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The cases
Published in Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young, Paediatric Radiology for MRCPCH and FRCR, 2020
Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young
Radiographic signs include: — widening of the epiphyseal plate.— reduction in the apparent height of the epiphysis.— a line drawn tangential to the lateral border of the femoral neck should normally pass through the lateral aspect of the femoral capital epiphysis.— displacement of the medial femoral metaphysis so that it no longer overlies the acetabulum.
Clinical specialties
Published in Andrew Schofield, Paul Schofield, The Complete SAQ Study Guide, 2019
Andrew Schofield, Paul Schofield
A young boy attends your GP clinic complaining of left-sided hip pain since yesterday. He is now limping due to pain in the hip on walking. He has also suffered with asthma, which is well controlled with salbuta- mol. You suspect a slipped upper femoral epiphysis (SUFE) after a full history and examination are concluded. Which gender is more predisposed to SUFE? (1)What age range is typical for this condition? (1)Give two risk factors, other than gender, for a SUFE. (2)What cartilage makes up the epiphyseal plate? (1)What is typically found on examination? (2)Name three differential diagnoses for hip pain in a child. (3)
Rickets
Published in Alisa McQueen, S. Margaret Paik, Pediatric Emergency Medicine: Illustrated Clinical Cases, 2018
A thorough social and dietary history is helpful, as is a detailed family history. Children may present with skeletal deformities, skeletal pain, slippage of epiphyses, fractures, growth disturbances, seizures, hypotonia, or lethargy. Radiography is the test of choice to confirm the diagnosis. Characteristic findings include widening and irregularity of the epiphyseal plates, cupped metaphyses, fractures, and bowing of limbs. Calcium, phosphate, alkaline phosphatase, PTH (parathyroid hormone), and 25-hydroxyvitamin D levels may be obtained.
Application of 3D printing navigation system in pediatric epiphyseal complex lesion surgery
Published in Computer Assisted Surgery, 2023
Haoqi Cai, Haiqing Cai, Zhigang Wang
The most significant difference in the skeletal system between children and adults lies in the epiphysis and physeal plate and the epiphyseal complex [1]. Epiphyseal injury is a general term involving damage to the longitudinal growth mechanism of bone, including epiphysis, epiphyseal plate, ring around the epiphyseal plate (Ranvier area), growth-related articular cartilage, and metaphyseal injury. The incidence of epiphyseal injuries in children under 16 years of age ranges from 6% to 30% [2]. Innate metabolic diseases, infections, tumors and fractures may lead to epiphyseal damage [1,3]. According to statistics, about 5 to 10% of children experience growth failure after epiphyseal injury [2]. It mainly involves two aspects: abnormalities in limb length and abnormalities in limb alignment that will seriously affect children’s joint quality and walking function and then affect life quality [4–9]. They will be secondary to abnormalities in the spine, hip joints, and other joints over time [10].
Findings in ancient Egyptian mummies from tomb KV64, Valley of the Kings, Luxor, with evidence of a rheumatic disease
Published in Scandinavian Journal of Rheumatology, 2023
LM Öhrström, R Seiler, S Bickel, F Rühli
The skeleton is intact, in full anatomical position. The skull is tilted forwards and multiple bandage layers are recognizable. The arms are placed next to the body with the hands in front of the pelvis, but not clasped. The pelvis is slightly inclined to the right side. There is a discrete convex scoliotic malposition of the lumbar spine to the right side and a discrete left convex malposition of the cervical spine, as well as flattening and missing lordosis of the lumbar spine, and missing kyphosis of the thoracic spine (Figure 5B). These are presumably post-mortem changes, caused by the body positioning within the coffin. The dens axis is centred, and no significant degenerative or erosive changes of the spine and articulations are recorded. The cranial cavity appears to be empty; no brain remnants or residues of embalming substance can be delimited. Within the thoracoabdominal and pelvic regions, there are several hyperdense areas found bilaterally, presumably packing material or organ packages. The epiphyseal plates are predominantly closed (at most, still partial delineation of a very fine remnant line at the femoral heads, distal femora, and proximal tibiae). The symphyses show possible slight degenerative changes. No further pathological changes or variants from anatomical norms are observed.
KLF2 reduces dexamethasone-induced injury to growth plate chondrocytes by inhibiting the Runx2-mediated PI3K/AKT and ERK signalling pathways
Published in Autoimmunity, 2023
Yulong Ma, Tao Peng, Xudong Yao, Chaonan Sun, Xiaowei Wang
Epiphyseal injury is a unique bone disease in children [1]. Once this damage, it will affect the growth of children and the normal growth and development of the children’s bones [2]. Epiphyseal plate is a component of cartilage, which is closely related to the proliferation and apoptosis of chondrocytes [3]. Dexamethasone (Dex) is a kind of glucocorticoid (GCs) with anti-inflammatory, detoxification and anti-allergy effects [4]. Glucocorticoids have immune suppression, anti-shock, antipyretic and detoxification effects, and are widely used in paediatric clinics for asthma, chemotherapy, anti-shock, antipyretic and the treatment of other diseases treatment [5–7]. However, long-term use of Dex can induce growth plate chondrocytes (GPCs) apoptosis, impair differentiation, and inhibit cell proliferation and bone growth [7, 8].