ABSTRACT
L'IRM corps entier de diffusion 1,5T est une technique d'imagerie qui fournit des renseignements aussi bien morphologique que fonctionnel avec de nombreuses indications notamment dans les pathologies cancéreuses. Objectif: Faire le bilan d'activité de l'IRM corps entier en insistant sur son apport dans la pathologie cancéreuse. Méthodologie:Etude transversale descriptive avec collecte rétrospective des donnéesincluant les patients ayantréalisé une IRM corps entier pourtumeur maligne sur une période de quatre ans. La saisie et l'analyse des données ont été réalisées grâce aux logiciels Epi Info.Résultats:31,19% des patients avaient un âge compris entre 61 et 70 ans. Le cancer de la prostate était le plus représenté avec 34,68% suivi du cancer du sein 31,45%. L'IRM corps entier était réalisée pour le bilan d'extension dans 39,52% et dans 37,10% pour un bilan d'évolutivité. Les localisations métastatiques étaient observées dans 49% des cas avec une atteinte prépondérantede l'étage abdomino-pelvien 72,13%. Les localisations métastatiques osseuses étaient de 73,77%,hépatiques 26,23% et pulmonaire 14,75%. Les atteintes ganglionnaires de 57,14%. Une progression tumorale a été observée chez 53,33% des patients lors du suivi.Conclusion: L'IRM corps entier permet une fine analyse dans l'évaluation de la pathologie cancéreuse pour l'extension tumorale, la réponse thérapeutique et la recherche de cancer primiti
1.5T whole-body diffusion MRI is imaging that provides both morphological and functional information.It presents several indicationsparticularly in oncology. Objective: Assess the activity of whole-body MRI, emphasizing its contribution to oncologyMethodology:Descriptive retrospective study of patients who had undergone whole-body MRIfor malignancy over a four-year period. Data entry and analysis were performed using Epi Info software.Results:31.19% of patients were between 61 and 70 years old. Prostate cancer was the most represented with 34.68% followed by breast cancer 31.45%.Whole-body MRI was requested for an extension assessment in 39.52% and 37.10% for progress assessment. It revealed metastatic abnormalities in 49%. Abdomino-pelvic region was the most affected area with 72.13%. Metastatic organ involvement was predominantly in the bone 73.77%, followed by the liver 26.23% and the lung14.75%. Lymph node involvement was 57.14%.Tumor progression was observed in 53.33% of patients during follow-up.Conclusion:Whole body MRI allows a fine analysis in the evaluation of the cancerous pathology for the tumor extension, the therapeutic response and the search for primary cancer
Subject(s)
Humans , Male , Female , Bone and BonesABSTRACT
Objectifs. Déterminerla place de la scintigraphie osseuse 3 temps dans le diagnostic del'ostéonécrose avasculaire de la tête fémorale (OATF).Matérielset Méthode. Nousavons colligérétrospectivement62 scintigraphies osseuses (SO+)mettant en évidence uneOATF. Ces SO+ ont été réalisées au Service de Médecine Nucléaire du CHU YOde Ouagadougou,de 2017à 2022. Un formulaire de recueil de données a permis de collecter les données générales et les résultats de la scintigraphie osseuse. L'étude descriptive consistait à calculer les fréquences pour les variables qualitatives et les moyennes pour les variables quantitatives.La SO en trois temps a été faite chez tous les patients après injection de 296 à 925 MBq d'un dérivé diphosphonate : l'hydroxyméthyléne diphosphonate(HMDP) marqué au technétium 99 m (Tc99m). Résultats. 62patients ont présenté une SO+ à la recherche scintigraphique de l'OATF de 2016 à 2021. Leur âge moyen est de 35 ± 14,18 ans avec une nette prédominance féminine (75,8%). La principale étiologie retrouvée etaitla drépanocytose. La douleur coxale avec ou sans boiterie a indiquéla réalisation de la SO dans 41,66 % des cas. Lesvingt-cinqpatients (40,3%) qui avaient bénéficié d'une TDM de la hanche concernée ont été adressés pour confirmation du diagnostic (n=4), bilan pré opératoire (n=9), recherche d'autres foyers(n=12). Pour lesonzepatients atteints de pathologie cancéreuse,le diagnostic d'OATF était fortuit au décours d'une SO réalisée dans le cadre de leur bilan d'extension. Sur les images scintigraphiques tardives, les atteintes de type II de GOLLSHALK étaient majoritaires,suivies des atteintes de type III puis de type I. Il n'y avait pas d'atteinte de type IV. Conclusion. La SO est efficace dans la caractérisation de l'OATF avant l'apparition de la symptomatologie clinique et de la traduction radiologique. Lorsque l'IRM est disponible et n'est pas contre indiquée, la SO est la modalité diagnostique à utiliser en deuxième intention.
