RESUMO
We describe a patient with an aggressive granulomatous lesion around a cementless total hip prosthesis, which simulated a tumor. The granuloma showed a uniform histopathology, which included mononuclear cells and metal wear particles. Aggressive granulomatous lesions in replaced hips are a distinct condition, different from simple loosening or infection; the lesions may grow rapidly, so that revision surgery is indicated soon after diagnosis.
Assuntos
Artroplastia de Quadril , Granuloma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Idoso , Artroplastia de Quadril/instrumentação , Diagnóstico Diferencial , Granuloma/etiologia , Granuloma/cirurgia , Humanos , Masculino , Complicações Pós-OperatóriasRESUMO
Stress fracture of the tibia occurs in individuals who subject their extremities to repeated trauma. They can arise in otherwise healthy bone that is subjected to excessive loads (as in the marathon runner) or in abnormal bone that is subjected to minor loads (as in osteoporosis). These fractures may be anywhere along the tibial shaft and tend to be either transverse or oblique in orientation. We report two cases of stress fracture that ran longitudinally in the distal one third of the tibia. Both patients were healthy and did not describe excessive physical activity prior to fracture. Both describe a repetitive twisting action prior to fracture. Computed tomography was diagnostic in both cases following abnormal bone scans and normal plain radiographs. This unusual pattern of fracture has been reported on only four occasions in five patients in the literature.
Assuntos
Fraturas de Estresse/diagnóstico por imagem , Tíbia/diagnóstico por imagem , Fraturas da Tíbia/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cintilografia , Medronato de Tecnécio Tc 99m , Tomografia Computadorizada por Raios XRESUMO
To evaluate lead exposure in stained glass workers, we measured blood lead levels in 12 professional glass workers, in 5 hobbyists, and in 4 workers' family members. Professional workers lead levels (mean 20.7 micrograms/dl) were higher than hobbyists' (11.6 micrograms/dl) (P = 0.02) or family members' (11.3 micrograms/dl). Levels increased with years worked, hours worked per week, and percentage of work involving lead. The mean lead concentration in settled dust samples from a stained glass workshop was 11,000 parts per million. Stained glass workers are at increased risk of lead exposure.
