scholarly journals Case Report : Multiple Stress Fractures (hamate, triquetrum, 2nd, 3rd, and 4th Metacarpal bones) in an Amateur Tennis Player

Author(s):  
Hatim Mohammed A. AlShareef ◽  
Alhusain Mohammad Alshareef ◽  
Mohammed Hussein AlKaff

Background: upper extremity stress fractures are infrequent events in tennis sport. According to our literature, we have only identified 6 case reports of upper limb stress fractures among amateur or professional tennis players. To the best of our knowledge, this is the only case report where stress fractures occur in: hamate, triquetrum, 2nd, 4th, and 5th metacarpal bones simultaneously. Case presentation: 27 years old lady, presented with acute burning pain at the base of her right thumb. There was not a history of direct trauma. Her symptoms start to appear after 3 days of playing tennis. Physical examination was negative for tenderness, swelling and erythema. The rheumatoid factor was elevated (20.3 iu/ml). the diagnosis of multiple stress fractures was made by the suggestive MRI findings. Conclusion: Although stress fractures of the upper limbs are not common, it is of a great value to keep the clinical suspicion high towards it. Especially in amateur or professional athletes with persistent or worsening symptoms. The best modality to confirm such fractures is MRI.

2021 ◽  
pp. 20210057
Author(s):  
Amar Ajay Chotai ◽  
Dipayan Mitra

We present a 1-year-old boy who presented to the emergency department with a 7-day history of diarrhoea and vomiting. The initial renal function profile demonstrated a urea of 55 mmol l−1 (normal range between 5 and 20 mmol l−1), creatinine 695 micromol/L (normal range between 62–106 micromol/L) and potassium 9.1 mmol l−1 (normal range between 3.5–5.0 mmol l−1), with a profound metabolic acidosis. Upon examination, there were no significant findings, specifically no neurological abnormality. He was prescribed back-to-back Salbutamol nebulisers, to increase the shift of extracellular potassium into the intracellular space, followed by i.v. calcium gluconate, with some improvement in potassium levels. A further 5 mmol of sodium bicarbonate was given, as well as a stat dose of 1 mg/kg furosemide, and per rectal calcium resonium. He was then commenced on an infusion with 10% dextrose with insulin. He was subsequently found to be in urinary retention and a catheter was inserted, which drained 1700 ml. A subsequent renal function profile, 24 hours after admission, demonstrated improvement with urea 39 mmol l−1, creatinine 300 micromol/L and potassium 3.0 mEq/L.


2014 ◽  
Vol 27 (02) ◽  
pp. 155-158 ◽  
Author(s):  
U. Geissbühler ◽  
P. Karli ◽  
F. Forterre ◽  
E. Linon

SummaryA two-year-old female Lucerne Hound was presented with a one-week history of signs of progressive neck pain, inappetence, apathy, and an elevated rectal temperature. Findings of magnetic resonance imaging (MRI) were consistent with a foreign body abscess in the epidural space at the level of the first and second cervical vertebrae. A leftsided dorso-lateral atlantoaxial approach was performed, revealing an epidural abscess containing a grass awn. The clinical signs resolved within three days of surgery and the dog made a full recovery. This case report shows that grass awns can migrate to the atlantoaxial region in dogs and MRI findings lead to a suspicion of caudo-cranial migration within the spinal canal.


2020 ◽  
Vol 13 (3) ◽  
pp. 1239-1243
Author(s):  
Shenthol Sasankan ◽  
Lorraine Rebuck ◽  
Gloria Darrah ◽  
Moises Harari Turquie ◽  
Ian Rabinowitz

We report on the clinical history of a 49-year-old female with metastatic pancreatic cancer. She was initially treated with standard chemotherapy as per current guidelines. She was found to have both a BRAF and P53 mutation, and received dabrafenib and trametinib with deep responses, both radiographically and biochemically (CA19-9). Her response has been more clinically relevant than responses in previous case reports of patients with BRAF-positive pancreatic cancer treated with targeted therapy. To the best of our knowledge, this is the first case report showing a dramatic therapeutic response to combination therapy with dabrafenib and trametinib in metastatic pancreatic cancer.


2018 ◽  
Vol 140 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Iuliana Vaxman ◽  
Daniel Shepshelovich ◽  
Lucille Hayman ◽  
Pia Raanani ◽  
Meir Lahav

Currently, there are only 2 case reports of Waldenström macroglobulinemia (WM) associated with severe neutropenia. This is a case report of a woman with a past medical history of WM who presented with neutropenic fever. The patient’s febrile neutropenia resolved after RCD chemotherapy (cyclophosphamide 750 mg/m2, dexamethasone 20 mg, and rituximab 375 mg/m2). Fourteen days after administration, the neutrophil level had started to rise and normalized after 6 days. To the best of our knowledge, this is the 3rd reported case of agranulocytosis due to WM.


Revista CEFAC ◽  
2019 ◽  
Vol 21 (2) ◽  
Author(s):  
Mariana Campos Limongi ◽  
Flávio Ricardo Manzi ◽  
José Benedito Fonseca Limongi

ABSTRACT The etiology of alterations of the temporomandibular joint, such as ankylosis and bifid condyle, comprises several causes including trauma. However, otological infections cannot be overlooked as a probable cause of alterations of the temporomandibular joint, because the proximity between the external auditory canal and the temporomandibular joint facilitates the spread of infection in the region. This article presents a case-report of a patient with bifid condyle of the temporomandibular joint, in which the patient had no history of facial trauma, but had suffered recurrent otitis infections during her childhood. In parallel, a second case-report is described of temporomandibular joint ankylosis in a 12-year-old patient with a history of facial trauma during her childhood. The purpose of this study was to highlight and emphasize the importance of early diagnosis of temporomandibular joint disorders to avoid the development of facial asymmetries, restore function, esthetics, and the psychological state of the patient.


