik


    The load capacity of bonded joints can be increased if transverse pressure is applied at the interface. The transverse pressure is assumed to introduce a Coulomb-friction contribution to the cohesive law for the interface. Response and load capacity for a bonded single-lap joint was derived using...... non-linear fracture mechanics. The results indicated a good correlation between theory and tests. Furthermore, the model is suggested as theoretical base for determining load capacity of bonded anchorages with transverse pressure, in externally reinforced concrete structures....

  16. Joint for deployable structures (United States)

    Craighead, N. D., II; Preliasco, R. J.; Hult, T. D. (Inventor)


    A joint is described for connecting a pair of beams to pivot them between positions in alignment or beside one another, which is of light weight and which operates in a controlled manner. The joint includes a pair of fittings and at least one center link having opposite ends pivotally connected to opposite fittings and having axes that pass through centerplates of the fittings. A control link having opposite ends pivotally connected to the different fittings controls their relative orientations, and a toggle assemly holds the fittings in the deployed configuration wherein they are aligned. The fittings have stops that lie on one side of the centerplane opposite the toggle assembly.

  17. Evaluation of the magnitude of hip joint deformation in subjects with avascular necrosis of the hip joint during walking with and without Scottish Rite orthosis. (United States)

    Karimi, Mohammad Taghi; Mohammadi, Ali; Ebrahimi, Mohammad Hossein; McGarry, Anthony


    The femoral head in subjects with leg calve perthes disease (LCPD) is generally considerably deformed. It is debatable whether this deformation is due to an increase in applied loads, a decrease in bone mineral density or a change in containment of articular surfaces. The aim of this study was to determine the influence of these factors on deformation of the femoral head. Two subjects with LCPD participated in this study. Subject motion and the forces applied on the affected leg were recorded using a motion analysis system (Qualsis(TM)) and a Kistler force plate. OpenSim software was used to determine joint contact force of the hip joint whilst walking with and without a Scottish Rite orthosis. 3D Models of hip joints of both subjects were produced by Mimics software. The deformation of femoral bone was determined by Abaqus. Mean values of the force applied on the leg increased while walking with the orthosis. There was no difference between bone mineral density (BMD) of the femoral bone of normal and LCPD sides (p-value>0.05) and no difference between hip joint contact force of normal and LCPD sides. Hip joint containment appeared to decrease follow the use of the orthosis. It can be concluded that the deformation of femoral head in LCPD may not be due to change in BMD or applied load. Although the Scottish Rite orthosis is used mostly to increase hip joint containment, it appears to reduce hip joint contact area. It is recommended that a similar study is conducted using a higher number of subjects.

  18. Magnetic resonance imaging of bone bruising in the acutely injured knee--short-term outcome

    Energy Technology Data Exchange (ETDEWEB)

    Davies, N.H.; Niall, D.; King, L.J.; Lavelle, J.; Healy, J.C. E-mail:


    AIM: To investigate the short-term outcome and associated injuries of bone bruising in the acutely injured knee. METHOD AND MATERIALS: Thirty patients (age range 17-39 years, mean 28 years) with bone bruising identified on magnetic resonance imaging (MRI) after an acute knee injury were rescanned 12-14 weeks post-injury. The volume of bone bruising was measured on coronal STIR (short TI inversion recovery) images and correlation made with the presence and type of ligamentous and osteochondral injuries. RESULTS: All bone bruises were present on repeat MRI. Twenty of the 30 patients (67%) had associated anterior cruciate ligament (ACL) injuries, seven of the 30 (23%) had collateral ligament injuries and three of the 30 (10%) had no associated ligamentous injuries. Greater than 50% reduction in bone bruise volume was demonstrated at repeat scanning in 24 of the 30 patients (80%) and less than 50% in five of the 30 patients (17%). One patient showed an increase in volume of bone bruising at follow-up. There was no correlation between initial size or size reduction of bone bruising and the presence/absence or type of associated injuries. In 21 patients the bone bruises resolved from the periphery, whilst eight patients showed bone bruises that resolved towards the joint margin, all of whom had associated osteochondral injuries. Of the 30 patients, 17 showed bone bruising that extended to the joint margin, 10 of whom had associated osteochondral injuries on MRI. On clinical review some degree of knee pain was still present in all but one of the patients reviewed. The single patient who reported complete resolution of symptoms was one of the three patients with isolated bone bruising CONCLUSION: Bone bruises persist for at least 12-14 weeks, which is longer than previously quoted. Two discrete patterns of bone bruise resolution have been demonstrated. The size and persistence of bone bruising is not related to the presence or absence or type of associated ligamentous

  19. Knee joint morphogenesis of the quail (Coturnix japonica) embryo. (United States)

    Shojaei, Bahador; Talebhemat, Mahdokht; Hashemnia, Shadi; Shojaeepour, Saeedeh


    Knee joint development and its morphogenetic events have been studied in human, chicken and other animal models and differences have been found in the pattern of the knee joint morphogenesis among the studied species. According to the small number of studies which have focused on the chronology of knee morphogenesis, a "morphogenetic timely pattern" is hard to suggest. Quail is an animal model for which there is no information about knee joint morphogenesis. This study was planned to define the time table of the knee joint structures formation in this bird. For this purpose embryonated Japanese quail eggs were incubated for 3 to 12 days. Embryos were removed from their eggs every twelve hours and staged according to Ainsworth et al. The hind limbs of the embryos at the stages 17 to 41 were dissected and 6 μm thick slides were prepared from their knee region. The time of appearance of menisci, ligaments, articular cavity and other knee joint components were identified in the quail embryo. During quail knee morphogenesis we observed the appearance of a three layered interzone, femorotibial cavitation and long bone ossification earlier than in chicken. A hypothesis is presented on the differential role of the flexor and extensor muscles of the knee joint on embryonic knee development in birds as compared with humans.

  20. Biomechanical Aspects of Shoulder and Hip Articulations: A Comparison of Two Ball and Socket Joints

    Directory of Open Access Journals (Sweden)

    Mustafa Qusay Ismael


    Full Text Available The shoulder and hip joints though essentially both are ball and socket joints, show structural variability to serve functional aims at revealing some of the structural and functional properties of each of the two joints regarding the factors that contribute to the stability of any joint in the body, namely: bone, ligament, and muscleTwenty dried scapula, hip, humerus, and femur were used. The area of the articular surfaces was estimated by molding a sheet of dental wax. Using special graphics software, a novel procedure was described to calculate the area under the curve, which was postulated to indicate the degree of curvature. Tension test was applied using a testometric machine, which was locally modified to suit biological specimens. A finite element analysis was designed to study the articulating bones under different loading conditionsIn the hip joint, the area of the articular surface of the head of the femur and that of the lunate showed no significant statistical difference. For the shoulder joint, the articular areas of the head of the humerus and the glenoid were statistically different. No statistical significance was observed regarding curvature of the articular surfaces within both the hip and shoulder joints; however, the values were significantly different between the hip and shoulder. In the tension test, the site of rupture of the capsule of the shoulder joint was found to be at its anteroinferior part. The more contact between the area of the cup and ball, as was demonstrated in the hip joint, the more stable the joint. On the contrary, the shoulder articular surfaces have less area of contact, which makes it more mobile and decreases stability. The insignificant difference in curvature within both joints indicates a good congruity and thus more stability especially during joint movement. The curvature difference between the head of femur and the head of humerus indicates that the range of motion is quite

  1. Desmoid type fibromatosis in the facet joint of lumbar spine: Case report and review of literature

    Energy Technology Data Exchange (ETDEWEB)

    Kim, So Jung; Ha, Doo Hoe; Lee, Sang Min; Kang, Hae Youn [CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)


    Desmoid type fibromatosis is a benign fibroblastic tumor arising from the fascia or musculoaponeurosis. It may occur in various locations, but most commonly in the shoulder girdle and neck; to our knowledge, there has been no reported case originating from a facet joint of the spine. We report CT and MR imaging findings of a desmoid type fibromatosis, involving the facet joint of the L3-4 spine with bone involvement.

