The importance of cone beam CT in the radiological detection of osteomalacia

Çakur, Binali; Sümbüllü, Muhammed Akif; Dağistan, Saadettin; Durna, Doğan

doi:10.1259/dmfr/54466132

Cited by 9 publications

(9 citation statements)

References 7 publications

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“…The lamina dura may be especially thin in individuals with long-standing or severe osteomalacia. The teeth are not altered in this condition in as much as they are fully developed before the onset of osteomalacia[ 49 50 51 ] [ Figure 4 ].…”

Section: R Adiological M Anifestations Omentioning

confidence: 99%

Vitamin D deficiency in adolescents

Soliman¹,

Sanctis²,

Elalaily³

et al. 2014

Indian J Endocr Metab

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The prevalence of severe vitamin D deficiency (VDD) in adolescents is variable but considerably high in many countries, especially in Middle-east and Southeast Asia. Different factors attribute to this deficiency including lack of sunlight exposure due to cultural dress codes and veiling or due to pigmented skin, and less time spent outdoors, because of hot weather, and lower vitamin D intake. A potent adaptation process significantly modifies the clinical presentation and therefore clinical presentations may be subtle and go unnoticed, thus making true prevalence studies difficult. Adolescents with severe VDD may present with vague manifestations including pain in weight-bearing joints, back, thighs and/or calves, difficulty in walking and/or climbing stairs, or running and muscle cramps. Adaptation includes increased parathormone (PTH) and deceased insulin-like growth factor-I (IGF-I) secretion. PTH enhances the tubular reabsorption of Ca and stimulates the kidneys to produce 1, 25-(OH) 2D3 that increases intestinal calcium absorption and dissolves the mineralized collagen matrix in bone, causing osteopenia and osteoporosis to provide enough Ca to prevent hypocalcaemia. Decreased insulin like growth factor-I (IGF-I) delays bone growth to economize calcium consumption. Radiological changes are not uncommon and include osteoporosis/osteopenia affecting long bones as well as vertebrae and ribs, bone cysts, decalcification of the metaphysis of the long bones and pseudo fractures. In severe cases pathological fractures and deformities may occur. Vitamin D treatment of adolescents with VDD differs considerably in different studies and proved to be effective in treating all clinical, biochemical, and radiological manifestations. Different treatment regiments for VDD have been discussed and presented in this mini-review for practical use. Adequate vitamin D replacement after treating VDD, improving calcium intake (milk and dairy products), encouraging adequate exposure to the sun and possible enrichment of the stable food with vitamin D in areas with high prevalence of VDD are important measures to prevent the harmful consequences of VDD.

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Section: R Adiological M Anifestations Omentioning

confidence: 99%

Vitamin D deficiency in adolescents

Soliman¹,

Sanctis²,

Elalaily³

et al. 2014

Indian J Endocr Metab

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“…In addition to being a medicolegal issue, appropriate management of incidental findings can prevent undesirable outcomes in these patients. Findings, based on their location, nature, and effects on adjacent structures, may or may not require referral, intervention, more imaging, or long-term monitoring [ 13 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

Incidental Findings on Cone Beam Computed Tomography Studies outside of the Maxillofacial Skeleton

Barghan

Tahmasbi-Arashlow

Nair

2016

International Journal of Dentistry

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Objective. To define the presence and prevalence of incidental findings in and around the base of skull from large field-of-view CBCT of the maxillofacial region and to determine their clinical importance. Methods. Four hundred consecutive large fields of view CBCT scans viewed from January 1, 2007, to January 1, 2014, were retrospectively evaluated for incidental findings of the cervical vertebrae and surrounding structures. Findings were categorized into cervical vertebrae, intracranial, soft tissue, airway, carotid artery, lymph node, and skull base findings. Results. A total of 653 incidental findings were identified in 309 of the 400 CBCT scans. The most prevalent incidental findings were soft tissue calcifications (29.71%), followed by intracranial calcifications (27.11%), cervical vertebrae (20.06%), airway (11.49%), external carotid artery calcification (10.41%), lymph node calcification (0.77%), subcutaneous tissue calcification and calcified tendonitis of the longus colli muscle (0.3%), and skull base finding (0.15%). A significant portion of the incidental findings (31.24%) required referral, 17.76% required monitoring, and 51% did not require either. Conclusion. A comprehensive review of the CBCT images beyond the region of interest, especially incidental findings in the base of skull, cervical vertebrae, pharyngeal airway, and soft tissue, is necessary to avoid overlooking clinically significant lesions.

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“…However, parsing apart the difference in the radiographic appearance of pseudofractures caused by nutritional versus inherited/acquired deficiencies in the modern radiographic literature is complicated by the fact that, with the exception of case studies, many studies do not separate out the cause of the deficiency (e.g. Ҫakur et al, 2012;Fogelman and Carr, 1980;Reginato et al, 1999).…”

Section: Cause Of Vitamin D Deficiencymentioning

confidence: 99%

Radiographically recognizable? An investigation into the appearance of osteomalacic pseudofractures

Jennings

Buckberry

Brickley

2018

International Journal of Paleopathology

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Pseudofractures, lucent bands that occur due to a build-up of osteoid, are a key feature of osteomalacia. In paleopathology, pseudofractures are often marked by small, linear cracks in the cortex of the bone surrounded by irregular, bony spicule formation. Radiography can be used to help diagnose pseudofractures, both clinically and in paleopathology. A detailed understanding of the radiographic appearance of pseudofractures and their development is, therefore, necessary to aid a diagnosis of vitamin D deficiency. The present study examined the clinical literature to determine current ideas on the appearance of pseudofractures with the aim of applying this knowledge to paleopathology. A radiographic study of the characteristics of pseudofractures was performed on five individuals with clear skeletal features of osteomalacia from archaeological sites in Canada and the United Kingdom dating to the medieval period (5 th to 15 th centuries) and the 19 th century. Results show that the radiographic appearance of pseudofractures could potentially reveal information about the cause of the deficiency and the chronicity of pseudofractures. This type of information has the potential to further our understanding of the lived experiences of archaeological individuals with osteomalacia.

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The importance of cone beam CT in the radiological detection of osteomalacia

Cited by 9 publications

References 7 publications

Vitamin D deficiency in adolescents

Vitamin D deficiency in adolescents

Incidental Findings on Cone Beam Computed Tomography Studies outside of the Maxillofacial Skeleton

Radiographically recognizable? An investigation into the appearance of osteomalacic pseudofractures

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