11/305. Complex regional pain syndrome.Complex regional pain syndrome is a chronic pain syndrome that is often instigated by postoperative or post-traumatic events. The disease process can progress through three stages, the first of which tends to respond best to treatment. A review of the literature is presented, followed by a report of a patient who developed symptoms of complex regional pain syndrome following a water-skiing accident.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
12/305. Suprascapular nerve entrapment at the spinoglenoid notch in a professional baseball pitcher.Suprascapular nerve injuries at the spinoglenoid notch are uncommon. The true incidence of this lesion is unknown; however, it appears to be more common in athletes who participate in sports involving overhead activities. When a patient is being evaluated for posterior shoulder pain and infraspinatus muscle weakness, electrodiagnostic studies are an essential part of the evaluation. electromyography will identify an injury to the suprascapular nerve as well as assist in localizing the site of injury. In addition, imaging studies are also indicated to help exclude other diagnoses that can mimic a suprascapular nerve injury. The initial management should consist of cessation of the aggravating activity along with an organized shoulder rehabilitation program. If the patient fails to improve with 6 months to 1 year of nonoperative management, surgical exploration of the suprascapular nerve should be considered. Release of the spinoglenoid ligament with resultant suprascapular nerve decompression may result in relief of pain and a return of normal shoulder function.- - - - - - - - - - ranking = 0.28571428571429keywords = pain (Clic here for more details about this article) |
13/305. Clinics in diagnostic imaging (40). iliotibial band syndrome.A 51-year-old male cyclist presented with a mass over the lateral portion of his knee. MR scans showed a cystic collection deep to the iliotibial band (ITB). Diagnosis of the ITB syndrome and its differentiation from other cause of painful lateral knee masses, such as meniscal cyst, lateral collateral ligament injury and Segond fracture, are discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
14/305. Tricuspid insufficiency after blunt chest trauma in a nine-year-old child.The case of a traumatic tricuspid insufficiency in a child, due to an anterior and septal leaflet rupture at the annulus level is reported for the first time. The early diagnosis 2 months after the trauma enabled a rapid and simple tricuspid valvuloplasty by laeflet reinsertion on the annulus associated with annuloplasty with a good result 6 months after the repair.- - - - - - - - - - ranking = 0.097302417714367keywords = chest (Clic here for more details about this article) |
15/305. Cyclops syndrome occurring after partial rupture of the anterior cruciate ligament not treated by surgical reconstruction.Cyclops syndrome is one of the specific causes of loss of extension of the knee following anterior cruciate ligament (ACL) reconstruction. The syndrome is manifested by progressive loss of extension associated with pain and audible clunk at terminal extension caused by a pedunculated nodule of fibrovascular proliferative tissue usually arising from the graft. The entity has been described recently and has been reported exclusively as a complication of ACL reconstructions. We report the case of a patient with symptoms and arthroscopic and histological findings compatible with cyclops syndrome that developed after a partial ACL rupture that was not treated by surgical reconstruction. A different etiology and classical histological and immunohistological microscopic analysis of the nodule presented in this report may further clarify the pathogenesis of the cyclops syndrome.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
16/305. Shoulder impingement in tennis/racquetball players treated with subscapularis myofascial treatments.Conservative care of the athlete with shoulder impingement includes activity modification, application of ice, nonsteroidal anti-inflammatory drugs, subacromial corticosteroid injections, and physiotherapy. This case report describes the clinical treatment and outcome of three patients with shoulder impingement syndrome who did not respond to traditional treatment. Two of the three were previously referred for arthroscopic surgery. All three were treated with subscapularis trigger point dry needling and therapeutic stretching. They responded to treatment and had returned to painless function at follow-up 2 years later.- - - - - - - - - - ranking = 0.14285714285714keywords = pain (Clic here for more details about this article) |
