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Liu X, Ren Q, Bai J, Kang P, Ren G, Li X, Feng X. Imaging analysis of 1 138 supernumerary teeth by using cone-beam computed tomography. Hua Xi Kou Qiang Yi Xue Za Zhi 2023; 41:671-677. [PMID: 38597032 PMCID: PMC10722453 DOI: 10.7518/hxkq.2023.2023110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/11/2023] [Indexed: 04/11/2024]
Abstract
OBJECTIVES This study aims to analyze and summarize the characteristics of supernumerary teeth by using cone-beam computed tomography (CBCT). METHODS A total of 718 patients with 1 138 supernumerary teeth were retrospectively collected. Age, gender, number, location, morphology, eruption status, and accompanying symptoms of the supernumerary teeth were statistically analyzed. The relationship relative to jaws, gender, and eruption status were analyzed and discussed. RESULTS The average age of the patients was 9.54±5.32 years, and the male to female ratio was 2.88∶1. About 77.02% of the patients sought medical advice during the mixed dentition period, and 50.70% had one supernumerary tooth. These supernumeraries were most commonly conical in shape, and 85.76% of them were in the incisor region, 92.09% in the upper jaw, 46.75% in inverted position, and 86.20% unerupted. Overall, 65.29% of them had fully developed roots, and 60.63% had an impact on adjacent structures. Significant differences were found in eruption status, morphology, zoning, direction, root development, and impact on adjacent structures between the supernumerary teeth located in the upper and lower jaws (P<0.05). Significant differences were also detected in gender, morphology, zoning, orientation, root development, and impact on adjacent structures between erupted and unerupted teeth (P<0.05). The incidence of supernumerary teeth in the incisor region was higher in males than that in females. Moreover, the root of supernumeraries was more completely developed in males than in females (P<0.05). CONCLUSIONS For supernumerary teeth, CBCT images can provide accurate three-dimensional radiographic data and are valuable for clinical diagnosis and treatment planning.
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Affiliation(s)
- Xiaolin Liu
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China
| | - Qun Ren
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China
| | - Jiuping Bai
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China
| | - Pei Kang
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China
| | - Guiyun Ren
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China
| | - Xiangjun Li
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China
| | - Xiaowei Feng
- Dept. of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Hebei Medical University, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, Shijiazhuang 050017, China
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Patel S, Abella F, Patel K, Lambrechts P, Al-Nuaimi N. Clinical and radiographic features of external cervical resorption - An observational study. Int Endod J 2023; 56:1475-1487. [PMID: 37801348 DOI: 10.1111/iej.13968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/30/2023] [Accepted: 08/17/2023] [Indexed: 10/07/2023]
Abstract
AIM To determine the prevalence of symptoms, clinical signs and radiographic presentation of external cervical resorption (ECR). METHODOLOGY This study involved 215 ECR lesions in 194 patients referred to the Endodontic postgraduate Unit at King's College London or Specialist Endodontic practice (London, UK). The clinical and radiographic findings (periapical [PA] and cone beam computed tomography [CBCT]) were readily accessible for evaluation. A checklist was used for data collection. Inferential analysis was carried out to determine if there was any potential association between type and location of tooth in the jaw as well as sex, age of the patient and ECR presentation and radiographic feature. RESULTS Eighty-eight patients (94 teeth) were female and 106 patients were male (121 teeth), the mean age (±SD) was 41.5 (±17.7) years. Fifteen patients (7.7%) had more than one ECR lesion. The most affected teeth were maxillary central incisors (21.4% [46 teeth]) and mandibular first molars (10.2% [22 teeth]). ECR was most commonly detected as an incidental radiographic finding in 58.1% [125 teeth] of the cases. ECR presented with symptoms of pulpal/periapical disease in 23.3% [n = 50] and clinical signs (e.g. pink spot, cavitation) in 16.7% [36 teeth] of the cases. Clinical signs such as cavitation (14%), pink spot (5.1%) and discolouration (2.8%) were uncommon, but their incidence increased up to 24.7% when combined with other clinical findings. ECR was detected in the resorptive and reparative phases in 70.2% and 29.8% of the cases respectively. CONCLUSION ECR appears to be quiescent in nature, the majority being asymptomatic and diagnosed incidentally from PA or CBCT. When assessed with the Patel classification, most lesions were minimal to moderate in relation to their height (1 or 2) and circumferential spread (A or B). However, the majority of ECRs were in (close) proximity to the pulp. Symptoms and clinical signs were associated with (probable) pulp involvement rather than the height and circumferential spread of the lesion. Clinical signs were more frequently associated when ECR affected multiple surfaces.
