PubMed · 13763739
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P LOUYOT, A GAUCHER, J MICHON, J SOMMELET, G RAUBER, MACINOT. 1961. [Rheumatic cotyloiditis].. https://pubmed.ncbi.nlm.nih.gov/13763739/
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Clinical manifestations of primary hyperparathyroidism include neuromuscular, intestinal, and osseous symptoms with osteolytic lesions of the bone and pathological fractures. In most cases a primary adenoma of the parathyroid gland leads to an increased production of the parathormone with subsequent osteoclastic bone catabolism. Surgical treatment entails removal of the parathyroid adenoma. We present a female patient and the possible diagnostic and differential diagnostic difficulties encountered in interdisciplinary management.
In 1996 the quality of the early management of 100 consecutive patients referred to the SW Thames regional pelvic and acetabular unit between 1989 and 1992 was studied. The management of these patients was assessed in four specific areas, and guidelines were laid down. It was found that in 56% of patients the early management did not meet these suggested standards, with 34% having deficiencies in more than one area. These results were presented and published. Five years later, the early management of a further 100 consecutive referrals was assessed using these same guidelines, in order to close the audit loop. The treatment of 57% of patients still did not reach the guideline standards, but the number with problems in more than one area fell to 20%. There has been improvement in the early management of pelvic and acetabular injuries. The use of external fixation in cases of severe haemorrhage increased, but frames were often poorly applied. Early communication with the specialist centre was encouraged but unfortunately there was still an unacceptable delay in referral. The frequency of delayed referral actually increased during the 5 years between study groups.
We report 2 cases of bone defects of the acetabulum. The first case was a patient who underwent a total hip arthroplasty. An intraoperative bleeding occurred because of an injury of an intrapelvic artery. Preoperative radiographs did not show this bone defect. A similar abnormality of the acetabulum was found in a series of 30 pelves that were dissected for a cadaver study. In this case, the bone defect was located in the center of the right acetabulum.