11/12. Atypical decubital fibroplasia in a young patient with melorheostosis.A case of atypical decubital fibroplasia of the right forearm arising in a 25-year-old male with melorheostosis is presented. The diagnosis of melorheostosis involving the right-sided bones was made by radiographical studies, and the patient has been obliged to use crutches due to the contracture and limited range of motion of the right leg. Two painless masses occurred in the subcutis of the posterior aspect of the right forearm over the excrescences of the underlying ulna due to melorheostotic deformity. Grossly, ill-defined firm masses, which measured 3 x 6 x 1.5 cm and 4 x 5 x 1 cm, respectively, were white and intermingled with yellow fatty tissue. Histologically, the lesions consisted of a proliferation of plump fibroblastic cells with abundant collagenous stroma. Vascular proliferation and occasional eosinophilic degeneration of the collagen fibers were also seen. The gross and histological features were those of atypical decubital fibroplasia (ischemic fasciitis). Immunohistochemically, the plump fibroblastic cells were positive for vimentin, but negative for desmin, muscle specific actin, and alpha-smooth muscle actin. Chondroid metaplasia was focally noted and round-shaped cells within this area were positive for S-100 protein. This lesion seemed to be a fibroblastic response against the long-standing, intermittent ischemia of the subcutaneous tissue between the bony excrescences due to melorheostosis and the weight-bearing forces of the crutch.- - - - - - - - - - ranking = 1keywords = motion (Clic here for more details about this article) |
12/12. Chronic ankle pain and fibrosis successfully treated with a new noninvasive augmented soft tissue mobilization technique (ASTM): a case report.This clinical case report demonstrates the clinical effectiveness of a new form of soft tissue mobilization in the treatment of excessive connective tissue fibrosis (scar tissue) around an athlete's injured ankle. The scar tissue was causing the athlete to have pain with activity, pain on palpation of the ankle, decreased range of motion, and loss of function. Surgery and several months of conventional physical therapy failed to alleviate the athlete's symptoms. As a final resort, augmented soft tissue mobilization (ASTM) was administered. ASTM is an alternative nonsurgical treatment modality that is being researched at Performance Dynamics (Muncip, IN). ASTM is a process that uses ergonomically designed instruments that assist therapists in the rapid localization and effective treatment of areas exhibiting excessive soft tissue fibrosis. This is followed by a stretching and strengthening program. Upon the completion of 6 wk of ASTM therapy, the athlete had no pain and had regained full range of motion and function. This case report is an example of how a noninvasive augmented form of soft tissue mobilization (ASTM) demonstrated impressive clinical results in treating a condition caused by connective tissue fibrosis.- - - - - - - - - - ranking = 2keywords = motion (Clic here for more details about this article) |
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