scholarly journals Symphysis Pubis Osteomyelitis with Bilateral Adductor Muscles Abscess

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Saad M. Alqahtani ◽  
Fan Jiang ◽  
Bardia Barimani ◽  
Marie Gdalevitch
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Septic Arthritis ◽  
Rare Condition ◽  
Pubic Symphysis ◽  
Symphysis Pubis ◽  
Definitive Treatment ◽  
Presenting Symptoms ◽  
First Case ◽  
Adductor Muscles ◽  
Pubis Symphysis

Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA), which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain.

Medical management of coral reef aorta through optimised diuretic use and angiotensin receptor blockade

2021 ◽  
Vol 14 (6) ◽  
pp. e242724
Author(s):  
Nicodemus Edrick Oey ◽  
Haresh Tulsidas ◽  
Krithikaa Nadarajan
Keyword(s):  
Coral Reef ◽  
Medical Management ◽  
Rare Condition ◽  
Definitive Treatment ◽  
Receptor Blockade ◽  
Angiotensin Receptor ◽  
Endovascular Stenting ◽  
Refractory Hypertension ◽  
First Case ◽  
Angiotensin Receptor Blockade

Coral reef aorta (CRA) is a rare condition with potentially devastating complications. It is characterised by atherosclerotic calcification and stenosis of the visceral part of the aorta, usually occurring at the juxtarenal or suprarenal locations, and causing refractory hypertension and renal dysfunction. Surgical intervention, which is the recommended definitive treatment, is associated with significant morbidity and mortality. Endovascular stenting has been reported to be an alternative management option. To the best of our knowledge, this is the first case report to describe medical management of a patient with CRA with diuretics and angiotensin receptor blockade without surgical treatment.

Combined occipitoatlantoaxial rotatory fixation

2011 ◽  
Vol 8 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Matthew R. Fusco ◽  
Todd C. Hankinson ◽  
Curtis J. Rozzelle
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Closed Reduction ◽  
Open Reduction ◽  
Rare Condition ◽  
Head Position ◽  
Definitive Treatment ◽  
Halo Traction ◽  
Counter Rotation ◽  
Atlantoaxial Rotatory Fixation ◽  
Rotatory Fixation

Occipitoatlantoaxial rotatory fixation (OAARF) is a rare condition involving fixed rotational subluxation of the atlas in relation to both the occiput and axis. Atlantoaxial rotatory fixation (AARF) appears to precede OAARF in most cases, as untreated AARF may cause compensatory counter-rotation and occipitoaxial fixation at an apparently neutral head position. We report a case of OAARF in an 8-year-old girl with juvenile idiopathic arthritis. Cervical imaging demonstrated slight rightward rotation of the occiput at 7.63° in relation to C-2 and significant rightward rotation of C-1 at 65.90° in relation to the occiput and at 73.53° in relation to C-2. An attempt at closed reduction with halo traction was unsuccessful. Definitive treatment included open reduction, C-1 laminectomy, and occipitocervical internal fixation and fusion.

scholarly journals “Primary Hyperparathyroidism (PHPT) in Children: Two Case Reports and Review of the Literature”

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Gerdi Tuli ◽  
Jessica Munarin ◽  
Daniele Tessaris ◽  
Raffaele Buganza ◽  
Patrizia Matarazzo ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Standard Treatment ◽  
Case Reports ◽  
Osteolytic Lesion ◽  
Recurrent Abdominal Pain ◽  
Definitive Treatment ◽  
Presenting Symptoms ◽  
First Case ◽  
Serum Pth ◽  
Hungry Bone

Primary hyperparathyroidism (PHPT) is a rare disorder in children and adolescents. Typical biochemical features are hypercalcemia and hypophosphatemia, but the clinical features can be heterogeneous, and in some cases, symptoms are vague and nonspecific, leading to misdiagnosis or late diagnosis. Herein, we report two cases of PHPT in pediatric age with different presenting symptoms, pain in the foot, and progressive alteration of the gait in the first case and recurrent abdominal pain with emotional lability in the second. Biochemical and radiological assessment confirmed PHPT. Both cases were treated surgically as definitive treatment, but in the second case, previous medical treatment with cinacalcet, a calcimimetic agent, was required to reduce serum PTH and calcium levels. After surgery, despite conventional treatment with calcium and calcitriol, case 1 developed a hungry bone syndrome. The analysis of the MEN-1 (Multiple Endocrine Neoplasia) gene was negative in both cases. A diagnosis of PHPT should be considered when children or adolescents present bone pain with radiological imaging of osteolytic lesion and biochemical feature of hypercalcemia associated with hypophosphatemia. In PHPT, the gold standard treatment is represented by surgery followed by strict postoperative endocrine monitoring to maintain adequate homeostasis of calcium and bone metabolism.