  2. Arthrodesis of the proximal interphalangeal joint affected with septic arthritis in 8 horses.


    Groom, L J; Gaughan, E M; Lillich, J D; Valentino, L W


    Arthrodesis was performed to treat septic arthritis of the proximal interphalangeal joint of 8 horses. Records of the horses were reviewed to determine outcome and possible factors that influenced success or failure. All horses were female. Seven horses had 1 joint treated and 1 horse was treated for bilateral pelvic limb involvement. The duration of sepsis before surgery ranged from 1 to 66 days. Bone lysis and production was radiographically apparent in 7 horses before surgery. Six horses h...

  3. Comparison of Upper Limb Joint Forces During Straight Line and Turning Wheelchair Maneuvers (United States)


    epicondyle, lateral epicondyle, radial styloid, ulnar styloid and the second metacarpophalangeal joint of the subjects [11]. Another three markers...Gellman, D. R. Chandler, L. Petrasek, I. Sie, R. Adkins, R. L. Waters, “Carpal tunnel syndrome in paraplegia patients,” J. Bone Joint Surg. Am...propulsion during fatigue,” Arch. Phys. Med. Rehabil., vol. 75, pp.85-93, 1994. [5] R. S. Burnham, R. D. Steadward, “Upper extremity peripheral nerve

  4. Temporomandibular joint ankylosis fixation technique with ultra thin silicon sheet

    Directory of Open Access Journals (Sweden)

    G S Kalra


    Full Text Available Background: Temporomandibular joint ankylosis is a highly distressing condition in which the joint space is obliterated by scar tissue and the patient has an inability to open the mouth. Different autogenous and alloplastic interposition materials have been used after the resection of the ankylotic bone to achieve desirable and long lasting results. The recurrence of disease is most distressing for both patients and surgeon. We have been using ultra thin silicon sheet as our preferred material for providing proper fixation and cover to the joint. We have been encouraged by good patient compliance, no implant extrusion and favourable outcome. Materials and Methods: The clinical study included 80 patients with temporomandibular joint ankylosis, treated between April 2001 and March 2009. In all patients, temporomandibular joint ankylosis had resulted following trauma. Diagnosis was based on clinical assessment supplemented by radiographic examination consisting of a panoramic radiograph, axial and coronal computer tomography. The technique of using ultra thin silicon sheet covering whole of the joint space fixed with non-absorbable nylon 3-0 suture both medially to medial pterygoid muscle and laterally to periosteum of zygomatic arch was employed in all patients. Results: A total of 80 patients were in this study (59 males and 21 females. The aetiology of temporomandibular joint ankylosis was post-traumatic in all cases. The patients′ age ranged from 5 to 45 years. The disease was unilateral in 61 cases and bilateral in 19 cases. Twelve patients, who had previous surgery done in the form of gap arthroplasty in 6 cases, costochondral graft in 4 cases and temporalis muscle in 2 cases, presented with recurrence on the same side. The pre-op inter-incisal mouth opening ranged from 4 to 12 mm. The intraoperative inter-incisal mouth opening ranged from 28 to 46 mm. An additional procedure was done in 13 patients, including placement of costochondral

  5. Automatic finger joint synovitis localization in ultrasound images (United States)

    Nurzynska, Karolina; Smolka, Bogdan


    A long-lasting inflammation of joints results between others in many arthritis diseases. When not cured, it may influence other organs and general patients' health. Therefore, early detection and running proper medical treatment are of big value. The patients' organs are scanned with high frequency acoustic waves, which enable visualization of interior body structures through an ultrasound sonography (USG) image. However, the procedure is standardized, different projections result in a variety of possible data, which should be analyzed in short period of time by a physician, who is using medical atlases as a guidance. This work introduces an efficient framework based on statistical approach to the finger joint USG image, which enables automatic localization of skin and bone regions, which are then used for localization of the finger joint synovitis area. The processing pipeline realizes the task in real-time and proves high accuracy when compared to annotation prepared by the expert.

  6. Neuropathic arthropathy (Charcot's joint) in dialysis patients

    Energy Technology Data Exchange (ETDEWEB)

    Meneghello, A.; Bertoli, M.


    To the author's knowledge, uraemic neuropathy has not been previously reported as a cause of Charcot's joint. In this paper they present three cases in which the association between clinical and radiographic patterns suggest the diagnosis of neuropathic arthropathy. The features of uraemic neuropathy are stressed and the role of secondary hyperparathyroidism in the development of this type of arthropathy is discussed. The extremely severe hyperparathyroidism reported here, may cause tendon and ligament disease, especially at the site of their bone insertion. Uraemic tendon and ligament failures weaken joints and produce further instability, which may be a precipitating factor of uraemic Charcot's joint in patients undergoing chronic haemodialysis. 5 figs.

  7. Joint Custody and Coparenting. (United States)

    Sell, Kenneth D.

    Results are presented of an intensive search of U.S. newspapers and periodicals on the joint custody of children after divorce, where both parents have continued responsibility for parenting and where the children spend part of each week, month, or year with both of the parents. Areas of concern addressed by these materials include the following:…

  8. Jointness: A Selected Bibliography (United States)


    Leavenworth: U.S. Army Combined Arms Center, Combat Studies Institute, 2008. 428pp. (UA25 .C55 2008) carl /download/csipubs...SMARTbook: Guide to Joint, Multinational & Interagency Operations. 2nd ed., rev. Lakeland, FL: Lightning Press, 2009. 302pp. (U260 .W33 2009) Whittaker

  9. Keyed shear joints

    DEFF Research Database (Denmark)

    Hansen, Klaus

    This report gives a summary of the present information on the behaviour of vertical keyed shear joints in large panel structures. An attemp is made to outline the implications which this information might have on the analysis and design of a complete wall. The publications also gives a short...

  10. Jointness, A Selected Bibliography. (United States)


    The Services’ Judge Advocates and Lawyers Move Toward the Next Century. Study Project. Car- lisle Barracks: US Army War College, 5 April 1993. 57pp...Shaping America’s Future Mili- tary." Parameters 24 (Winter 1994-1995): 19-29. Barlow, Jason B. "Interservice Rivalry in the Pacific." Joint Force

  11. Paget's disease of bone (osteitis deformans). (United States)

    Ankrom, M A; Shapiro, J R


    Paget's disease of bone is important in geriatric populations because it is the second most common bone disorder after osteoporosis. In older people, it may be responsible for chronic back pain and joint pain, skeletal deformities, hearing loss, and cranial nerve compression. Paget's disease can reduce both function and mobility in the older people. In addition to newer tests for assessing the activity of Paget's disease, effective therapy is available in the form of salmon calcitonin for nasal administration and new third generation bisphosphonates. Frequently, treatment can reverse the course of the disease. For these reasons, it is feasible for the physician to adopt an aggressive approach to diagnosis and treatment. The objective should be to relieve pain, improve mobility, and forestall debilitating complications. This review will focus on the manifestations and clinical management of Paget's disease. Two cases are presented that illustrate common management problems in older patients.

  12. Cartilage Calcification Mimics Polychondritis in Bone Scintigraphy

    Directory of Open Access Journals (Sweden)

    Hasan Atilgan


    Full Text Available 58 year-old male patient with sternal pain was referred to our Nuclear Medicine Clinic for bone scintigraphy for 2.5 months. Markedly increased activity accumulation in the first bilateral sternocostal junction and increased activity accumulations in 3rd, 4th, 5th sternocostal junctions and lateral portion of inferior part of corpus sterni were seen in late static images without increased perfusion and hyperemia. Soft tissue density and lytic lesions were seen bilaterally in bilateral first costa, sternocostal joints and in right side of xiphoid in his 3D computed tomography (CT. Sternocostal lesions that were seen in bone scintigraphy and CT, was reported as normal in biopsy.

