PURPOSE: To describe the MR findings of simple bone cyst. MATERIALS AND METHODS: We analyzed the signal intensity of the cystic contents, their margins, and internal septae, and the presence of bony fragment and pathologic fracture, and enhancement patterns in MRI of 10 pathologically confirmed simple bone cysts. RESULTS: On MR imaging, the cystic contents were of homogeneously low signal intensity on T1WI and high signal intensity on T2WI in nine cases and fluid-fluid level was seen in one case. The cystic margins were dark in all sequences. There were not any fragment in the cysts. Among the four cases with pathologic fracture, one case had fluid-fluid level and two had some areas of enhancement in the cyst or adjacent soft tissue. All nine cases with gadolinium enhancement showed thin rim enhancement along the inner margin of the cysts and internal septae. CONCLUSION: Homogeneous fluid-like signal intensity of cystic content and thin rim enhancement of margin and internal septae in MR imaging are believed to be helpful in the diagnosis of simple bone cyst.
Bone Cysts* ; Diagnosis ; Fractures, Spontaneous ; Gadolinium ; Magnetic Resonance Imaging

We report a case of insufficiency fracture of the sternum in a 70-year-old female patient with a review of the literature. She complained of sudden onset chest pain and aggravating dyspnea. She has been managed with corticosteroid due to chronic obstructive pulmonary disease for 15 years. Diagnosis of sternal insufficiency fracture presented with thoracic kyphosis was made on the basis of absence of trauma history, radiologic findings of lateral chest radiograph, bone scintigraphy and chest computed tomography. Thoracic kyphosis and osteoporosis secondary to menopause, corticosteroid therapy and limited mobility due to chronic obstructive pulmonary disease were considered as predisposing factors of the sternal insufficiency fracture in this patient.
Aged ; Case Report ; Female ; Fractures, Spontaneous/radiography ; Fractures, Spontaneous/diagnosis* ; Fractures, Spontaneous/complications ; Human ; Kyphosis/complications ; Lung Diseases, Obstructive/complications ; Osteoporosis, Postmenopausal/complications ; Sternum/radiography ; Sternum/injuries*

STUDY DESIGN: Literature review. OBJECTIVES: To present updated information on the diagnosis of osteoporotic spinal fractures (OSFs). SUMMARY OF LITERATURE REVIEW: Conventional modalities including simple radiographs, bone mineral density (BMD) tests, and bone scans are sufficient for diagnosis of OSFs. However, other clinical and radiographic clues should be considered for prediction of the prognosis and differential diagnosis. MATERIALS AND METHODS: Review of the relevant literature. RESULTS: Clinical clues including morphometric changes in the vertebral body are sufficient for diagnosis of OSFs. BMD testing is helpful for diagnosis of osteoporosis. However, simple radiographs and BMD tests do not present sufficient information on the prognosis of OSFs. The location of the involved segments, morphological characteristics, and other co-morbidities should be taken into consideration in the initial management of OSFs. Moreover, pathologic conditions leading to spinal fractures should be taken into account in some clinical situations. CONCLUSIONS: With increasing reports of complicated OSFs or other pathologic fractures, other diagnostic modalities and clinical factors should be considered in predicting the prognosis of OSFs and differentiating OSFs from other pathologic conditions.
Bone Density ; Diagnosis* ; Diagnosis, Differential ; Fractures, Spontaneous ; Osteoporosis ; Prognosis ; Spinal Fractures*

A case of chordoma occurred in the right femoral head and gluteus maximus muscle is reported. The case was a 61 year old female who complained of severe painful limitation of motion of the hip and radiating pain to the posterior aspect of right thigh for ten months. Roentgenological study revealed pathological fracture of femoral neck with osteoporotic change. For the treatment of femoral neck fracture, Moore type prosthetic femoral head replacement was performed. The cut surface of the resected femoral head showed multiple necrotic foci here and there, whitishgrey in color and gellatinous in consistency. The diagnosis was confirmed as a chordoma by microscopic examination. Femoral head and gluteus maximus muscle is one of very rare site of chordoma in the previous literature.
Chordoma ; Diagnosis ; Female ; Femoral Neck Fractures ; Femur Neck ; Fractures, Spontaneous ; Head ; Hip ; Humans ; Thigh

The term “non-ossifying fibroma of bone” was introduced by Jaffe and Lichenstein in 1942 to describe a distinctive benign lesion occuring near the ends of the long bones in young people, and the lesion was subsequently described by Hatcher as a developmental defect rather than a true tumor. This lesion was presented as a clear-cut entity on the basis of pathological, clinical and roentgenographic manifestations. The diagnosis of non-ossifying fibroma was made by the histopathological findings of the curetted tissues. The authors have seen and studied 5 cases of non-ossifying fibroma from February 1976 to September 1981. The average duration of follow up was 2.2 years, with a range from 0.8 to 5 years, and the results of treatment were as follows: l. Of the five cases, two were associated with pathologic fractures. 2. The sites of the lesions in all cases were the long bones in the lower extremity. 3 In all cases, the complaints were of only a few days or weeks duration before admission to the hospital, and no cases were discovered incidentally by roentgenographic examination. 4. Good results were obtained by treatment with curettage and bone graft.
Curettage ; Diagnosis ; Fibroma ; Follow-Up Studies ; Fractures, Spontaneous ; Lower Extremity ; Transplants

