Osteochondromatosis

骨软骨瘤病
  • 文章类型: Case Reports
    评估了1岁的雄性嗜中性雪貂(Mustelaputoriusfuro)的左肘关节异常。放射学照片显示左前臂近端骨增生性病变。计算机断层扫描证实了左桡骨近端的大型薄壁扩张骨性病变,并确定了中轴脊柱的多灶性增生性病变。其中两个导致脊髓压迫。进行了左前肢截肢和全肩胛骨切除术。组织病理学显示,界限分明的肿块具有薄薄的成熟板层骨边缘和不连续的软骨帽,该软骨帽被与相邻骨连续的软骨膜/骨膜覆盖。结果与骨软骨瘤或骨软骨瘤病最一致(即,多发性软骨外生体,遗传性多发性外生体)。在该标本中未观察到恶性转化的证据。手术后三个月,与主人的口头通信确认恢复正常活动水平,没有出现神经系统症状。建议重复检查和影像学检查。
    A 1-year-old male neutered ferret (Mustela putorius furo) was evaluated for an abnormal left cubital joint. Radiographs demonstrated a proliferative osseous lesion of the left proximal antebrachium. Computed tomography confirmed a large thin-walled expansile osseous lesion of the left proximal radius and identified multifocal proliferative lesions of the axial spine, two of which caused spinal cord compression. A left forelimb amputation with total scapulectomy was performed. Histopathology revealed a well-demarcated mass with a thin rim of mature lamellar bone and a discontinuous cartilage cap covered by a perichondrial/periosteal membrane continuous with the adjacent bone. Findings were most consistent with an osteochondroma or osteochondromatosis (i.e., multiple cartilaginous exostoses, hereditary multiple exostoses). No evidence of malignant transformation was observed within this specimen. Three months post-surgery, verbal correspondence with the owner confirmed return to normal activity level and no emergence of neurological signs. Repeat examination and imaging were recommended.
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  • 文章类型: Journal Article
    猫骨软骨瘤病是与猫白血病病毒(FeLV)感染相关的自发性骨软骨外生症,或由于外生体糖基转移酶1(EXT1)基因的移码变异。骨软骨瘤病被诊断为仅在室内,12岁,绝育的女性,俄罗斯蓝猫射线照片显示肘部双侧钙化增生,肋软骨和胸软骨关节,扭曲了正常的骨骼结构.严重的,增殖的关节表现一致,圆形肿块,导致完全强直.主要的组织病理学发现是骨软骨增生,由多个不规则的分化良好的透明软骨岛组成,并由类骨组织包围和界定。骨软骨瘤的免疫组织化学,骨髓和纵隔淋巴结,使用主要的抗FeLVgp70抗体,骨髓前病毒DNA实时聚合酶链反应阴性。对EXT1基因的外显子6进行测序,并且核苷酸BLAST分析证明不存在移码变体。这项研究报告了10岁以上动物中唯一的自发性猫科动物骨软骨瘤病病例。
    Feline osteochondromatosis is a spontaneous osteocartilaginous exostosis associated with feline leukaemia virus (FeLV) infection or due to a frameshift variant in the exostosin glycosyltransferase 1 (EXT1) gene. Osteochondromatosis was diagnosed in an indoor-only, 12-year-old, neutered female, Russian Blue cat. Radiographs revealed bilateral calcified proliferations in the elbow, costochondral and sternochondral joints, which distorted the normal skeletal structure. Grossly, the proliferated joints presented with consistent, rounded masses, causing complete ankylosis. The main histopathological finding was an osteocartilaginous proliferation composed of multiple irregular islands of well-differentiated hyaline cartilage surrounded and delimited by osteoid tissue. Immunohistochemistry of the osteochondromas, bone marrow and mediastinal lymph nodes, using a primary anti-FeLV gp70 antibody, and FeLV proviral DNA real-time polymerase chain reaction on bone marrow were negative. Sequencing of exon 6 of the EXT1 gene was performed and nucleotide BLAST analysis demonstrated the absence of a frameshift variant. This study reports the only case of spontaneous feline osteochondromatosis in an animal more than 10 years old.
