Orthopedic

The shoulder, one of the most detailed areas in orthopedic surgery, can be a significant source of problems, especially for athletes and the elderly. The shoulder region consists of three main bones. Ligaments, muscles, and tendons connect these bones together and move them. Repeated strenuous activities, accidents, and sports performed with incorrect technique lead to the wear and tear of these tissues. Wear and tear manifest as pain and movement restriction in the early period and calcification in the later period.

Orthopedic Oncology is the branch of diagnosis and surgical treatment of bone and soft tissue tumors that develop in the musculoskeletal system and tumor masses that have spread to the bone (metastasis) from other organs.

Orthopedic oncology is the branch that diagnoses and surgically treats bone tumors and soft tissues that occur in the musculoskeletal system and mass tumors that have spread (metastasized) to the bones from other organs.

Bone tumor is an abnormal growth in bone tissue that invades and replaces healthy tissues, weakening the bones and causing fractures. The cause of most bone tumors is unknown.

If left untreated, they can lead to the loss of function of the affected organ or even death. Most bone tumors are benign and do not threaten life.

Malignant bone tumors include:

Osteosarcomas: Malignant tumors that spread to the bones from other organs.

Multiple Myeloma: The most common primary bone cancer.

Ewing’s Sarcoma: Typically develops in individuals aged 5 to 20 years, causing bone destruction with a large mass of soft tissue.

Chondrosarcomas: A type of bone tumor that usually appears as a mass in the hip, pelvis, or shoulder between the ages of 40-70.

Most patients with tumors suffer from continuous pain. Pathological fractures may occur, increasing the severity of pain. Some tumors cause symptoms such as fever and night sweats. Sometimes, they may appear as painless masses.

The treatment of benign bone tumors varies depending on the type of tumor and the age of the patient, but in most cases, monitoring is sufficient.

In some cases, medication reduces pain. Some may disappear on their own over time (especially in children). In some types of tumors, their recurrence may occur even if the mass is removed. Some benign tumors can also turn into malignant tumors over time.

The most important factor in treating malignant bone cancers is the type and stage of the tumor. Treatment may include surgical removal of the tumor alone or removal of healthy tissue surrounding the tumor. Radiation therapy and chemotherapy may also be used in combination with other treatments.

The basic diagnostic methods used in orthopedics are:
✔X-ray
✔Ultrasonography
✔CT (Computed Tomography)
✔MR Imaging
✔Bone scintigraphy
✔Angiography
✔Biopsy

X-rays are a fast and painless method for imaging the body’s structures, especially bones. X-rays pass through your body. However, they appear absorbed depending on the density of the material they pass through. Dense materials like bones and metals appear white in X-rays. Air in the lungs appears black. Fat and muscles appear in shades of gray.

This method uses ultrasound waves to image the internal structure of the body. Ultrasound waves have a much higher frequency than what the human ear can hear. When ultrasound waves hit different tissues, they reflect in different ways. These reflections create images of tissues and organs on the ultrasound machine’s screen. This way, abnormal tissues like cysts and tumors can be detected.

Doppler ultrasonography is used to determine blood flow in vessels and associated diseases. In this method, sound waves are sent, but with the movement of blood, there are changes in sound frequencies. Thanks to these changes, information about the speed and direction of blood flow can be obtained.

This method allows X-rays to image tissues and organs in the body in a cross-sectional view. CT scans provide more detailed information than regular X-rays. They are especially used in diagnosing head injuries, brain tumors, and other brain diseases. CT scans can also visualize bones and soft tissues, as well as blood vessels through computed tomography angiography.

MRI, or magnetic resonance imaging, is a non-invasive diagnostic tool that does not involve harmful radiation like X-rays. In MRI, images are created using radiofrequency waves in a strong magnetic field. MRI, which is highly effective in imaging soft tissues, can detect cancerous areas that cannot be found using other methods.

It is a method to examine the entire body at once. It is used to determine whether the tumor has spread to the bones. In the initial stage of the examination, the radioactive material is injected into the vein. Then, at regular intervals, any part of the bones that accumulates more radioactive material is examined more. Inflammation in the bone may be associated with a tumor or may be due to other causes such as trauma or infection.

It is used for imaging the arteries in certain parts of the body, and it is the best method that can be used to show the vascular properties of the tumor. It is usually needed when planning before surgery.

A biopsy is the process of taking a small piece of body tissue and examining it under a microscope. The tissues taken are usually subjected to some microbiological and molecular biology tests. Biopsies are typically performed in suspected disease cases. For example, if there is a tumor or an abnormal mass in the body, a biopsy must be done to determine whether it is a tumor or not. Arthroscopy is performed by inserting devices of medium thickness (about 4 mm) from the skin into the joint after inflating it with water by injecting water into the joint. It is a more useful method compared to open surgery in terms of the risk of infection, pain after surgery, and cosmetic appearance.