RESUMO
Gout is known to occur in a variety of organs but most commonly presents as an inflammatory arthropathy. A few reported cases have documented its occurrence in prosthetic neo-joints or juxta-articular to this. We present the first reported case at a bone prosthesis interface remote from any joint and mimicking sarcoma recurrence because of its unusual location.
Assuntos
Neoplasias Ósseas/cirurgia , Interface Osso-Implante/diagnóstico por imagem , Gota/diagnóstico por imagem , Gota/etiologia , Prótese do Joelho/efeitos adversos , Osteossarcoma/cirurgia , Neoplasias Ósseas/complicações , Neoplasias Ósseas/diagnóstico por imagem , Interface Osso-Implante/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Pessoa de Meia-Idade , Osteossarcoma/complicações , Osteossarcoma/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodosRESUMO
OBJECTIVES: Neurofibromatosis type I (NF1) is a multisystem neurocutaneous disorder with varied musculoskeletal manifestations. Dural ectasia is a known association, whilst pedicular anomalies have been described, although not as frequently as other skeletal manifestations. However, reports of pedicular and other spinal clefts or fractures in combination with dural ectasia in NF1 are scarce. We aimed to identify osseous defects in the posterior elements of NF1 patients with dural ectasia. METHODS: Images of patients with NF1 and back pain were reviewed for osseous defects in the posterior elements. RESULTS: Four patients were identified with NF1, back pain, dural ectasia and bone defects. The imaging appearances of the defects are illustrated. CONCLUSIONS: Defects in the spinal posterior elements of patients with NF1, back pain and dural ectasia may be dysplastic, stress fractures or, most probably, multifactorial in origin. Computed tomography demonstrates these defects most clearly.
Assuntos
Dura-Máter/anormalidades , Dura-Máter/diagnóstico por imagem , Fraturas de Estresse/diagnóstico por imagem , Neurofibromatose 1/complicações , Neurofibromatose 1/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/anormalidades , Adulto , Dor nas Costas , Dilatação Patológica , Feminino , Fraturas de Estresse/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Fraturas da Coluna Vertebral/complicações , Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
The increase in metal-on-metal hip arthroplasties has led to concern regarding the effect of raised serum and tissue metal ion levels. Our aim was to determine changes in the integrity and function of cells of the immune system after exposure to CoCr nanoparticles in specific cell culture experiments. Nanometer-sized particles of CoCr were made from a manufacturer's forged CoCr used for metal-on-metal articulations. Primary, murine dendritic cells and T and B lymphocytes then were exposed to these CoCr particles under cell culture conditions and then assayed for viability and proliferation/activation. CoCr nanoparticles did not directly activate dendritic cells or regulate B cells. Although nanoparticles were not directly toxic to resting T cells, Signals 1- and 2-dependent T cell proliferation were reduced. This may explain the observed reduction in CD8+ T cells observed in patients with metal-on-metal implants.
