scholarly journals Scaphoid Cysts: Literature Review of Etiology, Treatment, and Prognosis

Hand ◽  
2018 ◽  
Vol 14 (6) ◽  
pp. 751-759 ◽  
Author(s):  
Tyler Safran ◽  
Jessica Hazan ◽  
Becher Al-Halabi ◽  
Hassan Al-Naeem ◽  
Sabrina Cugno
Keyword(s):  
Range Of Motion ◽  
Bone Cyst ◽  
Limited Range ◽  
Wrist Pain ◽  
Treatment Modalities ◽  
Carpal Bone ◽  
Cystic Lesions ◽  
Bone Cysts ◽  
Limited Range Of Motion

Background: Cystic lesions of the carpal bones are rare entities that are infrequently reported in the literature. Scaphoid intraosseous cystic lesions represent a rare subset of carpal bone cysts. This review aims to summarize the available evidence on the evaluation and treatment of scaphoid cystic lesions to help guide clinical management. Methods: Systematic electronic searches were performed using PubMed, Ovid, and Embase databases. Studies included were graded for their risk of bias. Pooled descriptive statistics were performed on incidence, etiology, physical exam findings, treatment, and follow-up. Results: A total of 38 patients representing 41 scaphoid cystic lesions were pooled from 27 articles. Patients presented with wrist pain without fracture (n = 27), pathological fracture (n = 9), swelling only (n = 1), or were asymptomatic (n = 4). Cystic lesions of the scaphoid were initially revealed on imaging with radiographs alone (n = 22), radiographs in combination with computed tomography (CT) (n = 10) or magnetic resonance imaging (n = 6), CT alone (n = 1), or using all 3 modalities (n = 2). Intraosseous ganglia were identified most frequently (n = 31), followed by “bone cyst-like pathological change” (n = 3), unicameral bone cysts (n = 2), aneurysmal bone cysts (n = 2), primary hydatid cysts (n = 2), and cystic like changes post fall (n = 1). Treatment modalities included curettage and bone graft (n = 39) or below-elbow cast (n = 2). On follow-up (average of 21.3 months; n = 40), all patients improved clinically after treatment and were found to have full wrist range of motion without pain (n = 31), slightly reduced grip strength (n = 3), limited range of motion (n = 2), or persistent mild discomfort (n = 2). Conclusions: Scaphoid cystic lesions are most commonly intraosseous ganglia, but can include other etiologies as well. The main presenting symptom is radial wrist pain that usually resolves after treatment. The presence of intracarpal cystic lesions should be considered in the differential diagnosis of wrist pain.

scholarly journals Responsiveness of Outcome Measures in Juvenile Idiopathic Arthritis Patients Treated with Methotrexate

1970 ◽  
Vol 32 (1) ◽  
pp. 1-5
Author(s):  
Mohammad Imnul Islam ◽  
Mahmuda Hossain ◽  
Manik Kumar Talukder ◽  
Jesmin Ara Begum ◽  
Shahana A Rahman
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Range Of Motion ◽  
Effect Size ◽  
Global Assessment ◽  
Limited Range ◽  
Limited Range Of Motion ◽  
Activity Measures ◽  
Inflammatory Drugs ◽  
Medical University

Objective: To investigate the responsiveness of disease activity measures in juvenile idiopathic arthritis (JIA) patients treated with methotrexate (MTX) using the Standardized response median (SRM) and the effect size (ES). Design: Prospective observational study. Duration of the study was from June 2005 to December 2007. Setting: This study was carried out in the department of Paediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. Participants: A total of 58 consecutive patients were enrolled in the study but 40 patients completed their regular follow-up. All patients received MTX orally along with non-steroidal anti-inflammatory drugs (NSAID) and/or steroid. Results: The subjective variables including physician's and parent's global assessment were most responsive instrument. Among the articular variables, number of joints with limited range of motion was the most responsive. Functional ability was the lowest responsive. Conclusion: While SRM and ES had been used to evaluate the responsiveness, the physician's and parent's global assessment and number of joints with limited range of motion were the most responsive outcome measure in the therapeutic response in JIA patients. Keywords: Standardized response median (SRM); effect size (ES); responsiveness.DOI: 10.3329/bjch.v32i1.5992Bangladesh Journal of Child Health 2008; Vol.32(1): 1-5  

scholarly journals Proximal interphalangeal joint replacement with an unconstrained pyrocarbon prosthesis (Ascension®): a long-term follow-up

2012 ◽  
Vol 38 (6) ◽  
pp. 680-685 ◽  
Author(s):  
G. Heers ◽  
H. R. Springorum ◽  
C. Baier ◽  
J. Götz ◽  
J. Grifka ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Limited Range ◽  
Degenerative Joint Disease ◽  
Proximal Interphalangeal Joint ◽  
Joint Disease ◽  
Long Term Results ◽  
Complication Rates ◽  
Limited Range Of Motion

