scholarly journals Extensive Heterotopic Ossification of Bilateral Hip and Knee Joints in a Patient with Recurrent Traumatic Injuries

2021 ◽  
pp. 1-5
Author(s):  
Qi-Yong Cao ◽  
Zhipeng Yan ◽  
Kai-Wen Wang ◽  
Janice Wing-Tung Kwong ◽  
Ching-Lung Lai ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Computer Tomography ◽  
Soft Tissues ◽  
Lower Limbs ◽  
Knee Joints ◽  
Deep Fascia ◽  
3D Ct ◽  
Early Recovery ◽  
Traumatic Injuries ◽  
Heterotopic Ossifications

Background: Heterotopic ossification (HO) refers to the growth of lamellar bone in soft tissues. Extensive heterotopic ossification is rarely seen. In this case, we illustrate a 35-year-old civilian patient with extensive HO due to recurrent traumatic injuries with no neurological deficit. Case Presentation: A 35-year-old man, with a history of recurrent trauma episodes in the past year, presented with pain and swellings in bilateral lower limbs. Physical examination showed stiffness and deformities of bilateral hip and knee joints. Plain x-ray showed patchy ossification extending from hip joints to knee joints bilaterally. 3-dimensional Computer Tomography (3D-CT) showed extensive heterotopic ossifications along gluteal muscles, quadratus muscles and the deep fascia beneath, confirming the diagnosis of extensive heterotopic ossifications of bilateral hip and knee joints. Excision of ossified tissues and re-mobilization of iliotibial bands were performed. Early recovery after surgery (ERAS) strategy was used to speed up recovery. Conclusion: i) Extensive heterotopic ossification in civilian patients is possible. Clinical history should be reviewed to rule out recurrent traumatic injury. Surgery should be considered. ii) Three-dimensional Computer Tomography (3D-CT) is a viable tool for surgical planning to show the extent, site, and anatomical relationship with adjacent tissues. iii) Post-op early recovery after surgery (ERAS) should be considered for better clinical outcomes.

scholarly journals Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

2021 ◽  
Vol 18 (8) ◽  
pp. 4219
Author(s):  
Magdalena Mackiewicz-Milewska ◽  
Małgorzata Cisowska-Adamiak ◽  
Katarzyna Sakwińska ◽  
Iwona Szymkuć-Bukowska ◽  
Iwona Głowacka-Mrotek
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Heterotopic Ossification ◽  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
University Hospital ◽  
Pain Sensation ◽  
Vein Thrombosis ◽  
Cord Injury

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.

scholarly journals Custom-Made 3D-Printed Implants as Novel Approach to Reconstructive Surgery after Oncologic Resection in Pediatric Patients

2021 ◽  
Vol 10 (5) ◽  
pp. 1056
Author(s):  
Giovanni Beltrami ◽  
Gabriele Ristori ◽  
Anna Maria Nucci ◽  
Alberto Galeotti ◽  
Angela Tamburini ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Soft Tissues ◽  
Lower Limbs ◽  
Host Bone ◽  
Limb Salvage Surgery ◽  
Musculoskeletal Tumor ◽  
Musculoskeletal Tumor Society ◽  
Custom Made ◽  
3D Printed

Recently, custom-made 3D-printed prostheses have been introduced for limb salvage surgery in adult patients, but their use has not been described in pediatric patients. A series of 11 pediatric patients (mean age 10.8 years; range 2–13) with skeletal tumors treated with custom-made implants for the reconstruction of bony defects is described. Patients were followed up every 3 months. Functional results were evaluated by the Musculoskeletal Tumor Society Score (MSTS) for upper and lower limbs. The mean follow-up was 25.7 months (range 14–44). Three patients died after a mean of 19.3 months postoperatively—two because of disease progression and the other from a previous malignancy. Three patients experienced complications related to soft tissues. One patient required device removal, debridement, and antibiotic pearls for postoperative infection. Partial osseointegration between grafts and host bone was observed within a mean of 4 months. At the final follow-up, mean MSTS score was 75%. 3D prostheses may yield biological advantages due to possible integration with the host bone and also through the use of vascularized flaps. Further research is warranted.

