1/11. Blau syndrome: a new kindred.Blau syndrome is a rare condition typically defined by granulomatous arthritis, skin eruption, and uveitis occurring in the absence of lung or other visceral involvement. Other characteristic physical findings include synovial cysts and camptodactyly. We describe a new kindred demonstrating autosomal dominant inheritance and anticipation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/11. Epidural hematoma secondary to a rupture of a synovial cyst.BACKGROUND CONTENT: With modern advances in imaging studies, synovial cysts are becoming more evident as a common component of erosive lumbar degenerative disc disease causing spinal stenosis and radiculopathy. Whereas hemorrhage can occur inside the cyst and is reported, rupture causing epidural hematoma is a rare complication and finding of this disorder. PURPOSE: To report a rare clinical presentation of a synovial cyst and spinal stenosis, where rupture of the cyst leads to an early cauda equina syndrome. STUDY DESIGN: Case report with a review of literature. methods: Clinical history, physical findings, and magnetic resonance imaging studies of a patient with an intraspinal synovial cyst at L4-5 1 week before a sudden worsening of symptoms are reported. RESULTS: A case report is presented of a male with a known synovial cyst at L4-5, presenting initially with neurogenic claudication. This patient developed sudden worsening of symptoms with bilateral lower extremity pain, weakness, and radiculopathy with difficult voiding. The patient had developed an epidural hematoma, secondary to rupture of a synovial cyst, documented at surgical decompression. CONCLUSIONS: Although synovial cyst associated with erosive facet and erosive degenerative disc disease are common, rupture of the cyst is not. A case report of a ruptured synovial cyst leading to an early cauda equina syndrome is presented. This case illustrates the spectrum of clinical features and presentations possible with spinal stenosis complicated by lumbar synovial cyst formation.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/11. Resolution of a synovial cyst of the lumbar spine without surgical therapy -- a case report.Synovial cysts originating from the facet joint of the lumbar spine are a rare cause of radiculopathy. Surgical resection is considered to be the treatment of choice, although very little is known about the natural history of spinal synovial cysts. Only six cases have been published up to now concerning the spontaneous regression of a cyst without invasive therapy. We present the history of a patient suffering from sciatic pain caused by a synovial cyst at the level of L4/5, and we describe the spontaneous remission of the cyst, discussing the radiological and clinical findings and comparing our findings with respect to the current literature. CLINICAL PRESENTATION: The patient suffered from sciatic pain for 5 months without neurological deficits. Magnetic resonance tomography revealed a cystic structure adjacent to the facet joint L4/5. Presuming a synovial cyst, we scheduled surgery and at the same time started conservative treatment, including physical therapy and analgesic medication. The patient's condition improved significantly during conservative treatment, so that surgery was cancelled. A second magnetic resonance tomography showed that the cyst had dramatically shrunken, without any narrowing of the spinal canal. CONCLUSIONS: Up to now, synovial cysts of the lumbar spine have usually been treated operatively, but we and others have shown that spontaneous resolution of the cyst seems possible, so that extensive conservative treatment should always be considered as the first therapeutic option, provided that there are no severe neurological deficits.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/11. The use of CT scan in the evaluation of non-popliteal synovial cysts about the knee.We investigated the diagnostic approach to non-popliteal synovial cysts about the knee. Included were all cases that occurred at the Wilford Hall USAF Medical Center in the past 5 years. The five patients all presented with a mass about the knee. The history and physical exam placed synovial cyst high on all five differential lists. All patients had a CT scan, and the CT failed to identify the cystic nature of the mass in any of them. We conclude that the CT scan is not useful in the evaluation of suspected non-popliteal synovial cysts about the knee.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/11. Adventitial cystic disease of the popliteal artery.In a 27-year-old man with claudication, computed tomography (CT) demonstrated a popliteal cyst and an adventitial cyst of the popliteal artery. Adventitial cystic disease was unexpected because the patient had a diminished pedal pulse on plantar flexion of the foot, a physical finding suggesting popliteal artery entrapment syndrome. CT was useful in the initial examination of this young patient with suspected popliteal vascular disease because of its accuracy and noninvasiveness.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/11. Dorsal wrist pain and the occult scapholunate ganglion.Ten consecutive patients who presented with dorsal wrist pain, no history of trauma, and no physical signs other than local tenderness over the scapholunate ligament junction had surgery. The obvious pathologic finding in eight was ganglionic degeneration in a particular area on the dorsal scapholunate interosseous ligament. The operation resulted in dramatic relief of pain and return to full function for the duration of follow-up in most patients.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/11. Irritative neuritis of the dorsal sensory branch of the ulnar nerve from underlying ganglion.Although sites of ulnar nerve compression or disruption are generally apparent in a detailed physical examination, ulnar nerve involvement that is confined to the dorsal sensory branch of the ulnar nerve is unusual. Three patients presented with pain over the dorsal ulnar aspect of the hand associated with a cystic mass on the ulnar border of the wrist and hand. Stretching of the dorsal cutaneous branch from an underlying ganglion or proliferative synovium was present in all three of the patients.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/11. shoulder joint rupture in juvenile rheumatoid arthritis producing bicipital masses and a hemorrhagic sign.Multiple episodes of shoulder joint rupture leading to the development of bicipital masses occurred in a 6-yr-old boy with the systemic form of juvenile rheumatoid arthritis. Observations made during the rapid evolution of the masses included early physical findings in the proximal upper arm which suggested a malignancy. An unusual hemorrhagic sign appeared in the cease of the elbow. A sequence of events is postulated to explain the course of development of these masses.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/11. Chronic sciatica caused by tuberculous sacroiliitis. A case report.STUDY DESIGN. This is a case report. OBJECTIVES. To report and discuss a case of tuberculosis sacroiliitis with anterior synovial cyst presenting as chronic sciatica. SUMMARY OF BACKGROUND DATA. This is a report of clinical manifestation, physical findings, computed tomography scan, and results after surgical treatment in a 58-year-old woman with tuberculous sacroiliitis, which caused chronic sciatica. methods. The physical findings, laboratory data, radiographs, and computed tomography scan of sacroiliac joints were studied. sacroiliitis with anterior synovial cyst was shown in computed tomography scan. Posterior arthrotomy and drainage of the synovial cyst were performed. After surgery, she was treated with three combined antituberculosis drugs for 9 months. RESULTS. Lowenstein-Jensen culture and histologic examination confirmed the diagnosis of tuberculous sacroiliitis. At 3 years, she had no back pain or sciatica and a complete functional recovery. CONCLUSIONS. Tuberculous sacroiliitis with anterior synovial cyst is a rare cause of chronic sciatica. Lateral compression of the pelvis, Gaenslen's test, and Patrick's test should be included in evaluation of patients with sciatica. Computed tomography scan is a superb diagnostic method for sacroiliitis. Arthrotomy and drainage effectively relieve the sciatica. Three combined antituberculosis drug therapy should be given after surgery.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
10/11. A 24-year-old woman with dorsal wrist swelling.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 page 455.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
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