Subungual Exostosis of the Great Toe

2011 ◽  
Vol 4 (6) ◽  
pp. 376-378 ◽  
Author(s):  
Roop Singh ◽  
Mantu Jain ◽  
Rakesh Goel ◽  
Ramchander Siwach ◽  
Rajneesh Kalra ◽  
...  
Keyword(s):  
Benign Lesion ◽  
Plain Radiograph ◽  
Excisional Biopsy ◽  
Great Toe ◽  
Therapeutic Level ◽  
Level Of Evidence ◽  
The Past ◽  
Calcified Lesion ◽  
Nail Removal

Subungual exostosis is an acquired, benign, and solitary bone tumor of the distal phalanx occurring beneath or adjacent to nail. A 18-year-old man presented with a lump, ulceration, and pain on his right big toe. This complaint was present for the past 2 years. Initially, lump and pain were present, and since the past 6 months ulceration and superadded infection occurred. Plain radiograph showed a calcified lesion that was continuous with the phalangeal cortical surface in the distal dorsal aspect of the big toe. Excisional biopsy with complete nail removal and reconstruction of the tip of the toe were done. Histopathology confirmed the diagnosis of subungual exostosis. Clinical or radiological recurrence was not observed after 26 months of follow-up. The case is reported to present the tumor overview and to highlight that the diagnosis of this benign lesion should not be missed. Clinical and radiological features allow early diagnosis and treatment thus preventing the lesion to progress to the stage of onycholysis. Level of Evidence: Therapeutic, Level IV

scholarly journals Nora’s lesion of the distal ulna: a case report

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110643
Author(s):  
Cheng Han Lin ◽  
Karl Wu
Keyword(s):  
Benign Lesion ◽  
Excisional Biopsy ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Distal Ulna ◽  
Nora’S Lesion ◽  
Calcified Lesion ◽  
Bone Cortex ◽  
Painless Mass ◽  
Hands And Feet

Nora’s lesion, also known as bizarre parosteal osteochondromatous proliferation (BPOP), is a very rare benign lesion with few published cases. BPOP is more common in adults during the second to third decades of life, and usually occurs on the hands and feet. Radiologically, it appears as a calcified mass attached to the bone cortex that grows rapidly and that recurs easily following resection. Aggressive features on imaging and confusing histopathological findings usually result in misdiagnosis or mistreatment. Herein, we present a case of a rare bony tumour involving the distal ulna presenting as a painless growing mass. An excisional biopsy with clear margins was performed without disturbing the ulnar nerve and arteries. There was no recurrent mass or calcified lesion 1 year after surgery. Based on its rarity and difficult diagnosis, BPOP should be considered in the differential diagnosis of a painless mass in the distal ulnar region. Careful follow-up after surgery is essential, even without lesion recurrence.

scholarly journals The Use of a Synthetic Cartilage Implant for Hallux Rigidus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0045
Author(s):  
Niall Smyth ◽  
Jonathan Kaplan ◽  
Amiethab Aiyer
Keyword(s):  
Polyvinyl Alcohol ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Hallux Rigidus ◽  
Reference List ◽  
Great Toe ◽  
Level Of Evidence ◽  
High Level ◽  
Ability Measure

Category: Other Introduction/Purpose: Hallux rigidus is one of the most common pathologies afflicting the foot. Various joint salvage techniques have been described with a multitude of different implants. Recently, a synthetic cartilage implant composed of polyvinyl alcohol (PVA) received FDA premarket approval for treatment of arthritis of the great toe and has been used in over 4,000 cases. The purpose of this study was to systematically review the clinical evidence supporting the use of a PVA implant in hallux rigidus. Methods: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Using the terms “cartiva OR polyvinyl alcohol OR synthetic cartilage OR hemiarthroplasty AND hallux rigidus OR great toe arthritis OR first toe arthritis “ we searched the PubMed/Medline database in December 2017. In addition, the reference list of publications were scanned for further relevant studies. Results: 4 studies met the inclusion criteria, all of which were derived from a single randomized controlled trial. At short-term follow-up (2 years), patients undergoing placement of a PVA implant had significant improvement in Foot and Ankle Ability Measure (FAAM) sports and activity of daily living, as well as VAS pain scores. The outcomes of the surgery were found to be noninferior compared to arthrodesis. At intermediate follow-up (5 years), the improvement in clinical outcomes persisted and implant survivorship was 96%. Conclusion: There are limited studies available detailing the outcomes of a PVA implant for hallux rigidus, however the results that are available demonstrate a high level of evidence. There are no long-term publications assessing the outcomes of a PVA implant for hallux rigidus.

