Application value of imaging examination in the diagnosis of Muller-Weiss disease / 中国骨伤

OBJECTIVE@#To analyze radiological characteristics of Muller-Weiss disease, evaluate the clinical value of the imaging examination in diagnosis of Muller-Weiss disease.@*METHODS@#The imaging data of 26 patients with Muller-Weiss disease were collected from September 2015 to August 2020, including 7 males and 19 females, aged 43 to 68 years old with an average of (52.7±4.6) years old. In the X-ray examination observed the shape and position of the navicular bone. The talar-first metatarsal angle(TFM) was measured on the weight-bearing anteroposterior radiograph. The arch angle and angle between mid-axis of talus and mid-axis of the first metatarsal(Meary angle) were measured on the weight-bearing lateral radiographs. The morphology, density, adjacent joint space and position of the navicular bone were evaluated by computed tomography(CT), and magnetic resonance imaging(MRI) was used to observe the shape, signal, cartilage and surrounding soft tissue changes of the navicular bone.@*RESULTS@#Among 26 patients, 21 cases were unilateral and 5 cases were bilateral;X-ray examination showed that the lateral part of navicular bone of foot was compressed and flattened, showing"comma like"or"drop like", navicular moved to the medial side, partial fragmentation of bone, peripheral articular hyperplasia, uneven density and narrowing of relationship gap. According to Meary angle and deformity degree of the affected foot on the lateral X-ray of the load-bearing foot, Maceira staging was performed. There were 0 cases in stageⅠ, 2 cases in stage Ⅱ, 11 cases in stage Ⅲ, 9 cases in stage Ⅳand 4 cases in stage Ⅴ. CT examination showed bone fragmentation, medial displacement of navicular bone and formation of the talocalcaneal joint. MRI examination showed the irregular shape and uneven signal of navicular bone, narrowing of joint space, talocalcaneal joint surface hyperplasia and cartilage destruction, tarsal joint effusion and swelling of surrounding soft tissue.@*CONCLUSION@#Muller-Weiss disease has specific imaging manifestation, and an accurate diagnosis can be made based on the patient's age, gender, and clinincal history. Preoperative imaging examination can stage the disease, help clinicians to formulate better surgical plans, and postoperative imaging examination can better evaluate the surgical effect.

Tratamiento artroscópico del osteoma osteoide en el astrágalo / Arthroscopic treatment of osteoid osteoma in the talus

Introducción: El osteoma osteoide (OO) es el tumor osteoblástico benigno más frecuente. La ubicación en el astrágalo es del 2 al 10%. La resección es la única opción curativa. Presentamos una serie de 2 casos de osteoma osteoide en cuello del astrágalo con resección artroscópica y radiofrecuencia como tratamiento. Material y Métodos: Presentamos dos pacientes de 23 y 24 años, con dolor crónico en tobillo e imágenes por tomografía y resonancia compatibles con osteoma osteoide. Resultados: Los pacientes evolucionaron favorablemente, con una mejoría notable del score AOFAS, recuperación completa del cuadro y sin recidivas a los 18 meses de seguimiento. Discusión: El diagnóstico suele ser tardío, siendo el primer síntoma el dolor de predominio nocturno y que alivia con el uso de salicilatos. La extirpación artroscópica del OO del tobillo puede ser un procedimiento exitoso con mínimas complicaciones, siendo el tumor fácil de localizar y visualizar. Conclusión: Obtuvimos resultados satisfactorios para el paciente, con tiempos de recuperación breves y menor riesgo de infección. El procedimiento muy recomendable. Tipo de estudio: Serie de casos. Nivel de Evidencia: V

Introduction: Osteoid osteoma (OO) is the most frequent benign osteoblastic tumor. The location in the talus is 2 to 10%. Resection is the only curative option. We present arthroscopic resection and use of radiofrequency as treatment. Material and methods: We present two patients aged 23 and 24 years, with chronic ankle pain, computed tomography and magnetic resonance images compatible with osteoid osteoma. Results: Patients showed complete recovery after procedures, with an notable improvement of AOFAS and no recurrence after a follow-up of 18 months. Discussion: Late diagnosis is usually due to the first symptom being a pain, with nocturnal predominance and relieved by the use of salicylates. Arthroscopic removal of the OO of the ankle can be a successful procedure with minimal complications, being easy to locate and completely visualize the tumor. Conclusion: We obtained satisfactory postoperative results, with short recovery times and decreased risks of infection. We highly recommend the procedure. Type of study: Case series. Level of Evidence: V

