Search

Simple Summary: This study investigates the relationship between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), often associated with olfactory impairment. Utilizing next-generation sequencing on 22 individuals with OGM, the research identified mutations with SMO/SUFU, with AKT1, and as wild type. The presence of planum sphenoidale hyperostosis (PSH) correlated with significant variations in tumour morphology and negatively impacted olfactory function, affecting odour threshold, discrimination, identification, and overall olfactory performance. Additionally, perifocal oedema was linked to decreased olfactory performance. The study also found that age over 65 and female gender were associated with reduced olfactory capabilities. Despite these findings, no direct link between olfactory impairment and tumour mutations was established, possibly due to the limited sample size. The research suggests further investigation with a larger participant group in order to better understand the impact of OGM driver mutations on olfactory function. Purpose: The study aims to examine the possible correlation between genomic alterations and preoperative olfactory function in patients with olfactory groove meningioma (OGM), due to the frequent presence of olfactory impairment. Methods: We utilised next-generation sequencing to analyse samples from 22 individuals with OGM in order to detect driver mutations. Tumour morphology was assessed using preoperative imaging, whereas olfactory function was examined using Sniffin' Sticks. Results: In a study of 22 OGM patients, mutations were as follows: 10 with SMO/SUFU, 7 with AKT1, and 5 as wild type. Planum sphenoidale hyperostosis (PSH) was present in 75% of patients, showing significant variation by mutation (p = 0.048). Tumour volumes, averaging 25 cm3, significantly differed among groups. PSH negatively impacted olfaction, notably affecting odour threshold, discrimination, identification, and global olfactory performance score (TDI) (p values ranging from <0.001 to 0.003). Perifocal oedema was associated with lower TDI (p = 0.009) and altered threshold scores (p = 0.038). Age over 65 and female gender were linked to lower thresholds and discrimination scores (p = 0.037 and p = 0.019). Conclusion: The study highlights PSH and perifocal oedema's significant effect on olfactory function in OGM patients but finds no link between olfactory impairment and tumour mutations, possibly due to the small sample size. This suggests that age and gender affect olfactory impairment. Additional research with a larger group of participants is needed to explore the impact of OGM driver mutations on olfactory performance. [ABSTRACT FROM AUTHOR]

Several studies have documented the occurrence of hyperostosis, a bone condition that results in bone thickening, in specimens of Trichiurus lepturus, an important commercial species. A total of 102 Largehead Hairtail fish samples from Rio de Janeiro, Brazil, were obtained from artisanal fishers and divided into 4 size classes. Biometric measurements and radiographic images were taken for all exemplars. Hyperostosis was observed in 69.69% of the individuals, with the first detection of the condition in an exemplar measuring from 385 mm in total length. The affected skeletal regions included the cleithrum, supraoccipital, frontal, dorsal pterygiophores, and haemal spines. An increase in the occurrence frequency of hyperostosis was noticed in correlation with size, suggesting a connection with the aging process and an ontogenetic pattern for the species. Histological analysis indicated a high remodeling process in affected structures. In addition, we highlight the specie daily vertical migration, associated with temperature variation, as a potential contributor to the onset of this osteological condition in marine teleosts. [ABSTRACT FROM AUTHOR]

Objectives DISH is a common musculoskeletal disorder; however, the imaging features and disease continuum from early to advanced stages is poorly understood. The purpose of this study was to evaluate the prevalence of DISH and early-phase DISH in an American population and to assess the extent and pattern of ectopic mineralization across the thoracic spine. Methods Data were retrieved in collaboration with the Rochester Epidemiology Project. We conducted a retrospective image evaluation of a sample of individuals over 19 years of age with CT of the thoracic spine from a Northern US catchment area. Stratified random sampling by age and sex was used to populate the study. We examined the prevalence and extent of ectopic mineralization along the thoracic spine using previously established criteria. Results A total of 1536 unique images (766 female and 770 male individuals) including 16 710 motion segments were evaluated for imaging features of the continuum of DISH. Collectively, 40.5% of all motion segments evaluated displayed evidence of ectopic mineralization in the thoracic spine. The prevalence of early-phase DISH was 13.2% (10.4% of female and 15.8% of male individuals). The prevalence of established DISH was 14.2% (7.4% of female and 20.9% of male individuals). Remarkable heterogeneity was detected in individuals within each disease classification, based on the extent of the thoracic spine affected and degree of mineralization. Conclusions The continuum of imaging features associated with DISH is detected in more than one in four adults and both sexes in an American population. [ABSTRACT FROM AUTHOR]

A previously healthy adult male presented with a slowly enlarging orbital mass associated with 5 mm of non-pulsatile proptosis. On imaging, a soft tissue lesion with avid contrast enhancement and associated bony hyperostosis was noted. The lesion and hyperostotic bone were surgically debulked, and significant arterial bleeding was noted intraoperatively consistent with an arteriovenous malformation. Histopathologic analysis revealed a vascular malformation with enhanced microvasculature infiltrating the periosteum. While vascular lesions elsewhere in the body can be associated with skeletal changes, bony hyperostosis is a rare feature of orbital vascular malformations. [ABSTRACT FROM AUTHOR]

Summary: This study investigated bone mineral density assessment for patients with DISH. DXA-based T-scores overestimated bone quality, while MRI-based VBQ scores and CT-based HU values provided accurate assessments, particularly for advanced degenerative cases. This enhances accurate evaluation of BMD, crucial for clinical decision-making. Purpose: To investigate the diagnostic effectiveness of DXA, MRI, and CT in assessing bone mineral density (BMD) for diffuse idiopathic skeletal hyperostosis (DISH) patients. Methods: Retrospective analysis of 105 DISH patients and 116 age-matched controls with lumbar spinal stenosis was conducted. BMD was evaluated using DXA-based T-scores, MRI-based vertebral bone quality (VBQ) scores, and CT-based Hounsfield unit (HU) values. Patients were categorized into three BMD subgroups. Lumbar osteophyte categories were determined by Mata score. Demographics, clinical data, T-scores, VBQ scores, and HU values were collected. Receiver operating characteristic (ROC) analysis identified VBQ and HU thresholds for diagnosing normal BMD using DXA in controls. Correlations between VBQ, HU, and lumbar T-score were analyzed. Results: Age, gender, and BMI showed no significant differences between DISH and control groups. DISH patients had higher T-score (L1–4), the lowest T-score, and Mata scores. VBQ and HU did not significantly differ between groups. In controls, VBQ and HU effectively diagnosed normal BMD (AUC = 0.857 and 0.910, respectively) with cutoffs of 3.0 for VBQ and 104.3 for HU. DISH had higher normal BMD prevalence using T-scores (69.5% vs. 58.6%, P < 0.05), but no significant differences using VBQ (57.1% vs. 56.2%, P > 0.05) and HU (58.1% vs. 57.8%, P > 0.05). Correlations revealed moderate correlations between HU and T-scores (L1–4) in DISH (r = 0.642, P < 0.001) and strong in controls (r = 0.846, P < 0.001). Moderate negative correlations were observed between VBQ and T-scores (L1–4) in DISH (r = − 0.450, P < 0.001) and strong in controls (r = − 0.813, P < 0.001). Conclusion: DXA-based T-scores may overestimate BMD in DISH. VBQ scores and HU values could effectively complement BMD assessment, particularly in DISH patients or those with advanced lumbar degeneration. [ABSTRACT FROM AUTHOR]

