Dear Dr Vaishya,
I'm uploading here Otner's database of paleopathology from the Global History of Health Project. The database has some info on each case and the links on the right in evey line lead to specific images of each specimen. Maybe you'll find something useful here.
Also, try the project's site for further info:
http://global.sbs.ohio-state.edu/
Regards,
Claudia
This is really a very rare case. Hyperparathyreoidism, severe osteoporosis or other systematic bone disease should be excluded.
My answer is above'. I have seen it only in Rheumatoid Arthritis, as Panayot stated osteoporosis due to the rheumatic disease and may be due to steroid treatment might be implicated/
Stress # upper tibia (and rarely of the fibula) have been described in association with knee OA. They often present with acute exacerbation of pain with difficulty in weight bearing. We prefer to manage them with single stage TKR with long tibial stem.
Depending on the individual case and severity of joint pain due to OA, TKP seems useful to me.
But, if the pain mostly comes from proximal tibia under loading conditions, a pysical therapy program with unloading, elektrotherapy, maybe magnet or ultrasound therapy might be helpful.
I saw such cases in very rare "vitamin D resistant" osteomalacia due to FGF-23-producing, mostly benign tumors with phosphate wasting - one might suspect other bone lesions throughout the body (clinical symptoms?, bone scintigraphy?), very high bone alkaline phosphatase, low phosphorus in blood and high phosphate secretion, while having normal calcium and 25-hydroxy-vitamin D3 and relatively normal parathormone.
Recently saw one of my old operated case (14yrs ago) with acute onset of pain & increasing deformity (valgus) of the right knee for the last 3 months. Suggestions, please?
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