• Title/Summary/Keyword: Pathological fracture

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Foraminal Synovial Cyst Associated with Ankylosing Spondylitis

  • Kim, Heyun-Sung;Ju, Chang-Il;Kim, Seok-Won
    • Journal of Korean Neurosurgical Society
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    • v.50 no.1
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    • pp.54-56
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    • 2011
  • Ankylosing spondylitis (AS) is frequently associated with inflammatory lesions of the spine and continuous fatigue stress fractures; however, an association with an intraspinal synovial cyst has not been previously reported. A 55-year-old man with a five year history of AS who presented with back pain and a right radiculopathy was admitted to the hospital. Five years previously, he underwent a percutaneous vertebroplasty for an osteoporotic L1 compression fracture, and was diagnosed with AS at that time. Plain radiographs showed aggravated kyphosis and a stress fracture through the ossified posterior element, below the prior vertebroplasty. Magnetic resonance images revealed a right foraminal cystic lesion at the L2-L3 level with effacement of the nerve root. A 1.6 cm cystic lesion that appeared to arise from the L2-L3 facet joint without direct communication was excised from the L2-L3 foramen. Pathological examination confirmed synovial cyst. The patient's symptoms resolved immediately after surgery except for a mild dysesthesia of the right leg. We report herein a rare case of foraminal synovial cyst associated with AS accompanying posterior element fracture with a review of literature.

Diagnostic Performance of Diffusion-Weighted Steady-State Free Precession in Differential Diagnosis of Neoplastic and Benign Osteoporotic Vertebral Compression Fractures: Comparison to Diffusion-Weighted Echo-Planar Imaging

  • Shin, Jae Ho;Jeong, Soh Yong;Lim, Jung Hyun;Park, Jeongmi
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.154-161
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    • 2017
  • Purpose: To evaluate the diagnostic performance of diffusion-weighted steady-state free precession (DW-SSFP) in comparison to diffusion-weighted echo-planar imaging (DW-EPI) for differentiating the neoplastic and benign osteoporotic vertebral compression fractures. Materials and Methods: The subjects were 40 patients with recent vertebral compression fractures but no history of vertebroplasty, spine operation, or chemotherapy. They had received 3-Tesla (T) spine magnetic resonance imaging (MRI), including both DW-SSFP and DW-EPI sequences. The 40 patients included 20 with neoplastic vertebral fracture and 20 with benign osteoporotic vertebral fracture. In each fracture lesion, we obtained the signal intensity normalized by the signal intensity of normal bone marrow (SI norm) on DW-SSFP and the apparent diffusion coefficient (ADC) on DW-EPI. The correlation between the SI norm and the ADC in each lesion was analyzed using linear regression. The optimal cut-off values for the diagnosis of neoplastic fracture were determined in each sequence using Youden's J statistics and receiver operating characteristic curve analyses. Results: In the neoplastic fracture, the median SI norm on DW-SSFP was higher and the median ADC on DW-EPI was lower than the benign osteoporotic fracture (5.24 vs. 1.30, P = 0.032, and 0.86 vs. 1.48, P = 0.041, respectively). Inverse linear correlations were evident between SI norm and ADC in both neoplastic and benign osteoporotic fractures (r = -0.45 and -0.61, respectively). The optimal cut-off values for diagnosis of neoplastic fracture were SI norm of 3.0 in DW-SSFP with the sensitivity and specificity of 90.4% (95% confidence interval [CI]: 81.0-99.0) and 95.3% (95% CI: 90.0-100.0), respectively, and ADC of 1.3 in DW-EPI with the sensitivity and specificity of 90.5% (95% CI: 80.0-100.0) and 70.4% (95% CI: 60.0-80.0), respectively. Conclusion: In 3-T MRI, DW-SSFP has comparable sensitivity and specificity to DW-EPI in differentiating the neoplastic vertebral fracture from the benign osteoporotic vertebral fracture.