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Affiliation(s)
- Shanon Patel
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Private Practice, London, UK
- Guy's & St. Thomas', NHS Trust, London, UK
| | | | - Kreena Patel
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Paul Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Nassr Al-Nuaimi
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Department of Restorative & Aesthetic Dentistry, College of Dentistry, University of Baghdad, Baghdad, Iraq
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Zhang Y, Zhang H, Zhang H, Ouyang Y, Su R, Yang W, Huang B. Glioblastoma and Solitary Brain Metastasis: Differentiation by Integrating Demographic-MRI and Deep-Learning Radiomics Signatures. J Magn Reson Imaging 2023. [PMID: 37955154 DOI: 10.1002/jmri.29123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/26/2023] [Accepted: 10/27/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Studies have shown that deep-learning radiomics (DLR) could help differentiate glioblastoma (GBM) from solitary brain metastasis (SBM), but whether integrating demographic-MRI and DLR features can more accurately distinguish GBM from SBM remains uncertain. PURPOSE To construct and validate a demographic-MRI deep-learning radiomics nomogram (DDLRN) integrating demographic-MRI and DLR signatures to differentiate GBM from SBM preoperatively. STUDY TYPE Retrospective. POPULATION Two hundred and thirty-five patients with GBM (N = 115) or SBM (N = 120), randomly divided into a training cohort (90 GBM and 98 SBM) and a validation cohort (25 GBM and 22 SBM). FIELD STRENGTH/SEQUENCE Axial T2-weighted fast spin-echo sequence (T2WI), T2-weighted fluid-attenuated inversion recovery sequence (T2-FLAIR), and contrast-enhanced T1-weighted spin-echo sequence (CE-T1WI) using 1.5-T and 3.0-T scanners. ASSESSMENT The demographic-MRI signature was constructed with seven imaging features ("pool sign," "irregular ring sign," "regular ring sign," "intratumoral vessel sign," the ratio of the area of peritumoral edema to the enhanced tumor, the ratio of the lesion area on T2-FLAIR to CE-T1WI, and the tumor location) and demographic factors (age and sex). Based on multiparametric MRI, radiomics and deep-learning (DL) models, DLR signature, and DDLRN were developed and validated. STATISTICAL TESTS The Mann-Whitney U test, Pearson test, least absolute shrinkage and selection operator, and support vector machine algorithm were applied for feature selection and construction of radiomics and DL models. RESULTS DDLRN showed the best performance in differentiating GBM from SBM with area under the curves (AUCs) of 0.999 and 0.947 in the training and validation cohorts, respectively. Additionally, the DLR signature (AUC = 0.938) outperformed the radiomics and DL models, and the demographic-MRI signature (AUC = 0.775) was comparable to the T2-FLAIR radiomics and DL models in the validation cohort (AUC = 0.762 and 0.749, respectively). DATA CONCLUSION DDLRN integrating demographic-MRI and DLR signatures showed excellent performance in differentiating GBM from SBM. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yuze Zhang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hongbo Zhang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Hanwen Zhang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ying Ouyang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ruru Su
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Wanqun Yang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Biao Huang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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M M, Pillai DS. Correlation of Diabetic Status and Coronavirus Disease 2019 (COVID-19) in Patients With Mucormycosis: A Retrospective Clinical Study. Cureus 2023; 15:e48936. [PMID: 38111411 PMCID: PMC10727452 DOI: 10.7759/cureus.48936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
AIM Coronavirus disease 2019 (COVID-19) and its association with diabetes might lead to mucormycosis, and studies have reported an association between them. This study aims to find the correlation between COVID-19 and diabetic status in patients with mucormycosis and its role in disease progression and prognosis. The objectives of the study are to analyze the clinical range of mucormycosis in those with diabetes and COVID-19 and to correlate the clinical and radiographic findings. MATERIALS AND METHODOLOGY A retrospective cohort analysis was carried out at Saveetha Dental College and Hospitals in Chennai (approval number: IHEC/SDC/OMED-2204/23/218). The data collection was done from the institution's electronic database from April 2019 to April 2023 which included the patients' age and gender and COVID-19 and diabetic status and clinical and radiographic features of mucormycosis. RESULTS From the data analyzed, 25 patients had a history of mucormycosis with diabetes and COVID-19 infections. The patients' average age was 47.76, out of which 22 were males and three were females. The chi-squared test showed no significant association between age (0.178), diabetes (0.465), and COVID-19 (0.583). Spearman's correlation was done showing an association between mucormycosis, diabetes, and COVID-19. Radiographically, 100% of the patients had involvement of the maxillary sinus, followed by the palate (32%), orbit (28%), nasal floor (24%), ethmoidal sinus (16%), sphenoidal sinus (12%), and frontal sinus (8%). CONCLUSION The findings of this study point out the importance of considering the presence of systemic comorbidities like diabetes in COVID-19 patients. Early identification, surgical debridement, and antifungal medications are part of the treatment for increased survival.