Objective: Determine the role of three-step bone scintigraphy (BS) in the diagnosis of aseptic osteonecrosis of the femoral head (AOFH).Materials and Method: Retrospectively we collected 62 positive bone scans (BS+) at aseptic osteonecrosis of the femoral (AOFH). These BS+ were carried out at the Nuclear Medicine Department of CHU YO, from 2017 to 2022. A data collection form has been prepared. It made it possible to collect general data and the results of the bone scintigraphy. The descriptive study consisted of calculating the frequencies for the qualitative and the the means for the quantitative variables. The three-step BS was performed in all patients after injection of 296 to 925 MBq of a diphosphonate derivative: hydroxy methylene diphosphonate (HMDP) labeled with technetium 99 m (Tc99m).Results: 62 patients were positive (BS +) in the aseptic avascular osteonecrosis of the femoral head scintigraphic research from 2016 to2021. Their average age is 35 ± 14.18 years with a clear female predominance (75.8%). The main etiology fremains sickle cell anemia. Hip pain with or without lameness indicated the realization of SO in 41.66% of cases. The twenty-five patients (40.3%) who had undergone CT of the affected hip were referred for confirmation of the diagnosis (n=4), preoperative workup (n=9), search for other foci (n=12). For the eleven patients with cancerous pathology, the diagnosis of AOFH was fortuitous after an BS performes as part of their extension workup. On the late scintigraphic images, type II involvement of GOLLSHALK was predominant, followed by by type then type I. There was no type IV involvement. Conclusion: BS is sensitive in the detection of aseptic avascular osteonecrosis of the femoral head before the onset of clinical symptoms and radiological translation. When MRI is available and not contraindicated, BS is the second-line modality
Subject(s)
Humans , Male , Female , Osteonecrosis , Bone and BonesABSTRACT
Background: The efficacy of palliative external beam radiotherapy (PRT) for relief of metastatic bone pain had been well established, a single fraction is as effective as multiple fractions in relieving bone pain, but variation exist among the radiation oncologist in our environment on the ideal dose per fraction regimen. Methods: We retrospectively reviewed data from breast cancer patients treated with PRT using linear accelerator for metastatic bone pain in University College Hospital Ibadan between 2005 and 2009. The extracted information includes bio-data, presenting symptoms, metastatic sites, and bone pain assessment before and after four weeks of PRT using visual analogue pain scale (VAS), radiation doses, fractionation numbers and number of re-irradiation. Results: There were 161 eligible breast cancer patients who were treated with PRT secondary to painful bone metastases between 1st January 2005 and 31st December 2009. Majority were females with only 1.2% male patients (Figure 1). Table 1 showed demographic characteristics of treated patients with mean age of 45.2 years, pain was the major presenting complaint (92.5%) and multiple bony metastases constituted the highest metastatic presentation (52.2%). Table 2 shows patient's responses to PRT treatment for pain relief (complete responses of 88.8% and 11.2% partial responses). No significant association between patient's responses to PRT and magnitude of radiation doses delivered. However, fractionation sizes were significantly associated with re-irradiation p-value < 0.05. Conclusion: No differences exist between various dose fractionation schemes in terms of relief from painful bony metastases. However, shorter dose fractionation schemes are associated with re-irradiation of previously irradiated sites
Subject(s)
Bone and Bones , Breast Neoplasms , Dose Fractionation, Radiation , Neoplasm Metastasis , NigeriaABSTRACT
Background: spondyloarthropathies (SpA) are a group of chronic inflammatory rheumatic conditions that share multiple clinical features including axial and/or peripheral arthritis, enthesitis, absence of serum rheumatoid factor and presence of common extra articular manifestations. Objective: the aim of this work is to study bone mineral density and trabecular bone score at patients with non-radiographic axial spondyloarthropathy. Patients and Methods: this study is a cross sectional study in which 200 patients having chronic back pain selected from those attending the outpatient clinic and inpatient of Al-Azhar University Hospitals, Damietta and were divided into two groups: 1- (Group A, study group): (160) patients had inflammatory low back pain fulfilling Calin criteria for inflammatory low back pain. 2- (Group B, control group): (40) patients had mechanical low back pain not fulfilling