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  • 文章类型: Journal Article
    除了一些病例报告,尚未研究骨软骨瘤病的骶髂关节(SIJ)受累。我们旨在使用横断面成像来确定这种参与的患病率和特征。
    在这项回顾性研究中,3名观察员(1名初级放射科医师和2名肌肉骨骼放射科医师)独立回顾了我们数据库中患有骨软骨瘤(≥2例跨骨骼骨软骨瘤)的患者的计算机断层扫描(CT)或磁共振成像(MRI)的SIJ受累.最终决定是由两位肌肉骨骼放射科医生在后来的联席会议上达成的共识。
    在我们数据库中的36例骨软骨瘤病患者中,22例(61%)有覆盖SIJ的横断面成像(14例女性,男性8例;年龄范围7-66岁;平均年龄23岁;MRI13例,9CT)。其中,16例(73%)患有关节内骨软骨瘤。为了在横断面成像中识别SIJ骨软骨瘤,肌肉骨骼放射科医师和初级放射科医师与两位肌肉骨骼放射科医师的最终共识决定之间的观察者间达成了实质性共识[κ=0.67;95%置信区间(CI):0.34,1.00]。在横断面成像的队列中,在6例有(n=2)和无(n=4)骶髂骨软骨瘤的不同患者中发现了附件SIJ(n=6,27%)和髂骶复合体(n=2,9%)的解剖变异.
    横断面影像显示SIJ频繁(73%)受累于骨软骨瘤病,which,虽然是一种罕见的疾病,然而,在鉴别诊断此类SIJ解剖变异体如副SIJ和髂骶骨复合体时,需要加以考虑.在骨软骨瘤病患者中,将这些变体与骨软骨瘤区分开具有挑战性。
    Apart from a few case reports, sacroiliac joint (SIJ) involvement in osteochondromatosis has not been studied. We aimed to determine the prevalence and characteristics of such involvement using cross-sectional imaging.
    In this retrospective study, three observers (one junior radiologist and two musculoskeletal radiologists) independently reviewed computed tomography (CT) or magnetic resonance imaging (MRI) of patients in our database who had osteochondromatosis (≥2 osteochondromas across the skeleton) for SIJ involvement. The final decision was reached by the consensus of the two musculoskeletal radiologists in a later joint session.
    Of the 36 patients with osteochondromatosis in our database, 22 (61%) had cross-sectional imaging covering SIJs (14 females, 8 males; age range 7-66 years; mean age 23 years; 13 MRI, 9 CT). Of these, 16 (73%) had intra-articular osteochondromas. For identifying SIJ osteochondromas on cross-sectional imaging, interobserver agreement was substantial [κ = 0.67; 95% confidence interval (CI): 0.34, 1.00] between the musculoskeletal radiologists and moderate (κ = 0.59; 95% CI: 0.23, 0.94) between the junior radiologist and the final consensus decision of the two musculoskeletal radiologists. In the cohort with cross-sectional imaging, the anatomical variations of the accessory SIJ (n = 6, 27%) and iliosacral complex (n = 2, 9%) were identified in six different patients with (n = 2) and without (n = 4) sacroiliac osteochondromas.
    Cross-sectional imaging shows frequent (73%) SIJ involvement in osteochondromatosis, which, although a rare disorder, nevertheless needs to be considered in the differential diagnosis of such SIJ anatomical variants as the accessory SIJ and iliosacral complex. Differentiating these variants from osteochondromas is challenging in patients with osteochondromatosis.