SAPHO syndrome is a complex disease that encompasses both inflammatory arthritis and/or osteitis and dermatologic manifestations. It is considered a rare disease, in fact, no clinical trials have been conducted on its therapy and management. Therefore, therapeutic approach is based on small case studies. Here, we described the case of a 63-year-old woman affected by SAPHO syndrome, treated with the selective IL-23p19 antagonist, Risankizumab, after unsuccessful therapies with Methotrexate, Infliximab, Adalimumab, and an allergic reaction to Secukinumab. At the beginning of therapy, in November 2022, the patient presented with arthritis in both knees associated with palmar pustulosis and guttate psoriasis on the trunk. DAPSA score was 24, PtGA 80 mm, PASI score 11.1, and BSA 40%. Thereafter, Risankizumab was started at the standard dosage of 150 mg. At week 24 patient achieved clinical remission, DAPSA score was 8, PtGA was 30 mm, PASI was 1, and BSA 2.5. Patient maintained clinical remission state at the subsequent week 52 evaluation. At the same time, the patient did not report any adverse effects. Health-related quality of life was also assessed at the same time points aforementioned, showing significant improvement. In conclusion, this case report wants to point out the efficacy and safety of Risankizumab in SAPHO syndrome, reporting a sustained disease remission through a 12 months long follow-up period. We can consider IL-23p19 targeted therapy as a novel treatment option for SAPHO—with a high efficacy potential—especially on patients that have already been treated with other biologics. [ABSTRACT FROM AUTHOR]

The article discusses synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, a rare autoinflammatory disease that manifests with articular and cutaneous symptoms. The exact cause of SAPHO syndrome is unknown, but it is believed to have a genetic basis and be linked to underlying infections and immune dysfunction. The syndrome is characterized by extra-articular and cutaneous manifestations, including lung and pleural involvement, digestive tract issues, kidney problems, ocular manifestations, nervous system complications, thrombosis, osteoporosis, sarcopenia, and cardiac manifestations. The article highlights the need for further research to understand the diverse clinical manifestations of SAPHO syndrome. [Extracted from the article]

Background: Multisegmental pathologic autofusion occurs in patients with ankylosing spondylitis (AS) and diffuse idiopathic skeletal hyperostosis (DISH). It may lead to reduced vertebral bone density due to stress shielding. Methods: This study aimed to determine the effects of autofusion on bone density by measuring Hounsfield units (HU) in the mobile and immobile spinal segments of patients with AS and DISH treated at a tertiary care center. The mean HU was calculated for five distinct regions—cranial adjacent mobile segment, cranial fused segment, mid-construct fused segment, caudal fused segment, and caudal adjacent mobile segment. Means for each region were compared using paired-sample t-tests. Multivariable regression was used to determine independent predictors of mid-fused segment HUs. Results: One hundred patients were included (mean age 76 ± 11 years, 74% male). The mean HU for the mid-construct fused segment (100, 95% CI [86, 113]) was significantly lower than both cranial and caudal fused segments (174 and 108, respectively; both p < 0.001), and cranial and caudal adjacent mobile segments (195 and 115, respectively; both p < 0.001). Multivariable regression showed the mid-construct HUs were predicted by history of smoking (−30 HU, p = 0.009). Conclusions: HUs were significantly reduced in the middle of long-segment autofusion, which was consistent with stress shielding. Such shielding may contribute to the diminution of vertebral bone integrity in AS/DISH patients and potentially increased fracture risk. [ABSTRACT FROM AUTHOR]

A new kannemeyeriiform dicynodont is described from the Upper Triassic Tecovas Formation (Dockum Group) of west Texas, U.S.A. The taxon, Argodicynodon boreni gen. et sp. nov., is diagnosed by numerous cranial characters including: squamosal-interparietal sutural contact broad and interdigitating; tall, narrow intertemporal region formed by the parietals with long postorbitals forming the lateral face of the dorsal platform; interparietal forms knobby, bilobed exostoses that wedge between the parietals to form a W-shaped outline in dorsal view; basioccipital and exoccipital contributions to the occipital condyle are distinct, and the dorsal fossa separating the exoccipitals is deeply incised and dorsoventrally deep; caniniform process of the maxilla is dorsoventrally deep and well developed; and an elongated tab-like medial process of the articular exceeds the width of the quadrate roller. A phylogenetic analysis based on 23 continuous and 176 discrete (numeric) morphological characters and 120 taxa finds Argodicynodon conservatively to be a placeriine near the Placerias + Moghreberia group, representing the oldest placeriine in the southwestern U.S.A. and the first named dicynodont genus from the Dockum Group of Texas. A review of Euramerican dicynodont records exposes their hidden diversity and abundance in Laurasia during the Late Triassic. The records of Argodicynodon and other previously undescribed dicynodont fossils from nearby localities underscores the diversity of non-Placerias dicynodonts in the North American Upper Triassic. [ABSTRACT FROM AUTHOR]

El síndrome de fricción escapulotorácica, resalto o chasquido escapular es un cuadro poco frecuente, descrito, por primera vez, por Boinet, en 1867. Se produce por una incongruencia en la articulación escapulotorácica, asociada a múltiples causas, como bursitis, exostosis, masas óseas, tejidos fibrótico o muscular anómalos, consolidación defectuosa de fracturas o variaciones de la anatomía costal o escapular. El propósito de este artículo es comunicar un caso clínico de una adolescente con dolor incapacitante y deformidad en la región escapular derecha, de más de cuatro años de evolución. Los estudios diagnósticos revelaron una masa ósea única subescapular sugestiva de un osteocondroma de gran tamaño, más de 2,5 cm x 4 cm x 4 cm. También, se presenta una revisión y actualización de la bibliografía sobre el diagnóstico y el tratamiento actual de esta enfermedad.

Introduction: The commonest benign bone tumours, Osteochondromas, which can be solitary or multiple involving the metaphyseal region of long bones, rarely presents in the axial skeleton such as pelvic girdle which warrants surgical excision in case of symptoms arising out of pressure effects. Case report: In this study we are herewith reporting unusual case of pubic tubercle osteochondroma which is solitary and pedunculated in a 37-year-old female. She had the swelling for the past 15 years which is asymptomatic except for mild hydroureteronephrosis which was an incidental diagnosis, however we managed the patient with surgical excision of the tumour with elaborate preoperative radiological imaging using both X-ray and CT. Histopathological examination was confirming the diagnosis of osteochondroma. Conclusion: Asymptomatic pelvic osteochondroma should be borne in mind in patients with incidental swelling in the groin region especially females who may be reluctant to seek medical attention due to social stigma. Keywords: Osteochondroma, Pubic tubercle, surgical excision, solitary

This article discusses spheno-orbital meningiomas (SOM), a type of brain tumor that affects the sphenoid bone and can cause symptoms such as proptosis, visual impairment, diplopia, and headaches. The study aims to identify correlations between the extent of tumor resection and the risk of recurrence, specifically focusing on the bony tumor portion (BTP) and the soft tumor portion (STP). The results suggest that the extent of resection of the STP may reduce the recurrence rate of SOM, while the same may not be true for the BTP. The authors recommend a patient-based surgical strategy that prioritizes safe maximal resection of the STP while preserving neurological functions. [Extracted from the article]

