B131400

Left femur

The distal third of shaft is greatly expanded mediolaterally and is highly porotic (being more extensive than normal development).  The whole of the shaft is bowed anteroposteriorly and the distal end is medially rotated.  There is a large area of new woven bone on the proximal third of the shaft.

Disease Classification:

Metabolic-deficiency-rickets

M004000

Eighth thoracic to the fourth lumbar vertebrae

The bodies and apophyseal joints of the eighth thoracic to fourth lumbar vertebrae are fused. Bone destruction in the tenth thoracic to first lumbar bodies has resulted in severe anterior kyphosis (c 140 degrees), corresponding to Pott’s disease of the spine. A cloaca drains from the anterior body of the fourth lumbar vertebra.

Co-existing Pathology:

There is mild marginal osteophytosis evident on the superior body of the eighth thoracic vertebra, possibly a consequence of the severe changes in the spine caused by Pott’s disease.

Disease Classification:

Infective-specific-bacterial-tuberculosis

Degenerative joint disease-osteophytosis

M024500

Mandible

There is a sub-oval growth of compact bone (40mm mediolateral, 46.2mm anteroposterior, 44.2mm superoinferior) with a flattened superior surface attached to the left mandibular condyle. The surface of the growth is formed of smooth and regular cortical bone with two large folds on the medial aspect and a build-up of spicular bone on the lateral surface. In contrast, the superior surface of the deposit is slightly concave and consists of irregular, uneven lamellar bone which is spongy in appearance. This may reflect the outline of the bone and soft tissue architecture at the point of contact with the temporal area.

Considering the age of this individual, there is relatively little wear on the occlusal surfaces of the teeth, and the left mandibular molars are slightly more worn than the right. It is possible that the pathological lesion reduced masticatory function throughout the jaw. The radiograph reveals a disorganised trabecular internal structure with an irregular radiodense area along the superior border, which was presumably in contact with the temporal bone.

The lesion is large, continuous with the medullary cavity, arises from a physeal area and contains trabecular bone surrounded in the main by cortical bone. These are all characteristic of osteochondromas which occasionally occur in the mandible. This lesion would have caused progressive facial asymmetry.

Disease Classification:

Neoblastic-benign-osteochondroma

M027000

Cranium

There is a flattened spherical mass of bone, 34mm in diameter and extending 18mm above the normal bone surface. This is attached to the right parietal notch, and overlaps the temporal bone just above the mastoid process. The lesion is lobulated with a smooth surface of dense lamellar bone and occasional porosity. The majority of the base of the growth lies above the normal bone surface. No bone changes are present on the endocranial surface.

Disease Classification:

Neoplastic-benign-osteoma

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