Overview on Auto inflammatory Bone Disorders: From Pathogenesis to Clinical Manifestations

Chronic Recurrent Multifocal Osteomyelitis (CRMO)

Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a rare disease occurring in childhood. It is characterized by insidious onset and variable clinical manifestations that may mimic infections or malignancies [1]. Since CRMO may be neither multifocal nor recurrent, some authors suggest replacing it with the term chronic nonbacterial osteomyelitis (CNO) that includes different disorders with sterile bone inflammation [2]. Synovitis, acne, pustulosis, hyperostosis and osteitis syndrome (SAPHO) is the adult form of CRMO with prominent skin manifestations [3]. CRMO is frequently associated with other inflammatory diseases such as psoriasis and inflammatory bowel disease [4]. CRMO pathogenesis is largely unknown; however, an unbalance towards proinflammatory cytokines has been demonstrated [5,6]. Recently a South Asian child with CRMO and psoriasis has been found harboring an autosomal recessive mutation of FBLIM1 gene [7]. 

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Back Pain, Causes, Symptoms and Physiotherapy

Every fourth woman and every sixth man in the world coming to the Orthopedic or Neurology Departments complain of spinal pains - information from WHO, Decade of Bones and Joints 2000-2010 (Lars Lidgren). According to our observations there are six main causes of such spinal disorders: 1. Lumbar Hyperlordosis causes by flexion contracture of hips and in result anterior tilt of the pelvis. Common in persons with Minimal Brain Dysfunction (MBD). Pain syndromes appear after overstress in some kinds of jobs or in sport. 2. Lumbar or thoracic-lumbar left convex “C” scoliosis in 2nd/A etiopathological group (epg) or ”S” scoliosis in 2nd/B epg in Lublin classification. Pain syndromes appear after overstress in some kinds of jobs or in sport. 3. Stiffness of the spine as clinical sign of “I” scoliosis in 3rd epg group in Lublin classification. 4. Spondylolisthesis or spodylolisis in sacral-lumbar or lumbar spine. 5. Urgent “nucleus prolapsed” (in German “Hexen Schuss”). 6. Extremely cooling of the back part of trunk during work or intensive walking in low temperature. In many of patients in clinical examination we see positive Laseguae test. Sometimes we see weakness of extensors of the feet or paresis of the foot. Our observations confirm that not surgery, but physiotherapy can be beneficial to the patients with spinal problems. 

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The Inadequate Treatments for Patients before and after Osteoporotic Hip Fracture

Hip fracture will count for a significant problem in the aging group in the near future. Although the fracture is always being considered unexpected, either the fracture itself or the complication of the fracture treatments, patients and medical personnel should aware of the so call unexpected fractures and complications are really preventable and predictable with careful alertness. 

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Prevalence of Paediatric Fractures in Teaching Department of Orthopaedics and Musculoskeletal Trauma in Eastern Slovakia during the Year 2018

Objective: To determine the prevalence of different fractures among paediatric age 0-19 years in teaching department of orthopaedics and musculoskeletal trauma during one year. Methods: We retrospectively evaluated all children younger than twenty years who presented to our institution with a new fractures or fractures combined with dislocations within the calendar year 2018. The main outcome measures were the annual fracture and dislocation incidence in our population in central Europe. Results: There were 783 paediatric patients with fractures or dislocations. 181 (26%) were with forearm fractures, 161 (23%) ankle and foot fractures, 145 (21%) hand fractures, 75 (11%) shoulder fractures, 32 (34%)elbow dislocations, 27 (28%) patellar dislocations (25), and (2) knee dislocation. Conclusion: Distal radius fractures and dislocated elbows are the most common fractures and dislocations among childhood (0-19 years) in our University Hospital. 

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Kahler's Disease Revealed by a Fracture of the Humeral Diaphysis

Kahler's disease or multiple myeloma is a malignant hematological pathology, characterized by the malignant proliferation of plasma cells. Reporting a case of a humeral shaft fracture in a non-traumatic context that revealed Kahler's disease during paraclinical investigations. Management involves histological confirmation of the pathology, osteosynthesis of the fracture by static centromedullary nailing, with medical treatment made of biphosphonate combined with a chemotherapy protocol targeting the disease. The management of a pathological fracture is a diagnostic emergency, but never an operating emergency. A diagnosis of certainty must be made before any intervention.

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