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Igbinoba Z, Jaramillo D. MR Imaging of the Developing Pediatric Marrow: An Overview of Pearls and Pitfalls. Semin Musculoskelet Radiol 2023; 27:22-29. [PMID: 36868242 DOI: 10.1055/s-0043-1762583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
The dynamic and developing pediatric skeleton is a well-elucidated process that occurs in a stepwise faction. Normal development has been reliably tracked and described with Magnetic Resonance (MR) imaging. The recognition of the normal patterns of skeletal development is essential, as normal development may mimic pathology and vice versa. The authors review normal skeleton maturation and the corollary imaging findings while highlighting common marrow imaging pitfalls and pathology.
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Affiliation(s)
- Zenas Igbinoba
- Department of Radiology, New York Presbyterian Hospital, New York, New York
| | - Diego Jaramillo
- Department of Radiology, Columbia University Medical Center, New York, New York
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Adams NC, Alonge RL, Edmonds LD. Hawkins sign of the knee: Imaging appearance and clinical implication of an unusual pattern of disuse osteopenia. J Clin Imaging Sci 2022; 12:51. [PMID: 36128347 PMCID: PMC9479503 DOI: 10.25259/jcis_33_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022] Open
Abstract
Disuse osteopenia (DO) is a disorder due to reduced weight-bearing often following immobilization injuries. It is most commonly observed in the ankles and knees and is believed to be due primarily to increased bone reabsorption associated with disuse. Both traditional radiography and magnetic resonance (MR) imaging are useful in identifying abnormalities associated with DO. Specifically, linear subchondral osteopenia has been given the term "Hawkins sign" when seen in the talus, but this finding may also be seen elsewhere. When present, it not only is an indication of DO but also indicates the presence of sufficient vascular flow, and the unlikely development of avascular necrosis. We report a case of Hawkins sign of the knee demonstrated on radiography and MR and demonstrate the clinical importance of recognizing this sign, outside its usual setting, in assessing the prognosis of a healing fracture.
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Affiliation(s)
- Nicholas C. Adams
- Department of Radiology, David Grant Medical Center, Fairfield, California, United States.,Corresponding author: Nicholas C. Adams, Department of Radiology, David Grant Medical Center, Fairfield, California, United States.
| | - Robin L. Alonge
- Department of Radiology, David Grant Medical Center, Fairfield, California, United States
| | - Lance D. Edmonds
- Department of Radiology, David Grant Medical Center, Fairfield, California, United States
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The Proximal Tibia Loses Bone Mineral Density After Anterior Cruciate Ligament Injury: Measurement Technique and Validation of a Quantitative Computed Tomography Method. Arthrosc Sports Med Rehabil 2021; 3:e1921-e1930. [PMID: 34977649 PMCID: PMC8689278 DOI: 10.1016/j.asmr.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/20/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Results Conclusions Level of Evidence
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Veeriah V, Paone R, Chatterjee S, Teti A, Capulli M. Osteoblasts Regulate Angiogenesis in Response to Mechanical Unloading. Calcif Tissue Int 2019; 104:344-354. [PMID: 30465120 DOI: 10.1007/s00223-018-0496-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 11/16/2018] [Indexed: 12/29/2022]
Abstract
During mechanical unloading, endothelial cells reduce osteogenesis and increase bone resorption. Here we describe the feedback response of endothelial cells to unloaded osteoblasts. Primary endothelial cells, ex vivo mouse aortic rings and chicken egg yolk membranes were incubated with conditioned medium from mouse primary osteoblasts (OB-CM) subjected to unit gravity or simulated microgravity, to assess its effect on angiogenesis. In vivo injection of botulin toxin A (Botox) in the quadriceps and calf muscles of C57BL/6J mice was performed to mimic disuse osteoporosis. Unloaded osteoblasts showed strong upregulation of the pro-angiogenic factor, VEGF, and their conditioned medium increased in vitro endothelial cell viability, Cyclin D1 expression, migration and tube formation, ex vivo endothelial cell sprouting from aortic rings, and in ovo angiogenesis. Treatment with the VEGF blocker, avastin, prevented unloaded OB-CM-mediated in vitro and ex vivo enhancement of angiogenesis. Bone mechanical unloading by Botox treatment, known to reduce bone mass, prompted the overexpression of VEGF in osteoblasts. The cross talk between osteoblasts and endothelial cells plays a pathophysiologic role in the response of the endothelium to unloading during disuse osteoporosis. In this context, VEGF represents a prominent osteoblast factor stimulating angiogenesis.
