Stress fracture of the palmar, distal cortex of the third metacarpal bone: A diagnostic challenge with a good prognosis

2021 ◽  
Author(s):  
Ran Shan ◽  
Anna S. Johnston ◽  
Sarah M. Rosanowski ◽  
John O'Shea ◽  
Christopher M. Riggs
Keyword(s):  
Stress Fracture ◽  
Good Prognosis ◽  
Metacarpal Bone ◽  
Diagnostic Challenge ◽  
The Third

scholarly journals Increased sclerostin associated with stress fracture of the third metacarpal bone in the Thoroughbred racehorse

2018 ◽  
Vol 7 (1) ◽  
pp. 94-102
Author(s):  
N. Hopper ◽  
E. Singer ◽  
F. Henson
Keyword(s):  
Stress Fracture ◽  
Cathepsin K ◽  
Metacarpal Bone ◽  
Apoptotic Cells ◽  
Contralateral Limb ◽  
Fracture Group ◽  
Osteocyte Apoptosis ◽  
The Third ◽  
Thoroughbred Racehorses ◽  
Osteocytic Osteolysis

Objectives The exact aetiology and pathogenesis of microdamage-induced long bone fractures remain unknown. These fractures are likely to be the result of inadequate bone remodelling in response to damage. This study aims to identify an association of osteocyte apoptosis, the presence of osteocytic osteolysis, and any alterations in sclerostin expression with a fracture of the third metacarpal (Mc-III) bone of Thoroughbred racehorses. Methods A total of 30 Mc-III bones were obtained; ten bones were fractured during racing, ten were from the contralateral limb, and ten were from control horses. Each Mc-III bone was divided into a fracture site, condyle, condylar groove, and sagittal ridge. Microcracks and diffuse microdamage were quantified. Apoptotic osteocytes were measured using TUNEL staining. Cathepsin K, matrix metalloproteinase-13 (MMP-13), HtrA1, and sclerostin expression were analyzed. Results In the fracture group, microdamage was elevated 38.9% (sd 2.6) compared with controls. There was no difference in the osteocyte number and the percentage of apoptotic cells between contralateral limb and unraced control; however, there were significantly fewer apoptotic cells in fractured samples (p < 0.02). Immunohistochemistry showed that in deep zones of the fractured samples, sclerostin expression was significantly higher (p < 0.03) than the total number of osteocytes. No increase in cathepsin K, MMP-13, or HtrA1 was present. Conclusion There is increased microdamage in Mc-III bones that have fractured during racing. In this study, this is not associated with osteocyte apoptosis or osteocytic osteolysis. The finding of increased sclerostin in the region of the fracture suggests that this protein may be playing a key role in the regulation of bone microdamage during stress adaptation. Cite this article: N. Hopper, E. Singer, F. Henson. Increased sclerostin associated with stress fracture of the third metacarpal bone in the Thoroughbred racehorse. Bone Joint Res 2018;7:94–102. DOI: 10.1302/2046-3758.71.BJR-2016-0202.R4.

scholarly journals IgG4-related intracranial disease

2018 ◽  
Vol 32 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Shahine Goulam-Houssein ◽  
Jeffrey L Grenville ◽  
Katerina Mastrocostas ◽  
David G Munoz ◽  
Amy Lin ◽  
...  
Keyword(s):  
Plasma Cells ◽  
Surgical Intervention ◽  
Case Series ◽  
Hypertrophic Pachymeningitis ◽  
Diagnostic Challenge ◽  
Perineural Spread ◽  
Related Disease ◽  
The Third ◽  
Igg4 Related Disease ◽  
Intracranial Involvement

IgG4-related disease (IgG4-RD) is a multi-organ chronic inflammatory process caused by infiltration of IgG4-positive plasma cells in one or more organs. Intracranial involvement has only recently become better recognized. Our case series adds to the growing literature on the varying presentations of intracranial IgG4 by describing the clinical and imaging findings of three patients who presented to our institution with intracranial involvement. Our first patient presented with a mass-forming IgG4 pachymeningitis mimicking a sphenoid wing meningioma, which is to our knowledge the largest mass-forming pachymeningitis published in the literature. Our second case depicts another presentation of extensive IgG4 pachymeningitis involving both cavernous sinuses and surrounding Meckel’s caves. The third case describes a patient with presumed lymphocytic hypophysitis, which was later determined to be IgG4-related hypophysitis with concomitant pachymeningitis and perineural spread along the optic nerves. The delayed diagnoses in our cases illustrates the diagnostic challenge that clinicians face in differentiating intracranial IgG4-RD from other infiltrative diseases such as sarcoidosis, granulomatous disease, tuberculosis and lymphoma. Earlier consideration of IgG4-related hypophysitis and hypertrophic pachymeningitis in the differential diagnosis can prevent significant morbidity including unnecessary surgical intervention and organ failure secondary to extensive fibrosis.

scholarly journals Benign Osteoblastoma Involving Maxilla: A Case Report and Review of the Literature

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
K. Bokhari ◽  
M. S. Hameed ◽  
M. Ajmal ◽  
Rafi A. Togoo
Keyword(s):  
Case Report ◽  
Surgical Excision ◽  
Good Prognosis ◽  
Histopathological Diagnosis ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Long Term Follow Up ◽  
Rare Benign Tumor ◽  
Benign Osteoblastoma ◽  
Maxilla And Mandible

