scholarly journals Paravertebral compartment syndrome after exercise: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Tomofumi Ogoshi ◽  
Motoo Yoshimiya ◽  
Hiroshi Ichibakase ◽  
Takayoshi Kimura ◽  
Masafumi Kameoka ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Conservative Management ◽  
Creatine Phosphokinase ◽  
Good Resolution ◽  
Compartment Pressure ◽  
Case Presentation ◽  
Paravertebral Muscles ◽  
Old Japanese ◽  
Severe Back Pain ◽  
Spinal Muscles

Abstract Background Paravertebral compartment syndrome occurring without trauma is quite rare. We report a case of compartment syndrome that occurred after spinal exercises. Case presentation A 23-year-old Japanese rower developed severe back pain and was unable to move 1 day after performing exercises for the spinal muscles. Initial evaluation at a nearby hospital revealed hematuria and elevated creatine phosphokinase levels. He was transferred to our hospital, where magnetic resonance imaging revealed no hematoma but confirmed edema in the paravertebral muscles. The compartment pressure measurements were elevated bilaterally. Despite his pain being severe, his creatine phosphokinase levels were expected to peak and decline; his urine output was normal; and surgery was undesirable. Therefore, we opted for conservative management. The next day, the patient’s compartment pressure diminished, and his pain levels decreased to 2/10. After 5 days, he was able to walk without medication. Conclusions We present a rare case of compartment syndrome of the paravertebral muscles with good resolution following conservative management. We hope our case findings will help avoid unnecessary surgery in cases of paravertebral compartment syndrome.

Survival of both twins in a pregnancy complicated by pre-viable cord prolapse at 21 weeks of gestation

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Abdullah Alnoman ◽  
Ghazi Alsarraj ◽  
Richard Brown
Keyword(s):  
Conservative Management ◽  
Perinatal Outcome ◽  
Positive Outcomes ◽  
Premature Rupture ◽  
Case Presentation ◽  
Vitro Fertilization ◽  
Obstetric Emergency ◽  
Cord Prolapse ◽  
Umbilical Cord Prolapse

AbstractBackgroundUmbilical cord prolapse is rare but a very serious obstetric emergency. Its incidence has declined over time and significant advances in its management have improved perinatal outcome.Case presentationA 38-year-old woman (gravida 3, para 0) conceived a dichorionic twin pregnancy through in vitro fertilization presented at 21 weeks of gestation with premature rupture of membrane of the presenting twin. At 21+4 weeks’ gestation, cord prolapse of the presenting twin into the vagina was identified by ultrasound. Parents chose conservative management, and planned cesarean section was done at 27+4 weeks.ConclusionOur case demonstrates that conservative management with measures to reduce the risks of infection and a planned delivery can result in positive outcomes even in cases where the cord prolapse occurs prior to viability.

scholarly journals Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Takehiro Hashimoto ◽  
Ryuichi Takenaka ◽  
Haruka Fukuda ◽  
Kazuhiko Hashinaga ◽  
Shin-ichi Nureki ◽  
...  
Keyword(s):  
Septic Shock ◽  
Therapeutic Strategy ◽  
Yersinia Pseudotuberculosis ◽  
Immunocompromised Host ◽  
Immunocompetent Patient ◽  
Case Presentation ◽  
Gram Negative ◽  
Old Japanese ◽  
The Right ◽  
Immunocompetent Patients

Abstract Background Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. Case presentation A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse. Conclusions We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

scholarly journals Neonate born with ischemic limb to a COVID-19 positive mother: management and review of literature

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shahana Perveen ◽  
Karmaine A. Millington ◽  
Suchitra Acharya ◽  
Amit Grag ◽  
Vita Boyar
Keyword(s):  
Differential Diagnosis ◽  
Compartment Syndrome ◽  
Upper Extremity ◽  
Preterm Neonate ◽  
Review Of Literature ◽  
Case Presentation ◽  
Ischemic Limb ◽  
History Of ◽  
Hand Amputation ◽  
Work Up

AbstractObjectivesTo describe challenges in diagnosis and treatment of congenital neonatal gangrene lesions associated with history of maternal coronavirus disease 2019 (COVID-19) infection.Case presentationA preterm neonate was born with upper extremity necrotic lesions and a history of active maternal COVID-19 infection. The etiology of his injury was challenging to deduce, despite extensive hypercoagulability work-up and biopsy of the lesion. Management, including partial forearm salvage and hand amputation is described.ConclusionsNeonatal gangrene has various etiologies, including compartment syndrome and intrauterine thromboembolic phenomena. Maternal COVID-19 can cause intrauterine thrombotic events and need to be considered in a differential diagnosis.

scholarly journals Falsely diagnosed thyrotoxicosis caused by anti-streptavidin antibodies and pre-wash procedures

