scholarly journals Scapular Winging following Sports-Related Injury in a Rugby Player

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Shinya Ishizuka ◽  
Akinori Kobayakawa ◽  
Hideki Hiraiwa ◽  
Hiroki Oba ◽  
Takefumi Sakaguchi ◽  
...  
Keyword(s):  
Physical Examination ◽  
Muscle Weakness ◽  
Sports Injury ◽  
High Viscosity ◽  
Rugby Player ◽  
Serratus Anterior ◽  
Long Thoracic Nerve ◽  
Scapular Winging ◽  
Male High School ◽  
The Right

The most common cause of medial scapular winging is long thoracic nerve palsy (LTN) and subsequent serratus anterior muscle dysfunction. A 16-year-old right-handed male high-school rugby player developed severe right-sided neck and shoulder pain after tackling an opponent while playing rugby. Six weeks after initial injury, the patient observed shoulder muscle weakness when performing his daily activities. On physical examination, limited active elevation of the right shoulder in the scapular plane and scapular winging was observed. Magnetic resonance imaging revealed atrophy of both the SA and subclavius muscles on the right side, and we initially suspected an LTN injury sustained. However, while detailing his history, the patient explained that he also had noted difficulty sucking high viscosity drinks such as shakes and smoothies since childhood. In addition, physical examination showed weakness of the orbicularis oculi muscle. Considering the facial muscle weakness, facioscapulohumeral dystrophy (FSHD) was also suspected, and genetic testing showed chromosome 4q35 deletion with restriction fragments 17 kb and 3 tandem repeated DNA confirming the diagnosis of FSHD. Clinicians should be aware that FSHD could be one of the differential diagnoses of scapular winging after sports injury, and surgeons should rule out the diagnosis of FSHD before performing any surgical treatment for SA palsy.

scholarly journals Winged scapula following axillary thoracotomy with long thoracic nerve preservation

2020 ◽  
Vol 13 (2) ◽  
pp. e232970
Author(s):  
Tomomi Isono ◽  
Shigeshi Mori ◽  
Hidenori Kusumoto ◽  
Hiroyuki Shiono
Keyword(s):  
Rare Condition ◽  
Serratus Anterior ◽  
Long Thoracic Nerve ◽  
Nerve Preservation ◽  
Thoracic Nerve ◽  
Winged Scapula ◽  
The Right ◽  
A Site ◽  
Electric Scalpel ◽  
Fourth Intercostal Space

Winged scapula is a rare condition caused by injuries to the long thoracic nerve (LTN) and accessory nerves. A 69-year-old man underwent surgery for right lung cancer. Video-assisted thoracic surgery was converted to axillary thoracotomy at the fourth intercostal space. The latissimus dorsi was protected, and the serratus anterior was divided on the side anterior to the LTN. Two months after discharge, he presented with difficulty in elevating his right arm and protrusion of the scapula from his back. Active forward flexion of the right shoulder was limited to 110° and abduction to 130°. He was diagnosed with winged scapula. After 6 months of occupational therapy, the symptoms improved. The LTN may have been overstretched or damaged by the electric scalpel. We recommend an increased awareness of the LTN, and to divide the serratus anterior at a site as far as possible from the LTN to avoid postoperative winged scapula.

scholarly journals A Patient with Clavicle Fracture and Recurrent Scapular Winging with Spontaneous Resolutions

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Kendra E. Keenan ◽  
John G. Skedros
Keyword(s):  
Clavicle Fracture ◽  
Serratus Anterior ◽  
Long Thoracic Nerve ◽  
Scapular Winging ◽  
Inflammatory Neuropathy ◽  
Fracture Nonunion ◽  
Joint Separation ◽  
Surgical Manipulation ◽  
Acromioclavicular Joint Separation

Injury to the long thoracic nerve with resulting serratus anterior palsy is a typical cause of medial scapular winging. We report a case of a 70-year-old female with scapular winging in the setting of a mildly comminuted midshaft clavicle fracture. The winging persisted for three months after the fracture, which became a nonunion. The winging spontaneously resolved prior to open reduction and internal fixation of the nonunion. The winging recurred after this surgery. The recurrence was attributed to transient irritation and/or inflammatory neuropathy of the brachial plexus caused by the surgical manipulation. This second episode of winging again spontaneously resolved. There are few reported cases of scapular winging in the setting of a clavicle fracture and only one case of recurrent scapular winging. In that case, which was in the setting of an acromioclavicular joint separation, the second episode of winging required long-term use of a brace. By contrast, our patient did not require bracing because the recurrent winging spontaneously resolved, making this a novel case. This case is important because it illustrates that recurrent scapular winging can occur, and spontaneously resolve, in the setting of a mid-shaft clavicle fracture after subsequent reconstruction of a fracture nonunion.