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Affiliation(s)
- Madhumitha M
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, IND
| | - Devika S Pillai
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, IND
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Abstract
Aim This study aimed to evaluate the potential usefulness of Chat Generated Pre-Trained Transformer-3 (ChatGPT-3) in oral and maxillofacial radiology for report writing by identifying radiographic anatomical landmarks and learning about oral and maxillofacial pathologies and their radiographic features. The study also aimed to evaluate the performance of ChatGPT-3 and its usage in oral and maxillofacial radiology training. Materials and methods A questionnaire consisting of 80 questions was queried on the OpenAI app ChatGPT-3. The questions were stratified based on three categories. The categorization was based on random anatomical landmarks, oral and maxillofacial pathologies, and the radiographic features of some of these pathologies. One oral and maxillofacial radiologist evaluated queries that were answered by the ChatGPT-3 model and rated them on a 4-point, modified Likert scale. The post-survey analysis for the performance of ChatGPT-3 was based on the Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis, its application in oral and maxillofacial radiology training, and its recommended use. Results In order of efficiency, Chat GPT-3 gave 100% accuracy in describing radiographic landmarks. However, the content of the oral and maxillofacial pathologies was limited to major or characteristic radiographic features. The mean scores for the queries related to the anatomic landmarks, oral and maxillofacial pathologies, and radiographic features of the oral and maxillofacial pathologies were 3.94, 3.85, and 3.96, respectively. However, the median and mode scores were 4 and were similar to all categories. The data for the oral and maxillofacial pathologies when the questions were not specifically included in the format of the introduction of the pathology, causes, symptoms, and treatment. Out of two abbreviations, one was not answered correctly. Conclusion The study showed that ChatGPT-3 is efficient in describing the pathology, characteristic radiographic features, and describing anatomical landmarks. ChatGPT-3 can be used as an adjunct when an oral radiologist needs additional information on any pathology, however, it cannot be the mainstay for reference. ChatGPT-3 is less detail-oriented, and the data has a risk of infodemics and the possibility of medical errors. However, Chat GPT-3 can be an excellent tool in helping the community in increasing the knowledge and awareness of various pathologies and decreasing the anxiety of the patients while dental healthcare professionals formulate an appropriate treatment plan.
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Affiliation(s)
- Jyoti Mago
- Oral and Maxillofacial Radiology, University of Nevada, Las Vegas (UNLV), Las Vegas, USA
| | - Manoj Sharma
- Public Health, University of Nevada, Las Vegas (UNLV), Las Vegas, USA
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Nandini DB, Devi TP, Deepak BS, Sanjeeta N. Incidental finding of orthokeratinized odontogenic cyst with unusual features. J Oral Maxillofac Pathol 2022; 26:130. [PMID: 35571311 PMCID: PMC9106234 DOI: 10.4103/jomfp.jomfp_133_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/03/2021] [Accepted: 01/25/2022] [Indexed: 12/04/2022] Open
Abstract
Orthokeratinized odontogenic cyst (OOC) is a rare developmental odontogenic cyst occurring in the jaw with debated etiology. It was originally believed to be a variant of odontogenic keratocyst (OKC) but is now considered to be a distinct entity. The majority of the cases occur in the third and fourth decades of life. The common site is the mandibular posterior region with a male predilection. Swelling is the most common symptom which may be accompanied by pain, although in most cases, the lesion is asymptomatic. These lesions mostly present as unilocular radiolucency often associated with an impacted tooth. They may mimic dentigerous cyst and OKC in radiologic and histopathologic presentation, however, differ in biological behavior, pathogenesis and prognosis in comparison. Hence, making an accurate diagnosis is essential. This article describes an incidental finding of OOC in a 28-year-old female during radiographic investigation for orthodontic treatment. This case showed some rare features such as multilocular radiolucency, nonkeratinized epithelium in areas of inflammation, few cholesterol clefts with giant cells, presence of dentinoid-like material and dystrophic calcification in the capsule.