This article explores the mechanisms underlying meningioma-induced hyperostosis, a condition where tumors can form lamellar, hyperostotic bone in the tumor microenvironment. The study focuses on TRAF7 missense mutations, which are believed to promote bone formation in the meningioma microenvironment. The researchers used patient-derived meningioma cells and osteoblasts to investigate the biochemical mechanisms driving hyperostosis. They found that the TRAF7 missense mutation identified in a hyperostotic sphenoid wing meningioma contributed to the transdifferentiation of meningioma cells into osteoblast-like cells, leading to hyperostosis. These findings may have implications for the development of new medical therapies or the discovery of novel pathways of bone formation. [Extracted from the article]

Pachydermoperiostosis (PDP), also known as Touraine-Solente-Gole syndrome or primary hypertrophic osteoarthropathy, is a very rare disease mainly characterized by pachyderma, finger clubbing, hyperhidrosis, and periostosis. We reported a case of a patient who suffered from gradual pain and enlargement of both hands and feet for 25 years despite receiving treatment from multiple clinics. He also experienced gradual abnormal changes in his face and scalp. Radiographic images of the lower limbs revealed the presence of subperiosteal bone growth and periosteal hypertrophy. The diagnosis of complete PDP was made late due to its rarity and the unfamiliarity of medical practitioners with the diagnosis. This case highlighted the need for medical practitioners to be aware of rare diseases so that patients may be diagnosed and treated earlier and thereby relieving their anxiety and improve their quality of life. [ABSTRACT FROM AUTHOR]

Background: Multiple hereditary exostosis (MHE) is a rare autosomal dominant disorder characterized by multiple osteochondromas. There is a paucity of literature concerning total hip arthroplasty (THA) in patients with MHE. The aim of this study is to report long-term outcomes of THA in patients with MHE. Methods: Fourteen patients undergoing 15 THA's for the treatment of osteoarthritis in the presence of osteochondromas and proximal femoral deformity secondary to MHE were reviewed. Mean age at the time of surgery and follow-up was 56 and 12 years. Seven (47%) had uncemented femoral components. Eleven hips had coxa valga on preoperative imaging. Clinical outcomes were assessed with both Harris hip scores (HHS) and Musculoskeletal Tumor Society Scores (MSTS). Results: Following surgery, there was an improvement in the HHS (48–82, p < 0.01) and MSTS scores (41–70%, p < 0.01). Complications occurred in 5 patients leading to reoperation in 3 patients, of which 2 patients underwent a revision procedure at 19 and 20-years postoperative. The 10-year revision free survival was 100%. Conclusions: THA in the setting of MHE reliably improves patient function. One in three patients will have a postoperative complication; however, the long-term incidence of revision is low. [ABSTRACT FROM AUTHOR]

Osteochondroma is a proliferative condition that affects cartilage and bone in rare cases. Osteochondroma of the ribs is uncommon in dogs, and its manifestation has the potential to induce compression and harm to the vasculature and internal organs of the thoracic cavity. The discoverable evidence of this condition was encountered during the dissection of the chest of a 5-year-old male dog of mixed breed, who had no previous record of illness. The salient features noted during the dissection process were the identification of four dome-shaped masses which evinced a solid consistency and were found to be located in the right hemithorax, thus leaving an impression on the caudal lobes of the right lung. The masses were distinguished by their smooth surfaces and hard texture. Upon histological analysis, the lesion was characterized by spongy bone enveloped by periosteum and hyaline cartilage. The results obtained from the study's macroscopic and microscopic levels indicated multiple cartilaginous exostosis. [ABSTRACT FROM AUTHOR]

Objective: External auditive exostosis (EAE), known as surfer's ear, is a temporal bone outgrowth resulting from ear exposure to cold air and water. This review aims to shed light on the prevalence of EAE among worldwide surfers. Methods: By a thorough retrieval of the PubMed, we found all original investigations performed on EAE among suffers. The retrieval time was from the construction of the database to December 2022. Agency for Healthcare Research and Quality (AHRQ) methodology checklist for assessing the quality of cross-sectional/prevalence study was performed. Results: 19 articles were selected involving 2997 surfers on whom 2032 presented EAE. The prevalence of EAE was ranged from 53 to 90% with a mean at 67.8%. 3 investigations were performed from USA, five from UK and Ireland, five from Australia and New Zealand and six from Japan and Europe. Conclusion: Cold water exposure, combined with wind and prolonged surfing activity, contributes to the development of EAE. Symptoms range from mild discomfort to hearing loss and recurrent infections. Preventive measures, such as raising awareness and promoting the use of ear protection, are crucial. Further research is needed to improve prevention strategies and understand the underlying mechanisms of EAE. [ABSTRACT FROM AUTHOR]

Marine teleost species of commercial interest are often reported with hyperostosis, an osteological condition that results in bone thickening. Various specimens of Atlantic Spadefish Chaetodipterus faber (n = 86) obtained from artisanal fishermen in Rio de Janeiro, Brazil, were radiographed and assessed to detect the occurrence of hyperostosis across four different size classes. Of the examined individuals, 58.62% displayed signs of hyperostosis, which manifested in eight skeletal regions, notably in the supraoccipital crest, cleithrum and supraneural areas. In the vertebral column, hyperostosis was more frequently observed in haemal spines than in neural spines, predominantly between the sixth and eighth caudal vertebrae. The smallest size class (<200 mm total length) showed a low frequency of hyperostosis at 7.89%. This frequency escalated for larger classes, reaching 94.12% in individuals measuring 200–300 mm in total length and was observed in all individuals exceeding 300 mm. Hyperostosis exhibited an ontogenetic development pattern, where both the occurrence frequencies and the sizes of the affected bones expanded in proportion to the fish size. This is the first description of the hyperostosis pattern of development for the species, an important commercial resource. [ABSTRACT FROM AUTHOR]

This article, published in the Arab Journal of Interventional Radiology, presents a case study of a 74-year-old woman who experienced chronic swelling and pain in her left lower extremity. After failed conservative management, a CT scan revealed that the swelling was caused by compression of the left common iliac vein by an osteophyte near the L5-S1 disk. The patient underwent a low-traumatic intervention, which involved the placement of a venous stent to eliminate the compression. The patient remained asymptomatic without residual pain or swelling for over a year. The article highlights the importance of considering external compression as a potential cause of lower extremity edema or thrombotic symptoms, particularly in elderly individuals with risk factors for spinal osteoarthritis. The case study demonstrates that venous stenting can be an effective treatment for this condition. [Extracted from the article]