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Takuya Ishikawa ◽  
Hiroyuki Sakai ◽  
Tokutaro Itaya ◽  
Suwanai Hirotsugu ◽  
Jumpei Shikuma ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Magnetic Particle ◽  
Thyroid Function Tests ◽  
Case Presentation ◽  
Analytical Interference ◽  
Function Tests ◽  
Inappropriate Treatment ◽  
Published Report ◽  
Old Japanese ◽  
Polyethylene Glycol Precipitation

Abstract Background Anti-streptavidin antibodies are causal determinants of analytical interference during Thyroid function tests, and numerous reports have detailed such interference, with anti-streptavidin antibodies attracting attention. Case presentation We conducted a straightforward investigation of interference due to anti-streptavidin antibodies, with a case of a 60-year-old Japanese man who consulted our department for inconsistencies between his clinical course and Thyroid function tests. Experiments were conducted using Cobas8000 e602, which employs assay procedures with pre-wash to evaluate FT4 and FT3 levels. Conclusions To our knowledge, this is the first published report to clearly investigate such interferences using a combination of polyethylene glycol precipitation, heterophilic blocking tube precipitation, streptavidin-coated magnetic particle precipitation, and different instruments with or without pre-wash. Clinicians should consider that interferences caused by anti-streptavidin antibodies could lead to a misdiagnosis of thyrotoxicosis. Moreover, discussions between laboratory specialists, clinicians, and manufacturers are required to identify interferences and avoid unnecessary examinations and inappropriate treatment.

scholarly journals Endoscopic Fascia Release for Forearm Chronic Exertional Compartment Syndrome: Case Report and Surgical Technique

Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. NP58-NP61 ◽  
Author(s):  
Elizabeth A. Miller ◽  
Anna L. Cobb ◽  
Tyson K. Cobb
Keyword(s):  
Case Report ◽  
Compartment Syndrome ◽  
Single Incision ◽  
Invasive Technique ◽  
Compartment Pressure ◽  
Chronic Exertional Compartment Syndrome ◽  
Exertional Compartment Syndrome ◽  
Before And After ◽  
History Of ◽  
Forearm Pain

Background: Chronic exertional compartment syndrome (CECS) of the forearm is traditionally treated with open compartment release requiring large incisions that can result in less than optimal esthetic results. The purpose of this study is to describe a case report of 2 professional motocross patients with forearm CECS treated endoscopically using a minimally invasive technique. Methods: Two professional motocross racers presented with a history of chronic proximal volar forearm pain when motocross riding. Other symptoms included paresthesia and weakness, which, at times, led to an inability to continue riding. Both failed conservative management. Compartment pressure measurements were performed before and after provocative exercises to confirm diagnosis of CECS. Release of both the volar and dorsal compartments was performed endoscopically through a single incision. Results: Symptoms resolved after surgery. The first patient resumed riding at 1 week, competing at 3 weeks, and continues to ride competitively without symptoms at 3 years postoperative. The second patient began riding at 1 week and won second place in the National Supercross finals 5 weeks after simultaneous bilateral release. Conclusions: This technique is simple and effective. The cannula used protects the superficial nerves while allowing release through a small, cosmetically pleasing incision.

scholarly journals Fasciotomy through Multiple Small Skin Incisions for the treatment of early acute osteofascial compartment syndrome in children

2020 ◽  
Author(s):  
Xiaowei Yuan ◽  
Jun Wu ◽  
Xiangyang Qu ◽  
Ming Li ◽  
Linjun Jiang ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Nerve Conduction Velocity ◽  
Pediatric Patients ◽  
Early Stage ◽  
Healing Time ◽  
Compartment Pressure ◽  
Excellent Outcome ◽  
And Function ◽  
Average Procedure Time

Abstract Background The purpose of the present study is to investigate the therapeutic effect of fasciotomy through multiple small skin incisions for the treatment of early osteofascial compartment syndrome in children.Methods From January 2009 to May 2017, 56 pediatric patients with early osteofascial compartment syndrome in their limbs were admitted into our department and treated with multiple small skin incisions for decompression at the early stage. The skin incisions, function and sensation of the limbs were followed up.Results The osteofascial compartment syndrome was diagnosed at 7.4±2.1 hours after injury, and then fasciotomy was performed at 1.4±0.4 hours later. The average procedure time of fasciotomy was 12.7±4.8 minutes. No postoperative incision infections or neurovascular injuries were observed in all the patients. The incisions completely healed in 7-10 days with an average healing time of 8 days without secondary suture. The patients were followed up for an average of 5.1 years. No Volkmann’s contractures in the injured climbs were found. The appearance, electromyography and nerve conduction velocity of the affected limbs were not significantly different from that of the contralateral limbs. All the patients were free of symptoms, were full recovery of sensation and function, being an “excellent” outcome at the latest follow-up. Conclusion Fasciotomy through multiple small skin incisions, which can be useful to decompress the compartment pressure with fewer complications, is a simple and effective strategy for the treatment of early osteofascial compartment syndrome in children.

