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Dysplasia epiphysealis hemimelica: radiographic and magnetic resonance imaging features and clinical outcome of complete and incomplete resection
Objectives The objectives of this communication were to discuss radiographic and magnetic resonance (MR) imaging manifestations and clinical outcome after complete and incomplete resection of the mass of dysplasia epiphysealis hemimelica (DEH). Materials and methods Clinical records, radiographs, an...
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Published in: | Skeletal radiology 2010, Vol.39 (1), p.85-90 |
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description | Objectives
The objectives of this communication were to discuss radiographic and magnetic resonance (MR) imaging manifestations and clinical outcome after complete and incomplete resection of the mass of dysplasia epiphysealis hemimelica (DEH).
Materials and methods
Clinical records, radiographs, and MR images of eight patients with DEH were retrospectively examined. Six patients were treated by complete excision of the lesional mass, and two patients were treated by incomplete resection at our University Hospitals during the period from 1980 to 2006.
Results
We found that, unlike in osteochondroma, DEH was radiographically not clearly separable from the underlying or host bone with preserved cortical bone and marrow continuity. The finding in the talus distinguished DEH from (osteochondroma-like) parosteal osteosarcoma, in which a radiolucent demarcation line clearly separated the tumor from the host bone. The DEH mass had a well-defined low to intermediate signal intensity on T1-weighted images and an intermediate to high signal intensity on T2-weighted images, with irregularity of the articular surface. Simple excision was performed in all patients. The excision was complete in six patients and incomplete in two patients whose lesions was juxta-articular in the ankle and articular in the knee, respectively. The residual mass slowly absorbed and vanished, resulting in mild flaring of the affected portion of the epiphysis. No local recurrence or complication was seen in any of the eight patients.
Conclusions
Although the radiographic signs of DEH are characteristic, (osteochondroma-like) parosteal osteosarcoma should be differentiated from DEH when there is a radiolucent separation line between the mass and host bone in the talus. Simple excision was effective in the management of DEH if the deformity was not complicated. Incompletely excised masses resolved and vanished with time. |
doi_str_mv | 10.1007/s00256-009-0803-x |
format | article |
fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_733866978</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A730797061</galeid><sourcerecordid>A730797061</sourcerecordid><originalsourceid>FETCH-LOGICAL-c498t-5a43a55618aa04bc7d350850efbcba18d1b89c7ba4e3a8e3ba94fb0687fd24603</originalsourceid><addsrcrecordid>eNp9ks9u1DAQxiMEokvhAbigCAScUsaxYzu9VeWvVIkLnC3Hmey6ytrBTqTuY_DGzHZXrUCAfBjN-PeNPZqvKJ4zOGMA6l0GqBtZAbQVaODVzYNixQSvq5pJ9rBYAZeiqrnQJ8WTnK8BmFKNfFycsFYzDgxWxc_3uzyNNntb4uSnzS6jHX0uN7j1Wxy9s-dlsr2P62SnjXelDX25teuAMyUJcww2OCw91XxYlwPaeaHyLedGH6jDWMZldnGLZRxKitOIM94CPtylpEE3-xieFo8GO2Z8doynxfePH75dfq6uvn76cnlxVTnR6rlqrOC2aSTT1oLonOp5A7oBHDrXWaZ71unWqc4K5FYj72wrhg6kVkNfCwn8tHh76Dul-GPBPJutzw7H0QaMSzaKcy1lqzSRb_5L1qymtroh8OUf4HVcUqApTA2aNULJlqBXB2htRzQ-DHFO1u07mgvFQbUKJCPq7C8UnZ4W42LAwVP9NwE7CFyKOScczJRoKWlnGJi9W8zBLYbcYvZuMTekeXH879Jtsb9XHO1BwOsjYDPtcUi0a5_vuLpWQjAuiasPXKarsMZ0P_i_X_8F0eLZHQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>208154769</pqid></control><display><type>article</type><title>Dysplasia epiphysealis hemimelica: radiographic and magnetic resonance imaging features and clinical outcome of complete and incomplete resection</title><source>Springer Nature</source><creator>Bahk, Won-Jong ; Lee, Han-Yong ; Kang, Yong-Koo ; Park, Jung-Mi ; Chun, Kyeong-A ; Chung, Yang-Guk</creator><creatorcontrib>Bahk, Won-Jong ; Lee, Han-Yong ; Kang, Yong-Koo ; Park, Jung-Mi ; Chun, Kyeong-A ; Chung, Yang-Guk</creatorcontrib><description>Objectives
The objectives of this communication were to discuss radiographic and magnetic resonance (MR) imaging manifestations and clinical outcome after complete and incomplete resection of the mass of dysplasia epiphysealis hemimelica (DEH).
