scholarly journals Monoarthritis of the Elbow Revealing Osteoid Osteoma: A Case Report and Literature Review

2021 ◽  
Vol 28 (4) ◽  
pp. E202145
Author(s):  
Najlae El Ouardi ◽  
Siham Sadni ◽  
Laila Taoubane ◽  
Aziza Mounach ◽  
Ahmed Bezza

Osteoid osteoma is a rare benign osteoblastic tumor that mainly occurs in the extra-articular segments of lower limb long bones. The elbow is an exceptional location for osteoid osteoma. The diagnosis is usually delayed since the elbow is a rare site for this tumor and unspecific clinical signs, such monoarthritis, may mimic other more common conditions. We report the case of a 16-year-old girl who presented with chronic monoarthritis of the elbow which was treated falsely as tuberculous arthritis and monoarticular rheumatoid involvement. The laboratory tests were negative. Computed tomography scan and magnetic resonance imaging showed the focal nidus at the coronoid process of the ulna with mild synovitis. The diagnosis of osteoid osteoma was not made until the disease had been progressing for eighteen months and the elbow had already become stiff. Arthroscopic excision of the lesion was performed, and histopathology of the nidus was consistent with osteoid osteoma. Since then, the patient has been pain-free with an improved elbow range of motion.

2008 ◽  
Vol 11 (03) ◽  
pp. 145-149
Author(s):  
Qibin Ye ◽  
Xiaodong Pang ◽  
Jianhua Gao ◽  
Hong Wang ◽  
Lihong Ning

We report the case of a 12-year-old girl with an unusual "third upper extremity" developed in her back around the axis. Radiography, ultrasound, computed tomography scan, and magnetic resonance imaging revealed the development of a complex deformity comprised of long bones and fluid, largely resembling an upper limb; as well as a fluid-filled membrane sac whose contents favored a fetus in fetu.


2021 ◽  
Vol 31 (03) ◽  
pp. 740-744
Author(s):  
Sarita Jilowa ◽  
Purnima Paliwal ◽  
Arun Kapur ◽  
G. C. Verma

AbstractOsteochondromas are common benign tumors developing as an abnormal bony growth in the metaphyseal region. Being more of a developmental anomaly rather than a true neoplasm, they are usually found around the growth plates of long bones such as the knee, hip, and shoulder. These are typically managed conservatively if they are asymptomatic; however, they require excision in symptomatic patients. A 38-year-old woman presented with a huge swelling causing disfigurement measuring 16 × 16 cm on the left side of chest wall. Radiographs and computed tomography scan showed a bony outgrowth at costochondral junction of second rib which was in continuity with the periosteum. Excision via mediastinal sternotomy and left thoracotomy was done. Histopathological features corroborated with the radiological diagnosis of osteochondroma. Osteochondroma should be considered in the differential diagnosis of chest wall tumors. Rib is an extremely rare site of presentation. The cartilaginous cap becomes fully ossified and is lost in longstanding lesions. Huge tumors at such a location can cause irritation of adjacent viscera which can lead to pleural effusion or hemothorax; therefore, a cautious and logical approach to diagnosis is warranted for appropriate therapeutic management.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Liping Xu ◽  
Xinwei Song ◽  
Yan Zhang ◽  
Na Lin ◽  
Ji-An Wang

Abstract Background Sjögren’s syndrome is a common autoimmune disease that can involve the nervous system, but rarely both the central and peripheral. Long-term use of high-dose corticosteroids and immunosuppressants are the main risk factors for Cryptococcus infection in patients with Sjögren’s syndrome, of which pulmonary infection is the most common, while multiple bone infections are rare. Case presentation A 46-year-old Chinese woman with a 2-year history of Sjögren’s syndrome presented to our hospital with numbness of limbs, shortness of breath, and weakness. Blood immunochemistry showed that antinuclear antibody (1:640), anti-Sjögren’s syndrome-A antibodies, and anti-centromere antibodies were strongly positive. Cranial magnetic resonance imaging revealed multiple demyelinating lesions in the white matter of bilateral cerebral hemispheres. Electromyography indicated serious peripheral nerve injury, especially in lower limbs. Computed tomography scan of lumbar vertebral displayed multiple high-density shadows, and the corresponding vertebrae on magnetic resonance imaging showed abnormal low signal intensity on T1 and T2 sequences. Positron emission tomography–computed tomography showed multiple lesions with high 18F-fluorodeoxyglucose uptake in lung and vertebral bodies. Both lung and bone biopsies suggested Cryptococcus infection, with the diagnosis of Sjögren’s syndrome with nervous system injury combined pulmonary and osseous cryptococcosis. She took a reduced dose of prednisone about 10 mg/day, terminated mycophenolate mofetil, and began to take immunoglobulin of 0.4 g/kg/day intravenously for 5 days, fluconazole (400 mg/day) for 6 months. Within 3 weeks, her chest radiography showed a marked improvement, and 3 months later, the pulmonary lesions disappeared on her computed tomography scan. Conclusions This case exhibits an extremely rare condition of neural involvement in Sjögren’s syndrome combined with pulmonary and osseous cryptococcosis. This report also highlights the crucial role of detailed clinical examination, serologic markers, and biopsy in avoiding misdiagnosis. Currently, there is no guideline for this situation; in this case, we controlled the disease successfully with antifungal drugs and adequate gamma globulin, followed by an appropriate dose of corticosteroids.


