Monday, May 30, 2011

Fibrous dysplasia of bone - Diagnosis

Laboratory studies:-Molecular diagnostics using chain polymerization techniqueSerum alkaline-phosphatase is elevated during the active phase of the disease and is useful for evaluating disease progression in patients treated with bisphosphonates-25% Of patients suffering from vitamin D deficiency, the level of vitamin D, calcium and phosphate are useful to exclude ricketsAnd gonadosteroizii-pituitary gonadotropins are important to assess early puberty.
Imaging Studies:Plain X-ray bone: femur bone is most affected. Long bones and spinal injuries are affecting the shaft of the expansion into metaphysics. Typical glass matrix lesion looks crushed. Endosteal lesion produces collapse. The contour of the bone is increased by injury. Classical deformation by affecting proximal femur is described as a hunchback because varus.Scintigraphy with technetium 99 bone scan shows increased catchment areas affected due to the activity of osteoblasts observed in radiographs. The study is useful to distinguish the form of polyostotic disease monostotic.CT scan confirmed the bone lesions within the bone. It is useful to distinguish fibrous dysplasia a neoplasm. Show homogeneous matrix.Bone biopsy is useful for diagnosis of fibrous dysplasia, especially in cases monostotic. Open biopsy should be performed only as part of a multidisciplinary approach to differentiate benign and malignant bone tumors.Histological examination: macroscopic lesion is located centrally and sandy gray to palpation. The microscopic appearance showed a collagen matrix / fiber or fiber neoniform oriented bone formed trabecular bone metaplasia. Spiculii immature bone that are produced are short and irregular and are lined by osteoblasts. The appearance of Chinese letters is. Small nodules of cartilage are found in bone matrix in 10% of cases.The differential diagnosis is made with the following conditions: encondromul, eosinophilic granuloma, fibroma nonosificant, giant cell tumor, hemangioma, primary hyperparathyroidism, neurofibromatosis type 1, Paget disease, bone metastases.

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