Case: A 19-year-old man with Multiple Hereditary Exostoses presented with cervical pain without neurological symptoms and/or signs. Magnetic resonance revealed a large C2 osteochondroma, occupying a part of the medullary canal. He was submitted to an en bloc resection with hemilaminectomy without fusion. At the 1-year follow-up, he presented resolution of pain and no neurological symptoms or signs, without cervical instability or radiological signs of disease recurrence. Conclusion: Cervical osteochondroma is usually asymptomatic. Neurological compression and differentiation to chondrosarcoma are the main concerns. Surgical excision allows the local cure of the disease and is usually performed without fusion. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Diffuse idiopathic skeletal hyperostosis (DISH) involves spine ligament ossification. Computer‐assisted navigation (CAN) effectively aids complex surgeries, such as anterior cervical osteotomy, to alleviate progressive DISH‐related dysphagia. We describe a 68‐year‐old man with sudden onset dysphagia to both solids and liquids. Radiographic Imaging revealed DISH lesions from C2 down to the thoracic spine. The patient was successfully treated with CAN anterior osteotomy and resection of DISH lesions from C3–C6 and had complete symptom relief within 2 weeks post‐operatively. [ABSTRACT FROM AUTHOR]

The article discusses the diagnosis of Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) syndrome, a rare disorder characterized by bone hyperostosis and osteitis. The early diagnosis of SAPHO syndrome is challenging due to the lack of specific biomarkers and remarkable biochemical tests. Various imaging techniques, such as X-ray, bone scintigraphy, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT, are used to diagnose and differentiate SAPHO syndrome from other diseases. The article emphasizes the importance of combining clinical manifestations with imaging presentations to support the diagnosis of SAPHO syndrome. [Extracted from the article]

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) is a rare chronic inflammatory disease that develops in adults. We present a case of SAPHO syndrome in a 37‐year‐old male presenting with gradually worsening back and neck pain for a 7‐year period. The episodes were preceded by a history of pustular skin eruptions, which first appeared on the upper trunk and then involved his face and were pustular and scarring. The purpose of presenting this case report from Iraq is to raise awareness about this rare condition, which is frequently misdiagnosed and under‐recognized. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the frequency of ear canal protection use and looked at its influence on external auditory exostosis severity and knowledge about external auditory exostosis among windsurfers and kitesurfers on the German coast. Method: This retrospective cross-sectional study interviewed 130 windsurfers and kitesurfers along the German coast on knowledge of external auditory exostosis, exposure time, use of neoprene hoods and earplugs, and otological complaints. Participants underwent bilateral video-otoscopic examination. Results: Knowledge of external auditory exostosis was 'good' or 'excellent' in 78 of 130 (60 per cent) individuals and 'poor' or non-existent in 52 of 130 (40 per cent) individuals. Knowledge was positively correlated with hours of exposure, otological complaints and frequency of ear canal protection use. A significant negative influence of neoprene hood use on external auditory exostosis severity was shown. Conclusion: The positive effect of external auditory exostosis knowledge on the frequency of ear canal protection and the reduction of external auditory exostosis risk implies a need for health education on this topic. [ABSTRACT FROM AUTHOR]

Aim: No studies have examined the association between plasma pentosidine levels and ossification diseases in large cohorts of Japanese residents. This study aimed to investigate the association between cervical ossification of the posterior longitudinal ligament (OPLL) and other ossification diseases, including diffuse idiopathic skeletal hyperostosis, lumbar spondylosis and knee osteoarthritis (OA), by examining plain radiographs of the knee, and cervical, thoracic and lumbar spine from 1690 participants, and the association between these diseases and plasma pentosidine. Design: We enrolled 1690 participants (596 men and 1094 women) from mountainous and coastal areas from the study population of the previous Research on Osteoarthritis/Osteoporosis Against Disability study. X‐ray examination of the cervical/thoracic/lumbar spine and knee was carried out only in these individuals, and not those from urban areas. Plasma pentosidine concentrations were determined using enzyme‐linked immunoassays. Results: Radiographic OPLL was detected in 30 (17 men, 13 women) of 1562 individuals who underwent X‐ray examination of the cervical spine. OPLL, diffuse idiopathic skeletal hyperostosis, lumbar spondylosis Kellgren–Lawrence (KL) grade, and knee OA KL grade were associated with high plasma pentosidine concentrations (all P < 0.05). Furthermore, significant intragroup differences (KL grade 4 vs 3) of plasma pentosidine concentration were observed between the lumbar spondylosis and knee OA groups. The plasma pentosidine concentration was significantly associated with age, OPLL, lumbar spondylosis (KL grade 4) and knee OA (KL grade 4). Conclusions: OPLL is significantly associated with other ossification diseases. The development of more severe OA might lead to the accumulation of plasma pentosidine. Plasma pentosidine levels were associated with OPLL and severe OA. Geriatr Gerontol Int 2024; 24: 154–160. [ABSTRACT FROM AUTHOR]

Cross-sectional studies on diffuse idiopathic skeletal hyperostosis have focused on its incidence and related factors. However, the long-term changes caused by the disease remain unclear. This longitudinal cohort study aimed to elucidate the progression of diffuse idiopathic skeletal hyperostosis and its effects on physical function, health-related quality of life, and spinal alignment. We recruited 255 older adults (87 men and 168 women; average age, 71.3 years in 2014) who attended local health checkups in 2014 and 2020. Height, body weight, body mass index, blood pressure, grip strength, functional reach, and bone mineral density were measured. The prevalence, location, number of ossified contiguous vertebrae, and spinopelvic parameters were estimated using whole-spine standing radiographs. For health-related quality of life assessment, the Oswestry disability index and EuroQuol-5D were obtained. We performed a 1:1 case-control study with age and sex-matched patients with and without diffuse idiopathic skeletal hyperostosis and analyzed progression over a 6-year period. In 2014, 39 (15.3%) of 255 patients were diagnosed with diffuse idiopathic skeletal hyperostosis (24 males and 15 females), which occurred more frequently in the elderly and males. In 2020, 12 (4.3%) patients were newly diagnosed with diffuse idiopathic skeletal hyperostosis, and 28 (71.7%) of 39 patients diagnosed in 2014 showed varying degrees of progression. Compared with age- and sex-matched patients without diffuse idiopathic skeletal hyperostosis, patients with the condition had higher body mass index and lumbar bone mineral density, larger sagittal vertical axis, and greater T1-pelvic angle. Changes in physical function and spinal-pelvic parameters during the 6-year period did not differ between the groups. Over a 6-year period, the prevalence of diffuse idiopathic skeletal hyperostosis increased by 4.3%, and it progressed in 71.7% of patients. However, it had little effect on longitudinal physical function, health-related quality of life, and spinopelvic parameters in older adults. [ABSTRACT FROM AUTHOR]

The "carpal boss" is a variant present in 19% of the population according to cadaveric studies but becomes symptomatic in only 1% of cases. With the rising popularity of "yoga," which includes prolonged hyperextension at the wrist joint with weight bearing, an increasing number of individuals with silent carpal boss present with dorsal wrist pain due to impingement over the dorsal soft tissues by this innocuous bony protuberance. This warrants the attention of radiologists and clinicians while dealing with wrist pain. It can be challenging to identify this bossing on routine radiographs, necessitating special views. We describe the use of dynamic ultrasound in diagnosing "symptomatic" carpal boss, the effects of which become even more evident on imaging during hyperextension—the triggering movement. [ABSTRACT FROM AUTHOR]