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  • 文章类型: Journal Article
    UNASSIGNED:肩关节滑膜骨软骨瘤病(SOC)是一种罕见的疾病,特征不明确。这项研究评估了与其他关节SOC不同的肩关节SOC的临床特征和术后功能结果。
    UNASSIGNED:回顾性评估了接受关节镜检查的28个肩关节SOC的特征。十个肩膀(35.7%)患有肩袖撕裂(RCT),并同时接受关节镜肩袖修复。平均随访期为83.6个月(范围,24-154个月)。比较了有和没有伴随RCT的病例之间的人口学特征和关节镜下局部的松散体。射线照相术,超声检查,或术前和术后进行磁共振成像。对所有病例进行疼痛视觉模拟量表(VAS)评分和满意度评定,评估肩关节功能评分,同时进行RCT检查.
    UNASSIGNED:无随机对照试验的患者平均年龄为36.2±15.6岁,有随机对照试验的患者平均年龄为58.3±7.2岁。七个肩膀(7%)患有骨关节炎。关节镜检查显示多个空间中有松散的身体,包括肱骨关节,肩峰下(SA)空间,和肱二头肌肌腱鞘。总的来说,在12个肩部的多个空间发现了松散的尸体(42.9%)。在SA空间中仅在没有RCT的4个肩部(22.2%)和有RCT的7个肩部(70.0%)中发现了松散的身体。疼痛的VAS从3.9±2.3显著降低至1.1±1.3(p<0.001)。关节镜治疗后并发RCT患者的功能评分显着增加(均p<0.05)。术后成像的22名患者中有3名(13.6%)出现SOC复发,但没有患者有复发性RCT。
    UNASSIGNED:通过关节镜治疗可实现疼痛缓解和患者满意度。与其他关节不同,松散的身体可以同时出现在肩部的几个空间,包括肱骨关节,SA空间,和肱二头肌肌腱鞘。早期诊断SA空间的SOC有助于预防骨关节炎和RCT进展。
    UNASSIGNED: Synovial osteochondromatosis (SOC) of the shoulder is a rare condition with unclear characteristics. This study evaluated the clinical features and postoperative functional outcomes of SOC of the shoulder that are distinct from SOC of other joints.
    UNASSIGNED: The characteristics of 28 shoulders with SOC that underwent arthroscopy were retrospectively assessed. Ten shoulders (35.7%) had rotator cuff tears (RCTs) and underwent concomitant arthroscopic rotator cuff repair. The mean follow-up period was 83.6 months (range, 24-154 months). Demographic characteristics and loose bodies localized under arthroscopy were compared between cases with and without concomitant RCTs. Radiography, ultrasonography, or magnetic resonance imaging were performed preoperatively and postoperatively. Visual analog scale (VAS) scores for pain and satisfaction were evaluated for all cases, and functional scores were assessed in shoulders with concomitant RCTs.
    UNASSIGNED: The average age was 36.2 ± 15.6 years among patients without RCTs and 58.3 ± 7.2 years among patients with RCTs. Seven shoulders (7%) had osteoarthritis. Arthroscopy revealed loose bodies in multiple spaces, including the glenohumeral joint, subacromial (SA) space, and biceps tendon sheath. Overall, loose bodies were found in multiple spaces in 12 shoulders (42.9%). Loose bodies were found in the SA space only in 4 shoulders (22.2%) without RCTs and in 7 shoulders (70.0%) with RCTs. VAS for pain decreased significantly from 3.9 ± 2.3 to 1.1 ± 1.3 (p < 0.001). The functional scores increased significantly after arthroscopic management for patients with concurrent RCTs (all p < 0.05). Recurrence of SOC occurred in 3 of the 22 shoulders (13.6%) who underwent postoperative imaging, but no patient had a recurrent RCT.
