Hand Bones

Os autores relatam um caso de osteoartropatia hipertrófica do tipo primária em paciente de 29 anos de idade, com dores articulares e aumento de volume das extremidades há 15 anos. Ao exame físico apresentava baqueteamento dos dedos e unhas em "vidro de relógio". A osteoartropatia hipertrófica foi considerada como primária porque foram excluídas todas as causas da forma secundária. As principais alterações radiológicas foram: espessamento das camadas corticais dos ossos tubulares e reação periosteal contínua do tipo lamelar. Não foram notadas alterações dos espaços articulares.

Tuberculous dactylitis (Spina Ventosa) is an uncommon and a rare condition which is difficult to differentiate from other lesions, particularly tumors.There is a spindle shaped expansion of the short tubular bones due to tuberculous granuloma.Hence it is also known as Spina Ventosa.We report the case of a 12-yearold, healthy, right handed boy who consulted for progressive painful swelling of 6-month duration in the left thumb, which had developed after an alleged accidental thorn prick injury.The plain radiograph of the thumb, revealed extensive destruction of the first (Thumb) Metacarpal associated with a pathological fracture. Magnetic resonance imaging (MRI) showed an Osteolytic Lesion in first Metacarpal with ballooning out and thinning of the Cortical bone and with an extra osseous lesion, breaching the cortex. The diagnosis of tuberculous dactylitis was confirmed by histological characteristics and positive acid fast bacilli using ZiehlNeelsen stain. Surgical debridement and a...

This study examines the osteological changes in the hands and fingers of rock climbers that result from intense, long‐term mechanical stress placed on these bones. Specifically, it examines whether rock climbing leads to metacarpal and phalange modelling in the form of increased cortical thickness as well as joint changes associated with osteoarthritis. This study also attempts to identify specific climbing‐related factors that may influence these changes, including climbing intensity and frequency of different styles of climbing. Radiographs of both hands were taken for each participant and were scored for radiographic signs of osteoarthritis using an atlas method. Total width and medullary width were measured directly on radiographs using digital calipers and used to calculate cross‐sectional area and second moment of area based on a ring model. We compared 27 recreational rock climbers and 35 non‐climbers for four measures of bone strength and dimensions (cross‐sectional area, se...

Background/Aims: To evaluate the relationship of socioeconomic status (SES) and body mass index (BMI) with skeletal maturation in children from Marrakech (Morocco). Methods: SES, BMI z-score and bone age (BA) were measured in a cohort of 623 children (280 boys and 343 girls, chronological age (CA) ranged from 6.6 to 18.8 years, mean 14.1 years). BA estimation was performed with the Greulich and Pyle atlas. Two social groups (privileged and unfavorable SES) were defined. A multiple linear regression analysis was performed to assess the relationship between BA-CA and age-and sex-specific BMI z-score. Results: Global maturation delay was seen in the sample (BA-CA –0.56; SD 1.29). There was a significant relationship between skeletal maturation (BA-CA) and child BMI z-score among both genders. Bone age was more advanced in children with a greater BMI z-score. Privileged SES was positively associated with children’s BA-CA for girls but there was no association for boys. In the boys’ samp...

CONTEXT AND OBJECTIVE: Patients with end stage renal disease (ESRD) and secondary hyperparathyroidism (HPT2) are prone to develop heterotopic calcifications and severe bone disease. Determination of the sites most commonly affected would decrease costs and patients' exposure to X-ray radiation. The aim here was to determine which skeletal sites produce most radiographic findings, in order to evaluate hemodialysis patients with HPT2, and to describe the most prevalent radiographic findings. DESIGN AND SETTING: This study was cross-sectional, conducted in one center, the Hospital Universitário Clementino Fraga Filho (HUCFF), in Rio de Janeiro, Brazil. METHODS: Whole-body radiographs were obtained from 73 chronic hemodialysis patients with indications for parathyroidectomy due to severe HPT2. The regions studied were the skull, hands, wrists, clavicles, thoracic and lumbar column, long bones and pelvis. All the radiographs were analyzed by the same two radiologists, with great expe...

Tubercular dactylitis or spina ventosa is the tubercular infection of phalanges, metacarpals and metatarsals termed after cystic swelling of short tubular bones by tubercular infection. Here we presented two rare cases of spina ventosa in a 10 years old female and a 16 years old male patients. In both cases there was swelling of digits with stiffness. The radiographs were suggestive of chronic osteolytic infection with cortical destruction and diffuse sclerosis. We managed them with adequate surgical debridement, splintage and anti-tubercular therapy with good functional recovery. Spina ventosa or tubercular dactylitis is a rare condition and is often missed on diagnosis due to vague non-specific presentation, unavailability of rapid diagnostic tests and can be confused with other mimicking diseases. Any swelling over small tubular bones of hand or feet should raise the suspicion of spina ventosa, especially in endemic countries for tuberculosis. In neglected chronic infections, sur...