There have been limited publications that report long-term outcomes of pyrocarbon implants. This report describes both clinical and radiographic long-term results for patients who have been treated with pyrocarbon proximal interphalangeal implants. Thirteen implants in ten patients are reported for an average follow-up of 8.3 years (range 6.2–9.3). All patients were suffering from degenerative joint disease. Five of the 13 digits were free of pain, the remaining eight digits had mild to moderate pain (visual analogue scale 2–5). The average active range of motion was 58° (SD 19°) at latest examination. X-ray results were unremarkable in six digits with an acceptable position of the prosthesis. However, in seven patients significant radiolucent lines (≥ 1 mm) were observed. Three prostheses demonstrated a migration of the proximal component, and one a subsidence of the distal component. Our study does not support the use of this implant for treatment of osteoarthritis of the finger joint owing to high complication rates and limited range of motion.

scholarly journals Treatment of posttraumatic lumbar interspinous ligament calcification with partial resection of spinous processes and calcified interspinous ligaments: case report

2019 ◽  
Vol 30 (3) ◽  
pp. 362-366 ◽  
Author(s):  
Angela Mae Richardson ◽  
Joanna Elizabeth Gernsback ◽  
John Paul G. Kolcun ◽  
Steven Vanni
Keyword(s):  
Range Of Motion ◽  
Traumatic Injury ◽  
Ct Scanning ◽  
Limited Range ◽  
Partial Resection ◽  
Heterotopic Bone ◽  
Interspinous Ligament ◽  
Limited Range Of Motion ◽  
Spinous Processes

The authors report on the first surgical treatment for traumatic interspinous ligament calcification, with significant radiographic and symptomatic improvements at long-term follow-up. Heterotopic ossification occurs following traumatic injury but does not typically affect the interspinous ligaments. While these ligaments can calcify with age, this is rarely seen in patients younger than 50 years of age. The authors present the unusual case of a 31-year-old man who suffered traumatic fractures of thoracic and lumbar spinous processes. He developed progressive low-back pain that failed to respond to conservative treatments. At presentation, he was neurologically intact. CT scanning demonstrated partial calcification of the interspinous ligaments at L2–3, L3–4, and L4–5 with significant hypertrophy of the spinous processes at those levels. He did not have significant disc pathology, and his symptoms were attributed to the limited range of motion caused by the enlarged spinous processes. Partial resection of the spinous processes and calcified interspinous ligaments was performed to remove the heterotopic bone. The patient was seen in follow-up at 5 months postoperatively for imaging, and he was interviewed at 1 and 2 years postoperatively. He is doing well with significant pain relief and an improved range of motion. His Oswestry Disability Index improved from 25 preoperatively to 18 at 2 years postoperatively.

Activity- vs. structural-oriented treatment approach for frozen shoulder: a randomized controlled trial

2017 ◽  
Vol 31 (5) ◽  
pp. 686-695 ◽  
Author(s):  
Renata Horst ◽  
Tomasz Maicki ◽  
Rafał Trąbka ◽  
Sindy Albrecht ◽  
Katharina Schmidt ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Conventional Therapy ◽  
Daily Life ◽  
Frozen Shoulder ◽  
Limited Range ◽  
Mcgill Pain Questionnaire ◽  
Daily Life Activities ◽  
Limited Range Of Motion ◽  
Days Of Therapy

Objective: To compare the short- and long-term effects of a structural-oriented (convential) with an activity-oriented physiotherapeutic treatment in patients with frozen shoulder. Design: Double-blinded, randomized, experimental study. Setting: Outpatient clinic. Subjects: We included patients diagnosed with a limited range of motion and pain in the shoulder region, who had received a prescription for physiotherapy treatment, without additional symptoms of dizziness, a case history of headaches, pain and/or limited range of motion in the cervical spine and/or temporomandibular joint. Interventions: The study group received treatment during the performance of activities. The comparison group was treated with manual therapy and proprioceptive neuromuscular facilitation (conventional therapy). Both groups received 10 days of therapy, 30 minutes each day. Main measures: Range of motion, muscle function tests, McGill pain questionnaire and modified Upper Extremity Motor Activity Log were measured at baseline, after two weeks of intervention and after a three-month follow-up period without therapy. Results: A total of 66 patients were randomized into two groups: The activity-oriented group ( n = 33, mean = 44 years, SD = 16 years) including 20 male (61%) and the structural-oriented group ( n = 33, mean = 47 years, SD = 17 years) including 21 male (64%). The activity-oriented group revealed significantly greater improvements in the performance of daily life activities and functional and structural tests compared with the group treated with conventional therapy after 10 days of therapy and at the three-month follow-up ( p < 0.05). Conclusions: Therapy based on performing activities seems to be more effective for pain reduction and the ability to perform daily life activities than conventional treatment methods.