scholarly journals Spontaneous Septic Arthritis of Pubic Symphysis in an Elite Athlete

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
F. Jasmijn Smits ◽  
Herman Frima ◽  
Christoph Schaeffeler ◽  
Christoph Sommer
Keyword(s):  
Septic Arthritis ◽  
Groin Pain ◽  
Severe Disease ◽  
Pubic Symphysis ◽  
Pubic Bone ◽  
Reactive Protein ◽  
Image Guided ◽  
First Case ◽  
Additional Image ◽  
Invasive Intervention

Septic arthritis of the pubic symphysis is a potentially severe disease. Athletes are at risk of this form of spontaneous arthritis, as inflammation of the pubic bone due to muscular stress is relatively common. Oedema due to inflammation might predispose to infection through bacteraemia or local bacterial translocation. Suspicion should be raised when an athlete complains of groin pain and has signs of infection (i.e., fever, elevated white blood cell count, and elevated C-reactive protein). Diagnosis is made by imaging showing signs of inflammation combined with positive (blood) cultures. Broad spectrum antibiotics should be started upon suspicion and adjusted according to cultures. An abscess causing clinical deterioration under antibiotic treatment is an indication for invasive intervention (i.e., surgical or image-guided drainage). This is the first case of spontaneous septic arthritis of the pubic symphysis in an athlete requiring surgical and additional image-guided drainage.

scholarly journals Acute Osteomyelitis of the Symphysis Pubis after Inguinal Hernia Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Recep Tekin ◽  
Rojbin Ceylan Tekin ◽  
Figen Ceylan Cevik ◽  
Remzi Cevik
Keyword(s):  
Inguinal Hernia ◽  
Rare Complication ◽  
Rare Condition ◽  
Pubic Symphysis ◽  
Symphysis Pubis ◽  
Acute Osteomyelitis ◽  
Inflammatory Condition ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Complication Of Surgery

Osteomyelitis of pubic symphysis is infectious inflammatory condition of the symphysis pubis and rare complication of surgery around inguinal and groin region. It should be kept in mind in the differential diagnosis of lower pelvic pain and should be sought in cases of pelvic insufficiency fractures. Herein, we present a case of a 55-year-old man with osteomyelitis of the symphysis pubis following inguinal hernia surgery for diagnosis and management of this rare condition.

Comparative characteristics of pregnancy-related symphysis pubis dysfunction

2021 ◽  
Vol 9-10 (219-220) ◽  
pp. 34-38
Author(s):  
Meruert Temirova ◽  
◽  
Serik Iskakov ◽  
Keyword(s):  
Pregnant Women ◽  
Clinical Manifestations ◽  
Pubic Symphysis ◽  
Symphysis Pubis ◽  
Endocrine Disorders ◽  
Minimal Risk ◽  
Disease Pathogenesis ◽  
Normal Body Weight ◽  
Pubis Symphysis ◽  
Symphysis Diastasis

The problem of an acceptable choice of the method of delivery for symphysis pubis dysfunction is relevant in modern obstetrics. Since the incidence of this condition varies between 1 in 300 and 1 in 30,000 pregnancies. And such a large variation in the frequency of symphysis pubis dysfunction is explained by the lack of a clear terminology for this disease, pathogenesis, and uniform diagnostic criteria. Purpose of the study. Analysis and comparative characteristics of pregnant women with pubis symphysis diastasis and clinical dysfunction of the pubis symphysis and without it. Material and methods. A retrospective analysis of 1210 birth histories and exchange cards of pregnant women in the period from 2015 to 2019. Results and discussion. In the group with clinical manifestations of pubic symphysis dysfunction, with overweight and obese of I, II, III degrees, as well as with diseases of the blood, cardiovascular system and endocrine disorders. And the group without clinical manifestations of pubic symphysis dysfunction consisted of multigravida with normal body weight. Conclusions. Vaginal delivery preferred by method of delivery for pregnant women with or without clinical manifestations of pubic symphysis, associated with minimal risk of pubis symphysis rupture. Keywords: pubis dysfunction, pregnancy, delivery.