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Affiliation(s)
- D B Nandini
- Department of Oral Pathology and Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - T Premlata Devi
- Department of Conservative Dentistry and Endodontics Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - B S Deepak
- Department of Conservative Dentistry and Endodontics Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
| | - Ngairangbam Sanjeeta
- Department of Oral Pathology and Microbiology, Regional Institute of Medical Sciences, Imphal, Manipur, India
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Pulvirenti A, Margonis GA, Morales-Oyarvide V, McIntyre CA, Lawrence SA, Goldman DA, Gonen M, Weiss MJ, Ferrone CR, He J, Brennan MF, Cameron JL, Lillemoe KD, Kingham TP, Balachandran V, Qadan M, D’Angelica MI, Jarnagin WR, Wolfgang CL, Castillo CFD, Allen PJ. Intraductal Papillary Mucinous Neoplasms: Have IAP Consensus Guidelines Changed our Approach?: Results from a Multi-institutional Study. Ann Surg 2021; 274:e980-e987. [PMID: 31804389 PMCID: PMC8503800 DOI: 10.1097/sla.0000000000003703] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To evaluate the influence of consensus guidelines on the management of intraductal papillary mucinous neoplasms (IPMN) and the subsequent changes in pathologic outcomes. BACKGROUND Over time, multiple guidelines have been developed to identify high-risk IPMN. We hypothesized that the development and implementation of guidelines should have increased the percentage of resected IPMN with high-risk disease. METHODS Memorial Sloan-Kettering (MSK), Johns Hopkins (JH), and Massachusetts General Hospital (MGH) databases were queried for resected IPMN (2000-2015). Patients were categorized into main-duct (MD-IPMN) versus branch-duct (BD-IPMN). Guideline-specific radiographic/endoscopic features were recorded. High-risk disease was defined as high-grade dysplasia/carcinoma. Fisher's exact test was used to detect differences between institutions. Logistic regression evaluated differences between time-points [preguidelines (pre-GL, before 2006), Sendai (SCG, 2006-2012), Fukuoka (FCG, after 2012)]. RESULTS The study included 1210 patients. The percentage of BD-IPMN with ≥1 high-risk radiographic feature differed between centers (MSK 69%, JH 60%, MGH 45%; P < 0.001). In MD-IPMN cohort, the presence of radiographic features such as solid component and main pancreatic duct diameter ≥10 mm also differed (solid component: MSK 38%, JH 30%, MGH 18%; P < 0.001; duct ≥10 mm: MSK 49%, JH 32%, MGH 44%; P < 0.001). The percentage of high-risk disease on pathology, however, was similar between institutions (BD-IPMN: P = 0.36, MD-IPMN: P = 0.48). During the study period, the percentage of BD-IPMN resected with ≥1 high-risk feature increased (52% pre-GL vs 67% FCG; P = 0.005), whereas the percentage of high-risk disease decreased (pre-GL vs FCG: 30% vs 20%). For MD-IPMN, there was not a clear trend towards guideline adherence, and the rate of high-risk disease was similar over the time (pre-GL vs FCG: 69% vs 67%; P = 0.63). CONCLUSION Surgical management of IPMN based on radiographic criteria is variable between institutions, with similar percentages of high-risk disease. Over the 15-year study period, the rate of BD-IPMN resected with high-risk radiographic features increased; however, the rate of high-risk disease decreased. Better predictors are needed.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnostic imaging
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/surgery
- Adenocarcinoma, Papillary/diagnostic imaging
- Adenocarcinoma, Papillary/pathology
- Adenocarcinoma, Papillary/surgery
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Pancreatic Ductal/diagnostic imaging
- Carcinoma, Pancreatic Ductal/pathology
- Carcinoma, Pancreatic Ductal/surgery
- Female
- Humans
- Male
- Middle Aged
- Neoplasm Grading
- Neoplasm Staging
- Pancreatic Neoplasms/diagnostic imaging
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Practice Guidelines as Topic
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Affiliation(s)
| | - Georgios A Margonis
- Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Caitlin A McIntyre
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sharon A Lawrence
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Debra A Goldman
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Mithat Gonen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Matthew J Weiss
- Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Cristina R Ferrone
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Jin He
- Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Murray F Brennan
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - John L Cameron
- Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Keith D Lillemoe
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - T Peter Kingham
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Vinod Balachandran
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - William R Jarnagin
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Christopher L Wolfgang
- Department of Surgery, The Sol Goldman Pancreatic Cancer Research Center, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Peter J Allen
- Department of Surgery, Hepatopancreatobiliary Service, Duke, University School of Medicine, Durham, NC
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Marin C, Dave M, Hunter KD. Malignant Odontogenic Tumours: A Systematic Review of Cases Reported in Literature. Front Oral Health 2021; 2:775707. [PMID: 35048074 PMCID: PMC8757763 DOI: 10.3389/froh.2021.775707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Malignant odontogenic tumours (MOTs) arise either de novo from the tooth forming tissues, their developmental residues or from existing odontogenic epithelial or mesenchymal neoplasms in the jaws. Their management requires extensive surgery due to their infiltrative nature and risk of metastasis. There is a need to understand the clinical and pathological features of MOTs to inform both treatment algorithms and prognostication. This is an area of diagnostic pathology which presents substantial difficulties in diagnosis, compounded by inconsistent use of terminology. Thus, this systematic review aimed to describe the clinical and pathological features of MOTs with a view to consolidating the literature and defining problematic areas in diagnosis and classification. Methods: An electronic database search was conducted in Web of Science, PubMed/Medline, and Embase. Additionally, the grey literature and reference lists of selected papers searched for completeness. Nine hundred and sixty articles were initially identified. Following removal of duplicates and application of inclusion/exclusion criteria, 312 articles were included for qualitative analysis. Results: The 312 articles encompassed a total of 507 patients with most lesions located within the mandible (74.3%). The most common first histological diagnosis was ameloblastic carcinoma (25.7% of all diagnoses), but there is considerable variation in how and when various diagnostic terms are used, and several misdiagnoses were reported. An initial benign diagnosis was made in 24.7% of patients, followed by a later malignant diagnosis and in this sub-group, the most common benign first diagnosis was ameloblastoma (42.4%). Cervical lymph nodes were the most common site of metastasis (9.3% of patients). With respect to distant metastasis (DM), the lungs were the most common organ affected (11.2% of DM patients) with metastasising ameloblastoma the most commonly reported tumour which metastasised to the lungs. Overall, 26.8% of patients developed recurrence. Conclusion: Overall, the quality of the literature on MOTs is poor. This review of the literature has highlighted variations in diagnostic terms and criteria which has resulted in areas of confusion with potential for misdiagnosis. This consolidation of primary data has identified key areas for targeted research including further discussion on the malignant potential of ameloblastoma.