Materials and methods
Clinical records, radiographs, and MR images of eight patients with DEH were retrospectively examined. Six patients were treated by complete excision of the lesional mass, and two patients were treated by incomplete resection at our University Hospitals during the period from 1980 to 2006.
Results
We found that, unlike in osteochondroma, DEH was radiographically not clearly separable from the underlying or host bone with preserved cortical bone and marrow continuity. The finding in the talus distinguished DEH from (osteochondroma-like) parosteal osteosarcoma, in which a radiolucent demarcation line clearly separated the tumor from the host bone. The DEH mass had a well-defined low to intermediate signal intensity on T1-weighted images and an intermediate to high signal intensity on T2-weighted images, with irregularity of the articular surface. Simple excision was performed in all patients. The excision was complete in six patients and incomplete in two patients whose lesions was juxta-articular in the ankle and articular in the knee, respectively. The residual mass slowly absorbed and vanished, resulting in mild flaring of the affected portion of the epiphysis. No local recurrence or complication was seen in any of the eight patients.
Conclusions
Although the radiographic signs of DEH are characteristic, (osteochondroma-like) parosteal osteosarcoma should be differentiated from DEH when there is a radiolucent separation line between the mass and host bone in the talus. Simple excision was effective in the management of DEH if the deformity was not complicated. Incompletely excised masses resolved and vanished with time.</description><identifier>ISSN: 0364-2348</identifier><identifier>EISSN: 1432-2161</identifier><identifier>DOI: 10.1007/s00256-009-0803-x</identifier><identifier>PMID: 19813010</identifier><identifier>CODEN: SKRADI</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Biological and medical sciences ; Care and treatment ; Case Report ; Child ; Child, Preschool ; Clinical outcomes ; Diseases of the osteoarticular system ; Dysplasia ; Epiphyses - diagnostic imaging ; Epiphyses - surgery ; Female ; Fibrous Dysplasia of Bone - diagnostic imaging ; Fibrous Dysplasia of Bone - surgery ; Humans ; Imaging ; Investigative techniques, diagnostic techniques (general aspects) ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Medicine & Public Health ; Nuclear Medicine ; Orthopedics ; Osteoarticular system. Muscles ; Pathology ; Patient outcomes ; Postoperative Complications ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Radiography ; Radiology ; Retrospective Studies ; Surgery ; Treatment Outcome ; Tumors of striated muscle and skeleton</subject><ispartof>Skeletal radiology, 2010, Vol.39 (1), p.85-90</ispartof><rights>ISS 2009</rights><rights>2015 INIST-CNRS</rights><rights>COPYRIGHT 2010 Springer</rights><rights>ISS 2010</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c498t-5a43a55618aa04bc7d350850efbcba18d1b89c7ba4e3a8e3ba94fb0687fd24603</citedby><cites>FETCH-LOGICAL-c498t-5a43a55618aa04bc7d350850efbcba18d1b89c7ba4e3a8e3ba94fb0687fd24603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4023,27922,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22744136$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19813010$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bahk, Won-Jong</creatorcontrib><creatorcontrib>Lee, Han-Yong</creatorcontrib><creatorcontrib>Kang, Yong-Koo</creatorcontrib><creatorcontrib>Park, Jung-Mi</creatorcontrib><creatorcontrib>Chun, Kyeong-A</creatorcontrib><creatorcontrib>Chung, Yang-Guk</creatorcontrib><title>Dysplasia epiphysealis hemimelica: radiographic and magnetic resonance imaging features and clinical outcome of complete and incomplete resection</title><title>Skeletal radiology</title><addtitle>Skeletal Radiol</addtitle><addtitle>Skeletal Radiol</addtitle><description>Objectives
The objectives of this communication were to discuss radiographic and magnetic resonance (MR) imaging manifestations and clinical outcome after complete and incomplete resection of the mass of dysplasia epiphysealis hemimelica (DEH).
Materials and methods
Clinical records, radiographs, and MR images of eight patients with DEH were retrospectively examined. Six patients were treated by complete excision of the lesional mass, and two patients were treated by incomplete resection at our University Hospitals during the period from 1980 to 2006.