scholarly journals Sonoanatomy revisited: the long thoracic nerve

2019 ◽  
Vol 21 (3) ◽  
pp. 349 ◽  
Author(s):  
Ke-Vin Chang ◽  
Wei-Ting Wu ◽  
Kamal Mezian ◽  
Ondřej Naňka ◽  
Levent Özçakar
Keyword(s):  
Distal Segment ◽  
Serratus Anterior Muscle ◽  
Accidental Injury ◽  
Serratus Anterior ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Long Thoracic Nerve ◽  
Scanning Method ◽  
Thoracic Nerve ◽  
Scapular Winging

The long thoracic nerve (LTN) arises from the C5, C6 and C7 roots and innervates the serratus anterior muscle. Scapular winging is the landmark manifestation of LTN neuropathy and may develop after an accidental injury during selective cervical nerve root or inter-scalene brachial plexus blocks. Although its sonoanatomy has been described in the previous literature, how to gradually identify the entire nerve course has rarely been discussed. In this regard, the present paper aims to elaborate the scanning method of the LTN from its origin to its distal segment.

EMBRYOMA OF KIDNEY (WILMS' TUMOR) IN CHILDREN

PEDIATRICS ◽  
1949 ◽  
Vol 4 (2) ◽  
pp. 197-200
Author(s):  
LLOYD B. DICKEY ◽  
L. R. CHANDLER
Keyword(s):  
Survival Rate ◽  
Physical Examination ◽  
Wilms Tumor ◽  
Left Kidney ◽  
Bottle Feeding ◽  
Postoperative Radiation ◽  
History Of ◽  
The Right ◽  
Infants And Young Children ◽  
Careful Physical Examination

A series of 12 cases of Wilms' tumor, in which the diagnosis was confirmed in all instances by examination of the gross or microscopic tissue, is reported, with a survival rate of 33.3%. Four patients are living and well, 4, 8, 10, and 15 years, respectively, after treatment. All recurrences appeared less than 10 months after treatment. The sex incidence, and the sex survival incidence were exactly equal. Six tumors were in the left kidney, and six in the right. Eight of the patients were under 2 years of age when first diagnosed and treated, and all were under 7 years. The history of breast or bottle feeding was irrelevant. In a large number of these and reported cases, the presence of the tumor was the first symptom, and in a considerable number the only symptom. This fact stresses the importance of careful physical examination of infants and young children, regardless of complaint, or of lack of it. The finding of calcification in the tumor is possibly a good prognostic sign. All three patients in whom calcification was noted in the tumor are living and well. Immediate removal of the tumor by transperitoneal nephrectomy, with postoperative radiation to the area, seems to be the advisable treatment.

Appendicitis: a rare adverse event in colonoscopy

2021 ◽  
Vol 14 (7) ◽  
pp. e242523
Author(s):  
Samer Al-Dury ◽  
Mohammad Khalil ◽  
Riadh Sadik ◽  
Per Hedenström
Keyword(s):  
Emergency Department ◽  
Adverse Event ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
De Novo ◽  
Perforated Appendicitis ◽  
Lower Quadrant ◽  
The Right ◽  
Right Lower Quadrant

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.

Interosseous Muscle Pain in the Pianist's Hand: A Description of 27 Cases of Musician's Hand

2007 ◽  
Vol 22 (1) ◽  
pp. 24-25
Author(s):  
Naotaka Sakai
Keyword(s):  
Muscle Weakness ◽  
Muscle Pain ◽  
Deep Part ◽  
Piano Performance ◽  
Medical Problems ◽  
Main Symptom ◽  
Left Hand ◽  
Dorsal Hand ◽  
Right Hand ◽  
The Right

Among 703 professional pianists with medical problems in their hands seen by the author between 1981 and 2000, there were 27 patients who had interosseous muscle pain (23 women, 4 men; mean age, 30 yrs). The main symptom was dorsal hand pain during piano performance, especially when striking the keys with each finger rounded, mainly in the scale technique. Tenderness was noted in the deep part of the dorsal hand in the interosseous muscles, but not along or around the finger extensors. Patients sometimes complained of muscle weakness on abduction of the index, ring, and/or little fingers when performing octaves or chords on the piano keyboard. Resisted abduction and adduction testing of the fingers reproduced the pain which they experienced during or after performance. Pain occurred in the right hand in 10, left hand in 5, and bilaterally in 12. The pain was localized in the 4th and 5th interossei in 15 patients, in the 3rd and 4th in 14 patients; in the 2nd and 3rd in 11 patients; and in the 1st and 2nd in 1 patient.