  13. The development of interpretation for temporomandibular joint roentgenograms

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo; Ahn, Pyung Kyu; Park, Tae Won [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)


    The authors analyzed the morphological change of bone structure from 3,140 radiographs (1570 joints) of 785 patients with temporomandibular joint arthrosis, which were obtained by the oblique lateral transcranial projection and orthopantomographs. The interrelation of bone change and clinical symptoms duration of the disease were examined. Also, the bone changes of articular eminence, condyle, articular fossa were examined according to positional change of the condyle in the mouth open and close state. The results were as follows. 1. In the 785 patients with TMJ arthrosis, 782 patients (99.62%) show the positional change of the condyle. Among them 691 patients (88.03%) show the bone change. 2. In TMJ arthrosis patients with bone changes 451 patients (65.27%) showed both the condylar positional changes and bone changes bilaterally. 198 patients (28.65%) show the condylar positional changes bilaterally and bone changes unilaterally. 3. The bone changes in the TMJ arthrosis were in order of frequency eburnation (647 cases, 32.8%), erosion (548 cases , 27.79%), flattening (418 cases, 21.20%), deformity (138 cases, 6.99%), sclerosis (115 cases, 5.83%), marginal proliferation (106 cases, 5.38%). The region of bone change in TMJ arthrosis with condylar positional changes were in order of frequency the articular eminence (43.97%) condylar head (38.64%), articular fossa (17.39%). 4. In the patients with bone changes, their clinical symptoms were pain (44.34%), clicking sound (33.5%), limitation of mouth opening (22.52%). In the patients complaining pain the most frequent bone change was erosion (28.60%), in the patients complaining clicking sound, eburnation (28.97%) in the patients complaining the limitation, eburnation (29.40%). Also in the patients with the duration below 1 year most common bone change was eburnation. 5. The most common condylar positional change was downward position (39.94%) in closed state, restricted movement of condyle (30.07%) in open state. The

  14. Subchondral bone in osteoarthritis: insight into risk factors and microstructural changes. (United States)

    Li, Guangyi; Yin, Jimin; Gao, Junjie; Cheng, Tak S; Pavlos, Nathan J; Zhang, Changqing; Zheng, Ming H


    Osteoarthritis (OA) is a major cause of disability in the adult population. As a progressive degenerative joint disorder, OA is characterized by cartilage damage, changes in the subchondral bone, osteophyte formation, muscle weakness, and inflammation of the synovium tissue and tendon. Although OA has long been viewed as a primary disorder of articular cartilage, subchondral bone is attracting increasing attention. It is commonly reported to play a vital role in the pathogenesis of OA. Subchondral bone sclerosis, together with progressive cartilage degradation, is widely considered as a hallmark of OA. Despite the increase in bone volume fraction, subchondral bone is hypomineralized, due to abnormal bone remodeling. Some histopathological changes in the subchondral bone have also been detected, including microdamage, bone marrow edema-like lesions and bone cysts. This review summarizes basic features of the osteochondral junction, which comprises subchondral bone and articular cartilage. Importantly, we discuss risk factors influencing subchondral bone integrity. We also focus on the microarchitectural and histopathological changes of subchondral bone in OA, and provide an overview of their potential contribution to the progression of OA. A hypothetical model for the pathogenesis of OA is proposed.

  15. Differences in the stress distribution in the distal femur between patellofemoral joint replacement and total knee replacement: a finite element study

    NARCIS (Netherlands)

    Jonbergen, H.P. van; Innocenti, B.; Gervasi, G.L.; Labey, L.; Verdonschot, N.J.


    BACKGROUND: Patellofemoral joint replacement is a successful treatment option for isolated patellofemoral osteoarthritis. However, results of later conversion to total knee replacement may be compromised by periprosthetic bone loss. Previous clinical studies have demonstrated a decrease in distal fe

  16. Bone building with bortezomib (United States)

    Roodman, G. David


    In this issue of the JCI, Mukherjee et al. report that bortezomib, a clinically available proteasome inhibitor active against myeloma, induces the differentiation of mesenchymal stem/progenitor cells (MSCs) — rather than mature osteoprogenitor cells — into osteoblasts, resulting in new bone formation (see the related article beginning on page 491). These results were observed when MSCs were implanted subcutaneously in mice or were used to treat a mouse model of postmenopausal bone loss. Others have reported that immunomodulatory drugs (e.g., thalidomide and lenalidomide), which are active against myeloma, also block the activity of bone-resorbing osteoclasts. These results reflect the utility of targeting endogenous MSCs for the purpose of tissue repair and suggest that combining different classes of agents that are antineoplastic and also inhibit bone destruction and increase bone formation should be very beneficial for myeloma patients suffering from severe bone disease. PMID:18219395

  17. Microgravity Stress: Bone and Connective Tissue. (United States)

    Bloomfield, Susan A; Martinez, Daniel A; Boudreaux, Ramon D; Mantri, Anita V


    The major alterations in bone and the dense connective tissues in humans and animals exposed to microgravity illustrate the dependency of these tissues' function on normal gravitational loading. Whether these alterations depend solely on the reduced mechanical loading of zero g or are compounded by fluid shifts, altered tissue blood flow, radiation exposure, and altered nutritional status is not yet well defined. Changes in the dense connective tissues and intervertebral disks are generally smaller in magnitude but occur more rapidly than those in mineralized bone with transitions to 0 g and during recovery once back to the loading provided by 1 g conditions. However, joint injuries are projected to occur much more often than the more catastrophic bone fracture during exploration class missions, so protecting the integrity of both tissues is important. This review focuses on the research performed over the last 20 years in humans and animals exposed to actual spaceflight, as well as on knowledge gained from pertinent ground-based models such as bed rest in humans and hindlimb unloading in rodents. Significant progress has been made in our understanding of the mechanisms for alterations in bone and connective tissues with exposure to microgravity, but intriguing questions remain to be solved, particularly with reference to biomedical risks associated with prolonged exploration missions.

  18. Shifting bone marrow edema of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Moosikasuwan, Josh B.; Schultz, Elizabeth [Department of Radiology, North Shore University Hospital, 300 Community Drive, NY 11030, Manhasset (United States); Miller, Theodore T. [Department of Radiology, North Shore University Hospital, 300 Community Drive, NY 11030, Manhasset (United States); Department of Radiology, North Shore University Hospital, 825 Northern Boulevard, NY 11021, Great Neck (United States); Math, Kevin [Department of Radiology, Beth Israel Medical Center, First Avenue at 16th Street, NY 10003, New York (United States)


    The purpose of our study is to describe shifting bone marrow edema in the knee as the MR imaging feature of intra-articular regional migratory osteoporosis of the knee. Five men, aged 45-73 years, were referred by orthopedic surgeons for MR imaging evaluation of knee pain, which had been present for 2 weeks to 6 months. One patient had a prior history of blunt trauma. None had risk factors for osteonecrosis. Four patients had two MR examinations and the patient with prior blunt trauma had four. Plain radiographs were obtained in all patients. In all cases, a large area of marrow edema initially involved a femoral condyle, with migration of the bone marrow edema to the other femoral condyle, tibia, and/or patella occurring over a 2- to 4-month period. Adjacent soft tissue edema was present in all five patients, while none had a joint effusion. Radiographs of two patients showed generalized osteopenia. In the absence of acute trauma or clinical suspicion of infection, a large area of bone marrow edema without a zone of demarcation may represent intra-articular regional migratory osteoporosis. Demonstration of shifting bone marrow edema on follow-up examinations suggests this diagnosis. (orig.)