    UNASSIGNED: Pain relief and patient satisfaction were achieved via arthroscopic management. Unlike in other joints, loose bodies can occur simultaneously in several spaces in the shoulder, including the glenohumeral joint, SA space, and biceps tendon sheath. Early diagnosis of SOC of the SA space can help prevent osteoarthritis and RCT progression.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    骨软骨瘤病是一种良性增殖性疾病,其特征是软骨覆盖的骨突起。在人类和大多数哺乳动物中,EXT1或EXT2基因的变异与骨软骨瘤病的病因密切相关.然而,在猫中,骨软骨瘤病只与猫白血病病毒感染有关。在这项研究中,探讨与猫科动物骨软骨瘤病病因有关的其他因素,我们检测了一只猫白血病病毒阴性的骨软骨瘤病猫的EXT1和EXT2基因.遗传分析揭示了EXT1基因外显子6的杂合单碱基对重复(XM_023248762.2:c.1468dupC),导致EXT1蛋白中提前终止密码子。值得注意的是,这种移码变体被认为是人类骨软骨瘤病中最常见的致病变体之一。我们的数据首次表明,遗传变异在猫的骨软骨瘤病中具有病因学作用,就像人类和其他动物一样。
    Osteochondromatosis is a benign proliferative disorder characterized by cartilage-capped bony protuberances. In humans and most mammals, variants in the EXT1 or EXT2 gene are strongly correlated with the etiology of osteochondromatosis. However, in cats, osteochondromatosis has only been associated with feline leukemia virus infection. In this study, to explore other factors involved in the etiology of feline osteochondromatosis, we examined the EXT1 and EXT2 genes in a feline leukemia virus-negative cat with osteochondromatosis. Genetic analysis revealed a heterozygous single base pair duplication in exon 6 of the EXT1 gene (XM_023248762.2:c.1468dupC), leading to a premature stop codon in the EXT1 protein. Notably, this frameshift variant is recognized as one of the most common pathogenic variants in human osteochondromatosis. Our data suggest for the first time that genetic variants can have etiologic roles in osteochondromatosis in cats, as in humans and other animals.
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  • 文章类型: Journal Article
    Hereditary osteochondromatosis is an uncommon, autosomal, dominant condition characterized by the presence of multiple bone growths.
    To analyze factors associated with health-related quality of life (HRQoL) among children > 2 years and adults receiving follow-up at a tertiary care children\'s hospital in Argentina.
    Cross-sectional study of a follow-up cohort. HRQoL was measured using the Pediatric Quality of Life Inventory® (PedsQL) and the Short Form Health Survey (SF- 36). Sex, age, sociodemographic characteristics, height, radiology, axis alteration and limb function, presence of pain, and malignant change were recorded. Severity was classified as per Pedrini et al. Parametric and non-parametric tests and regression analysis were done.
    A total of 66 cases (47 children and 19 adults) were included. Male/female ratio: 1.7/1. Median age: 13.4 years (r: 2.21-55.3). Pain was observed in 30/47 children and in 17/19 adults. Considering the adult bone age (or epiphyseal closure) as the cutoff point to define adult status, 11/37 children and 18/27 adults had a severe disease and 2/38 children and 9/27 adults had short stature. The average value of the physical component of HRQoL in children was 65.9 (SD: 22.5) and, in adults, 27.2 (IQR: 18.5- 34.7). The presence of pain and clinical severity were significantly associated with a lower HRQoL, both in children and adults.
    This study found that pain and disease severity had a negative effect on HRQoL.
    Introducción. La exostosis múltiple hereditaria es una enfermedad poco frecuente autosómica dominante caracterizada por presencia de múltiples proyecciones óseas.
    Analizar factores asociados a la calidad de vida relacionada con la salud (CVRS) en niños >2 años y en adultos en seguimiento en un hospital de pediatría de alta complejidad de Argentina. Población y métodos. Estudio transversal de una cohorte en seguimiento. La CVRS se midió con Pediatric Quality of Life Inventory® (PedsQL) y Short Form Health Survey (SF-36). Se registró sexo, edad, características sociodemográficas, estatura, radiología, alteración de eje y función de miembros, presencia de dolor y malignización. Se clasificó la gravedad según Pedrini y col. Se realizaron pruebas paramétricas, no paramétricas y análisis de regresión.
