Alex Norman

Juxtacortical Circumscribed Myositis Ossificans: Evolution and Radiographic Features'

Abstract Juxtacortical myositis, a localized circumscribed type of myositis ossificans in close apposition to bone, was seen in 4 patients. A history of local injury, most often related to trauma, was demonstrated in 3. The evolution of the focus of myositis ossificans can be correlated with the time lapse following trauma. Radiographic evolution parallels the histologic pattern of maturation. A “radiolucent zone” of soft tissue separates the lesion from the underlying periosteal reaction and cortex. This important roentgen sign points up the lack of intimate connection between the lesion and adjacent bone which differentiates myositis ossificans from juxtacortical osteosarcoma.

Persistence or recurrence of pain: a sign of surgical failure is osteoid-osteoma.

Excision of an osteoid-osteoma brings prompt and permanent relief from symptoms. Recurrence of pain indicates persistence or failure to totally remove the nidus (9 of 73 patients), and only rarely a true recurrence. Long symptom-free intervals may follow partial excision of the lesion.

Periosteal chondroma. A report of ten cases and review of the literature.

Periosteal chondroma is a slow-growing benign cartilaginous tumor of limited size arising within or under the periosteum, which, through constant pressure, induces cortical erosion and periosteal reaction. Ten new cases of periosteal chondroma are reported. All were treated by marginal or intralesional excision. No local recurrence was seen following this treatment. These patients demonstrated the clinical, roentgenographic, and pathologic features of this benign entity, which aid diagnosis, thereby avoiding overtreatment.

Simple Bone Cysts: Factors of Age Dependency

Patient age plays a significant role in the presentation and clinical behavior of bone cysts. In children, cysts behave more aggressively than in adults and the recurrence rate for patients in the first decade of life is four times that in the adolescent. Simple bone cysts are less frequent after 17 years of age and 80% of cysts in the young are located in the proximal end of the shaft of the humerus and femur. Pathological fractures will call attention to the cyst and the highest incidence of fractures is in childhood (0--10 years).

Osteoid-osteoma inducing pronounced overgrowth and deformity of bone.

A rare complication of osteoid-osteoma is localized overgrowth and/or deformity of bone. Six of 64 cases reviewed had this growth disturbance. All patients developing deformities had their onset of symptoms before 5 years of age. Not one of the patients had limb equalization or correction of the deformity after removal of the osteoid-osteoma. The longest follow-up was 8 years. Speculations on the underlying cause for this form of growth abnormality, and the incidence in infants and very young children suggests that immediate surgical treatment is the best course of action.

Fibrosarcoma Complicating Bone Infarction in a Caisson Worker: A Case Report

A case of anaplastic fibrosarcoma arising at the site of an old infarct in the femoral shaft of a caisson worker is reported. References to similar cases are cited. The occurrence of sarcomata in association with other non-neoplastic bone lesions is discussed.

Intracapsular and paraarticular chondromas.

Intracapsular and paraarticular chondromas are rare benign tumors. The authors report four such lesions, three of which occurred about the knee and one at the hip. Radiographs showed calcified soft-tissue masses in the infrapatellar region of the knee in three patients. In the hip, the lesion was not visible on conventional radiographs. Three lesions originated from the joint capsule and one was extracapsular. These lesions should be differentiated from synovial chondromatosis and other calcified lesions occurring about the joints. After local excision, the tumors usually do not recur.

Osteonecrosis of the distal pole of the carpal scaphoid following fracture — A rare complication

A case of carpal scaphoid fracture followed by osteonecrosis of the distal fragment alone is presented.

The "pelvic digit"--an unusual developmental anomaly.

Five cases of a rare developmental anomaly involving extraskeletal bone formation are described — four in the pelvis and one arising from the 12th rib. Three of these bony growths, called “Pelvic digits” had well developed “joints” or pseudoarticulations. The similarity of this anomaly to posttraumatic myositis ossificans and avulsion injuries of the pelvis (rectus femoris) is pointed out and a differential diagnosis offered.

Mixed sclerosing bone dysplasia coexisting with dysplasia epiphysealis hemimelica (Trevor-Fairbank disease)

The coexistence of mixed sclerosing bone dysplasia and dysplasia epiphysealis hemimelica is a rare anomaly. This combination of abnormalities has not been previously reported. The clinical, radiographic, and pathologic features of this condition are discussed and the methods of treatment of articular complications are reviewed.