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Arkiv for kategorien ‘Patologi’

Tertiary syphilitic ulceration of the scalp [en]

tirsdag den 3. december 2013
Tertiary syphilitic ulceration of the scalp Tertiary syphilitic ulceration of the scalp

Black and white photographs of the head of a man aged 39 years, who had contracted syphilis 12 years previously. Photographs shows a view of the patient's head showing the tertiary syphilitic ulceration of the scalp. 15 Mar 1894

Credit: St Bartholomew's Hospital Archives & Museum, Wellcome Images

Via thechirurgeonsapprentice

Fracture of a single bone trabeculum in osteoporosis [en]

fredag den 11. oktober 2013

Fracture of a single bone trabeculum in osteoporosis (16x).

By Michael J. Klein, M.D., Department of Pathology, Mount Sinai School of Medicine, New York.

Source: www.microscopyu.com

A Rare Case of Skeletal Fluorosis Due to Excessive Tea Drinking [en]

fredag den 29. marts 2013

A 47-year-old Michigan woman developed a bone disease rarely seen in the U.S. after she drank a pitcher of tea made from at least 100 tea bags daily, for 17 years, researchers report.

The Detroit woman visited the doctor after experiencing pain in her lower back, arms, legs and hips for five years.

X-rays revealed areas of very dense bone on the spinal vertebrae and calcifications of ligaments in her arm, said study researcher Dr. Sudhaker D. Rao, a physician at Henry Ford Hospital who specializes in endocrinology and bone and mineral metabolism.

The researchers suspected the woman had skeletal fluorosis, a bone disease caused by consuming too much fluoride (a mineral found in tea as well as drinking water).

The patient’s blood levels of fluoride were four times higher than what would be considered normal, the researchers said.

Skeletal fluorosis is endemic in regions of the world with naturally high levels of fluoride in drinking water, including some parts of India and China, but is rare in Europe and North America. (Low levels of fluoride are added to drinking water in the United States to prevent cavities, but aren’t high enough to cause fluorosis.)

Rao said the patient was originally referred to him because her doctors suspected she had cancer, which can also show up on an X-ray as areas of dense bone. But because Rao had seen cases of skeletal fluorosis in his native India, “I was able to recognize it immediately,” he said.

Excess fluoride is typically eliminated from the body by the kidneys, Rao said. But if one consumes a lot of it, as this patient did through tea drinking, over time, the fluoride forms crystal deposits on bone, Rao said.

A few other cases of skeletal fluorosis caused by tea drinking have been reported in the United States. In these cases, patients typically drank a gallon of tea a day, Rao said. Rao and colleagues instructed their patient to stop drinking tea, after which she experienced an improvement in symptoms. The fluoride deposits will gradually go away as the bone remodels (or repairs) itself, a process that occurs frequently in the body, Rao said.

A description of the case was published March 21 in the New England Journal of Medicine.

(Source: Yahoo! via fuckyeahforensics)

Prosthetic nose used by a a woman with syphilis (19th cent.) [da]

lørdag den 16. februar 2013
Prosthetic nose (19th cent.)
Prosthetic nose (19th cent.)

We don’t know much about her. We don’t even know her name. What we do know is that the woman who wore the above prosthetic lost her nose in the middle of the 19th century due to a raging case of syphilis.

Read more on Lindsey Fitzharris' wonderful blog The Chirurgeon's Apprentice: "Syphilis: A Love Story"

Diffuse Idiopathic Skeletal Hyperostosis (DISH) [da]

lørdag den 16. februar 2013

A 'Spine Lecture' I found on YouTube by Spiro Antoniades, M.D.

I am sure that in the future you will here more of DISH here on the blog!

Diffuse idiopathic skeletal hyperostosis (DISH) is a spondyloarthropathy also known as Forestier's disease and ankylosing hyperostosis. It is a noninflammatory disease, with the principal manifestation being calcification and ossification of spinal ligaments and the regions where tendons and ligaments attach to bone (entheses). The whole spine may be involved, and bony ankylosis occurs, although the disc spaces and facet joints remain unaffected. In advanced stages, the disease may look like melted candle wax. The calcification and ossification is most common in the right side of the spine. In people with dextrocardia and situs inversus this calcification occurs on the left side, which confirms the role of the descending thoracic aorta in preventing the physical manifestations of DISH on one side of the spine. (Wikipedia)

A Diaphyseal Giant Cell Tumor of Bone Involving Radius [da]

mandag den 28. januar 2013

A Diaphyseal Giant Cell Tumor of Bone Involving Radius

This is one of the rare presentations of the giant cell tumor of bone, a lesion that can be rather difficult to deal with even in its typical form. It is normally seen at the ends of the long bones and it is purely lytic (radiolucent) in most cases.

The above example is accompanied by secondary aneurysmal bone cyst and prominent periosteal new bone formation making a radiological diagnosis almost impossible. Microscopy (apart from the presence of too much osteoid) was typical, however. The patient, a 50-year-old man, had no lesions in the other bones.

Source: Medical School

Ovarian tumour, with teeth and a bone fragment inside, found in a Roman-age skeleton [da]

torsdag den 24. januar 2013
Calcified ovarian teratoma
Calcified ovarian teratoma

A team of researchers led by the UAB has found the first ancient remains of a calcified ovarian teratoma, in the pelvis of the skeleton of a woman from the Roman era.

