Specialists

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Sarcoma (Epitheloid and Synovial)

Basics Description Epithelioid sarcoma: A high-grade soft-tissue sarcoma that is prone to local recurrence, lymph node invasion, and pulmonary metastases. Most common soft-tissue sarcoma of the upper extremity Often confused with granulomatous processes Occurs often in young patients (15-40 years old) Synovial sarcoma: A high-grade malignancy on the soft tissue Occurs in para-articular regions […]

Sacral Insufficiency Fracture

Basics Description Sacral Insufficiency fractures occur in the sacral ala between the SI joints and the neural foramina (Denis Zone 1). The fracture pattern adopts a characteristic H-shape, which is pathonemonic of the condition. It is postulated that the vertical limbs of the H occur 1st, followed by the transverse fracture line. In ~50% […]

Metastatic Bone Disease

Basics Description The most common cause of destructive bone lesions in the adult The amount of bone destruction varies from small amounts to complete fracture. Bone metastases occur less commonly in children than in adults. Virtually any malignancy may metastasize to bone. With some cancers (such as breast and prostate cancer), virtually all patients […]

Heterotopic Ossification

Basics Description Pathologic bone formation as a consequence of direct trauma or central nervous system injuries Bone formed in heterotopic locations such as muscle, subcutaneous tissues, or nerves Most commonly occurs at the hip, elbow, and shoulder joints. Epidemiology Less common in children than in adults, and more common in males than in females […]

Hemophilia

Basics Description This disorder of clotting factor results in easy bleeding. Secondary effects may occur in any system (most importantly brain, joint, muscle, and nerve) secondary to bleeding. Depending on its severity, it usually is diagnosed in early childhood. Classification: Severe: <1% clotting factor activity Moderate: 1-5% clotting factor activity Mild: >5% clotting factor […]

Giant Cell Tumor

Basics Description A benign but often locally aggressive neoplasm, characterized by large numbers of uniformly distributed, osteoclastlike giant cells and a background population of plump, epithelioid-to-spindle mononuclear cells. The vast majority of these tumors are located near the articular end of a tubular bone; ~50% occur in the knee. Other frequently involved sites: Distal […]

Ewing Sarcoma

Basics Description Ewing sarcoma is a malignant bone tumor of the long bones, pelvis, and spine usually seen in childhood. Bone pain is the most common finding. Fever and an elevated white blood cell count and ESR sometimes are found. Nerve root irritation may be noted in patients with spinal lesions. It most commonly […]

Elbow Arthritis

Basics Description The elbow can be affected by inflammatory and noninflammatory arthropathies. Regardless of the underlying pathologic process, elbow arthritis generally presents with pain on ROM and loading of the affected joint. Epidemiology Incidence Uncommon Primary osteoarthritis accounts for 1-2% of all elbow arthritis; the remainder are inflammatory or posttraumatic. Can occur in any […]

Desmoid Tumor (Extra-Abdominal)

Basics Description A common benign soft-tissue tumor that occurs in young patients Although this tumor never metastasizes, a high rate of local recurrence occurs in the following locations: Neck: 8% Shoulder: 22% Upper arm: 6% Chest wall/back: 17% Buttock/hip: 6% Thigh: 12% Knee: 7% Lower leg: 5% Synonyms: Desmoid tumor; Extra-abdominal fibromatosis; Well-differentiated fibrosarcoma; […]

Cervical Spine Trauma: Dislocation and Subluxation

Basics Description 11,000 cases annually require surgery. Average hospital stay: 9.4 days ; a prolonged stay partly attributable to delay in diagnosing vertebral injuries (frequently missed) Careful trauma-patient evaluation, increased understanding of injury patterns, and advanced imaging and treatment have decreased the morbidity and mortality associated with spinal column injuries . Classification: The Denis […]