Results
We found that, unlike in osteochondroma, DEH was radiographically not clearly separable from the underlying or host bone with preserved cortical bone and marrow continuity. The finding in the talus distinguished DEH from (osteochondroma-like) parosteal osteosarcoma, in which a radiolucent demarcation line clearly separated the tumor from the host bone. The DEH mass had a well-defined low to intermediate signal intensity on T1-weighted images and an intermediate to high signal intensity on T2-weighted images, with irregularity of the articular surface. Simple excision was performed in all patients. The excision was complete in six patients and incomplete in two patients whose lesions was juxta-articular in the ankle and articular in the knee, respectively. The residual mass slowly absorbed and vanished, resulting in mild flaring of the affected portion of the epiphysis. No local recurrence or complication was seen in any of the eight patients.
Conclusions
Although the radiographic signs of DEH are characteristic, (osteochondroma-like) parosteal osteosarcoma should be differentiated from DEH when there is a radiolucent separation line between the mass and host bone in the talus. Simple excision was effective in the management of DEH if the deformity was not complicated. Incompletely excised masses resolved and vanished with time.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Care and treatment</subject><subject>Case Report</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Clinical outcomes</subject><subject>Diseases of the osteoarticular system</subject><subject>Dysplasia</subject><subject>Epiphyses - diagnostic imaging</subject><subject>Epiphyses - surgery</subject><subject>Female</subject><subject>Fibrous Dysplasia of Bone - diagnostic imaging</subject><subject>Fibrous Dysplasia of Bone - surgery</subject><subject>Humans</subject><subject>Imaging</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine & Public Health</subject><subject>Nuclear Medicine</subject><subject>Orthopedics</subject><subject>Osteoarticular system. Muscles</subject><subject>Pathology</subject><subject>Patient outcomes</subject><subject>Postoperative Complications</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Radiography</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumors of striated muscle and skeleton</subject><issn>0364-2348</issn><issn>1432-2161</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><recordid>eNp9ks9u1DAQxiMEokvhAbigCAScUsaxYzu9VeWvVIkLnC3Hmey6ytrBTqTuY_DGzHZXrUCAfBjN-PeNPZqvKJ4zOGMA6l0GqBtZAbQVaODVzYNixQSvq5pJ9rBYAZeiqrnQJ8WTnK8BmFKNfFycsFYzDgxWxc_3uzyNNntb4uSnzS6jHX0uN7j1Wxy9s-dlsr2P62SnjXelDX25teuAMyUJcww2OCw91XxYlwPaeaHyLedGH6jDWMZldnGLZRxKitOIM94CPtylpEE3-xieFo8GO2Z8doynxfePH75dfq6uvn76cnlxVTnR6rlqrOC2aSTT1oLonOp5A7oBHDrXWaZ71unWqc4K5FYj72wrhg6kVkNfCwn8tHh76Dul-GPBPJutzw7H0QaMSzaKcy1lqzSRb_5L1qymtroh8OUf4HVcUqApTA2aNULJlqBXB2htRzQ-DHFO1u07mgvFQbUKJCPq7C8UnZ4W42LAwVP9NwE7CFyKOScczJRoKWlnGJi9W8zBLYbcYvZuMTekeXH879Jtsb9XHO1BwOsjYDPtcUi0a5_vuLpWQjAuiasPXKarsMZ0P_i_X_8F0eLZHQ</recordid><startdate>2010</startdate><enddate>2010</enddate><creator>Bahk, Won-Jong</creator><creator>Lee, Han-Yong</creator><creator>Kang, Yong-Koo</creator><creator>Park, Jung-Mi</creator><creator>Chun, Kyeong-A</creator><creator>Chung, Yang-Guk</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>2010</creationdate><title>Dysplasia epiphysealis hemimelica: radiographic and magnetic resonance imaging features and clinical outcome of complete and incomplete resection</title><author>Bahk, Won-Jong ; Lee, Han-Yong ; Kang, Yong-Koo ; Park, Jung-Mi ; Chun, Kyeong-A ; Chung, Yang-Guk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c498t-5a43a55618aa04bc7d350850efbcba18d1b89c7ba4e3a8e3ba94fb0687fd24603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Care and treatment</topic><topic>Case Report</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Clinical outcomes</topic><topic>Diseases of the osteoarticular system</topic><topic>Dysplasia</topic><topic>Epiphyses - diagnostic imaging</topic><topic>Epiphyses - surgery</topic><topic>Female</topic><topic>Fibrous Dysplasia of Bone - diagnostic imaging</topic><topic>Fibrous Dysplasia of Bone - surgery</topic><topic>Humans</topic><topic>Imaging</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine & Public Health</topic><topic>Nuclear Medicine</topic><topic>Orthopedics</topic><topic>Osteoarticular