criteria of inflammatory back pain. Results: regarding results of clinical examination, there was significant increase of arthritis, dactylitis, enthesitis and psoriasis in Group A when compared to Group B (43.3%, 16.7%, 30.0%, 20.0% vs 3.3%, 0.0%, 3.3% and 3.3% respectively). In addition, there was significant increase of arthritis plus dactylitis and arthritis plus enthesitis in Group A when compared to Group B (16.7%, 30.0% vs 3.3% and 0.0% respectively). Conclusion: results of the present study proved that, both bone mineral density and trabecular bone scores showed early changes in patients with non-radiographic axial spondylo-arthropathy. In addition, both correlated with each other and with results of axial magnetic resonance imaging. Thus, they are advocated in diagnosis of nr. SPA
Subject(s)
Bone Density , Bone and Bones , Spondylarthropathies , Trabecular MeshworkABSTRACT
Background: Lateral condyle fractures of the distal humerus are the second most common fractures at the elbow in the paediatric population usually between the ages of 6-10 years old making up 5-20% of fractures in children. The aim of the present study was to assess the early results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation. Methods: Our clinical trial was conducted involving 12 patients treated with open reduction and internal fixation (ORIF). Preoperative stage included clinical evaluation, routine investigations and radiological evaluation. Fractures were classified using the Milch. Patients were followed up weekly until radiological union of the fracture was evident. Results: 83.3% of our patients were males, while 16.7% were females. According to mechanism of injury, falling down continues to play a major role in causing disability. At (3-5) weeks all cases were with soft callus remove K wire; at 8 weeks, all cases were with union fracture; but at 12 weeks, one case (8.3%) was with mild stiffness and the rest was with full range of motion. As regards the carrying angle in our study, only 16.7% were with abnormal carrying angle. 33.3% were complicated; one case with mild limitation of motion and valgus; one case with varus and two cases with superficial infection. Conclusions: The open reduction and internal fixation of lateral humeral condyle fracture is the ideal treatment and it has a rate of complications
Subject(s)
Bone and Bones , Egypt , Fracture Fixation, Internal , Open Fracture ReductionABSTRACT
Background: Closed, locked intramedullary nailing has been accepted as the gold standard in the care of femoral fractures, with reported union rates as high as 98-100%. Closed, locked intramedullary nailing often requires expensive equipment which is a challenge in developing countries.Segmental long bone fractures are often a result of high-energy trauma and hence often associated with a lot of injuries to the surrounding soft tissues. This consequently results in higher rates of delayed or nonunion. This study was proposed to review the outcome of management of segmental fractures with locked intramedullary nails, using an open method of reduction. Methods: A retrospective analysis was made of data obtained from all segmental long bone fractures treated with intramedullary nailing over a 1-year period. Records were retrieved from the folders of patients operated on from January 2011 to December 2011. Patients were followed up for a minimum of 1 year after the surgery. Results: We managed a total of 12 segmental long bone fractures in 11 patients. Eight of the 12 fractures were femoral fractures and 10 of the fractures were closed fractures. All but one fracture (91.7%) achieved union within 4 months with no major complications. Conclusions: Open method of locked intramedullary nailing achieves satisfactory results when used for the management of long bone fractures. The method can be used for segmental fractures of the humerus, femur, and tibia, with high union rates. This is particularly useful in low-income societies where the use of intraoperative imaging may be unavailable or unaffordable. It gives patients in such societies, a chance for comparable outcomes in terms of union rates as well as avoidance of major complications. Larger prospective studies will be necessary to conclusively validate the efficacy of this fixation method in this environment
Subject(s)
Bone and Bones , Developing Countries , Fracture Fixation , Fractures, Bone , Open Fracture ReductionABSTRACT
