ABSTRACT
La seudoartrosis congénita de clavícula es una rara malformación de etiología todavía no aclarada. La afectación bilateral es excepcional. Aun siendo una malformación congénita su diagnóstico puede prolongarse hasta avanzada la niñez, presentando los pacientes una deformidad indolora del tercio medio de la clavícula en ausencia de traumatismo previo. El tratamiento es controvertido, y puede ser quirúrgico o no según la repercusión funcional y estética. Presentamos un caso de afectación bilateral y analizamos la bibliografía encontrada al respecto (AU)
Congenital pseudarthrosis of the clavicle is a rare malformation in which the aetiology is still unclear. Bilateral involvement is exceptional. Although it is a congenital malformation, it may not be diagnosed until late childhood, with patients presenting with a painless deformity of the middle third of the clavicle in the absence of prior trauma. The treatment is controversial, and may be surgical, depending on the functional impact and aesthetics. A case of bilateral involvement is presented, together with a review of the relevant literature (AU)
Subject(s)
Humans , Male , Infant , Pseudarthrosis/congenital , Pseudarthrosis/complications , Clavicle/pathology , Clavicle/ultrastructure , Pseudarthrosis/physiopathology , Pseudarthrosis , Diagnosis, DifferentialABSTRACT
Dentro de la estimación forense de la edad, las recomendaciones del AGFAD establecen la práctica de estudios de radiología de la clavícula para el diagnóstico de la edad en la franja entre los 18 y 21 años de edad. Se presenta un estudio sobre una muestra de 123 radiografías digitales de tórax de sujetos entre 5 y 75 años de edad en las que se ha analizado el estado de fusión de la epífisis esternal de la clavícula. En este estudio la edad mínima a la que se ha podido valorar la existencia de un estado de fusión completa (estadios 4 y 5 de Schmeling) ha sido de 19,7 años. Se analiza la bibliografía actualizada sobre este fenómeno y se apuntan una serie de sugerencias adicionales a las propuestas por AGFAD
In 2000 the AGFAD published their recommendations about forensic age estimations. They recommended an X ray of the clavicle (collar bone) in cases of subjects between 18 and 21 years of age. We present a study on stages of fusion of clavicle sternal epiphyses in a 123 digital X-rays from a population sample between 5 and 75 years of age. In our research minimum age at which complete fusion was achived (stages 4 or 5 in Schmeling method) has been 19,7 years of chronological age. A review of the medico legal literature about age estimation based on sternal end of the clavicle has been included. It´s pointed out that forensic experts should bear in mind some suggestions when applying AGFAD recommendations to obtain an age estimation based in clavicle X-rays
Subject(s)
Male , Female , Child , Adolescent , Adult , Middle Aged , Humans , Epiphyses/cytology , Epiphyses/ultrastructure , Clavicle/cytology , Clavicle/ultrastructure , Age Determination by Skeleton/methods , Radiography, Thoracic , Image Processing, Computer-Assisted/methods , Diagnostic Imaging/methods , Anatomy, Comparative/methods , Anatomy, Comparative/trends , Radiation/classificationABSTRACT
Ewing's sarcoma is considered a primary malignant tumor of bone. Histologically, it is characterized by small round cells with poorly delineated borders. Ultrastructural studies reveal large amounts of glycogen aggregated in the undifferentiated cytoplasm of the tumor cells which show variable amount of organelles. The cell membrane shows desmosomes in some cases but not in others. Intercellular argentophylic fibers are by and large absent. In a survey of human sarcomas for the possible presence of viral agents, a sarcoma has been encountered in a 15 year old male originating in the area of the posterior bladder wall and prostate that satisfies morphologic criteria for the diagnosis of Ewing's sarcoma but is extraskeletal in origin. Histology and ultrastructure as well as tissue cultural characteristics of this tumor were studied in comparison with a second patient (age 14) with Ewing's sarcoma originating in the right clavicle. None of the two tumors yielded virus particles in culture.
