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Dish (Forestier Disease) Fractures
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
The underlying diagnosis is diffuse idiopathic skeletal hyperostosis (DISH). There are non-marginal syndesmophytes from C2 to T1. The disc spaces remain preserved and non-ossified, which differentiates this condition from ankylosing spondylitis (AS) (Table 11.1).
Choroid Plexus Tumors and Meningiomas
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Kenneth K. Wong, Elwira Szychot, Jennifer A. Cotter, Mark Krieger
Grossly, meningiomas are well-circumscribed, firm, tan, or grayish lesions arising from the meninges. Hyperostosis of adjacent bones may be present. Microscopically benign meningiomas usually have a bland, whorled appearance, with little anaplasia or mitotic activity. Psammoma bodies may be present. Histologic variants (e.g., fibrous, transitional, angiomatous) can be identified but are of little prognostic significance. Malignant varieties are identified on the basis of clinical behavior (rapid growth or recurrence, invasiveness), pathologic features such as microscopic features of malignancy (cellular or nuclear anaplasia, mitotic figures), or specific histologic type (rhabdoid, papillary, anaplastic) (Figure 19.7).
Future and Novel Unexplored Indications of Retinoids
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
The severe forms of ichthyoses warrant aggressive therapy and usually respond to systemic retinoids. Both acitretin (1 mg/kg/day) and isotretinoin (1–2 mg/kg/day) have been shown to reduce scaling and discomfort with improved heat tolerance and sweating. One study showed that a low dose of acitretin (0.2–0.3 mg/kg/d) was useful in bullous ichthyosiform erythroderma and lamellar ichthyosis, even after use for more than 12 years. The patients were well controlled with no observed side effects; however, skeletal hyperostosis can take a longer time to develop (55).
Isotretinoin for acne vulgaris – an update on adverse effects and laboratory monitoring
Published in Journal of Dermatological Treatment, 2022
Haady Fallah, Marius Rademaker
There are several non-controlled case series that document the development of hyperostoses or bony spurs on radiological examinations of patients treated with high dose isotretinoin (1 mg/kg/day or greater) (57–60). However, in each of these studies, the radiological findings did not correlate well with musculoskeletal symptoms. Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by entheseal ossification and/or calcification mainly involving the thoracic spine (61). It is a relatively common condition, especially in older individuals, making case reports of a possible association between isotretinoin and DISH difficult to interpret. In one study, the overall prevalence of DISH in the healthy population over the age of 50 years was 15% in women and 25% in men (62). DISH is more prevalent in developed nations and has been linked to metabolic syndrome (61).
Leopoli-Cencelle (9th–15th centuries CE), a centre of Papal foundation: bioarchaeological analysis of the skeletal remains of its inhabitants
Published in Annals of Human Biology, 2020
Marica Baldoni, Francesca Romana Stasolla, Giuseppina Scano, Luigi Tonino Marsella, Olga Rickards, Cristina Martínez-Labarga
In one individual (SU 5901) the pattern of lesions on the spine led to the differential diagnosis of Diffuse Idiopathic Skeletal Hyperostosis (DISH; Figure 6(b)). As reported in the literature, the manifestations of the disease include extensive hyperostosis at joint margins, muscular attachment sites, and particularly the vertebral column (Ortner 2003; Waldron 2019). In the latter, the presence of large bridging osteophytes and consequent vertebral fusion is generally limited in the thoracic region, mainly developing under the anterior longitudinal ligament (Ortner 2003). Although the observed pattern is not yet completely understood it has been hypothesised that the passage of the descending aorta on the left side of the thoracic vertebral bodies could be one of its determining causes (Ortner 2003; Waldron 2019). The complete record of pathological dental and skeletal lesions detected in the analysed individuals is reported in Supplementary Table 2 and 3, respectively.
Combined neurosurgical and orbital intervention for spheno-orbital meningiomas - the Manchester experience
Published in Orbit, 2020
J. Young, F. Mdanat, A. Dharmasena, P. Cannon, B. Leatherbarrow, C. Hammerbeck-Ward, S. Rutherford, S. Ataullah
Morphologically, SOMs comprise two components: intraosseous growth with associated hyperostosis, as well as an intradural, soft-tissue component that is often thin and carpet-like.4–8 Some authors have made a distinction between “intraosseous meningioma”, which only involves bony changes, and “en plaque meningioma” which has an intradural soft-tissue component along with intraosseous invasion and associated hyperostosis.23 None of the patients in this study had singular soft-tissue or bony involvement. Hyperostosis was associated with soft-tissue changes in all cases and vice-versa. Nonetheless, the extent of these components differed considerably in each individual case. Ringel et al6 explained that the distinction of these two tumour entities is most probably the result of studies conducted when magnetic resonance imaging (MRI) technology was not available. Other forms of imaging, such as computed tomography (CT) might not reveal the soft-tissue component of the tumour, especially if very thin. Additionally, MRI scans help detect extension of the soft-tissue tumour into surrounding structures such as the intraorbital spaces. Thus, it is imperative that both CT and MRI scans are performed preoperatively.