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Query: UMLS:C0005940 (bone disease)
 7,459 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Histiocytosis X is still of unknown origin. Its clinical patterns are various and it is above all a bone disease of children, mostly boys. It is a tumoral condition basically benign but with a strong tendency toward dissemination and destruction. Its natural history is unpredictable. The authors have reviewed 37 cases after a 44 months mean follow-up for bringing up a better understanding of the role of orthopedic surgery. The diagnosis was always based on biopsies looking for at least two basic signs out of four possible ones. Scintigraphy was used to detect other locations. MRI was used to evaluate the effect of treatment. In single eosinophilic granuloma, curettage was associated with biopsy. Local injections of corticoids may help in spinal locations. In disseminated forms, surgical treatment should be little aggressive, limited to a biopsy of the most superficial lesion. These forms should be treated by radiotherapy corticotherapy and chemotherapy, as well as the aggressive lesions, the extensive ones, the threatening ones and those which are not accessible.
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PMID:[Localizations of histiocytosis X in bone]. 141 Jul 17

From 1984 to 1990 the authors reviewed the radiologic-clinical charts of 237 patients affected with multiple myeloma (MM). The series included 127 males and 110 females (mean age: 66 years) who had been classified according to Durie and Salmon clinical criteria. All the patients underwent X-rays of the skeleton, as recommended in international literature; moreover, 148 subjects underwent whole-body bone scintigraphy, and 130 bone marrow scintigraphy. A selected group of cases (18 male/female patients) were submitted to bone densitometry employing both quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA). The results follow: 1) in the first stage of the disease, a high number of patients (29.5%) exhibits no skeletal abnormalities on X-rays; the most common lesion locations include the spine (49%), skull (35%), pelvis (34%), ribs (33%), humeri (22%), femora (13%) and mandible (10%); 2) the most frequent pattern is osteolysis, as a characteristic "punched-out" multiple lesion; the second most frequent lesion is osteopenia (43%), especially in the spine; pathologic fractures are common (54%) in the ribs, vertebral bodies, limbs; typical associations of features and sites are seen on X-ray images, which sometime make diagnosis easier; 3) whole-body scintigraphy, revealing aspecific uptake only in the presence of pathological fractures, is not recommended in the first staging of the disease, but is considered as a valuable technique in the follow-up, when the patients become symptomatic; 4) bone marrow scintigraphy, especially in the "marrow expansion" pattern, might be considered as an attempt made by the body to recover the central space which was destroyed by myelomatous involvement. The prognostic value of this technique is still to be assessed; 5) bone densitometry, by confirming the grade of osteopenia, reveals that osteoporosis is a peculiar pattern of bone disease in MM, which is not related to age only; 6) conventional radiography of the skeleton is the method of choice in the diagnosis of lytic areas of MM, and remains, as yet, irreplaceable. The other diagnostic techniques--i.e., CT and MRI--can be used to evaluate the extent of bone and soft tissue involvement, in the cases with questionable diagnosis, and to assess the degree of marrow involvement.
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PMID:[Bone disease in multiple myeloma. A study of 237 cases]. 163 29

Bone scans in two patients with Gaucher's disease were reported as consistent with Gaucher's-associated osseous crises. A bone-radiogallium subtraction study was also initially negative in each individual (although it later became positive in one). At surgery both patients were seen to have osteomyelitis. These two cases point out the difficulty in attempting to diagnose osteomyelitis in the presence of Gaucher's bone disease. A possible role for MRI in such instances was mentioned. Also noted was clinical reluctance to accept a diagnosis of osteomyelitis (positive bone-radiogallium subtraction study) in an afebrile Gaucher's patient.
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PMID:Diagnosing osteomyelitis in Gaucher's disease. Observations on two cases. 193 92