2016 ◽  
Vol 33 (S1) ◽  
pp. S386-S387 ◽  
Author(s):  
A. Almada ◽  
R. Simões ◽  
M. Constante ◽  
P. Casquinha ◽  
M.J. Heitor

IntroductionStuttering is a speech disorder characterized by involuntary repetition, prolongation or cessation of a sound. This dysfluency may be developmental or acquired. Acquired dysfluency can be classified as neurogenic or psychogenic.ObjectivesThis case report aims to describe and discuss a case of psychogenic stuttering, providing an updated review on this disorder.MethodsIn and outpatient interviews were performed by Neurology and Psychiatry. Investigation to exclude organic causes included lab exams, electrocardiogram, electroencephalography, computed tomography scan and magnetic resonance imaging. A literature review in Science Direct database, with the keywords “psychogenic stuttering”, was also conducted.ResultsA 63-year-old man was admitted to the Beatriz Ângelo Hospital with an acute stuttering. Speech was characterized by the repetition of initial or stressed syllables, little affected by reading out loud or singing. Comprehension, syntaxes and semantic were not compromised, as weren’t sensory and motor abilities. During admission, stuttering characteristics changed. Multiple somatic complaints and stress prior to the onset and bizarre secondary behaviors were also detected. Work-up didn’t show an organic etiology for that sudden change. An iatrogenic etiology was considered, as sertraline and topiramate were started for depression 1 month before. However, the stuttering pattern, the negative results, the psychological and the social life events suggested a psychogenic etiology.ConclusionsPsychogenic stuttering finds its origin in psychological or emotional problems. It is best classified as a conversion reaction. The differential diagnosis between psychogenic and neurological stuttering can be challenging.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2013 ◽  
Vol 3 ◽  
pp. 8 ◽  
Author(s):  
Dayananda Kumar Rajanna ◽  
Vaibhav Pandey ◽  
Sujit Janardhan ◽  
Sujatha N Datti

Giant fibroids are known to arise from the uterus, and very rarely from the broad ligament. Large fibroids often undergo hyaline, cystic, and at times, red degeneration. In the present case, cystic degeneration with intervening septations in an adnexal mass raised the suspicion of ovarian neoplasm as the ovaries were not seen as separate from the lesion. The ultrasonographic and contrast-enhanced computed tomographic findings of this case were characteristic of ovarian neoplasm. The differential diagnosis included rare possibility of giant fibroid with cystic degeneration. The diagnosis was confirmed on histopathological examination. The patient underwent excision of the broad ligament fibroid, hysterectomy, and bilateral salpingo-oophorectomy. Magnetic resonance imaging has a role in the diagnosis of such lesions.


2019 ◽  
Vol 8 (2) ◽  
pp. 1-5
Author(s):  
Marrakchi jihene ◽  
Mejbri Maha ◽  
Sana Mahfoudhi ◽  
Besbes Ghazi

Isolated sphenoid sinus mucocele (SSM) is a rare entity that can result in serious sequelae if diagnosis and treatment are inappropriately delayed. Typically, mucoceles are asymptomatic, and they are accidentally identified after computed tomography scan or magnetic resonance imaging of the maxillofacial area performed for other pathologic issues. We report a case of isolated SSM that only presented with headache for over a year, and also review the literature regarding surgical management of such entity.


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