ABSTRACT
Osteosarcoma is the most frequent malignant bone neoplasm, followed by chondrosarcoma and Ewing sarcoma. The diagnosis of bone neoplasms is generally made through histological evaluation of a biopsy. Clinical and radiological features are also important in aiding diagnosis and to complete the staging of bone cancer. In addition to these, there are several non-specific serological or specific molecular markers for bone neoplasms. In bone tumors, molecular markers increase the accuracy of the diagnosis and assist in subtyping bone tumors. Here, we review these markers and discuss their role in the diagnosis and prognosis of the three most frequent malignant bone neoplasms, namely osteosarcoma, chondrosarcoma, and Ewing sarcoma.
ABSTRACT
BACKGROUND: Developmental dysplasia of the hip is an anomaly of the hip joint. In patients with early diagnosis, within 3 to 6 months of life, the treatment is essentially conservative and involves the use of dynamic harness. The indication for the use of the Tubingen hip flexion splint is a dysplastic hip. The aim of this study is to report the experience of the Orthopaedic Clinic of the "University of Catania" regarding conservative treatment with the Tubingen harness of dysplastic hips diagnosed in children within 3 months of life. METHODS: From January 1997 to July 2012, 5137 infants (10,274 hips) aged within 3 months of life were submitted to ultrasonographic hip assessment. Start, duration of treatment, and outcome were investigated. RESULTS: A total of 351 (6.83%) patients affected by developmental dysplasia of the hip for a total of 544 dysplastic hips (5.3%) were treated with the Tubingen hip flexion splint. Treatment was started on average 39 days of life. Harness were dressed for 24 hours a day and applied for a mean of 3.8 months. Mean follow-up was 6.4 years (range, 2.2 to 14 y). We obtained the following results: 482 (90.44%) dysplastic, unstable, or dislocated hips were successfully converted into type I hips with an α-angle of >64 degrees in the splint. Complications were reported in 3 (0.55%) hips.No statistically significant relationship was found between the duration of therapy and the time when treatment was started, early or late within the first week of life (P=0.152). CONCLUSIONS: Dysplastic, unstable, and dislocated hips can be successfully treated with the Tubingen hip flexion splint, reporting good clinical and ultrasonographic outcomes.
Subject(s)
Hip Dislocation, Congenital , Hip Joint , Splints , Early Diagnosis , Female , Hip Dislocation, Congenital/diagnosis , Hip Dislocation, Congenital/therapy , Hip Joint/diagnostic imaging , Hip Joint/physiopathology , Humans , Infant , Infant, Newborn , Male , Orthotic Devices , Range of Motion, Articular , Treatment Outcome , UltrasonographyABSTRACT
BACKGROUND: Data from the literature regarding the clinical profile of growing pains are limited. The purpose of this study was to define the clinical features, familial history, laboratory findings, and therapeutic outcome of growing pains in children. METHODS: Thirty children (18 male and 12 female; 3 to 14 y of age) who presented with growing pains between January 2006 and December 2007 were enrolled and prospectively followed up for 1 year. The inclusion criterion was lower extremity pain, which was recurrent and lasted for >3 months. The exclusion criteria were any abnormal systemic or local symptoms and signs, joint involvement, and limp or limitation of activity. Laboratory tests, including complete blood count, erythrocyte sedimentation rate, and serum calcium and phosphorus levels, were performed in all children. RESULTS: The study group had pain during the night and afternoon in 43.3% and 56.7% of cases, respectively. Both lower limbs were involved in 80% of cases, causing awakening and crying episodes in 40% and 37% of cases, respectively. The frequency of pain was as follows: daily, 5%; weekly, 45%; monthly, 35%; and every 3 months, 15%. The pains were relieved by massaging the affected site in 95% of cases and by analgesics in 5% of children. A family history of growing pains was positive in 20% of patients. All patients had laboratory tests within normal values. CONCLUSION: Growing pain is a frequent noninflammatory syndrome consisting of intermittent, often annoying, pains that affect the lower extremities of children. Clinical diagnosis is easy if precise inclusion and exclusion criteria in the history and physical examinations are strictly followed. Patients and family reassurance is mandatory. LEVEL OF EVIDENCE: This is a Level I prospective study.
Subject(s)
Musculoskeletal Diseases/complications , Pain/etiology , Adolescent , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Incidence , Italy/epidemiology , Male , Musculoskeletal Diseases/diagnosis , Pain/diagnosis , Pain/epidemiology , Pain Measurement , Retrospective Studies , Severity of Illness IndexABSTRACT
Despite significant advances in intraoperative antimicrobial procedures, deep infection remains the most devastating complication following total joint arthroplasty. Clinical studies' results and safety profile of antibiotic-loaded bone cement are discussed in this review. Antibiotic bone cement prophylaxis is a safe and effective strategy in reducing the risk of deep infection following primary total joint arthroplasty.