  19. The Findings of {sup 99m}Tc-MDP Bone Scan in Primary malignant Bone Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, In Young; Lee, Kung Han; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul; Koh, Chang Soon; Kang, Heung Sik; Lee, Sang Hoon; Lee, Han Koo [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Tc-99m-MDP bone scan was performed in 31 patients with primary malignant bone tumors, 22 patients with osteogenic sarcoma, 5 patients with chondrosarcoma and 4 patients with Ewing's sarcoma. The findings were classified by isotope intensity of accumulation in tumor as grade 1 to 3, overall pattern of isotope distribution in tumor as grade 1 to 3, and distortion of bony outline as grade 1 to 3. Histologic classifications were correlated with scan findings in 22 patients with osteogenic sarcoma. The results were as follows. 1) In 22 patients with osteogenic sarcoma, markedly increased isotope intensity higher than sacroiliac joint with patchy areas of decreased intensity and severe bony distortion were found in 16 patients. The correlations between histologic classification and scan findings were not discovered. 2) In 5 patients with chondrosarcoma, mildly increased isotope intensity with patchy areas of increased intensity and mild bony distortion were found in 4 patients. 3) In 4 patients with Ewing's sarcoma, markedly increased homogenous intensity with moderate bony distortion were found in 3 patients. Conclusively there were common findings in each 3 primary malignant bone tumors and Tc-99m-MDP bone scan was complemented with radiologic studies in differentiating primary malignant bone tumors.

  20. Bones and oil reservoirs : bioengineers use oilpatch technology to study fluid flow in bones

    Energy Technology Data Exchange (ETDEWEB)

    Marsters, S.


    The fact that porosity and the presence of channels are qualities that are common to oil reservoirs and bones, led to the use of reservoir modelling technology in investigating bone disorders and to the discovery of dramatic changes in the structure and blood supply of osteoarthritic bones that lie under degenerating cartilage. CMG (Computer Modelling Group) Ltd., developers of reservoir simulation software claim that their software packages can help with the modelling of cellular responses to strains and deformations that occur as fluid flows through bone after a traumatic event such as a tear in the anterior cruciate ligament, a common sports-related injury. Researchers at the University of Calgary expect that by looking at the changes in blood and fluid flow within the bone, they can attain a better understanding of the chain of events that leads to osteoarthritis. Better understanding of the progression of the disease could eventually lead to more precise administration of drugs to deal with osteoarthritic pain, and even to the prevention of painful arthritic joints.

  1. Adrenal gland and bone. (United States)

    Hardy, Rowan; Cooper, Mark S


    The adrenal gland synthesizes steroid hormones from the adrenal cortex and catecholamines from the adrenal medulla. Both cortisol and adrenal androgens can have powerful effects on bone. The overproduction of cortisol in Cushing's disease leads to a dramatic reduction in bone density and an increase risk of fracture. Overproduction of adrenal androgens in congenital adrenal hyperplasia (CAH) leads to marked changes in bone growth and development with early growth acceleration but ultimately a significant reduction in final adult height. The role of more physiological levels of glucocorticoids and androgens on bone metabolism is less clear. Cortisol levels measured in elderly individuals show a weak correlation with measures of bone density and change in bone density over time with a high cortisol level associated with lower bone density and more rapid bone loss. Cortisol levels and the dynamics of cortisol secretion change with age which could also explain some age related changes in bone physiology. It is also now clear that adrenal steroids can be metabolized within bone tissue itself. Local synthesis of cortisol within bone from its inactive precursor cortisone has been demonstrated and the amount of cortisol produced within osteoblasts appears to increase with age. With regard to adrenal androgens there is a dramatic reduction in levels with aging and several studies have examined the impact that restoration of these levels back to those seen in younger individuals has on bone health. Most of these studies show small positive effects in women, not men, but the skeletal sites where benefits are seen varies from study to study.

  2. Demineralized bone matrix and human cancellous bone enhance fixation of porous-coated titanium implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren


    Allogenic bone graft has been considered the gold standard in connection with bone graft material in revision joint arthroplasty. However, the lack of osteogenic potential and the risk of disease transmission are clinical challenges. The use of osteoinductive materials, such as demineralized bone...... of DBM alone, DBM with CB, or allograft on the fixation of porous-coated titanium implants. DBM100 and CB produced from human tissue were included. Both materials are commercially available. DBM granules are placed in pure DBM and do not contain any other carrier. Titanium alloy implants, 10 mm long × 10...... (gold standard), respectively. A standardized surgical procedure was used. At sacrifice 6 weeks after implantation, both distal femurs were harvested. The implant fixation was evaluated by mechanical push-out testing to test shear mechanical properties between implant and the host bone...

  3. Hypercalciuric Bone Disease (United States)

    Favus, Murray J.


    Hypercalciuria plays an important causal role in many patients with calcium oxalate (CaOx) stones. The source of the hypercalciuria includes increased intestinal Ca absorption and decreased renal tubule Ca reabsorption. In CaOx stone formers with idiopathic hypercalciuria (IH), Ca metabolic balance studies have revealed negative Ca balance and persistent hypercalciuria in the fasting state and during low dietary Ca intake. Bone resorption may also contribute to the high urine Ca excretion and increase the risk of bone loss. Indeed, low bone mass by DEXA scanning has been discovered in many IH patients. Thiazide diuretic agents reduce urine Ca excretion and may increase bone mineral density (BMD), thereby reducing fracture risk. Dietary Ca restriction that has been used unsuccessfully in the treatment of CaOx nephrolithiasis in the past may enhance negative Ca balance and accelerate bone loss. DEXA scans may demonstrate low BMD at the spine, hip, or forearm, with no predictable pattern. The unique pattern of bone histologic changes in IH differs from other causes of low DEXA bone density including postmenopausal osteoporosis, male hypogonadal osteoporosis, and glucocorticoid-induced osteoporosis. Hypercalciuria appears to play an important pathologic role in the development of low bone mass, and therefore correction of urine Ca losses should be a primary target for treatment of the bone disease accompanying IH.

  4. Glutamate signalling in bone.

    Directory of Open Access Journals (Sweden)

    Karen eBrakspear


    Full Text Available Mechanical loading plays a key role in the physiology of bone, allowing bone to functionally adapt to its environment, however characterisation of the signalling events linking load to bone formation is incomplete. A screen for genes associated with mechanical load-induced bone formation identified the glutamate transporter GLAST, implicating the excitatory amino acid, glutamate, in the mechanoresponse. When an osteogenic load (10N, 10Hz was externally applied to the rat ulna, GLAST (EAAT1 mRNA, was significantly down-regulated in osteocytes in the loaded limb. Functional components from each stage of the glutamate signalling pathway have since been identified within bone, including proteins necessary for calcium-mediated glutamate exocytosis, receptors, transporters and signal propagation. Activation of ionotropic glutamate receptors has been shown to regulate the phenotype of osteoblasts and osteoclasts in vitro and bone mass in vivo. Furthermore, glutamatergic nerves have been identified in the vicinity of bone cells expressing glutamate receptors in vivo. However, it is not yet known how a glutamate signalling event is initiated in bone or its physiological significance. This review will examine the role of the glutamate signalling pathway in bone, with emphasis on the functions of glutamate transporters in osteoblasts.

  5. Blood: bone equilibrium

    Energy Technology Data Exchange (ETDEWEB)

    Neuman, M.W.


    The conundrum of blood undersaturation with respect to bone mineralization and its supersaturation with respect to bone's homeostatic function has acquired a new equation. On the supply side, Ca/sup 2 +/ is pumped in across bone cells to provide the needed Ca/sup 2 +/ x P/sub i/ for brushite precipitation. On the demand side, blood is in equilibrium with bone fluid, which is in equilibrium with a mineral more soluble than apatite. The function of potassium in this equation is yet to be found.

  6. Olecranon bone graft: revisited. (United States)

    Mersa, Berkan; Ozcelik, Ismail Bulent; Kabakas, Fatih; Sacak, Bulent; Aydin, Atakan


    Autogenous bone grafts are frequently in use in the field of reconstructive upper extremity surgery. Cancellous bone grafts are applied to traumatic osseous defects, nonunions, defects after the resection of benign bone tumors, arthrodesis, and osteotomy procedures. Cancellous bone grafts do not only have benefits such as rapid revascularization, but they also have mechanical advantages. Despite the proximity to the primary surgical field, cancellous olecranon grafts have not gained the popularity they deserve in the field of reconstructive hand surgery. In this study, the properties, advantages, and technical details of harvesting cancellous olecranon grafts are discussed.

  7. Exercise-induced metacarpophalangeal joint adaptation in the Thoroughbred racehorse. (United States)

    Muir, P; Peterson, A L; Sample, S J; Scollay, M C; Markel, M D; Kalscheur, V L


    Repetitive bone injury and development of stress fracture is a common problem in humans and animals. The Thoroughbred racehorse is a model in which adaptive failure and associated development of stress fracture is common. We performed a histologic study of the distal end of the third metacarpal bone in two groups of horses: young Thoroughbreds that were actively racing (n = 10) and a group of non-athletic horses (n = 8). The purpose of this study was to determine whether development of articular microcracks was associated with specific alterations to subchondral plate osteocytes. Morphometric measurements were made in five regions of the joint surface: lateral condyle, lateral condylar groove, sagittal ridge, medial condylar groove, and medial condyle. The following variables were quantified: hyaline cartilage width; calcified cartilage width; the number of tidemarks; microcrack density at the articular surface; blood vessel density entering articular cartilage; the presence of atypical bone matrix in the subchondral plate; bone volume fraction; and osteocyte density. Adaptation of articular cartilage was similar in both groups of horses. Vascularization of articular cartilage was increased in the group of non-athletic horses. Microcracks, which typically had an oblique orientation to the joint surface, were co-localized with blood vessels, and resorption spaces. Microcracking was increased in the condylar grooves of athletic horses compared with the other joint regions and was also increased compared with the condylar groove regions of non-athletic horses. Coalescence of microcracks also led to development of an intracortical articular condylar stress fracture in some joints and targeted remodeling of affected subchondral plate. The subchondral plate of the condyles in athletic horses was sclerotic, and contained atypically stained bone matrix with increased numbers of osteocytes with atypical morphology. However, osteocyte numbers were not significantly different

  8. Texture Analysis and Modified Level Set Method for Automatic Detection of Bone Boundaries in Hand Radiographs

    Directory of Open Access Journals (Sweden)

    Syaiful Anam


    Full Text Available Rheumatoid Arthritis (RA is a chronic inflammatory joint disease characterized by a distinctive pattern of bone and joint destruction. To give an RA diagnosis, hand bone radiographs are taken and analyzed. A hand bone radiograph analysis starts with the bone boundary detection. It is however an extremely exhausting and time consuming task for radiologists. An automatic bone boundary detection in hand radiographs is thus strongly required. Garcia et al. have proposed a method for automatic bone boundary detection in hand radiographs by using an adaptive snake method, but it doesn’t work for those affected by RA. The level set method has advantages over the snake method. It however often leads to either a complete breakdown or a premature termination of the curve evolution process, resulting in unsatisfactory results. For those reasons, we propose a modified level set method for detecting bone boundaries in hand radiographs affected by RA. Texture analysis is also applied for distinguishing the hand bones and other areas. Evaluating the experiments using a particular set of hand bone radiographs, the effectiveness of the proposed method has been proved.

  9. Bone graft materials in fixation of orthopaedic implants in sheep. (United States)

    Babiker, Hassan


    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking skeletal bones. The osteoconductive properties of the composite might be improved by adding bone marrow aspirate (BMA), which can be harvested during surgery. Other alternatives to bone graft are demineralised bone matrix (DBM) and human cancellous bone (CB). DBM is prepared by acid extraction of human bone and includes bone collagen, morphogenetic proteins and growth factors. The combination of DBM with CB and with allograft might improve the healing potential of these grafts around non-cemented orthopaedic implants and thereby the implant fixation. Study I investigates the effect of HA/Collagen composite alone and in combination with BMA on the early fixation of porous coated titanium implants. In addition, the study compares also the effect of autograft with the gold standard allograft. By using a sheep model, the implants were inserted in the trabecular bone of femoral condyles. The test biomaterials were placed in a well defined peri-implant gap. After the observation period, the bone-implant specimens were harvested and evaluated mechanically by a destructive push

  10. Early biomarkers of joint damage in rheumatoid and psoriatic arthritis. (United States)

    Mc Ardle, Angela; Flatley, Brian; Pennington, Stephen R; FitzGerald, Oliver


    biomarkers in rheumatoid and psoriatic arthritis, evaluated the evidence for their potential as biomarkers of bone (joint) damage, and outlined how mass spectrometry-based targeted and multiplexed measurement of candidate biomarker proteins is likely to accelerate their clinical validation and the development of clinical diagnostic tests.

  11. Early biomarkers of joint damage in rheumatoid and psoriatic arthritis.

    LENUS (Irish Health Repository)

    Mc Ardle, Angela


    biomarkers in rheumatoid and psoriatic arthritis, evaluated the evidence for their potential as biomarkers of bone (joint) damage, and outlined how mass spectrometry-based targeted and multiplexed measurement of candidate biomarker proteins is likely to accelerate their clinical validation and the development of clinical diagnostic tests.

  12. Is bone scintigraphy necessary in the initial surgical staging of chondrosarcoma of bone?

    Energy Technology Data Exchange (ETDEWEB)

    Douis, Hassan; James, Steven L.; Davies, Mark A. [Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Grimer, Robert J. [Royal Orthopaedic Hospital, Department of Orthopaedic Oncology, Birmingham (United Kingdom)


    To assess the value of whole-body bone scintigraphy in the initial surgical staging of chondrosarcoma of bone. A retrospective review was conducted of the bone scintigraphy reports of a large series of patients with peripheral or central chondrosarcoma of bone treated in a specialist orthopaedic oncology unit over a 13-year period. Abnormal findings were correlated against other imaging, histological grade and the impact on surgical staging. A total of 195 chondrosarcomas were identified in 188 patients. In 120 (63.8%) patients the reports of bone scintigraphy noted increased activity at the site of one or more chondrosarcomas. In one patient the tumour was outside the field-of-view of the scan, and in the remaining 67 (35.6%) cases, there was increased activity at the site of the chondrosarcoma and further abnormal activity in other areas of the skeleton. Causes of these additional areas of activity included degenerative joint disease, Paget's disease and in one case a previously undiagnosed melanoma metastasis. No cases of skeletal metastases from the chondrosarcoma were found in this series. Multifocal chondrosarcomas were identified in three cases. In two it was considered that all the tumours would have been adequately revealed on the initial MR imaging staging studies. In only the third multifocal case was an unsuspected, further presumed low-grade, central chondrosarcoma identified in the opposite asymptomatic femur. Although this case revealed an unexpected finding the impact on surgical staging was limited as it was decided to employ a watch-and-wait policy for this tumour. There is little role for the routine use of whole-body bone scintigraphy in the initial surgical staging in patients with chondrosarcoma of bone irrespective of the histological grade. (orig.)

  13. Reconstruction of the Scapholunate Ligament Using Capitohamate Bone-Ligament-Bone. (United States)

    Nakamura, Toshiyasu; Abe, Koji; Iwamoto, Takuji; Ochi, Kensuke; Sato, Kazuki


    Background The biomechanical properties of the capitohamate (CH) ligament are equivalent to those of the scapholunate (SL) interosseous ligament. We reconstructed the SL ligament using the CH bone-ligament-bone substitute for chronic injury of the SL ligament. Patients and Methods Beginning in 2008, 15 wrists of 14 patients with an average age of 38 years underwent this procedure with a minimum follow-up of 2 years. Thirteen wrists had an SL joint gap more than 3 mm, and two had a complete SL ligament disruption with a severe dorsal intercalated segment instability (DISI) deformity. Kirschner wires (K-wires) were removed 8 weeks after the surgery, then active ROM exercise began. Pain (on visual analog scale [VAS]), wrist motion (angle), radiographic characteristics, such as SL gap (mm) and SL angle, and Modified Mayo Wrist Score (MMWS) were evaluated. Technique The SL joint was reduced by manipulation or with the use of joysticks, then temporary fixed with K-wires. A dorsal trough was then made between the scaphoid and the lunate. The proximal half of the CH ligament was harvested with attached bone from the capitate and hamate (CH bone-ligament-bone), inset into the SL trough, and fixed firmly with 1.2-mm diameter titanium screws in the scaphoid and lunate, respectively. Results The VAS improved from 77 preoperatively to 12 postoperatively. The average wrist extension/flexion was 74°/60°. There was no ossification of the reconstructed SL at the final follow-up. The SL gap improved from an average of 4.8 mm to an average of 2.1 mm, and the SL angle changed from 67° to 55°. The MMWS improved to 82 points postoperatively from a preoperative average of 47 with eight excellent, five good, and two fair results.

