51/181. Calcifying tendinitis of the rotator cuff with cortical bone erosion. Calcifying tendinitis occurs most commonly in the rotator cuff tendons, particularly involving the supraspinatus tendon insertion, and is often asymptomatic. Cortical erosion secondary to calcifying tendinitis has been reported in multiple locations, including in the rotator cuff tendons. We present a pathologically proven case of symptomatic calcifying tendinitis involving the infraspinatus tendon with cortical erosion with correlative radiographic, CT, and MR findings. The importance of considering this diagnosis when evaluating lytic lesions of the humerus and the imaging differential diagnosis of calcifying tendinitis and cortical erosion are discussed. ( info) |
52/181. Recurrent tendinitis after treatment with two different fluoroquinolones. Tendinopathies with and without tendon rupture are rare adverse events, occurring mainly following older fluoroquinolones, but recently also to an increasing extent following levofloxacin. We report the first case of tendinitis after treatment with moxifloxacin, and of recurrent tendinitis after treatment with 2 different fluoroquinolones. From these findings we conclude hitherto unexplained class effect of fluoroquinolones in respect of the development of tendinitis. ( info) |
53/181. Acute calcific tendinitis of the gluteus medius: a case report with serial magnetic resonance imaging findings. A case of calcific tendinitis of the gluteus medius is presented. Calcification was evident in the soft tissue adjacent to the greater trochanter on plain radiographs. On the initial magnetic resonance images (MRI), inflammatory edematous change was detected not only in the gluteus medius but also in the bone marrow of the greater trochanter, corresponding to the painful area. Three months later, calcification disappeared on plain radiographs and the femur showed normal signal intensity on MRI. Initial MRI excluded other diseases' including infection and bone tumor, and serial MRI confirmed that the change in extraosseous and intraosseous findings were in accordance with self-limiting clinical symptoms. ( info) |
54/181. Acute calcific tendinitis of the finger--a case report. Acute calcific tendinitis of the hand is rare and often misdiagnosed as infection, fracture or periarthritis. It frequently occurs in peri-menopausal women and is caused by deposits of hydroxyapatite crystals. We describe acute calcific tendinitis of the flexor digitorum superficialis insertion in an elderly man taking oral anticoagulants. The differential diagnoses and recommended treatment are discussed. ( info) |
55/181. An underdiagnosed hip pathology: apropos of two cases with gluteus medius tendon tears. Until recently, gluteus medius tendon tears have been the sort of hip pathology that is relatively unknown in the realm of rheumatology. Their diagnosis can pose a serious challenge to physicians, despite diligence. In this report we summarize two relevant cases and put forward some hints for their evaluation. magnetic resonance imaging is quite beneficial in demonstrating the pathology and ruling out other likely pathologies after a prompt physical examination. physicians should exercise care and vigilance in order not to overlook these cases, in which prompt physical examination and radiological interventions remain a prerequisite in the diagnostic algorithm. ( info) |
56/181. Longstanding isolated juvenile onset HLA-B27 associated peripheral enthesitis. We describe a 17-year-old girl who has had HLA-B27 associated peripheral enthesitis for ten years with no other clinical manifestation of seronegative spondyloarthropathy. This case supports our hypothesis that peripheral enthesitis may occur alone during childhood, as the only clinical feature of the HLA-B27 associated disease process. ( info) |
57/181. Atypical pattern of acute severe shoulder pain: contribution of sonography. A patient presented with an atypical pattern of acute severe shoulder pain. Sonography elucidated the mechanism of the pain and allowed effective treatment. The patient was unable not only to move her shoulder but also to flex and to extend her elbow. Sonography showed a calcific deposit in the subscapularis tendon with local edema displacing the long head of the biceps tendon out of the bicipital groove. Local injection of a glucocorticoid under ultrasonographic control was followed within 7 days by subsidence of the subscapularis tendon edema and by a return of the long head of the biceps tendon to its normal position in the bicipital groove. ( info) |
58/181. Magnetic resonance appearance of bone marrow edema associated with hydroxyapatite deposition disease without cortical erosion. The authors report the magnetic resonance (MR) appearance of bone marrow edema associated with hydroxyapatite deposition disease without cortical erosion. Hydroxyapatite deposition disease may have bone marrow edema on MR imaging without radiographic evidence of cortical erosion, mimicking the appearance of fracture, neoplasm, or infection. awareness of this association can prevent unnecessary additional imaging evaluation or biopsy. ( info) |
59/181. Biceps tendinitis caused by an osteochondroma in the bicipital groove: a rare cause of shoulder pain in a baseball player. Tendinitis of the long head of the biceps brachii muscle is commonly seen in athletes who do repetitive overhead motions. Common causes of biceps tendinitis include impingement syndrome, subluxation of the biceps tendon, and attrition tendinitis, whereas biceps tendinitis secondary to a bone neoplasm is rare. A case of biceps tendinitis caused by an osteochondroma arising in the left humeral bicipital groove in a 25-year-old male baseball player is reported. The tumor was hook-shaped, originated from the inferomedial portion of the humeral lesser tubercle, and surrounded the biceps tendon. Symptoms of increasing pain and inability to throw resulted from direct irritation of the biceps tendon by the tumor. Total excision of the tumor relieved the symptoms within 3 weeks. To our knowledge, there have been no reported cases in the English-language literature of biceps tendinitis caused by an osteochondroma. ( info) |
60/181. Tendonitis in variant hyperimmunoglobulinaemia D and periodic fever syndrome--a rare disease with a new symptom. Hyperimmunoglobulinaemia D syndrome (HIDS) is defined as recurrent fever, generalised lymphadenitis, abdominal pain, arthritis and raised polyclonal serum IgD >100 IU/ml. The cause is a mutation in the mevalonate kinase gene. Other periodic fever syndromes are known. We report a new patient and describe orbital tendonitis as a hitherto unreported symptom CONCLUSION: Without any underlying cause, the tendonitis must be seen as new symptom of variant hyperimmunoglobulinaemia D syndrome. We speculate that the inflammation of the Tenon spatium is similar to the process of inflammation of the connective tissue in the joint in hyperimmunoglobulinaemia D syndrome where deposits of C3 and IgM are present. Variant hyperimmunoglobulinaemia D syndrome can be present in one family. ( info) |