1/6. Imaging rounds. Bilateral condensing osteitis of the clavicles.The following case illustrates the roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon. The initial history, physical findings, and roentgenographic examinations are found on the first two pages. The following pages present the final clinical and roentgenographic differential diagnosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/6. Syphilitic osteitis in a patient with secondary syphilis and concurrent human immunodeficiency virus infection.Destructive bone disease is a well-recognized complication of congenital and tertiary syphilis. Clinically significant osteitis and osteomyelitis are rare complications of primary or secondary syphilis in patients who are not infected with human immunodeficiency virus (hiv). We report a case of an hiv-infected man who presented with symptomatic, left ulnar osteitis as the initial manifestation of secondary syphilis. The patient's clinical course was complicated by a pathological fracture, but he responded to high-dose intravenous penicillin g therapy and surgical intervention. Results of physical examination on follow-up at 15 months were normal, and a serofast (rapid plasma reagin [RPR]) titer of 1:4 and a markedly decreased uptake on bone scintigraphy were observed. Our case report suggests that bone disease can represent an atypical manifestation of early acquired syphilis and that hiv-positive patients who present with orthopedic complaints or bone lesions should be evaluated for the presence of syphilitic bone disease.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/6. osteitis pubis.BACKGROUND: A 55-year-old woman was seen for pubic symphysis tenderness that started 3 weeks after bladder suspension surgery for urinary incontinence. A diagnosis of osteitis pubis was made based on the results of the physical, radiographic, and laboratory examinations. The paucity of information on this topic in primary care textbooks prompted a literature review of the subject. methods: A computer-assisted literature search of the medline files from 1966 to the present was performed using the terms "osteitis," "osteomyelitis," and "pubic symphysis." Older documents and papers of related interest were obtained by cross-reference of the bibliographies of the articles generated by the search. RESULTS AND CONCLUSIONS: osteitis pubis is an infrequent complication of pelvic surgery, parturition, or athletic activities. The diagnosis is made on the basis of the typical findings of pubic tenderness and pain on hip abduction that occurs a few weeks following the inciting event. Initial treatment consists of rest, physical therapy, and oral nonsteroidal or glucocorticoid anti-inflammatory medications. The use of intra-articular glucocorticoid injections is controversial. Surgery is rarely indicated and should be reserved for patients who have severe pain or pubic instability that has not responded to conservative therapy.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
4/6. A 42-year-old woman with low back pain.The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to orthopedic surgeons. The initial history, physical findings, and roentgenographic examinations are noted on this page. The clinical and roentgenographic diagnoses are presented on the following pages.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/6. Condensing osteitis of the clavicle: case report and review of the literature.osteitis condensans of the clavicle is a rare condition characterized by pain in the shoulder and often limitation of motion of the shoulder. The medical history and results of the physical examination, laboratory data, and radiographic studies (including computed tomography and magnetic resonance imaging), often establish the diagnosis. patients who have slight or no pain usually require no treatment. Varying results have been reported for many different methods of treatment, including surgical excision, chemotherapy, antibiotics, nonsteroidal anti-inflammatory medications, radiation, local corticosteroid injection, and physical therapy. A typical case report and the differential diagnosis for condensing osteitis of the clavicle are presented.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
6/6. Bacterial osteitis pubis in a weight lifter without invasive trauma.osteitis pubis is a well-known complication of invasive procedures about the pelvis which is caused by a bacterial infection. It is also now known that osteitis pubis in athletes is an inflammatory disorder rather than infectious as previously thought. It occurs in athletes who place significant repetitive stresses across the symphysis in such activities as running, race walking, gymnastics, soccer, rugby, basketball, and tennis. This case report, however, describes a weight lifter who developed a bacterially caused osteitis pubis without any invasive trauma. He was evaluated thoroughly and no other focus of infection was found. He was treated conservatively with intravenous antibiotics and physical therapy. At 3 months follow-up he had returned to his usual fitness activities without limitations. Although most osteitis pubis in athletes is inflammatory in nature, health care providers must keep an index of suspicion that an infectious etiology is possible in this population even without invasive trauma.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |