Posterior Tibialis Tendon Rupture in a Closed Bimalleolar-Equivalent Ankle Fracture: Case Report

2017 ◽  
Vol 10 (6) ◽  
pp. 572-577 ◽  
Author(s):  
Richard M. Wardell ◽  
Andrew E. Hanselman ◽  
Scott D. Daffner ◽  
Robert D. Santrock

Ankle fractures with an associated posterior tibialis tendon (PTT) rupture are rare injuries and have only been described in a number of case reports. These prior reports include patients that had an open fracture and/or an associated medial malleolar fracture component. In this unique case report, we present a patient that sustained a closed bimalleolar-equivalent ankle fracture/dislocation without medial malleolar involvement which was irreducible due to a PTT rupture and subsequent distal segment interposition in the tibiotalar joint. Identification of acute PTT rupture with associated ankle fracture is important because early repair is associated with significantly better functional outcomes compared with late repair. These injury patterns may easily be missed due to the limitations with physical examination and standard imaging often encountered during initial evaluation of routine ankle fractures. Therefore, physicians should maintain a high level of suspicion in the appropriate clinical setting in order to provide appropriate diagnosis and timely surgical intervention. Levels of Evidence: Descriptive, Level V: Single case report

2020 ◽  
Vol 25 (04) ◽  
pp. 508-512
Author(s):  
Jason D. Wink ◽  
Olatomide Familusi ◽  
Ines C. Lin

We present a case of a 26-year-old right hand dominant male landscaper with a slow growing right ring finger subungual mass. MRI confirmed a 0.9 × 1.5 × 0.9 cm well circumscribed subungual mass believed to be consistent with a glomus tumor, although size and symptoms were not consistent with that diagnosis. The mass was completely excised and diagnosis of schwannoma was confirmed by H&E histology. A literature search was performed utilizing the term “subungual schwannoma.” Four case reports were found describing this diagnosis in the hand as well as a single case report describing it in the foot. In summary, this is a 26-year-old male who presents with a schwannoma in the unusual subungual location. Although rare, based on our case and the existing literature, subungual schwannomas should be included in the differential diagnosis of a slow growing subungual mass, particularly if symptoms and exam are inconsistent with more common etiologies.


2019 ◽  
Vol 10 (1) ◽  
pp. 24-31 ◽  
Author(s):  
Luis Arrevola ◽  
María Almudena Acero ◽  
María Jesús Peral

Punctate inner choroidopathy (PIC) is a rare inflammatory chorioretinopathy that predominantly affects young myopic women. Visual prognosis is generally good, but occurrence of choroidal neovascularization (CNV) is common and may be vision threatening. Case reports and short case series support the effectiveness of intravitreal anti-vascular endothelial growth factor (VEGF) agents (ranibizumab and bevacizumab) for CNV associated with PIC given their anti-angiogenic and anti-inflammatory effects. Evidence concerning aflibercept, a more recent intravitreal anti-VEGF, is limited to a single case report. In this case report, we illustrate the case of a 43-year-old myopic woman presenting with visual acuity loss and distortion in the right eye over the last 5 days in whom CNV associated with PIC was diagnosed. Treatment with 1 injection per month of intravitreal aflibercept for 2 months and full-dose oral prednisone for 1 week, being tapered afterwards, improved visual acuity and resolved CNV, with benefits lasting up to 24 months.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Wejdan Almotairi ◽  
Abdullah Alhamam ◽  
Aali Alotaibi ◽  
Tarek El Sharkawy ◽  
Hind S. Alsaif ◽  
...  

Background. Adrenal cavernous hemangiomas (AH) are benign nonfunctional vascular tumors rarely discovered as incidental findings on imaging studies or autopsies. This study presents a single case report of AH with another rare finding of the Liesegang ring. Also, we reviewed 73 case reports of cavernous adrenal hemangioma to provide an overview of AH’s clinical characteristics. Case Report. A nonfunctional AH was incidentally discovered in a 59-year-old morbidly obese female patient with a 10-year history of hypertension and thyroidectomy. An abdominal computed tomography (CT) scan showed a left suprarenal mass of ∼16 cm in diameter. While the patient had no clinical manifestations from the hemangioma, all laboratory tests were within the normal values with no indication of a functional adrenal tumor. The mass was removed by open left adrenalectomy. The microscopic histological examination revealed a laminated structure with wide blood-filled spaces with a central core of necrotic and hemorrhagic changes, characteristic of a cavernous AH with the presence of a rare Liesegang ring. Conclusion. Although rare, AH should be considered as a differential diagnosis for adrenal masses. This is the first reported case of a cavernous AH with rare microscopic findings of the Liesegang ring.