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Affiliation(s)
- Constanza Marin
- Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, University of Sheffield, Sheffield, United Kingdom
- Unidad de Patología y Medicina Oral, Facultad de Odontología, Universidad Andres Bello, Viña del Mar, Chile
| | - Manas Dave
- Division of Dentistry, The University of Manchester, Manchester, United Kingdom
| | - Keith D. Hunter
- Unit of Oral and Maxillofacial Medicine, Pathology and Surgery, University of Sheffield, Sheffield, United Kingdom
- Department of Oral Pathology and Biology, School of Dentistry, University of Pretoria, Pretoria, South Africa
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Abstract
RATIONALE Multifocal intraosseous hemangioma, which affects multiple body parts, is rare. The selection of appropriate lesion sites for biopsy and effective treatment in multifocal intraosseous hemangioma is challenging. Here, we report a case of multifocal intraosseous hemangioma. PATIENT CONCERNS A 49-year-old woman was admitted to our department with a chief complaint of aggravated lumber pain for 10 days. DIAGNOSES Radiographic imaging revealed lesions involving the bilateral ribs, lumbar vertebrae, ilium, pubis, and proximal femur. Open biopsy in the ilium established the pathological diagnosis of intraosseous hemangioma. INTERVENTIONS For the symptomatic lumbar spine, the patient selected radiotherapy as the initial treatment. OUTCOMES As of the one-year follow-up, no symptoms of recurrence have been observed. LESSONS This rare case demonstrates the importance of the selection of the appropriate lesion to confirm the diagnosis and effective treatment for patients with multifocal disease. Radiotherapy plays an important role in the treatment of patients with symptomatic vertebral hemangiomas without neurologic deficits.
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Petrusevska-Marinkovic S, Kondova-Topuzovska I, Milenkovic Z, Kondov G, Anastasovska A. Clinical, Laboratory and Radiographic Features of Patients with Pneumonia and Parapneumonic Effusions. Open Access Maced J Med Sci 2016; 4:428-434. [PMID: 27703568 PMCID: PMC5042628 DOI: 10.3889/oamjms.2016.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/08/2016] [Accepted: 08/22/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND: Parapneumonic effusions complicating pneumonia are associated with increased morbidity and mortality. AIM: To determine the role of the clinical, laboratory and radiographic features to the differential diagnosis of patients with community- acquired pneumonia (CAP) without effusion, uncomplicated parapneumonic effusion (UCPPE) and complicated parapneumonic effusion (CPPE). MATERIAL AND METHODS: We analysed 148 patients with CAP without effusion, 50 with UCPPE and 44 with CPPE. In three groups of patients, the majority was male patients (58.11%, 58%, 61.36%) consequently. RESULTS: The chronic heart failure was the most common comorbidity in a group with CAP (28; 18.92%) and UCPPE (7; 14%), alcoholism (12;12.77%) in a group with CPPE. Patients with CPPE had significantly longer fever compared to patients with CAP without effusion (p = 0.003). Pleuritic chest pain (86.36%) and dyspnea (88.64%) were the most common symptoms in CPPE, then to group with UCPPE (60%; 52%), and in CAP without effusion (25.68%; 47,97%). Diffuse pulmonary changes were detected more frequently in the group with CAP without effusion compared with the group with CPPE (64.86 % vs. 27.27 %), while the segment lung changes were more common in patients with CPPE (50% vs. 20.27%). Patients with CPPE were significant with higher erythrocytes sedimentation rate (ESR), white blood cells (WBC) and serum C- reactive protein (CRP) than it the other two groups (p = 0.00090, p = 0.01, p= 0.000065). CONCLUSION: Proper analysis of clinical, laboratory and radiographic features of patients with CAP and parapneumonic effusion can prevent mismanagement in these patients and will reduce morbidity and mortality.
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Affiliation(s)
- Sanja Petrusevska-Marinkovic
- University Infectious Diseases Clinic, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Irena Kondova-Topuzovska
- University Infectious Diseases Clinic, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Zvonko Milenkovic
- University Infectious Diseases Clinic, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Goran Kondov
- University Thoracocardiovascular Surgery Clinic, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Ankica Anastasovska
- University Infectious Diseases Clinic, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
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11
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Kaili W, Guangning Z, Li L, Laiqing X, Wenhao G. [Calcifying epithelial odontogenic tumor: two cases report]. Hua Xi Kou Qiang Yi Xue Za Zhi 2016; 34:104-107. [PMID: 27266209 PMCID: PMC7030786 DOI: 10.7518/hxkq.2016.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/18/2015] [Indexed: 06/06/2023]
Abstract
Calcifying epithelial odontogenic tumor (CEOT) is a rare benign epithelial tumor of odontogenic origin. CEOT is a benign but a locally infiltrative tumor. CEOT has two clinical variants: intraosseous (central) CEOT and extraosseous (peripheral) CEOT. The peripheral type is rare. In this paper, we report two cases of CEOT. The diagnoses of the cases were verified by histopathology. This study aims to explore the clinical and imaging appearances of CEOT and improve the understanding of the disease.
