scholarly journals Melioidosis of the Musculoskeletal System

2019 ◽  
Vol 29 (2) ◽  
pp. 121-127 ◽  
Author(s):  
Rajamani Perumal ◽  
Abel Livingston ◽  
Sumant Samuel ◽  
Santhosh Kumar Govindaraju
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Septic Arthritis ◽  
Musculoskeletal System ◽  
Medical Management ◽  
Clinical Presentation ◽  
Treatment Modalities ◽  
Soft Tissue Abscess ◽  
Musculoskeletal Involvement

Objective: Recent studies indicate that India is an endemic region for Burkholderia pseudomallei infection. We aimed to describe the clinical presentation of B. pseudomallei infection of the musculoskeletal system and summarise the various treatment modalities used in our clinical practice. Subjects and Methods: Patients with confirmed microbiological diagnosis of B. pseudomallei infection involving the musculoskeletal system treated from January 2007 to December 2016 with a minimum follow-up of 1 year were included. A retrospective review of medical records was carried out and patients’ demographic data, co-morbidities, clinical presentation, and details of medical and surgical treatment were documented. Results: Of 342 patients diagnosed with B. pseudomallei infection, 37 (9.2%) had musculoskeletal involvement; 26 patients (23 males) followed up for at least a year were included in the study. Four patients (15%) had multisystem involvement and 10 (37%) had multiple musculoskeletal foci of infection; 15 patients (58%) had osteomyelitis, 10 (38%) had septic arthritis with or without osteomyelitis, and 1 patient (4%) presented with only soft tissue abscess. All patients required surgical intervention in addition to medical management. Surgical treatment varied from soft tissue abscess drainage, arthrotomy for septic arthritis, decompression and curettage for osteomyelitis, and/or use of antibiotic (meropenem or ceftazidime)-loaded polymethylmethacrylate bone cement for local drug delivery. At final follow-up (average: 37 months, range: 12–120), all patients were disease free. Conclusion: We found the rate of musculoskeletal involvement in B. pseudomallei infection to be 9.2%. Appropriate surgical treatment in addition to medical management resulted in resolution of disease in all our patients.

scholarly journals Subungual Glomus Tumor- Clinical Presentation And Treatment

2014 ◽  
Vol 3 (2) ◽  
pp. 45-48 ◽  
Author(s):  
Shyamal Chandra Debnath ◽  
Suman Kumar Roy ◽  
RR Kairy
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Tumor ◽  
Clinical Presentation ◽  
Glomus Tumor ◽  
Rare Condition ◽  
Surgical Excision ◽  
Tissue Mass ◽  
Delay In Diagnosis ◽  
Nail Deformity

Glomus tumor is a rare condition and constitutes only 1 % of all soft tissue tumor of body. Glomus tumor is familiar for its unusual presentation and long standing symptoms due to delay in diagnosis. Authors have presented the clinical behavior and treatment of 7 patients with subungual soft tissue mass. Following surgical excision, all patients cured of symptoms, at the end of follow up, no recurrence occurred; post operative nail deformity was insignificant. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18250 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 45-48

Rare Facial Clefts

2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Marta Fijałkowska ◽  
Bogusław Antoszewski
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue ◽  
Clinical Presentation ◽  
Treatment Plan ◽  
General Rule ◽  
Common Type ◽  
Facilitated Communication ◽  
Facial Clefts ◽  
Therapeutic Problem ◽  
Variable Clinical Presentation

AbstractIn 1976 Dr. Paul Tessier described numeric classification for rare craniofacial clefts. He first emphasized that a fissure of the soft tissue corresponds, as a general rule, to a cleft of the bony structure. The classification, easy to understand, became widely accepted because the recording of the malformations was simple and facilitated communication between observers.was to present our own experience with treatment of patients with rare facial clefts.Our Department has 11 patients with rare craniofacial clefts under its care. This group includes 8 boys and 3 girls. The patients aged from 2 months to 18 years at the time of the first consultation.In two patients the cleft was median, in seven patients it was one-sided and in two – bilateral. The most common type of cleft was number 6, and the rarest were 2, 3, and 7. All patients underwent surgical treatment.Atypical facial clefts are rare congenital anomalies, however because of functional and aesthetic disturbances they constitute a serious medical and therapeutic problem. Facial clefts are characterized by variable clinical presentation and require individualized treatment plan.

scholarly journals Nasal Cavity Ossifying Fibrosarcoma: An Unusual Fibro-Osseous Neoplasm

2010 ◽  
Vol 89 (11) ◽  
pp. E1-E3 ◽  
Author(s):  
Yadiel A. Alameda ◽  
Carlos Perez-Mitchell ◽  
José M. Busquets
Keyword(s):  
Soft Tissue ◽  
Nasal Cavity ◽  
English Language ◽  
Clinical Presentation ◽  
Soft Tissue Mass ◽  
Histopathologic Examination ◽  
Left Nasal Cavity ◽  
Tissue Mass ◽  
Language Literature

We describe the case of a 65-year-old woman who presented with left nasal obstruction. Clinical and radiographic examinations revealed the presence of a soft-tissue mass that had obliterated the left nasal cavity. The mass was completely excised via an endoscopic approach. Histopathologic examination identified the tumor as an ossifying fibrosarcoma. The patient recovered uneventfully and remained free of disease at the 2-year postoperative follow-up. To the best of our knowledge, no case of an ossifying fibrosarcoma of the nasal cavity has been previously reported in the English-language literature. We discuss the features of this case and the clinical presentation, diagnosis, and management of fibrosarcomas of the nasal cavity and paranasal sinuses.

scholarly journals Clinical Features and Treatment of Fibrous Histiocytomas of the Tongue: A Systematic Review

2017 ◽  
Vol 22 (01) ◽  
pp. 094-102 ◽  
Author(s):  
Austin Nguyen ◽  
Adam Vaudreuil ◽  
Paul Haun ◽  
Gabriel Caponetti ◽  
Christopher Huerter
Keyword(s):  
Surgical Treatment ◽  
Clinical Presentation ◽  
Malignant Tumors ◽  
Case Reports ◽  
Data Synthesis ◽  
Excellent Outcome ◽  
Fibrous Histiocytomas ◽  
Pleomorphic Sarcoma ◽  
Level Data

Introduction Benign fibrous histiocytomas are common lesions of the skin that rarely affect the tongue. Such cases are available in the literature exclusively as case reports. Similarly, malignant fibrous histiocytoma, now classified as undifferentiated pleomorphic sarcoma, is exceedingly rare in the tongue and not fully understood. Objectives This study systematically reviews the available literature discussing the clinical and pathological features of malignant and benign fibrous histiocytomas. Data Synthesis A total of 20 cases were included in this review. Patient-level data were extracted from cases to include clinical presentation, workup, treatment, and outcome. Conclusion Benign fibrous histiocytomas are consistent in clinical and histopathologic presentation. Surgical treatment provides excellent outcome, with no recurrence in all excised cases. Malignant tumors have a more aggressive clinical and pathological presentation. Surgical treatment with possible adjuvant radiotherapy resulted in recurrence in 40% of cases (follow-up of 24 months), and death due to disease in 47% of patients (follow-up of 19 months).

Fifty Years of Experience with Chordomas in Southeast Scotland

Neurosurgery ◽  
1985 ◽  
Vol 16 (2) ◽  
pp. 166-170 ◽  
Author(s):  
P. O'Neill ◽  
B.A. Bell ◽  
J.D. Miller ◽  
I. Jacobson ◽  
W. Guthrie
Keyword(s):  
Clinical Presentation ◽  
Surgical Intervention ◽  
Slow Growth ◽  
Multicenter Trial ◽  
Treatment Modalities ◽  
Therapeutic Approaches ◽  
Slow Growth Rate ◽  
The Past ◽  
New Therapeutic Approaches

Abstract We report the clinical presentation and management of 34 patients with a histologically proven chordoma, treated in the neurosurgical departments in Edinburgh and Dundee, over the past 50 years. Although these tumors are commonly regarded as being locally invasive with a variable, but generally slow growth rate, they can metastasize, and this may precede surgical intervention, as in one of our patients. Our cases are compared to those in previously published series, and a comprehensive review of the treatment modalities for tumors at various sites is presented. The optimal treatment to be recommended from our own experience, and that of others, is aggressive operation and radiotherapy. A combination of hyperthermia and chemotherapy has shown some promise, but remains untested, and highlights the need for a multicenter trial with long follow-up to allow the evaluation of new therapeutic approaches.

scholarly journals A challenging entity of endovascular embolization with ONYX for brainstem arteriovenous malformation: Experience from 13 cases

