Oesophageal carcinoma with solitary patellar metastasis: a rare case report

The incidence of tumours found in the patella, including primary and metastatic tumours, is low. Solitary metastasis of oesophageal carcinoma (OC) in the patella is even rarer. A 50-year-old man presented to our clinic because of pain and limited range of motion in the right knee for 4 hours and after a fall. On the basis of the patient’s medical history, he was diagnosed with OC 2 months previously and underwent two cycles of paclitaxel liposome combined with tiggio chemotherapy (oral tiggio, 40 mg, two times/day, with a treatment cycle of 3 weeks). A 99mTc-methylene diphosphonate bone scintigraphy scan showed increased radioactivity in the right patella. A right knee biopsy showed the presence of patellar metastasis from OC. Unfortunately, the patient denied additional treatment and was discharged for personal reasons. At the 1-month follow-up, which was conducted by a telephone survey, we learned that the patient had died of acute pulmonary embolism. X-rays and computed tomography are useful for diagnosing patellar metastases, but 99mTc-methylene diphosphonate bone scintigraphy can help physicians diagnose patellar metastasis of OC more rapidly. Biopsy with pathology is the gold standard for diagnosing patellar metastases. Additionally, timely surgical treatment prolongs the survival time of these patients.

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Dysplasia epiphysealis hemimelica of the radial head: a rare case report

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04004-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Hiva Mohamadian ◽

Mansour Bahardoust ◽

Borzouyeh Molazem Sanandaji ◽

Saba Saberi

Keyword(s):

Radial Head ◽

Elbow Joint ◽

Limited Range ◽

Lower Limbs ◽

Case Presentation ◽

Limited Range Of Motion ◽

Rare Case Report ◽

The Right ◽

Dysplasia Epiphysealis Hemimelica

Abstract Background Dysplasia epiphysealis hemimelica (DEH) is a rare benign overgrowth generally affecting the epiphyses and short bones of the lower limbs. DEH in the elbow joint is extremely rare, and to date, only three cases of DEH have been reported in the radial head. Case presentation In this study, we report a case of DEH located in the radial head of the right elbow of a 10-year-old boy, which was presented with elbow pain and limited range of motion. In clinical examination, an asymmetrical enlargement was observed over the elbow. The lesion was resected surgically, and the patient’s symptoms resolved afterward. The histologic analysis of the lesion confirmed the diagnosis of DEH. Conclusion This report highlights the role of DEH in the differential diagnosis of elbow pathologies, particularly its differentiation from osteochondroma.

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Impairment Tutorial: Rating Tears of the Acetabular Labrum

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2006.novdec02 ◽

2006 ◽

Vol 11 (6) ◽

pp. 4-7

Author(s):

Charles N. Brooks ◽

Richard E. Strain ◽

James B. Talmage

Keyword(s):

Magnetic Resonance ◽

Hip Arthroscopy ◽

Age Groups ◽

Limited Range ◽

Labral Repair ◽

X Rays ◽

Joint Stability ◽

Acetabular Labrum ◽

Complete Excision ◽

Limited Range Of Motion

Abstract The primary function of the acetabular labrum, like that of the glenoid, is to deepen the socket and improve joint stability. Tears of the acetabular labrum are common in older adults but occur in all age groups and with equal frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all rely on production of pain in the groin (typically), clicking, and/or locking with passive or active hip motions. Diagnostic tests or procedures rely on x-rays, conventional arthrography, computerized tomography, magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and hip arthroscopy. Hip arthroscopy is the gold standard for diagnosis but is the most invasive and most likely to result in complications, and MRA is about three times more sensitive and accurate in detecting acetabular labral tears than MRI alone. Surgical treatment for acetabular labrum tears usually consists of arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of-motion tests).

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Surgical Treatment for Malunion of the Lateral Humeral Epicondyle with Posterior Subluxation of the Radial Head: A Case Report and Literature Review

Case Reports in Orthopedics ◽

10.1155/2018/1901235 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4

Author(s):

Koichi Yano ◽

Yasunori Kaneshiro ◽

Hideki Sakanaka

Keyword(s):

Lateral Collateral Ligament ◽

High Energy ◽

Limited Range ◽

Forearm Rotation ◽

Collateral Ligament ◽

Lateral Epicondyle ◽

Limited Range Of Motion ◽

Contracture Release ◽

Normal Congruence ◽

The Right

A 24-year-old right-handed man suffered right olecranon and lateral epicondylar fracture from high energy trauma. Fixation of olecranon was performed by a previous doctor. Three months after operation, he presented with limited range of motion (ROM) of the right elbow caused by malunion of the lateral epicondylar fracture and subluxation of the radiohumeral joint. Preoperative ROM of the right elbow was flexion 110° and extension −75°. Forearm rotation was pronation 85° and supination 65°. Fragment excision of the lateral epicondyle, which was 27 mm in length, and lateral collateral ligament repair using anchors were performed. Fourteen months postoperatively, contracture release of the elbow was performed. Twenty-four months postoperatively, radiograph of the elbow showed normal congruence without osteoarthritic changes and the ROM of the right elbow was flexion 120° and extension −35°. Forearm rotation was pronation 90° and supination 70°. In the surgical setting, in case of the size of the lateral epicondylar fragment is relatively large, the fragment should be fixed or lateral collateral ligament should be repaired when the instability of the elbow is found.