scholarly journals SAT-374 The Many Faces of Parathyroid Carcinoma in the Philippines: A Case Series

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Margaret C Encarnacion ◽  
Celeste O Ramos ◽  
Eduardo Thomas M Aquino ◽  
Roberto C Mirasol ◽  
Michael L Villa
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Carcinoma ◽  
Surgical Techniques ◽  
Case Series ◽  
Clinical Endocrinology ◽  
Rare Condition ◽  
The Philippines ◽  
Papillary Thyroid ◽  
Presenting Symptoms ◽  
First Case

Abstract Introduction: Parathyroid carcinoma is rare, affecting less than 1% of patients with primary hyperparathyroidism (PHPT). 1 Parathyroid carcinoma with concomitant papillary thyroid carcinoma is also rare, and the etiology is not fully defined. Clinical Case: We present 3 patients with parathyroid carcinoma and discuss their presenting symptoms, characteristics, and treatment. Two women and 1 man (2 Filipinos and 1 Marshallese) with age range 53-68 years old had parathyroid carcinoma. Two had primary hyperparathyroidism, one had non-functioning type of parathyroid carcinoma. Two had concomitant bone or renal disease. All three had concurrent thyroid disease- 2 had papillary thyroid microcarcinoma, one had colloid goiter. Because each one had different indications for neck surgery, different surgical techniques were done. Parathyroid cancer size ranged from 2.0-5.2 cm, with capsular and vascular invasion in all three. One case had double parathyroid carcinoma. No lymph node metastasis was identified. On follow up, the patient with the largest tumor size had tumor recurrence within 1 year from surgery. Conclusion: To the best of our knowledge, this is the first case series on parathyroid carcinoma in the Philippines, and includes the 7th case of double parathyroid carcinoma worldwide. Parathyroid carcinoma is a rare condition, and coupled with its highly variable presentation, as seen in the 3 cases, presents clinicians with a difficulty in arriving at a diagnosis. Histopathology remains the gold standard in diagnosis and is a key in guiding management. Since coexisting thyroid and parathyroid disease may occur, thyroid pathology should be evaluated in the presence of PHPT. References: 1. Elizabeth Shane; Parathyroid Carcinoma, The Journal of Clinical Endocrinology & Metabolism, Volume 86, Issue 2, 1 February 2001, Pages 485-493, https://doi.org/10.1210/jcem.86.2.7207.

Severe Antithrombin III Deficiency in an Infant Associated with Multiple Arterial and Venous Thromboses

1976 ◽  
Vol 36 (03) ◽  
pp. 495-502 ◽  
Author(s):  
Geoffrey Mendelsohn ◽  
Edward D. Gomperts ◽  
Dennis Gurwitz
Keyword(s):  
Antithrombin Iii ◽  
Adult Life ◽  
Rare Condition ◽  
Male Infant ◽  
Liver Cells ◽  
Liver Pathology ◽  
Fixed Tissue ◽  
Formalin Fixed Tissue ◽  
First Case ◽  
At Iii

SummaryInherited antithrombin III (AT-II, heparin cofactor) deficiency is a rare condition, presenting with thrombotic disease in adult life. This paper reports an 8 months old South African Black male infant with multiple large vessel venous and arterial thromboses, and E. coli septicaemia. This was associated with an extremely low plasma AT-II level. Micronodular cirrhosis and intracytoplasmic hyaline globules in the liver cells were present. These globules were eosinophilic, and PAS-positive after diastase. They measured approximately 5 μ to 30 μ in diameter, occurred singly in the liver cells and were located mainly in the periportal areas. The histological findings in the liver are similar to those observed in α1-antitrypsin (AAT) deficiency in which the intracytoplasmic globules represent accumulation of altered AAT. Immunochemical studies carried out on formalin fixed tissue failed to detect cross reaction material with anti-α1 antitrypsin or anti-AT III antiserum. This is the first case report of AT-III deficiency presenting in infancy. It is also the first case associated with distinctive liver pathology.The available data presented are insufficient to distinguish between an inborn defect and acquired causes of the severely depressed AT-III plasma level and the distinctive liver pathology.