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12
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Xu B, Xie X, Zhou X, Zhai M, Yang W. Spontaneous rupture of primary splenic angiosarcoma: A case report. Oncol Lett 2015; 10:3271-3273. [PMID: 26722324 DOI: 10.3892/ol.2015.3714] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 07/30/2015] [Indexed: 12/18/2022] Open
Abstract
Primary angiosarcoma of the spleen is an extremely rare malignant neoplasm of vascular origin that often has a poor prognosis. The majority of cases presents with splenic rupture and hemorrhage. The present study retrospectively analyzed the case of 77-year-old female who presented with diffuse abdominal pain and distension. During laparotomy, a huge actively bleeding spleen was identified and a splenectomy was performed. Since an accurate diagnosis could not be achieved by abdominal computed tomography, a pathological examination was performed. The patient and the family refused post-operative adjuvant chemotherapy and radiation therapy. The patient succumbed to uncontrolled hemorrhagic shock and lung metastases at 2 weeks post-surgery.
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Affiliation(s)
- Botao Xu
- Division of General Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China ; Department of General Surgery, Zhuji City People's Hospital of Zhejiang Province, Zhuji, Zhejiang, P.R. China
| | - Xiaona Xie
- Pulmonary Division, Wenzhou Traditional Chinese Medicine Hospital, Wenzhou, Zhejiang, P.R. China
| | - Xiong Zhou
- Division of General Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Menghe Zhai
- Division of General Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
| | - Wenjun Yang
- Division of General Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
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13
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Abstract
Langerhans cell histiocytosis (LCH) is a group of idiopathic disorders characterized by proliferation of bone marrow derived Langerhans cells and mature eosinophils. Their clinical features simulate common oral findings such as gingival enlargement, oral ulcers, and mobility of teeth, along with nonspecific radiographic features; hence, diagnosing such lesions becomes difficult for the oral physicians. These lesions are commonly seen in childhood; however, we are reporting a case of LCH in 29-year-old adult male. A provisional diagnosis of giant cell granuloma was considered based on history and examination, although the lesion was histologically proven to be LCH and was confirmed with immunohistochemical staining of S100 protein and CD1a antigen. The purpose of this paper is to enhance the understanding of diverse, nonpathognomical oral presentation of LCH that is easily misdiagnosed and overlooked by dentist.
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Affiliation(s)
- Y Pavan Kumar
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
| | - Jayshree Agrawal
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
| | - J Mohanlakshmi
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
| | - P Suresh Kumar
- Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Rushikonda, Visakhapatnam, Andhra Pradesh, India
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14
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Xie X, Xu B, Yu C, Chen M, Yao D, Xu X, Cai X, Ding C, Wang L, Huang X. Clinical analysis of pulmonary cryptococcosis in non-HIV patients in south China. Int J Clin Exp Med 2015; 8:3114-3119. [PMID: 26064200 PMCID: PMC4443034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 02/03/2015] [Indexed: 06/04/2023]
Abstract
AIMS The aim of this study was to investigate the clinical characteristics of pulmonary cryptococcosis occurring in non-HIV patients, and to develop early diagnosis of pulmonary cryptococcosis in immunocompetent cases as well. METHODS We retrospectively reviewed the clinical data of 41 non-HIV infected patients with pulmonary cryptococcosis who were admitted to the First Affiliated Hospital of Wenzhou Medical University from January 2006 to April 2014. RESULTS The study included a total of 41 patients (23 males and 18 females) with mean age of 47 years. 12.19% of patients had a history of direct exposure to pigeon droppings; 31.70% of the patients' working or living environments were potentially contaminated by fungal spores. Almost one-third of the patients involved into the study were asymptomatic. The most common clinical manifestations were cough, expectoration and hemoptysis. The most common radiological manifestation was single node or mass in lung, which was described as untypical. Of all cases, 11 patients were diagnosed by CT-guided percutaneous cutting needle biopsy (PCNB), 5 patients were diagnosed by operation, and Crytococcus spore was found in 7 patients' cerebrospinal fluid. 8 patients' blood Cryptococcus Neoformans capsular polysaccharide antigens latex agglutination tests were positive. 36 patients received antifungal therapy. 5 patients underwent surgical resection. During 6 to 24 months follow-up, 40 cases showed total recovery and 1 cases showed improvement. CONCLUSIONS Pulmonary cryptococcosis in non-HIV subjects might be related to fungus-contaminated environmental exposure. The great variations and protean manifestations of its clinical features often lead to misdiagnosis. Recognition and invasive examination of non-HIV infected patients' pulmonary cryptococcosis in the early stage may help with improvement of its diagnosis and prognosis.
