P071 Osteoid osteoma in children: About 15 cases

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
N Khernane ◽  
S Fortas ◽  
M M Makhloufi ◽  
T Boussaha
Keyword(s):  
Femoral Neck ◽  
Ct Scan ◽  
Vertebral Body ◽  
Osteoid Osteoma ◽  
Lower Limbs ◽  
Bone Tumours ◽  
Lumbar Pain ◽  
Surgical Removal ◽  
Posterior Arch ◽  
Impact Compression

Abstract Background Osteoid osteoma (OO)also called osteoblastoma, if the localization is in the spine, is a benign osteoblastic tumor of variable clinical expression, depending on the location of the lesion. It represents 2% to 3% of bone tumours and 15% of benign bone tumours in children. It affects mainly older children and adolescents and most often occurs in the lower limb, especially the femur. The diagnosis is radio-clinical. The aim of this study is to demonstrate the effectiveness of surgical removal of the tumor, the therapeutic difficulty in certain osteoarticular localizations and finally the radio-clinical evolution after surgery. Material & methods We report the radio-clinical outcomes of a series of 15 children (4 girls/11 boys; aged of 03–14 years) with OO operated in our department, over a period of 08 years (2011–2019). Results The OO is located in most of cases of the lower limbs: acetabulum (1 case); femoral neck (3 cases); femoral diaphysis (2 cases); tibial diaphysis (4 cases); distal metaphysis of the tibia (1 case); talus (1 case) and in the spine (3 cases: vertebral body of T3, the posterior arch of T12 and the sacrum S3). Nocturnal pain yielding to aspirin, was the main symptom. It was associated with lameness when walking in patients with location of OO in the lower limbs. Diagnosis was delayed in patients with localization of OO in the spine (after 3 years) and in the talus (after 2 years). Imaging (standard Rx, CT scan and MRI) allowed the diagnosis of OO in all cases (nidus and cocarde image) and assessed the loco-regional impact (compression of the spinal canal in the sacral location; eccentricity of the femoral epiphysis, in the acetabular location, scoliosis in the spinal location). Thirteen children received surgical treatment under fluoroscopic guidance, which consisted of: A surgical abstention was decided in 2 cases: an inaccessible location at the bottom of the acetabulum and the T3 thoracic vertebral body localization in a 6-year-old girl. 12 operated children have good outcomes. However, 03 children experienced post-therapy problems: lumbar pain radiating towards the left thigh in the girl with sacral location (S3) despite the large laminectomy; a relapse 7 months later in the child with the femoral neck localization; A valgus misalignment of the right knee after removal of the OO of the proximal metaphysis of the tibia with a relapse 3 months later. Conclusion OO is a rare, benign tumor. However, certain locations can lead to diagnostic difficulties, loco-regional, organic and functional repercussions and certain constraints on their therapeutic management. Modern imaging helps to improve the care of these patients, both in terms of early diagnosis (scintigraphy, CT scan and MRI) and therapeutic precision (photo-coagulation, radiofrequency ablation).

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

Posterior Midline Approach for a C2 Schwannoma: 2-Dimensional Operative Video

2020 ◽  
Author(s):  
Sorin Aldea ◽  
Abdu Alkhairy ◽  
Irina Joitescu ◽  
Caroline Le Guerinel
Keyword(s):  
Posterior Approach ◽  
Main Step ◽  
Surgical Removal ◽  
Posterior Arch ◽  
Favorable Result ◽  
Lateral Compression ◽  
Bone Removal ◽  
Far Lateral ◽  
Midline Approach ◽  
Posterior Midline

Abstract C2 schwannomas are rare lesions that may develop in the spinal canal, in the area of the C2 ganglion situated posterior to the C1C2 articulation, in the extraspinal area or in a combination of these 3 sectors.1,2 The surgical removal of these lesions is delicate because of the intimate relationships the schwannomas develop with the V3 segment of the vertebral artery.  A variety of lateral, far-lateral, or extreme lateral approaches have been described in order to tackle these lesions. We use a posterior midline approach that takes advantage of the predominantly extradural development of C2 schwannomas. In this technique, the main step is the debulking of the posterior articular sector of the tumor, which is easily accessible through a midline posterior approach and necessitates minimal bone removal. In most cases, removal of the homolateral posterior arch of C1 is sufficient in order to create an adequate access. These maneuvers create the necessary space for dissecting both the intradural and extraspinal sectors of the schwannoma.  We present this technique through a case with a minimal intradural component exerting mainly a lateral compression of the spinal cord. The tumor was operated through the midline mini-invasive posterior approach with a favorable result. We demonstrate the surgical technique in video and discuss the nuances.