  14. Genetic variables of various manifestations of osteochondrosis and their correlations between and within joints in Dutch warmblood horses. (United States)

    van Grevenhof, E M; Schurink, A; Ducro, B J; van Weeren, P R; van Tartwijk, J M F M; Bijma, P; van Arendonk, J A M


    Osteochondrosis (OC) is an important orthopedic developmental disorder in many horse populations. A review of the literature revealed widely variable heritability estimates for the disorder. We estimated the genetic variables (heritabilities and genetic correlations) of various manifestations of OC. Femoropatellar, tarsocrural, and metacarpophalangeal and metatarsophalangeal joints of 811 randomly selected yearlings from the Royal Warmblood Studbook of The Netherlands, descending from 32 representative stallions, were scored for OC at 28 predilection sites. At each site, OC was scored in 5 categories, distinguishing between flattened bone contours and fragments. At the animal level, the overall heritability of OC was 0.23, the heritability of flattened bone contours was 0.08, and the heritability of fragments was 0.22. At the joint level, heritability was greatest in the tarsocrural joints, intermediate in the metacarpophalangeal and metatarsophalangeal joints, and least in the femoropatellar joints. The heritability estimates for the contralateral joint homologs were very similar. The genetic correlation between the tarsocrural and femoropatellar joint was strong, whereas correlations between the metacarpophalangeal and metatarsophalangeal and other joints were moderate. The genetic correlation between flattened bone contours and fragments at the animal level was 0.80. Scoring OC on a 5-point categorical scale resulted in greater heritability on the observed scale than when analyzing OC as a binary trait. Our results suggest that selection against OC could best be performed by taking into account the OC status of all 4 joints, the femoropatellar, the tarsocrural, and the metacarpophalangeal and metatarsophalangeal joints, and discerning between flattened bone contours and fragments.

  15. Nano-engineered titanium for enhanced bone therapy (United States)

    Gulati, Karan; Atkins, Gerald J.; Findlay, David M.; Losic, Dusan


    Current treatment of a number of orthopaedic conditions, for example fractures, bone infection, joint replacement and bone cancers, could be improved if mechanical support could be combined with drug delivery. A very challenging example is that of infection following joint replacement, which is very difficult to treat, can require multiple surgeries and compromises both the implant and the patient's wellbeing. An implant capable of providing appropriate biomechanics and releasing drugs/proteins locally might ensure improved healing of the traumatized bone. We propose fabrication of nanoengineered titanium bone implants using bioinert titanium wires in order to achieve this goal. Titanium in the form of flat foils and wires were modified by fabrication of titania nanotubes (TNTs), which are hollow self-ordered cylindrical tubes capable of accommodating substantial drug amounts and releasing them locally. To further control the release of drug to over a period of months, a thin layer of biodegradable polymer PLGA poly(lactic-coglycolic acid) was coated onto the drug loaded TNTs. This delayed release of drug and additionally the polymer enhanced bone cell adhesion and proliferation.

  16. Achieving joint benefits from joint implementation

    Energy Technology Data Exchange (ETDEWEB)

    Moomaw, W.R. [Tufts Univ., Medford, MA (United States)


    Joint Implementation (JI) appears to have been born with Applied Energy Services Guatemala project in 1988. That project, to plant 52 million trees, protect existing forests from cutting and fire, and enhance rural development, is being implemented by CARE Guatemala to offset 120 per cent of the emissions of a small coal burning power plant that has been built in Connecticut. Since that time, several utilities and governments have initiated additional projects. Not all of these necessarily consist of tree planting in other countries, but may consist of energy efficiency or energy conservation programs designed to reduce carbon emissions by at least as much as the additional releases from a new facility. All JI projects share the characteristic of linking the release of greenhouse gases in an industrial country with an offset that reduces or absorbs a comparable amount in another country. The emitter in the industrial country is willing to pay for the reduction elsewhere because costs are less than they would be at home.

  17. A clinical study of temporomandibular disorder. The value of bone scintigraphy as an aid to diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Sugiura, Masashi [Nippon Dental Univ. (Japan). School of Dentistry at Niigata


    Temporomandibular disorder (TMD) is still not defined with respect to the point of an entity, terminological problems, and clinical classification and gradings. Moreover, diagnostic problems of internal deranegement and osteodeformity at the temporomandibular joint such as type IV and mechanism of bone remodeling at condylar head are also still not clear. In this investigation, we tried to classify the severity and progressive grading according to the symptoms and objective laboratory data taken from soft tissues such as muscles related to mastication, discs and ligaments, and hard tissues such as condylar head and temporal bone changes around the temporomandibular joint. Preliminary diagnostic clinical tool of the assessment of temporomandibular joint by maens of bone scintigraphy was attributed to the additional diagnostic procedure and research for the bone remodeling for the temporomandibular disorder because this can be defined between subjective and objective symptoms in this disorder. Bone scintigraphy will solve many problems concerning undefined degenerative bone changes in TMD, enable more accurate diagnosis, and the selection of treatment and prognosis in future investigation. Also, it is believed single photon emission computed tomography (SPECT) nuclear bone imaging is a highly accurate diagnostic method for craniomandibular disorders. (author)

  18. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... ionizing radiation to produce pictures of any bone in the body. It is commonly used to diagnose ... bone x-ray makes images of any bone in the body, including the hand, wrist, arm, elbow, ...

  19. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... the body. X-rays are the oldest and most frequently used form of medical imaging. A bone ... bones. top of page How should I prepare? Most bone x-rays require no special preparation. You ...

  20. Laundry joint venture. (United States)

    Giancola, D; Voyvodich, M


    Many hospitals are concerned about the loss of control which is associated with contracting for linen service. On the the hand, many laundries do not have the resources or experience to serve hospitals in a comprehensive and trouble-free manner. In many communities a joint venture, such as the one described here, can successfully combine the interests of the hospital and laundry communities without causing the hospitals to lose control of the service and without requiring the laundry operator to have detailed knowledge of hospital operations. As more hospitals opt for contract service, and if this service is to be provided at the lowest total cost, the hospitals and the laundries must come to grips with the problems surrounding the laundry-hospital interface. A joint venture, such as that described here, is one way to accomplish this.

  1. Joint International Accelerator School

    CERN Multimedia

    CERN Accelerator School


    The CERN and US Particle Accelerator Schools recently organised a Joint International Accelerator School on Beam Loss and Accelerator Protection, held at the Hyatt Regency Hotel, Newport Beach, California, USA from 5-14 November 2014. This Joint School was the 13th in a series of such schools, which started in 1985 and also involves the accelerator communities in Japan and Russia.   Photo courtesy of Alfonse Pham, Michigan State University.   The school attracted 58 participants representing 22 different nationalities, with around half from Europe and the other half from Asia and the Americas. The programme comprised 26 lectures, each of 90 minutes, and 13 hours of case study. The students were given homework each day and had an opportunity to sit a final exam, which counted towards university credit. Feedback from the participants was extremely positive, praising the expertise and enthusiasm of the lecturers, as well as the high standard and quality of their lectures. Initial dis...