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Affiliation(s)
- Vimal Veeriah
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, via Vetoio - Coppito 2, 67100, L'aquila, Italy
| | - Riccardo Paone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, via Vetoio - Coppito 2, 67100, L'aquila, Italy
| | - Suvro Chatterjee
- Anna University K.B.Chandrashekar Research Centre, Chennai, India
- Department of Biotechnology, Anna University, Chennai, India
| | - Anna Teti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, via Vetoio - Coppito 2, 67100, L'aquila, Italy.
| | - Mattia Capulli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, via Vetoio - Coppito 2, 67100, L'aquila, Italy
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New Veterinary Biologic Products. J Am Vet Med Assoc 2018. [DOI: 10.2460/javma.252.8.932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kon E, Ronga M, Filardo G, Farr J, Madry H, Milano G, Andriolo L, Shabshin N. Bone marrow lesions and subchondral bone pathology of the knee. Knee Surg Sports Traumatol Arthrosc 2016; 24:1797-814. [PMID: 27075892 DOI: 10.1007/s00167-016-4113-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/25/2016] [Indexed: 01/03/2023]
Abstract
Bone marrow lesions (BMLs) around the knee are a common magnetic resonance imaging (MRI) finding. However, despite the growing interest on BMLs in multiple pathological conditions, they remain controversial not only for the still unknown role in the etiopathological processes, but also in terms of clinical impact and treatment. The differential diagnosis includes a wide range of conditions: traumatic contusion and fractures, cyst formation and erosions, hematopoietic and infiltrated marrow, developmental chondroses, disuse and overuse, transient bone marrow oedema syndrome and, lastly, subchondral insufficiency fractures and true osteonecrosis. Regardless the heterogeneous spectrum of these pathologies, a key factor for patient management is the distinction between reversible and irreversible conditions. To this regard, MRI plays a major role, leading to the correct diagnosis based on recognizable typical patterns that have to be considered together with coexistent abnormalities, age, and clinical history. Several treatment options have been proposed, from conservative to surgical approaches. In this manuscript the main lesion patterns and their management have been analysed to provide the most updated evidence for the differential diagnosis and the most effective treatment.
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Affiliation(s)
- Elizaveta Kon
- Biomechanics and Technology Innovation Laboratory, II Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy. .,Nano-Biotechnology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy.
| | - Mario Ronga
- Orthopaedics and Traumatology - Department of Biotechnology and Life Sciences (DBSV), University of Insubria, Varese, Italy
| | - Giuseppe Filardo
- Biomechanics and Technology Innovation Laboratory, II Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Jack Farr
- OrthoIndy Cartilage Restoration Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Henning Madry
- Department of Orthopaedic Surgery, Center of Experimental Orthopaedics, Saarland University Medical Center, Homburg/Saar, Germany
| | - Giuseppe Milano
- Department of Orthopaedics, Catholic University, A. Gemelli University Hospital, Rome, Italy
| | - Luca Andriolo
- Biomechanics and Technology Innovation Laboratory, II Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy
| | - Nogah Shabshin
- Department of Radiology, Hospital of University of Pennsylvania, Philadelphia, PA, USA.,Department of Radiology, HaEmek University Medical Center, Afula, Israel
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