1/165. Extensive post-traumatic ossification of the patellar tendon. A report of two cases.Two men, aged 21 and 50 years, were seen with ossification of the patellar tendon after injury to the knee in adolescence. They complained of pain and had patella alta. Large bony masses were excised from below the affected patellae. The patellar tendon was then reconstructed using a Leeds-Keio ligament. The results at six and ten years, respectively, were good, with neither patient having pain or an extension lag.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
2/165. spinal cord compression caused by unusual location and extension of ossified ligamenta flava in a Caucasian male. A case report and literature review.STUDY DESIGN: A case report of a spinal cord compression caused by ossification of the ligamenta flava is presented together with a review of the literature. OBJECTIVE: To present the diagnosis of ossification of the ligamenta flava in a Caucasian man with a proximal thoracic myelopathy. SUMMARY OF BACKGROUND DATA: This case shows that the upper parts of the thoracic spine can be involved in ossification of the ligamenta flava, which never before has been reported in Caucasian individuals. Furthermore, it is advised that computed tomography scanning and magnetic resonance imaging be combined to provide an accurate diagnosis and proper preoperative evaluation of the bony changes, spinal cord, and compression of the spinal cord. methods: A patient with a thoracic spinal cord compression caused by ossification of the ligamenta flava was treated surgically and made a good clinical recovery. Imaging studies, surgical findings, and results of histopathologic investigations were analyzed to substantiate the diagnosis. RESULTS: The results of the surgical findings seemed to be in contrast with those of the imaging studies. This contrast was occasioned by the uncommon perioperative finding of a fusion of the completely ossified upper and lower parts of the involved adjacent ligamenta flava. Ossification of the ligamenta flava was diagnosed by histopathologic examination, which revealed endochondral ossification and lamellar bone formation without fragments of ligamenta flava. CONCLUSION: Although rarely reported in whites, ossification of the ligamenta flava should be considered in all patients presenting with a spinal cord compression, even at high thoracic levels. The prognosis after decompressive surgery can be good, especially if intramedullary hyperintensities are absent on preoperatively performed T2-weighted magnetic resonance images.- - - - - - - - - - ranking = 0.12553841260061keywords = upper (Clic here for more details about this article) |
3/165. Elongated stylohyoid process: a report of three cases.The stylohyoid process is part of the stylohyoid chain--the styloid process, the stylohyoid ligament, and the lesser cornu of the hyoid bone. The stylohyoid chain is derived from the second branchial arch. Mineralisation of the stylohyoid ligament and ossification at the tip may increase the length of the styloid process. An elongated stylohyoid or styloid process is considered to be the source of craniofacial and cervical pain commonly known as Eagle's syndrome. In some instances the stylohyoid process may be considerably elongated, yet remain asymptomatic. This paper reports three patients with elongated stylohyoid processes discovered incidentally on routine radiographic examination.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
4/165. Current therapy in the management of heterotopic ossification of the elbow: a review with case studies.Heterotopic ossification, or the appearance of ectopic bone in para-articular soft tissues after surgery, immobilization, or trauma, complicates the surgical and physiatric management of injured joints. The chief symptoms of heterotopic ossification are joint and muscle pain and a compromised range of motion. Current therapies for prevention or treatment of heterotopic ossification include surgery, physical therapy, radiation therapy, and medical management. Unlike heterotopic ossification of the hip, heterotopic ossification of the elbow has not been extensively investigated, leaving its optimal management ill-defined. To remedy this deficiency, we review risk factors, clinical anatomy, physical findings, proposed mechanisms, and current practice for treatment and prevention of heterotopic ossification. We then consider and draw conclusions from four cases of elbow injury treated at our institutions (three complicated by heterotopic ossification) in which treatment included surgery, radiation therapy, physical therapy, and medical therapy. We summarize our institutional practices and conclude with a call for a randomized clinical trial to better define optimal management of heterotopic ossification of the elbow.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
5/165. Ossifying intramuscular metastasis from colon cancer: report of a case.PURPOSE: This report presents a patient who developed severe buttock pain because of an ossified intramuscular metastasis from a sigmoid colon cancer. methods: This is a case report and review of the literature for intramuscular metastasis from colon cancer. RESULTS: Computed tomography and magnetic resonance imaging showed a soft-tissue mass with heavy calcification. Histologically, mature compact bone was observed with adenocarcinoma cells dispersed among the bony trabeculae. CONCLUSION: When an intramuscular mass is seen, even if it contains extensive calcification, metastasis from colon cancer should be included in differential diagnosis.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