The study as an opinion survey identified Road Traffic Accidents (RTA); falling from height and gunshots/matchets as the causes of bone injuries in Maiduguri; Nigeria. Injuries sustained include fracture and dislocation. Structured Interview Schedule (SIS) and Focused Group Discussion (FGD) were the instruments used to obtain data. Population of study comprised of those involved in bone injuries between January and December; 2008. The sample size of 700 respondents was selected using stratified random sampling technique. Frequency distribution and percentages were employed to analyze data. Findings of the study revealed parents/families; relatives and friends as some of the sources of decision to patronize Traditional Bone Setting (TBS) while culture; phobia for hospitalization; no amputation and less expensive were some of the reasons adduced for patronage. Based on the findings; enactment of stringent laws/bye-laws or re-enforcement of existing ones (if any); counselling and enlightenment were suggested/recommended
Subject(s)
Bone and Bones , Decision Making , Nigeria , Wounds and InjuriesABSTRACT
Gangrene usually supervenes following prolonged pressure of tight splintage by traditional bone setters (TBS) in the process of treating fractures. However; various complications such as blisters; pressure sores; Volkmann's ischaemia/ contracture; Crush syndrome and pregangrene occur by the same mechanism depending on degree of pressure and duration of splintage of the limb. Method: This is a guest lecture delivered to resident doctors. Literature search was done through the internet and some unlisted journals and texts. Experiences of various institutions in Nigeria and abroad concerning bone setters' gangrene were elucidated. Attempt was made to broaden the concept of bone setters' gangrene to include all complications that arise through the same mechanism. The aetiology; pathophysiology and treatment of the various conditions were highlighted and the solution and way-forward suggested. Result: The various health institutions recorded unacceptably high percentage of amputations secondary to bone setters' gangrene e.g. Zaria - 57to 63; Jos - 60-77.8. Enugu recorded mortality of 26.7while Banjul had 11.1mortality in their series. Nearly all the series suggested education of bone setters as a solution. Conclusion: A different approach to limiting bone setters' gangrene is suggested such as condemning bone setters' practice and expanding orthopaedic care
Subject(s)
Bone and Bones , GangreneABSTRACT
Gangrene usually supervenes following prolonged pressure of tight splintage by traditional bone setters (TBS) in the process of treating fractures. However; various complications such as blisters; pressure sores; Volkmann's ischaemia/ contracture; Crush syndrome and pregangrene occur by the same mechanism depending on degree of pressure and duration of splintage of the limb. Method: This is a guest lecture delivered to resident doctors. Literature search was done through the internet and some unlisted journals and texts. Experiences of various institutions in Nigeria and abroad concerning bone setters' gangrene were elucidated. Attempt was made to broaden the concept of bone setters' gangrene to include all complications that arise through the same mechanism. The aetiology; pathophysiology and treatment of the various conditions were highlighted and the solution and way-forward suggested. Result: The various health institutions recorded unacceptably high percentage of amputations secondary to bone setters' gangrene e.g. Zaria - 57to 63; Jos - 60-77.8. Enugu recorded mortality of 26.7while Banjul had 11.1mortality in their series. Nearly all the series suggested education of bone setters as a solution. Conclusion: A different approach to limiting bone setters' gangrene is suggested such as condemning bone setters' practice and expanding orthopaedic care
Subject(s)
Bone and Bones , GangreneABSTRACT
Giant cell tumours (GCT) are the commonest bone tumours worldwide. It is rarely malignant but when it does it progresses to fibrosarcoma with high mortality. Otherwise it causes poor cosmesis; disability and pathological fractures. A total of 19 cases of histologically established Giant cell tumour of the bone were reviewed prospectively in a 5 year study. 14 cases were benign; 4 malignant and one was a malignant transformation. Lesions around the knee accounted for 42.2of the cases; but the radius was the commonest single bone affected with 26.3. Eleven patients had curettage; five of them had autogenous bone grafting while the remaining six had bone grafting and plate augmentation. One patient had fore-quarter amputation while seven had tumour resection. There was no recurrence recorded among those that had currretage and autogenous bone grafting. 33of those that had curettage and bone cementing as well as 16.6of those that had resection presented with recurrence. One patient died within 3 months of surgery due to metastasis to the lungs; liver and spleen. Mean follow up was 9.2 months (range of 2 to 60 months). With early presentation; curretage and bone grafting is often effective; late presentation however has an increased risk of recurrence due to soft tissue involvement; dearth of investigative tools and financial constraints
