Negative magnetic resonance imaging in femoral neck stress fracture with joint effusion: a case report

2016 ◽  
Vol 45 (6) ◽  
pp. 843-846 ◽  
Author(s):  
Nobutoshi Seki ◽  
Koichiro Okuyama ◽  
Keiji Kamo ◽  
Mitsuho Chiba ◽  
Yoichi Shimada
2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Tomofumi Nishino ◽  
Hisashi Sugaya ◽  
Naoya Kikuchi ◽  
Yu Watanabe ◽  
Hajime Mishima ◽  
...  

Abstract Background Femoral neck stress fractures are rare and often recognized as overuse injuries that occur in young athletes or military personnel. A case following osteonecrosis of the femoral head is quite rare; even more uncommon is its occurrence in the bilateral hips. Magnetic resonance imaging has been established as the preferred tool for diagnosing nondisplaced femoral neck stress fracture due to overuse injury. Magnetic resonance imaging was also useful to detect the initial lesion even in this case, although the etiology was different between overuse injury and insufficiency fracture. Case presentation A 41-year-old Japanese woman diagnosed with bilateral early stage idiopathic osteonecrosis of the femoral head was observed non-weight-bearing as much as possible using a stick. However, her pain and difficulty in walking progressed. Bilateral femoral neck stress fractures were subsequently detected by magnetic resonance imaging. The fracture initially appeared as a spot of bone marrow edema at the medial site of the femoral neck, and then developed into a fracture line. The patient underwent internal fixation of both hips with sliding hip screws to stabilize the stress fractures. In addition, the preparatory reaming served as core decompression of the femoral heads, as well as being treatment for osteonecrosis. Her bone mineral density and 25-hydroxy vitamin D values were low for her age. We administered eldecalcitol and teriparatide acetate. Her symptoms mostly improved, and the fracture lines and necrotic lesions on magnetic resonance imaging reduced at 5 months after the surgery. Conclusions Bilateral femoral neck stress fractures are a very rare condition and are often missed. It is important to listen to the patient’s complaints and perform an appropriate examination. We encountered a case of bilateral femoral neck stress fracture that occurred in a patient with early stage osteonecrosis of the femoral head, and were able to observe progression of stress fracture since before fracture occurred. This is considered to be the first report to capture imaging changes before and after the onset.


2019 ◽  
Vol 12 ◽  
pp. 117954411987871 ◽  
Author(s):  
Paul Krebs ◽  
James Borchers

A 13-year-old female soccer and basketball athlete presented with pain in the arch of her foot. Magnetic resonance imaging confirmed the diagnosis of a middle cuneiform stress fracture. The patient’s stress fracture healed nonoperatively over a 10-week period complicated by nonadherence to a fracture boot, after which she was progressed back to full activity. Knowledge of these fractures and their treatment are important for sports medicine physicians, as they can often be overlooked, given their infrequent occurrence. There have been 8 previous case reports and 1 case series on cuneiform stress fractures, and these are summarized with this case report.


2014 ◽  
Vol 38 (2) ◽  
pp. 212-214 ◽  
Author(s):  
Mehmet Beyazal ◽  
Necip Pirinççi ◽  
Alpaslan Yavuz ◽  
Sercan Özkaçmaz ◽  
Gülay Bulut

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.


2019 ◽  
Vol 53 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Lucas Regis ◽  
Ana Celma ◽  
Jacques Planas ◽  
Ricardo Lopez ◽  
Sarai Roche ◽  
...  

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