A Case Report of Integrative Korean Medicine Treatment of a Patient with a Compression Fracture Arising from Metastasis of Prostate Cancer to the Spine (전립선암의 척추전이로 인해 압박골절이 발생한 환자에 대한 한방처치 1례)

  • Kim, Seok-woo;Kim, Soo-yeon;Kim, Dong-woo;Kang, Kyung-rae;Ha, Do-hyung;Kim, Soo-yeon;Oh, Seung-ju;Jin, Dong-eun
    • The Journal of Internal Korean Medicine
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    • v.40 no.5
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    • pp.841-850
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    • 2019
  • Objective: The aim of this study was to report the effects of traditional Korean medicine as a treatment for the pain of a compression fracture in a patient with metastatic prostate cancer. Methods: A 60-year-old male patient with a compression fracture was treated with herbal medicines, acupuncture, and pharmacopuncture for 25 days. His chief complaints were severe low back pain, pain and numbness in both legs, and right groin pain. The effect of treatment was evaluated by the numerical rating scale (NRS) score for pain, the Oswestry Disability Index (ODI) score, and blood test results (CBC-diff count, CRP, ESR, etc.). Results: After 25 days of inpatient treatment, the patient's pain was controlled. The NRS and ODI scores were lower and most pathological symptoms had decreased. Conclusions: Traditional Korean medicine can be a solution for patients with compression fractures arising from metastasis of prostate cancer to the spine.

Epidural Hematoma after Minor Trauma on Patient with Biparietal Osteodystrophy

  • Yilmaz, Muhammet Bahadir;Egemen, Emrah;Ozbakir, Bora;Tekiner, Ayhan
    • Journal of Korean Neurosurgical Society
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    • v.53 no.1
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    • pp.57-58
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    • 2013
  • Thinning of parietal bone bilaterally is extremely rare but well known phenomenon. Approximate prevalence is 0.4-0.5% according to radiological scans, case reports and anthropologic researches. Even though biparietal osteodystrophy occurs mostly in over 60-year-old women, it shows no special association with race or geographical area tendency. Current definition was changed by understanding that is a pathological situation, not an anatomical variety or result of growing old in time. Biparietal osteodystrophy may have an unusual presentation and treatment still remains unclear. We aim to present a patient with biparietal osteodystrophy associated with minor head trauma that caused parietal fracture and epidural hematoma underneath.

구강의 횡문근육종

  • Cho, Han-Kuk;Kim, Hun-Il;Yeuh, In-Haeng;Shin, Mu-Soo
    • The Journal of the Korean dental association
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    • v.12 no.12
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    • pp.913-918
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    • 1974
  • The authors have observed clinically and histopathologically on two cases of rhabdomyosarcomas occurred in the oral cavity. The results were as follow: 1. A case of adult pleomorphic rhabdomyosarcoma, involving the right mandibular third molar area of 52 year old male, revealed pathological fracture of the right mandibular angle area. Microscopically, sections of this tumor showed cross striations by staining of phosphotungstic acid hematoxylin. 2. A case of embryonal alveolar rhabdomyosarcoma, involving the right buccal area of one year and ten months old female, revealed severe bone destruction on the right mandibular body area. Microscopically, sections of this tumor did not show cross striations.

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Full mouth rehabilitation with vertical dimension increase in patient with severly worn dentition (과도한 치아 마모를 보이는 환자에서 수직고경 증가를 동반한 전악 구강 회복 증례)

  • Jo, Wi-Sang;Kim, Seong-A;Kim, Sung-Yong;Bang, Joo-Hyuk
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.1
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    • pp.107-115
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    • 2021
  • Excessive pathological attrition over the entire dentition can cause decreased masticatory function, and pathological problems of the temporomandibular joint and the muscular nervous system. In this case, 71 year-old male patient with severe attrition and fracture across the entire tooth was treated by full mouth rehabilitation for regaining space of restoration. In order to determine the appropriate vertical dimension of the patient's occlusion, facial appearance, aesthetics, restoration space were evaluated, and provisional restoration of the raised vertical dimension was made. After 4 months of evaluation, the entire restoration of monolithic zirconia crown using CAD-CAM was completed. Through the above process, satisfactory aesthetic and functional results were obtained.

