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1.
Eur J Radiol ; 67(1): 62-7, 2008 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-18337044

RESUMEN

This article presents a systematic review of the current biomedical literature surrounding the aetiopathogenesis and histopathological features of bone marrow oedema, reactive bone change and haemorrhage. Bone marrow oedema is generally demonstrated as a non-specific finding on magnetic resonance imaging in association with infections, tumours and avascular necrosis. When it occurs in isolation as a primary event not triggered by any obvious bony pathology in the clinical setting of debilitating joint pain, it constitutes the "bone marrow oedema syndrome". Although the latter diagnosis is based on magnetic resonance (MR) imaging, showing the lesion as areas of signal hyperintensity within the marrow, recent radiology-histology correlational studies have shown variably interstitial marrow oedema, necrosis, fibrosis and trabecular bone abnormalities. In light of these facts, the use of the term bone marrow oedema syndrome in a radiological context might be considered questionable, but histopathological techniques are not sensitive in detecting increased extracellular fluid. Reactive bone changes may be focal or diffuse and usually amount to increased bone formation. Bone marrow haemorrhage, due to trauma, results in bone bruising, a condition in which the size of the bruise and associated osteochondral injury determines the outcome, although the natural history of these lesions is still being researched.


Asunto(s)
Enfermedades de la Médula Ósea/diagnóstico , Edema/diagnóstico , Hemorragia/patología , Articulación de la Rodilla/patología , Imagen por Resonancia Magnética/métodos , Osteoporosis/diagnóstico , Femenino , Humanos , Masculino , Síndrome
2.
Acta Neurochir (Wien) ; 149(6): 623-7, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17508125

RESUMEN

UNLABELLED: Sacral agenesis is an uncommon condition characterised by total or partial absence of the sacrum. The association of this condition with craniocervical junction abnormalities is extremely rare. CASE REPORT: We describe a 3-year-old girl who, at the age of 8 months, while being investigated for short stature, was found to have significant craniocervical instability associated with anomalies of the odontoid peg. In addition to this she had partial sacral agenesis but genetic tests showed a normal karyotype. Due to the inherent difficulty of surgical fixation and immobilisation in an infant of her age, she was managed conservatively in a soft cervical orthosis. At the age of three years, surgery for decompression and stabilisation was deemed necessary due to the onset of neurological morbidity. CONCLUSION: The authors describe this extremely rare association and discuss the difficulties faced while deciding the optimum surgical strategy for managing such young children with craniocervical instability.


Asunto(s)
Anomalías Múltiples/cirugía , Articulación Atlantoaxoidea/anomalías , Vértebras Cervicales/anomalías , Luxaciones Articulares/congénito , Inestabilidad de la Articulación/congénito , Malformaciones del Sistema Nervioso/cirugía , Apófisis Odontoides/anomalías , Sacro/anomalías , Fusión Vertebral , Anomalías Múltiples/diagnóstico por imagen , Articulación Atlantoaxoidea/patología , Articulación Atlantoaxoidea/cirugía , Trasplante Óseo , Vértebras Cervicales/patología , Vértebras Cervicales/cirugía , Preescolar , Anomalías Craneofaciales/diagnóstico , Descompresión Quirúrgica , Femenino , Estudios de Seguimiento , Humanos , Procesamiento de Imagen Asistido por Computador , Lactante , Luxaciones Articulares/diagnóstico , Luxaciones Articulares/cirugía , Inestabilidad de la Articulación/diagnóstico , Inestabilidad de la Articulación/cirugía , Imagen por Resonancia Magnética , Malformaciones del Sistema Nervioso/diagnóstico , Hueso Occipital/patología , Hueso Occipital/cirugía , Apófisis Odontoides/patología , Apófisis Odontoides/cirugía , Sacro/patología , Compresión de la Médula Espinal/diagnóstico , Compresión de la Médula Espinal/cirugía , Tomografía Computarizada por Rayos X
4.
Knee ; 13(2): 151-7, 2006 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-16338137

RESUMEN

The aim of this in vitro study was to measure and compare the biomechanical properties and mode of failure of the five different methods of meniscal repair. Reproducible tears were created in 50 bovine medial menisci and repaired in a standardized fashion with one of the following devices: the RapidLoc meniscal repair device (Mitek Products, Westwood, MA), an 8 mm Mitek meniscal repair system (Mitek Products, Westwood, MA), Clearfix screw (Innovasive Devices, Marlborough, MA), a single vertical mattress suture of 2-0 Ti-Cron (Ethicon, Massachusetts) and a vertical mattress suture of No. 1 PDS II (Johnson and Johnson Int.). The repairs were tested by single cycle load to failure in a materials testing machine. The mean loads to failure for each of the repair groups were as follows: Mitek RapidLoc 44.9 N, Mitek meniscal repair system 20.3 N, Clearfix screw 37.4 N, vertical Ti-Cron 66.1 N and vertical PDS suture 103.0 N. The mean load to failure was significantly greater with PDS vertical sutures than with other techniques (P<0.05). The Mitek RapidLoc had the least extension at failure (14.8 mm) (P<0.05). This study confirms meniscal repair with vertical PDS sutures confers the highest biomechanical stability and that the new Mitek RapidLoc device offers improved load to failure than the previous generations.


Asunto(s)
Implantes Absorbibles , Meniscos Tibiales/fisiopatología , Meniscos Tibiales/cirugía , Dispositivos de Fijación Ortopédica , Suturas , Animales , Bovinos , Técnicas In Vitro , Ácido Láctico , Ensayo de Materiales , Poliésteres , Polímeros , Polipropilenos , Resistencia a la Tracción/fisiología , Lesiones de Menisco Tibial , Soporte de Peso/fisiología
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