Presencia y biometría del os trigonum en individuos chilenos: estudio radiológico / Presence and biometry of the os trigonum in Chilean individuals: radiological study

El tubérculo lateral del proceso posterior del talo se fusiona generalmente con el cuerpo de este hueso, sin embargo, debido al estrés (flexión plantar forzada) aplicado durante los años de la adolescencia o cuando un centro osificado parcialmente e incluso totalmente osificado se fractura, se provoca una falta de unión, dando lugar a un hueso accesorio denominado Os trigonum (OT). En algunos casos puede producirse el síndrome os trigonum o síndrome de pinzamiento posterior, el cual se caracteriza por un dolor agudo o crónico de la región posterior del tobillo. Basado en lo anterior, se realizó un estudio retrospectivo entre el período de Agosto de 2017 a Mayo de 2018, en el cual se analizaron radiografías bilaterales de 205 pacientes concurrentes al Hospital Hernán Henríquez Aravena de Temuco, Chile. De la población estudiada, 154 fueron de sexo femenino y 51 de sexo masculino cuyas edades fluctuaron entre los 15 y 85 años, Las proyecciones radiológicas utilizadas fueron de pie lateral, tobillo lateral o calcáneo lateral, para así para determinar la prevalencia de OT y contribuir acerca de su distribución en pie derecho e izquierdo y aparición según sexo y edad. Del total de la muestra, se encontraron 24 individuos que presentaban OT (11,7 %) de los cuales 18 (75 %) correspondían al sexo femenino y 6 (25 %) al sexo masculino. Además se realizaron mediciones del largo y ancho del OT. Los datos obtenidos son una contribución al conocimiento de los huesos accesorios del pie en la población chilena.

The lateral tubercle of the posterior process of the talus is generally fused with the body of this bone, however, due to stress (forced plantar flexion) applied during the adolescent years. Also, when a partially ossified and even fully ossified center fractures, it causes a lack of union, giving rise to an accessory bone called Os trigonum (OT). In some cases Os trigonum syndrome or posterior impingement syndrome may occur, which is characterized by acute or chronic pain in the posterior region of the ankle. Based on the above, a retrospective study was conducted between August 2017 and May 2018, in which bilateral radiographs of 205 patients attending the Hernán Henríquez Aravena Hospital of Temuco were analyzed. Of the population studied, 154 were female and 51 were male, whose ages fluctuated between 15 and 85 years. The radiological projections used were lateral foot, lateral ankle and calcaneus lateral, to determine the prevalence of OT and provide information about its distribution in right and left foot and appearance according to sex and age. From the total sample, 24 individuals were found who had OT (11.7 %) of which 18 (75 %) corresponded to the female sex and 6 (25 %) to the male sex. In addition, measurements of the length and width of the OT were made. The data obtained is a contribution to the knowledge of the accessory bones of the foot in the Chilean population.

Artroscopía de la articulación subastragalina: técnica quirúrgica, indicaciones, resultados y complicaciones / Subtalar joint arthroscopy: surgical technique, indications, results and complications

Introducción: El abordaje artroscópico para el tratamiento de la patología subastragalina se encuentra en pleno desarrollo. El propósito del presente trabajo es efectuar una descripción de las indicaciones, técnica quirúrgica, resultados y complicaciones en la realización de la artroscopía de la articulación subastragalina. Material y método: Se presenta 14 pacientes con patología de la articulación subastragalina, tratados durante los años 2003 al 2009. Se realizaron 11 artroscopías posteriores y 3 laterales. Seguimiento: 36 meses (R=15-69). Todos los pacientes fueron evaluados mediante el score AOFAS y a los 12 meses de la cirugía se les pregunto: 1- Si estaban satisfechos con el resultado de la cirugía. 2- Si volverían a realizar la intervención. Resultados: La indicación más frecuente de artroscopía para la articulación subastragalina ha sido en nuestra casuística la artrosis (35,71 por ciento). El score AOFAS promedio fue de 88,42 (R=46-100). El 78,58 por ciento de los pacientes estaban satisfechos con el resultado del procedimiento y un 85,72 por ciento volvería a operarse. Tuvimos una complicación de un paciente con hipoestesia del talón (7,14 por ciento). Conclusiones: La artroscopía de la articulación subastragalina es una herramienta diagnóstica y terapéutica segura, reproducible y confiable, exige un conocimiento de la anatomía artroscópica de la región y debe ser llevada a cabo por artroscopistas con experiencia. Diseño del estudio: Serie de casos. Nivel de evidencia: IV.