Objectives: To determine the incidence of spinal hematoma and its relation to neurological deficit after trauma in patients with spinal ankylosis from diffuse idiopathic skeletal hyperostosis (DISH). Materials and methods: A retrospective review of 2256 urgent or emergency MRI referrals over a period of 8 years and nine months revealed 70 DISH patients who underwent CT and MRI scans of the spine. Spinal hematoma was the primary outcome. Additional variables were spinal cord impingement, spinal cord injury (SCI), trauma mechanism, fracture type, spinal canal narrowing, treatment type, and Frankel grades during injury, before and after treatment. Two trauma radiologists reviewed MRI scans blinded to initial reports. Results: Of 70 post-traumatic patients (54 men, median age 73, IQR 66–81) with ankylosis of the spine from DISH, 34 (49%) had spinal epidural hematoma (SEH) and 3 (4%) had spinal subdural hematoma, 47 (67%) had spinal cord impingement, and 43 (61%) had SCI. Ground-level fall (69%) was the most common trauma mechanism. A transverse, AO classification type B spine fracture (39%) through the vertebral body was the most common injury type. Spinal canal narrowing (p <.001) correlated and spinal cord impingement (p =.004) associated with Frankel grade before treatment. Of 34 patients with SEH, one, treated conservatively, developed SCI. Conclusions: SEH is a common complication after low-energy trauma in patients with spinal ankylosis from DISH. SEH causing spinal cord impingement may progress to SCI if not treated by decompression. Clinical relevance statement: Low-energy trauma may cause unstable spinal fractures in patients with spinal ankylosis caused by DISH. The diagnosis of spinal cord impingement or injury requires MRI, especially for the exclusion of spinal hematoma requiring surgical evacuation. Key Points: • Spinal epidural hematoma is a common complication in post-traumatic patients with spinal ankylosis from DISH. • Most fractures and associated spinal hematomas in patients with spinal ankylosis from DISH result from low-energy trauma. • Spinal hematoma can cause spinal cord impingement, which may lead to SCI if not treated by decompression. [ABSTRACT FROM AUTHOR]

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome, a rare immune-mediated inflammatory disease, poses diagnostic and therapeutic challenges owing to its multi-system involvement, high heterogeneity, and lack of specific laboratory tests. Additionally, lacking evidence-based treatment recommendations, with the primary approach focusing on symptomatic relief. Herein, we report the case of a 32-year-old Chinese woman who presented with recurrent, generalized multiple osteoarticular pain lasting over one year and skin erythema pustulosis for 11 months. Traditional treatments, including non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and other traditional approaches, yielded no significant effects. Despite the prior use of adalimumab and acitretin capsules, the treatment remained unsatisfying, especially regarding the skin lesions. Considering the complex pathogenesis of SAPHO syndrome, the patient was orally administered baricitinib (2 mg), a Janus kinase (JAK) inhibitor, twice daily. A notable improvement in both skin lesions and osteoarticular pain was observed within two weeks of treatment initiation. Subsequently, the dosage of baricitinib was halved and continued for an additional three months, during which regular follow-ups revealed neither disease recurrence nor adverse effects. Collectively, the successful treatment of refractory SAPHO syndrome with baricitinib presents a promising implication for addressing the therapeutic challenges of this rare autoimmune condition, offering a potential breakthrough in managing its complex manifestations. [ABSTRACT FROM AUTHOR]

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare chronic inflammatory disease mainly manifested as skin and osteoarticular lesions. Herein, we describe a female patient with SAPHO syndrome exhibited paradoxical psoriasis and primary palmoplantar pustulosis (PPP) worsened during treatment with adalimumab. We then switched to secukinumab and obtained significant improvement in both skin lesions and osteoarticular pain. These findings suggest that secukinumab might be an appropriate option for patients with SAPHO syndrome who present with TNF-α-inhibitor-induced paradoxical psoriasis. [ABSTRACT FROM AUTHOR]

Hip involvement is one of the most common skeletal manifestations of hereditary multiple exostoses (HME) in 30-90% of the patients. The anatomical changes in the proximal femur in patients with HME, may lead to deformities and related functional deficits. Its effect on the range of motion (ROM) of the hip joint is not well described. The aim of this study was to evaluate the role of hip deformity of HME disease in the ROM of the hip joint. It was hypothesized that certain morphological parameters affect the ROM of the hip joint. Conclusively, 44 patients including 27 men and 17 women (88 hips) were evaluated. Hips are divided in Group 1 (no ROM limitation group) and Group 2 (ROM limitation group). The head-neck ratio (HNR), center edge angle (CE), Sharp's acetabular angle (SAA), alpha angle (AA), neck shaft angle (NSA) and ROM parameters were measured. The correlations between radiological parameters (SAA, CE, NSA, AA and HNR), and the ROM data (F, E, Abd, Add, IR and ER) were statistically evaluated. All evaluated parameters (SAA, CE, NSA, AA) except the HNR do not show significant differences between study group 1 (no ROM limitation group) and group 2 (ROM limitation group). The means of the HNR in group 1 were significantly higher than those in group 2 (HNR: 1.23 vs. 0.92, p<0.001). In group 2 HNR showed a strong positive correlation with Abd (PC 0.72, p<0.001), E (PC 0.7, p<0.001), ER (PC 0.67, p<0.001), IR (PC 0.67, p<0.001) and F (PC 0.66, p<0.001). HME patients with hip involvement have better ROM of the hip joint, if they have the higher HNR. Additionally, a positive correlation between HNR and ROM capacity was determined. [ABSTRACT FROM AUTHOR]

An immature female Bullmastiff presented for assessment of swelling of the right dorsal orbital region, causing discomfort. Computed tomography showed osseous proliferation of the calvarium, frontal bone and concurrent unilateral osseous changes at the level of the left mandible. Ventral new bone formation and remodelling changes were noted between vertebrae C7 and T1. The vertebral bodies of C5, C6 and C7 were fused. Histopathology was consistent with calvarial hyperostosis syndrome. Subsequently, the dog developed neurological signs: proprioceptive ataxia and lower motor neuron ambulatory tetraparesis. Magnetic resonance imaging showed mild osseous spinal cord compression at C7 level. Calvarial hyperostosis syndrome described in this report is the first recorded case of a dog having concurrent hyperostotic changes affecting the calvarium, mandible and cervical vertebrae in a dog. [ABSTRACT FROM AUTHOR]

Hereditary multiple exostosis (HME) is a rare genetic disorder characterized by multiple bony spurs or lumps, commonly affecting the long bones. This case report exposes the clinical presentation, diagnosis, and management of HME in a 28-year-old female nurse, who initially presented with persistent bilateral knee pain. After extensive evaluation involving orthopaedic and oncology specialists, the diagnosis of HME was made. Despite the discovery of multiple exostoses, the patient reported improvement following a tailored physiotherapy regimen. This case study underscores the complexity and broad spectrum of symptoms associated with HME. It emphasizes the importance of a multidisciplinary approach in diagnosing and managing such conditions, which can lead to better patient outcomes and an improved quality of life. By shedding light on the role of physiotherapy in managing rare genetic disorders such as HME, this case report contributes to the growing body of literature exploring noninvasive treatment options for these diseases. [ABSTRACT FROM AUTHOR]