  2. Joint Forces Capabilities (United States)


    for countering the proliferation of weapons of mass destruction (WMD) in space. The Space Operations Center ( SPOC ), USSPACECOM is the single point...of contact for assessing space capabilities. Combatant commanders, subordinate JFCs, and Services can access this information from the SPOC via the...special operations forces SPOC Space Operations Center SSBN fleet ballistic missile submarine SST space support team UJTL Universal Joint Task List UN

  3. Australias Joint Approach (United States)


    the early nineties as well. 219 Systems Thinking and Systems Engineering for Defence Strategic Planning, Richard Hodge , Kym Hendrickson and Geoff...Head Capability Systems, dated 9 December 2013. 272 Private communications with LTCOL Nick Floyd, Deputy Director Joint Concepts, JCC, March...with LTCOL Nick Floyd, 29 October 2014. 307 Pathway to Change: Evolving Defence Culture, 2012, p1. 308 Ibid, p3. 309 Communication with Dr Irena Ali

  4. Nonarthritic hip joint pain. (United States)

    Enseki, Keelan; Harris-Hayes, Marcie; White, Douglas M; Cibulka, Michael T; Woehrle, Judith; Fagerson, Timothy L; Clohisy, John C


    The Orthopaedic Section of the American Physical Therapy Association (APTA) has an ongoing effort to create evidence-based practice guidelines for orthopaedic physical therapy management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF). The purpose of these clinical practice guidelines is to describe the peer-reviewed literature and make recommendations related to nonarthritic hip joint pain.

  5. The international joint commission


    Clamens, Murray


    For over 92 years the International Joint Commission (IJC), United States and Canada, has effectively served the two nations in approving and providing continuous oversight of water resource projects along the 5000-mile common border, in assisting the governments in preventing and resolving issues and disagreements regarding the use of these waters, and in addressing other environmental issues affecting or potentially affecting one or both of the countries. During the first years of the 20th...

  6. Joint Urban Operations (United States)


    in Kosovo , the Red Cross provided the most accurate figures on the number of Kosovo refugees, helping US and other coalition services to estimate the...Port-au-Prince, Ramadi, Fallujah, and cities in Bosnia, Serbia, and Kosovo ). This clearly indicates an increase in the frequency of US joint...areas perhaps including shantytowns, and military areas. Buildings may range from single-story wooden or mud dwellings to high-rise apartments and

  7. Successfully Developing Joint Leaders (United States)


    officer’s pyramid representing his career, there is merely the word “joint”. Therefore, unless the officer adamantly pursues a joint assignment it...had the chance to participate in Bosnia stability operations. It is how we were taught to work with locals and the experiences I took with me that...Drug Ops, OAF, OEF, OIF, Bosnia , Unconventional) - When you participated in an operation was there any “joint” involvement? If “yes”, did you feel

  8. Pyogenic arthritis of sacroiliac joint in children

    Directory of Open Access Journals (Sweden)

    Rakonjac Zoran


    Full Text Available Introduction Pyogenic infection of sacroiliac joint (SIJ is very rare in children. It is the result of haematogenous spread primarily affecting the joint. The process is usually monoarticular. By rule, sequestra are rarely formed, there are no greater bone destructions, but there is usually early bone sclerosing. Case outline Due to the pain in the lumbosacral area spreading down the right leg and positive Lazarevic's sign, a 13-yearold boy was referred to a neuropediatrician. He was suffering from lumbosciatica. In the first three sick days, laboratory tests were done as well as X-ray examination. High febrility and laboratory results indicated the existence of infection of unknown localization. Diagnostic examination: radiography of the lungs and heart, computerized tomography (CT, nuclear magnetic resonance (NMR, ultrasound (US of hips and painful sacroiliac area and US of abdomen could not localise the infection. Radiography of SIJ (Barschoni focused the attention on SIJ. Scintigraphy of the skeleton with 99mTc-DPD pointed to the intensified collection of radiopharmaceuticals in the area around SIJ. Localized changes, erythema and signs of abscess in the projection of SIJ appeared the fifth day since the appearance of the disease. Incision was performed as well as evacuation of purulent content, and bacterial analysis isolated Staphylococcus aureus. Therapy with antibiotics was applied according to the antibiogram three weeks parenterally (intravenously and two weeks per os. After five weeks, clinical and laboratory results were normal. The patient has been monitored for eight months since the appearance of the disease. Conclusion In children with symptoms and signs of lumbosciatica, among other things, attention should be paid, differentially and diagnostically speaking, to pyogenic infection of SIJ. The skeletal scintigraphy helps early diagnosis of pyogenic infection of SIJ, when localized clinical signs have not been formed yet. In our


    Directory of Open Access Journals (Sweden)

    Saodat Asilova


    Full Text Available Presented the experience of the application of stable osteosynthesisby three Kirschner wires on diaphyseal fractures of the metacarpal bones at 74 patients.Indications for osteosynthesiswas opened (6%, closed (94%, non-united, mal-unitedfractures and false joints of metacarpal bonesdiaphysis. Patients were performed intraosseous anesthesia atdistal epimetaphysisarea of radial bone.Describeda method of operation extramedullaryosteosynthesis using three Kirschner wires. Also,describedmethod of wedge osteotomy for full recovery of hand function. Good results were obtained in 83.1% of patients, satisfactory at 13.6%, and unsatisfactory results in 3.4% of patients

  10. Nanomaterials promise better bone repair


    Qifei Wang; Jianhua Yan; Junlin Yang; Bingyun Li


    Nanomaterials mimicking the nano-features of bones and offering unique smart functions are promising for better bone fracture repair. This review provides an overview of the current state-of-the-art research in developing and using nanomaterials for better bone fracture repair. This review begins with a brief introduction of bone fracture repair processes, then discusses the importance of vascularization, the role of growth factors in bone fracture repair, and the failure of bone fracture rep...

  11. BONES, TEACHER'S GUIDE. (United States)

    Elementary Science Study, Newton, MA.


  12. Children's bone health

    NARCIS (Netherlands)

    I.M. van der Sluis (Inge)


    textabstractThe thesis can be divided in two main parts. In the first part (Chapter 2 to 5) bone mineral density, bone metabolism and body composition in healthy children and young adults have been evaluated, while in the second part (Chapter 6 to 10) these issues were studied in children with vario

  13. Biodegradable synthetic bone composites (United States)

    Liu, Gao; Zhao, Dacheng; Saiz, Eduardo; Tomsia, Antoni P.


    The invention provides for a biodegradable synthetic bone composition comprising a biodegradable hydrogel polymer scaffold comprising a plurality of hydrolytically unstable linkages, and an inorganic component; such as a biodegradable poly(hydroxyethylmethacrylate)/hydroxyapatite (pHEMA/HA) hydrogel composite possessing mineral content approximately that of human bone.

  14. Osteotransductive bone cements. (United States)

    Driessens, F C; Planell, J A; Boltong, M G; Khairoun, I; Ginebra, M P


    Calcium phosphate bone cements (CPBCs) are osteotransductive, i.e. after implantation in bone they are transformed into new bone tissue. Furthermore, due to the fact that they are mouldable, their osteointegration is immediate. Their chemistry has been established previously. Some CPBCs contain amorphous calcium phosphate (ACP) and set by a sol-gel transition. The others are crystalline and can give as the reaction product dicalcium phosphate dihydrate (DCPD), calcium-deficient hydroxyapatite (CDHA), carbonated apatite (CA) or hydroxyapatite (HA). Mixed-type gypsum-DCPD cements are also described. In vivo rates of osteotransduction vary as follows: gypsum-DCPD > DCPD > CDHA approximately CA > HA. The osteotransduction of CDHA-type cements may be increased by adding dicalcium phosphate anhydrous (DCP) and/or CaCO3 to the cement powder. CPBCs can be used for healing of bone defects, bone augmentation and bone reconstruction. Incorporation of drugs like antibiotics and bone morphogenetic protein is envisaged. Load-bearing applications are allowed for CHDA-type, CA-type and HA-type CPBCs as they have a higher compressive strength than human trabecular bone (10 MPa).

