1/21. Mondor's disease.BACKGROUND: Mondor's disease is a rare entity characterized by thrombophlebitis of the subcutaneous veins of the anterolateral thoraco-abdominal wall. The most common clinical manifestations are a painful subcutaneous cord, sensation of tension, and skin retraction. This condition is usually a benign and self-limited process, although it has been associated with breast cancer. methods: We describe four new cases, two men and two women, and comment on the clinical signs and possible etiopathogenic features. General physical examination, radiologic and ecographic studies, laboratory analysis including tumor markers, and exhaustive coagulation study were carried out on all patients. RESULTS: No cases were associated with malignant disease and/or hypercoagulability stage. With conservative treatment, the evolution proved favorable in all patients. CONCLUSIONS: Mondor's disease is usually a benign and self-limited process, but we recommend laboratory studies and physical examination, including mammography in women, in order to rule out the presence of systemic disorders, especially breast cancer.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/21. Calcified external iliac vein thrombosis.Linear calcification in the soft tissues of the pelvis in the region of the external iliac vein should suggest the possibility of calcified external iliac vein thrombosis, particularly in patients with a suspicious clinical history or physical findings. Extremity and pelvic venography corroborate the plain film findings.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
3/21. Mondor's disease and breast cancer.Mondor's disease or thrombophlebitis of the subcutaneous veins of the chest region is an uncommon condition and is rarely associated with breast cancer. From January 1980 to June 1990, 63 cases of Mondor's disease were diagnosed (57 women and 6 men). In 31 patients, no apparent cause was determined (primary disease), whereas in 32 cases, the disease was secondary because the etiopathogenesis could be discerned. The identified potential causes were three cases of myentasis (all in men), eight cases of accidental local trauma (seven in women), seven cases of iatrogenic origin (three surgical breast biopsies, one skin biopsy, one needle biopsy, one mastectomy, and one reconstruction operation), six cases of inflammatory process, and eight cases associated with breast cancer (all females). Three of the tumors were less than 1 cm in diameter. The authors performed conservative surgery in four patients and demolitive in the other four. In this series, the incidence of breast cancer in association with Mondor's disease was the highest yet reported (12.7%). It was concluded that Mondor's disease may at times be caused by breast carcinoma. This association is by no means exceptional and implies that mammography should always be performed for Mondor's disease, even when the results of a physical examination are negative.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
4/21. Trousseau syndrome and the unknown cancer: use of positron emission tomographic imaging in a patient with a paraneoplastic syndrome.Trousseau syndrome is defined as a migratory thrombophlebitis found typically in patients with an underlying malignancy. Conventional diagnostic testing and imaging can be used to successfully diagnose a primary malignancy in approximately 85% to 95% of patients. However, along with a comprehensive medical history and physical examination, numerous tests are frequently required, including blood tests, tumor markers, chest radiography, upper endoscopy, and computed tomography of the chest, abdomen, and pelvis. We present a case in which positron emission tomographic imaging was important for diagnosing the malignancy underlying Trousseau syndrome. Positron emission tomography may play an important role in the efficient evaluation of such cases.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
5/21. Respiratory failure and hypercoagulability in a toddler with Lemierre's syndrome.A 3.5-year-old healthy boy with 4 days of fever was referred to the emergency department for respiratory distress. The physical examination was remarkable for stupor, tachycardia, tachypnea, and dyspnea. Initial blood tests showed pancytopenia. He rapidly developed torticollis. Computerized tomography of the neck revealed a thrombus in the internal jugular vein. A presumptive diagnosis of Lemierre's syndrome was made and he was started on antibiotics and anticoagulation. He subsequently developed adult respiratory distress syndrome and required high frequency oscillatory ventilation for 9 days. blood cultures were positive for fusobacterium necrophorum. Screening for hypercoagulability revealed 2 known risk factors: a mutation in the prothrombin gene and elevated lipoprotein a.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
