1/6. Spectrum of Schwartz-Jampel syndrome includes micromelic chondrodysplasia, kyphomelic dysplasia, and Burton disease.Follow-up and re-evaluation of four patients originally described as examples of severe infantile "micromelic chondrodysplasia" resembling Kniest disease, "kyphomelic dysplasia," and "Burton skeletal dysplasia" revealed the diagnosis of Schwartz-Jampel syndrome (SJS, myotonic chondrodysplasia) in all of them. SJS may be suspected in neonates with Kniest-like chondrodysplasia, congenital bowing of shortened femora and tibiae, and facial manifestations consisting of a small mouth, micrognathia, and possibly pursed lips. The disorder must be differentiated from the Stuve-Wiedemann syndrome, a genetically distinct myotonic chondrodysplasia with similar clinical but different skeletal changes and an unfavorable early prognosis. The demise of "kyphomelic dysplasia" as a nosological entity reemphasizes the symptomatic nature of congenital bowing of the long bones.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/6. Isolated medial cuneiform tuberculosis: a case report.Skeletal involvement in extrapulmonary tuberculosis is extremely rare, and foot involvement accounts for less than 10% of osteoarticular tuberculosis. tuberculosis osteomyelitis of the foot can also mimic a wide range of pathology. As a result, this condition is often misdiagnosed, or the true nature of the lesion is identified late in the diagnostic process. This article reports a case of tuberculosis in the medial cuneiform of a 3-year-old girl. Initially misdiagnosed as osteochondrosis, the patient returned 2 years later with a draining sinus on the medial aspect of the left midfoot. New radiographs showed a cystic lesion in the substance of the medial cuneiform. A diagnosis of tuberculosis was established after biopsy and histopathological examination of operative specimen. Antituberculosis treatment was implemented and continued for 16 months. At that time, clinical signs of infection had ceased.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/6. Puncture wound osteochondritis of the foot caused by CDC group Vd.A case of puncture wound osteochondritis of the foot caused by CDC group Vd is presented because of the unusual nature of the infecting organism. This organism may be confused with pseudomonas aeruginosa, the usual pathogen responsible for this type of infection, but does not have a similar antimicrobial susceptibility profile. For this reason, it is important to obtain appropriate culture specimens and to identify and test the susceptibility of bacterial isolates from cases of puncture wound-associated osteochondritis so that optimal therapeutic regimens can be determined.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/6. Surgical treatment of Freiberg's infraction with the use of total joint replacement arthroplasty.Freiberg's infraction is an osteochondrosis of the second metatarsal head, although it may be seen less often in the other metatarsals. It usually occurs in the second decade of life and is more commonly seen in females. The etiology is generally of a traumatic nature and symptoms include painful, limited range of motion of the joint. If untreated, destructive joint changes may lead to a painful degenerative arthritis requiring surgical intervention. The authors discuss joint replacement with a Swanson Silastic flexible hinged toe implant.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/6. Perthes disease conplicated by so called osteochondritis dissecans.A patient was followed for about 11 years from the onset of Perthes disease (age 12). The radiographs during the period demonstrated the actual development of a free ossicle which was formed by resorption of a portion of the original femoral head, resulting in a wafer and subsequent enlargement by new bone formation. Changes of a similar nature have been described in idiopathic necrosis of the femoral heads in adults.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/6. Intraepiphyseal osteotomy for progressive tibia vara: case report and rationale of management.tibia vara (Blount's disease) is characterized by two components, the epiphyseal, which is concerned with articular relationships, and physeal/metaphyseal, which may produce angulation of a long bone. Although the initial etiology is not known, it appears that asymmetrical pressure applied to the angulated proximal tibia results in progressive deformity. In the initial stages, medial and posteromedial pressure causes growth retardation of the epiphysis (articular instability) and the physis (tibia vara). Nonsurgical or surgical treatment that relieves the pressure generally permits reconstitution of normal growth. Continued abnormal pressure and shear forces applied to the physis may result in disorderly enchondral ossification and produce a true osteochondrosis, which may lead to permanent physeal arrest. osteotomy alone to relieve medial pressure may allow the tibia to grow straight, but residual medial epiphyseal compression and joint instability may persist. A case is reported of a 13 1/2 year follow-up of a patient in whom intraepiphyseal osteotomy restored articular congruity without interfering with longitudinal growth. The risks and experimental nature of this procedure are emphasized.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |