Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and...

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Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty by Sung-Jin Shin, Uk Nam, Sang-Rim Kim, Hee Joong Kim, Dimitris Dimitriou, Guoan Li, Young-Min Kwon, Harry Rubash, and Kwang Woo Nam JBJS Case Connect Volume 5(2):e40 May 13, 2015 ©2015 by The Journal of Bone and Joint Surgery, Inc.

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Transcript of Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and...

Page 1: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee

Contractures Treated with Total Joint Arthroplasty

by Sung-Jin Shin, Uk Nam, Sang-Rim Kim, Hee Joong Kim, Dimitris Dimitriou, Guoan Li, Young-Min Kwon, Harry Rubash, and Kwang Woo Nam

JBJS Case ConnectVolume 5(2):e40

May 13, 2015

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 2: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Color Doppler ultrasonography showed that the subcutaneous lesions were the vascular-origin lesions.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 3: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Teleradiograph of the lower extremities showed dense cortical hyperostosis with a “dripping candle wax” appearance from the left pelvis to the left foot and including the entire left lower

limb.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 4: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 5: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 6: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 7: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 8: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 9: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

The relationship between osseous abnormalities of melorheostosis and the sclerotomal distribution was shown on the bone scintigraphic image.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 10: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Anteroposterior radiograph of the hip made at fourteen months after surgery.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 11: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Pathological examination revealed marked endosteal sclerosis with thickened and enlarged osseous trabeculae associated with marrow fibrosis (hematoxylin and eosin, ×40 original

magnification).

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.

Page 12: Vascular Malformations Corresponding to Sclerotomes in Multifocal Melorheostosis: Painful Hip and Knee Contractures Treated with Total Joint Arthroplasty.

Anteroposterior and lateral radiographs of the left knee at thirty-two months after surgery.

Sung-Jin Shin et al. JBJS Case Connect 2015;5:e40

©2015 by The Journal of Bone and Joint Surgery, Inc.


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