The spinal cord injury centre of Nizam's Institute of Medical Sciences, Andhra Pradesh, India has been functioning now for 8 months and offers its services to the population of 80 million in the state. To date, 92 patients with a spinal cord injury have been treated; 51 had a thoracolumbar spinal injury. This report presents the results of the management of these 51 patients. Preoperatively both CT and MRI were performed and the radiological findings were correlated with outcome. Twenty five had a thoracic and 26 a lumber location. Twenty nine patients underwent surgical treatment (15 thoracic and 14 lumbar) and the others were treated conservatively (10 thoracic and 12 lumbar). All these operations were carried out within 2 weeks following trauma, and methylprednisolone therapy was instituted in those who reached the hospital early. Contraindications for surgery included a delay in admission of more than 3 weeks following trauma, a focus of sepsis, bedsores, a generalised bone disorder such as osteopenia, and medical illnesses. Transpedicular screw-plate fixation was performed in 27 patients, and two patients underwent decompressive laminectomy and interlaminar bone and wire fixation. Delayed spinal decompression was offered to one patient to relieve radiculopathy. Fracture-dislocation spinal injury and those with transection of the spinal cord had the worst outcome, whilst patients with a wedge compression fracture and cord oedema fared better. Operated cases had a shorter hospital stay, and complications of immobilisation were limited. Positive psychological influence of mobilisation and early acclimatisation to the altered style of living with their disability were the most significant outcomes following surgery.
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PMID:Early surgery for thoracolumbar spinal cord injury: initial experience from a developing spinal cord injury centre in India. 764 63

Although osteoporosis is the most common bone disease of the Western world, the diagnosis of osteoporosis or risk for osteoporosis remains problematic despite major advances in technology to measure bone mass in recent years. There is a need to perform more fundamental studies on bone in normal and pathological conditions, in order to progress our knowledge and to detect in time patients at risk for osteoporotic fracture. The BIOMED I project "Assessment of Quality of Bone in Osteoporosis" (PL920296) and 116 other projects were chosen out of a total of 1200 proposals by the Commission of the European Communities, Directorate General XII, Science, Research and Development. The present paper outlines the project proposals. European centers with recognised expertise in assessment of bone, micro-macro-structure, biochemistry, geochemistry and biomechanics will concert their findings on ex vivo bone tissue samples, with the aim to discover a new assessment or combination of assessments for the appreciation of bone quality in vivo. The following modalities for assessment of bone in addition to the established techniques as radiogrammetry, photonabsorptiometry, DEXA, QCT and single photonabsorptiometry, will be incorporated: mechanical testing and fracture mechanics, ultrasound, bone biochemistry, three dimensional imaging, NMR spectroscopy and MRI. Special attention will be given to the standardization of ultrasound velocity and attenuation measurements in a working group bringing together the expertise of 10 centers.
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PMID:Assessment of quality of bone in osteoporosis--BIOMED I: fundamental study of relevant bone. 775 Feb 46

Bone scintigraphy (bone scanning) is a sensitive diagnostic tool used to detect the presence and extent of primary and secondary bone disease. Unlike X-rays, MRI, and CT scans, which focus primarily on structural anatomy, bone scans depict the dynamic physiologic response of bone to an insult. We review bone scanning principles, their indication in eye care, and demonstrations of their use in eye involvement from both primary and metastatic bone disease.
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PMID:Bone scintigraphy: a review of the procedure and its applications. 797 May 66