Thumb Injuries and Instabilities. Part 2: Spectrum of Lesions

2021 ◽  
Vol 25 (02) ◽  
pp. 355-365
Author(s):  
Alain G. Blum ◽  
Marnix T. van Holsbeeck ◽  
Stefano Bianchi
Keyword(s):  
Soft Tissues ◽  
Imaging Techniques ◽  
Metacarpophalangeal Joint ◽  
Resonance Imaging ◽  
Ligament Injuries ◽  
First Line ◽  
Collateral Ligament ◽  
Traumatic Injuries ◽  
Line Imaging

AbstractThe motor function of the thumb and its alignment with regard to the hand make it particularly vulnerable to trauma. Pathology encountered in this joint is varied, and imaging techniques play a crucial role in the diagnosis and characterization of injury. Despite advances in imaging technology, acute thumb injuries remain a challenge for radiologists. Currently, standard radiography and ultrasonography are frequently used first-line imaging techniques. Computed tomography is most often indicated for complex fractures and dislocations. Magnetic resonance imaging may be used to optimally characterize soft tissues and bone marrow. In this article, we cover the most common traumatic injuries: fractures, dislocations, collateral ligament injuries of the metacarpophalangeal joint, as well as soft tissue lesions.

scholarly journals Heterotopic Ossification of the Peroneus Longus Tendon in the Retromalleolar Portion with the Peroneus Quartus Muscle: A Case Report

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Song Ho Chang ◽  
Takumi Matsumoto ◽  
Koichi Okajima ◽  
Masashi Naito ◽  
Jun Hirose ◽  
...  
Keyword(s):  
Case Report ◽  
Heterotopic Ossification ◽  
Soft Tissues ◽  
Calcific Tendinitis ◽  
Lamellar Bone ◽  
Peroneus Longus Tendon ◽  
Histological Features ◽  
Longus Tendon ◽  
Peroneus Longus ◽  
Cuboid Bone

Heterotopic ossification (HO) is an ectopic formation of the lamellar bone in the soft tissues. Some authors have previously reported HO or calcific tendinitis of the peroneus longus tendon at the level of the cuboid bone, while the HO of the peroneus longus tendon in the retromalleolar portion has not been reported. The purpose of this report is to describe clinical, radiological, and histological features of this rare ossification and its treatment. To the best of our knowledge, this is the first report presenting a case of HO of the peroneus longus tendon, which developed in the retromalleolar portion.

scholarly journals Pyelonephritis can be a source of a life threatening necrotizing myofasciitis

2014 ◽  
Vol 8 (5-6) ◽  
pp. 462
Author(s):  
Haytham Kamel ◽  
Mohamed Soliman Edris Awed ◽  
Ahmed Fouad Kotb
Keyword(s):  
Necrotizing Fasciitis ◽  
Adult Male ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Relevant Literature ◽  
Deep Fascia ◽  
Necrotizing Myositis ◽  
Life Threatening

Necrotizing fasciitis is a progressive, rapidly spreading, inflammatory infection located in deep fascia. It may cause necrosis of skin and subcutaneous tissue and can even result in involvement of adjacent soft tissues such as muscles resulting in necrotizing myositis. We report the case of an adult male presenting with necrotizing myofasciitis secondary to left pyelonephritis. We also review the relevant literature.

scholarly journals Magnetic resonance imaging in traumatic injuries of the ankle joint in children

2020 ◽  
Vol 24 (4) ◽  
pp. 266-271
Author(s):  
N. Yu. Serova ◽  
T. A. Akhadov ◽  
I. A. Melnikov ◽  
O. V. Bozhko ◽  
N. A. Semenova ◽  
...  
Keyword(s):  
Ankle Joint ◽  
Soft Tissues ◽  
Diagnostic Value ◽  
Ankle Injuries ◽  
Deltoid Ligament ◽  
Anterior Talofibular Ligament ◽  
Mri Findings ◽  
Traumatic Injuries ◽  
Sport Activities ◽  
Bone Fragments

Introduction. Sprain of the ankle joint is one of the most common injuries in children during sport activities. Purpose. To define MRI diagnostic value in ankle joint injuries. Material and methods. 30 patients , 18 boys and 12 girls aged 8-17 ( average age 14.6 years), were enrolled into the study. 20 of them (66.7%) were 12-14 years old, 3 (10%) - < 10 years old and 7 (23.3 %) - > 14 years old. A Philips AchievadStream 3.0 Tesla scanner was used for MRI examination. Results. MRI findings showed that 17 (56.7%) patients had damage of the anterior talofibular ligament; 8 patients had avulsion of bone fragments of the lateral ankle; 9 patients (30.0%) had partial deltoid ligament injuries. Complete rupture of ligaments was rare and was seen only in two patients (6.7%). Conclusion. MRI is a method of choice in assessing ankle injuries due to high contrast of soft tissues, high resolution and multi-planar potentials. MRI is especially useful in examining soft ankle tissue structures such as tendons, ligaments, nerves and fascia, as well as in revealing hidden / subtle bone damage.

scholarly journals Engineered osteoclasts as living treatment materials for heterotopic ossification therapy

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Wenjing Jin ◽  
Xianfeng Lin ◽  
Haihua Pan ◽  
Chenchen Zhao ◽  
Pengcheng Qiu ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Soft Tissues ◽  
Ectopic Calcification ◽  
Calcified Tissue ◽  
Restricted Activity ◽  
Calcium Minerals ◽  
Reliable Methods ◽  
Poor Adhesion