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Traumatic bilateral posterior dislocation of the shoulder: a case report

Open Medicine ◽

10.2478/s11536-013-0228-8 ◽

2013 ◽

Vol 8 (6) ◽

pp. 810-813

Author(s):

C. Garving ◽

T. Dienstknecht ◽

K. Horst ◽

M. Pishnamaz ◽

P. Kobbe ◽

...

Keyword(s):

Range Of Motion ◽

Shoulder Dislocation ◽

Limited Range ◽

Clinical Suspicion ◽

Posterior Dislocation ◽

X Rays ◽

Posterior Shoulder Dislocation ◽

Limited Range Of Motion ◽

Posterior Shoulder ◽

Bilateral Posterior Shoulder Dislocation

AbstractIntroduction. Bilateral posterior dislocation of the shoulder is a rare injury, accounted for about 2–5% of all shoulder dislocations. Main courses are electrical shock, epilepsy or extreme trauma with uncontrolled muscle forces. We report about a case of bilateral posterior shoulder dislocation without additional fractures but with a concomitant acromioclavicular joint dislocation. Case presentation. A 46-year-old Caucasian motorcyclist presented to our facility after a fall on slippery ground. He claimed pain in both shoulders with limited range of motion. The initial X-rays were inconclusive, clinical examination showed typical findings of a Rockwood injury with an additional limited external rotation so that a posterior shoulder dislocation was suspected. The CT scan confirmed the clinical suspicion. A closed reduction was performed followed by immobilization in a shoulder abduction pillow for 4 weeks and continuous physiotherapy. Upon follow up normal function with full range of motion was observed. Conclusion. A bilateral posterior shoulder dislocation can be caused by trauma and results in a limited range of motion with often additional injuries. Due to the unusually presentation the risk of missing the injury is increased. Therefore it is most important to consider this rare diagnosis and in case of clinical suspicion perform a careful algorithm of diagnostic.

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The management of intra-articular lateral femoral condyle (Hoffa) fracture of the knee using arthroscopy-assisted fixation: a case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20184445 ◽

2018 ◽

Vol 6 (11) ◽

pp. 3759

Author(s):

I. G. N. Wien Aryana ◽

Trimanto Wibowo

Keyword(s):

Internal Fixation ◽

Femoral Fracture ◽

Motor Vehicle ◽

Lateral Condyle ◽

X Rays ◽

Distal Femoral Fracture ◽

X Ray ◽

Hoffa Fracture ◽

Limited Range Of Motion ◽

The Right

A Hoffa fracture is a type of supracondylar distal femoral fracture with fracture line located in the coronal plane. It is a rare injury consisting of tangential (coronal shear) fracture of distal femoral condyles. Unicondylar knee fractures are rare and present some diagnostic difficulties due to poor visibility on standard X-ray and are especially harder to identify in non-displaced fracture. A fifty-four-year-old male presented to our emergency room with a chief complaint of pain over his right knee that started 10 months prior. He previously was involved in a motor vehicle accident and underwent open reduction and internal fixation with plate and screws. Physical examination revealed swelling and tenderness over the right knee with limited range of motion. Plain X-ray showed union of tibia plateau fracture with plate and screws and no evidence of distal femoral fracture. A magnetic resonance imaging of the right knee was performed and revealed an intraarticular lateral condyle femur fracture with transverse configuration that was previously missed on plain X-ray. Arthroscopy-assisted reduction and internal fixation using antero-posterior and postero-anterior oriented screws were performed and good reduction was achieved. Diagnosis of this type of fracture is challenging and require some experience. Awareness of such entity and strong clinical suspicion are essential for diagnosis because most of the time the standard X-rays may appear normal. Arthroscopy-assisted fracture fixation using antero-posterior and postero-anterior oriented screws for Hoffa fracture offers many advantages and allows for early mobilization postoperatively without any loss of reduction.

