Characteristics of Giant Cell Tumor of the Bone in Pediatric Patients: Our 18-Year, Single-Center Experience

A giant cell tumor (GCT) of the bone is characteristically found in skeletally mature patients. The tumor is rare in pediatric patients, and incidence reported in literature varies from 1.8% to 10.6%. We performed a retrospective study addressing symptoms, treatment, and outcome in pediatric patients who were diagnosed with GCT between March 1997 and January 2015 at our hospital. Fourteen (11.1%) of 126 surgically treated patients with histologically proven GCT were <19 years of age. We confirmed skeletal maturity using magnetic resonance imaging (MRI). Fourteen patients from 8 to 19 years old were identified. Sixteen lesions (76.2%) were found in long bones and 5 lesions (23.8%) in short bones. The most common site was around the knee in 8 patients (38%). GCTs mostly occur at the epi-metaphysis in 11 patients (52.3%). Regardless of the openness of epiphyseal plate, we observed GCT of bone in the epiphysis. Further study will be needed to prove the association between the presence of epiphyseal plate and location of tumor. Three patients (21.4%) had multicentric lesions, and four patients (28.5%) had local recurrence. Multicentric giant cell tumor and local recurrence occur more often in pediatric patients. The characteristics of GCT in pediatric patients do not differ from what is reported for GCT in adults.

Targeting chondrocytes for arresting bony fusion in ankylosing spondylitis

Bony fusion caused by pathological new bone formation manifests the clinical feature of ankylosing spondylitis (AS). However, the underlying mechanism remains elusive. Here we discovered spontaneous kyphosis, arthritis and bony fusion in mature CD4-Cre;Ptpn11f/f mice, which present the pathophysiological features of AS. A population of CD4-Cre-expressing proliferating chondrocytes was SHP2 deficient, which could differentiate into pre-hypertrophic and hypertrophic chondrocytes. Functionally, SHP2 deficiency in chondrocytes impeded the fusion of epiphyseal plate and promoted chondrogenesis in joint cavity and enthesis. Mechanistically, aberrant chondrocytes promoted ectopic new bone formation through BMP6/pSmad1/5 signaling. It is worth emphasizing that such pathological thickness of growth plates was evident in adolescent humans with enthesitis-related arthritis, which could progress to AS in adulthood. Targeting dysfunctional chondrogenesis with Smo inhibitor sonidegib significantly alleviated the AS-like bone disease in mice. These findings suggest that blockade of chondrogenesis by sonidegib would be a drug repurposing strategy for AS treatment.

Effect of epiphyseal plate fenestration on bone growth in dogs

This study is designed to know the effect of fenestration on the epiphyseal plate as amethod to truma and know it is effect on length of long bones Eleven of local breed bitched is used in this research are put in four group depending on the site of operation , tthree dogs in each group except for the last group which included tow dogs as follows: *the first group : the operation was performed on the distal epiphyseal plate of the femur *the second group : the operation was performed on the proximal epiphyseal plate of the tibia and fibula *the thrid group : the operation was performed on the distal epiphyseal plate of the tibia and fibula *the fourth group : the operation was performed on all sites mentioned above the cases was folowed up clinically and radiographically for six months , an x-Ray film was taken every fifteen days for the first three months and monthly for the other three months, the other hind limb of the animal was used for comparison. the clinical and radiographical follow up showed that fenestration of the epiphyseal platewas succssful to induce epiphysiodesis in first, third and fourth group without complication while it failed in the second group.

Foals Developmental Orthopedic Disease Associated with Metabolic and Biometric Characterization of Pregnant Overweight Crioulo Mares