Bone tumor in the trochanteric area is not infrequent and it is important to differentiate the tumors in this area for diagnosis, early settings of therapeutic plans and prognostic previsions. Twenty-one cases of benign bone tumors in the trochanteric area treated at Dept. of Orthopedi Surgery, College of Medicine, Ewha Womans University Hospital, from January 1975 to December 1983 were analysed and following results were obtained. l. of 21 cases, 10 cases were fibrous dysplasia, 6 cases were simple bone cyst, 3 were giant ce tumor and 2 were aneurysmal bone cyst. 2. Pathologic fractures were accompanied in 6 cases; 3 of fibrous dysplasia, 2 of simple bone cy: and 1 of aneurysmal bone cyst. 3. After treatment with curettage, bone graft and instrumentation, 3 cases recurred; 2 cases of fibrous dysplasia and 1 of simple bone cyst. 4. As prognostic factors, completeness of curettage, amount and source of bone graft were considered to be important.
Aneurysm ; Bone Cysts ; Clinical Study ; Curettage ; Early Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Transplants

A pathological fracture occurs spontaneously or with minimal trauma. The underlying pathological changes may be subtle and the diagnosis not obvious. The two goals in the treatment of pathologic fracture in weight bearing long bones are to provide relief of pain by secure fixation of the fracture and to permit early smbulation and a prompt return to prefracture status. Thirteen cases of pathological fracture were treated during the period from June, 1986 to February, 1988 at Kangnam Sacred Heart Hospital. The results are as follows. 1. Most patients were over 45 of age. 2. Malignancy was the common cause. 3. Most frequent involved site was femur. 4. Occured by trivial trauma such as slip down injury. 5. Satisfactory result by curettage, open reduction and internal fixation, bone graft or bone cement augmentation.
Clinical Study ; Curettage ; Diagnosis ; Femur ; Fractures, Spontaneous ; Heart ; Humans ; Transplants ; Weight-Bearing

The proposed factors that affect the prognosis of osteosarcoma are the patient's age, site and size of the primary lesion, pathologic features(type and grade), duration of symptoms, spread of disease (local or regional extension, distant metastasis) at diagnosis, the patient's sex, serum alkaline phos- phatase(ALP) and lactic dehydrogenase(LDH) levels, chromosomal number or DNA index, response to initial chemotherapy, location of the lesion on the bone, presence or absence of pathologic fracture, and mode of therapy. The purpose of this study is to analyze the factors that affect the 5-year survival rates of osteosarcoma. Total 25 patients were included in this study who had treated form Jan. 1988 to Apr. 1994. The overall 5-year survival rate of 25 patients was 65.43%, and the 5-year survival rates were sig- nificantly higher(P < 0.1) in the groups in which limb salvage operation with neoadjuvant chemothera- py were performed(66.67%), with longer duration of symptoms(>2 months; 83.33%), with lower serum level of LDH( < 300 U/L; 100%), and with smaller mass size( < 10cm; 72.92%). However there were no significant differences in the 5-year survival rates according to age and sex of the patients. We also suggest that the better prognosis will be observed in the patients with the favorable radiologic response to the preoperative chemotherapy.
Diagnosis ; DNA ; Drug Therapy ; Fractures, Spontaneous ; Humans ; Limb Salvage ; Osteosarcoma ; Prognosis ; Survival Rate

Syphilis was known to be generalized disease and it had been decreased until 1960's. But, it has been increased again recently. The author analysed the 22 cases of congenital syphilis which were treated at department of orthopaedic surgery at Ewha Womans University Hospital from Jan. 1979 to July 1983 and the following results were obtained. 1. There were no significant changes of the number of patient by years. 2. Common symptom and sign were hepatosplenomegaly(84%), fever(62%) and skin changes(50%), and pseudoparalysis was observed in one case. 3. Radiologic bone changes were observed in 11 cases (50%) and the following results were obtained: a. Below the two week old, there was relatively low incidence of bone change with 22%. b. There was high incidence of bone change in prematurity with 75%. c. Common features of bone changes were periosteal reaction, osteochondritis and metaphysitis (91%). Pathologic fracture was observed. in one case. 4. Although we have observed the bone changes only in 50% of cases, all the other reports has reported more than 80% and we thought that radiologic bone change would aid the diagnosis of congenital syphilis.
Clinical Study ; Diagnosis ; Female ; Fractures, Spontaneous ; Humans ; Incidence ; Osteochondritis ; Skin ; Syphilis ; Syphilis, Congenital

OBJECTIVES: Osteolytic bone lesions are common complications in multiple myeloma (MM), and can have an impact on quality of life due to the risk of fractures. Trabecular bone score (TBS) is a novel texture index derived from dual energy x-ray absorptiometry (DXA) of lumbar spine (LS) images that provides information about bone microarchitecture. The aim of this study was to evaluate whether TBS is useful in predicting bone fractures in MM patients. METHODS: TBS was calculated retrospectively from existing DXA images of the LS, in 20 patients with newly diagnosed MM. We analyzed the development of fractures in these patients. RESULTS: The median age of the patients was 66 years (range, 49–77 years). Osteolytic bone lesions were observed in 18 patients (90%) at the time of diagnosis. The median duration of follow-up was 40.0 months (95% confidence interval [CI], 33.2–46.2), 6 fracture events (long-bone fractures in 5 events, vertebral fracture in 1) occurred in 5 patients (25%). There were no significant differences between patients who experienced new onset fractures and patients who did not for all TBSs and T-scores, although the fracture group had lower levels than the no fracture group. However, among TBSs of individual LSs, only L2 showed significantly lower scores in patients who developed fractures (1.135 ± 0.085 [95% CI, 1.030–1.241] vs. 1.243 ± 0.169 [95% CI, 1.149–1.336], P = 0.032). CONCLUSIONS: TBS of the LS in MM patients may be helpful in predicting development of fractures; however, further investigation is needed.
Absorptiometry, Photon ; Diagnosis ; Follow-Up Studies ; Fractures, Bone ; Fractures, Spontaneous ; Humans ; Multiple Myeloma ; Quality of Life ; Retrospective Studies ; Spine