HYPEROSTOSIS

骨肥厚症
  • 文章类型: Journal Article
    化脓性汗腺炎(HS)是一种终末毛囊的自身炎症性皮肤病,可以零星存在,家族性,或综合征形式。已经对后者提出了分类,区分与已知遗传状况相关的病例,滤泡角质化疾病或自身炎性疾病。这篇综述侧重于这些实体的临床和遗传特征(即,坏疽性脓皮病[PG],痤疮和HS;PG,痤疮,化脓性关节炎和HS;银屑病关节炎,PG,痤疮和HS;滑膜炎,痤疮,脓疱病,骨增生,骨炎;等等),提出了与HS相关的自身炎症综合征的统称。
    Hidradenitis suppurativa (HS) is an autoinflammatory skin disorder of the terminal hair follicle, which can present in sporadic, familial, or syndromic form. A classification has been proposed for the latter, distinguishing cases associated with a known genetic condition, with follicular keratinization disorders or with autoinflammatory diseases. This review focuses on the clinical and genetic features of those entities (ie, pyoderma gangrenosum [PG], acne and HS; PG, acne, pyogenic arthritis and HS; psoriatic arthritis, PG, acne and HS; synovitis, acne, pustulosis, hyperostosis, osteitis; and so forth) for which the collective term HS-related autoinflammatory syndromes is proposed.
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  • 文章类型: Systematic Review
    BACKGROUND: Planar hyperostotic meningiomas account for 2-9% of intracranial meningiomas. They are characterized by planar node following the contours of the inner surface of the skull. Hyperostosis is present in most cases. Timely diagnosis of skull base tumors is usually simple due to early involvement of the cranial nerves. However, convexity meningiomas en plaque usually reach large dimensions that complicates surgery and radiotherapy.
    OBJECTIVE: To analyze the current state of diagnosis, molecular biology and surgical treatment of hyperostotic meningiomas en plaque.
    METHODS: A systematic review was performed in accordance with the PRISMA guidelines. Searching for literature data included the following keywords: «planar meningioma», «hyperostotic meningioma», «meningioma en plaque», «infiltrative meningioma». We reviewed the PubMed and Google Scholar databases until May 2023 and enrolled only full-text Russian-, English- or French-language reports.
    CONCLUSIONS: Among primary 332 reports, 35 references met the inclusion criteria. We found less severity or absence of focal neurological symptoms, comparable incidence of intracranial hypertension and no histological differences between planar and nodular meningiomas. Analysis of molecular biological features of planar meningiomas, including cell cultures, is feasible. There is no consensus regarding surgical treatment and radiotherapy. Most publications are case reports.
    CONCLUSIONS: The results of treatment of planar hyperostotic meningiomas, especially large and giant ones, are unsatisfactory. There is no a generally accepted algorithm for treating patients in the literature. This problem requires further research.
    Плоскостные («en plaque») гиперостотические менингиомы составляют от 2 до 9% внутричерепных менингиом. Они характеризуются наличием плоскостного узла, повторяющего контуры внутренней поверхности черепа, и в большинстве случаев формируют гиперостоз. Если при локализации в области основания черепа возможна своевременная диагностика по причине раннего вовлечения черепных нервов, плоскостные менингиомы свода черепа на момент постановки диагноза могут достигать значительных размеров, что затрудняет как хирургическое, так и лучевое лечение.
    UNASSIGNED: Анализ современного состояния проблемы диагностики, молекулярной биологии и хирургического лечения плоскостных гиперостотических менингиом свода черепа по данным литературы.
    UNASSIGNED: Систематический обзор выполнен в соответствии с рекомендациями PRISMA. Проведен поиск по ключевым словам: «planar meningioma», «hyperostotic meningioma», «meningioma en plaque», «infiltrative meningioma» — в базах PubMed и Google Scholar на всю глубину по май 2023 г., в исследование включены только полнотекстовые публикации на русском, английском или французском языках.