Several factors in the pathophysiology of obstructive sleep apnea (OSA) may increase the likelihood of excessive occlusal loads. Increased occlusal loads may compromise a tooth's mechanical resistance. This prospective controlled study assessed the frequency of OSA in patients presenting with tooth fracture. Patients with and without tooth fractures were selected in a consecutive manner from a private dental clinic between February 2018 and January 2020. Demographic and dental variables were registered. A parafunctional habits questionnaire, anthropometric measurements, and validated respiratory polygraphy were performed. Descriptive, comparative, and correlation statistical analyses were performed. Multiple regression analysis was also performed. Fifty-nine patients were included, and 29 presented tooth fracture. Patients with a tooth fracture formed the case group and patients without tooth fracture formed the control group. Patient age was significantly higher in the case group (59 ± 13 years) compared to the control group (44 ± 11 years). Most of the fractured teeth were molars, had a natural tooth as an antagonist, and were not endodontically treated. Twenty-one patients had OSA (apnea-hypopnea index: = 5 events per hour) in the case group compared with 12 patients in the control group (P = .027). Moreover, the patients in the case group had a significantly higher apnea-hypopnea index (P = .000). Multiple regression analysis showed that only age had a significant effect on tooth fracture (P = .002). However, there was a statistically significant relationship between OSA and the presence of tooth fracture in patients aged = 40 years (P = .041). OSA was more frequent in patients presenting with tooth fractures. [ABSTRACT FROM AUTHOR]

Exostosis (also known as osteochondroma) is the most common benign bony lump of young people, usually arising at the distal femur. Vascular complications associated with exostoses are rare and include true aneurysm or pseudoaneurysm formation, deep vein thrombosis, arteriovenous fistula, and arterial insufficiency of the limbs. Few case reports describe pseudoaneurysms resulting from exostoses in mature adults, and no consensus has been reached regarding the optimal therapy. We report the case of a 51-year-old male patient complaining of persistent right thigh pain with a pulsatile mass and right calf swelling, without a history of trauma or hereditary multiple exostoses. The diagnosis was confirmed by computed tomography angiography, which showed a pseudoaneurysm of the popliteal artery resulting from an exostosis on the lateral aspect of the distal femur. A Doppler ultrasound examination confirmed popliteal vein thrombosis caused by the compression of the pseudoaneurysm. Surgical treatment consisted of removing the exostosis, excision of the pseudoaneurysm, and an end-to-end anastomosis. The deep vein thrombosis was treated with rivaroxaban for 3 months. The patient was discharged after 6 days and followed up for 6 months with satisfactory results.

Introducción. La Protuberancia Occipital Externa (POE) es una superficie convexa y lisa que tradicionalmente no presenta ningún tipo de irregularidades. La aparición de un entesofito en individuos ha llamado la atención de los investigadores. Objetivo. Determinar la prevalencia, longitud, edad y sexo de una exostosis en forma de gancho desarrollada a nivel de la POE. Metodología. Estudio observacional descriptivo realizado en radiografías laterales de cráneo de individuos jóvenes. De 5065 radiografías, 4017 radiografías cumplieron con los criterios. Se procedió a la detección de la presencia de un gancho óseo en la POE y su medición. Resultados. Se incluyeron personas de ambos sexos entre 13 a 45 años: 2902 mujeres y 1115 varones. De las 4017 radiografías observadas, el 67% presentó la excrecencia en la POE, con rangos desde 5 a 24 mm en longitud, 511 tenían una longitud de 5 mm o mayor, 903 entre 9 a 12 mm de longitud y 253 de 13 a 24mm. Se observó en mayor proporción en el sexo masculino que el femenino (68% vs 32%). En los individuos de 40 años y más, solo un paciente de sexo masculino mostró la presencia del entesofito. Conclusión. Se ha encontrado una alta frecuencia del desarrollo de una protuberancia ósea a nivel del POE en jóvenes y adultos jóvenes de sexo masculino. Este es el primer estudio de este tipo realizado en la población del Paraguay. Para comprender la razón del desarrollo de esta excrecencia ósea, es necesario ampliar el área de investigación.

Background: Short stems were introduced into total hip arthroplasty (THA) to preserve bone stock, to transmit more load to the proximal femur, and to enable minimal invasive approaches. This study is the first long-term study (with a follow-up of 10 years) of the survival as well as the clinical and radiographic outcomes of the Fitmore hip stem, a short curved uncemented stem. Methods: In total, 123 Fitmore hip stems were prospectively evaluated. At the final 10-year follow-up, 80 Fitmore stems (78 patients: 30 female, 48 male) were eligible for evaluation. Clinical parameters were thigh pain, EQ-5D, Harris Hip Score (HHS) and Oxford Hip Score. Radiographic parameters were cortical hypertrophy (CH), bone condensation, cortical thinning, radiolucency, reactive lines, calcar rounding, calcar resorption, subsidence and varus/valgus position. Results: After 10 years, there was a survival rate of 99% (1 revision because of aseptic stem loosening). HHS had improved from 59 to 94 and Oxford Hip Score from 22 to 43. CH rate after 1 year was 69% and after 10 years 74%. In the first year, radiolucency was found in 58% and in 17.5% after 10 years. Subsidence after 1 year was 1.6 ± 1.6 mm and 5.0 ± 3.1 mm after 10 years. Conclusions: The Fitmore hip stem showed a survival rate of 99% as well as good clinical and radiographic outcomes in the long-term follow-up of 10 years. [ABSTRACT FROM AUTHOR]

To investigate the relationship between fluoride exposure and Osteochondroma (OC) prevalence, a cross-sectional study was conducted in drinking water endemic fluorosis areas of Heilongjiang Province, China. Our study first reported that the prevalence of OC was 2.3% in drinking water endemic fluorosis areas of Heilongjiang Province, China, and no difference in gender. Logistic regression analysis found that compared to 1st quartile participants, the prevalence of OC was 73% lower in the 2nd quartile participants of WF (Water fluoride), and 3.4 times higher among the 2nd quartile UF (Urinary fluoride) participants. Our study suggests that 0.259–0.420 mg/L of WF may be considered an appropriate level for reducing OC prevalence, while UF (≥0.750 mg/L) could slightly increase the prevalence of OC. In summary, the link between fluoride and OC prevalence is complicated and needs to be further investigated in a cohort population. [ABSTRACT FROM AUTHOR]

Hyperostosis frontalis interna (HFI) is an osseous overgrowth characterized by symmetrical, irregular bone apposition on the internal table of the frontal bone, which preferentially occurs in females. In 1719, Morgagni described the condition as one sign of a triad comprising HFI, hirsutism, and obesity (Morgagni's syndrome). The etiopathogenesis of HFI is largely unresolved, but the condition is frequently associated with metabolic, endocrine, and neuropsychiatric disorders. In archaeological cases, which rely solely on dry bone diagnosis, the cause of HFI generally remains unknown, as is also the case regarding accompanying signs and symptoms. Here, we report a case of pronounced HFI in the skeleton of an old‐adult woman from medieval Hildesheim dating to the 8th to 11th century CE. In addition to HFI, the cranium exhibits resorptive lesions of the sella turcica with dehiscence of the roof of the sphenoid sinus. The co‐occurrence of these lesions suggests an underlying common cause for them. On the basis of differential diagnosis, we consider a functioning pituitary neuroendocrine tumor (PitNET) as the most likely common cause for the two conditions. [ABSTRACT FROM AUTHOR]