Full mouth rehabilitation on the patient with severe tooth wear and tooth fracture using reestabilishment of occlusal vertical dimension (심한 치아 마모 및 파절 환자의 수직고경거상을 동반한 전악 수복 증례)

  • Lee, Ho-Sun;Joo, Se-Jin;Jin, Soo-Yoon;Kang, Dong-Wan;Lee, Gyeong-Je
    • Journal of Dental Rehabilitation and Applied Science
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    • v.32 no.3
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    • pp.224-231
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    • 2016
  • Severe dental attrition causes pathological changes of the tooth, imbalanced occlusion, and functional and aesthetic complications and can also result in a decrease in occlusal vertical dimension that can incur temporomandibular joint and muscular complications. Before restoring the vertical dimension with full-mouth prosthetic restorations, it is important to determine the amount of vertical lifting through complete diagnosis. In this study, a 59 year-old male patient with generalized attrition and fracture of teeth was treated with full-mouth zirconia prosthetic restoration in order to recover vertical dimension and aesthetics. Through the analysis of physiologic rest position and inter-canine distance, the treatment was planned for lifting 3 mm in vertical dimension. Interim crown were fabricated after full-mouth wax up, having the patient use for 6 months. The final monolithic and bilayered zirconia restorations were completed. The patient showed satisfaction in function and aesthetics for 18 months of follow-up since delivering the final restorations.

ADENOID CYSTIC CARCINOMA OF THE MANDIBLE (하악골에 발생한 Adenoid cystic carcinoma의 증예보고)

  • Shin, Mu-Soo;Kim, Hyun-Pung;Kim, Zi-Soo;Yuh, In-Haeng;Chang, Hyong-Rhok;Chung, Ki-Kun
    • The Journal of the Korean dental association
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    • v.10 no.4
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    • pp.241-245
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    • 1972
  • The authors have observed a case of adenold cystic carcinoma occured in molar portion of the left mandible in 59-year old woman. The results are as follows: 1. Roentgenographic findings revealed pathological fracture of the left mandibular body. 2. The patient complained of burning sensation of tongue and facial dull pain. 3. Microscopically, in the portion of glandular arrangoment of tumor cells, the mucinous materials were contained, and the mitotic figures of tumor cells did not appear in this case, and the stromal connective tissue revealed hyaline degeneration and myxomatous degeneration. 4. The tumor cells were infiltrated not only perinoural lymphatics, but also perineurum and intraneura tissue.

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Treatment of Facial Palsy in Hyangsang Medicine (구안와사(口眼喎斜)의 형상의학적 치료)

  • Kang Kyung Hwa;yeon Jong Won;Lee Yong Tae
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.6
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    • pp.1585-1597
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    • 2004
  • Facial palsy is a common disease in clinic, which can be classified into central and peripheral according to the causes. The central facial palsy is caused by cerebral vascular accident, brain tumor, etc. The peripheral facial palsy comes from cold stimulus on face, regional infection of virus, suppurative tympanitis, inflammation on mastoid process, pathological teeth, trauma like cranial fracture, and so forth, They have distinctive features in diagnosis. While the central facial palsy is followed by hemiplegia and articulation disorder, the peripheral one by the disappearance of wrinkles on the forehead and rising of eyeball on paralyzed side when closing the eyes. Most of the cases in this thesis are peripheral palsy. The social classes and ages of the patients are so various that the treatments must be applied from various standpoints. The statistical data shows that the functional weakness of the whole body is the fundamental condition of the facial palsy. Therefore it is very important to find and the exact pathology and treatment appropriate for Hyungsang of the patients.

Undifferentiated pleomorphic sarcoma of the mandible

  • Benites, Bernar Monteiro;Miranda-Silva, Wanessa;Fonseca, Felipe Paiva;Oliveira, Claudia Regina Gomes Cardim Mendes de;Fregnani, Eduardo Rodrigues
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.4
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    • pp.282-287
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    • 2020
  • Undifferentiated pleomorphic sarcoma (UPS) is a high-grade neoplasm that is usually located in the extremities and retroperitoneum. In the past, UPS was considered the most common soft tissue sarcoma in adults; due to improvements in diagnostic techniques, most cases have been reclassified as other lineage-specific tumors. Gnathic bones are rarely affected, and the clinicopathological characteristics of this neoplasm when diagnosed in the jaw remain to be better described. In this report, we present a rare case of mandibular UPS affecting an 88-year-old female who demonstrated a painful swelling on the right side of the mandible that was accompanied by a pathological fracture. Microscopic examination revealed a pleomorphic spindle-cell neoplasm with mitotic figures and necrosis. The patient underwent surgery and adjuvant radiotherapy but experienced metastasis after 12 months of follow-up and died. Diagnosis of UPS is challenging, and oral pathologists must be aware of this entity when dealing with aggressive undifferentiated neoplasms.