11/38. Flexor carpi radialis tendon rupture following chronic wrist osteoarthritis: a case report.A patient is reported with a history of multiple tendon ruptures including biceps, flexor hallucis longus and achilles tendons. He presented with closed rupture of the flexor carpi radialis tendon following long standing tendonopathy and scapho-trapezio-trapezoid arthrosis. Non-operative treatment was elected because of low physical demands on the upper extremity. Early management of scapho-trapezio-trapezoid arthritis can prevent flexor carpi radialis tendon rupture.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/38. Referred knee pain treated with electroacupuncture to iliopsoas.This is a case report of a 33-year-old woman who presented with an eight year history of deep left knee pain. The pain was originally diagnosed as deriving from osteoarthrosis of the hip secondary to dysplasia, however, the same pain returned at seven months, and again at 10 months, after successful hip resurfacing arthroplasty. Six to eight weeks after the start of the second relapse of referred knee pain, the patient sought acupuncture treatment at the British Medical Acupuncture Society's london teaching Clinic. A single myofascial trigger point was found in iliopsoas that reproduced the patient's pain. It was successfully treated with two sessions of electroacupuncture applied directly to the point. Pain referral to the knee from trigger points in the upper part of rectus femoris is well recognised, however, this pattern of referral from iliopsoas has not been described previously.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
13/38. X-linked spondyloepiphyseal dysplasia tarda: molecular cause of a heritable disorder associated with early degenerative joint disease.Spondyloepiphyseal dysplasia tarda (SEDT) is a genetically heterogeneous disorder often associated with the early onset of osteoarthrosis. The X-linked recessive form (SEDL) affects men and is characterized by reduced height, arm span exceeding total height, and barrel chest deformity. The radiographic phenotype comprises a hump-shaped deformity of vertebral bodies and mild epiphyseal dysplasia of the femoral head associated with early signs of hip arthrosis. The disorder is caused by mutations in the SEDL (or sedlin) gene on Xp22.12-p22.31. In 4 male patients from a German family, we identified a new nonsense mutation in SEDL exon 4 (C74A). The carrier status for the mutation could be confirmed in 2 women of the family, both of whom show no obvious signs of bone and joint diseases. SEDT should be kept in mind as a differential diagnosis in men with early "primary" bilateral osteoarthrosis.- - - - - - - - - - ranking = 0.27085642374969keywords = chest (Clic here for more details about this article) |
14/38. Celecoxib-induced methemoglobinemia.OBJECTIVE: To report a case of acute methemoglobinemia in a patient treated with celecoxib for osteoarthritis. CASE SUMMARY: A 72-year-old African American man developed an acute confusional state (ACS) one month after receiving celecoxib for osteoarthritis of his knee joints. There was no other identifiable cause of ACS such as any recognized cause of metabolic encephalopathy, meningoencephalitis, cerebrovascular accident, or drug intoxication. He was found to have severe methemoglobinemia (serum methemoglobin fraction 9%; reference range 0-0.2). His symptoms improved substantially, and serum methemoglobin levels decreased to 0.7% after the initiation of methylene blue therapy. He was discharged on oral riboflavin and ascorbic acid and was advised not to restart celecoxib therapy. He had not shown any recurrence of the symptoms at a follow-up visit 2 months after the withdrawal of celecoxib. DISCUSSION: Celecoxib is a nonsteroidal antiinflammatory drug that selectively inhibits cyclooxygenase-2. Acute methemoglobinemia can present as a syndrome of nonspecific symptoms such as headache, nausea, fatigue, dyspnea, and lethargy; these may progress to respiratory depression, coma, shock, seizures, and death. Although acute methemoglobinemia has been reported with the use of several drugs, including sulfonamides, as of August 13, 2004, this is the first case report of severe methemoglobinemia manifesting as ACS with celecoxib therapy. Use of the Naranjo probability scale indicated a probable relationship between the clinical manifestations of methemoglobinemia and celecoxib therapy in this patient. CONCLUSIONS: Celecoxib can be associated with acute methemoglobinemia. Prompt diagnosis of this condition, withdrawal of celecoxib, and treatment with the antagonists (methylene blue, ascorbic acid, riboflavin) can reverse this potentially serious condition.- - - - - - - - - - ranking = 3.2063490485672keywords = headache (Clic here for more details about this article) |
15/38. Bridging osteophyte of the anterosuperior sacroiliac joint as a cause of lumbar back pain.A case report is presented of a patient with an anterosuperior osteophytic bone bridge of the sacroiliac joint causing lumbar back pain. After prolonged physiotherapy, the bone bridge was excised, with complete resolution of the symptoms. Excision should only be considered in cases of symptomatic sacroiliac joint pain that does not respond to rehabilitation programmes and conservative treatment.- - - - - - - - - - ranking = 240.56934878316keywords = back pain, back (Clic here for more details about this article) |