    UNASSIGNED: Из 332 выявленных ссылок критериям включения соответствовали 35 источников. Отмечаются меньшая выраженность или отсутствие очаговых неврологических симптомов, сопоставимая частота внутричерепной гипертензии и отсутствие гистологических различий при плоскостных по сравнению с узловыми менингиомами. Подчеркивается целесообразность изучения молекулярно-биологических особенностей плоскостных менингиом, в том числе в клеточных культурах. Нет консенсуса в отношении тактики хирургического и лучевого лечения. Большинство публикаций является описанием клинических случаев.
    UNASSIGNED: Результаты лечения плоскостных гиперостотических менингиом свода черепа, особенно больших и гигантских, являются неудовлетворительными. Общепризнанный алгоритм лечения пациентов в литературе не представлен. Проблема требует дальнейших исследований.
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  • 文章类型: Systematic Review
    目的:滑膜炎、痤疮、脓疱性骨炎(SAPHO)是一种少见的异质性疾病,病因不明。经过外部验证和国际商定的诊断标准或结果,因此,SAPHO没有前瞻性随机对照试验。因此,没有商定的治疗标准。本研究旨在系统地整理和讨论SAPHO的治疗方案。
    方法:遵循“系统评价和荟萃分析的首选报告项目”指南,使用PubMed进行了系统的文献检索,Scopus和WebofScience数据库。包括前瞻性临床研究和回顾性病例收集,讨论涉及5名或更多参与者的SAPHO的管理和结果。文章不是以英文发表的,未报告明确结果的研究,仅依赖于患者报告结局的研究被排除.
    结果:共28项研究(20项观察性,8项开放标签临床研究)报告796名主要为欧洲种族的患者被纳入。报道的疗法差异很大,许多中心并行使用多种治疗。大多数患者(37.1%)单独或联合使用非甾体抗炎药。双膦酸盐(22.1%),常规(21.7%)和生物(11.3%)改善疾病的抗风湿性药物是下一个最常报道的治疗方法.报告的结果各不相同,结果好坏参半,这使得比较复杂化。双膦酸盐表现出最一致的骨关节症状改善,并与短暂的流感样症状有关。在使用TNF抑制剂治疗的患者中报告了矛盾的皮肤反应,但没有严重不良事件记录.大多数治疗对皮肤受累的影响有限或混合。最近一项调查Janus激酶抑制剂tofacitinib的研究在皮肤和指甲受累方面取得了有希望的结果。
    结论:目前尚无单一可用的治疗方案足以解决所有SAPHO相关症状。变量,有时描述性结局和治疗组合的使用会使结论和治疗建议复杂化.随机临床试验是必要的,以产生可靠的证据。
    OBJECTIVE: Synovitis acne pustulosis hyperostosis osteitis (SAPHO) is a rare heterogeneous disease of unknown aetiopathology. Externally validated and internationally agreed diagnostic criteria or outcomes and, as a result, prospective randomised controlled trials in SAPHO are absent. Consequently, there is no agreed treatment standard. This study aimed to systematically collate and discuss treatment options in SAPHO.
    METHODS: Following \'Preferred Reporting Items for Systematic Reviews and Meta-Analyses\' guidance, a systematic literature search was conducted using PubMed, Scopus and Web of Science databases. Prospective clinical studies and retrospective case collections discussing management and outcomes in SAPHO involving five or more participants were included. Articles not published in English, studies not reporting defined outcomes, and studies solely relying on patient-reported outcomes were excluded.
    RESULTS: A total of 28 studies (20 observational, 8 open-label clinical studies) reporting 796 patients of predominantly European ethnicity were included. Reported therapies varied greatly, with many centres using multiple treatments in parallel. Most patients (37.1%) received non-steroidal anti-inflammatory drugs alone or in combination. Bisphosphonates (22.1%), conventional (21.7%) and biological (11.3%) disease-modifying antirheumatic drugs were the next most frequently reported treatments. Reported outcomes varied and delivered mixed results, which complicates comparisons. Bisphosphonates demonstrated the most consistent improvement of osteoarticular symptoms and were associated with transient influenza-like symptoms. Paradoxical skin reactions were reported in patients treated with TNF inhibitors, but no serious adverse events were recorded. Most treatments had limited or mixed effects on cutaneous involvement. A recent study investigating the Janus kinase inhibitor tofacitinib delivered promising results in relation to skin and nail involvement.