scholarly journals Unicuspid aortic valve concomitant with aortic insufficiency presenting with infectious endocarditis: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Naoko Yuzawa-Tsukada ◽  
Toshikazu D. Tanaka ◽  
Satoshi Morimoto ◽  
Michihiro Yoshimura
Keyword(s):  
Case Report ◽  
Aortic Valve ◽  
Aortic Insufficiency ◽  
Infectious Endocarditis ◽  
Cardiac Abnormality ◽  
Case Presentation ◽  
Old Japanese ◽  
History Of ◽  
Nonbacterial Thrombotic Endocarditis ◽  
High Turbulence

Abstract Background A unicuspid aortic valve is a rare congenital cardiac abnormality. Despite its uncommon finding on an initial presentation, aortic insufficiency is accompanied with unicuspid aortic valve and this might reflect the natural history of progression in the morphology of unicuspid aortic valve. Case presentation We describe a 65-year-old Japanese man who was evaluated for endocarditis and found to have a unicuspid aortic valve concomitant with moderate aortic insufficiency, which was, owing to the lack of evidence of valve membrane destruction, independent of underlying infectious endocarditis. In addition, aortic insufficiency was progressed because of nonbacterial thrombotic endocarditis on the ventricular side, in areas of high turbulence around the heart valve. Conclusions Our case is unusual given the unicuspid aortic valve concomitant with aortic insufficiency, which was presumably independent of underlying infectious endocarditis because of the location of the vegetation and the lack of evidence of valve destruction. Therefore, attention should be paid to a variety of complications in the setting of unicuspid aortic valve.

A RAPID AND CONVENIENT METHOD FOR DETERMINING LIMB COMPARTMENT PRESSURE

2011 ◽  
Vol 23 (06) ◽  
pp. 435-444
Author(s):  
William Chu ◽  
Jiun-Hung Lin ◽  
Shih-Tsang Tang ◽  
Woei-Chyn Chu ◽  
Shuenn-Tsong Young ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Convenient Method ◽  
Strong Correlation ◽  
Cell Damage ◽  
Measurement Instrument ◽  
Critical Value ◽  
Compartment Pressure ◽  
Intracompartmental Pressure ◽  
Wall Displacement ◽  
Cells Death

Compartment syndrome (CS) is the pressure increasing within a confined anatomic space, which results in ischemia to the encompassed tissues and then leads to cells death. If left untreated, CS results in irreversible cell damage, further permanently postischemic scarring and contracture. The intracompartmental pressure is a major diagnostic consideration. Various methods of compartment pressure (CP) measurement have been developed since the late 1800s. They can be classified into invasive and noninvasive categories. Invasive methods are accurate but painful; whereas noninvasive approaches are more comfortable but less accurate. Both methods provide reproducible outcomes but also require specific CP measurement instrument to be performed. This research proposes a rapid and convenient method via examining ultrasonographic fascia wall displacement. For the viscoelastic nature of the compartment fascia, our experiment results have shown the ultrasonographic fascia displacement accurately reflects even small changes of the compartment diameter. There is a strong correlation between compartment pressure and fascia displacement ratio. It also recommends that the ratio of 1.4 could be chosen as the critical value for determining acute compartment syndrome. These results suggest that ultrasonography may serve as an adequate noninvasive tool to monitor CP variations.

scholarly journals Limb girdle muscular dystrophy: a case report initially presenting to an outpatient musculoskeletal physiotherapy clinic with spinal pain and functional weakness

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Simon O’Shea ◽  
Thomas M. Jenkins
Keyword(s):  
Case Report ◽  
Muscular Dystrophy ◽  
Spinal Pain ◽  
Limb Girdle Muscular Dystrophy ◽  
Case Presentation ◽  
Heterogenous Group ◽  
Muscular Disorders ◽  
Strengthening Exercises ◽  
Functional Movements ◽  
Spinal Muscles

Abstract Background The term limb girdle muscular dystrophy (LGMD) describes a group of genetic muscular disorders that require specialist input from neurologically trained clinicians. The plethora of potential symptoms of this heterogenous group can result in patients presenting initially to musculoskeletal (MSK) physiotherapists. Case presentation The following case report highlights the presentation of a 21 year old female attending with 2 years of spinal pain and an unusual pattern of weakness, namely when rising from a sitting position the hips were abducted and then internally rotated. Formal testing in clinic revealed no isolated weakness initially despite the odd functional movements. There were no neural limb pains and no upper or lower motor neuron concerns on testing. There were no other health concerns. Some gains were reported with recent physiotherapy strengthening exercises and these were persisted with but proved ineffective overall. The Biopsychosocial model was used judiciously to explore alternative pathologies and led to appropriate investigations, onward referral, diagnosis and appropriate management of LGMD. Extensive atrophy of the spinal muscles was evident on imaging which was not particularly identified within the physiotherapy testing process in the earlier stages. Creatine kinase levels were also significantly raised. Conclusions Being mindful of this novel presentation in musculoskeletal clinics may well aid future, similar cases to be identified. The case highlights the importance of looking at the functional impact as opposed to traditional testing methods especially in the early stages of such conditions.

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