ABSTRACT
Osteochondroma is a benign bone tumor that usually affects children and young adults. It is typically located in the metaphysis of long bones around the knee, although it could also affect flat bones like scapula. We report the case of a 11-year-old child with one year of evolution painful tumor at the dorsal surface of the scapula. He was diagnosed with osteochondroma of the scapula, uncommon location for this tumor. Due to the persistence of the symptomatology surgical excision was performed.
El osteocondroma es un tumor óseo benigno que afecta, en general, a niños y adultos jóvenes. Se localiza habitualmente en las metáfisis de los huesos largos alrededor de la rodilla, aunque también puede afectar a huesos planos como la escápula. Se presenta el caso clínico de un niño de 11 años con tumoración dolorosa en la superficie dorsal de la escápula de un año de evolución. Se diagnostica un osteocondroma escapular, localización poco frecuente para este tumor. Debido a la persistencia de la sintomatología, se realizó exéresis quirúrgica.
Subject(s)
Bone Neoplasms , Osteochondroma , Bone Neoplasms/diagnosis , Bone Neoplasms/surgery , Child , Humans , Male , Osteochondroma/diagnostic imaging , Osteochondroma/surgery , Pain , Scapula , Young AdultABSTRACT
El osteocondroma es un tumor óseo benigno que afecta, en general, a niños y adultos jóvenes. Se localiza habitualmente en las metáfisis de los huesos largos alrededor de la rodilla, aunque también puede afectar a huesos planos como la escápula.Se presenta el caso clínico de un niño de 11 años con tumoración dolorosa en la superficie dorsal de la escápula de un año de evolución. Se diagnostica un osteocondroma escapular, localización poco frecuente para este tumor. Debido a la persistencia de la sintomatología, se realizó exéresis quirúrgica
Osteochondroma is a benign bone tumor that usually affects children and young adults. It is typically located in the metaphysis of long bones around the knee, although it could also affect flat bones like scapula. We report the case of a 11-year-old child with one year of evolution painful tumor at the dorsal surface of the scapula. He was diagnosed with osteochondroma of the scapula, uncommon location for this tumor. Due to the persistence of the symptomatology surgical excision was performed.
Subject(s)
Humans , Male , Child , Bone Neoplasms/surgery , Bone Neoplasms/diagnosis , Osteochondroma/surgery , Osteochondroma/diagnostic imaging , Pain , ScapulaABSTRACT
Introducción. La displasia de desarrollo de cadera (DDC) es una patología que abarca desde una sutil displasia acetabular hasta luxaciones de cadera irreductibles. Ampliar el conocimiento sobre la DDC y sus posibilidades terapéuticas puede mejorar los cuidados de estos niños. Para ello, se aporta nuestra experiencia en el complicado cuidado de estos pacientes en nuestro centro hospitalario. Material y métodos. Se realizó un estudio descriptivo retrospectivo mediante la revisión de las historias clínicas de 36 pacientes diagnosticados de DDC y se recogieron datos epidemiológicos, antecedentes personales, clínicos de la exploración física y pruebas complementarias, tipo de tratamiento, complicaciones y resultados. Resultados. La DDC fue más frecuente en niñas (94 %) y la edad media al diagnóstico fue de 15 semanas de vida. Un 61 % se trató de forma conservadora, mientras que el resto requirió cirugía. Las complicaciones más frecuentes del arnés de Pavlik fueron debidas al roce con los tirantes. Hubo dos casos de necrosis avascular de cadera. Las complicaciones más frecuentes de la tracción percutánea y el yeso pelvipédico fueron dermatológicas. En la reducción abierta fue la fiebre y la anemia. Discusión. El tratamiento de la DDC es multidisciplinar e implica la colaboración de distintos profesionales sanitarios. Son precisas un gran número de intervenciones enfermeras en el cuidado de estos pacientes. Conclusiones. Los enfermeros tienen un papel significativo en el cuidado de estos pacientes y es fundamental su asesoramiento y apoyo a los padres de estos niños en tratamiento (AU)
Introduction. Developmental dysplasia of the hip (DDH) includes a wide spectrum of pathologic conditions, ranging from subtle acetabular dysplasia to irreductible hip dislocations. Expanding knowledge about DDH and its therapeutic possibilities can improve care for pediatric patients. We therefore provide our experience in the complicated care of these patients in our hospital. Method. A restrospective descriptive study was performed by means of the review of clinical records of 36 patients diagnosed with DDH. Epidemiological data, medical history, physical examination and additional tests, treatment modalities, complications and results were collected. Results. DDH was more common in girls (94 %) and the mean age at diagnosis was 15-weeks-old babies. 