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Solitary osteochondroma of scapula: A case report

Journal of Chitwan Medical College ◽

10.3126/jcmc.v6i3.16704 ◽

2017 ◽

Vol 6 (3) ◽

pp. 69-71

Author(s):

B D Sharma ◽

J Sitaula ◽

A Prajapati ◽

A P Regmi

Keyword(s):

Case Report ◽

Surgical Excision ◽

Ventral Surface ◽

Limited Range ◽

Histopathological Study ◽

Long Bones ◽

Limited Range Of Motion ◽

Solitary Osteochondroma ◽

Benign Tumours ◽

The Right

Osteochondromas are the most common benign tumours of bone. They are most commonly seen in the metaphyseal regions of long bones (femur, tibia, humerus). The scapula is rarely involved, and very few cases of solitary osteochondroma of scapula have been reported in literature. We present the case of a 17 year old male who presented with pain and limited range of motion of his right shoulder. CT scan revealed an osteochondroma on the dorsomedial surface of the right scapula extending into the ventral surface. Surgical excision was done and histopathological study showed osteochondroma of the scapula.

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Impact of Movement with Mobilization and Triceps Eccentric Strengthening in Tennis Elbow: Case Report

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i23b31412 ◽

2021 ◽

pp. 10-14

Author(s):

Nabeela Fatema ◽

Bodhisattva Dass ◽

Rinkle Hotwani

Keyword(s):

Elbow Joint ◽

Tennis Elbow ◽

Limited Range ◽

Treatment Session ◽

Manual Muscle Testing ◽

Outer Side ◽

Lateral Epicondyle ◽

Muscle Testing ◽

Limited Range Of Motion ◽

The Right

Background: Tennis elbow can be caused by repetitive wrist and arm motions. Pain is the primary symptom. It usually occurs on the outside of the elbow and sometimes in the forearm and wrist. Treatment includes rest, pain relievers and physiotherapy. Case Presentation: A 28years old male patient presented with a complaint of pain in outer side of the right side elbow. In subjective examination, He gave history of pain while playing tennis mainly in smashing the ball or passing shot, riding bike for more than 2kilometers, difficulty in holding objects sometimes as well. When this pain was unbearable to him he came to Physiotherapy department. Treatment: A Treatment session initially started with Cryotherapy (Ice Pack) application for 5min. On lateral epicondyle of right elbow. Then Ultrasound 0.8 watt/Cm² for 7minutes given, these helped in pain reduction. After 2days patient is asked to follow the commands to perform Triceps strengthening along with wrist strengthening with the help of Half Kg Dumb bell. There was an effect on the reduction of the symptoms of the patient which were pain, reduce strength and limited range of motion of wrist in right hand. After 1week of treatment, we added Mobilization with movement (Mulligan) technique at elbow joint. The same procedure was continued for 2weeks after which patient's symptoms were minimized as to the day of assessment. Outcome measures used for the evaluation of the symptoms were NPRS Scale for Pain, Manual Muscle Testing (MMT) for Strength. Conclusion: Triceps strengthening along with Mulligan technique for elbow joint was found to be effective in patients with severe pain and reduced strength.

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TORTIKOLIS MUSKULAR KONGENITAL

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.5.3.2013.4334 ◽

2014 ◽

Vol 5 (3) ◽

Author(s):

Imelda E. Kawatu ◽

Engeline Angliadi

Keyword(s):

