ABSTRACT
Hyperostosis frontalis interna (HFI) is an interesting but still a poor-known phenomenon, which may be found post-mortem. The authors have presented views on the aetiology, pathogenesis and symptomatology of HFI. The usefulness of this abnormality in the identification of sex and age has been pointed out.
Subject(s)
Frontal Bone/pathology , Hyperostosis Frontalis Interna/pathology , Health Status , Humans , Hyperostosis Frontalis Interna/classification , Skull/pathologyABSTRACT
The aim of this study was to recognize the radiological characteristics of hyperostosis frontalis interna (HFI) and to establish a valid and reliable method for its identification and classification. A reliability test was carried out on 27 individuals who had undergone a head computerized tomography (CT) scan. Intra-observer reliability was obtained by examining the images three times, by the same researcher, with a 2-week interval between each sample ranking. The inter-observer test was performed by three independent researchers. A validity test was carried out using two methods for identifying and classifying HFI: 46 cadaver skullcaps were ranked twice via computerized tomography scans and then by direct observation. Reliability and validity were calculated using Kappa test (SPSS 15.0). Reliability tests of ranking HFI via CT scans demonstrated good results (K > 0.7). As for validity, a very good consensus was obtained between the CT and direct observation, when moderate and advanced types of HFI were present (K = 0.82). The suggested classification method for HFI, using CT, demonstrated a sensitivity of 84%, specificity of 90.5%, and positive predictive value of 91.3%. In conclusion, volume rendering is a reliable and valid tool for identifying HFI. The suggested three-scale classification is most suitable for radiological diagnosis of the phenomena. Considering the increasing awareness of HFI as an early indicator of a developing malady, this study may assist radiologists in identifying and classifying the phenomena.
Subject(s)
Hyperostosis Frontalis Interna/diagnostic imaging , Imaging, Three-Dimensional/standards , Tomography, X-Ray Computed/standards , Aged , Aged, 80 and over , Female , Humans , Hyperostosis Frontalis Interna/classification , Male , Observer Variation , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Polyostotic fibrous (McCune-Albright) dysplasia is an uncommon nonhereditable disorder characterized by localized or widespread cystic changes in the skeleton. The limb bones are predominantly affected; craniofacial involvement is rare. We have encountered a severely affected man, with the additional manifestation of massive craniofacial hyperostosis. It is questionable whether this condition is an autonomous entity or represents the end of the spectrum of severity of polyostotic fibrous dysplasia.
Subject(s)
Fibrous Dysplasia of Bone/classification , Fibrous Dysplasia, Polyostotic/classification , Hyperostosis Frontalis Interna/classification , Adult , Fibrous Dysplasia, Polyostotic/diagnosis , Fibrous Dysplasia, Polyostotic/diagnostic imaging , Humans , Hyperostosis Frontalis Interna/diagnosis , Hyperostosis Frontalis Interna/diagnostic imaging , Male , Skull/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
THC is a remodelling process affecting the bones of the neurocranium. CT analysis shows that both the inner and the outer table as well as the diploë can be involved in this process. The term typical hyperostosis cranii (THC) replaces the terms derived from conventional radiography such as nebula frontalis, hyperostosis frontalis interna, etc., as CT shows transitional stages between them. A new type of THC is described. There are morphological similarities between THC and Paget's disease in CT.