    CONCLUSIONS: No single currently available treatment option sufficiently addresses all SAPHO-associated symptoms. Variable, sometimes descriptive outcomes and the use of treatment combinations complicate conclusions and treatment recommendations. Randomised clinical trials are necessary to generate reliable evidence.
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  • 文章类型: Review
    滑膜炎,痤疮,脓疱病,骨增生,骨炎(SAPHO)综合征是一种罕见的自身免疫性炎症性疾病,以骨关节和皮肤病表现为特征。最常见的骨关节表现涉及前胸壁,轴向骨架,和长骨。在SAPHO综合征中,颅骨受累的报道较少。我们在此介绍三例SAPHO综合征伴颅骨受累,并回顾了以前关于类似表现的文献。据透露,SAPHO综合征可能导致颅骨受累,可能涉及硬脑膜,导致肥厚性硬脑膜炎,但结果通常是好的。Janus激酶抑制剂可能是一种潜在的治疗选择。
    Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoimmune inflammatory disease characterized by osteoarticular and dermatological manifestations. The most common osteoarticular manifestations involve the anterior chest wall, axial skeleton, and long bones. Cranial bone involvement is less reported in SAPHO syndrome. We herein present three cases of SAPHO syndrome with cranial bone involvement, and review the previous literature on similar manifestations. It was revealed that SAPHO syndrome could lead to cranial bone involvement, which could involve the dura mater, leading to hypertrophic pachymeningitis, but the outcome is usually good. Janus kinase inhibitors may be a potential treatment option.
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  • 文章类型: Systematic Review
    我们描述了一名74岁的男性,患有顽固性特发性震颤(ET)和白花蛇颅骨增生,但未通过磁共振引导聚焦超声(MRgFUS)成功治疗。在手术前进行的计算机断层扫描显示颅骨密度比(SDR)为0.37,三皮质骨增生性颅骨白花蛇。MRgFUSMRI后无明显病变,并且在临床上没有注意到患者的手震颤的改善。我们系统回顾了文献,以了解那些接受MRgFUS治疗的骨肥大患者的预后。使用PubMed进行全面的文献检索,科克伦,和GoogleScholar数据库确定了3例接受MRgFUS治疗失败的增生症患者。临床发现,头骨特征,处理参数,并对结果进行了总结,展示不同模式/程度的双皮质肥大症和可变的特别提款权(即,从0.38到≥0.45)。虽然我们已经成功地治疗了双皮质骨肥大的患者(n=50),尽管SDRs可接受,但三骨肥大似乎是MRgFUS的禁忌症。
    We describe a 74-year-old male with intractable essential tremor (ET) and hyperostosis calvariae diffusa who was unsuccessfully treated with magnetic resonance-guided focused ultrasound (MRgFUS). A computed tomography performed prior to the procedure demonstrated a skull density ratio (SDR) of 0.37 and tricortical hyperostosis calvariae diffusa. No lesion was evident on post-MRgFUS MRI, and no improvement in the patient\'s hand tremor was noted clinically. We systematically reviewed the literature to understand outcomes for those patients with hyperostosis who have undergone MRgFUS. A comprehensive literature search using the PubMed, Cochrane, and Google Scholar databases identified 3 ET patients with hyperostosis who failed treatment with MRgFUS. Clinical findings, skull characteristics, treatment parameters, and outcomes were summarized, demonstrating different patterns/degrees of bicortical hyperostosis and variable SDRs (i.e., from 0.38 to ≥0.45). Although we have successfully treated patients with bicortical hyperostosis frontalis interna (n = 50), tricortical hyperostosis calvariae diffusa appears to be a contraindication for MRgFUS despite acceptable SDRs.
