Contrast-enhanced MRI is mandatory for a reliable diagnosis. Abscess formation was observed in approximately half of the MRI-diagnosed sacroiliitis cases and required minimally invasive drainage under CT guidance or frequently open surgery.

The purpose of this prospective controlled study was to compare healing quality following the implantation of ultraporous β-tricalcium phosphate, containing either expanded autologous mesenchymal stromal cells (trial group, 9 patients) or β-tricalcium phosphate alone (control group, 9 patients), into femoral defects during revision total hip arthroplasty. Both groups were assessed using the Harris Hip Score, radiography, and DEXA scanning at 6 weeks and 3, 6, and 12 months postoperatively. A significant difference in the bone defect healing was observed between both groups of patients (P < 0.05). In the trial group, trabecular remodeling was found in all nine patients and in the control group, in 1 patient only. Whereas, over the 12-month follow-up period, no significant difference was observed between both groups of patients in terms of the resorption of β-tricalcium phosphate, the significant differences were documented in the presence of radiolucency and bone trabeculation through the defect (P < 0.05). Using autologous mesenchymal stromal cells combined with a β-tricalcium phosphate scaffold is a feasible, safe, and effective approach for management of bone defects with compromised microenvironment. The clinical trial was registered at the EU Clinical Trials Register before patient recruitment has begun (EudraCT number 2012-005599-33).

This prospective study sought to evaluate the healing quality of implanted ultraporous β-tricalcium phosphate sown with expanded autologous mesenchymal stromal cells (MSCs) into femoral defects during revision hip arthroplasty. A total of 37 osseous defects in 37 patients were treated and evaluated concerning bone regeneration. Nineteen subjects received β-tricalcium phosphate graft material serving as a carrier of expanded autologous MSCs (the trial group A), nine subjects received β-tricalcium phosphate graft material only (the study group B) and nine subjects received cancellous allografts only (the control group C). Clinical and radiographic evaluations were scheduled at 6 weeks, 3, 6, and 12 months post-operatively, and performed at the most recent visit as well. All observed complications were recorded during follow-up to assess the use of an ultraporous β-tricalcium phosphate synthetic graft material combined with expanded MSCs in bone defect repair. The resulting data from participants with accomplished follow-up were processed and statistically evaluated with a Freeman–Halton modification of the Fischer’s exact test, a P < 0.05 value was considered to be significant. Whereas no significant difference was observed between the trial group A with β-tricalcium phosphate synthetic graft material serving as a carrier of expanded autologous MSCs and control group C with cancellous impaction allografting in terms of the bone defect healing, significant differences were documented between the study group B with β-tricalcium phosphate graft material only and control group C. Regarding adverse effects, six serious events were recorded during the clinical trial with no causal relationship to the cell product. β-tricalcium phosphate synthetic graft material serving as a carrier of expanded autologous MSCs appears safe and promotes the healing of bone defects in a jeopardized and/or impaired microenvironment. This clinical trial was registered at the EU Clinical Trials Register before patient recruitment (Registration number: EudraCT number 2012-005599-33; Date of registration: 2013-02-04).