6/165. osteochondroma of the L-5 vertebra: a rare cause of sciatic pain. Case report.Solitary or multiple osteochondromas, which are benign bone tumors that usually occur in the long bones, are rarely found in the vertebral column. When present in the spine, however, they have a predilection for the cervical or upper thoracic regions. The authors present the case of a solitary osteochondroma arising from the left L-5 articular process that contributed to sciatica; complete cure was achieved following its removal. It is possible to speculate that the cartilage of secondary ossification centers can be the origin of aberrant islands of cartilaginous tissue that cause the osteochondroma to form. The more rapid the ossification process of these centers, the greater the probability that aberrant cartilage will form. Therefore, the fact that osteochondromas are more frequently located in the higher segments of the vertebral column could be explained by the different durations of the ossification processes in these centers, which increase gradually below the cervical segments.- - - - - - - - - - ranking = 2.0627692063003keywords = pain, upper (Clic here for more details about this article) |
7/165. Unilateral osseous bridging between the arches of atlas and axis after trauma.STUDY DESIGN: This is a case report. OBJECTIVE: To present a case of osseous bridging between C1 and C2 of posttraumatic origin and with an associated closed head injury and to discuss its pathogenesis and clinical outcome after surgical resection. SUMMARY OF BACKGROUND DATA: Heterotopic ossifications of posttraumatic origin in the spine are rare. To the authors' knowledge, no cases have been reported of spontaneous bony bridging between C1 and C2 with a posttraumatic origin. methods: Heterotopic ossifications were detected when pain and limited axial rotation (left/right 10 degrees/0 degree/20 degrees) were persistent, despite intensive physical therapy. Because heterotopic ossifications were ankylosing C1 and C2, the decision was to resect the osseous bridge in combination with a careful mobilization of the cervical spine. Functional computed tomography was performed for analysis of the postoperative results. RESULTS: Four months after surgery, clinical examination showed asymptomatic increased axial rotation. Functional computed tomography indicated that left C1-C2 axial rotation was reduced, possibly related to impingement caused by residual bony spurs. Pathologic changes in the surrounding soft tissue may be another important factor in the persistent limitation of rotation. CONCLUSIONS: Osseous bridging between C1 and C2 may be considered when persistent pain and limited axial rotation are observed after trauma. Operative resection, together with careful intraoperative and postoperative mobilization, may be the treatment of choice.- - - - - - - - - - ranking = 1keywords = pain (Clic here for more details about this article) |
8/165. Melanotic schwannoma. An unusual case of an ossified soft tissue mass.A case of a melanotic schwannoma presenting as a soft tissue mass of the abductors of the hip is reported. The radiographic findings suggested myositis ossificans, but several subtle findings raised the concern for something else. A bilobed appearance, lack of classic zoning pattern of the ossification, and atypical pain pattern should alert the physician. biopsy should be considered if the radiographic and clinical presentations are not classic for myositis ossificans.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
9/165. Spontaneous fracture of an ossified stylohyoid ligament.The stylohyoid ligament extends from the styloid process to the hyoid bone. For an unknown reason it occasionally ossifies and forms a solid structure which can break because of trauma or even spontaneously. Symptoms of the fracture may mimic tumours, foreign bodies, infections or neuralgia. In our cases a spontaneous fracture of totally ossified stylohyoid ligaments presented as a painful neck swelling. The diagnosis was achieved by an ortopantomographic radiograph. In both cases the healing was spontaneous and complete.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
10/165. Tibiofibular syndesmosis and ossification. Case report: sequelae of ankle sprain in an adolescent football player.Heterotopic ossification development within the interosseous membrane of the ankle is an uncommon occurrence after routine ankle sprains. We present a case of a high school football player who sustained a syndesmosis ankle sprain. After 4 weeks, he continued to have pain, swelling, and range of motion restriction despite being treated with cryotherapy, NSAIDs, supportive taping, and progressive rehabilitation. The radiographs revealed a heterotopic ossification within the interosseous membrane of the distal extremity. The patient was initially treated conservatively and went on to have surgical excision with an excellent result. Symptomatic patients will require definitive surgery even without frank synostosis.- - - - - - - - - - ranking = 0.5keywords = pain (Clic here for more details about this article) |
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