Posttraumatic Osteolysis of the Pubic Bone Simulating Malignancy

Posttraumatic osteolysis (PO) of the os pubis is a diagnostic entity characterized at radiography by rapidly progressing destructive changes in fractures of the pubic body or rami. Fourteen patients with PO are here reported of whom in 8 the radiographic course of the condition was followed. They were all post-menopausal women and 7 were predisposed to osteopenia. The primary fractures were related to mild trauma in 7 patients and 7 had insufficiency fractures. Four patients had bilateral symmetrical PO. All 14 patients had concomitant insufficiency fractures of the sacrum observed at radiography, CT, scintigraphy or MR, probably due to pelvic instability caused by the PO of the os pubis. Symptoms of the sacral fractures usually dominated the clinical condition. Bony healing of the PO did not occur in any of the patients, but in all 8 patients followed radiographically, the fractures of the sacrum healed clinically and at CT. Knowledge about the condition is important to avoid unnecessary biopsy of the PO considered a metastatic lesion and/or extensive diagnostic search for a primary tumor.

Posttraumatic spinal osteolysis in ankylosing spondylitis as part of pseudoarthrosis. A case report

A case of ankylosing spondylitis with pronounced osteolysis of the 12th thoracic vertebral body as part of posttraumatic pseudoarthrosis is described. The appearance of posttraumatic osteolysis simulates a malignant lesion, and it is important to consider the diagnosis in cases of osteolytic lesions of unknown origin.

Fatigue fracture of the sacral bone associated with septic arthritis of the symphysis pubis

Fractures of the pubic rami are almost invariably associated with fractures of the posterior arch of the pelvic ring. Two women, aged 50 and 67 years, with septic arthritis of the symphysis pubis attended by severe low back pain, were followed with CT and MR imaging of the pelvis, as well as bond scintigraphy in one patient. In the first patient sacral fractures with severe displacement were revealed, prompting stabilizing symphysiodesis. In the second patient an undisplaced fatigue fracture was confirmed in the right half of the sacrum. In patients with pelvic laxity following arthritis of the symphysis and post-traumatic osteolysis associated with low back pain, displaced or occult fractures of the bones adjacent to the sacroiliac joints should be considered.

Posttraumatic osteolysis of the pubic bone simulating malignancy

Posttraumatic osteolysis (PO) of the os pubis is a diagnostic entity characterized at radiography by rapidly progressing destructive changes in fractures of the pubic body or rami. Fourteen patients with PO are here reported of whom in 8 the radiographic course of the condition was followed. They were all post-menopausal women and 7 were predisposed to osteopenia. The primary fractures were related to mild trauma in 7 patients and 7 had insufficiency fractures. Four patients had bilateral symmetrical PO. All 14 patients had concomitant insufficiency fractures of the sacrum observed at radiography, CT, scintigraphy or MR, probably due to pelvic instability caused by the PO of the os pubis. Symptoms of the sacral fractures usually dominated the clinical condition. Bony healing of the PO did not occur in any of the patients, but in all 8 patients followed radiographically, the fractures of the sacrum healed clinically and at CT. Knowledge about the condition is important to avoid unnecessary biopsy of the PO considered a metastatic lesion and/or extensive diagnostic search for a primary tumor.

[Pulmonary rheumatoid nodules. A rare disease onset in rheumatoid arthritis]

Rheumatoid nodules are a benign differential diagnosis to neoplasia and infection, when round lesions are accidental findings on chest X-ray. Two cases are reported of rheumatoid lung nodules as presenting features of rheumatoid arthritis. In each case, the diagnosis was verified by open biopsy.