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Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
Langerhans cell histiocytosis is the most common cause of vertebral plana in children. Other imaging features include lucent bone lesions, occurring most commonly in the skull, mandible, ribs and pelvis. Bone lesions are associated with periostitis. Lesions may resolve or become sclerotic.
Hyaline Bodies in the Walls of Odontogenic Cysts
Published in Roger M. Browne, Investigative Pathology of the Odontogenic Cysts, 2019
Hyaline bodies in the connective tissue walls of odontogenic cysts and periapical lesions, similar to those first described by Lewars36 within inflammatory lesions occurring in the buccal sulcus of full lower denture wearers, have been occasionally reported in the literature.25,37–40 Originally the inflammatory lesion containing these bodies was termed “chronic periostitis”.36 Since then, however, a variety of names have been used to describe these lesions which reflect the etiological factors thought to be important in pathogenesis: oral pulse granuloma,37,40 vegetable granuloma,39 food-induced granuloma,41 giant cell hyaline angiopathy42 and infection with Torulopsis glabrata.43 Characteristically these lesions consist of foreign body giant cells associated with hyaline rings within a chronically inflammed fibrous tissue stroma (Figure 3). The hyaline bodies themselves consist of circular or oval rings, sometimes with crenated borders, which may contain cellular connective tissue, inflammatory cells and/or giant cells, homogeneous or fibrillar eosinophilic material and occasionally small areas of droplet calcification.
Test Paper 3
Published in Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike, Get Through, 2017
Teck Yew Chin, Susan Cheng Shelmerdine, Akash Ganguly, Chinedum Anosike
Involvement of several joints in a single digit, with soft-tissue swelling, produces what appears clinically as a ‘sausage digit’. The bone proliferation produces an irregular and indistinct appearance to the marginal bone about the involved joint, characterised as a ‘fuzzy’ appearance or ‘whiskering’. Periostitis may take several forms. It may appear as a thin periosteal layer of new bone adjacent to the cortex, a thick irregular layer or irregular thickening of the cortex itself. Because of the degree of bone destruction, an involved joint may take the appearance of a ‘pencil and cup’, with one end of the joint forming a cup and the other a pencil that projects into this cup. One characteristic feature of psoriatic arthritis in the foot is the ‘ivory phalanx’, which classically involves the distal phalanges (especially in the first digit).
Modern management of diabetic foot osteomyelitis. The when, how and why of conservative approaches
Published in Expert Review of Anti-infective Therapy, 2018
Javier Aragón-Sánchez, Benjamin A Lipsky
The first layer of the bone tissues involved by infection is the periosteum (periostitis). This often leads to elevation of the periosteum, often accompanied by pain. Patients with severe neuropathy may not be able to feel any pain. However, sometimes deep sensation is preserved and patients may feel discomfort or pain when bone infection is developing. Subsequently, the cortical bone, and then the medullary bone, may be involved in the evolving infection. Clinicians must understand this sequential involvement as it affects the clinical presentation of the disease. In cases of early osteomyelitis (e.g. within a few weeks) plain X-rays may often do not yet display any signs of osteomyelitis as it takes a few weeks for sufficient demineralization to occur that is visible on radiographs. Osteomyelitis occurring in the feet of patients with diabetes without a foot wound (or previous history of foot ulcer) is not well-defined in the medical literature. The most likely cause of radiological bone destruction without a concomitant or previous foot ulcer is neuro-osteoarthropathy (Charcot disease) [11].
Long-Term Outcomes of Oral Anti-Tubercular Therapy in Patient with Tubercular Dacryoadenitis: A Case Series
Published in Ocular Immunology and Inflammation, 2019
Manpreet Singh, Nalini Gupta, Zoramthara Zadeng, Nirbhai Singh, Manpreet Kaur, Pankaj Gupta
Madge et al. classified OTb into five clinical groups: (i) classical periostitis, (ii) orbital soft tissue tuberculoma or cold abscess, with no bony destruction, (iii) orbital TB with evidence of bony involvement, not categorized as (i), (iv) orbital spread from the paranasal sinuses and (v) dacryoadenitis.1 In their report, eight patients were reported with TbD- mean age of 30 years, definite female preponderance (seven of eight patients), duration of symptoms (15 days- 3 years), and median duration of presentation of 5 months. Overall, TbD is regarded as the rarest among OTb.18
Chronic exertional compartment syndrome of the forearm
Published in The Physician and Sportsmedicine, 2019
Kunal Sindhu, Brian Cohen, Joseph A. Gil, Travis Blood, Brett D. Owens
Given the similarities in the presentation of CECS with many other conditions, clinicians must rule out other potential etiologies of exercise-induced pain [22]. If claudication is suspected, vascular and cardiac consultations should be requested. Imaging should be acquired if periostitis or stress fracture is suspected. Myositis, chronic ligamentous or muscle injury, and compressive neuropathies may also be considered in the differential diagnosis [22].