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Epiphysitis of the femoral head

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https://www.readbyqxmd.com/read/29137619/percutaneous-medial-hemi-epiphysiodesis-using-a-transphyseal-screw-for-caput-valgum-associated-with-developmental-dysplasia-of-the-hip
#1
Chang Ho Shin, Wan Kee Hong, Doo Jae Lee, Won Joon Yoo, In Ho Choi, Tae-Joon Cho
BACKGROUND: The purpose of this study was to evaluate the radiologic outcome of percutaneous medial hemi-epiphysiodesis using a transphyseal screw for the management of caput valgum associated with developmental dysplasia of the hip (DDH). METHODS: Eighteen hips (18 patients) having caput valgum treated with screw hemi-epiphysiodesis were followed for more than 2 years, and were included in this study. The mean age at the time of the index operation was 8.3 years (range, 4...
November 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28925593/fine-needle-aspiration-biopsy-diagnosis-of-primary-clear-cell-chondrosarcoma-a-case-report
#2
Kelsey E McHugh, Cynthia L Emory, Graham E Parks, Scott E Kilpatrick
Clear cell chondrosarcoma is a rare chondrosarcoma variant often involving the long bone epiphyses of young to middle aged adults. We report herein a case involving the left femoral head in a 25-year-old female with a 3-month history of worsening left hip pain. Radiographs revealed a complex, multifocal and lytic lesion centered in the left proximal femoral epiphysis with involvement of the femoral neck. Computed tomography-guided fine needle aspiration biopsy with concomitant core needle biopsy was performed, and a diagnosis of clear cell chondrosarcoma was rendered...
September 19, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28798039/physical-activity-during-adolescence-and-the-development-of-cam-morphology-a-cross-sectional-cohort-study-of-210-individuals
#3
Antony Palmer, Scott Fernquest, Mo Gimpel, Richard Birchall, Andrew Judge, John Broomfield, Julia Newton, Mark Wotherspoon, Andrew Carr, Sion Glyn-Jones
INTRODUCTION: Cam morphology is a strong risk factor for the development of hip pain and osteoarthritis. It is increasingly thought to develop in association with intense physical activity during youth; however, the aetiology remains uncertain. The study aim was to characterise the effect of physical activity on morphological hip development during adolescence. METHODS: Cross-sectional study of individuals aged 9-18 years recruited from Southampton Football Club Academy (103 male) with an age-matched control population (52 males and 55 females)...
August 10, 2017: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/28552677/a-long-term-follow-up-study-of-the-development-of-hip-disease-in-mucopolysaccharidosis-type-vi
#4
Esmee Oussoren, Johannes H J M Bessems, Virginie Pollet, Jan C van der Meijden, Lianne J van der Giessen, Iris Plug, Annick S Devos, George J G Ruijter, Ans T van der Ploeg, Mirjam Langeveld
Hip problems in Mucopolysaccharidosis type VI (MPS VI) lead to severe disability. Lack of data on the course of hip disease in MPS VI make decisions regarding necessity, timing and type of surgical intervention difficult. We therefore studied the development of hip pathology in MPS VI patients over time. Data were collected as part of a prospective follow-up study. Standardized supine AP pelvis and frog leg lateral radiographs of both hips were performed yearly or every 2years. Image assessment was performed quantitatively (angle measurements) and qualitatively (hip morphology)...
