1/47. Unusual longitudinal stress fractures of the femoral diaphysis: report of five cases.We present five cases of a distinctive type of longitudinal stress fracture of the upper femoral shaft in which the fracture line is parallel to the outer surface of the bone, in contrast to the perpendicular orientation to the cortical surface in previously reported cases of diaphyseal stress fractures. In two cases the fracture recurred after 15 and 18 months, respectively.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/47. An unusual extraspinal cause of bilateral leg pain.low back pain with pain radiating to the lower extremities is common in patients referred to a spine center. Lumbar spine pathology is commonly the etiology of such symptoms, but extraspinal causes of back and leg pain can manifest as a radicular disorder. Extraspinal etiologies must be considered in the workup of back and leg pain. This report describes an unusual case of spontaneously occurring bilateral femoral neck stress fractures presenting as low back pain with seemingly bilateral L4 radicular symptoms.- - - - - - - - - - ranking = 3038.0380083328keywords = back pain, back (Clic here for more details about this article) |
3/47. magnetic resonance imaging in the diagnosis of sacral stress fracture.Low back and buttock pain in athletes can be a source of frustration for the athlete and a diagnostic dilemma for the doctor. Sacral stress fractures have been increasingly recognised as a potential cause of these symptoms. As plain radiographs are often normal and the radiation load of an isotope bone scan is substantial, the alternative use of magnetic resonance imaging in the diagnosis of a sacral stress fracture is highlighted in this case report.- - - - - - - - - - ranking = 92.509421487603keywords = back (Clic here for more details about this article) |
4/47. Iatrogenic spondylolysis leading to contralateral pedicular stress fracture and unstable spondylolisthesis: a case report.STUDY DESIGN: A case report of iatrogenic spondylolysis as a complication of microdiscectomy leading to contralateral pedicular stress fracture and unstable spondylolisthesis. OBJECTIVE: To improve understanding of this condition by presenting a case history and roentgenographic findings of a patient that differ from those already reported and to propose an effective method of surgical management. methods: A 67-year-old woman with no history of spondylolysis or spondylolisthesis underwent an L4-L5 microdiscectomy for a left herniated nucleus pulposus 1 year before the current consultation. For the preceding 8 months, she had been experiencing low back and bilateral leg pain. Imaging studies revealed a left L4 spondylolytic defect and a right L4 pedicular stress fracture with an unstable Grade I spondylolisthesis. RESULTS: The patient was treated with posterior spinal fusion, which resulted in complete resolution of her clinical and neurologic symptoms. CONCLUSIONS: Iatrogenic spondylolysis after microdiscectomy is an uncommon entity. However, it can lead to contralateral pedicular stress fracture and spondylolisthesis, and thus can be a source of persistent back pain after disc surgery. Surgeons caring for these patients should be aware of this potential complication.- - - - - - - - - - ranking = 1519.0190041664keywords = back pain, back (Clic here for more details about this article) |
5/47. Stress fracture of the hip and pubic rami after fusion to the sacrum in an adult with scoliosis: a case report.Correction of adult scoliosis frequently involves long segmental fusions, but controversy still exists whether these fusions should include the sacrum. It has been suggested that forces associated with activities of daily living transfer the stresses to the remaining levels of the spine and to the pelvis. The case described here was a 43-year-old woman with scoliosis and chronic back pain refractory to non-surgical modalities. Radiographically, the patient had a 110 degree lumbar curve. An anterior and posterior fusion with Luque-Galveston instrumentation was performed. Six months postoperatively the patient returned with a 2-week history of right hip pain with no history of trauma. There was radiographic evidence of a displaced femoral neck fracture and pubic rami fractures. The femoral neck fracture was treated with a total hip replacement. Further surgeries were required to correct a lumbar pseudoarthrosis and hardware failure. We believe that this case provides evidence that fusion into the lumbosacral junction may distribute forces through the pelvic bones and hip resulting in stress and potential hardware complications, especially in patients at risk due to osteopenic conditions.- - - - - - - - - - ranking = 1426.5095826788keywords = back pain, back (Clic here for more details about this article) |