scholarly journals Amyand's hernia and acute appendicitis: Case presentation in Basic Hospital of Chone

2020 ◽  
Vol 4 (2) ◽  
pp. 19-23
Author(s):  
Orelvis Rodríguez Palmero ◽  
Liseidy Ordaz Marin ◽  
María Del Rosario Herrera Velázquez ◽  
Agustín Marcos García Andrade
Keyword(s):  
Abdominal Pain ◽  
Inguinal Hernia ◽  
Acute Appendicitis ◽  
Physical Examination ◽  
Iliac Fossa ◽  
Amyand’S Hernia ◽  
Case Presentation ◽  
The North ◽  
History Of ◽  
The Right

Present the case of a 66-year-old male patient, with a history of right inguinal hernia, who was referred to the emergency room at the IESS de Chone Basic Hospital in the north of the Manabí province, Ecuador, with symptoms of Abdominal pain of more than 24 hours of evolution located in the right iliac fossa and inguinal region on the same side, in the physical examination the hernia was impossible to reduce, so he was taken to the operating room, in the intervention the cecal appendix was found swollen within the hernial sac, a condition known as Amyand's hernia.

scholarly journals Seminoma and sertolioma in non-cryptorchid dog – case report

2021 ◽  
Vol 15 (4) ◽  
pp. 281-286
Author(s):  
Guilherme Mantuani Silva ◽  
Isabela Cristina de Oliveira ◽  
Rodrigo Samuel de Toledo ◽  
Juliana Evangelista Bezerril ◽  
Gabriela Maria Benedetti Vasques ◽  
...  
Keyword(s):  
Physical Examination ◽  
Ultrasound Examination ◽  
Histopathological Examination ◽  
Seminiferous Tubules ◽  
Biochemical Tests ◽  
Predisposing Factor ◽  
Left Testicle ◽  
Spindle Cells ◽  
Mixed Breed ◽  
The Right

The most common testicular neoplasms in dogs are seminoma, leydigocytoma and sertolioma, affecting middle--aged and elderly dogs, where cryptorchidism is a predisposing factor, as well as some breeds. It can occur alone or, less fren-quently, concurrently, generally affecting the same testicle. This study aimed to report the case of a non-cryptorchid 14-year--old mixed breed dog diagnosed with seminoma and sertolioma, each in a testicle. The animal showed an increase in scrotal volume, with no changes in other clinical parameters on physical examination. On ultrasound examination, it was possible to observe alterations suggestive of neoplasia in both testicles and prostatic alteration suggestive of benign prostatic hyperplasia. Complementary blood count and biochemical tests were performed and, as treatment, orchiectomy was performed. Fragments were collected from both testicles and sent for histopathological examination. Microscopy of the left testicle showed the presence of round cells, multiple and evident nucleoli, cells in different phases of mitosis and binucleation, these changes being compa-tible with seminoma. In contrast, in the right testicle, spindle and elongated cells (pseudo-lobular) were observed, presence of long cytoplasmic projections with rounded ovoid nucleus, spindle cells and degeneration of seminiferous tubules, compatible with sertolioma. It was observed that physical examination associated with ultrasound was efficient to detect the presence of neoplasms, being validated by histopathological examination. Orchiectomy was an assertive treatment indicated for this case.

scholarly journals Experience of using an integrated approach in the diagnosis of temporomandibular joint dysfunction

2022 ◽  
pp. 98-100
Author(s):  
A. A. Sultanov ◽  
Y. Y. Pervov ◽  
A. K. Yatsenko ◽  
M. A. Sultanova ◽  
D. O. Drozdova
Keyword(s):  
Physical Examination ◽  
Temporomandibular Joint ◽  
Orthodontic Treatment ◽  
Clinical Case ◽  
Mouth Opening ◽  
Integrated Approach ◽  
Masticatory Muscles ◽  
Temporomandibular Joint Dysfunction ◽  
The Right ◽  
Masseter Muscles

The article presents a clinical case of the diagnostics and treatment of the temporomandibular joint dysfunction (TMJ) in patient after orthodontic treatment. The hypertonia of masticatory muscles, limit of mouth opening and deviation of the jawbone to the right were observed during physical examination. Adhesion of the disk to the articular tubercle of the right temporal bone was detected on MRI. Hyperrotation of the articular head and the deviation of the jawbone to the right were observed on the charts during axiography. Disappearing of the feeling of heaviness in the right TMJ, free mouth opening, absence of deviation symptom, and the reduction of the rigidity of the masseter muscles were observed on the basis of diagnostic examinations after treatment. Presented clinical experience lets us make a conclusion that it is necessary to prescribe taking axiography and MRI during diagnosing and treating temporomandibular joint dysfunction.

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