May 19, 2017: Molecular Genetics and Metabolism
https://www.readbyqxmd.com/read/28529663/the-modified-dunn-procedure-for-slipped-capital-femoral-epiphysis-the-bernese-experience
#5
M Tannast, L M Jost, T D Lerch, F Schmaranzer, K Ziebarth, K A Siebenrock
PURPOSE: Based on previous investigations on the vascular blood supply to the femoral head, a technique for anatomical reduction after slipped capital femoral epiphysis was developed. This technique is a modification of the original technique by Dunn using a retinacular soft-tissue flap. This allows the visual control of the epiphyseal vascular blood supply. We report the experience at the inventor's institution with a critical discussion of the available literature. METHODS: Using a trochanteric osteotomy for surgical dislocation of the hip, a retinacular soft tissue flap is created containing the deep branch of the medial femoral circumflex artery, the external rotators and the capsule...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28434011/management-of-coxa-vara-septica-and-pseudoarthrosis-of-the-femoral-neck-a-case-report
#6
Hasime Qorraj Bytyqi, Cen Bytyqi
BACKGROUND Coxa vara and pseudoarthrosis of the femoral neck after septic hip arthritis is a very rare disease. The aim of this study was to present a case with pseudoarthrosis of the femoral neck, with coxa vara after neonatal septic arthritis of the right hip, and treatment of the pseudarthrosis with proximal femoral valgus osteotomy. CASE REPORT A 12-month-old female, who had suffered neonatal septic arthritis with a five-day history of fever and painful right hip now demonstrated painless limping to the right hip, pelvic obliquity, Trendelenburg-Duchenne gait, limitation of hip abduction, lower-extremity length discrepancy with 3...
April 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28334547/origin-of-cam-morphology-in-femoroacetabular-impingement
#7
William Z Morris, Ryan T Li, Raymond W Liu, Michael J Salata, James E Voos
Cam morphology of the proximal femur is an abnormal contour of the femoral head-neck junction present in approximately 15% to 25% of the asymptomatic population, predominantly in males. Alpha angle and femoral head-neck offset ratio are 2 objective measurement tools that define cam morphology. Both primary (idiopathic) and secondary cam deformity develops through distinct mechanisms. The cause of primary (idiopathic) cam morphology remains incompletely understood. Mounting evidence suggests that idiopathic cam morphology develops during adolescence through alterations in the capital femoral epiphysis in response to participation in vigorous sporting activity...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28316857/progressive-pseudorheumatoid-dysplasia-or-jia
#8
Geetha Wickrematilake
Progressive pseudorheumatoid dysplasia (PPD) or spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA) is a rare arthropathy of childhood involving the axial skeleton as well as small peripheral joints. A 10-year-old boy was referred by a general practitioner with pain and deformity in the fingers of hands and limping gait. There was no joint synovitis although the finger joints were bulky on examination with mild flexion deformity. Patient had exaggerated kyphosis and lumbar lordosis with pigeon chest and restricted hip joint movements...
2017: Case Reports in Rheumatology
https://www.readbyqxmd.com/read/28315184/epiphyseal-arterial-network-and-inferior-retinacular-artery-seem-critical-to-femoral-head-perfusion-in-adults-with-femoral-neck-fractures
#9
Dewei Zhao, Xing Qiu, Benjie Wang, Zihua Wang, Wei Wang, Jun Ouyang, Rona M Silva, Xiaotian Shi, Kai Kang, Dachuan Xu, Chuang Li, Shizhen Zhong, Yu Zhang, Kent E Pinkerton
BACKGROUND: A better understanding of the blood supply of the femoral head is essential to guide therapeutic strategies for patients with femoral neck fractures. However, because of the limitations of conventional techniques, the precise distribution and characteristics of intraosseous arteries of the femoral head are not well displayed. QUESTIONS/PURPOSES: To explore the characteristics and interconnections of the intraosseous vessel system between different areas of the femoral head and the possible blood supply compensatory mechanism after femoral neck fracture...