6/21. Deep vein thrombosis in an athletic military cadet.STUDY DESIGN: Resident's case problem. BACKGROUND: A 21-year-old healthy athletic male military cadet with complaint of worsening diffuse left knee pain was evaluated 4 days after onset. The knee pain began 2 hours after completing a long car trip, worsened over the subsequent 3 days, and became almost unbearable during the return trip. The patient reported constant pain, limited knee motion, and difficulty ambulating. In addition, he was unable to perform physical military training or attend academic classes due to the severe left knee pain. Past medical history revealed a mild left lateral calf strain 21/2 weeks prior, which completely resolved within 24 hours of onset. diagnosis: Our physical examination led us to either monoarticular arthritis, pseudothrombophlebitis (ruptured Baker's cyst), or a lower leg deep vein thrombosis (DVT) as the cause of knee pain. diagnostic imaging of this patient revealed a left superficial femoral vein thrombosis and popliteal DVT, with bilateral pulmonary emboli (PE). DISCUSSION: A systematic differential diagnosis was undertaken to rule out a potentially fatal DVT diagnosis as the cause of knee pain, despite minimal DVT risk factors. The physical therapist in a direct-access setting must ensure timely evaluation and referral of a suspected DVT, even when patient demographics cause the practitioner to question the likelihood of this diagnosis. The physical examination findings, clinical suspicion, and established clinical prediction rules can accurately dictate the appropriate referral action necessary.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
7/21. Atypical Mondor's disease mimicking a strangulated Spigelian hernia in a patient with a deep venous obstruction. A case report.Mondor's disease is a rare entity characterised by thrombophlebitis of the subcutaneous veins of the anterolateral thoraco-abdominal wall. The condition is usually benign and self-limiting. We report on a case of an inguinal localization of the disease, occurring on a dilated superficial epigastric vein acting as a collateral pathway due to a left ilio-femoral venous obstruction. The patient was referred to our department with a diagnosis of strangulated Spigelian hernia. General physical examination and ultrasonographic studies ruled out a complicated abdominal hernia and the presence of malignant disorders. A diagnosis of inguinal Mondor's disease in association with a chronic deep venous obstruction of the left ilio-femoral venous axis was made. The patient was treated with conservative therapy. warfarin was promptly started in order to impede progression of the thrombotic process to the ipsilateral great saphenous vein. Though atypical Mondor's disease is usually a benign, self-limiting process, it can cause unusual clinical patterns that might give rise to clinical dilemmas for the surgeon.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
8/21. High G training and superficial phlebitis: a case report.This is a report of bilateral phlebitis in an otherwise healthy 37-year-old male, occurring approximately 96 h post G-tolerance training. Of interest is an episode of significant physical activity occurring between the G-tolerance training and the onset of symptoms of phlebitis. health care professionals seeing patients post G training need to be aware of unusual possible sequelae, especially vascular in origin. Further information is needed before a causal relationship between G-tolerance training and superficial phlebitis can be demonstrated.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
9/21. Complications of caval interruption by Greenfield filter in quadriplegics.patients with acutely injured spinal cords are thought to be at increased risk for thromboembolic disease and often have contraindications to anticoagulation therapy. From 1981 to 1986, 13 patients with quadriplegia at the new england Regional Model spinal cord Injury Center had caval interruption with a Greenfield filter. Twelve patients had deep venous thrombosis documented by venogram results and one had pulmonary embolism documented by arteriogram results. "Quad cough" chest physical therapy was required for mobilization of pulmonary secretions in nine patients. Follow-up abdominal x-ray results revealed significant abnormalities referrable to the filter in five patients having undergone "quad cough" therapy. Four patients had distal migration of the filter; three of the four had deformation of the filter. laparotomy for bowel perforation was required in two of these patients. quadriplegia requiring vigorous chest physical therapy ("quad cough") for pulmonary toilet may be a contraindication to caval interruption by Greenfield filter. Alternative techniques in the management of patients with quadriplegia and pulmonary compromise must be considered.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
10/21. Bilateral upper extremity ischemia after administration of dihydroergotamine-heparin for prophylaxis of deep venous thrombosis.Prolonged arterial spasm as a complication of ergot-containing medications has been reported since antiquity. This article describes our experience with a patient who had severe bilateral arterial spasm in the upper extremities 6 days after the initiation of a regimen of dihydroergotamine and heparin for prophylaxis against deep venous thrombosis. The spasm was refractory to oral calcium channel blocking agents and direct intraarterial infusion of tolazoline (Priscoline). However, intraarterial nitroglycerin produced a prompt and dramatic improvement in symptoms and in physical and arteriographic findings. This experience suggests that intraarterial nitroglycerin may be an appropriate first choice for ergot-induced arterial spasm.- - - - - - - - - - ranking = 0.5keywords = physical (Clic here for more details about this article) |
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