Gorham disease of the spine.

STUDY DESIGN: This is a case report of Gorham disease of the spine with review of the literature. OBJECTIVE: To review the diagnosis, therapy, clinical course, and prognosis of Gorham disease of the spine. SUMMARY OF BACKGROUND DATA: This is the 17th reported case of spinal involvement by this rare type of idiopathic osteolysis. METHODS: The patient was studied with radiographs, nuclear bone scans, computed tomography scans, magnetic resonance scans, and biopsies. His spine was stabilized by posterior and anterior rods, corpectomies, and bone grafts. RESULTS: The patient's spine had remained stable for 22 months after surgery, but intractable chylothoraces and spreading bone destruction were present. CONCLUSIONS: Spinal Gorham disease has high morbidity and mortality, but the course in an individual patient is difficult to predict. Early spinal stabilization should be considered before irreversible neurologic complications occur.

Hypothenar hammer syndrome with embolic occlusion of digital arteries.

Although the hand is highly vascular and subjected to frequent and often repeated trauma, only 52 cases of true aneurysms have been described up to 1982 (Martin and Manktelow, 1982). Of these cases, 60% involved the ulnar artery. These injuries have a distinct tendency to occur in workers who routinely use hammers and screwdrivers, thus it can be considered an occupational disease (Middleton, 1933). A single violent traumatic event is rarely the cause, but rather repeated minor trauma over several months or years appears to be the more common history. A case with arteriographic demonstration of occlusion of the common and proper digital arteries secondary to emboli originating from a traumatic true aneurysm of the ulnar artery is presented.