Gelatinous Degeneration of the Bone Marrow: Two Case Reports Showing Different Hematological Features and Clinical Outcomes

2007 ◽  
Vol 118 (3) ◽  
pp. 165-166 ◽  
Author(s):  
Pasquale Niscola ◽  
Luca Maurillo ◽  
Massimiliano Palombi ◽  
Stefano Fratoni ◽  
Alessio Pio Perrotti ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Case Reports

scholarly journals Calcium phosphate injection of symptomatic bone marrow lesions of the knee: what is the current clinical evidence?

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
D. S. Angadi ◽  
D. Edwards ◽  
J. T. K. Melton
Keyword(s):  
Bone Marrow ◽  
Calcium Phosphate ◽  
Clinical Outcomes ◽  
Clinical Decision Making ◽  
Short Form ◽  
Case Reports ◽  
Objective Assessment ◽  
Weight Bearing ◽  
Bone Marrow Lesions ◽  
Phosphate Injection

Abstract Background Chronic bone marrow lesions (BML) in the weight-bearing portions of the knee are often associated with symptomatic degenerative arthritis resulting in pain and dysfunction. Injection of bone substitute material like calcium phosphate has been described. Whilst some studies have reported encouraging results others have shown limited benefit of this technique. Aim The aim was to collate the available evidence on the injection of calcium phosphate and systematically evaluate the results to answer the questions encountered in clinical decision making: (1) does it provide effective long-lasting pain relief to avoid further surgical intervention? (2) which factors (patient/surgical) significantly influence the outcome? and (3) does it adversely affect the outcomes of subsequent arthroplasty? Methods A literature search was performed to identify the studies describing the clinical outcomes of calcium phosphate injection for treatment of BML. We evaluated the reported clinical outcomes with respect to pain, function and complications. Isolated case reports and studies with no objective assessment of clinical outcomes were excluded. Results We noted 46 articles in the current literature of which 8 described clinical outcomes of calcium phosphate injection. Mean (plus/minus SD) score on the visual analog scale (VAS) has been reported to improve from 7.90 (± 0.38) to 2.76 (± 0.90), whereas the International Knee Documentation Committee (IKDC) score improved from 30.5 (SD not reported (NR)) to 53.0 (SD NR). Pre and post procedure Short form survey (SF-12) scores were 29.8 (SD NR) and 36.7 (SD NR), respectively. In one study, scores on the Tegner Lysholm knee scoring scale improved in 12 out of 22 patients, whereas the remainder had no change in symptoms. Extravasation of calcium phosphate into the joint was the most common complication, whereas no adverse effect has been reported on subsequent arthroplasty. Conclusion Limited data from the published studies would suggest that calcium phosphate injection of BML may potentially improve pain and function. However, no evidence is currently available to clearly identify patient/surgical factors that may influence the long-term outcomes of this procedure. Hence pragmatic, prospective studies with stratified patient cohorts and robust reporting of outcome measures are essential to improve the understanding of the indications and clinical effectiveness of this novel procedure.

scholarly journals Satisfactory long-term clinical outcomes after bone marrow stimulation of osteochondral lesions of the talus

2021 ◽  
Author(s):  
Quinten G. H. Rikken ◽  
Jari Dahmen ◽  
Sjoerd A. S. Stufkens ◽  
Gino M. M. J. Kerkhoffs
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Degenerative Changes ◽  
Osteochondral Lesions ◽  
Ankle Osteoarthritis ◽  
Bone Marrow Stimulation ◽  
Marrow Stimulation ◽  
The Mean