Background. Osteoblastoma is a rare benign tumor. This tumor is characterized by osteoid and bone formation with the presence of numerous osteoblasts. The lesion is more frequently seen in long bones and rarely involves maxilla and mandible. Due to its clinical and histological similarity with other bone tumors such as osteoid osteoma and fibro-osseous lesions, osteoblastoma presents a diagnostic dilemma.Case Report. Very few cases of osteoblastomas involving maxillofacial region have been reported in the literature. This case report involves osteoblastoma involving right maxilla in an 18-year-old male patient. Following detailed clinical examination, radiological interpretation, and histopathological diagnosis, surgical excision was performed. The patient was followed up for a period of 3 years and was disease free.Summary and Conclusion. Benign osteoblastoma involving jaw bones is a rare tumor. There is a close resemblance of this tumor with other lesions such as fibro-osseous lesions and odontogenic tumors and thus faces a diagnostic challenge. Surgical excision with a long-term follow-up gives good prognosis to this lesion—Benign Osteoblastoma.

scholarly journals Intraocular Tuberculosis

2013 ◽  
Vol 47 (4) ◽  
pp. 193-201 ◽  
Author(s):  
Swapnil Parchand ◽  
Vishali Gupta
Keyword(s):  
Diagnostic Tests ◽  
Early Stage ◽  
Specific Treatment ◽  
Good Prognosis ◽  
Molecular Diagnostic ◽  
Interferon Gamma Release Assay ◽  
Diagnostic Challenge ◽  
Global Epidemiology ◽  
Tuberculosis Therapy ◽  
Intraocular Tuberculosis

ABSTRACT Intraocular tuberculosis remains a major diagnostic challenge and it is extremely important to establish the diagnosis as the specific treatment helps in reducing the recurrences, thus reducing ocular morbidity. The present review aims to describe the global epidemiology and pathogenesis of intraocular tuberculosis with clinical spectrum and different presentations. The challenges in establishing the diagnosis with role of conventional tests like PPD skin test as well as current diagnostic tests including interferon gamma release assay and molecular diagnostic tests are discussed. The treatment requires anti-tuberculosis therapy with the use of concomitant corticosteroids and carries good prognosis provided the treatment is started in the early stage. How to cite this article Parchand S, Gupta V, Gupta A, Sharma A. Intraocular Tuberculosis. J Postgrad Med Edu Res 2013;47(4):193-201.

In vitro assessment of the motion of equine proximal sesamoid bones relative to the third metacarpal bone under physiologic midstance loads

2021 ◽  
Vol 82 (3) ◽  
pp. 198-206
Author(s):  
Sarah K. Shaffer ◽  
Natalia Sachs ◽  
Tanya C. Garcia ◽  
David P. Fyhrie ◽  
Susan M. Stover
Keyword(s):  
Metacarpal Bone ◽  
The Third ◽  
Sesamoid Bones ◽  
In Vitro Assessment

The stepped hybrid plate for carpal panarthrodesis

2009 ◽  
Vol 22 (05) ◽  
pp. 389-397 ◽  
Author(s):  
M. C. Díaz-Bertrana ◽  
F. Darnaculleta ◽  
J. Franch ◽  
J. L. Puchol ◽  
I. Durall
Keyword(s):  
Bone Tumour ◽  
Degenerative Joint Disease ◽  
Metacarpal Bone ◽  
Joint Disease ◽  
Incomplete Fusion ◽  
Carpal Bone ◽  
Low Grade ◽  
Screw Insertion ◽  
The Third ◽  
Metacarpal Bones

SummaryFifty-two carpal panarthrodeses (CP) were carried out in 44 dogs (eight bilateral), in a multicentre study using a single (n = 47) or double (n = 5) stepped hybrid CP plate. Of these 44 cases, 39 were between 20–55 kg in bodyweight , 26 were males , and the carpometacarpal was the most common joint involved. Falling and other impact trauma were the most common aetiology. Pain of unknown origin, carpal luxation, chronic accessory carpal bone fracture, distal comminuted intra-articular radial fracture, bone tumour, degenerative joint disease, canine erosive idiopathic polyarthritis, avascular necrosis of the radial carpal bone and fractures of several metacarpal bones were some of the pathologies reported. Fracture of the third metacarpal bone during screw insertion was the only intrasurgical complication. Malpositioning of the plate or screws and over-tightened screws were technical errors observed in seven of the procedures. The radial carpal bone was not fixed with a screw in two cases due to bone deformity. Concurrent plate breakage and bending in the same patient operated on bilaterally was observed during the follow-up period, which represented a major complication rate of 3.8% for all procedures. Minor complications were: low grade infection, lick granuloma, digit hyperextension, screw loosening or failure, incomplete fusion of some joints and a fracture of the third metacarpal bone at the distal screw hole of the plate; which represented a rate of 44.2% on all procedures. Complete carpal healing was observed radiographically in 94.2% of all procedures. Limb function was excellent to good, and all of the owners, except for one, were satisfied with the procedure.

Lag screw fixation of dorsal cortical stress fractures of the third metacarpal bone in 116 racehorses

2010 ◽  
Vol 42 (7) ◽  
pp. 586-590 ◽  
Author(s):  
S. L. JALIM ◽  
C. W. McILWRAITH ◽  
N. L. GOODMAN ◽  
G. A. ANDERSON
Keyword(s):  
Screw Fixation ◽  
Metacarpal Bone ◽  
Stress Fractures ◽  
The Third ◽  
Lag Screw
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