scholarly journals Acute otitis media in an infant complicated with osteoarthritis of temporomandibular joint and sub-periosteal abscess of the clavicle

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Kaoutar Cherrabi ◽  
Hind Cherrabi
Keyword(s):  
Septic Arthritis ◽  
Temporomandibular Joint ◽  
Nutritional Assessment ◽  
Acute Otitis Media ◽  
Clinical Signs ◽  
Rare Condition ◽  
Pediatric Emergency ◽  
Ear Infections ◽  
The Right

Abstract Background Otomastoiditis is a very frequent affection and a current complication of mal-treated benign ear infections in children. However, this a very rare case of the association of two rare complications of otomastoiditis in a newborn. On the one hand, septic arthritis of the temporomandibular joint which is a very rare condition that is difficult to diagnose, and when unrecognized or not treated accordingly, it can resolve in serious infectious complication and or definitive injury to the temporomandibular joint. On the other hand, osteomyelitis of the clavicle is also very rare, and only a few cases have been cited in the literature concerning infants. Case presentation This 46-day-old infant was brought to pediatric emergency consultation for 2 swelling inflammatory bulges, one in the right mastoid and pre-auricular regions, and another in the right basi-cervical area. The infant was hypertrophic febrile, hypotonic, and pale. He had preserved archaic reflexes. Besides, blood test showed an inflammatory syndrome, inflammatory anemia, and no other abnormalities. Upon supplementary computed tomodensitometry exam, the diagnosis of a combination of septic arthritis of the right temporomandibular joint and sub-periosteal abscess of the ipsilateral clavicle in a context of hypotrophy and malnutrition was suspected. A pus sample was obtained for bacteriological evaluation, after which the infant had a course of intravenous associated antibiotics, along with nutritional assessment and management. Surgical drainage of both collections was performed. The 6-month follow-up was satisfactory, without clinical signs of functional impact on temporomandibular joint, or acromioclavicular joint. Conclusion This work stresses the necessity of thorough clinical examination of infants even in cases of benign ear infections, as well as the importance of adapted treatment and follow-up, which could allow early diagnosis, appropriate treatment, or even prevention of severe complications that can be associated with such benign conditions.

scholarly journals Fetus in fetu: two case reports from North African country

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Moutaz Ragab ◽  
Omar Nagy Abdelhakeem ◽  
Omar Mansour ◽  
Mai Gad ◽  
Hesham Anwar Hussein
Keyword(s):  
Histopathological Examination ◽  
Case Reports ◽  
Abdominal Mass ◽  
Mature Teratoma ◽  
Surgical Techniques ◽  
Rare Condition ◽  
Mass Effect ◽  
Fetus In Fetu ◽  
Vascular Connection ◽  
First Case

Abstract Background Fetus in fetu is a rare congenital anomaly. The exact etiology is unclear; one of the mostly accepted theories is the occurrence of an embryological insult occurring in a diamniotic monochorionic twin leading to asymmetrical division of the blastocyst mass. Commonly, they present in the infancy with clinical picture related to their mass effect. About 80% of cases are in the abdomen retroperitoneally. Case presentation We present two cases of this rare condition. The first case was for a 10-year-old girl that presented with anemia and abdominal mass, while the second case was for a 4-month-old boy that was diagnosed antenatally by ultrasound. Both cases had vertebrae, recognizable fetal organs, and skin coverage. Both had a distinct sac. The second case had a vascular connection with the host arising from the superior mesenteric artery. Both cases were intra-abdominal and showed normal levels of alpha-fetoprotein. Histopathological examination revealed elements from the three germ layers without any evidence of immature cells ruling out teratoma as a differential diagnosis. Conclusions Owing to its rarity, fetus in fetu requires a high degree of suspicion and meticulous surgical techniques to avoid either injury of the adjacent vital structures or bleeding from the main blood supply connection to the host. It should be differentiated from mature teratoma.

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