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Affiliation(s)
- Xiaona Xie
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Botao Xu
- Division of General surgery, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Chang Yu
- Division of Radiology, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Mayun Chen
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Dan Yao
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Xiaomei Xu
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Xueding Cai
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Cheng Ding
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Liangxing Wang
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
| | - Xiaoying Huang
- Pulmonary Division, First Affiliated Hospital of Wenzhou Medical UniversityWenzhou, China
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Abstract
Ewing's sarcoma is the second most common malignant primary bone tumor of childhood and adolescence affecting mainly the diaphysis of long bones and flat bones. This tumor is extraordinarily rare in small bones of the hand and presents as a swelling with atypical radiological features of cystic and lytic lesion with scant periosteal reaction. The common differential diagnosis include osteomyelitis, tuberculosis, enchondroma and benign tumors. Moreover, skip metastasis to adjacent bones is even rarer. The prognosis of this condition is greatly influenced by the presence of metastasis at presentation, further emphasizing the importance of early diagnosis. Multimodality treatment using surgery, radiotherapy and chemotherapy is currently recommended though no consensus exists. We report a case of Ewing's sarcoma of the little finger proximal phalanx which was initially missed and developed skip metastasis to several metacarpals within 4 months.
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Affiliation(s)
- Anshu Shekhar
- Department of Orthopaedics, S. D. M. College of Medical Sciences and Hospital, Sattur, Dharwad, India,Address for correspondence: Dr. Anshu Shekhar, Department of Orthopaedics, S. D. M. College of Medical Sciences and Hospital, Sattur, Dharwad - 580 009, Karnataka, India. E-mail:
| | - Suresh Korlhalli
- Department of Orthopaedics, Karnataka Institute of Medical Sciences and Hospital, Hubli, Karnataka, India
| | - Gururaj Murgod
- Department of Orthopaedics, Karnataka Institute of Medical Sciences and Hospital, Hubli, Karnataka, India
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Nettem S, Nettemu SK, Basha K, Venkatachalapathi S. Implant-based oral rehabilitation of a variant model of type I dentinal dysplasia: A rare case report. Dent Res J (Isfahan) 2014; 11:513-7. [PMID: 25225567 PMCID: PMC4163832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Dentin dysplasia is an exceptionally rare, autosomal-dominant, hereditary condition, primarily characterized by defective dentin formation affecting both the deciduous and permanent dentitions. The etiology remains imprecise to date, in spite of the numerous hypotheses put forward and the constant updates on this condition. This case report of type I dentin dysplasia exhibits radiographic findings that are unique and diverse from the classical findings of various subtypes of this disease reported to date. This article also depicts the implant-based oral rehabilitation of the young patient diagnosed with this variant model of dentin dysplasia type I. Early diagnosis and implementation of this preventive and curative therapy is vital for avoiding premature exfoliation of deciduous and permanent dentition and the associated residual ridge resorption, thereby overcoming functional and esthetic deficits and ensuring protection of the remaining dentition from further harm.
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Affiliation(s)
- Sowmya Nettem
- Department of Periodontology and Oral Implantology, Melaka – Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia
| | - Sunil Kumar Nettemu
- Department of Periodontology and Oral Implantology, Melaka – Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia
| | - K. Basha
- Jas Dento Medico Center, Bangalore, Karnataka, India
| | - S Venkatachalapathi
- Department of Oral and Maxillofacial Surgery, Melaka – Manipal Medical College, Jalan Batu Hampar, Bukit Baru, 75150 Melaka, Malaysia
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17
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van der Esch M, Knol DL, Schaffers IC, Reiding DJ, van Schaardenburg D, Knoop J, Roorda LD, Lems WF, Dekker J. Osteoarthritis of the knee: multicompartmental or compartmental disease? Rheumatology (Oxford) 2013; 53:540-6. [PMID: 24292347 DOI: 10.1093/rheumatology/ket393] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Knee OA has been conceptualized as a multicompartmental disease, as a compartmental disease or as a combination of these two disease processes. The aim of this study was to determine the associations between four radiographic features (joint space narrowing, osteophyte formation, sclerosis and cysts) across and within the three knee compartments (medial tibiofemoral, lateral tibiofemoral and patellofemoral compartment) in knee OA. METHODS Data from the Amsterdam OA Cohort were used. In 298 patients diagnosed with knee OA, radiographic features were examined in three knee joint compartments. Radiographic features were scored according to standardized scoring methods. Factor analysis was used to examine associations between the four radiographic features across and within compartments. RESULTS A bifactor model showed a general multicompartmental factor: 10 of 12 radiographic features across the entire joint were associated with the general factor. The bifactor model also showed three compartmental factors-one for each compartment: joint space narrowing, sclerosis and to a lesser extent osteophyte formation were associated with these compartmental factors. CONCLUSION These findings suggest a multicompartmental disease process in the knee, characterized by associations among features across the entire joint, as well as compartmental disease processes in each knee compartment, characterized by associations among features within specific compartments. Longitudinal studies are needed to explore the possibility of the development from a compartmental disease to a multicompartmental disease and the impact of contributing factors on the development.