Long-Term Functional Outcome of Bilateral Spontaneous and Simultaneous Achilles Tendon Ruptures

2012 ◽  
Vol 5 (5) ◽  
pp. 318-320
Author(s):  
Prasad Ellanti ◽  
Nikos Davarinos ◽  
Thomas E. Burke ◽  
Lester G. D’Souza
Keyword(s):  
Risk Factors ◽  
Achilles Tendon ◽  
Functional Outcome ◽  
Chronic Diseases ◽  
Therapeutic Level ◽  
Level Of Evidence ◽  
Good Functional Outcome ◽  
Tendon Ruptures

Bilateral simultaneous ruptures are rare comprising less than 1% of all Achilles tendon ruptures. Risk factors for bilateral ruptures include chronic diseases and medications such as corticosteroids and fluoroquinolones. There is little in the literature on the long-term functional outcome of bilateral Achilles tendon ruptures. This article present a series of 3 cases of simultaneous and spontaneous bilateral Achilles tendon ruptures with a minimum of 5-year follow up suggesting a good functional outcome. Level of Evidence: Therapeutic Level IV

Surgery of the Forepart of the Foot in Rheumatoid Arthritis

Foot & Ankle ◽  
1982 ◽  
Vol 3 (3) ◽  
pp. 173-180 ◽  
Author(s):  
Nathaniel Gould
Keyword(s):  
Rheumatoid Arthritis ◽  
Metatarsal Head ◽  
Metatarsal Osteotomy ◽  
Great Toe ◽  
Extensor Tendons ◽  
Lateral Drift ◽  
First Metatarsal ◽  
The Past ◽  
Silastic Implant

The purpose of this paper is to introduce a surgical approach to treatment of severe forefoot deformities of rheumatoid arthritis. Briefly, the surgery consists of base of the first metatarsal osteotomy to correct metatarsus primus varus, and metatarsal head resection beginning with the fifth metatarsal and carried around in crescentic fashion through the necks of the other metatarsals, so that as an end result the great toe is the longest, the second next to the longest, etc. The short extensor tendons are dissected to their insertions and, since they have drifted laterally into the “valleys” pulling the toes into lateral drift with them, they are usually sacrificed. The long extensor tendons are appropriately lengthened to proper tension. All the toes are straightened by plantar capsulotomies, dermotomies, and long flexor tenotomies, and the toes held straight with C-.045 wire in shishkabob fashion. Then, under direct vision, each wire is drilled up into the metatarsal shaft, aligning the toes into parallel cosmetic fashion. In the early cases, a single stem silastic implant was utilized but for the past 5 years now the double stem silastic implant is employed for the first MTP joint and is inserted “upside down” in order to give its greater power towards the floor. A cast is not used, but the patient ambulates on a well-padded bandaged foot by the second or third day. Twenty patients (40 feet) were operated upon (17 females and 3 males, ages 28 to 72 years, average 47 years), with a follow-up of 3 to 5 years. Pain relief has been remarkable. Good great toe function has been obtained in all cases with excellent power to the floor and a satisfactory range of dorsiflexion ability. About 67% have developed some mild recurrence of hallux valgus, but none so severe that it has been disabling. All patients have been pleased with their final results.

scholarly journals Bizarre Parosteal Osteochondromatous Proliferation (Nora Lesion) in Upper and Lower Limbs: A Report of Three Cases and Review of Literature

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maryada Venkateshwar Reddy ◽  
Anjaneyulu Kandukuri ◽  
Vidyasagar Chandankere ◽  
Vinay Mathew Joseph ◽  
Annappareddy Venkata Gurava Reddy
Keyword(s):  
Benign Lesion ◽  
Plain Radiograph ◽  
Lower Limbs ◽  
Radiological Evaluation ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
Diagnostic Dilemma ◽  
Small Bones ◽  
The Right ◽  
High Index Of Suspicion