AbstractOsteoclasts (OCs), the only cells capable of remodeling bone, can demineralize calcium minerals biologically. Naive OCs have limitations for the removal of ectopic calcification, such as in heterotopic ossification (HO), due to their restricted activity, migration and poor adhesion to sites of ectopic calcification. HO is the formation of pathological mature bone within extraskeletal soft tissues, and there are currently no reliable methods for removing these unexpected calcified plaques. In the present study, we develop a chemical approach to modify OCs with tetracycline (TC) to produce engineered OCs (TC-OCs) with an enhanced capacity for targeting and adhering to ectopic calcified tissue due to a broad affinity for calcium minerals. Unlike naive OCs, TC-OCs are able to effectively remove HO both in vitro and in vivo. This achievement indicates that HO can be reversed using modified OCs and holds promise for engineering cells as “living treatment agents” for cell therapy.

EXPERIENCE OF SOFT TISSUES REPAIR IN SEVERE INJURIES OF LOWER LIMBS

2021 ◽  
Vol 26 (1) ◽  
pp. 34-39
Author(s):  
D. S. Varentsov ◽  
D. N. Klimin ◽  
D. N. Gerasimov ◽  
V. F. Kulagin ◽  
A. S. Modin ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Lower Limbs ◽  
Severe Injuries

Use of computed tomography data for forensic identification of an individual

2020 ◽  
Vol 6 (4) ◽  
pp. 41-45
Author(s):  
Sergey V. Leonov ◽  
Julia P. Shakiryanova
Keyword(s):  
Computed Tomography ◽  
Computer Tomography ◽  
Soft Tissues ◽  
Three Dimensional ◽  
Reference Points ◽  
Forensic Identification ◽  
Dimensional Model ◽  
Three Dimensional Model ◽  
The Face ◽  
Tomography Data

Background: The article presents our own experience of using computer tomography for identification of individuals with known results. Aims: The aim of the study was to verify the possibility of performing an identification study using a three-dimensional model obtained from computed tomography of the head. Identification was performed using a three-dimensional model of the head, based on computer tomography sections made in various projections, with a step of 1.231.25 mm. Two-dimensional images of the face (photos) were used for comparison. All comparative studies were conducted using approved methods of craniofacial and portrait identification: by reference points and contours. The experiment used a computer program that allows you to export DICOM-files of computed tomography results to other formats (InVesalius), as well as computer programs that directly work with the research objects (Autodesk 3ds Max, alternative programs Adobe Photoshop, Smith Micro Poser Pro). Results: In the course of research, it was found that, having computer tomography data of the head, it is possible to conduct identification studies on the following parameters: on the reconstructed three-dimensional model of the soft tissues of the face, on the three-dimensional model of the skull (craniofacial identification), on the features of the structure of the ear. Conclusion: Positive results were obtained when comparing objects, which makes it advisable to use them in practical and scientific activities.

scholarly journals Wildlife Ungulate Rescue and Emergency Services in the Pisa Area (Tuscany, Italy): Evaluation of a 9-Years Period (2010–2018)

2020 ◽  
Vol 7 ◽  
Author(s):  
Maria Irene Pacini ◽  
Francesca Bonelli ◽  
Angela Briganti ◽  
Simonetta Citi ◽  
Stefania Perrucci ◽  
...  
Keyword(s):  
Diagnostic Imaging ◽  
Emergency Management ◽  
Clinical Data ◽  
Traffic Accidents ◽  
Biochemical Analysis ◽  
Soft Tissues ◽  
Emergency Services ◽  
Imaging Diagnosis ◽  
Traumatic Injuries ◽  
Car Accidents

Background: We analyzed the clinical data of wildlife ungulates admitted for emergency care to the Veterinary Teaching Hospital (VTH), Department of Veterinary Medicine, University of Pisa over a 9-years period.Methods: Clinical data of all the wildlife ungulates admitted to the VTH were recorded. Blood samples were also taken from the animals for hematological and biochemical analysis. An assessment of ecto- and endoparasites was carried out, diagnostic imaging assessment was performed, and the outcomes were recorded.Results: Data concerning clinical parameters, blood work, parasitological analysis, and diagnostic imaging diagnosis were expressed as prevalence.Conclusion: The rescue and emergency treatments were related mostly to traumas caused by car accidents, followed by other causes. The traumatic injuries were mostly severe, characterized by multiple lesions involving hard and soft tissues. In this study, traffic accidents were the main cause of wildlife rescue and emergency management. This is probably due to the increased population of ungulates over the years, along with the considerable anthropization of the Pisa area.

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