1/15. Unusual case of septic arthritis of the hip: spread from adjacent adductor pyomyositis.Distinguishing intracapsular and extracapsular hip infections may be clinically difficult. Because of this difficulty in diagnosis, the spread of an extracapsular infection into the hip joint may be missed and lead to significant joint destruction. The case of a patient who suffered from the spread of adductor pyomyositis to the hip joint is reported. The delay in diagnosis of an intracapsular hip infection led to significant intra-articular destruction and ultimately necessitated a Girdlestone resection arthroplasty. The patient's hip function was salvaged with a total hip arthroplasty. The presence of an extracapsular hip infection should mandate serial physical examinations and aggressive evaluation to rule out intracapsular spread. A delay in diagnosis of an intracapsular hip infection can lead to catastrophic results.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/15. Recurrent focal myositis of the peroneal muscles.Recurrent focal myositis is a rare entity and can be difficult to diagnose and treat. A long-term follow-up and diagnostic evaluation was carried out in a patient who presented with ankle stiffness secondary to a painful mass within the calf. This process was diagnosed as focal myositis of the peroneal muscles, which recurred over a period of 7 yr. A review of the literature regarding focal myositis, treatment options and a successful conservative therapy regimen, as an alternative to a surgical protocol, are presented. After making the diagnosis with the help of a muscle biopsy, long-term therapy should be considered. Conservative treatment of focal myositis with anti-inflammatory drugs and physical therapy can be successful but recurrence may occur if the medical treatment is interrupted.- - - - - - - - - - ranking = 0.16669623836095keywords = physical (Clic here for more details about this article) |
3/15. Anterior tibial compartment syndrome due to the pyomyositis in a patient with rheumatoid arthritis. A case report.Anterior tibial compartment syndrome was developed due to pyomyositis in a 33-year-old male patient with rheumatoid arthritis while receiving steroid therapy during the follow-up period. The preoperative physical examination, laboratory findings, MRI images, intraoperative observation and postoperative histopathological examinations confirmed the association with pyomyositis. The surgical drainage and antibiotic treatment were effective, and in the follow-up period, neuromuscular dysfunctions disappeared completely within 6 months. The patient has been asymptomatic for 4 years of follow-up. To date, anterior tibial compartment syndrome due to pyomyositis in a case with rheumatoid arthritis has not been reported.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
4/15. A rare case of salmonella-mediated sacroiliitis, adjacent subperiosteal abscess, and myositis.We report the case of a 16-year-old female who was ultimately diagnosed with salmonella sacroiliitis, adjacent subperiosteal abscess, and myositis of the left iliopsoas, gluteus medius, and obturator internus muscles. Early and accurate recognition of this syndrome and other infectious musculoskeletal syndromes can prove difficult for the emergency physician, as these disease processes require special attention to pain of proportion to physical findings and a high index of suspicion.- - - - - - - - - - ranking = 0.16669623836095keywords = physical (Clic here for more details about this article) |
5/15. Infantile polymyositis: a case report.A 10-month-old Japanese boy developed progressive muscle weakness and hypotonia at 3 months of age. Because of striking inflammatory cellular infiltration in his muscle biopsy, he was diagnosed as having infantile polymyositis and was placed on steroid and immunosuppressive medication when he was 10-month-old. His physical condition was not significantly altered, though serum creatine kinase (CK) level was normalized (1,500 iu/l 90 iu/l). These findings contrast with previous reports documenting improvement with steroid administration.- - - - - - - - - - ranking = 0.16669623836095keywords = physical (Clic here for more details about this article) |
6/15. McArdle's disease diagnosed following statin-induced myositis.We describe the case of a 69-year-old man with a history of muscular symptoms dating back to his childhood; McArdle's disease (glycogen-storage disease V) was diagnosed following an episode of myositis in which a statin and physical exertion appear to have been precipitating factors. This case demonstrates that the ischaemic lactate-ammonia test still has a place in screening patients with symptoms suggestive of McArdle's disease and emphasizes the importance of carrying out glycogen phosphorylase histochemistry on the skeletal muscle biopsy to confirm the diagnosis. In patients who develop a raised plasma creatine kinase level or muscular symptoms during lipid-lowering therapy, the clinician should be alert to the possibility of an underlying myopathy.- - - - - - - - - - ranking = 0.16669623836095keywords = physical (Clic here for more details about this article) |
7/15. Multifocal pyomyositis in an immunocompetent patient.pyomyositis is defined as suppurative infection of the skeletal muscle and usually occurs in immunocompromized patients. We managed a 23-year-old man admitted for myalgia and evidence of infection, with onset after a strenuous physical activity. Numerous muscles were involved. Multiple abscesses were visualized by ultrasonography and computed tomography, with predominant involvement of the pelvic muscles. Examination of the aspirate from a forearm abscess recovered staphylococcus aureus. No factors associated with immunodeficiency were found. Appropriate antimicrobial therapy ensured complete resolution of the infection. pyomyositis is rare in immunocompetent individuals. myalgia, fever, and rhabdomyolysis should suggest pyomyositis. Computed tomography and magnetic resonance imaging are the best investigations for confirming the diagnosis.- - - - - - - - - - ranking = 0.16669623836095keywords = physical (Clic here for more details about this article) |
8/15. Eosinophilic perimyositis as the presenting feature of a monoclonal T-cell expansion.A 51-year-old physically active man was investigated for exertional myalgias and muscle stiffness. On examination he had mild proximal muscle weakness of the upper extremities and retraction of the digit flexors. blood eosinophilia was present, but serum creatine kinase (CK) levels and an electromyographic study were normal. A skin-fascia-muscle biopsy of the calf revealed a macrophagic and CD4 T-cell infiltration of the perimysium, and a T-cell expansion was observed in blood, bone marrow, and muscle. A diagnosis of eosinophilic perimyositis was made, and prednisone and azathioprine were administrated with a good clinical response. This case highlights the differential diagnosis of blood eosinophilia with muscle disorders, and underscores that eosinophilic perimyositis may be the expression of a T-cell monoclonal expansion. Although the pathogenesis behind the T-cell expansion is unclear but probably inflammatory, we suggest regular follow-up to allow early treatment of any T-cell lymphoproliferative malignancy that may develop.- - - - - - - - - - ranking = 0.16669623836095keywords = physical (Clic here for more details about this article) |
9/15. Neuromuscular disorders in clinical practice: case studies.Neuromuscular disorders represent a large group of highly varied and interesting clinical disorders, many of which have major general medical manifestations. These disorders can be diagnosed largely based on the patient's history and physical examination with a little help from modern technology. Despite the outdated belief that neurologic conditions are diagnosed but rarely treatable, all cases discussed herein represent disorders for which there are extensive options and opportunities for meaningful management. These 16 brief case overviews challenge and refresh diagnostic skills and provide the framework for selected comments regarding management options.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
10/15. Polyarteritis manifesting as calf myositis and fever.A patient presented with fever of undetermined cause for two months. On physical examination, bilateral calf tenderness was elicited, prompting a diagnostic muscle biopsy for polyarteritis. This limited form of polyarteritis is reviewed in the context of this case and previously reported cases. Polyarteritis limited to muscle seems to have a good prognosis and responds readily to steroids alone.- - - - - - - - - - ranking = 0.16669623836095keywords = physical (Clic here for more details about this article) |
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