Two hundred and fifty-three multiple myeloma patients (136 males and 117 females; mean age 66 years) classified by the clinical criteria of Durie and Salmon underwent skeletal radiography; 148 of them had total body bone scintigraphy, and 130 bone marrow scintigraphy. A selected group of them (18 patients, both males and females) had densitometric bone examination, employing both quantitative computed tomography (QCT) and dual energy X-ray absorptiometry (DXA). The results can be summarized as follows: 29.7% of patients exhibited no skeletal abnormalities at early staging. Spine (49%), skull (35%), pelvis (34%), ribs (33%), humeri (22%), femora (13%), and mandible (10%) were the most frequently involved locations. The main pattern is osteolysis as a characteristic "punched-out" multiple lesion (43.3%), but the most frequent lesion is osteopenia (43.9%), particularly evident in the spine; pathologic fractures (54%) are seen in the ribs, vertebral bodies, limbs; typical radiographic associations of features and sites are observed, which sometimes make diagnosis easier. Total body scintigraphy, revealing aspecific uptake only in the presence of pathologic fractures, is not recommended in the first staging of the disease, but it is considered as an important technique in the follow-up, when the patients become symptomatic. Bone marrow scintigraphy, especially in the "marrow expansion" pattern, might be considered as a form of compensating attempt to recover the lost central space, destroyed by myelomatous involvement, of which it defines the pathologic and prognostic status. Bone densitometry, as it confirms the grade of osteopenia, reveals that osteoporosis is a peculiar characteristic pattern of bone disease in multiple myeloma, not only due to age. Conventional skeletal radiography is the main support in the diagnosis of lytic areas of multiple myeloma, and it remains--today--irreplaceable. The other diagnostic techniques (i.e., CT and MRI) may be used to detect the extent of bone and soft tissue involvement, in areas of complicated anatomy, and to define the degree of marrow involvement.
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PMID:[Bone disease in multiple myeloma. Analysis of 253 controlled cases, with reappraisal of diagnostic criteria and current imaging techniques]. 849 72

Although bone scintigraphy is an extremely sensitive method for the detection of focal bone disease, small lesions below the resolution of planar imaging may be missed. This is a report of a patient with carcinoma of the breast who showed tumor progression 1 year after initial treatment. Complete evaluation was performed in order to detect the origin of increased level of a tumor marker. Although planar bone scintigraphy could not demonstrate any lesion in the spine, multiple metastases were detected in the lumbar and the thoracic spines on SPECT imaging. Only some of these lesions were seen with MRI. Repeat planar bone imaging 6 weeks later showed multiple bone lesions in the lumbar and thoracic areas.
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PMID:Metastases seen on SPECT imaging despite a normal planar bone scan. 867 88

Fibrous dysplasia is a benign bone disorder. It is diagnosed by distinctive X-ray radiography, CT, and MRI findings. Although bone scintigraphy helps to identify the tumor origin according to accelerated bone turnover, the glucose metabolism in fibrous dysplasia has not yet been investigated. We reported a case of fibrous dysplasia in craniofacial bone which showed signs of the acceleration of bone mineral turnover without elevated glucose utilization by Technetium-99m-HMDP SPECT and Fluorine-18-FDG PET. We concluded that the growth of fibrous dysplasia needed the acceleration of bone mineral turnover without an increase in glucose metabolism.
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PMID:Increased bone mineral turnover without increased glucose utilization in sclerotic and hyperplastic change in fibrous dysplasia. 967 17

A 69-year-old Japanese woman was referred to our hospital because of abnormal skull X-ray findings. Serum total alkaline phosphatase, bone-specific alkaline phosphatase 3, osteocalcin and propeptide carboxyterminal of type I procollagen (PICP) levels were markedly elevated. Urinary excretion of hydroxyproline was also increased, suggesting that both bone formation and resorption were accelerated. Radiography of the skull showed "cotton wool" appearance. T1-enhanced MRI revealed that the skull-cap and diploe were swelled up. In 99mTc-MDP bone scintigraphy, all areas of the skull and a part of the right hemipelvis showed high uptake of the radioisotope. Based on the findings we made diagnosis of Paget's disease of bone which is a rare bone disorder in Japanese. Three-month oral administration of etidronate disodium resulted in normalization of serum PICP levels and urinary hydroxyproline excretion, whereas alkaline phosphatase levels were only partially lowered. Levels of the markers of bone turnover remained normal during a follow-up period of 3 months after the discontinuation of the treatment.
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PMID:A patient with Paget's disease of bone treated with etidronate disodium. 991 22


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