The Half-Moon Sign of the Femoral Neck Is Nonspecific for the Diagnosis of Osteoid Osteoma.

2016 ◽  
Vol 206 (3) ◽  
pp. W54-W54 ◽  
Author(s):  
Bradley J. Carra ◽  
Dillon C Chen ◽  
Liem T. Bui-Mansfield
Keyword(s):  
Femoral Neck ◽  
Osteoid Osteoma

scholarly journals Rehabilitation Strategies in Management of Complex Case of Cervical Burst Fracture- A Case Report

2021 ◽  
pp. 205-208
Author(s):  
Rishika H. Gabada ◽  
Pooja Kasatwar ◽  
Chaitanya A. Kulkarni
Keyword(s):  
Ct Scan ◽  
Vertebral Body ◽  
Motor Vehicle ◽  
Burst Fracture ◽  
Compression Fracture ◽  
Complex Case ◽  
Fracture Dislocation ◽  
X Rays ◽  
Spinal Compression ◽  
Spinal Compression Fracture

A burst fracture is a descriptive term for an injury to the spine in which the vertebral body is severely compressed. They typically occur from severe trauma, such as a motor vehicle accident or a fall from a height. With a great deal of force vertically onto the spine, a vertebra may be crushed .If it is only crushed in the front part of the spine, it becomes wedge shaped and is called a compression fracture. However, if the vertebral body is crushed in all directions it is called a burst fracture. Burst fractures cause severe pain. The diagnosis of a burst fracture is usually made by x-rays and a CT scan. Occasionally, an MRI scan may be ordered as well, in order to assess the amount of soft tissue trauma, bleeding or ligament disruption. The review of the CT scan and x-rays allows the treating physician to make a determination as to the level of the fracture, whether it is a compression fracture, burst fracture or fracture dislocation. A spinal compression fracture also may be caused by trauma to the spine. Events that may cause trauma to the spine can include: A car accident, a hard fall or a fall from a height of more than 15 feet, landing on the feet, and a blow to the head. Any fall from a standing height that results in a spinal compression fracture or any other fracture most likely indicates weak bones due to osteoporosis. The physical exam should be performed to document both spinal deformity, that is, angulation of the spine or tenderness of the spine at the level of fracture, as well as, a neurologic exam. Neurologic exam should include testing of the muscle strength, sensation, and reflexes of the lower extremities, as well as, testing of bowel and bladder sphincter control. A 36 year old man was brought to the hospital as he had a fall from electric pole approximately 20 feet height. He had sustaining injury to the neck. Surgery was done as patient was diagnosed with C6 burst fracture with fracture dislocation of C5-C7. Therapeutic Interventions includes exercises, strengthening exercises, cervical fracture fixation, and traction.

scholarly journals An isolated pilomatricoma of the leg: a rare location – A Case Study

2021 ◽  
pp. 28
Keyword(s):  
Head And Neck ◽  
Lower Limbs ◽  
Surgical Removal ◽  
Skin Tumour ◽  
Postoperative Course ◽  
Hair Matrix ◽  
Rare Location ◽  
The Right

Pilomatricoma is a rare, benign skin tumour arising from the hair matrix. The usual locations are the head and neck. Localization in the lower limbs is exceptional. The diagnosis of certainty is histological. Treatment is complete surgical removal to avoid recurrence. We report in this article the case of a rare localization of a pilomatricoma on the right leg, in a 25-year-old patient operated with complete surgical removal. The postoperative course was simple and without recurrence after 2 months of follow-up.

The walls of the femoral neck as an auxiliary tool for femoral stem positioning

2021 ◽  
pp. 112070002110407
Author(s):  
Samuel Morgan ◽  
Ofer Sadovnic ◽  
Moshe Iluz ◽  
Simon Garceau ◽  
Nisan Amzallag ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Accurate Determination ◽  
Femoral Stem ◽  
Posterior Wall ◽  
Anterior Wall ◽  
Femoral Anteversion ◽  
Lower Limbs ◽  
Imaging Analysis ◽  
Femoral Condyles

