1/4. Tumor debulking by radiofrequency ablation in hypertrophic pulmonary osteoarthropathy associated with pulmonary carcinoma.A 73-year-old male with stage IV lung adenocarcinoma presented with leg swelling and clubbing of the fingers on both hands upon physical examination, and bone scintigrams demonstrated marked accumulation of 99mTc-MDP in the long bones adjacent to the patellae. A diagnosis of hypertrophic pulmonary osteoarthropathy associated with primary lung cancer was made. Radiofrequency ablation (RFA) was utilized for cytoreduction, because the patient refused chemotherapy. One-month follow-up CT scans revealed low density of the ablated area associated with ablation necrosis. Cytoreduction by RFA rapidly alleviated the arthralgia and swelling, but not the clubbing of fingers. Follow-up bone scintigrams demonstrated a reduction in patellar uptake after RFA.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
2/4. Crohn's disease with oral presenting signs masquerading as chronic osteomyelitis.BACKGROUND: A case of Crohn's disease (CD) was diagnosed following recognition of oral and systemic signs and symptoms in a 19-year-old male patient. methods: Clinical investigation utilized included blood tests (full blood count, electrolytes, urea, creatinine, liver function tests), computed tomogrphy scans, magnetic resonance imaging scans, oral biopsies, colonoscopy and biopsies of the terminal ileum and colon. RESULTS: A diagnosis of CD was made which then allowed appropriate medical treatment to be initiated. CONCLUSION: The importance of a thorough medical history and full physical examination with appropriate investigations as dictated by clinical findings is demonstrated.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |
3/4. Finger clubbing in match factory workers in fiji.This communication reports of two cases of digital clubbing in a factory manufacturing matches in Vitilevu, fiji islands. Both these cases were occupationally exposed to chemicals used in the manufacture of matches. They had physical contact with these chemicals including rhodamine B dye. Subjects who worked in the same factory area, including one worker who had FEV1.0 and FVC values below the predicted normal, but who did not handle chemicals showed no evidence of finger clubbing.- - - - - - - - - - ranking = 0.059535774883814keywords = physical (Clic here for more details about this article) |
4/4. Colonic hamartomatous polyposis associated with hypertrophic osteoarthropathy.A 7-year-old girl with an unremarkable family history was admitted with complaints of diarrhea containing mucus and blood, abdominal pain, weight loss and fever for 10 months. Although her symptoms, physical examination and laboratory results were highly suggestive of inflammatory bowel disease, radiologic studies and colonoscopy demonstrated multiple colonic polyps. A bilateral and symmetric lamellar periosteal reaction and osteopenia were present on her extremity radiographs. The chest radiograph and thoracic CT scan were normal. The histologic nature of the polyps was determined as hamartoma. One month after subtotal colectomy, the patient's symptoms resolved and she gained 7 kg in weight. The association of generalized juvenile polyposis and hypertrophic osteoarthropathy has previously been described in five cases; arteriovenous malformations were present in four of them. In our case the polyps were hamartomatous and localized in the colon, without associated arteriovenous malformation.- - - - - - - - - - ranking = 1keywords = physical examination, physical (Clic here for more details about this article) |