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Imaging Findings of Metabolic
Bone Disease
Autores: Connie Y. Chang, MD; Daniel I. Rosenthal, MD; Deborah M. Mitchell, MD; Atsuhiko Handa, MD; Susan V. Kattapuram, MD; Ambrose J. Huang, MD
Se analiza una serie de 6 pacientes en forma retrospectiva portadores de masas pulmonares con contacto parietal, que fueron pasibles de ser puncionados bajo método ecográfico por vía percutánea, con el objetivo de arribar a un diagnóstico anatomo-patológico.
Se enfatiza el rol de ésta técnica de imagen en pacientes seleccionados, analizando los resultados obtenidos, destacando de la misma su accesibilidad y la no utilización de radiaciones ionizantes.
El rendimiento diagnóstico obtenido fue excelente, lográndose en todos los casos arribar a una muestra de tejido suficiente para su análisis, sin un incremento de las complicaciones del procedimiento.
Palabras clave Tórax, Biopsia, Ultrasonido, Diagnóstico.
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Metabolic bone diseases are a diverse group of diseases that result
in abnormalities of (a) bone mass, (b) structure mineral homeostasis,
(c) bone turnover, or (d) growth. Osteoporosis, the most
common metabolic bone disease, results in generalized loss of bone
mass and deterioration in the bone microarchitecture. Impaired
chondrocyte development and failure to mineralize growth plate
cartilage in rickets lead to widened growth plates and frayed metaphyses
at sites of greatest growth. Osteomalacia is the result of
impaired mineralization of newly formed osteoid, which leads to
characteristic Looser zones. Hypophosphatasia is a congenital condition
of impaired bone mineralization with wide phenotypic variability.
Findings of hyperparathyroidism are the result of bone resorption,
most often manifesting as subperiosteal resorption in the
hand. Renal osteodystrophy is the collection of skeletal findings observed
in patients with chronic renal failure and associated secondary
hyperparathyroidism and can include osteopenia, osteosclerosis,
and “rugger jersey spine.” Hypoparathyroidism is most commonly
due to iatrogenic injury, and radiographic findings of hypoparathyroidism
reflect an overall increase in bone mass. Thyroid hormone
regulates endochondral bone formation; and congenital hypothyroidism,
when untreated, leads to delayed bone age and absent, irregular,
or fragmented distal femoral and proximal tibial epiphyses.
Soft-tissue proliferation of thyroid acropachy is most often observed
in the hands and feet. The findings of acromegaly are due to excess
growth hormone secretion and therefore proliferation of the bones
and soft tissues. Vitamin C deficiency, or scurvy, impairs posttranslational
collagen modification, leading to subperiosteal hemorrhage
and fractures
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