6/47. Olecranon stress fracture in a weight lifter: a case report.Stress fractures have been reported in the upper limb of sportspeople involved in upper limb dominated events. Olecranon stress fractures have been cited in baseball pitchers, javelin throwers, and gymnasts. The unusual case of a stress fracture of the olecranon in a young weight lifter is reported here. The minimally displaced stress fracture was treated with tension band and two Kirschner wires. The fracture healed in four months and the patient returned to light sports activity after six months.- - - - - - - - - - ranking = 2keywords = upper (Clic here for more details about this article) |
7/47. Fracture of the first rib as a consequence of pertussis infection.We report the first described case of a first rib fracture secondary to pertussis infection. An 11-year-old boy presented with sudden onset of severe right-sided pleuritic chest pain on a background of a 6 week history of a coughing illness and considerable weight loss. Pertussis was clinically suspected and proven on serology. A cause for the severe pain was initially difficult to confirm, causing some concern regarding possible underlying pathology, but was later demonstrated to be due to a first rib fracture. The anatomy of the first rib, and the biomechanical forces placed upon it that are exacerbated during a coughing illness are described.- - - - - - - - - - ranking = 92.509421487603keywords = back (Clic here for more details about this article) |
8/47. Pedicle fracture after instrumented posterolateral lumbar fusion: a case report.STUDY DESIGN: The case report of a 60-year-old man with late onset back pain after lumbar spine fusion is presented. OBJECTIVE: To report the rare complication of bilateral pedicle stress fractures after instrumented posterolateral lumbar fusion. SUMMARY OF BACKGROUND DATA: A 56-year-old man underwent revision spinal surgery for ongoing back pain secondary to pseudoarthroses. A posterolateral L4-S1 instrumented fusion using pedicle screws was performed. Autologous bone graft was applied to the decorticated lateral masses. The internal fixation was removed 2 years later, at which time plain radiographs showed that the fusion mass was solid. At the age of 60 years, the man presented with worsening back pain. Plain radiographs and computed tomographic scans demonstrated bilateral L4 pedicle stress fractures. A bone scan indicated that these were recent in origin. METHOD: The clinical assessment was undertaken by the senior author and surgeon. Investigations included plain radiography, computer tomography, and scintographic imaging. A systematic literature review of the relevant publications was performed. RESULTS: In the reported patient, bilateral pedicle stress fractures developed 2 years after pedicle screw removal from an L4-S1 instrumented posterolateral lumbar spine fusion. This occurred at the uppermost level of the fusion mass. CONCLUSIONS: The pedicle is the weakest point in the neural arch after posterolateral fusion. Although movement continues at the level of the disc space anteriorly, the pedicle is susceptible to fracture. Pedicle fracture is a rare late complication of posterolateral lumbar spine fusion.- - - - - - - - - - ranking = 4280.5287480363keywords = back pain, back, upper (Clic here for more details about this article) |
9/47. Stress fractures of the sacrum. An atypical cause of low back pain in the female athlete.low back pain is a common finding in an athletically active premenopausal female population. We describe an unusual cause of persistent low back/sacroiliac pain: a fatigue-type sacral stress fracture. Plain radiographs, bone scans, computed tomography, and magnetic resonance imaging studies were obtained in the female athletes to determine the nature of the pathologic abnormality. The most significant risk factor for fatigue-type sacral stress fractures was an increase in impact activity due to a more vigorous exercise program. Potential risk factors such as abnormal menstrual history, dietary deficiencies, and low bone mineral density were examined. The clinical course was protracted, with an average 6.6 months of prolonged low back pain before resolution of symptoms. Sacral fatigue-type stress fractures did not preclude the athletes from returning to their previous level of participation once healing had occurred.- - - - - - - - - - ranking = 8651.5669175603keywords = back pain, back (Clic here for more details about this article) |
10/47. Stress fracture of the ulna in a professional tennis player using a double-handed backhand stroke.Stress fractures of the ulna are uncommon injuries, but they have been reported in athletes from various sports. In tennis players stress fractures of the ulna are described exclusively in the nondominant forearm of athletes using a two-handed backhand stroke. We report such a case in a 24-year-old tennis player, with special emphasis on diagnostic imaging, accurate grading of the injury, and specific treatment recommendations.- - - - - - - - - - ranking = 462.54710743802keywords = back (Clic here for more details about this article) |
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