Subject(s)
Carpal Bones , Synovitis, Pigmented Villonodular/diagnosis , Wrist Joint , Adult , Arthrodesis , Bone Cysts/complications , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Pain/etiology , Range of Motion, Articular , Synovitis, Pigmented Villonodular/complications , Synovitis, Pigmented Villonodular/physiopathology , Synovitis, Pigmented Villonodular/surgery , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To determine the incidence of bone islands in leprosy patients. DESIGN: X-rays of feet and hands of patients with Hansen's disease (leprosy) were reviewed retrospectively. A second group of related age- and sex-matched patients who did not have Hansen's disease was used for control purposes. Controls had undergone hand and foot X-rays during diagnosis of other pathologies. The patients with Hansen's disease were compared with the control groups, and were also analyzed as subgroups with different types of leprosy. The results were subjected to statistical analysis. PATIENTS: Ninety patients with Hansen's disease were randomly selected for this study. Patients who had had ulcers on hands or feet were excluded from the study. RESULTS AND CONCLUSIONS: Bone islands were demonstrated in 20 patients with Hansen's disease; no bone islands were observed in the controls. This was statistically significant (P < 0.01). Bone islands were only seen in patients with lepromatous leprosy and borderline types but were not demonstrated in patients with tuberculoid leprosy. There was also a statistically significant relationship for a disease duration of 15 years or more. The cause of this raised incidence of enostosis in leprosy patients is not clear, but there may be a genetic predisposition in patients with leprosy, or it may be a side effect of leprosy, especially the lepromatous form.
Subject(s)
Bone Diseases/diagnostic imaging , Leprosy/diagnostic imaging , Adult , Aged , Bone Diseases/pathology , Bone and Bones/diagnostic imaging , Bone and Bones/pathology , Diagnosis, Differential , Female , Humans , Leprosy/pathology , Male , Middle Aged , RadiographyABSTRACT
We performed a neurological and radiological study of the wrists of 58 patients with Hansen's disease and 60 age-matched healthy control subjects. Significant differences (p < 0.01) were found between the groups in the carpal glenoid sector, the radial physeal widening index, the carpal ulnar distance, the carpal index and in distal radio-ulnar discrepancy. Comparison of the results in three subgroups of leprous patients with sensory impairment (group A-1), motor deficit (A-2) and no neurological impairment (A-3), showed significant differences (p < 0.01) between group A-1 and the other two. This suggests that in these patients the changes in the carpus and radiocarpal joint may be caused by neuropathic arthropathy of the wrist. Our findings are of particular interest since there are few reports of neuropathic arthropathy in non-weight-bearing joints.
Subject(s)
Arthropathy, Neurogenic/microbiology , Leprosy/complications , Wrist Joint , Adult , Aged , Anthropometry , Arthropathy, Neurogenic/diagnostic imaging , Arthropathy, Neurogenic/pathology , Case-Control Studies , Female , Humans , Male , Middle Aged , Neurologic Examination , Radiography , Range of Motion, Articular , Weight-BearingABSTRACT
A retrospective study was made of 30 stress fractures in elderly patients engaged in noncompetitive sporting activities, mostly marching and running. Fractures were located exclusively in the lower limbs. In many cases the diagnosis was delayed and in several cases was incorrect because the stress fracture was mistaken for other conditions. Given that the number of senior citizens engaged in active life and sporting activities is constantly growing, physicians should be aware of this type to ensure early diagnosis and appropriate treatment.
