1/4. Benign fibrous histiocytoma of the posterior arch of C1 in a 6-year-old boy: a case report.STUDY DESIGN: Presented is a unique case report of a rare bone tumor: a benign fibrous histiocytoma (BFH) located in the posterior arch of C1 in a 6-year-old child. OBJECTIVE: To describe a benign fibrous histiocytoma of bone and the differential diagnostic considerations based on the authors' case report. SUMMARY OF BACKGROUND DATA: A BFH is a rare tumor composed of varying degree of fibroblast-like spindle cells, foam cells, and multinucleated giant cells. Approximately 86 cases have been reported in literature. Its exact nature remains somewhat controversial. A lesion may be designated a benign fibrous histiocytoma based on clinical, radiographic, and microscopic criteria. MATERIALS AND methods: The clinical symptoms, plain radiographs, computerized tomography (CT), magnetic resonance images (MRI), bone scintigraphy, and histologic section of the lesion are discussed, evaluated, and compared with other benign bone lesions. RESULTS: This case is, to the best of the authors' knowledge, the first benign fibrous histiocytoma to be reported in the cervical spine of a child. Various benign lesions such as nonossifying fibroma, giant-cell tumor, fibrous dysplasia, aneurysmal bone cyst, osteoblastoma, and eosinophilic granuloma are included in the differential diagnosis. CONCLUSION: Benign fibrous histiocytoma is a rare skeletal tumor. Because of this and its nonpathognomonic microscopic features, the diagnosis can be somewhat troublesome. However, by systematically reviewing patient's symptoms, tumor location, and radiographic and microscopic characteristics, other benign lesions can be eliminated. The diagnosis of a BFH is one of exclusion.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/4. gastroesophageal reflux disease in an 8-year-old boy: a case study.OBJECTIVE: To present the diagnosis and management of gastroesophageal reflux disease found in a pediatric patient, to discuss the importance of a detailed case history, and to bring forward some of the most important clues, both verbal and nonverbal, that can lead to the diagnosis. CLINICAL FEATURES: An 8-year-old boy was brought to a chiropractic clinic by his mother complaining of headache and neck pain. Based on the history and physical examination, a diagnosis of cervicogenic headache was made. INTERVENTION AND OUTCOME: Treatment consisted of chiropractic manipulation of the upper cervical spine in combination with cranial treatment was applied in addition to dietary advice. The headache returned and the patient was then referred to a colleague for a second opinion. Based on a detailed history, gastroesophageal reflux disease was diagnosed and the patient was referred to a specialist for suitable treatment. CONCLUSION: Because of the position as first-line health practitioners, it is inevitable that doctors of chiropractic will be faced with complaints of a nonbiomechanical nature. It is important to recognize conditions, such as gastroesophageal reflux, at an early stage and to refer appropriately.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/4. Cervical epidural abscess in an afebrile patient: a case report.OBJECTIVE: The aim of the study was to discuss a case of cervical epidural abscess and present the clinical features and diagnosis of this disorder. CLINICAL FEATURES: A 52-year-old man had severe neck pain for 1 week. He had a long history of chronic recurrent neck pain, including 2 previous neck surgeries. He was afebrile on each visit, but developed rapid onset of motor loss, which necessitated immediate magnetic resonance imaging referral. The patient died in the magnetic resonance imaging tube. INTERVENTION AND OUTCOME: Because of the aggressive nature of the infection, causing death only 1 week after the initial onset of symptoms, there was no opportunity to institute treatment of the abscess. CONCLUSION: Spinal epidural abscess is a relatively rare but potentially life-threatening disorder in which the most common initial symptom is spinal pain. Because of this, patients with early spinal epidural abscess will often consult a chiropractic physician or other primary contact spine specialist. It is important for clinicians to be alert to the diagnostic features of spinal epidural abscess so that early treatment can be instituted.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/4. intracranial hypotension causing headache and neck pain: a case study.OBJECTIVE: The purpose of this study is to discuss the presentation, examination, diagnosis, and treatment of a case of intracranial hypotension presenting to a chiropractic office as acute severe headache and neck pain. CLINICAL FEATURES: Flexion injury during a weight lift resulted in a severe postural headache and upper cervical spine pain in a 51-year-old man. The patient presented with unusual symptoms, but normal palpatory findings, and a lack of postural distortion. INTERVENTION AND OUTCOME: Based on the history, symptoms, and examination findings, the patient was referred for an emergency medical evaluation. A diagnosis of intracranial hypotension was made, and a dural leak was confirmed by radioisotope cisternography. The patient made a complete recovery. CONCLUSIONS: intracranial hypotension can cause headache and neck pain that may appear to be musculoskeletal in nature. The key symptom is the orthostatic nature of the headache.- - - - - - - - - - ranking = 2keywords = nature (Clic here for more details about this article) |