scholarly journals Nonunion of the First Sternocostal Synchondrosis Accompanied by Sternoclavicular Joint Synovitis

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Makoto Takeuchi ◽  
Tomohiro Goto ◽  
Kiminori Yukata ◽  
Naoto Suzue ◽  
Daisuke Hamada ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Arthroscopic Surgery ◽  
Limited Range ◽  
Sternoclavicular Joint ◽  
Resection Arthroplasty ◽  
First Rib ◽  
Limited Range Of Motion ◽  
Lateral Portion ◽  
Functional Ct

Injury to the sternocostal synchondrosis of the first rib is quite rare. We report one such case in a 50-year-old man with nonunion of the first sternocostal synchondrosis accompanied by synovitis of the sternoclavicular joint. He first underwent arthroscopic surgery of the left sternoclavicular joint. Postoperatively, the patient’s symptoms decreased by half, but another pain and crepitus at the inferior lateral portion of the sternoclavicular joint developed. Since MRI and functional CT reexaminations revealed nonunion of the first sternocostal synchondrosis, resection arthroplasty of the first sternocostal joint was performed. This resulted in immediate resolution of the symptoms. At 2-year follow-up, his symptoms disappeared entirely with no limited range of motion of the shoulder.

Modified Z-Plasty Repair of Webbed Neck Deformity Seen in Turner and Klippel-Feil Syndrome

2002 ◽  
Vol 39 (3) ◽  
pp. 261-266 ◽  
Author(s):  
Katie R. Hikade ◽  
George J. Bitar ◽  
Milton T. Edgerton ◽  
Raymond F. Morgan
Keyword(s):  
Range Of Motion ◽  
Limited Range ◽  
Posterior Surface ◽  
Fibrous Band ◽  
Limited Range Of Motion ◽  
Anterior Flap ◽  
Aesthetic Results ◽  
The Web ◽  
Posterior Midline

Objective: Webbed neck deformity exists in many syndromes including Turner's or Klippel-Feil syndrome. Multiple problems are encountered with existing techniques to correct a webbed neck deformity. In Turner's syndrome, a subcutaneous band of thickened fascia and a low neck hairline present a challenge to the surgeon when designing a repair. The authors propose the following new technique that addresses both issues. Material and Methods: Five patients with webbed neck underwent this new procedure. A Z-plasty is performed with the midline arm down the length of the web. The subcutaneous fibrous band is excised, the shortened trapezius is released, and the hair-bearing flap is excised. The anterior flap is rotated and advanced to join its mate flap from the contralateral neck at the posterior midline. A resultant dog-ear near the acromion is corrected with an additional Z-plasty. Results: In all five patients, the functional and aesthetic results were very satisfactory to both patient and surgeon. An 11-year follow-up is presented with excellent correction of the webbing. Both limited range of motion and the cosmetic deformity are addressed by this technique. Conclusion: The results obtained by using the simplified modified Z-plasty technique for repair of webbed neck deformity are very satisfactory. We propose the use of this technique for correction of webbed neck deformities whenever the posterior surface of the neck web contains a significant amount of hair.

P038 Let’s look at coxitis features in enthesitis-related arthritis population

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Makhlouf Yasmine ◽  
Hanene Ferjani ◽  
Kaouther Maatallah ◽  
Wafa Triki ◽  
Dorra Ben Nessib ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Hip Replacement ◽  
Disease Onset ◽  
Limited Range ◽  
Treatment Modalities ◽  
Radiographic Findings ◽  
Male Predominance ◽  
Enthesitis Related Arthritis ◽  
Limited Range Of Motion ◽  
The Mean