The most frequent clinical manifestation of anaplastic thyroid cancer is a rapidly enlarging mass at the frontal part of the neck. It is accompanied by severe compression symptoms such as dysphagia and dyspnoea with hoarseness, which could be partially due to paresis of the recurrent laryngeal nerve. We treated a patient with symptoms consistent with a retropharyngeal abscess -swelling of the posterior pharyngeal wall, odynophagia, pain in the left side of the neck, elevated inflammatory markers. The diagnosis of anaplastic thyroid cancer was unexpectedly made after surgery and a subsequent histological examination. Case reportAn 80-year-old woman was referred to Dpt. of Otolaryngology, Head and Neck Surgery, Charles University Medicine Faculty, Teaching Hospital in Hradec Králové from a local hospital where she was treated for suspected urine infection. She suffered from chronic hypertension and insulin-dependent diabetes mellitus and diabetes mellitus was not perfectly compensated. Regarding her family history, there was one relevant piece of information concerning the death of her daughter at the age of 52 from pancreatic cancer.Odynophagia and pain in the left side of the neck appeared during the hospitalization in the local hospital accompanied with significant weight loss. Inflammation markers were significantly elevated (C-reactive protein 239 mg/l, leucocytes 25x10 9 /l). Due to the clinical findings, a computer tomography investigation (CT) was performed and a retropharyngeal abscess was found as well as hypertrophy of the left lobe of the thyroid gland. The existence of a tumour was considered as well and the patient was transferred to Dpt. of Otolaryngology, Head and Neck Surgery, Charles University Medicine Faculty, Teaching Hospital in Hradec Králové.At the time of admission the patient had pronounced swelling of the left side of her neck. It seemed to be the left lobe of the thyroid gland with retrosternal extension. We could also see swelling of the posterior pharyngeal wall, Summary: Introduction: The authors present a rare case of a patient with symptoms consistent with retropharyngeal abscess. The diagnosis of anaplastic thyroid cancer was made after surgery and subsequent histological examination. Case report: An 80-year-old woman was referred to Dpt. of Otolaryngology, Head and Neck Surgery, Charles University Medicine Faculty, Teaching Hospital in Hradec Králové with odynophagia and pain in the left side of the neck. The patient had pronounced swelling of the left side of her neck. We could also see swelling of the posterior pharyngeal wall, more pronounced on the left side. Inflammation markers were markedly elevated. Administration of antibiotics intravenously (amoxicillin combined with clavulan acid and gentamicin) was started. A computer tomography investigation (CT) was performed and a retropharyngeal abscess was found. The existence of a tumour was considered as well. An acute endoscopic examination and a puncture of the retropharyngeal space at the site of the swelling were performed,...

Charcot foot neuropathic osteoarthropathy is a disorder affecting the soft tissues, joints, and bones of the foot and ankle. The disease is triggered in a susceptible individual through a process of uncontrolled inflammation leading to osteolysis, progressive fractures and articular malpositioning due to joint subluxations and dislocations. The progression of the chronic deformity with a collapsed plantar arch leads to plantar ulcerations because of increased pressure on the plantar osseous prominences and decreased plantar sensation. Subsequent deep soft tissue infection and osteomyelitis may result in amputation. The Charcot foot in diabetes represents an important diagnostic and therapeutic challenge in clinical practice. Conservative treatment remains the standard of the care for most patients with neuropathic disorder. Offloading the foot and immobilization based on individual merit are essential and are the most important recommendations in the active acute stage of the Charcot foot. Surgical realignment with stabilization is recommended in severe progressive neuropathic deformities consisting of a collapsed plantar arch with a rocker-bottom foot deformity.

A retrospective study of 68 cases of tumours and tumour - like lesions related to the scapula, included in the registry of the Bone Tumour Reference Centre at the Institute of Pathology/University Clinics, Basle, has been carried out. Each case was evaluated for lesion entity, activity and location, age and sex of the patient, and, in 49 files with available radiographic documentation (mostly plain films), for radiologic appearance, with the aim to predict the histologic diagnosis or at least the correct dignity of the lesion. Statistically most frequent were cartilaginous tumours. More than 1/3 of all cases were osteochondromas, which demonstrated mostly a typical appearance. They were encountered predominantly in the first 3 decades in males and were located most often in the body of the scapula. 1/4 of all cases were chondrosarcomas, which were prevailing in the 4th-7th decades, but were occasionally found at a younger age too. Chondrosarcomas were located mainly at the lateral scapular margin over the inferior angle and in the acromion and coracoid process and their appearance ranged from typical to falsely benign. 1/3 of the cases represented a number of other benign and malignant histological entities.

We report the case of a 55-year-old woman with a 6-month history of progressive paresis of the right radial nerve. Perioperative imaging detected a spindle-shaped expansion of the radial nerve caused by an isolated local deposit of amyloid (amyloidoma). The deposit was resected in 2 phases and the resulting defect was bridged by a sural nerve autograft. Overall internal and hematological examination did not reveal systemic amyloidosis or lymphoproliferative disorder. The reason for our report is that localized forms of amyloid neuropathy are very rare.

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