For the diagnosis of such uncommon presentations, radiological investigations like digital radiography and magnetic resonance imaging are critical, with magnetic resonance imaging often serving as the preferred method. The gold standard for treating the growth involves complete excision.
A 13-year-old male patient attended the outpatient clinic with a chief complaint of pain localized to the front of his right knee for ten months, and a history of prior trauma. The infrapatellar area (Hoffa's fat pad) of the knee joint's magnetic resonance image showed a well-demarcated lesion incorporating internal septations.
The outpatient clinic received a visit from a 25-year-old female with left anterior knee pain, which has lasted two years, and no previous injury. The magnetic resonance imaging of the knee joint revealed an ill-defined lesion near the anterior patella-femoral articulation; this lesion was affixed to the quadriceps tendon and had internal septations visible within it. Both procedures involved the complete removal of the affected area, resulting in a successful preservation of function.
In outdoor orthopedic settings, the rare occurrence of synovial hemangioma within the knee joint showcases a slight female preponderance, frequently tied to a previous history of trauma. Our current research encompasses two cases of patellofemoral pain, implicating both the anterior and infrapatellar fat pads. The gold standard procedure for preventing recurrence in such lesions is en bloc excision, which was employed in our study, ultimately yielding favorable functional outcomes.
A rare orthopedic finding, synovial hemangioma of the knee joint, predominantly affects women and often follows prior trauma. host response biomarkers This study's two cases shared a characteristic patellofemoral etiology, affecting both the anterior and infrapatellar fat pads. En bloc excision, the gold standard for treating these lesions to prevent recurrence, was the procedure employed in our study, achieving favorable functional results.
Intra-pelvic femoral head relocation, a rare post-total hip arthroplasty issue, can occur.
A revision of a total hip arthroplasty was performed on a 54-year-old Caucasian female. Open reduction was required to repair the anterior dislocation and avulsion of her prosthetic femoral head. During the operative intervention, the femoral head exhibited a migration into the pelvic region, guided by the psoas aponeurosis's path. An anterior approach to the iliac wing was necessary for the retrieval of the migrated component in a subsequent procedure. Remarkably, the patient's recovery post-surgery proceeded smoothly, and two years after the operation, she remains free of any issues connected to the post-surgical complication.
The literature primarily details instances of trial component migration occurring during surgical procedures. Microbiology antagonist The authors' analysis revealed only one case involving a definite prosthetic head, utilized during a primary total hip arthroplasty. The revision surgical procedure resulted in no cases of post-operative dislocation or definitive femoral head migration being documented. Insufficient long-term research on the retention of intra-pelvic implants compels us to recommend their removal, especially in the case of younger patients.
The literature often cites instances of intraoperative migration, specifically regarding trial components. The authors' findings consisted of only one case illustrating a definitive prosthetic head placement during a primary total hip arthroplasty. Subsequent to the revision procedure, no cases of post-operative dislocation or definitive femoral head migration were encountered. Because of the scarcity of prolonged studies examining intra-pelvic implant retention, we recommend the removal of such implants, especially in younger patients.
Spinal epidural abscess (SEA) is the accumulation of infection within the epidural space, due to a multitude of causative agents. Tuberculous infection of the spine represents a substantial cause of spinal conditions. SEA is often associated with a patient's history of fever, back pain, difficulties in walking, and neurological infirmity. Employing magnetic resonance imaging (MRI) as the initial diagnostic tool for infection, further confirmation is obtained through examination of the abscess sample for microbial growth. Relieving the compression on the spinal cord and draining pus are achieved through the surgical procedure of laminectomy and decompression.