Abstract Purpose The purpose of the present study was to evaluate the clinical and radiological outcomes of arthroscopic bone marrow stimulation (BMS) for the treatment of osteochondral lesions of the talus (OLTs) at long-term follow-up. Methods A literature search was conducted from the earliest record until March 2021 to identify studies published using the PubMed, EMBASE (Ovid), and Cochrane Library databases. Clinical studies reporting on arthroscopic BMS for OLTs at a minimum of 8-year follow-up were included. The review was performed according to the PRISMA guidelines. Two authors independently conducted the article selection and conducted the quality assessment using the Methodological index for Non-randomized Studies (MINORS). The primary outcome was defined as clinical outcomes consisting of pain scores and patient-reported outcome measures. Secondary outcomes concerned the return to sport rate, reoperation rate, complication rate, and the rate of progression of degenerative changes within the tibiotalar joint as a measure of ankle osteoarthritis. Associated 95% confidence intervals (95% CI) were calculated based on the primary and secondary outcome measures. Results Six studies with a total of 323 ankles (310 patients) were included at a mean pooled follow-up of 13.0 (9.5–13.9) years. The mean MINORS score of the included studies was 7.7 out of 16 points (range 6–9), indicating a low to moderate quality. The mean postoperative pooled American Orthopaedic Foot and Ankle Society (AOFAS) score was 83.8 (95% CI 83.6–84.1). 78% (95% CI 69.5–86.8) participated in sports (at any level) at final follow-up. Return to preinjury level of sports was not reported. Reoperations were performed in 6.9% (95% CI 4.1–9.7) of ankles and complications related to the BMS procedure were observed in 2% (95% CI 0.4–3.0) of ankles. Progression of degenerative changes was observed in 28% (95% CI 22.3–33.2) of ankles. Conclusion Long-term clinical outcomes following arthroscopic BMS can be considered satisfactory even though one in three patients show progression of degenerative changes from a radiological perspective. These findings indicate that OLTs treated with BMS may be at risk of progressing towards end-stage ankle osteoarthritis over time in light of the incremental cartilage damage cascade. The findings of this study can aid clinicians and patients with the shared decision-making process when considering the long-term outcomes of BMS. Level of evidence Level IV.

scholarly journals Bone marrow abnormalities detected by magnetic resonance imaging as initial sign of hematologic malignancies

2018 ◽  
Author(s):  
Ida Sofie Grønningsæter ◽  
Aymen Bushra Ahmed ◽  
Nils Vetti ◽  
Silje Johansen ◽  
Øystein Bruserud ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Bone Marrow ◽  
Magnetic Resonance ◽  
Case Reports ◽  
Cell Types ◽  
Hematologic Malignancies ◽  
Resonance Imaging ◽  
Initial Sign ◽  
Magnetic Resonance Imaging Mri

The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.

SCAPHOID BONE BRUISING – PROBABLY NOT THE PRECURSOR OF ASYMPTOMATIC NON-UNION OF THE SCAPHOID

2007 ◽  
Vol 32 (3) ◽  
pp. 337-340 ◽  
Author(s):  
N. LA HEI ◽  
I. MCFADYEN ◽  
M. BROCK ◽  
J. FIELD
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Classification System ◽  
Complete Resolution ◽  
Scaphoid Bone ◽  
Bone Bruise ◽  
Radiological Findings ◽  
Non Union ◽  
Bone Bruising

The MRI finding of bone marrow oedema, without fracture, following trauma to the scaphoid has been called a ‘bone bruise’. A similar injury is found in the knee, considered benign and managed conservatively. In the scaphoid, there is the concern that this lesion may lead to scaphoid non-union. This study addresses that concern. The clinical and radiological findings of 41 patients with a scaphoid bone bruise on MRI are described, an MRI classification system proposed and clinical outcomes investigated. Patients were immobilised for 6 weeks. At 3 months, 8 remained symptomatic and had repeat MRI. Four of these showed complete resolution of the bruise, the others improvement. At 6 months, 2 of the 8 complained of minor, intermittent discomfort but progressed to resolution of symptoms. This study suggests that the scaphoid bone bruise is a benign injury with predictable recovery and is unlikely to result in long-term morbidity in the form of non-union.

scholarly journals Long-Term Clinical Outcomes Survey of Bone Marrow-Derived Cell Therapy in Critical Limb Ischemia in Japan

2018 ◽  
Vol 82 (4) ◽  
pp. 1168-1178 ◽  
Author(s):  
Kazuhisa Kondo ◽  
Kenji Yanishi ◽  
Ryo Hayashida ◽  
Satoshi Shintani ◽  
Rei Shibata ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Cell Therapy ◽  
Clinical Outcomes ◽  
Critical Limb Ischemia ◽  
Limb Ischemia

Abstract 145: Use of Bromocriptine in the Management of Peripartum Cardiomyopathy: A Systematic Review

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Garly Rushler Saint Croix ◽  
Michel Ibrahim ◽  
Sandra Chaparro
Keyword(s):  
Clinical Outcomes ◽  
Case Reports ◽  
Thrombotic Event ◽  
Case Control ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
The Other ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Multicenter Rct