2017 ◽  
Vol 23 (5) ◽  
pp. 497-503 ◽  
Author(s):  
Hengwei Jin ◽  
Zhan Liu ◽  
Qing Chang ◽  
Chang Chen ◽  
Huijian Ge ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Intracranial Hemorrhage ◽  
Arteriovenous Malformations ◽  
Clinical Presentation ◽  
Gamma Knife Radiosurgery ◽  
Endovascular Embolization ◽  
Treatment Modalities ◽  
Patient Demographics ◽  
Partially Occluded

Objective Brainstem arteriovenous malformations (AVMs) are rare lesions with a high risk of intracranial hemorrhage and are challenging to treat. We present our experience of endovascular embolization with Onyx in these aggressive lesions. Materials and methods Between 2007 and 2016, 13 patients with brainstem AVMs were embolized with Onyx at our center. Twelve patients presented with intracranial hemorrhage and one with headache. Retrospective examinations of patient demographics, clinical presentation, angiographic features, treatment modalities, postoperative complications and outcomes were carried out. Results The AVMs were in the midbrain in 10 patients (one anterior and nine posterior or dorsal), in the posterior pons in two and pontomedullary in one. Complete occlusion was achieved in three patients. Gamma knife radiosurgery was performed in six patients who were near-completely or partially embolized. Postoperative complications, including five cases of ischemia and one case of hemorrhage, resulted in four cases of neurological deterioration and two deaths. Clinical follow-up was obtained in 10 patients at a mean period of 45.2 months (range 3 to 93 months). During the follow-up, good clinical outcomes were observed in seven patients with posterior or dorsal midbrain AVMs, and one patient with a posterior pons AVM that was partially occluded died of intracranial hemorrhage. Conclusion Endovascular embolization for brainstem AVM with Onyx is a technical challenge and the reflux of Onyx may cause severe complications. Individualized treatment is needed based on the specific subtype of brainstem AVM.

Fracture of the Second Metatarsal Base

2003 ◽  
Vol 93 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Gregory Morris ◽  
Kelly Nix ◽  
Flair D. Goldman
Keyword(s):  
Differential Diagnosis ◽  
Clinical Presentation ◽  
Recovery Period ◽  
Treatment Modalities ◽  
Transverse Fracture ◽  
Imaging Studies ◽  
Improve Treatment ◽  
Second Metatarsal ◽  
The Mean

Fracture of the second metatarsal is a cause of chronic midfoot pain that has not been thoroughly examined in the literature. A retrospective review of medical charts and imaging studies was undertaken to investigate this phenomenon. The clinical presentation, differential diagnosis, results of imaging studies, and treatment modalities are described for eight patients with midfoot pain who were treated for a mean of 3.7 months (range, 0 to 12 months) before imaging studies showed a nondisplaced transverse fracture of the second metatarsal base. Initial radiographs indicated fracture in only one patient. Two patients later had surgical bone grafting, two patients had asymptomatic nonunion, and three patients eventually healed. At the last follow-up examination, one patient was continuing treatment with immobilization and electrical bone stimulation. For the seven patients in whom symptoms resolved, the mean recovery period was 14 months (range, 5 to 23 months). Further research is needed to improve treatment and outcomes for this condition. (J Am Podiatr Med Assoc 93(1): 6-10, 2003)

scholarly journals Monoarticular Hip Involvement in Pseudogout

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Figen Kocyigit ◽  
Ersin Kuyucu ◽  
Ali Kocyigit
Keyword(s):  
Rheumatoid Arthritis ◽  
Surgical Treatment ◽  
Soft Tissue ◽  
Synovial Fluid ◽  
Biochemical Analysis ◽  
Medical Condition ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Fluid Analysis ◽  
Soft Tissue Abscess

Pseudogout is the acutest form of arthritis in the elderly. Although clinical manifestations vary widely, polyarticular involvement is typical mimicking osteoarthritis or rheumatoid arthritis. Monoarticular involvement is relatively rare and is generally provoked by another medical condition. There are reported cases of hip involvement by pseudogout in monoarticular form. However, all of the cases were presented as septic arthritis. In this report, we present a case of monoarticular hip involvement mimicking soft tissue abscess. We confirmed the pseudogout diagnosis after ultrasonographic evaluation of the involved hip joint and pathological and biochemical analysis of synovial fluid analysis. Diagnosis is important to avoid unnecessary medical and surgical treatment in cases of the bizarre involvement of hip in pseudogout.

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