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Clinical Example: Bone graft psoriatic acro osteolysis
| This elderly patient presented with
a progressive thumbnail deformity. A history of psoriasis was revealed
only postoperatively... |
| Click on each image
for a larger picture |
| Plain films showed resorption of the
distal two thirds of the distal phalanx: |
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| Comparison views of the opposite side: |
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| MRI demonstrated ill defined soft tissue
replacement of the majority of the distal phalanx: |
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| With contrast enhancement of the transformed
area: |
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| Exploration revealed no discrete
tumor, and a nondiagnostic frozen section. Because of diagnostic uncertainty
and in order to avoid intraoperative cross contamination, a cancellous
freeze dried allograft was used as a terminal graft: |
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| This incorporated, with some terminal
resorption: |
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