Abstract Background Enthesitis-related arthritis (ERA) is a defined juvenile idiopathic arthritis subtypes, which presents with enthesitis, arthritis and axial skeleton involvement. ∼20–50% of JIA patients have hip involvement within 1–6 years of diagnosis onset [1]. The frequency of coxitis in ERA category is not recognized. The aim of this study was to assess coxitis features and its management in ERA population. Methods A retrospective study including children with ERA according to the International League of Associations for Rheumatology (ILAR). Data recorded included sociodemographic features, disease characteristics (disease duration, extra-articular manifestations, and presence of HLAB27) as well as treatment modalities. Regarding coxitis, we collected radiographs, ultrasound (US) and magnetic resonance imaging (MRI) of the hip when performed. Coxitis was defined by clinical (limited range of motion) and/or radiographic findings (destruction, synovitis, bone marrow oedema). Results The study included 51 patients with ERA. There was a male predominance (78.4%). The mean age of onset of the disease was 12.2 years [6–16]. The mean current age was 24.3 years old [9–59]. A family history of spondyloarthritis was found in 26.8% of cases. A positive HLAB27 was reported in 85.7% of cases. The distribution of extra-articular manifestations (37.5%) was as follows: ocular (n = 8), cardiovascular (n = 2), gastrointestinal (n = 1), pulmonary (n = 4). A peripheral onset was found in 39% and a peripheral and axial onset was reported in 42% of patients. Hip involvement was found in 78.4% of the patients and revealed the disease in 43% of cases. The mean delay between disease onset and coxitis was 4.5 years [0–34]. Coxitis was bilateral and destructive in 82.5% and 51% of cases respectively. The most limited range of motion was the internal rotation (68%), followed by hip flexion (48%) and the external rotation (43.2%). In patients with normal hip radiography (n = 8), US or MRI depicted early changes in 75% of cases. Hip replacement was noted in ten patients and was bilateral in 70% of cases. Regarding treatment modalities, NSAIDs and csDMARD (MTX n = 14, SLZ n = 8, biologics n = 2) were prescribed in 76.4% and 52% respectively. Most of the patients had physical therapy (88%) and 23.5% of them had intra-articular corticoid injection. Twenty-six percent of the patients had hip replacement. Conclusion Our study showed a high prevalence of coxitis among ERA patients. There is a need to further optimize therapeutic strategies for such patients.

Bone Matrix Therapy for Aneurysmal Bone Cysts

2005 ◽  
Vol 95 (4) ◽  
pp. 394-397 ◽  
Author(s):  
Brian Carpenter ◽  
Travis Motley
Keyword(s):  
Demineralized Bone Matrix ◽  
Bone Cyst ◽  
Bone Matrix ◽  
Treatment Modalities ◽  
Bone Cysts ◽  
Athletic Activity ◽  
High School Athlete ◽  
Early Return ◽  
Aneurysmal Bone Cysts

Aneurysmal bone cysts are unique pathologic entities that cause pain and local osseous destruction. Many surgical treatment modalities have been described. This article reports on the case of a 16-year-old high school athlete with left heel pain due to an aneurysmal bone cyst in the calcaneus. Curettage of the bone cyst was performed, and the void was filled with a commercially available mixture of cancellous bone and demineralized bone matrix. Early return to athletic activity was achieved, with no recurrence noted at 3-year follow-up. (J Am Podiatr Med Assoc 95(4): 394–397, 2005)

Simulated Compensatory Motion of Transradial Prostheses

2008 ◽  
Author(s):  
Derek Lura ◽  
Rajiv Dubey ◽  
Stephanie L. Carey ◽  
M. Jason Highsmith
Keyword(s):  
Range Of Motion ◽  
Shoulder Joint ◽  
Degrees Of Freedom ◽  
Biomechanical Model ◽  
Elbow Flexion ◽  
Limited Range ◽  
Joint Movement ◽  
Range Of Movement ◽  
Limited Range Of Motion ◽  
Compensatory Motion

The prostheses used by the majority of persons with hand/arm amputations today have a very limited range of motion. Transradial (below the elbow) amputees lose the three degrees of freedom provided by the wrist and forearm. Some myoeletric prostheses currently allow for forearm pronation and supination (rotation about an axis parallel to the forearm) and the operation of a powered prosthetic hand. Older body-powered prostheses, incorporating hooks and other cable driven terminal devices, have even fewer degrees of freedom. In order to perform activities of daily living (ADL), a person with amputation(s) must use a greater than normal range of movement from other body joints to compensate for the loss of movement caused by the amputation. By studying the compensatory motion of prosthetic users we can understand the mechanics of how they adapt to the loss of range of motion in a given limb for select tasks. The purpose of this study is to create a biomechanical model that can predict the compensatory motion using given subject data. The simulation can then be used to select the best prosthesis for a given user, or to design prostheses that are more effective at selected tasks, once enough data has been analyzed. Joint locations necessary to accomplish the task with a given configuration are calculated by the simulation for a set of prostheses and tasks. The simulation contains a set of prosthetic configurations that are represented by parameters that consist of the degrees of freedom provided by the selected prosthesis. The simulation also contains a set of task information that includes joint constraints, and trajectories which the hand or prosthesis follows to perform the task. The simulation allows for movement in the wrist and forearm, which is dependent on the prosthetic configuration, elbow flexion, three degrees of rotation at the shoulder joint, movement of the shoulder joint about the sternoclavicular joint, and translation and rotation of the torso. All joints have definable restrictions determined by the prosthesis, and task.

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