61 % of the cases were treated conservatively, and the rest of the patients were treated by means of surgery. In the case of Pavlik Harness, complications were more frequent due to friction with straps. There were two cases of avascular necrosis of the hip. In cases of percutaneous traction and closed reduction with spica cast, the most frequent complication was dermatological. In the case of open reduction, fever and anemia were the most common complications. Discusion. The treatment of DDH is multidisciplinary and involves the collaboration of different health professionals. A large number of nursing interventions are required in the care of these patients. Conclusions. Nurses have a significant role in the care of DDH patients. Their advise and support of these childrens parents during treatment is essential (AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Hip Dislocation, Congenital/nursing , Bone Diseases, Developmental/nursing , Nursing Process , Retrospective Studies , Orthotic Devices , Home Nursing/educationABSTRACT
STUDY DESIGN: Optical cross-sectional study. PURPOSE: To study the correlation between asymmetry of the back (measured by means of surface topography) and deformity of the spine (quantified by the Cobb angle). OVERVIEW OF LITERATURE: The Cobb angle is considered the gold standard in diagnosis and follow-up of scoliosis but does not correctly characterize the three-dimensional deformity of scoliosis. Furthermore, the exposure to ionizing radiation may cause harmful effects particularly during the growth stage, including breast cancer and other tumors. METHODS: Patients aged 13.15±1.96 years (range, 7-17 years; n=88) with Cobb angle greater than 10° were evaluated with X-rays and our back surface topography method through three variables: axial plane (DHOPI), coronal plane (POTSI), and profile plane (PC). Pearson's correlation was applied to determine the correlation between topographic and radiographic variables. One-way analysis of variance and Bonferroni correction were used to compare groups with different grades of scoliosis. Significance was set at p<0.01 and, in some cases, at p<0.05. RESULTS: We detected a positive, statistically significant correlation between Cobb angle with DHOPI (r=0.810) and POTSI (r=0.629) and between PC variables with thoracic kyphosis angle (r=0.453) and lordosis lumbar angle (r=0.275). In addition, we found statistically significant differences for DHOPI and POTSI variables according to the grade of scoliosis. CONCLUSIONS: Although the back surface topography method cannot substitute for radiographs in the diagnosis of scoliosis, correlations between radiographic and topographic parameters suggest that it offers additional quantitative data that may complement radiologic study.
ABSTRACT
We present the results of the clinical validity in the screening of idiopathic scoliosis with a nonharming method of back surface topography by means of structured light projection. A total of 155 patients were evaluated (mean age 13.3 years). They were divided into two groups: pathologic patients (scoliosis) and nonpathologic patients (control and asymmetries). An analytical case-control study was carried out. Our topographic method obtained 92% sensitivity and 74% specificity as a screening test in identifying patients with scoliosis (P=0.05). We could quantify the vertebral deformity of scoliosis in the three spatial planes by means of three topographic variables, Horizontal Plane Deformity Index, Posterior Trunk Symmetry Index and Columnar Profile, and to elaborate a combined screening algorithm with good reliability parameters.
Subject(s)
Back/diagnostic imaging , Light , Scoliosis/diagnostic imaging , Scoliosis/diagnosis , Adolescent , Algorithms , Case-Control Studies , Child , Female , Humans , Imaging, Three-Dimensional , Male , ROC Curve , Reproducibility of Results , Scattering, Radiation , Sensitivity and Specificity , Spine/diagnostic imaging , Young AdultABSTRACT
Idiopathic scoliosis requires a close follow-up while the patient is skeletally immature to detect early progression. Patients who are monitored by radiographs are exposed to high doses of ionizing radiation. The purpose of this study is to evaluate if an optic noninvasive method of back surface topography based on structured light would be clinically useful in the follow-up of young patients with idiopathic scoliosis. This could reduce the number of radiographs made on these children. Thirty-one patients with idiopathic scoliosis were submitted twice to radiograph and our topographic method at intervals of 6 months to 1 year. Three topographical variables were applied horizontal plane deformity index (DHOPI), posterior trunk symmetry index (POTSI), and columnar profile (PC). A statistically significant correlation was found between variations of Cobb angle with DHOPI (r=0.720, p<0.01) and POTSI (r=0.753, p<0.01) during the monitoring period. Hence, this topographic method could be useful in clinical practice as an objective adjuvant tool in routine follow-up of scoliosis.