17/305. Henoch-Schonlein purpura with thoraco-lumbar spine involvement precipitated by trampoline jumping.A nine-year-old boy with Henoch-Schonlein purpura (HSP) presented with an arthropathy of the thoraco-lumbar spine. The boy played on a trampoline for several days before the onset of the low-back pain. The vascultic rash of HSP is recognized to be pressure-dependent. The authors speculate that the arthropathy of HSP is also pressure-dependent and that the low back pain in this patient was consequent to the preceding trampoline jumping.- - - - - - - - - - ranking = 0.28571428571429keywords = pain (Clic here for more details about this article) |
18/305. Localized pigmented villonodular synovitis as a rare cause of chronic anterolateral ankle pain in an equestrienne.An unusual case of localized pigmented villonodular synovitis of the ankle as a rare cause of chronic anterolateral ankle pain in a 16-year-old horsewoman is presented. Intra-articular nodular forms of pigmented villonodular synovitis can only be diagnosed arthroscopically, macroscopic and microscopic aspects being typical. We believe that this lesion is more likely a reactive process secondary to repetitive microtrauma rather than a true neoplasm. Our patient presented with pathology in the left ankle, the side by which one mounts and dismounts a horse, forcing, in both activities, ankle dorsiflexion. Moreover, an English saddle was used by our patient, upon which one rides with the ankle maintained in dorsiflexion. At arthroscopy, the soft-tissue mass was seen to be entrapped in the joint between the talus and the tibia at dorsiflexion of the ankle. This had caused a slowly progressive enlargement of the lesion because of fibrosis resulting from reactive inflammation associated with this repetitive microtrauma, thus causing irritation, pain, and synovitis due to impingement.- - - - - - - - - - ranking = 0.85714285714286keywords = pain (Clic here for more details about this article) |
19/305. Chronic calf pain in athletes due to sural nerve entrapment. A report of 18 cases.We retrospectively analyzed the charts of 13 athletes (18 limbs) who had sural nerve entrapment localized in the passage of the nerve through the superficial sural aponeurosis. There were 11 men and 2 women (average age, 43 years; range, 31 to 59). All patients reported chronic calf pain that was exacerbated during physical exertion. Delay to diagnosis averaged 9 months (range, 5 to 24). Tenderness in the calf was identified along the course of the sural nerve in all cases. In 10 patients (15 limbs) electrodiagnostic testing before surgery was positive. After failure of nonoperative treatment, surgery was conducted under local anesthesia. Neurolysis was performed by incising the superficial sural aponeurosis and the fibrous band in it through which the nerve passes. The results of the operation were evaluated in terms of residual symptoms, ability to return to the former sport, and degree of patient satisfaction. A final follow-up examination was performed an average of 14 months (range, 6 to 30) after the operation. The final result was excellent in 9 limbs (2 bilateral), good in 8 limbs (2 bilateral), and fair in 1 case. The differential diagnosis of sural nerve entrapment in athletes is discussed. Increase in sural muscle mass or development of local fibrous scar tissue compromised the sural nerve in its course through the unyielding and inextensible superficial sural aponeurosis.- - - - - - - - - - ranking = 0.71428571428571keywords = pain (Clic here for more details about this article) |
20/305. A novel approach to pain relief pre-therapeutic exercise.Musculoskeletal problems are often multifactorial and consequently can be challenging to treat. This paper examines management of chronic musculoskeletal conditions in the light of Panjabi's stabilisation subsystems and Dye's concept of homeostasis and critical symptom threshold. In many circumstances treatment can aggravate symptoms. Tape may be used to unload painful structures to minimise the aggravation of the symptoms so treatment can be directed at improving the patient's 'envelope of function'. This involves specific muscle training of the dynamically unstable segment/s and increasing the mobility of the less flexible surrounding soft tissues. Three case studies of chronic low back and leg pain, patellofemoral pain and shoulder impingement secondary to multidirectional instability, are presented as examples of multifactorial musculoskeletal problems requiring unloading, stabilisation and control.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
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