August 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28288077/comparison-of-surgical-outcomes-between-a-triplane-proximal-femoral-osteotomy-and-the-modified-dunn-procedure-for-stable-moderate-to-severe-slipped-capital-femoral-epiphysis
#10
Jakub Sikora-Klak, James D Bomar, Christina N Paik, Dennis R Wenger, Vidyadhar Upasani
BACKGROUND: Recent studies have demonstrated the intra-articular cartilage and labral damage that can occur from the proximal femoral cam-like deformity of a moderate to severe slipped capital femoral epiphysis (SCFE). The approach to treating this deformity in a symptomatic Loder stable hip is controversial. The purpose of this study was to compare radiographic outcomes, complication rates, and revision rates between Imhauser type triplane proximal femoral osteotomy (TPFO) and the modified Dunn procedure (MDP)...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28194709/high-survivorship-and-little-osteoarthritis-at-10-year-followup-in-scfe-patients-treated-with-a-modified-dunn-procedure
#11
Kai Ziebarth, Milan Milosevic, Till D Lerch, Simon D Steppacher, Theddy Slongo, Klaus A Siebenrock
BACKGROUND: The modified Dunn procedure has the potential to restore the anatomy in hips with slipped capital femoral epiphyses (SCFE) while protecting the blood supply to the femoral head and minimizing secondary impingement deformities. However, there is controversy about the risks associated with the procedure and mid- to long-term data on clinical outcomes, reoperations, and complications are sparse. QUESTIONS/PURPOSES: Among patients treated with a modified Dunn procedure for SCFE, we report on (1) hip pain and function as measured by the Merle d'Aubigné and Postel score, Drehmann sign, anterior impingement test, limp, and ROM; (2) the cumulative survivorship at minimum 10-year followup with endpoints of osteoarthritis (OA) progression (at least one Tönnis grade), subsequent THA, or a Merle d'Aubigné and Postel score < 15; (3) radiographic anatomy of the proximal femur measured by slip angle, α angle, Klein line, and sphericity index; and (4) the risk of subsequent surgery and complications...
April 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28040082/the-physiopathology-of-avascular-necrosis-of-the-femoral-head-an-update
#12
REVIEW
Enrique Guerado, Enrique Caso
The physiopathology of the femoral head bone necrosis is similar for children and for adults. The disease is characterized by apoptosis of bone cells - bone marrow and bone forming cells-resulting in head collapse with a subsequent lesion of the overlying cartilage, and therefore flattening of the rounded surface shape of the head articulating with the acetabulum, provoking, eventually, secondary osteoarthritis. When the disease becomes clinically evident already destructive phenomena have occurred and collapse will eventually ensue...
December 2016: Injury
https://www.readbyqxmd.com/read/27935852/three-cases-of-japanese-acromicric-geleophysic-dysplasia-with-fbn1-mutations-a-comparison-of-clinical-and-radiological-features
#13
COMPARATIVE STUDY
Kosei Hasegawa, Chikahiko Numakura, Hiroyuki Tanaka, Mahoko Furujo, Toshihide Kubo, Yousuke Higuchi, Miho Yamashita, Hirokazu Tsukahara
Acromicric dysplasia (AD) and geleophysic dysplasia (GD) are rare skeletal dysplasias characterized by short stature, acromelia, joint contracture, hepatomegaly, hoarseness and respiratory distress. Compared with GD, AD presents with milder clinical and radiological features. Radiological findings of AD and GD consist of shortened tubular bones of the hands and feet, and deformed capital femoral epiphyses. The genetic cause of AD and some cases of GD was shown to be mutations in the transforming growth factor (TGF) β-binding protein-like domain 5 of the fibrillin 1 gene (FBN1), which is also mutated in Marfan syndrome...
January 1, 2017: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/27852906/assessment-of-femoral-head-revascularization-in-legg-calv%C3%A3-perthes-disease-using-serial-perfusion-mri
#14
COMMENT
Harry K W Kim, Jamie Burgess, Alec Thoveson, Paul Gudmundsson, Molly Dempsey, Chan-Hee Jo
BACKGROUND: Legg-Calvé-Perthes disease is a juvenile form of osteonecrosis of the femoral head. The purpose of this study was to use serial perfusion magnetic resonance imaging (MRI) to determine the pattern and rate of revascularization of the femoral heads of patients with the active stage of Legg-Calvé-Perthes disease. METHODS: We performed a prospective study of 29 patients (30 hips) with a mean age (and standard deviation) of 8.4 ± 1.9 years who were diagnosed with Waldenström Stage-1 or 2 Legg-Calvé-Perthes disease...
November 16, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27796801/the-femoro-epiphyseal-acetabular-roof-fear-index-a-new-measurement-associated-with-instability-in-borderline-hip-dysplasia
#15
COMPARATIVE STUDY
Michael Wyatt, Jan Weidner, Dominik Pfluger, Martin Beck
BACKGROUND: The definition of osseous instability in radiographic borderline dysplastic hips is difficult. A reliable radiographic tool that aids decision-making-specifically, a tool that might be associated with instability-therefore would be very helpful for this group of patients. QUESTIONS/PURPOSES: (1) To compare a new radiographic measurement, which we call the Femoro-Epiphyseal Acetabular Roof (FEAR) index, with the lateral center-edge angle (LCEA) and acetabular index (AI), with respect to intra- and interobserver reliability; (2) to correlate AI, neck-shaft angle, LCEA, iliocapsularis volume, femoral antetorsion, and FEAR index with the surgical treatment received in stable and unstable borderline dysplastic hips; and (3) to assess whether the FEAR index is associated clinical instability in borderline dysplastic hips...