2015 ◽  
Vol 86 (11) ◽  
pp. e4.169-e4
Author(s):  
Aseel Al-Ansari ◽  
Richard Jon Llewellyn Walters

A 45-year old woman presented with a twelve-month history of intense migraines. She described episodes of blurred vision in association with the headaches, during which she invariably found that one or other of her pupils became dilated with a degree of eyelid retraction on the affected side. These unusual symptoms resolved spontaneously with improvement of the headache.After exclusion of a lesional cause with brain and neck imaging, we concluded that her symptoms were secondary to autonomic dysfunction in relation to her headache.Horner's syndrome is due to paralysis of the ipsilateral cervical sympathetic chain and comprises ptosis, miosis, enopthalmos and anhidrosis. A Reverse Horner's syndrome, otherwise known as Pourfour du Petit, in theory, is the opposite, and comprises eyelid retraction, mydriasis and hyperhidrosis. Where documented, it is attributed to irritation, rather than complete deficiency of the ipsilateral sympathetic chain. Previous case reports have shown that Pourfour du Petit can occur due to the same mechanisms as a Horner's syndrome. In only one other case report has it been described as an autonomic feature in relation to headache.


2021 ◽  
Vol 8 ◽  
Author(s):  
Min Fu ◽  
Pan Hu ◽  
Gang Zhang ◽  
Ludonghan Huang ◽  
Huan Xu ◽  
...  

Significance: Perifoveal exudative vascular anomalous complex (PEVAC) is a unique clinical lesion. It manifests as isolated lesions and is easily misdiagnosed. Thus far, few PEVAC case reports have been published. PEVAC is typically inconsistent with other reported macular lesions.Purpose: To report our 24-month follow-up experience on the treatment of PEVAC with a micropulse laser (MPL).Case Report: A 56-year-old Chinese woman with no history of other diseases complained of decreased vision in her left eye that had persisted for more than 1 year. Comprehensive ophthalmic examinations were performed, including a vision test, slit lamp fundus exam, optical coherence tomography (OCT), optical coherence tomography angiography (OCT-A), fluorescein fundus angiography (FFA) and indocyanine green angiography (ICGA). Intravitreal injection of ranibizumab was ineffective, and bleeding, exudation and visual acuity were not improved. After two rounds of micropulse laser (MPL) treatment, the patient was followed up, and the prognosis was good.Conclusion: PEVAC is very rare, and early diagnosis is important, as the lesions readily cause irreversible damage. Our results indicate that an MPL can be used as an alternative treatment for PEVAC patients.


2021 ◽  
Vol 91 (1) ◽  
Author(s):  
Sandeep Sharma ◽  
Parikshit Thakare ◽  
Ketaki Utpat ◽  
Unnati Desai

The coexisting presence of hydatid disease with aspergillus colonization is a rare finding. The 20-year-old presented with symptoms of hemoptysis with past history of tuberculosis. On further evaluation, the patient was diagnosed as a case of aspergilloma and managed conservatively. After one year of presenting with similar complaints, the patient was turned out to be hydatid disease with aspergillus colonization on the basis of clinic-radiological and bronchoscopic evaluation. Till now only a few case reports have been reported. We report a unique case report of a similar presentation.


Author(s):  
Akshay Rao

Background. Brachial Monomelic Amyotrophy (BMMA) has been called as Hirayama disease (HD) when it is characterized by unilateral distal upper limb weakness and atrophy that shows progression for a limited period and is associated with typical features on MRI of cervical spine in flexion. Objective was to explore the differences when BMMA affects the proximal upper limb muscles with the help of case report. Methods. A case report of BMMA in an adult Indian male is represented. Results. A 30-year-old man presented to us with a history of weakness in the proximal aspect of his left upper limb that began four years ago. The weakness was progressive up until 6 months prior to his presentation since when the weakness had neither worsened nor improved. Cervical spine contrast enhanced MRI revealed mild loss of cervical lordosis, but no features of HD like localized cord atrophy, loss of attachment of dura from subjacent lamina on neutral position axial T2WI MRI, nor any presence of posterior epidural crescentic enhancing mass on flexion contrast sagittal T1WI MRI. The patient was managed with supportive therapy and has been under regular follow up ever since. His clinical status has been stable. Conclusions. We support the suggestion to consider proximal Brachial Monomelic Amyotrophy to be a separate entity and to be distinguished from Hirayama disease that should be reserved for patients with distal upper limb involvement with cervical MRI findings on flexion studies.


Author(s):  
Ozlem Ece Basaran ◽  
Emine Seda Guvendag Guven ◽  
Suleyman Guven

<p>Hematometra is a condition of retained blood or clot in the uterus. If just the cervix is affected by collection, the condition is described as hematocervix. The hematocervix should be suspected in a women with amenorrhea and recurrent lower abdominal pain. The objective of this case report was to report a rare case of isolated hematocervix following cesarean delivery.</p><p>A 27-years-old primigravidae woman was admitted with the complaints of severe pelvic pain and amenorrhea. She had the history of full term delivery via cesarean section because of prolonged latent phase of labor almost 3 months ago. Pelvic examination, transvaginal sonography and MRI findings were confirmed the diagnosis of hematocervix cervical dilatation and curettage following vaginal misoprostol was done and the women was discharged with good health status.</p><p>The increased rates of cesarean delivery in all over the world caused increase in rare complication such as isolated hematocervix. Dilatation and drainage of cervical collection is safe and effective treatment in such cases.</p>


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