Background: Musculoskeletal changes in growing foals can be linked to metabolic disorders which affect the cartilage metabolism associated of obesity during the late gestation of the mares, negatively affecting the athletic performance of the otherwise prospective foals. High basal insulin levels can be associated with increased weight and obesity of the mares, altering the supply of the glucose to the fetus and the production of IGF-1, which plays an important role in the endochondral cartilage metabolism. The present study aims to describe the association of the articular and the physeal possible lesions and the IGF-1 levels of the foals to metabolic and biometric measurements alterations of the overweight Crioulo mares in the late gestation.Materials, Methods & Results: A prospective and observational cohort study was conducted using the foals and the overweight mares at field conditions. Twenty-eight foals and their overweight mothers were utilized. The foals’ biometric and metabolic features as weight and height; glucose, total cholesterol, cholesterol HDL, triglycerides, basal insulin, leptin, glucose, total T4 and IGF-1 were analyzed, from the birth until the weaning period around sixth month of life of it. All the foals, at the weaning period, were submitted to the radiograph examination of the tarsal joints and the metacarpal-phalangeal joints to evaluate signs of lesions and the possible distal metacarpal physeal changes, respectively. The mares’ biometric and metabolic features as weight, height and fat tail-head deposition; basal insulin, leptin, glucose, total cholesterol, cholesterol HDL and triglycerides were analyzed at the final period of gestation. The basal insulin levels of the foals at the second, fourth and sixth month of life were 9.87 + 1.82 µUI/mL, 9.13 + 1.94 µUI/mL, 9.39 + 2.54 µUI/mL. The IGF-1 levels of the foals at the second, third, fourth, fifth and sixth month of life were 290.27 + 79.72 ng/mL; 180.77 + 66.22 ng/mL; 151.79 + 46.64 ng/mL; 110.81 + 33.13 ng/mL and 89.59 + 14.00 ng/mL. Foals presented osteoarthritis (92.85%) of the distal tarsal joints and 50% of it presented physitis of the distal metacarpal epiphyseal plate. The weight and the basal insulin levels of the mares at the last three months of gestation were 501.80 + 6.4 kg, 511.76 + 8.0 kg, 533.23 + 8.2 kg and 11.7 + 2.1 µUI/mL, 9.8 + 1.1 µUI/mL, 13.7 + 1.6 µUI/mL, respectively.Discussion: In the present study, from the second to the sixth month of the period life, the foals showed IGF-1 levels of 290 to 89 ng/mL, and demonstrated, at 6-month-old, a prevalence of 92.85% of distal tarsus lesions and 50% of physitis of the distal metacarpal epiphyseal plate. In association, the overweight mares showed an increase of the insulin basal levels when nearing parturition. The occurrence of physitis in 50% of the 6-month-old foals in the present study demonstrate that the metabolic changes are involved in this process and the IGF-1 levels were observed to be lower than in healthy foals of other breeds. The lower IGF-1 levels during the developmental period of the foals are associated with a decrease of bone density and mass, musculoskeletal atrophy and osteoarthritis. In the present study, the decreasing curve of IGF-1 levels (P < 0.05) of the foals, from the second to sixth month of life, is similar to others researches with foals from other breeds from 0 to 7 months of life. In previous researches with Crioulo horses, it was observed that foals aged less than 18 months had up to 100% of prevalence of articular tarsus lesions. This suggest that the tarsus lesions observed in 92.85% of the 6-month-old foals in the present study, could not heal and that lesions should remain in the foals to adulthood.

Rickets in white-eared opossums (Didelphis albiventris)

ABSTRACT: Two young opossums were necropsied and diagnosed with rickets. This study aims to describe the clinical-pathological aspects of rickets in Didelphis albiventris. Macroscopically, the opossums presented kyphosis and scoliosis, lateral deviation of the limbs in varus, locomotion difficulty, and enlargement with softening of costochondral junctions (rickety rosary). Samples of bones and joints were processed for hematoxylin and eosin staining and Masson’s trichrome. Microscopically, we observed thickening of the epiphyseal plate, characterized by irregular and multifocal proliferation of serialized and hypertrophic cartilage zones, which formed circular groups of large, dysplastic chondrocytes towards the spongy zone, often surrounded by non-mineralized osteoid tissue. In the cortical bone, there were pale eosinophilic zones around the Havers channels consistent with non-mineralized osteoid. The staining of Masson’s trichrome evidenced the accumulation of osteoid tissue in cortical and trabecular bones. It is possible that a mixed cause of absorption deficiency of vitamin D3 associated with an unbalanced Ca:P diet based on lactose-free milk and fruits may have triggered the disease.

One Case of Forensic Clinical Identification of Ulnar Radius Fracture not Involving Epiphysis

In order to investigate the relationship between injury and injury of the identified person, to determine the real disability of the identified person, to determine whether the fracture of ulna and radius of the identified person is involved in the epiphysis, and to be commissioned by the court, the identified person is specially re-identified. According to the contents and methods of the Technical Specification for Forensic Identification (SF/ZJD0103003-2011) of the Ministry of Justice, the forensic clinical examination was conducted. After consulting the case data and conducting the forensic clinical examination of the identified person, this appraisal concluded that the left ulna and radius broken line of the patient disappeared, the epiphyseal plate was clear, and there was no deformity, and the disability grade was not constructed according to the provisions of the Classification of the degree of disability caused by human injury.