2020 ◽  
Author(s):  
Brad Ridout ◽  
Joshua Kelson ◽  
Andrew Campbell ◽  
Kate Steinbeck

BACKGROUND Given the high level of interest and increasing familiarity with Virtual Reality (VR) among adolescents, there is great potential to use VR to address their unique health care delivery needs while in hospital. While there have been reviews into the use of VR for specific health conditions and procedures, none to date have reviewed the full scope of VR hospital interventions for adolescents, who despite experiencing virtual environments differently to younger children, are often combined with them as a homogenous group. OBJECTIVE The aim of this review was to systematically identify available evidence regarding the use of VR interventions for adolescent patients in hospital settings, to evaluate their effectiveness, suitability and safety, and to identify gaps and opportunities for future research. METHODS PubMed, PsycINFO, Medline and Scopus databases were searched using keywords and phrases. Retrieved abstracts (n=1,525) were double screened, yielding 276 articles for screening at the full-text level. Of these, eight articles met the review inclusion criteria. Data were extracted into a standardized coding sheet, and a narrative synthesis was performed due to the heterogeneity of the identified studies. RESULTS Four randomized controlled trials (RCTs) and four single case report interventions were identified for inclusion, all of which aimed to reduce pain and/or anxiety. The scenarios targeted were burn pain, venepuncture, chemotherapy, pre-operative anxiety, and palliative care. Three out of four RCTs found significant reductions in pain and/or anxiety outcomes measures when using VR compared to standard care or other distraction techniques. However, only one study combined self-reported experiences of pain or anxiety with any physiological measures. Single case reports relied primarily on qualitative feedback, with patients reporting reduced pain and/or anxiety and a preference for VR over no VR. CONCLUSIONS VR can provide a safe and engaging way to reduce pain and anxiety in adolescents while in hospital, particularly when VR software is highly immersive and specifically designed for therapeutic purposes. As VR becomes more accessible and affordable for use in hospitals, larger and more diverse studies that capitalise on adolescents’ interest and aptitude towards VR, and the full range of capabilities of this emerging technology, are needed to build on these promising results.


Author(s):  
Imen Ksiaa ◽  
Safa Ben Aoun ◽  
Sourour Zina ◽  
Dhouha Nefzi ◽  
Sana Khochtali ◽  
...  

Abstract Objective To describe a case of Behçet disease (BD) uveitis manifesting with sequential bilateral neuroretinitis associated with prepapillary inflammatory vitreous exudate (PIVE). Material and methods A single case report documented with multimodal imaging. Results A 37-year-old man developed neuroretinitis with associated PIVE in the left eye. He was diagnosed with ocular toxoplasmosis and treated accordingly based on positive serologic testing and negative work-up for other entities, including BD. The disease course was favorable, but 1 year later a similar neuroretinitis developed in the right eye. Extraocular features of BD became evident only at the time of the second eye involvement, and the patient received corticosteroid and immunosuppressive therapy. Swept source (SS) OCT showed at the acute phase in both eyes a typical “mushroom-shaped” prepapillary hyperreflectivity of the PIVE. SS OCT angiography (OCTA) demonstrated a corresponding prepapillary hypointense area due to shadowing effect, decreasing in size while scanning deeper layers. It also detected peripapillary retinal hypervascularity in both eyes and a sectoral area of flow signal loss in the first involved left eye. Visual acuity improved following the resolution of the PIVE and associated acute inflammatory changes in both eyes. The left eye showed residual optic disc pallor and retinal nerve fiber layer defects. Conclusion Sequential bilateral neuroretinitis associated with PIVE may occur before other clinical features of BD become evident. SS OCT and OCTA can provide useful information for the diagnosis and management of this rare, but typical, ocular manifestation of BD uveitis.


Cortex ◽  
1988 ◽  
Vol 24 (2) ◽  
pp. 347-355 ◽  
Author(s):  
A. Charnallet ◽  
S. Carbonnel ◽  
J. Pellat

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