Differential diagnosis of some simple osseous lesions associated with sickle-cell anemia

Sanger, Roger G.; Greer, Robert O.; Averbach, Robert E.

doi:10.1016/0030-4220(77)90106-2

Cited by 13 publications

(18 citation statements)

References 20 publications

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“…In a previous study, evaluation of the intraoral radiographs of 16 children under 10 years of age with SCA demonstrated increased radiolucency of the bone and a coarse trabecular pattern in 100% of the sample; none of the healthy controls presented bony changes [20]. The same radiographic features were observed in 85% of 80 individuals with SCD (5-40 years), with lower occurrence (50%) in younger children (5-10 years) and higher occurrence (100%) in adolescents (17-21 years) [21].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of panoramic radiomorphometric indices related to low bone density in sickle cell disease

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Evaluation of panoramic radiomorphometric indices related to low bone density in sickle cell disease

et al. 2011

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“…Since infarctions are less common in facial bones [15], it is likely that in these patients vaso-occlusive crises with major systemic symptomatology did not affect the mandible. It may be suggested that radiopaque areas in jaws could be a consequence of subclinical vaso-occlusions, causing bony microinfarctions [14]. Identification of infarcted areas is important, since it is believed that these areas are prone to develop osteomyelitis due to the lower vascularization [38].…”

Section: Discussionmentioning

confidence: 99%

“…Although increased spacing of bony trabeculae is not considered a pathognomonic sign of SCD [14,23,25], this radiographic feature has been frequently described in sickle subjects [4,19,[22][23][24]32], and may produce bony expansion of maxilla, increased overjet and spacing of maxillary incisors [16].…”

Section: Discussionmentioning

confidence: 99%

“…During generalized sickle cell crises, vaso-occlusive involvement of mandible of ischemic and aseptic nature can occur, displaying odontogenic pain or neuropathy [17,29] and contributing for dental pulp death [36]. Literature reports few cases of mandibular infarction [14,15,17,37], probably due to significant collateral circulation and difficulty in documenting infarction in this bone [9]. Kavadia-Tsatala et al [29] found 14% of 42 SCA patients with radiopaque areas on panoramic radiographs that were considered of vasoocclusive origin considering symptomatology and absence of dental lesions or acute infection.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the maxillofacial area, radiographic features frequently associated with SCD patients have been reported, such as increase radiolucency of the jaws due to the decreased number of trabeculae, coarse trabeculae pattern, thin inferior border of mandible, distinct areas of radiopacity, stepladder appearance created in the interdental alveolar bone by horizontal rows of trabeculation and osteomyelitis [4,[14][15][16][17][18][19][20][21][22]. Few studies have analyzed their prevalence among SCD patient and healthy controls [23][24][25][26][27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

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Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

et al. 2011

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This study was conducted to investigate the relationship among radiographic features observed on panoramic radiographs of sickle cell disease patients and analyze their relationship with history of systemic severity of the disease. Panoramic radiographs of 71 subjects with sickle cell disease were evaluated for the presence of the following radiographic bony alterations: radiopaque areas, increased spacing of bony trabeculae, horizontal arrangement of bony trabeculae and corticalization of mandibular canal. History of clinical systemic severity was assessed through direct questioning about the frequency of vaso-occlusive crisis, history of stroke, clinical jaundice, femur head necrosis, and leg ulceration. Chi-square or Fisher's exact test were applied in order to analyze possible associations between radiographic features and history of complications, with p < 0.05 significance level. Increased spacing of bony trabeculae was statistically associated with absence of corticalization of mandibular canal (p < 0.01) and horizontal arrangement of bony trabeculae (p = 0.04). Statistically significant associations were demonstrated between history of clinical jaundice and presence of increased spacing of bony trabeculae (p = 0.02) and between history of stroke and presence of horizontal arrangement of bony trabeculae (p = 0.04). Based on the results of the current study, maxillofacial radiographic features may be associated with clinical parameters of systemic complications in sickle cell disease patients. The relationship between radiographic features and history of complications associated with clinical severity of sickle cell disease has not been demonstrated in the literature. Acknowledgment of such possible association may help establish prognosis and influence clinical treatment of systemic and oral complications.

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Hypomineralization disorder in tropical Southeast Asia during the agricultural revolution: Analysis of morbidity and mortality

Vlok,

Oxenham,

McFadden

et al. 2024

Intl J of Osteoarchaeology

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This paper presents evidence for hypomineralization disorders (rickets and osteomalacia) in non‐adults at Man Bac, a Neolithic site from northern Vietnam dated to 4000–3500BP, contributing to the well‐described disease burden at the site that includes scurvy, treponemal disease, thalassemia, and malaria. Forty‐four non‐adults (<20 years of age‐at‐death) were assessed for macroscopic and radiographic evidence for hypomineralization disorders. Differential diagnosis was completed using traditional methods and three‐level standardized criteria to combat the challenges of overlapping pathological features between hypomineralization disorder and the other diseases already diagnosed at the site. In addition, a diagnostic certainty approach was applied to investigate the impact of lesion ambiguity on our findings. Kaplan–Meier and Fishers exact tests were applied to assess age‐at‐death‐related epidemiological patterns of hypomineralization disorder and co‐morbid relationships with scurvy, thalassemia, and treponemal disease. Almost 50% of the non‐adult assemblage presented with evidence for hypomineralization disorder, which was associated with decreased survivorship in childhood. Potential epidemiological relationships between scurvy and hypomineralization disorders, and thalassemia and hypomineralization disorders are described. The former relationship may be due to the likelihood of the introduction of rice resulting in multi‐micronutrient deficiency, including vitamin C and calcium deficiency, and cultural attitudes to sunlight. The latter relationship may relate to the pathophysiology of thalassemia that can result in secondary osteomalacia possibly contributing to the development of hypomineralization disorder in the thalassemic non‐adults. The findings are significant as they present possible approaches for diagnosis of disease embedded within complex disease burdens where individuals are likely suffering from co‐morbidities.

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Differential diagnosis of some simple osseous lesions associated with sickle-cell anemia

Cited by 13 publications

References 20 publications

Evaluation of panoramic radiomorphometric indices related to low bone density in sickle cell disease

Evaluation of panoramic radiomorphometric indices related to low bone density in sickle cell disease

Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

Hypomineralization disorder in tropical Southeast Asia during the agricultural revolution: Analysis of morbidity and mortality

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