The purpose of this case report is to describe the case of a patient with ankylosing spinal hyperostosis (ASH) and lumbar spine fracture complicated by ureteral injury mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation followed by the cervical spine fracture. A consecutive analysis and summary of the medical history, radiological documentation, operative procedure, complications, and outcomes were performed. A 59-year-old man presented with abdominal pain three weeks after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the L3/L4 level and features of ASH. Additionally, MRI scans demonstrated hyperintense fluid collection within L3/L4 intervertebral space communicating with both psoas major muscles, mimicking spondylodiscitis with osteomyelitis features and retroperitoneal abscess formation. An in situ instrumented lumbar fusion at the L2-L3-L5-S1 levels with implantation vertebral body replacement implant at the L3/L4 level was performed. Postoperative CT imaging revealed evidence of post-traumatic right ureteral injury. Following urological treatment covering nephrectomy and ureter ligation, the patient was maintained at a 2-year follow-up. After this period, the patient presented again with tetraparesis after sustaining a low-energy fall. The performed CT scans demonstrated a three-column fracture at the C5/C6 level. The combined anterior and posterior osteosynthesis at the C4-C5-C6-C7 levels was performed. This case report presents the rare clinical constellation regarding the lumbar spine fracture complicated by ureteral injury followed by a cervical spine fracture regarding the same patient. The potential injury of retroperitoneal structures, including the ureter after hyperextensive lumbar spine fracture, should be considered in ASH patients. In this case, one should be aware of the atypical clinical presentation regarding the observed spondylodiscitis- and osteomyelitis-like features. [ABSTRACT FROM AUTHOR]

Introduction: Hereditary multiple exostoses (HME) Masada IIB has traditionally been treated by gradual ulnar lengthening with questionable efficacy in reducing the dislocated head. One-bone forearm (OBF) has been used as a reconstructive procedure in forearm deformities with very scarce literature for HME. The study aims to report short-term results of OBF as a definitive procedure for severe forearm deformities in Masada IIB patients with respect to clinical and radiological parameters. Materials and Methods: Four patients with HME Masada IIb were included in this retrospective study. All patients complained of forearm and wrist deformity with an abnormal bony protrusion restricting elbow motion. Indications for OBF were ulnar shortening > 3 cm, dysplastic proximal radius with convex radial head and restricted prono-supination. All patients were examined pre-operatively and post-operatively clinically and radiographically using the Peterson's outcome score. Results: The average age was 13 years (12–14 years). Pre-operative ulnar shortening, carpal slip percentage, and radial articular angle was 3.4 cm, 79.5%, and 47.5°, respectively. All radial heads were dislocated with convex articular surface restricting elbow extension and forearm prono-supination. At the latest follow-up, the mean elbow flexion was 110° with forearm in 10° supination. The mean carpal slip percentage, radial articular angle, and Peterson functional grade was 15%, 22.5°, and 8 points, respectively. The mean follow-up period was 30.25 months with no recurrence. Conclusion: We recommend one bone forearm as a definitive procedure in HME Masada IIB patients with severe forearm deformities with ulnar shortening > 3 cm and dysplastic proximal radius with a dislocated radial head, for faster return to function. [ABSTRACT FROM AUTHOR]

The primary objective of this study was to determine the role of fibroblast growth factor 23 (FGF-23) in the pathogenesis of diffuse idiopathic skeletal hyperostosis (DISH). A total of 61 patients with DISH and 61 age- and sex-matched control patients without DISH were included in this study. The serum FGF-23, creatinine, inorganic phosphate, calcium, albumin, albumin-adjusted calcium and alkaline phosphatase, and C-reactive protein were assessed in both groups. Based on the extent of ossification, DISH group was further divided into T-DISH and L-DISH subgroups. Data were comparatively analyzed between DISH and Non-DISH groups and among T-DISH, L-DISH, and Non-DISH groups, respectively. Besides, the number of ossification segments of all DISH patients was quantified and the correlation between the number of ossification segments and the serum concentration of FGF-23 was analyzed. The results revealed that serum FGF-23 was significantly higher in DISH group than in Non-DISH group, regardless of gender. Interestingly, serum Pi was significantly lower in DISH group than in Non-DISH group. Moreover, a significant difference in serum FGF-23 among T-DISH, L-DISH, and Non-DISH groups was also observed. In contrast to Non-DISH group, both T-DISH and L-DISH subgroups displayed significantly higher serum FGF-23 level. Although the mean value was relatively higher in L-DISH subgroup, no statistically significant difference was found between T-DISH and L-DISH subgroups. In addition, a moderately positive correlation was identified between the number of ossification segments and the serum level of FGF-23. It can be concluded that serum FGF-23 could serve as a positive biomarker for DISH and may play a significant role in ectopic ossification in DISH. [ABSTRACT FROM AUTHOR]

Objectives: The present study investigated the association of skeletal indicator of stress presence with mean age‐at‐death as a means of understanding whether commonly studied indicators are indeed indicative of increased frailty. Materials and Methods: Using a medieval Gaelic population from Ballyhanna (Co. Donegal), the present study assessed the association between skeletal indicators of stress and mean age‐at‐death using the Kaplan–Meier survival function with log rank test to determine whether these indicators were associated with younger age‐at‐death, and therefore increased frailty, in sub‐adults only (0 to 18 years, N = 139) and through comparison to an all‐ages cohort (N = 318). Results: Only linear enamel hypoplasia was found to be associated with significantly decreased survivorship across the all‐ages cohort but, conversely, was associated with increased survivorship when analysis was restricted to sub‐adults. All other indicators assessed were associated with increased age‐at‐death for both all‐age cohorts and sub‐adult cohorts (cribra orbitalia), increased age‐at‐death when assessing all ages only (porotic hyperostosis and healed periosteal lesions); or were sufficiently rare in adults to prevent comparative analysis (stunting and micronutrient deficiency). Increased survivorship in individuals with higher numbers of co‐morbid skeletal indicators was observed for both sub‐adults alone and all age cohort. Discussion: These findings suggest that these commonly recorded skeletal indicators may be more accurately viewed simply as records of stressor exposure and subsequent survival only, rather than providing evidence that these sub‐adults are frailer than their similarly aged‐at‐death peers. Thus, the demographic and sociocultural context is essential to the interpretation of observed skeletal indicators of stress. [ABSTRACT FROM AUTHOR]