Muscle Hypertrophy ◽

Limited Range ◽

Neck Muscle ◽

Congenital Muscular Torticollis ◽

Limited Range Of Motion ◽

Good Improvement ◽

The Right ◽

Surgical Treatments ◽

Muscular Torticollis ◽

Fetal Position

Abstract: Torticollis, or wryneck, is a group of symptoms based on many causes that clinically manifests itself as a crooked or rotated neck. Congenital muscular torticollis is the most common type of congenital torticolllis which occurs in four per 1000 births and one per 300 live births with 75% of these cases on the right side. It was found that 90.1% of plagiocephalic cases incured this torticollis. In this condition, due to contractions of the neck muscles, the head turns and tilts to one side, meanwhile the chin points to the opposite side. Congenital muscular torticollis is caused by a shortening of the sternocleidomastoid muscle due to trauma during labour or abnormal fetal position in utero. Signs and symtoms of congenital muscular torticollis are recognized as early as two months after birth in which the head turns to one side associated with neck muscle hypertrophy, muscle spasm, and a limited range of motion (ROM). The management of congenital muscular torticollis consists of pharmacological, non-pharmacological, and surgical treatments. The prognosis is stated as good if there is a good improvement after 6 months of rehabilitation, but it is stated bad if there is no improvement after 6 months of treatment with a continuation of the asymetrical face. Keywords: congenital muscular torticollis, management Abstrak: Tortikolis adalah kekakuan leher yang menimbulkan spasme otot yang secara klinis bermanifestasi sebagai leher yang bengkok atau terputar. Tortikolis bukan merupakan suatu diagnosis melainkan kumpulan gejala dengan berbagai gangguan yang mendasarinya. Tortikolis muskular kongenital ialah bentuk yang paling umum dari tortikolis kongenital dengan insiden sekitar 4 per 1000 kelahiran, dan 1 dari setiap 300 kelahiran hidup. Pada tortikolis muskular kongenital terjadi kontraksi otot-otot leher (75% terbanyak pada sisi kanan) yang menyebabkan posisi kepala turn dan tilt ke satu sisi dan dagu mengarah ke sisi yang berlawanan. Penyebab terjadinya tortikolis muskular kongenital ialah pemendekan otot sternokleidomastoid akibat trauma selama proses persalinan, atau posisi bayi dalam kandungan. Umumnya, gejala dan tanda klinis diketahui pada 2 bulan pertama dimana kepala mengarah ke arah sisi sakit, pembesaran otot-otot leher, spasme otot, dan keterbatasan lingkup gerak sendi leher. Penanganan tortikolis muskular kongenital terdiri dari farmakologis, non-farmakologis, dan pembedahan. Prognosis disebut baik bila tercapai hasil yang baik setelah 6 bulan terapi dengan penanganan rehabilitasi, dan memburuk bila tidak terdapat perubahan dalam 6 bulan terapi ditandai oleh wajah yang asimetris. Kata kunci: tortikolis muskular kongenital, penanganan

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Dynamic External Fixator as Treatment for Congenital Little Finger Contracture

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1721563 ◽

2020 ◽

Author(s):

Kenji Ohira ◽

Yoshitaka Hamada ◽

Takeyasu Toyama ◽

Yoshitaka Minamikawa

Keyword(s):

Clinical Practice ◽

Soft Tissue ◽

External Fixator ◽

Limited Range ◽

Joint Contracture ◽

Soft Tissue Release ◽

Hand Therapy ◽

Limited Range Of Motion ◽

The Right ◽

Little Finger

Abstract The surgical soft tissue release of extension contracture at metacarpophalangeal (MP) joint is technically easy; however, the preventive hand therapy after surgery is really difficult in clinical practice. Congenital MP joint contracture, especially little finger, is also difficult to spread its limited range of motion (ROM). Here, we present a patient with a congenital MP joint contracture of the little finger managed with dynamic external fixator (DEF). A 21-year-old male irritated from limited ROM associated with pain of the right little finger of more than 1 year. The symptom started after trauma on his hand while playing lacrosse. Further examination revealed that his MP joint was congenitally contracted. To address this pathology, DEF followed by orthotic therapy was done. Two years after the procedure and therapy, the MP joint ROM of the finger surpassed that of the contralateral unaffected digit without pain and recurrence. The patient was able to return to his sports of lacrosse.

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Rhizarthrosis Bilateral – Trapeziectomy Versus Arthroplasty with Dual Mobility Prosthesis: Case Report

Surgical Case Reports ◽

10.31487/j.scr.2021.03.11 ◽

2021 ◽

pp. 1-9

Author(s):

Saverio Comitini ◽

Giuseppe Mobilia ◽

Matteo Berti ◽

Luca Amendola ◽

...

Keyword(s):

Case Report ◽

Limited Range ◽

Pain Scale ◽

Left Hand ◽

Limited Range Of Motion ◽

Prosthesis Replacement ◽

Radiographic Grade ◽

Multiple Variables ◽

The Right ◽

Quick Dash

Background: The trapeziometacarpal joint is the second joint affected by osteoarthritis in the hand. The symptoms and clinical presentation are characterized by pain, limited range of motion, muscle weakness with loss of strength, bone deformities and disability. The symptomatology often is not related to the radiographic grade of osteoarthrosis. Therefore, in addition to the radiographic stage of the disease, the treatment is influenced by multiple variables such as age, functional requirement, symptoms and stability of the joint. Objective: There are several options of surgical treatments. Although trapeziectomy and its technical variation is the gold standard for treatment, prosthesis replacement can be used with good results. This case report discusses the case of a 70-year-old male who presents bilateral trapeziometacarpal osteoarthrosis treated with two different techniques with different timelines. Methods: The patient underwent a trapeziectomy on the right hand and arthroplasty with implant on the left. In both TMC the stage of the disease was grade III according to the Eaton Litter classification and the results were evaluated according to clinical and radiographic criteria. The NPRS pain scale and the Quick Dash functional scale were used in subsequent checks. The mean follow-up was 12 months. Conclusion: There were no significantly different results with respect to pain, activities of daily living, mobility or strength. No complications were observed. The patient is satisfied with the treatment having found a better and earlier resumption of daily activity of the left hand treated with prosthesis replacement.

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