Subject(s)
Bone and Bones , Curettage , Giant Cell Tumors/diagnosis , Giant Cell Tumors/etiology , Giant Cell Tumors/therapyABSTRACT
The study was to ascertain the effect of quality and quantity of dietary protein on body growth; organ cellular and cytoplasmic size; serum protein concentration and molecular weights; erythrocyte fragility and bone mineralisation. Diets containing 20; 17 and 15protein were fed to Sprague Dawley Albino rats weighing about 90g for 21 days. The 20protein diet was a commercial diet better in nutrient composition and quality than the diet containing 17 and 15protein formulated in our laboratory. At the end of 21 days; kidney; testes; brain; pancreas; spleen and long bones ere taken for analysis. Results showed that the diet containing 20protein supported higher body weight; liver and testes cell size (Protein/DNA and weight/DNA ratios) and cytoplasmic size (RNA/DNA ratio). The pancreas cell size; heart; brain; pancreas and spleen cytoplasmic size were not changed by dietary protein level. Plasma protein concentration and the molecular weights; percent bone cash and percent calcium in it were the same at the three levels of dietary protein. TCA soluble plasma amino acid concentration was higher at 20dietary protein. Erythrocyte fragility was higher but erythrocyte ghost protein was lower at dietary protein below 20
Subject(s)
Blood Proteins , Bone and Bones , Dietary Proteins , Erythrocytes , GrowthABSTRACT
The study was to ascertain the effect of quality and quantity of dietary protein on body growth; organ cellular and cytoplasmic size; serum protein concentration and molecular weights; erythrocyte fragility and bone mineralisation. Diets containing 20; 17 and 15protein were fed to Sprague Dawley Albino rats weighing about 90g for 21 days. The 20protein diet was a commercial diet better in nutrient composition and quality than the diet containing 17 and 15protein formulated in our laboratory. At the end of 21 days; kidney; testes; brain; pancreas; spleen and long bones ere taken for analysis. Results showed that the diet containing 20protein supported higher body weight; liver and testes cell size (Protein/DNA and weight/DNA ratios) and cytoplasmic size (RNA/DNA ratio). The pancreas cell size; heart; brain; pancreas and spleen cytoplasmic size were not changed by dietary protein level. Plasma protein concentration and the molecular weights; percent bone cash and percent calcium in it were the same at the three levels of dietary protein. TCA soluble plasma amino acid concentration was higher at 20 dietary protein. Erythrocyte fragility was higher but erythrocyte ghost protein was lower at dietary protein below 20
Subject(s)
Blood Proteins , Bone and Bones , Dietary Proteins , GrowthABSTRACT
"Background: There has been increasing incidence of road traffic accidents and gun shot injuries in Benin City in the recent past. A major complication of these events is fracture of the bones. Various patterns of fractures are reported from different communities.Aim: To determine the pattern and outcome of fractures in Ikpoba Hill; a sub-urban community in Edo State.Methods: A retrospective study of all cases of fractures that presented to ""Our Medical Centre"" in Ikpoba Hill; a sub-urban community in Edo State between January 1998 and December 2004 was carried out. Parameters analysed included age; sex; and occupation; cause of fracture; site of fracture; associated injuries; treatment offered and outcome of management.Results: A total of 285 cases of fractures were seen over the period of study. There was a steady increase in the number of cases of fractures over the period of study. The 20 -29 years age group was more commonly affected (25.61). The male: female ratio was 1.9: 1. Civil servants and business people were most commonly affected (36.49and 24.56respectively). The humerus was the bone most commonly affected (24.32). Road traffic accident was the commonest aetiological factor accounting for 80. Some 69.47of the cases discharged themselves against medical advice to seek help with a traditional bonesetter. Head injury was the commonest cause of death (44.44). The average duration of hospital stay was 21 days.Conclusion: Road traffic accident was a common cause of fracture. The humerus was the bone most commonly fractured. Most patients with fracture prefer to patronize the traditional bone setters. Public enlightenment campaign should be mounted to discourage the attitude of most patients with fracture seeking help in traditional bonesetters' place."