    Se incluyeron 66 casos (47 niños y 19 adultos). Relación sexo masculino/femenino: 1,7/1. Mediana de edad: 13,4 años (r: 2,21- 55,3). Presentaron dolor 30 de 47 niños y 17 de 19 adultos. Si se considera la edad ósea adulta (o cierre epifisario) como punto de corte para definir el estado de adulto, 11 de 37 niños y 18 de 27 adultos presentaron forma grave de enfermedad, y se observó baja estatura en 2 de 38 niños y en 9 de 27 adultos. El valor promedio del componente físico de CVRS en niños fue 65,9 (DE: 22,5) y, en adultos, 27,2 (RIC: 18,5-34,7). La presencia de dolor y la gravedad clínica se asoció significativamente a menor CVRS tanto en niños como en adultos.
    En este estudio se observó que el dolor y la gravedad de la enfermedad tuvieron un efecto negativo en la CVRS.
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  • 文章类型: Journal Article
    A 6-months-old male mixed-breed dog was admitted to the veterinary hospital with lameness in the right pelvic limb, proprioceptive ataxia, and suspected spinal cord injury in the lumbosacral segment. Upon palpation, firm nodules were noted on the bony surface of the thoracic and pelvic limbs, ribs, vertebrae, and tail. The radiographic study showed nodules of low radiopacity with well-defined limits and smooth contours, one of which was overlapping the fifth lumbar vertebra. Given the clinical presentation indicative of spinal cord injury, the animal was subjected to hemilaminectomy for nodular resection. Histopathological examination of the biopsy enabled the diagnosis of osteochondroma. The clinical follow up after surgery showed improvement in walking, despite persistent monoparesis in the right pelvic limb. The radiographic study in association with clinical and histopathological exams allowed the diagnosis and monitoring of the lesions.
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  • 文章类型: Journal Article
    OBJECTIVE: To report on the outcome of single-bone forearm reconstruction (SBFR) as a salvage procedure in pediatric forearm pathologies.
    METHODS: Twenty-eight forearms in 27 patients (median age, 9.6 years; range, 3.4-29.7 years) treated with SBFR at a pediatric referral center were included in the study. Records and radiographs were retrospectively analyzed. Median follow-up was 84 months (range, 24-261 months). The most common underlying condition was multiple hereditary exostoses (MHEs) (17 of 28), followed by brachial plexus birth injury (5 of 28), Ollier disease (2 of 28), congenital radial head dislocation (2 of 28), and others (2 of 28).
    RESULTS: By 4 months (range, 2-10 months) after surgery, 21 of 28 forearms had united. Median resting postoperative forearm rotation was 10° pronation (range, neutral to 25° pronation). Before surgery, pain was present in 23 of 28 forearms. At the latest follow-up, pain was present in 5 of 28 forearms. In three of the 5 forearms with residual pain, this was attributed to ulnohumeral degenerative changes that existed prior to SBFR. Following SBFR, elbow flexion-extension range was maintained. In the subgroup with MHEs, radial articular angle was maintained (median, 37°-30°) and carpal slip percentage improved significantly (median, 40%-12%). Complications occurred in 8 forearms: 3 cases of nonunion in older patients (age, 30, 20, and 14 years), 2 cases of traumatic juxtaimplant fractures following successful union, 1 case of infection, 1 case of compartment syndrome, and 1 case of persistent radiocapitellar impingement. All complications were successfully treated. When stratified by age, none of the patients in the younger group (16 forearms, age < 12 years) had nonunions or pain at latest follow-up.
    CONCLUSIONS: The SBFR is an old, but generally reliable, option as a single-stage salvage procedure for a number of recalcitrant pediatric forearm pathologies. Success rate may be higher in younger patients.
    METHODS: Therapeutic IV.
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  • 文章类型: Case Reports
    Synovial chondromatosis is a rare benign condition. It most commonly affects the large joints. Presentation in the temporomandibular joint is rare. Our case was an incidental radiological finding and not diagnosed immediately, highlighting the ease with which conditions such as this can be missed, particularly in asymptomatic patients. Only 45% of patients with synovial chondromatosis show radiographic changes. Findings as significant as ours are unusual. An increased professional awareness of the radiological signs of synovial chondromatosis would be beneficial to improve diagnosis and prognosis for patients.
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