16/38. Degenerative disc disease in childhood and adolescence.Degenerative disk disease (DDD) is a common cause of low back pain and leg pain in children and infants. DDD is often unrecognized and under-diagnosed. This paper presents six cases of DDD in children and discusses the clinical presentation and pathophysiology of DDD.- - - - - - - - - - ranking = 48.113869756632keywords = back pain, back (Clic here for more details about this article) |
17/38. arthrodesis for osteoarthritis of the manubriosternal joint.osteoarthritis of the manubriosternal joint is rare. The diagnosis is not easy to make, and more serious causes of chest pain have to be ruled out first. We report one case that was treated with arthrodesis of the manubriosternal joint using double locking screw compression plating (LCP) with excellent results. Pre-operative CT-scan images with 3D reconstruction were used to measure the screw length and the drill stop depth. In this case report, we have shown that arthrodesis can be an effective way of treating osteoarthritis of the manubriosternal joint, when other measures fail. Furthermore, the use of a locking compression plate with appropriate and careful pre-operative planning affords a safe surgical technique, rapid pain relief and ultimately sound and asymptomatic union of the joint.- - - - - - - - - - ranking = 0.27085642374969keywords = chest (Clic here for more details about this article) |
18/38. "Broken heart syndrome" after separation (from OxyContin).We describe a 61-year-old woman with "broken heart syndrome" (Takotsubo-like cardiomyopathy) after abrupt postsurgical withdrawal of OxyContin. Her medical history was remarkable for long-term opiold dependence associated with the treatment of multi-Joint degenerative osteoarthritis. The patient presented to the emergency department 1 day after discharge from the hospital following total knee arthroplasty revision with acute-onset dyspnea and mild chest pain. She had precordial ST-segment elevation characteristic of acute myocardial infarction and elevated cardiac biomarkers. Emergency coronary angiography revealed no major coronary atherosclerosis. However, the left ventricular ejection fraction was severely decreased (26%), and new regional wall motion abnormalities typical of broken heart syndrome were noted. In addition to resuming her opioid therapy, she was treated supportively with bilevel positive airway pressure, diuretic therapy, morphine, aspirin, metoprolol, enalaprilat, intravenous heparin, nitroglycerin infusion, and dopamine infusion. Ventricular systolic function recovered completely by the fourth hospital day. To our knowledge, broken heart syndrome after opioid withdrawal has not been reported previously in an adult. Our case illustrates the importance of continuing adequate opiate therapy perioperatively in the increasing number of opioid-dependent patients to prevent potentially life-threatening complications such as broken heart syndrome.- - - - - - - - - - ranking = 0.27085642374969keywords = chest (Clic here for more details about this article) |
19/38. Acquired condylar hypoplasia: report of case.Evaluation for signs and symptoms of TMJ disturbances during childhood and early adolescence is important. Early occlusal treatment for mandibular asymmetries may reduce temporomandibular joint growth site pathofunction, thus resulting in less pain, headache, and asymmetrical development of the mandible.- - - - - - - - - - ranking = 3.2063490485672keywords = headache (Clic here for more details about this article) |
20/38. paraplegia, syringomyelia tarda and neuropathic arthrosis of the shoulder: a triad.A casually related triad of syringomyelia tarda, postparaplegia with secondary neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder has been presented. The development of neuropathic arthrosis of the shoulder in 2 of our paraplegic patients prompted us to look for a correlation and/or a common etiology. paraplegia secondary to spinal cord injury could be causative or at least an associated factor in a delayed proximal syringomyelia. It is the syringomyelia which can lead to the neuropathic arthrosis in the upper extremity, mainly, in the shoulder. There is an interesting pathological association of paraplegia and syringomyelia with neuropathic arthrosis. Earlier awareness of any neurological changes in the upper extremity of the paraplegic patient could point to recognition of syringomyelic process and portend a tendency toward neuropathic arthrosis of the shoulder. This would require a high index of suspicion, and subsequently a preventative, protective orthopedic approach to minimize the usual functional deformity that occurs when this neuropathy involves the shoulder.- - - - - - - - - - ranking = 2keywords = upper (Clic here for more details about this article) |
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