Devices for osteosynthesis of fractures and dislocations of the distal and proximal metaphyses
of the spine and elbow (diaphragms, wire, screws, plates);
The blood supply of developing long bones with special reference to the metaphyses
. J Bone Joint Surg Br 1956;38-B(4):928-33.
(1) Although it most commonly occurs within the metaphyses
of long bones in areas of rapid growth, osteopathia striata may potentially occur in all bones except the clavicles and the skull.
The primary targets of the primary disease are children, in which it mainly attacks metaphyses
of long bones, but may occur anywhere in the skeleton [1,3,4].
Magnetic resonance imaging demonstrated bright signal intensity on the metaphyses
and juxtaosseous soft tissue (Figure 2b).
The characteristic radiographic features are narrow joint space with wide metaphyses
, flat epiphyses, enlarged femoral heads with irregular acetabular margins.
In total, 12 features are assessed: mandibular ramus medial angulation; bending (bowing) of arm long bones; bending (bowing) of leg long bones; flaring, swelling, and/or cupping of metaphyses
; fraying and/or irregularity of metaphyseal bone margins; coxa vara (angulation of femoral neck of <120[degrees]); cortical thickening on the concave aspect of bowed long bones; flaring, swelling, and/or cupping of sternal rib ends (rachitic rosary); porous and/or irregular sternal rib end bone margins; alteration of rib neck angle or lateral straightening of rib body (thorax narrowing); anterior protrusion of sternal body (pigeon-chested); and ilium concavity (exaggerated medio-lateral curvature) (Table 1).
Gnawing damage by the fisher was confined to the femoral epiphyses and metaphyses
in both cases.
Repeat hip radiographs were obtained at that time, which revealed interval worsening of rachitic changes in the ileum and proximal femoral metaphyses
compared to previous imaging.
Poorly defined regions of lysis were identified within the proximal and distal right humeral metaphyses
. These lytic lesions extended proximally and distally to the margins of articular subchondral bone.
Homozygous mutations in the PAPSS2 gene lead to impaired sulfation of proteoglycans and cause spondyloepimetaphyseal dysplasia (SEMD) Pakistani type which is characterized by short stature, short bowed legs, platyspondyly, narrow intervertebral spaces, short femoral neck, irregular metaphyses
, and epiphyses.
Radiological features of hypochondroplasia are flared metaphyses
, narrowed interpedicular distance, square ilia, and short femoral necks.