骨感染性炎症与骨肿瘤的影像学比较

目的探讨分析四肢长骨感染性炎症和骨肿瘤的影像学改变,以实现四肢长骨感染性炎症和骨肿瘤的鉴别诊断,为临床资料提供参考依据。方法调查2006年1月-2013年2月住院156例患者,分为四肢长骨感染82例和骨肿瘤组74例患者;骨质异常的X线、CT和MRI征象以回顾性分析进行界定、观察、记录和统计学比较,采用SPSS 13.0统计软件进行分析。结果骨感染组死骨形成、髓腔内脓肿发生率均为100.00%,骨肿瘤组死骨形成、髓腔内脓肿发生率均为0,两组比较差异有统计学意义(P<0.05)。结论使用X线平片、CT、MRI、DSA等多种影像学检查手段,充分了解、运用各征象的意义,可以对四肢长骨感染性炎症和骨肿瘤进行正确的鉴别诊断,避免误诊。     

骨髓活检在诊断骨髓转移瘤中的价值

目的探讨骨髓活组织检查在诊断骨髓转移瘤中的价值。方法骨髓转移瘤患者行一步法骨髓抽吸取材,活检塑料包埋切片行HGF、Gomori染色,骨髓涂片行瑞特氏染色。结果骨髓活检检出率为97.1%,骨髓涂片检出率为60.9%,骨髓活检与骨髓涂片诊断相符率为57.9%;骨髓活检检出率明显高于骨髓涂片(P<0.01)。结论骨髓活检可作为诊断骨髓转移瘤的常规检测手段。     

Effect of dietary calcium deficiency on bone matrix-induced ectopic bone

The effect of dietary depletion of calcium on collagenous bone matrix-induced ectopic bone was studied, following thirty days of deficiency. While the molar ratio of phosphorus and calcium did not exhibit any significant differences between the control and experimental groups, individual concentrations of these minerals showed significant reduction in the ossicles derived from experimental rats. A concomitant decrease and increase in urinary excretion of calcium and phosphate was noted in the calcium deficient group; the serum levels of these parameters, however, were not affected. Both hexosamine and hydroxyproline levels appeared higher in calcium deficient ossicles. A significant elevation of alkaline and acid phosphatase as well as aryl sulfatase was observed in calcium deficient ossicles. There appeared to be no difference between control and experimental rats in the rate of calcification as measured by ⁴⁵Ca uptake. These results suggest that dietary deficiency induces significant resorption of ectopic bone without altering mineralization capacity. It is suggested that matrix-induced ectopic bone may be used as a suitable experimental model to study pathophysiology of bone loss under various experimental conditions.     

Renal bone disease

Advances in the last few years have led to an understanding of some of the mechanisms by which renal bone disease arises with the result that, despite their complexity, the objectives of treatment and the way in which these might be realized have become more accurately defined.     

Nutrition and bone

It is commonly believed that diet composition is important throughout life for optimizing bone health and reducing osteoporotic fracture risk. This contribution offers a critical overview of the main dietary components which are reported to be important. There is evidence to suggest that peak bone mass and later fracture risk are influenced by nutritional exposures in utero, in infancy and during childhood and adolescence. There are also particular concerns that individuals with a low calcium intake or vitamin D status may be at an increased risk, particularly at vulnerable periods during growth, and at times of high requirement (e.g. during pregnancy and lactation). Several other nutrients may play a key role in bone health, including vitamin K, phosphorus, potassium, magnesium, protein and sodium. In addition to specific nutrients, food groups (e.g. fruit and vegetables, pulses) may also have a positive effect on bone health.     

Chondroblastoma of bone

Background: Chondroblastoma is a rare and benign cartilaginous tumor of bone often localized in the epiphysis of long bones and affecting young persons between 10 and 20 years. Aim: To study the epidemiological, clinical and radiological aspects of bone chondroblastoma, to assess the outcome of chirurgical treatment and factors associated with recurrence. Methods: It's a retrospective study, concerning 13 patients with chondroblastoma of bone, attending the orthopedic department of Sahloul hospital between 1991 and 2007. The patients' age, sex, clinical features, radiological aspects, treatment and evolution were recorded. After initial clinical examination, all patients have had plane radiographs. Twelve patients were explored by Computed tomography. The treatment was surgical in every case: curettage of the lesion in 11 cases associated with bone grafting in 5 cases and cementation in one case, one in-bloc resection and one simple biopsy. Histology confirmed the diagnostic in all cases. Résultats: The average age of patients was 18, 2 years and sex ratio was 2, 3. the long bones are the most commonly involved. The main presenting symptoms were pain in all cases and local swelling in 8 cases. Radiographs showed a lytic geographic well-defined lesion in 7 cases. Computed tomography showed better calcifications and soft tissue extension. The mean follow-up of our patients was 8 years (6 mois-18 ans). Two recurrences were noted. Functional results were good in 11 cases. Conclusion: Chondroblastoma is a rare and benign cartilaginous tumor of bone which usually involves the epiphysis of long bones. Plane radiographs are sufficient for diagnostic in typical cases. MRI is interesting in unusual presentations and localizations. Curettage and grafting constitute the treatment of choice. Prognosis depends basically on a relatively high rate of recurrence. Aggressive feature of the lesion and incomplete curettage are the most important predictive factors of recurrence.     

Obesity during childhood and adolescence augments bone mass and bone dimensions

BACKGROUND: Studies of the effect of childhood obesity on bone accrual during growth have yielded conflicting results, largely related to the failure to adequately characterize the confounding effects of growth, maturation, and body composition. OBJECTIVE: The objective of this study was to determine the effect of childhood obesity on skeletal mass and dimensions relative to height, body composition, and maturation in males and females. DESIGN: In 132 nonobese (body mass index < 85th percentile) and 103 obese (body mass index > or = 95th percentile) subjects aged 4-20 y, whole-body and vertebral bone mineral content (BMC) was determined by using dual-energy X-ray absorptiometry, and bone area, areal bone mineral density (BMD), and fat and lean masses were measured. Vertebral volumetric BMD was estimated as BMC/area(1.5). RESULTS: Obesity was associated with greater height-for-age, advanced maturation for age, and greater lean mass for height (all P < 0.001). Sex-specific multivariate regressions with adjustment for maturation showed that obesity was associated with greater vertebral areal BMD for height, greater volumetric BMD, and greater vertebral BMC for bone area (all P < 0.05). After adjustment for maturation and lean mass, obesity was associated with significantly greater whole-body bone area and BMC for age and for height (all P < 0.001). CONCLUSIONS: In contrast with the results of prior studies, obesity during childhood and adolescence was associated with increased vertebral bone density and increased whole-body bone dimensions and mass. These differences persisted after adjustment for obesity-related increases in height, maturation, and lean mass. Future studies are needed to determine the effect of these differences on fracture risk.