Introduction: Bizarre parosteal osteochondromatous proliferation (BPOP) is a rare bone pathology affecting small bones of hand and feet. This benign lesion needs to be distinguished from many malignant bone tumors as it poses a diagnostic dilemma due to its clinical, radiological, and histological picture. We report three cases of BPOP affecting the hand and foot. Case 1: A 21-year-old gentleman presented with painful swelling in the long finger of the right hand. A plain radiograph showed a radio dense mass which was later excised and diagnosis confirmed in histopathology. There was no recurrence in 2 years of follow-up. Case 2: A 5-year-old boy presented with painful swelling over the right ankle with no history of antecedent trauma. Following radiological evaluation, the patient was successfully treated with excision. Case 3: A 35-year-old lady presented with a painful swelling on the dorsal aspect of her hand which was gradually increasing in size. After radiological evaluation, the patient was successfully treated with excision and lesion confirmed to be BPOP on histological examination. She was symptom free without recurrence in up to 2 years of follow-up. Conclusion: Nora’s lesion is a rare pathology requiring high index of suspicion. Excision is the recommended mode of treatment. All our cases responded well with excision with immediate pain relief following surgery and no recurrence in up to 2 years of follow-up. Keywords: Nora, bizarre parosteal osteochondromatous proliferation, neoplasm, tumor, benign.

scholarly journals Oral Verrucous Carcinoma: A Study of 12 Cases

2010 ◽  
Vol 04 (02) ◽  
pp. 202-207 ◽  
Author(s):  
Alper Alkan ◽  
Emel Bulut ◽  
Omer Gunhan ◽  
Bora Ozden
Keyword(s):  
Verrucous Carcinoma ◽  
Precancerous Lesion ◽  
Excisional Biopsy ◽  
Follow Up Study ◽  
Floor Of The Mouth ◽  
The Past ◽  
Verrucous Hyperplasia ◽  
Retromolar Trigone ◽  
Diagnostic Difficulties

Objectives: The purpose of this clinical study was to identify a clinical and histopathological relationship between verrucous hyperplasia, verrucous keratosis, and verrucous carcinoma.Methods: We evaluated 12 patients who had developed oral verrucous carcinoma in the past 10 years in a follow-up study. In this study, the diagnostic criteria included clinical and histopathological features of the lesions. Each lesion was examined by a single oral pathologist.Results: All the patients were diagnosed with verrucous carcinoma following excisional biopsy. One patient was diagnosed with verrucous hyperplasia and another with verrucous keratosis in their initial histological findings. Mandibular, posterior alveolar crest, and retromolar trigone were the most affected sites (41.6%), followed by the buccal mucosa (16.6%), the palate (16.6%), the floor of the mouth (16.6%), and the lip (8.3%). No patients had evidence of recurrence after treatment.Conclusions: Verrucous hyperplasia, verrucous keratosis, and verrucous carcinoma may not be distinguished clinically or may coexist, resulting in diagnostic difficulties. It should be kept in mind that verrucous hyperplasia may also develop from leukoplakic lesions, and it may transform into verrucous carcinoma or squamous-cell carcinoma, acting as a potential precancerous lesion. (Eur J Dent 2010;4:202-207)

scholarly journals An Unusual Clinical Presentation of Merkel Cell Carcinoma: A Case Report

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Deba P. Sarma ◽  
Dawn E. Heagley ◽  
Julianne Chalupa ◽  
Meredith Cox ◽  
James M. Shehan
Keyword(s):  
Elderly Patients ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Clinical Presentation ◽  
Benign Lesion ◽  
Excisional Biopsy ◽  
The Sun ◽  
Merkel Cell ◽  
Exposed Skin

Introduction. Merkel cell carcinoma is a rare, aggressive neuroendocrine cell carcinoma arising in the sun-exposed skin of elderly patients. Most of these tumors are located in the dermis. An unusual clinical presentation of such a tumor in the subcutis, if not biopsied, may be easily mistaken as a benign lesion.Case Presentation. An 83-year-old white woman presented with a several-month history of a painless 7 mm subcutaneous mass that was initially thought to be a lipoma. A conservative follow-up was planned. At the insistence of the patient, an excisional biopsy of the mass was performed revealing a subcutaneous Merkel cell carcinoma. The tumor cells stained positively for CK 20, chromogranin, and synaptophysin. No other primary or metastatic tumors found after a thorough work-up. The patient was treated with local irradiation. She remains disease free at her six-month follow-up visit.Conclusion. When a new growth is encountered in the sun-exposed skin of elderly patients, a biopsy is warranted even if the lesion clinically appears benign.

scholarly journals An Unusual Case of Extranodal Rosai-Dorfman Disease Manifesting as an Epibulbar Mass

2015 ◽  
Vol 6 (3) ◽  
pp. 351-355 ◽  
Author(s):  
Hang M. Tran ◽  
Sahmon Chinichian ◽  
Kris Storkersen ◽  
Keith Tokuhara
Keyword(s):  
Unusual Case ◽  
Clinical Course ◽  
Excisional Biopsy ◽  
Incisional Biopsy ◽  
Black Race ◽  
Subcutaneous Nodules ◽  
The Past ◽  
Rosai Dorfman Disease ◽  
Histopathologic Evaluation