The find confirms the presence in antiquity of this type of tumour – formed by the remains of tissues or organs, which are difficult to locate during the examination of ancient remains. Inside the small round mass, four teeth and a small piece of bone were found.

Teratomas are usually benign and contain remains of organic material, such as hair, teeth, bones and other tissues. There are no references in the literature to ovarian teratomas in ancient remains like those found in this study, led by the researcher Núria Armentano of the Biological Anthropology Unit of the UAB and published in the International Journal of Paleopathology.

The tumour in question is rounded in shape, with a wrinkled surface, of the same colour as the bones, about 43 mm long and 44 mm in diameter. It was found in the right-hand part of the pelvis of a woman of between 30 and 40 years of age and who lived around 1,600 years ago, and came from the Roman cemetery in the archaeological site of La Fogonussa (Lleida). A macroscopic examination and a scan revealed four teeth of anomalous morphology inside the tumour, two of which were adhering to the inside wall of the tumour, and a small bone fragment.

Read more here

Original article: Núria Armentano, Mercè Subirana, Albert Isidro, Oscar Escala, Assumpció Malgosa, "An ovarian teratoma of late Roman age", International Journal of Paleopathology, Volume 2, Issue 4, December 2012, Pages 236-239, ISSN 1879-9817, 10.1016/j.ijpp.2012.11.003. (pdf)

Acute Osteomyelitis – Historically known as “Bone Fever” [da]

fredag den 28. december 2012

Via biomedicalephemera:

Acute Osteomyelitis

Osteo-: Bone
-myelo-: Marrow
-itis: Fever

Top: Acute supperative osteomyelitis in femur - note the purulent cavities and pus-filled medullary canal at A, B, and C. In this case, the epiphysis (E) and conjunctive cartilage (D) are uninfected.

Center Left: Acute osteomyelitis of tibia, cicatrices showing common position of sinuses in bone.

Center Right: Acute epiphysial separation due to osteomyelitis following typhoid fever.

Bottom: Early stage of acute osteomyelitis in tibia. Note site “A” - where the infection passed from the periosteum to the interior of the bone. The articular cartilages (C) are sodden with pus from the infected joint.

Acute osteomyelitis is most commonly seen in children and those with diabetes. It is rarely “spontaneous” - the bacteria that infect the subperosteum and marrow have to be introduced into the bloodstream somehow, and there is usually a known source.

Systemic infection or traumatic injury are the most common ways that bacteria (today, most commonly Staphylococcus aureus) can get to the bones. Historically, scarlet fever (caused by group A Streptococcus pyogenes) and typhoid fever (Salmonella typhi) were known to cause a large number of osteomyelitis cases in their wake.

When children develop osteomyelitis, the long bones of the body (the femur, humerus, etc.) are most often affected, whereas the spine and pelvis are most commonly affected in adults. This is because there is much greater bloodflow to the growing long bones in kids, and as such there’s much more opportunity for bacteria in the blood to infect the site.

Early symptoms of what used to be called “bone fever” are fever and bone pain (as one might assume), as well as local warmth and swelling, and an overall malaise. The bone infection usually presents after a patient appears to have recovered from a disease or wound, as it takes several days to become established enough to cause symptoms. Later on, if left untreated, extreme pain and open, often purulent, wounds above the infection may occur, as the bacteria bore canals through the affected bones.

Without treatment, osteomyelitis can lead to sepsis, complete breakdown of affected bones, or gangrene. When the epiphysis is affected by the infection, growth of that bone can be significantly stunted.

Today, the condition is usually treated with long-term, high-dosage, IV antibiotic therapy. If it’s not caught at the start of the infection, debridement of the bone (removing the infected tissue) may be required, and in extreme cases, bone resection (cutting out an entire chunk of infected bone) or amputation may be required. Prior to antibiotics, resection was the most common cure.

Source: Diseases of the Bones, their pathology, diagnosis, and treatment. Thomas Jones, 1887.

Deformity caused by the Chernobyl disaster [da]

onsdag den 26. december 2012

Deformity caused by the Chernobyl disaster

— Scarry effects of nuclear radiation!

Fibrodysplasia Ossificans Progressiva [da]

fredag den 19. oktober 2012

Fibrodysplasia Ossificans Progressiva (FOP for short) is a very rare disease that causes parts of the body (muscles, tendons, and ligaments) to turn to bone when they are damaged. This can often cause damaged joints to fuse together, preventing movement. Unfortunately surgical removal of the bone growths is ineffective as the body “heals” itself by recreating the removed bone. To make matters worse, the disease is so rare that it is often misdiagnosed as cancer, leading doctors to perform biopsies which can spark off worse growth of these bone-like lumps.

The most famous case is Harry Eastlack (see photo) whose body was so ossified by his death that he could only move his lips. Harry lived to 39 years of age. Prior to his death Eastlack agreed to donate his body for scientific study. His skeleton is on display at the Mütter Museum in Philadelphia, Pennsylvania

The diagnosis of this disease is very rare with only a few hundred cases being reported worldwide.

There is no cure.