ABSTRACT
A case of chondrosarcoma in 5 years old boy is presented. This type of neoplasm is extremely rare in this age group usually affecting patients in their forties and fifties. The tumor was located in the acetabular part of the ilium, ischial bone and the capsule what, again, is very rare, especially in children. Radiographs were atypical; there were no cloudy calcifications characteristic for malignant chondral tumors. The boy spent 2.5 years in several hospitals with various diagnoses being treated accordingly. The surgery performed was not radical: focal excision of the tumor was done and the capsule was entirely removed. No signs of avascular necrosis and no signs of neoplastic process recurrence were observed during 3 years follow-up.
Subject(s)
Bone Neoplasms/diagnosis , Chondrosarcoma/diagnosis , Ilium/diagnostic imaging , Bone Neoplasms/surgery , Child, Preschool , Chondrosarcoma/surgery , Follow-Up Studies , Humans , Ilium/surgery , Male , Radiography , Remission InductionABSTRACT
Eighteen cases of sclerosing osteomyelitis of the proximal femur in children and adolescent, chiefly boys, have been reported. The lack of local symptoms typical for infection is usually the cause of misdiagnosis and mistreatment. Persistent pain in the hip, especially nocturnal one is clinically characteristic. Unilateral thickening of the cortex at the level of lesser trochanter and below with condensed surrounding bone and sometimes a focus of translucency is found on the radiographs. The treatment should be surgical and "en bloc" resection of the changed bone is compulsory. Results of treatment have been assessed in 17 patients after a mean follow-up of 5 years.
Subject(s)
Femur/diagnostic imaging , Osteomyelitis/diagnosis , Osteomyelitis/surgery , Adolescent , Child , Child, Preschool , Diagnostic Errors , Female , Follow-Up Studies , Humans , Male , Osteosclerosis/diagnosis , Osteosclerosis/surgery , Radiography , Treatment OutcomeABSTRACT
Two hundred ninety-six cases of Perthes' disease with 334 affected hips (38 children had bilateral involvement) were treated by the principle of containment in a "broomstick cast" in abduction and internal rotation, preserved motion in the hip, and continuous traction. Prognostic indicators were recorded, including the age at the onset of the disease, Catterall Group, and risk factors. The mean follow-up period was 8.6 years. The average age at the last examination was 14.1 years (range, six to 25 years). The end results of the treatment were evaluated roentgenographically by the Heyman and Herndon method of quotients. In these 334 treated hips, the results were very good in 216 cases and good in 92 cases (92% very good and good combined), whereas in 23 cases, results were fair and in three, poor (8% fair and poor combined). The results were dependent on the age at the time of diagnosis, the degree of femoral head involvement, and presence of "head at risk," particularly femoral subluxation. The fair and poor results were found in children older than nine years of age, with total head involvement, crushing epiphysis, and presence of risk factors. The results in this study suggest the superiority of treatment in Perthes' disease by a functional method in comparison with the results of treatment by orthosis or femoral osteotomy. This method shortened considerably the time of treatment; the average time was 13 months.
Subject(s)
Casts, Surgical , Legg-Calve-Perthes Disease/therapy , Adolescent , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Legg-Calve-Perthes Disease/diagnostic imaging , Male , Prognosis , Radiography , Risk Factors , TractionABSTRACT
A series of 38 children and juveniles with eosinophilic granuloma located in 44 vertebral bodies was treated. The diagnosis was based on typical radiographic appearance, bone marrow examination and histology in cases where the lesion was surgically resected. Management consisted mainly of immobilization and unloading of the spine for 2-3 years. Since 1972 in order to shorten this period posterior arthrodesis of 3 vertebral bodies in thoracic spine and 2 vertebral bodies in lumbar spine by Albee-Gruca method is performed. Radiotherapy was applied in 1 case. In most of the cases full or partial regeneration of the vertebral body was achieved; the height was restored in 76% on average. The extent of regeneration was higher in younger children and in lumbar and cervical spine possibly because of lordosis in these segments.
Subject(s)
Histiocytosis, Langerhans-Cell/therapy , Spinal Diseases/therapy , Adolescent , Bone Marrow/pathology , Child , Female , Histiocytosis, Langerhans-Cell/diagnosis , Humans , Male , Spinal Diseases/diagnosis , Spinal Fusion/methodsABSTRACT
Osteogenic arthritis of the hip in children depending on the localization of the primary focus of infection can be classified into three types of femoral, acetabular and pelvic origin. These types differ as to the pathology as well as clinical course of the disease. Diagnostics and treatment is discussed. It was found that improper treatment in the early stage led to the chronic form of the disease. Clinical and radiological picture of osteogenic hip arthritis as well as its treatment is discussed on the basis of 125 cases reviewed. Different sequel to osteogenic hip arthritis depending on pathological origin, stage of the disease and method of treatment were pointed out.
Subject(s)
Osteoarthritis, Hip/diagnosis , Adolescent , Child , Female , Humans , Male , Osteoarthritis, Hip/classification , Osteoarthritis, Hip/therapy , Treatment OutcomeABSTRACT
Etiology, pathology, clinical and radiological symptoms, and course of transient synovitis of the hip was discussed on the basis of authors observation of 144 children as well as on literature. It was found that unloading the joint by staying in bed with slightly flexed hip led to subsidence of pain and return of full range of movement in 10 to 21 days. Only in older children the symptoms may persist 4 to 5 weeks. Permanent consequences of transient synovitis of the hip as elongation of the extremity and coxa magna in X-ray pictures are rarely observed. Transient synovitis of the hip seems not to have etiological links with Perthes disease.
Subject(s)
Hip Joint , Synovitis/diagnosis , Adolescent , Child , Child, Preschool , Female , Hip Joint/diagnostic imaging , Hip Joint/physiopathology , Humans , Infant , Male , Radiography , Range of Motion, Articular/physiology , Synovitis/physiopathology , Synovitis/therapyABSTRACT
Clinical and radiological picture as well as pathological classification of non specific hip arthritis in children were presented after reviewing 100 cases and on the base of literature. Different course and sequel of different pathological types of hip arthritis were pointed out with emphasis on suppurative arthritis of the hip. The management of all types of hip arthritis was discussed. The necessity of surgical drainage of the joint in the first 5-7 days of suppurative arthritis as the only measure to prevent irreversible hip destruction was underlined. The method should become popular among pediatric surgeons and pediatricians who are the first ones to take care of a child in the early stage of disease.
Subject(s)
Arthritis/diagnosis , Adolescent , Arthritis/therapy , Arthritis, Infectious/diagnosis , Arthritis, Infectious/therapy , Child , Child, Preschool , Drainage/methods , Female , Humans , Infant , Male , Osteoarthritis, Hip/diagnosis , Osteoarthritis, Hip/therapy , SuppurationABSTRACT
The aim of this paper was to investigate compensation processes of the proximal femoral end in 22 hip joints with II degrees and III degrees epiphyseolysis treated by cross osteotomy of the neck of the femur. After removal of retroversion and in most of the joints inferior displacement by osteotomy, progressive processes of modeling of the proximal femoral end, which recovered the correct outlines of the femoral neck and the axial relations of the head and the neck, were observed. Compensation processes contributed of growth found in some of the cases, due to premature closing of the sub-head epiphyses to improvement of treatment results of epiphyseolysis. On the other hand, disturbances physeal cartilage, made the late evaluation of the joint worse. It has been concluded on the basis of the author's own observations as well as data from literature that the result after surgical treatment of epiphysiolysis depends not only on obtained correction of displacement but also on compensation processes and growth disturbances of the proximal femoral end.
