Friday, 10 December 2021

Breaking News: FUNNY BONES, fragment #2

This blogpost represents a continuation of an earlier post, entitled (not surprisingly) "Funny Bones, fragment #1". Click HERE to review that background information.

HETEROTOPIC OSSIFFICATION, Myositis Ossificans   (OEDILF #T527921)
Heterotopic formation,
Extra-skeletal ossification:
Post-trauma, new bone
Seems to grow on its own —
Interferes with your re-ambulation.
Rarely, joints get encased, as in stone.

Usually asymptomatic, new bone formation in extra-skeletal sites seems to occur after physical or surgical trauma, particularly in the lower limbs following joint replacement. Occasionally, within several weeks after the inciting episode, tenderness and swelling near major joints may occur, needing to be differentiated from venous blockage, and requiring bone scanning for detection, as initial radiographs may be negative; this variant syndrome is known as myositis ossificans. Rarely, in progressive cases, surgery is eventually required to allow normal mobility at affected joints.

Temp AN:

Banker Elvis, consulted by phone:
"Let's invest in your smashed pelvic bone!
Get it rodded and plated,
And post-op," he then stated,
"We'll advance you a rather large loan."
("Its collateral? That house that you own.")
post op: medical jargon for 'post-operative' or 'post-operatively'.

Costs incurred by surgical care in the United States can be devastating. Multiple pelvic fractures may accompany major trauma to the trunk. It is, however, unusual for bankers to be consulted directly re the affordability of urgent surgical procedures.


"Mid-foot pain," I complain, "I'm no crank.
My foot suffered a serious yank.
ORIF stat I've requested
As my plain films suggested
The fracture type known as Lisfranc."
"ER staff and consultants, I thank."

ORIF: initialism for surgical intervention for bone fractures — open reduction, internal fixation

plain films: medical jargon for two-dimensional x-ray studies as opposed to CT, although digital media, not 'film' emulsion, are now generally used to analyze and record the images

With these injuries, involving one or more fractures, metatarsal bones of the lower foot are dissociated from the tarsus, making the mid-foot unstable. They were first observed in cavalry men during the Napoleonic Wars and later described by a French surgeon, Jacques Lisfranc de St-Martin. In English medical jargon they are known as Lisfranc (LIZ-frank or liz-FRANK) fractures. Self-diagnosis of this type of injury by a patient would be an unusual event.


To the DEXA test now we should turn
(Your bone mineral mass our concern).
Dual rays have a hand in
A bone-density stand-in;
Hip and spine fracture risk we discern.
DEXA, or dual energy X-ray absorptiometry, is a standardized imaging test to assess bone mass in the context of osteoporosis. Differential attenuation for the two photons of different energies is assessed for each element in a planar field, usually for hip and spine sites. The technique actually measures bone mass as mass per unit area (rather than volume) of tissue. Despite this drawback, the DEXA technique is excellent for serial tests in the same patient, and its use has become so widespread that its results are regarded as synonymous with bone mineral density.

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