Localização no calcâneo de linfoma não-Hodgkin B de grandes células primário do osso: relato de caso e revisão de literatura / Calcaneous involvement by primary large B-cell non-Hodgkin's lymphoma of bone: a case report and literature review

Descreve-se, neste artigo, um caso raro de linfoma não-Hodgkin B de grandes células extranodal primário do osso em um paciente de seis anos de idade, do sexo masculino, com manifestaçãoclínica e radiológica inicial em localização não-comum (tálus).

A case of a 6-year-old male primary B-cell non-Hodgkin's lymphoma with lytic bone lesion in an unusual location was demonstrated by clinical and radiologic examination.

Giant cell tumour of talus--a case report.

Giant cell tumour of the talus bone is rare and is usually seen in skeletally mature adults. Here a case of giant cell tumour of the talus in a skeletally immature boy of 15 years is reported. The patient presented with swelling and tenderness of the left ankle with an osteolytic lesion seen in the talus on x-ray. A trephine biopsy followed by left talar excision was done. Following the biopsy report the patient underwent arthotomy and joint clearance. There was no recurrence noted at six months follow-up.

Study of fifty human tali for calcaneal articular facets.

Fifty adult dry human tali from the Department of anatomy, Nepalgunj Medical College Chisapani, were studied. Observations were made on different types of articular facets of calcaneus for the tali. They were classified into four groups and their percentages of incidences were calculated. These findings were well correlated and compared with the literatures available.

Evidence for a new ad sysdrome: report of a large iranin sibship with severe multiple synostosis

An investigation was carried out on a young unrelated couple, both 29 years old, with two boys and three girls, 3 months to 8 years old. One boy and the mother were healthy, the other four children and the father were affected. The family, originally from the district of Nour, in northern Iran, near the Caspian Sea, was first counseled at the Genetic Clinic in Tehran in 1984. Several trips were made to the location in a period of five years, to examine this large family. The major anomalies in this family were brachyphalangia, elbow joint aplasia [humero - radial synostosis, 110 to 140°C], carpal/tarsal synostosis and talus/calcaneus fusion. All affected individuals present a fixation of the feet in supination position and because of partial synostosis [physis] of calcaneus and talus, walked on lateral side with the external cant of the foot. All deformities were studied by clinical examinations and radiological confirmations, on each affected individual

Fraturas do corpo do talo na criança / Fractures of the body of the talus in child

Os autores relatam dois pacientes portadores de fratura do corpo do talo com idades de quatro e seis anos de idade, tratados em seu serviço. Fazem revisäo da literatura e comentam as opçöes de tratamento e as complicaçöes da lesäo.

Ocorrência de os trigonum em crianças normais e assintomáticas / Occurence of os trigonum in normal and assymptomatic children

Os autores realizaram estudo de radiografias na incidência de perfil de 250 crianças clinicamente normais e assintomáticas, igualmente distribuídas quanto ao sexo e de idade entre sete e 13 anos, no intuito de verificar a ocorrência de os trigonum livre ou fundido ao talo (processo de Stieda ou processo trigonal). Em 26,4% dos casos, foram encontrados sinais radiográficos de uma das fases da evoluçäo do os trigonum, que se inicia como um esboço mal definido, passa por uma imagen bem delimitada e arredondada, que a seguir se triangulariza e, por fim, freqüentemente funde-se ao talo. Apesar de poder aparecer mais precocemente em um dos pés, os trigonum foi caracteristicamente bilateral, podendo no entanto ser assimétrico quanto à forma, dimensöes e fusäo com o talo. Por predispor ao aparecimento de patologias nos pés, de poder se confundir com fraturas e em virtude de sua alta freqüência, sua identificaçäo radiográfica assume especial importância