Background: Femoral anteversion is a major contributor to functionality of the hip joint and is implicated in many joint pathologies. Accurate determination of component version intraoperatively is a technically challenging process that relies on the visual estimation of the surgeon. The following study aimed to examine whether the walls of the femoral neck can be used as appropriate landmarks to ensure appropriate femoral prosthesis version intraoperatively. Methods: We conducted a retrospective study based on 32 patients (64 hips) admitted to our centre between July and September 2020 who had undergone a CT scan of their lower limbs. Through radiological imaging analysis, the following measurements were performed bilaterally for each patient: anterior wall version, posterior wall version, and mid-neck femoral version. Anterior and posterior wall version were compared and evaluated relative to mid-neck version, which represented the true version value. Results: Mean anterior wall anteversion was 20° (95% CI, 17.6–22.8°) and mean posterior wall anteversion was −12° (95% CI, −15 to −9.7°). The anterior walls of the femoral neck had a constant of −7 and a coefficient of 0.9 (95% CI, −9.8 to −4.2; p  < 0.0001; R2 0.77). The posterior walls of the femoral neck had a constant of 20 and a coefficient of 0.7 (95% CI, 17.8–22.5; p  < 0.0001; R2 0.60). Conclusions: Surgeons can accurately obtain femoral anteversion by subtracting 7° from the angle taken between the anterior wall and the posterior femoral condyles or by adding 20° to the angle taken between the posterior wall and the posterior femoral condyles.

Anatomy of the Spinal Cord

2021 ◽  
pp. 60-67
Author(s):  
Jennifer A. Tracy
Keyword(s):  
Spinal Cord ◽  
Vertebral Body ◽  
Spinal Canal ◽  
Conus Medullaris ◽  
Lower Limbs ◽  
Cervical Cord ◽  
Filum Terminale ◽  
Upper Limbs ◽  
Descending Pathways ◽  
Lumbar Vertebral Body

The spinal cord begins as the cervical cord immediately below the medulla and extends through the spinal canal, where it becomes the thoracic, lumbar, sacral, and coccygeal parts of the cord. In most persons, the spinal cord proper ends at the lower portion of the first lumbar vertebral body, where it forms the conus medullaris and, finally, the filum terminale. A cervical enlargement contains the innervation pathways of the upper limbs; a lumbar enlargement contains the pathways of the lower limbs. This chapter reviews ascending and descending pathways in the spinal cord.

scholarly journals The influence of the CT scan in the evaluation and treatment of nondisplaced femoral neck fractures in the elderly

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901983616 ◽  
Author(s):  
Tomas Zamora ◽  
Ianiv Klaber ◽  
Joaquin Ananias ◽  
Francisco Bengoa ◽  
Eduardo Botello ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Ct Scan ◽  
The Elderly ◽  
Femoral Neck Fractures

scholarly journals Hydatid Cyst of the Adrenal Gland: A Clinical Study of Six Cases

2006 ◽  
Vol 6 ◽  
pp. 2420-2425 ◽  
Author(s):  
Ali Horchani ◽  
Yassine Nouira ◽  
Kais Nouira ◽  
Haikel Bedioui ◽  
Emna Menif ◽  
...  
Keyword(s):  
Adrenal Gland ◽  
Hydatid Cyst ◽  
Ct Scan ◽  
Preoperative Diagnosis ◽  
Laparoscopic Approach ◽  
Lumbar Pain ◽  
History Of ◽  
Relationship Of ◽  
The Relationship

Hydatid cyst of the adrenal gland (HCAG) is an exceptional occurrence. We report our experience of six cases of HCAG and discuss the diagnosis and treatment of this hydatid localization. We retrospectively reviewed and analyzed the clinical files of six patients admitted to our institution from January 1990 to December 2000 for HCAG. Patients varied in age from 24—59 years. They were five males and one female. One patient had a history of pulmonary hydatidosis treated surgically 10 years previously. Five patients presented with lumbar pain and one patient had bouts of hypertension, headache, and palpitation. Physical examination was normal except in one patient who was hypertensive. Preoperative diagnosis was highly suggested by ultrasonography. CT scan performed in all cases clearly showed the relationship of the cyst with adjacent organs. Serology tests were positive in two cases. One patient had elevated urine VMA and was operated on with the diagnosis of cystic phaeochromocytoma. All six patients were operated on and had either an adrenalectomy (two cases) or partial pericystectomy (four cases). In one case, partial pericystectomy was conducted through a retroperitoneal laparoscopic approach. The hydatid nature of the cyst was confirmed pathologically. All patients had a smooth postoperative course with no cystic recurrence on follow-up. The diagnosis of HCAG is based mainly on ultrasonography and CT scan. Surgery with either partial or total excision of the cyst, with or without preservation of the adrenal gland, is the treatment of choice.

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