Objective: Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by osteophytes in the anterior vertebrae, and the presence of aorta may have an impact on their formation. However, the anatomical positional relationship between the aorta and osteophytes in patients with DISH remains controversial. This study aimed to evaluate the position of osteophytes in relation to aorta in DISH, and the influence of aortic pulsation on the formation of osteophytes from the perspective of morphology. Methods: We conducted a retrospective review of 101 patients diagnosed with DISH and symptomatic lumbar spinal stenosis between June 2018 and December 2021. A total of 637 segments with heterotopic ossification in DISH were used for quantitative measurements on CT scans. The Cartesian coordinate system was built up on the axial CT scans to reflect the relative position between aorta and osteophytes. Osteophytes were divided into adjacent aorta group (AD group) and non‐adjacent aorta group (N‐AD group). In terms of the morphology, osteophytes in the AD group were further divided into convex, flat, and concave types. The relative position between aorta and osteophytes, and the aorta‐osteophyte distance and morphology of osteophytes were compared. Univariate analysis of variance was performed for multiple groups, and two independent‐samples t‐tests were used for two groups. Results: From T5 to L4, aorta gradually descended from left side to middle of vertebrae, and osteophytes gradually shifted from right side of vertebrae (T5‐T10) to bilateral sides (T11‐L4). Of 637 osteophytes in DISH, 60.1% (383/637) were in AD group, including convex type 0.6% (4/637), flat type 34.7% (221/637), and concave type 24.8% (158/637). The N‐AD group accounted for 39.9% (254/637). Flat osteophytes were concentrated in T5‐T12, while concave osteophytes in T11‐L4. Overall, the aorta‐osteophyte distance of concave type was significantly smaller than that of flat type. Conclusion: Osteophytes are not always located on the right side of vertebrae, but move with the position of the descending aorta. Furthermore, the morphology of osteophytes varies by vertebral segment in DISH, which is related to aorta descending anteriorly in the spine. [ABSTRACT FROM AUTHOR]

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoimmune inflammatory disease characterized by osteoarticular and dermatological manifestations. The most common osteoarticular manifestations involve the anterior chest wall, axial skeleton, and long bones. Cranial bone involvement is less reported in SAPHO syndrome. We herein present three cases of SAPHO syndrome with cranial bone involvement, and review the previous literature on similar manifestations. It was revealed that SAPHO syndrome could lead to cranial bone involvement, which could involve the dura mater, leading to hypertrophic pachymeningitis, but the outcome is usually good. Janus kinase inhibitors may be a potential treatment option. [ABSTRACT FROM AUTHOR]

Introduction: cartilage-forming tumors are the most frequent primary bone tumors. They are characterized by a strange behavior due to their uncertain evolution and they are difficult to diagnose. Osteochondroma or cartilaginous exostosis is one of the most frequent skeletal tumors. It is a tumor typical of young individuals, with a slight predominance in males. It can be solitary or multiple and is part of the hereditary multiple exostosis syndrome. Patient information: it is presented a male patient, 21 years old, who began to present an increase in volume in the right cervical region secondary to a bone tumor of cartilaginous origin. Conclusions: in this case the location of the osteochondroma is rare (right cervical region). There was no genetic family history of the disease, no symptoms, only local volume increase. X-ray studies and computerized axial tomography are particularly useful in the diagnosis of this condition. [ABSTRACT FROM AUTHOR]

Introduction. The diffuse idiopathic skeletal hyperostosis (DISH), also known as Forestier-Rotès-Querol disease, is a systemic pathology characterized by the diffuse ossification of the ligaments of the spinal column. It can be linked to several metabolic disorders, such as obesity and type II diabetes, and its prevalence among the elderly population is high. DISH may be asymptomatic and only acknowledged in the imaging, or it can be associated to serious clinical conditions like stiffness, pain and reduced spine mobility. At the moment, specific guidelines for the treatment of the DISH do not exist. This article aims to analyze the available literature concerning the rehabilitation treatment in patients affected by DISH. Materials and methods. Until July 2023, PubMed, PEDro, Scopus and Google Scholar were accessed, with no time constraints. Results. The literature available is poor, but the authors of the selected studies suggest programs based on therapeutic exercise, manual therapy, postural education, instrumental physical therapy. The discrepancy between the results obtained in case report and in RCT and cohort study, may express the need of a personalized treatment, since the characteristic of the pathology are variable depending on the localization of the hyperostosis. The rehabilitation strategies just proposed may be investigated in order to create a therapeutic path for DISH patients. Conclusions. Patients affected by DISH may cope with conditions of severe disability, caused by stiffness, pain, respiratory and dysphagic symptoms. The physiotherapy program should be based on stretching and mobility exercises to avoid pain and stiffness. This can be seen as the starting point, so that in the future this pathology might be more researched and easily diagnosed, in order to create useful guidelines and to better manage this less-known clinical condition. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to present the demographic data, diagnostic and treatment methods of tumors, and postoperative clinical outcomes of 121 patients diagnosed with osteochondroma who underwent surgical treatment at a tertiary oncology center. Patients and Methods: A total of 121 patients between 18 and 65 years of age, diagnosed with osteochondroma and treated surgically, with a minimum follow-up period of 1 year, were retrospectively included in the study between 2009 and 2019. The tumor size and cartilage cap thickness were analyzed with ROC analysis to determine significant cutoff values for distinguishing hereditary tumors from solitary tumors. Results: The average age of the patients was 31.7±12.9 years, and 57% of the patients were male. The mean tumor size was calculated as 43.4 mm, and the mean cartilage cap thickness was 7.1 mm. In addition, hereditary osteochondroma was diagnosed in 16.5% of the patients, and chondrosarcoma resulting from malignant transformation was detected in 1.7% of the cases. The tumor size and cartilage cap thickness in patients with hereditary osteochondroma were significantly higher than in solitary cases. The tumor size and cartilage cap thickness were identified as important indicators for distinguishing hereditary tumors from solitary tumors. ROC analysis resulted in a cutoff value of 7.5 mm for cartilage cap thickness and 49 mm for tumor size. Conclusion: Osteochondroma treatment can generally be successfully managed with surgical intervention, and postoperative complications are rare. This study provides important information to support clinical decisions in the treatment and follow-up of osteochondroma pati ents. [ABSTRACT FROM AUTHOR]

Study Design: This study adopted a retrospective cohort study design. Purpose: This study aimed to clarify the influence of diffuse idiopathic skeletal hyperostosis (DISH) on bone fusion after transforaminal lumbar interbody fusion (TLIF). Overview of Literature: The negative effects of DISH on lumbar degenerative diseases have been reported, and DISH may be involved in the onset and severity of lumbar spinal canal stenosis. Patients with DISH have significantly more reoperations after posterior lumbar fusion, including TLIF. However, the effects of DISH on bone fusion after TLIF have not been reported. Methods: The medical records of patients with intervertebral TLIF from 2012 to 2018 were retrospectively examined. The patients were divided into those with fusion and those with pseudoarthrosis, and the following data were compared: age, sex, DISH, diabetes mellitus, smoking, drinking, albumin levels, body mass index ≥30 kg/m², and L5/S fixation. Statistical analyses were performed using regression models. Results: In this study, 180 patients (78.6%) had fusion and 49 patients (21.4%) had pseudoarthrosis. The number of patients with DISH was significantly higher in the pseudoarthrosis group than in the fusion group (36.7% and 21.7%, respectively; univariate p=0.031, multivariate p=0.019). No significant differences in age, sex, diabetes mellitus, smoking, drinking, albumin levels, body mass index ≥30 kg/m2, and L5/S fixation were observed between the two groups. The risk factors for bone fusion were statistically analyzed in 57 patients with DISH. DISH with a caudal end below Th11 was an independent risk factor for pseudoarthrosis (univariate p=0.011, multivariate p=0.033). Conclusions: DISH is an independent risk factor for pseudoarthrosis after one intervertebral TLIF, and DISH with a caudal end below Th11 is associated with a higher risk of pseudoarthrosis than DISH without a caudal end below Th11. [ABSTRACT FROM AUTHOR]