Purpose: To report an unusual presentation of a 48-year-old man with a salmon-colored epibulbar mass, whose pathology was consistent with extranodal Rosai-Dorfman disease (RDD). Method: We conducted a retrospective and interventional case report. Results: A 48-year-old white man presented with progressive left eye irritation, redness, and multiple large subcutaneous nodules on his arms and torso over the past year. He did not have any lymphadenopathy, lymphocytosis, or fever. Visual acuity and intraocular pressures were normal in both eyes. He had mild vertical diplopia on downward gaze. Slit lamp examination revealed a non-tender salmon-colored epibulbar mass of 1.0 × 1.2 cm. Incisional biopsy was performed. Histopathologic evaluation revealed emperipolesis, with positive CD68, positive S100, and negative CD1a staining. These findings were consistent with extranodal RDD. At the 24-month follow-up, there were no signs of recurrence, and his diplopia resolved. Conclusions: This case of RDD is rare because of the concurrent epibulbar mass with subcutaneous nodules on the torso and arms. Extranodal RDD with epibulbar mass involvement tends to be unilateral, occurring mainly in males, and evenly among people of white and black race. An epibulbar mass of any color should raise concern for systemic lymphoma and RDD. The clinical course for extranodal RDD is typically benign. Excisional biopsy is often done for diagnosis and treatment. Recurrence of the unilateral epibulbar mass after biopsy is rare, but common with bilateral epibulbar masses.

Clinical and Radiological Outcomes of Subtalar Arthroereisis for Management of Planovalgus Foot in Children With Cerebral Palsy: 3-Year Follow-up

2020 ◽  
pp. 193864002098091
Author(s):  
Hasan Magdi Elbarbary ◽  
Amr Said Arafa ◽  
Abo Bakr Zein Said ◽  
Mohamed Hegazy ◽  
Mina Waheeb Reiad ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Minimally Invasive ◽  
Prospective Study ◽  
Good Alternative ◽  
Therapeutic Level ◽  
The Past ◽  
Children With Cerebral Palsy ◽  
Subtalar Arthroereisis ◽  
A Prospective Study

Background Planovalgus deformity of the foot is common among cerebral palsy (CP) patients. It is an upcoming topic with debate and controversy that require further studies. Many clinical studies involving arthroereisis have shown acceptable results in short- and mid-term follow-up. The aim of this work was to evaluate the outcome of arthroereisis using a conventional screw placed percutaneously across the talocalcaneal articulation for the treatment of moderate planovalgus deformity in children with CP. Methods Between 2015 and 2018, a prospective study was conducted including 23 CP patients with bilateral flexible planovalgus deformity with follow-up period ranging from 24 to 40 months (mean of 36.7 months). The radiological and clinical outcomes were assessed. The patient/parent outcome was evaluated using the Oxford Ankle Foot Questionnaire for Children (OxAFQ-C). Results The results showed statistically significant improvement in both radiological and clinical data as well as patient’s symptoms and parent’s satisfaction. Conclusion Results obtained from literature from the past decades after arthroereisis for the correction of moderate planovalgus deformity in CP patients are promising. The few studies reported on that procedure shared the same harmony with our study giving a chance to be a good alternative to joint destructive procedures. Our technique is simple, effective, economical, and minimally invasive if used in selected pediatric CP patients. Levels of Evidence Therapeutic, Level IV

scholarly journals Pleomorphic lipoma of the bulbar conjunctiva

2018 ◽  
Vol 11 (1) ◽  
pp. e226548
Author(s):  
Emily Li ◽  
Jonathan Silbert ◽  
John Sinard
Keyword(s):  
Excisional Biopsy ◽  
Bulbar Conjunctiva ◽  
Histopathological Analysis ◽  
The Third ◽  
The Past ◽  
Pleomorphic Lipoma ◽  
The Right ◽  
Rare Diagnosis

A 55-year-old woman presented with a painless, pink mass of the right eye bulbar conjunctiva that had been gradually increasing in size for the past 10 years. Excisional biopsy with histopathological analysis revealed a rare diagnosis of pleomorphic lipoma. There was no recurrence at last follow-up evaluation 6 months postoperatively. To the best of our knowledge, this represents the third case of pleomorphic lipoma of the bulbar conjunctiva reported to date.

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