March 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27676730/multifocal-osteonecrosis-revealing-an-antiphospholipid-syndrome-case-report
#16
Sophie Legrève
OBJECTIVE: Multifocal osteonecrosis is rare. A zone of epiphyseal bone-marrow necrosis of three or more joints characterizes it. The most common risk factors are glucocorticoids intake and alcoholism. However, there is a series of other causes that could be incriminated in osteonecrosis, among which antiphospholipid syndrome. This case report, illustrates a primary antiphospholipid syndrome with only one clinical manifestation: multifocal osteonecrosis. OBSERVATIONS: A 30-year-old woman, with a medical history of left total hip replacement (THR), presents with severe right coxalgia and pain in both knees and shoulders...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27662386/capital-femoral-epiphyseal-extension-may-confer-physeal-stability-in-slipped-capital-femoral-epiphysis
#17
William Z Morris, Joshua K Napora, Keegan T Conry, Raymond W Liu
BACKGROUND: Factors including obesity and morphologic parameters around the hip that increase physeal stress are associated with an increased risk of slipped capital femoral epiphysis (SCFE). Recent evidence suggests that superior epiphyseal extension may confer stability to the physis and help protect against SCFE. The purpose of this study is to investigate the relationship between epiphyseal extension and SCFE using an age-matched and sex-matched cohort study. METHODS: We generated 2 separate cohorts for comparison: 89 patients with unilateral SCFE and 89 healthy subjects with no evidence of hip disease or deformity...
September 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27628762/-modified-pembersal-osteotomy-technique-with-lyophilized-human-allograft
#18
C Druschel, K Heck, C Kraft, R Placzek
OBJECTIVE: PemberSal osteotomy to improve femoral head coverage by rotating the acetabular roof ventrally and laterally. INDICATIONS: Insufficient coverage of the femoral head, and can be combined with other surgical procedures such as femoral intertrochanteric varus-derotation osteotomy and open reduction for developmental dysplasia and dislocation of the hip or to improve sphericity and containment in Legg-Calvé-Perthes disease. This specific acetabuloplasty can only be performed in patients with an open epiphyseal growth-plate...
December 2016: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/27418747/femoral-cam-deformity-due-to-anterior-capsular-force-a-theoretical-model-with-mri-and-cadaveric-correlation
#19
Cara Beth Lee, Hillard T Spencer, Kirsten F Nygaard
BACKGROUND: Cam deformity is associated with epiphyseal extension onto the anterosuperior femoral head-neck before physeal closure. A century ago, anatomists speculated that this femoral prominence acts as a pulley bar to withstand capsular compression in hip extension with pressure concentrated where the zona orbicularis (ZO) joins the iliofemoral ligament (IFL). An animal model has shown that growth plates deflect laterally and distally when exposed to forces perpendicular to growth...
December 2016: Journal of Orthopaedics
https://www.readbyqxmd.com/read/27398645/the-fate-of-hips-that-are-conservatively-treated-in-multiple-epiphyseal-dysplasia
#20
Seung-Ju Kim, Ashok K Ramanathan, Young-Sik Jeon, Hae-Ryong Song
We reviewed the radiologic and clinical outcomes of hip joints affected by multiple epiphyseal dysplasia in 40 patients. The average patient age was 9.6 years. All patients were followed up for an average of 7.2 years. No patient underwent surgical treatment. The variances of the center-edge angle and femoral head coverage had the greatest tendency to increase with conservative treatment and follow-up (P=0.011 and 0.015, respectively). The acetabular angle and the acetabular depth index at the first visit and the latest follow-up were statistically significantly different (P=0...
November 2017: Journal of Pediatric Orthopedics. Part B
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