The purpose of this study was to put forth a precise landmark-based technique for reconstructing the three-dimensional shape of human entheseal surfaces, to investigate whether the shape of human entheses is related to their size. The effects of age-at-death and bone length on entheseal shapes were also assessed. The sample comprised high-definition three-dimensional models of three right hand entheseal surfaces, which correspond to 45 male adult individuals of known age. For each enthesis, a particular landmark configuration was introduced, whose precision was tested both within and between observers. The effect of three-dimensional size, age-at-death, and bone length on shape was investigated through shape regression. The method presented high intra-observer and inter-observer repeatability. All entheses showed significant allometry, with the area of opponens pollicis demonstrating the most substantial relationship. This was particularly due to variation related to its proximal el...

In anthropological sciences, entheses are widely utilized as occupational stress markers. However, the reaction of entheseal surfaces to mechanical loading is not well understood. Furthermore, previous studies on entheses relied on the individuals' occupation-at-death. Past research by one of us has identified two patterns among hand entheses, proposing that they reflect two synergistic muscle groups. Here, we investigate the association between these patterns and habitual manual activity using an extensively documented skeletal sample and a three-dimensional system of quantification. The hand bones utilized belong to 45 individuals from mid-19th century Basel. These were male adults (18 to 48 years old) who were not directly related, showed no manual pathological conditions, and whose occupational activities during their lifetime were clearly documented and could be evaluated according to historical sources. The patterns of entheses were explored using principal component analy...

Tuberculous dactylitis is an unusual form of osteoarticular tuberculosis involving the short tubular bones of hands and feet, which is uncommon beyond six years of age. We report the case of a fifteen-year-old adolescent boy who was diagnosed with tuberculous dactylitis, involving contralateral hand and foot. His diagnosis was delayed due to lack of suspicion of this rare entity. The report also examines the diagnostic difficulties faced by clinicians in arriving at an appropriate diagnosis.

CONTEXT AND OBJECTIVE: Patients with end stage renal disease (ESRD) and secondary hyperparathyroidism (HPT2) are prone to develop heterotopic calcifications and severe bone disease. Determination of the sites most commonly affected would decrease costs and patients' exposure to X-ray radiation. The aim here was to determine which skeletal sites produce most radiographic findings, in order to evaluate hemodialysis patients with HPT2, and to describe the most prevalent radiographic findings. DESIGN AND SETTING: This study was cross-sectional, conducted in one center, the Hospital Universitário Clementino Fraga Filho (HUCFF), in Rio de Janeiro, Brazil. METHODS: Whole-body radiographs were obtained from 73 chronic hemodialysis patients with indications for parathyroidectomy due to severe HPT2. The regions studied were the skull, hands, wrists, clavicles, thoracic and lumbar column, long bones and pelvis. All the radiographs were analyzed by the same two radiologists, with great expe...

Background/Aims: To evaluate the relationship of socioeconomic status (SES) and body mass index (BMI) with skeletal maturation in children from Marrakech (Morocco). Methods: SES, BMI z-score and bone age (BA) were measured in a cohort of 623 children (280 boys and 343 girls, chronological age (CA) ranged from 6.6 to 18.8 years, mean 14.1 years). BA estimation was performed with the Greulich and Pyle atlas. Two social groups (privileged and unfavorable SES) were defined. A multiple linear regression analysis was performed to assess the relationship between BA-CA and age-and sex-specific BMI z-score. Results: Global maturation delay was seen in the sample (BA-CA –0.56; SD 1.29). There was a significant relationship between skeletal maturation (BA-CA) and child BMI z-score among both genders. Bone age was more advanced in children with a greater BMI z-score. Privileged SES was positively associated with children’s BA-CA for girls but there was no association for boys. In the boys’ samp...

To determine a more precise and reliable method between Greulich-Pyle (GP) and MacKay's (MK) method for the determination of skeletal age in an Indian pediatric population. We carried out a cross sectional study for the assessment of skeletal age on the basis of examination of hand and wrist radiographs of 106 patients (1-15 years of age) who presented with soft tissue injury to hand by the GP and the MK method. These radiographs were evaluated by a radiologist and an orthopedic surgeon independently. In girls, the mean age difference between chronological and skeletal age was 8 months by the GP method, whereas it was 17 months by MK method. For boys, the mean age difference was 10 months by the GP method and by MKs method, it was 20 months. By the GP method, 44% of the boys showed a more reliable estimate of age whereas it was 10% by the MK method. However, the same for girls was 25% by the GP method and 16% by the MK method. The inter-rater reliability for the raters was found...