Background: Prolactin metabolites have been shown to possibly be cardio-toxic in humans and play a role in the pathogenesis of Peripartum Cardiomyopathy (PPCM). Some studies have demonstrated medical treatment with bromocriptine, a dopamine agonist able to inhibit prolactin, associated with standard therapy to be beneficial not only in managing symptomatology but also in the reversal of disease process. The present study was performed to systematically review the PPCM literature and determine the therapeutic effect of bromocriptine on left ventricular function and clinical outcomes. Methods: We performed a literature review to identify randomized, nonrandomized clinical studies, case series and case reports that reported the use of bromocriptine in the management of PPCM. A total of 9 databases including MEDLINE, Embase, Cochrane, DARE and Scopus containing articles from January 1, 1945 to July 31, 2016 were analyzed. Results: We were able to identify and screen 410 potentially eligible publications through the databases. Based on our exclusion criterias, 8 studies were selected: one randomized control trial (RCT), two case control studies and five case reports. We found that Bromocriptine improved left ventricular ejection fraction (LVEF) and clinical outcomes in women with acute severe PPCM and no thrombotic event was reported. The RCT (n = 20) showed an improvement of composite end point of death, NYHA Class III/IV and LVEF < 35% (35 of 100) at 6 months. LVEF went from 27% (27 of 100) to 58% (58 of 100) in the group taking bromocriptine vs 36% (36 of 100) in the other group . One of the case controls (n = 51) showed LVEF improvement of 85% (43 of 51) and full recovery in 47% (24 of 51) after 6 months +/- 3 of treatment. The other case control study (n = 115) failed to suggest a beneficial effect of bromocriptine. However, all the five case reports (n = 7) showed LV improvement. Conclusion: Peripartum Cardiomyopathy is a rare but serious condition that affects childbearing women. Targeted therapies like bromocriptine have shown promising results but a large multicenter RCT is needed to evaluate furthermore the benefits and harms of bromocriptine before it can be adopted in routine clinical use.

Abstract P101: Mechanical Thrombectomy in COVID-19 Positive Patients With Large Vessel Occlusion: Pooled Review of Individual Case Series

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Muhammad Z Memon ◽  
Taha Nisar ◽  
Amit Singla ◽  
Anil Nanda ◽  
Gaurav Gupta ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Case Series ◽  
Individual Case ◽  
Large Vessel ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Historic Data ◽  
Meta Analyses

Background: COVID-19 has been shown to induce a hypercoagulable state thereby increasing the risk of arterial thrombosis resulting in Large Vessel Occlusion Stroke (LVOs) Objective: We performed a systematic review of published reports to study the clinical characteristics, and outcomes of COVID-19 acute ischemic stroke (AIS) patients with LVO treated with mechanical thrombectomy (MT) and compared them with historical controls. Methods: We conducted a systematic literature search from December 2019 to July 2020 using multiple combinations of keywords from PubMed and Ovid databases according to the PRISMA meta-analyses and systemic reviews guidelines and then pooled data from individual case series. We included studies where COVID -19 associated LVO cases were treated with MT and their clinical outcomes were reported. We then compared these findings with the historic patient data from the five landmark randomized MT trials, the Hermes collaborators (HC). Results: An initial search generated 12 studies but after excluding case reports and multiple reports comprising of the same series of patients, a total of five reports consisting of 51 patients were analyzed. The mean age of patients was 59 years (IQR 36-75), and 40 (78 %) were men. Median NIHSS on presentation was 20 (IQR 10-29). AIS with LVO was the presenting manifestation of COVID-19 in 16 (20%) of patients. Intracranial ICA was the most common site of occlusion found in 27 (53%) of patients with multi-territory occlusion in 10 (20 %). Final recanalization TICI ≥ 2b was achieved in 33 (64%) of patients but reocclusion was noted in 7 (14 %). Modified Rankin score (mRS) 0-2 was reported in 12 (23 %) of patients with 40 % in-hospital mortality. When compared to historic data from HC, COVID -19 patients were younger (59 vs 69 years), presented with a higher median NIHSS score (20 vs 17), and had a higher prevalence of ICA terminus occlusion (53% vs 21% ). Similarly, patient outcomes were poor in the COVID -19 group with mRs 0-2 in (23 % versus 46 %) and mortality (40 % vs 15 %) compared to Hermes group. Conclusion: COVID -19 AIS patients with LVO who underwent MT were younger, had multiple territory occlusions with a propensity for ICA terminus location, and had poor angiographic and clinical outcomes as compared to historic data.

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