A student, a 16-year-old male, complained of low back pain, progressively hindering his ability to walk over the last 12 days, and lower limb weakness for the previous 8 days, coupled with fever, generalized weakness, and a feeling of discomfort. Computed tomography of the brain and spine showed no significant findings. However, MRI of the left facet joint at the L3-L4 vertebral level demonstrated infective arthritis and a collection of abnormal soft tissue situated in the posterior epidural region, spanning from D11 to L5. This soft tissue accumulation compressed the thecal sac and cauda equina nerve roots, confirming an infective abscess. Similar soft tissue collections were found in the posterior paraspinal region and left psoas muscles, further reinforcing the diagnosis of infective abscess. An abscess was cleared from the patient's posterior region through an emergency decompression procedure. Thick pus was drained from multiple pockets, following a laminectomy performed on the vertebrae ranging from D11 to L5. cytotoxic and immunomodulatory effects Pus and soft tissue samples were submitted for analysis. Although the ZN, Gram's stain, and pus culture tests were devoid of microbial growth, GeneXpert testing detected the presence of Mycobacterium tuberculosis. The patient was registered within the RNTCP program, and anti-TB medications were administered according to their weight category. A neurological evaluation, looking for any improvement, was scheduled for post-operative day twelve, coinciding with the removal of sutures. A notable enhancement in lower limb strength was observed in the patient; a 5/5 strength rating was recorded for the right lower limb, whereas a 4/5 strength rating was present in the left lower limb. Beyond the specific improvements, the patient reported no backache or malaise upon discharge.
Tuberculosis, manifesting as a thoracolumbar epidural abscess, presents a rare yet serious threat of a lifelong vegetative state if diagnosis and treatment are delayed. The unilateral laminectomy, combined with collection evacuation, effects surgical decompression, yielding both diagnostic and therapeutic results.
Tuberculosis, manifesting as a thoracolumbar epidural abscess, is an infrequent yet potentially devastating condition, capable of causing a prolonged vegetative state without prompt and effective intervention. Unilateral laminectomy, combined with the evacuation of the collection, delivers a dual function in surgical decompression, both diagnosing and treating the condition.
The simultaneous inflammation of vertebrae and discs, medically termed infective spondylodiscitis, is usually caused by the hematogenous spread of infection. In the majority of cases, brucellosis presents as a febrile illness; nevertheless, spondylodiscitis can, in some rare instances, be a presentation of the illness. Human cases of brucellosis are clinically diagnosed and treated, but only in rare instances. We detail a case of a previously healthy man in his early seventies, presenting with symptoms reminiscent of spinal tuberculosis, which was ultimately diagnosed as brucellar spondylodiscitis.
Our orthopedic department received a visit from a 72-year-old farmer, whose complaint was persistent pain in his lower back. A medical facility near his residence, upon observing magnetic resonance imaging results suggestive of infective spondylodiscitis, suspected spinal tuberculosis, thus necessitating referral to our hospital for further management. Investigations revealed an unusual case of Brucellar spondylodiscitis in the patient, which required tailored management.
The clinical similarity between spinal tuberculosis and brucellar spondylodiscitis necessitates considering the latter as a differential diagnosis for elderly patients experiencing lower back pain coupled with indicators of a chronic infection. For early detection and appropriate management of spinal brucellosis, serological testing is essential.
A differential diagnosis for lower back pain, especially in the elderly with chronic infection symptoms, should include brucellar spondylodiscitis, as its clinical presentation can closely resemble spinal tuberculosis. The early identification and management of spinal brucellosis are facilitated by the use of serological tests.
In skeletally mature individuals, giant cell tumors of bone frequently affect the distal and proximal ends of long bones. A notably uncommon occurrence is a giant cell tumor affecting the bones of the hands and feet, and likewise rare is the presence of this tumor specifically within the talus.
In a 17-year-old female, a giant cell tumor of the talus was discovered, following a 10-month history of pain and swelling around the left ankle. The ankle radiographs revealed a lytic, expansile lesion encompassing the entire talus. As intralesional curettage was not a practical option in this patient, the surgical procedure of talectomy was carried out, followed by a calcaneo-tibial fusion. The diagnosis of giant cell tumor was established by the histopathology report. No recurrence was observed during the nine-year follow-up period; the patient continued her daily activities with minimal discomfort.
The knee and distal radius are among the more prevalent locations for the diagnosis of giant cell tumors. The talus, specifically among the foot bones, is remarkably seldom involved. In the early stages of this condition, the treatment protocol includes extended intralesional curettage with concomitant bone grafting; for late-stage presentations, the recommended treatment is talectomy and subsequent tibiocalcaneal fusion.
Giant cell tumors are most frequently located in the area of the knee and distal radius. The uncommon involvement of foot bones, especially the talus, is noteworthy. Treatment for early stages includes extended intralesional curettage with concomitant bone grafting, whereas advanced stages require talectomy and tibiocalcaneal fusion procedures.