Clinical and radiological parallels in congenital gigantism of the hand in children

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Abstract

Analysis of clinical manifestations of congenital wrist gygantism was performed in 67 children. Working classification of that pathology that facilitated the choice of surgical tactics was suggested. The following examination methods were used: roentgenologic (39 patients), rheovasographic (33) and radionuclide (12). Scintigraphic data of blood circulation and osteogenisis was detected to conform the clinical forms of the disease. Neither roentgenography nor rheovasography showed that correlation. The advantages of radionuclide method are its relative simplicity, sufficient informativeness and trustworthiness, low radiation load as well as possibility to obtain the data concerning bone tissue, growth zones and blood circulation of damaged segment.

About the authors

I. V. Shvedovchenko

Scientific and Practical Center for Medical and Social Expertise, Prosthetics and Rehabilitation of the Disabled. G.A. Albrecht

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Saint Petersburg

A. N. Bergaliev

Research Children's Orthopedic Institute. G.I. Turnera

Email: info@eco-vector.com
Russian Federation, Saint Petersburg

O. N. Sosnenko

Research Children's Orthopedic Institute. G.I. Turnera

Email: info@eco-vector.com
Russian Federation, Saint Petersburg

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2. Fig. Fig. 1. Appearance (a) and radiograph (b) of the hands of patient K., 11 years old, with congenital gigantism of the third finger of the right hand, 1st form.

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3. Fig. 2. Appearance (a) and radiograph (b) of the hands of patient S., 7 years old, with congenital gigantism of the III and IV fingers of the right and IV fingers of the left hand, 2nd form.

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4. Fig. 3. Appearance (a) and radiograph (b) of the hands of patient D., 13 years old, with congenital gigantism of the right hand, 3rd form.

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5. Fig. 4. Appearance (a) and scintigrams (b, c) of the hands of patient B. 2.5 years old with congenital gigantism of the third finger of the left hand, 1st form. b — perfusion phase: in the projection of the third finger of the left hand, a diffuse increase in the intensity of blood circulation by 18% is determined; c — phase of bone fixation: in the projection of the epimetaphyses of the phalanges of the third finger of the left hand, a distinct hyperfixation of the radiopharmaceutical is revealed (distal interphalangeal joint + 33%, proximal interphalangeal joint + 40%, metacarpophalangeal joint + 33% of the norm).

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6. Fig. 5. Appearance (a), radiograph (b) and scintigrams (c, d) of the hands of patient V., 12 years old, with congenital gigantism of the second finger of the left hand, 2nd form. c — perfusion phase: in the projection of the second finger of the left hand, there are no signs of hyperemia, the distribution of the radiopharmaceutical is uniform and identical to the individual norm; d — phase of bone fixation: in the projection of the epimetaphysis of the distal phalanx of the second finger of the left hand, a focus of radiopharmaceutical hyperfixation (+20%) is determined.

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7. Fig. 6. Appearance (a), radiograph (b) and scintigrams (c, d) of the hands of patient K., 2 years old, with congenital gigantism of the left hand, 3rd form. c — perfusion phase: in the projection of the left hand, a diffuse increase in the intensity of blood circulation by 40%; d — phase of bone fixation: in the projection of the metacarpal bones of the left hand, a diffuse increase in the accumulation of radiopharmaceuticals (+20%).

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