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  • 文章类型: Case Reports
    Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an umbrella term covering a constellation of bone lesions and skin manifestations, but has rarely been clarified in the clinic. We report a 28-year-old woman who had initial onset of SAPHO syndrome with involvement of the femur, and she experienced a tortuous diagnostic course. We also performed a literature review of SAPHO syndrome cases involving the femur and summarize several empirical conclusions by integrating previous findings with our case. Furthermore, we propose our perspective that ailment of the skin caused by infection of pathogens might be the first hit for triggering or perpetuating the activation of the immune system. As a result, musculoskeletal manifestations are probably the second hit by crosstalk of an autoimmune reaction. The skin manifestations preceding bone lesions can be well explained. Current interventions for SAPHO syndrome remain controversial, but drugs aiming at symptom relief could serve as the first preference for treatment. An accurate diagnosis and appropriate treatment can cure patients in a timely manner. Although the pathogenesis of SAPHO syndrome remains to be determined, physicians and surgeons still need to heighten awareness of this entity to avoid invasive procedures, such as frequent biopsies or nonessential ostectomy.
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  • 文章类型: Case Reports
    Child abuse is a major public health problem that can lead to critical consequences for the child and family. However, early identification of abuse may be difficult. An 8-month-old boy presented with extensive periosteal reaction in both upper and lower long bones. There was no specific history of injury. Caffey disease was initially considered as the diagnosis because the patient displayed fever and hyperostosis of multiple bones with elevated erythrocyte sedimentation rates and C-reactive protein and alkaline phosphatase levels. However, we suspected child abuse based on the clinical and radiological features. We eventually found out that the child had been injured through child abuse and were able to treat him. We report this case because child abuse cases may be confused with Caffey disease. This case report can, therefore, help distinguish between Caffey disease and child abuse.
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  • 文章类型: Case Reports
    Camurati-Engelmann disease (CED) is a rare, progressive diaphyseal dysplasia characterized as diaphyseal hyperostosis and sclerosis of the long bones. Corticosteroids, bisphosphonates, and losartan have been reported to be effective systemic medications used to reduce CED symptoms. There are no reports of osteoblastoma in patients with CED, and osteoblastoma in the distal radius is rare. We present a patient diagnosed with CED, based on radiological and histological examinations, at 11 years old. At 22 years old, she experienced severe pain in her right forearm and was treated with bisphosphonate, losartan, and prednisolone; however, the pain continued. An expansive and sclerotic lesion at the distal radius was observed on radiography. A follow-up plain radiograph indicated that the lesion was growing. Fluorodeoxyglucose positron emission tomography revealed solitary, intense radiotracer uptake, and a biopsy and surgical resection were performed due to suspected malignancy. Pathologic analysis showed anastomosing bony trabeculae rimmed by osteoblasts observed in a loose fibrovascular stroma. The lesion was diagnosed as an osteoblastoma. Following bone excision and artificial bone grafting, the patient\'s severe pain almost completely disappeared. At final follow-up, no evidence of osteoblastoma recurrence was noted. To our knowledge, this is the first case report of osteoblastoma arising in a patient with CED. Bone excision and artificial bone grafting may be a treatment option for local symptomatic osteoblastoma in patients with CED.
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  • 文章类型: Case Reports
    Diffuse idiopathic skeletal hyperostosis (DISH) also known as Forestier disease is a noninflammatory, systemic skeletal disease of unknown etiology. DISH is usually asymptomatic but may compress the posterior wall of the aero digestive tract and lead to dysphagia, globus, hoarseness, stridor, dyspnea, and neurological problems. Although dysphagia is not uncommon among the presenting symptoms of DISH but dysphonia and stridor are rarely reported. We report a 68-year-old man who presented with a history of progressive dysphagia over 1 year and recent dysphonia and stridor secondary to cervical osteophytes. We discuss the symptoms, radiological features, and management of this uncommon case of DISH in conjunction with review of literature.
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  • 文章类型: Letter
    暂无摘要。
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