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Affiliation(s)
- Martin van der Esch
- Amsterdam Rehabilitation Research Centre Reade, Dr Jan van Breemenstraat 2, PO 58271, 1040 HG Amsterdam, The Netherlands.
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18
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Abstract
Cemento-ossifying fibroma is a benign fibro-osseous lesion belonging to the same category as fibrous dysplasia and cementifying dysplasia. These are slow-growing lesions that are seen in the third and fourth decades of life. Both the ossifying fibroma and cemento-ossifying fibroma represent two extremes of the same disease process since histologically both contain bone and cementum. However, the term cemento-ossifying fibroma is justified on the basis of clinical and radiological correlation. Radiographs have become an essential tool in the diagnosis of lesions in the jaw, where the anatomy is complex. Nowadays, CT provides information for diagnosis as well as treatment planning. In this case series, we report three cases of cemento-ossifying fibroma that were histologically confirmed and discuss the imaging findings.
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Affiliation(s)
- R Mithra
- Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College, Potheri, Kanchipuram District, Tamil Nadu, India
| | - Pavitra Baskaran
- Department of Oral Medicine and Radiology, SRM Kattankulathur Dental College, Potheri, Kanchipuram District, Tamil Nadu, India
| | - M Sathyakumar
- Department of Oral and Maxillofacial Pathology, SRM Kattankulathur Dental College, Potheri, Kanchipuram District, Tamil Nadu, India
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Braga L, Renner JB, Schwartz TA, Woodard J, Helmick CG, Hochberg MC, Jordan JM. Differences in radiographic features of knee osteoarthritis in African-Americans and Caucasians: the Johnston county osteoarthritis project. Osteoarthritis Cartilage 2009; 17:1554-61. [PMID: 19735758 PMCID: PMC4068024 DOI: 10.1016/j.joca.2009.07.011] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 07/07/2009] [Accepted: 07/16/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine racial differences in tibiofemoral joint (TFJ) and patellofemoral joint (PFJ) radiographic osteoarthritis in African-American (AA) and Caucasian men and women. METHOD Multiple logistic regression was used to evaluate cross-sectional associations between race and tibiofemoral osteoarthritis (TF-OA) and the presence, severity and location of individual radiographic features of tibiofemoral joint osteoarthritis [TFJ-OA] (osteophytes, joint space narrowing [JSN], sclerosis and cysts) and patellofemoral joint osteoarthritis (PFJ-OA) (osteophytes, JSN and sclerosis), using data from the Johnston County Osteoarthritis Project. Proportional odds ratios (POR) assessed severity of TF-OA, TFJ and PFJ osteophytes, and JSN, adjusting for confounders. Generalized estimating equations accounted for auto-correlation of knees. RESULTS Among 3187 participants (32.5% AAs; 62% women; mean age 62 years), 6300 TFJ and 1957 PFJ were included. Compared to Caucasians, AA men were more likely to have TF-OA (adjusted odds ratio [aOR]=1.36; 95% CI, 1.00-1.86); tri-compartmental TFJ and PFJ osteophytes (aOR=3.06; 95%CI=1.96-4.78), and TFJ and PFJ sclerosis. AA women were more likely than Caucasian to have medial TFJ and tri-compartmental osteophytes (aOR=2.13; 1.55-2.94), and lateral TFJ sclerosis. AAs had more severe TF-OA than Caucasians (adjusted cumulative odds ratio [aPOR]=2.08; 95% CI, 1.19-3.64 for men; aPOR=1.56; 95% CI, 1.06-2.29 for women) and were more likely to have lateral TFJ JSN. CONCLUSIONS Compared to Caucasians, AAs were more likely to have more severe TF-OA; tri-compartmental disease; and lateral JSN. Further research to clarify the discrepancy between radiographic features in OA among races appears warranted.
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Affiliation(s)
- L. Braga
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA,Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA,Department of Radiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - J. B. Renner
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA,Department of Radiology, University of North Carolina at Chapel Hill, NC, USA
| | - T. A. Schwartz
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA,Department of Biostatistics, School of Public Health, University of North Carolina at Chapel Hill, NC, USA
| | - J. Woodard
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA
| | - C. G. Helmick
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - M. C. Hochberg
- Department of Medicine, Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J. M. Jordan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, NC, USA,Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA,Department of Medicine, University of North Carolina at Chapel Hill, NC, USA,Address correspondence and reprint requests to: Joanne M. Jordan, Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB# 7280, Chapel Hill, NC 27599-7280, USA. Tel: 1-919-966-0559; Fax: 1-919-966-1739;
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