1/10. amputation: two views.It has been over one year now since his surgery, and Allen has returned to school and work, ambulating on his prosthesis most of the time. As his phantom limb pain decreased and his proficiency in walking increased, his acceptance of his amputation has been demonstrated in his comments and references to himself and his relations with others. As he states, the more comfortable he is about his amputation, the easier it is for others to accept and relate to him. This, I think, is the key to approaching that final stage of acceptance mentioned earlier. The more we can help our patients accept their amputation initially by supporting them through this crisis period, the easier it will be for them to relate to others and grow emotionally from these relationships.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
2/10. Elastofibroma in shoulder osteoarthritis: a theoretical concept of the etiology.A case of unilateral, subscapular elastofibroma dorsi secondary to degenerative osteoarthritis in the ipsilateral glenohumeral joint is presented. A 69-year-old woman had experienced symptoms of osteoarthritis in the right shoulder since contracting septic arthritis when she was 7 years old. The patient noticed a soft tissue mass in the right subscapular region when she was 65 years old. The range of motion of the glenohumeral joint was severely restricted. Histopathologic examination of the excised mass revealed elastofibroma. The authors think the excessive scapulothoracic motion was important in formation of the lesion. This case indicates that elastofibroma is not a true neoplasm but a reactive lesion formed by repetitive minor trauma.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
3/10. Intra-articular elastofibroma of the shoulder joint.A 19-year-old man presented with an elastofibroma in his left shoulder joint. The patient had had limitation of motion in his left arm for 3 years, especially when rotating internally. radiography of his left shoulder showed bone erosion in the neck of the humerus. On MR imaging, a soft tissue mass was noted in the shoulder joint eroding bone. The mass showed similar signal intensity to that of surrounding muscles on T1- and T2-weighted images. At surgery, a soft, encapsulated mass was found attached to the subscapularis muscle. It was pathologically confirmed as an elastofibroma. This unusual manifestation of an elastofibroma is discussed.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
4/10. Familial adenomatous polyposis: case report and review of extracolonic manifestations.FAP, if left untreated, results in colorectal cancer. Appropriate early surgical intervention is of utmost importance. With the reduction in mortality from colorectal carcinoma, an increasing number of patients with FAP need lifelong follow-up to screen for extracolonic manifestations. Today, the major causes of death in patients with FAP who are cured of colorectal cancer, or have had a colectomy before its development, are desmoid tumors and periampullary carcinomas. In family members at risk, screening with flexible sigmoidoscopy should be initiated in adolescence; symptoms of diarrhea and rectal bleeding would warrant an even earlier examination. The upper gastrointestinal tract should be assessed endoscopically at the time the diagnosis of FAP is made. If any polyps are detected, a biopsy is essential. If no gastric or duodenal polyps are found, repeated examinations at 3-5 year intervals probably suffice in asymptomatic patients. Surgically, colectomy will be necessary. It is usually deferred until late adolescence, when it is thought that the patient will be mature enough to handle the emotional aspects of the operation as well as the possible future morbidity due to the procedure. The presence or absence of rectal polyps as well as the site and depth of any invasive rectal carcinoma will determine the appropriate surgical procedure. Alternatives must be well understood by the physician and discussed carefully with the patient preoperatively.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
5/10. Multiple cardiac papillary fibroelastoma and transient left ventricular apical ballooning syndrome in an elderly woman: case report.An elderly Japanese woman presented with evidence of a myocardial infarction. Emergency angiography showed no significant atherosclerotic disease, but the anterior and anteroseptal walls were akinetic, with 'ballooning' of the apex. She was suspected to have transient left ventricular apical ballooning syndrome (TLVABS). Two months later, transthoracic echocardiography showed normal left ventricular wall motion and function, together with a 5-mm cardiac papillary fibroelastoma (CPF) attached to the aortic valve. Transesophageal echocardiography showed a stalked CPF on the aortic side of the left coronary cusp, and a smaller CPF on the right coronary cusp. It was hypothesized that the CPF caused the TLVABS through myocardial stunning. This may occur as a result of transient dynamic ostial occlusion by the fibroelastoma, or because of emboli from the fibroelastoma which then subsequently spontaneously lysed. This syndrome may represent an unusual manifestation of transient cardiac ischemia. Whilst TLVABS has been mainly reported in Japanese patients, more recent studies have suggested that other populations might also be affected.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
6/10. Elastofibroma dorsi. A case report and review of the literature.Elastofibroma dorsi is a benign soft-tissue tumor characterized by the presence of elastic fibers among a stroma of collagenous and fatty connective tissue. This lesion characteristically is located in the subscapular region; however, it has been infrequently described in other anatomic locations. In the subscapular region, it can be a cause of periscapular pain, discomfort, and loss of range of motion. This paper presents a typical case and a brief review of the literature, concentrating on the clinical aspects of elastofibroma dorsi in addition to recent advances regarding the pathogenesis of this unusual lesion.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
7/10. A tendon sheath tumour presenting as trigger finger.The symptom of trigger finger may be caused by a variety of lesions. This report describes a trigger finger caused by a tumour in the tendon sheath. Trigger finger refers to transient arrest of motion in a finger. It may be caused by a variety of lesions such as those of the volar plate (Yancey & Howard, 1962) and joint capsule (Aldred, 1954), structural abnormalities of the metacarpal head (Flatt, 1961), lacerations of the flexor tendons (Janecki, 1976) and 'loose bodies' (Milford, 1971). Triggering as a result of tumour of the tendon sheath does not, however, appear to have been reported.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
8/10. fibroma of tendon sheath.Three cases of fibromas involving tendon sheath of right index finger, left ring finger, and tibial ligament in a 62-, a 54-, and a 30-year-old male patients, respectively, are described. Two cases (1 and 2) represented painless, slowly enlarging masses that limited motion of the involved digits. The third case was discovered at surgery during the repair of a tibial ligament after a motorcycle accident. Following surgical excisions, no recurrences were present 18 months and 9 months after resection. The fibromas of tendon sheath origin are distinct entities and should be separated from other lesions of tendon sheaths. Trauma should be considered as the etiology. The fibromas are benign lesions but may recur.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
9/10. Experience with peritendinous fibrosis of the dorsum of the hand.Fifteen patients with a diagnosis of peritendinous fibrosis of the dorsum of the hand (Secretan's disease) were treated between 1958 and 1980. Thirteen patients had excision of a dorsal fibroma with extensor tendolysis when necessary. Preoperative findings included a hard dorsal mass and limitation of motion. Postoperative courses were characterized by prolonged periods of rehabilitation and recurrent episodes of swelling. Twelve of 15 patients returned to work 3 to 30 months postoperatively. Permanent disability was substantial. None of these patients had significant wound healing problems, and all had improved range of motion. The question of self-inflicted injury was raised in five cases but could not be demonstrated.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
10/10. Nuchal fibroma.Nuchal fibroma was diagnosed in a 54-year-old diabetic woman with a two year history of increased skin thickness of her low-posterior neck and interscapular region, causing discomfort and limitation of neck and arm motion. Physical and laboratory examinations excluded further disorders. The patient was released, free from symptoms, after complete excision of the soft tissue tumor.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
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