  15. Pseudoanaplastic tumors of bone

    Energy Technology Data Exchange (ETDEWEB)

    Bahk, Won-Jong [Uijongbu St. Mary Hospital, The Catholic University of Korea, Department of Orthopaedic Surgery, Gyunggido, 480-821 (Korea); Mirra, Joseph M. [Orthopaedic Hospital, Orthopedic Oncology, Los Angeles, California (United States)


    To discuss the concept of pseudoanaplastic tumors of bone, which pathologically show hyperchromatism and marked pleomorphism with quite enlarged, pleomorphic nuclei, but with no to extremely rare, typical mitoses, and to propose guidelines for their diagnosis. From a database of 4,262 bone tumors covering from 1971 to 2001, 15 cases of pseudoanaplastic bone tumors (0.35% of total) were retrieved for clinical, radiographic and pathologic review. Postoperative follow-up after surgical treatment was at least 3 years and a maximum of 7 years. There were eight male and seven female patients. Their ages ranged from 10 to 64 years with average of 29.7 years. Pathologic diagnoses of pseudoanaplastic variants of benign bone tumors included: osteoblastoma (4 cases), giant cell tumor (4 cases), chondromyxoid fibroma (3 cases), fibrous dysplasia (2 cases), fibrous cortical defect (1 case) and aneurysmal bone cyst (1 case). Radiography of all cases showed features of a benign bone lesion. Six cases, one case each of osteoblastoma, fibrous dysplasia, aneurysmal bone cyst, chondromyxoid fibroma, giant cell tumor and osteoblastoma, were initially misdiagnosed as osteosarcoma. The remaining cases were referred for a second opinion to rule out sarcoma. Despite the presence of significant cytologic aberrations, none of our cases showed malignant behavior following simple curettage or removal of bony lesions. Our observation justifies the concept of pseudoanaplasia in some benign bone tumors as in benign soft tissue tumors, especially in their late evolutionary stage when bizarre cytologic alterations strongly mimic a sarcoma. (orig.)

  16. Mechanobiology and joint conformity regulate endochondral ossification of sesamoids. (United States)

    Sarin, V K; Carter, D R


    Sesamoid bones form by the endochondral ossification of sesamoid cartilages. This ossification process is thought to be similar to that responsible for the formation of secondary ossific nuclei in long-bone epiphyses. Sesamoids ossify much later in development than do epiphyses, however, and bone formation within sesamoids often begins by way of multiple ossific nuclei. Endochondral growth and ossification in the formation of secondary ossific nuclei have previously been correlated with distributions of the octahedral shear and hydrostatic stresses generated in vivo within cartilage anlagen. In this study, we used two-dimensional finite element analysis to predict the distributions of octahedral shear and hydrostatic stresses in an idealized model of a sesamoid cartilage subjected to in vivo loading. We examined the influence of sesamoid joint conformity. The distribution of an osteogenic stimulus was calculated with an approach similar to that used to predict epiphyseal ossification. The results suggest that, compared with conforming joints, nonconformity between the sesamoid cartilage and its articulating surface, which arises during early development, produces higher contact pressures within the sesamoid and leads to a thicker articular cartilage layer. For a nonconforming joint surface, the results suggest that ossification is favored anywhere within a broad internal region of the sesamoid, whereas a layer at the articular surface will remain cartilaginous. These findings highlight the subtle differences between ossification processes in epiphyses and sesamoids, indicating that the mechanical stress environment in sesamoids produces a diffuse stimulus leading to the onset of ossification and that the degree of joint nonconformity may influence the thickness of the articular cartilage layer.

  17. Laboratory characterization of rock joints

    Energy Technology Data Exchange (ETDEWEB)

    Hsiung, S.M.; Kana, D.D.; Ahola, M.P.; Chowdhury, A.H.; Ghosh, A. [Southwest Research Inst., San Antonio, TX (United States). Center for Nuclear Waste Regulatory Analyses


    A laboratory characterization of the Apache Leap tuff joints under cyclic pseudostatic and dynamic loads has been undertaken to obtain a better understanding of dynamic joint shear behavior and to generate a complete data set that can be used for validation of existing rock-joint models. Study has indicated that available methods for determining joint roughness coefficient (JRC) significantly underestimate the roughness coefficient of the Apache Leap tuff joints, that will lead to an underestimation of the joint shear strength. The results of the direct shear tests have indicated that both under cyclic pseudostatic and dynamic loadings the joint resistance upon reverse shearing is smaller than that of forward shearing and the joint dilation resulting from forward shearing recovers during reverse shearing. Within the range of variation of shearing velocity used in these tests, the shearing velocity effect on rock-joint behavior seems to be minor, and no noticeable effect on the peak joint shear strength and the joint shear strength for the reverse shearing is observed.

  18. Full Scale 3D Preoperative Planning System of the Ankle Joint Replacement Surgery with Multimedia System

    Directory of Open Access Journals (Sweden)

    Shuh-Ping Sun


    Full Text Available This study is intended to develop a computer-aided pre-surgical planning and simulating system in a multimedia environment for ankle joint replacement surgery. This system uses full-scale 3D reverse engineering techniques in design and development of the pre-surgical planning modules for ankle joint replacement surgery. This planning system not only develops the real-scale 3D image of the artificial ankle joint but also provides a detailed interior measurement of the ankle joint from various cutting planes. In this study, we apply the multimedia user interface to integrate different software functions into a surgical planning system with integrated functions. The functions include 3D model image acquisition, cutting, horizontal shifting and rotation of related bones (tibia and talus of the ankle joint in the predetermined time. For related bones of the ankle joint, it can also be used to design artificial ankle joints for adults in Taiwan. Those planning procedures can be recorded in this system for further research and investigation. Furthermore, since this system is a multimedia user interface, surgeons can use this system to plan and find a better and more efficient surgical approach before surgery. A database is available for this system to update and expand, which can provide different users with clinical cases as per their experience and learning.

  19. Ankylosis of the distal interphalangeal joint in a horse after septic arthritis and septic navicular bursitis. (United States)

    Honnas, C M; Schumacher, J; Kuesis, B S


    A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an attempt to prevent ascending contamination of the joint, placing the limb in a short limb cast, and inserting a Penrose drain into the joint for passive drainage of septic exudate. The goal of treatment was to encourage ankylosis of the distal interphalangeal joint. Because of the filly's persistent lameness and laxity of the lateral collateral ligament in the contralateral carpus, the palmar nerves of the affected foot were injected with a long-acting local anesthetic at the level of the proximal sesamoid bones to encourage weight-bearing. Ankylosis of the distal interphalangeal joint was complete 9 months after the puncture, but a grade-2 lameness remained and the horse had a varus deformity resulting from ligamentous laxity of the lateral collateral ligament in the contralateral carpus.

  20. A method for delineation of bone surfaces in photoacoustic computed tomography of the finger

    CERN Document Server

    Biswas, Samir; Steenbergen, Wiendelt; Manohar, Srirang


    Photoacoustic imaging of interphalangeal peripheral joints is of interest in the context of using the synovial membrane as a surrogate marker of rheumatoid arthritis. Previous work has shown that ultrasound produced by absorption of light at the epidermis reflects on the bone surfaces within the finger. When the reflected signals are backprojected in the region of interest, artifacts are produced, confounding interpretation of the images. In this work, we present an approach where the photoacoustic signals known to originate from the epidermis, are treated as virtual ultrasound transmitters, and a separate reconstruction is performed as in ultrasound reflection imaging. This allows us to identify the bone surfaces. Further, the identification of the joint space is important as this provides a landmark to localize a region-of-interest in seeking the inflamed synovial membrane. The ability to delineate bone surfaces allows us not only to identify the artifacts, but also to identify the interphalangeal joint spa...