system. Muscles</topic><topic>Pathology</topic><topic>Patient outcomes</topic><topic>Postoperative Complications</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Radiography</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumors of striated muscle and skeleton</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bahk, Won-Jong</creatorcontrib><creatorcontrib>Lee, Han-Yong</creatorcontrib><creatorcontrib>Kang, Yong-Koo</creatorcontrib><creatorcontrib>Park, Jung-Mi</creatorcontrib><creatorcontrib>Chun, Kyeong-A</creatorcontrib><creatorcontrib>Chung, Yang-Guk</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Biological Sciences</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Skeletal radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bahk, Won-Jong</au><au>Lee, Han-Yong</au><au>Kang, Yong-Koo</au><au>Park, Jung-Mi</au><au>Chun, Kyeong-A</au><au>Chung, Yang-Guk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dysplasia epiphysealis hemimelica: radiographic and magnetic resonance imaging features and clinical outcome of complete and incomplete resection</atitle><jtitle>Skeletal radiology</jtitle><stitle>Skeletal Radiol</stitle><addtitle>Skeletal Radiol</addtitle><date>2010</date><risdate>2010</risdate><volume>39</volume><issue>1</issue><spage>85</spage><epage>90</epage><pages>85-90</pages><issn>0364-2348</issn><eissn>1432-2161</eissn><coden>SKRADI</coden><abstract>Objectives
The objectives of this communication were to discuss radiographic and magnetic resonance (MR) imaging manifestations and clinical outcome after complete and incomplete resection of the mass of dysplasia epiphysealis hemimelica (DEH).
Materials and methods
Clinical records, radiographs, and MR images of eight patients with DEH were retrospectively examined. Six patients were treated by complete excision of the lesional mass, and two patients were treated by incomplete resection at our University Hospitals during the period from 1980 to 2006.
Results
We found that, unlike in osteochondroma, DEH was radiographically not clearly separable from the underlying or host bone with preserved cortical bone and marrow continuity. The finding in the talus distinguished DEH from (osteochondroma-like) parosteal osteosarcoma, in which a radiolucent demarcation line clearly separated the tumor from the host bone. The DEH mass had a well-defined low to intermediate signal intensity on T1-weighted images and an intermediate to high signal intensity on T2-weighted images, with irregularity of the articular surface. Simple excision was performed in all patients. The excision was complete in six patients and incomplete in two patients whose lesions was juxta-articular in the ankle and articular in the knee, respectively. The residual mass slowly absorbed and vanished, resulting in mild flaring of the affected portion of the epiphysis. No local recurrence or complication was seen in any of the eight patients.
Conclusions
Although the radiographic signs of DEH are characteristic, (osteochondroma-like) parosteal osteosarcoma should be differentiated from DEH when there is a radiolucent separation line between the mass and host bone in the talus. Simple excision was effective in the management of DEH if the deformity was not complicated. Incompletely excised masses resolved and vanished with time.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>19813010</pmid><doi>10.1007/s00256-009-0803-x</doi><tpages>6</tpages></addata></record> |
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subjects | Adolescent Biological and medical sciences Care and treatment Case Report Child Child, Preschool Clinical outcomes Diseases of the osteoarticular system Dysplasia Epiphyses - diagnostic imaging Epiphyses - surgery Female Fibrous Dysplasia of Bone - diagnostic imaging Fibrous Dysplasia of Bone - surgery Humans Imaging Investigative techniques, diagnostic techniques (general aspects) Magnetic Resonance Imaging Male Medical sciences Medicine & Public Health Nuclear Medicine Orthopedics Osteoarticular system. Muscles Pathology Patient outcomes Postoperative Complications Radiodiagnosis. Nmr imagery. Nmr spectrometry Radiography Radiology Retrospective Studies Surgery Treatment Outcome Tumors of striated muscle and skeleton |
title | Dysplasia epiphysealis hemimelica: radiographic and magnetic resonance imaging features and clinical outcome of complete and incomplete resection |
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