scholarly journals Clinical examination of brachial and pelvic plexus tumors

2007 ◽  
Vol 22 (6) ◽  
pp. 1-5 ◽  
Author(s):  
Shelly Lwu ◽  
Rajiv Midha

✓A thorough history and physical examination are fundamental to the assessment of patients with brachial and pelvic plexus tumors. Typical of most peripheral nerve tumors, the presenting symptoms and signs are few, and if present, can be subtle. Presenting complaints may include a palpable mass lesion, either symptomatic or asymptomatic; sensory alterations; pain; motor deficits; visceral symptoms; or autonomic dysfunction. Motor deficits are usually a late feature in the pathogenesis of this lesion, and a progressive course of pain and significant sensory and motor deficits suggests a malignant pathological process. A detailed family history may reveal familial syndromes and neurocutaneous disorders that predispose the patient to neoplasia, such as neurofibromatosis. The physical examination should be conducted in a systematic fashion, looking for any cutaneous features and motor and sensory deficits. The mass should also be examined for form, consistency, and mobility. An irregular, firm, and immobile mass suggests a malignant lesion. Complete and accurate clinical information must be gathered to pinpoint the anatomical localization of the lesion and formulate a differential diagnosis.

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Uzodimma Ejike Onwuasoanya

Abstract Background Testicular torsion is a urological emergency and needs urgent intervention to prevent testicular loss and impaired future fertility. It is commonly seen in the neonatal and adolescent age groups. Testicular torsion can also present outside these common age groups with uncommon symptoms and signs. We report case series of patients managed at Lily Hospitals Limited, Warri, Delta State, Nigeria with atypical presentation of testicular torsion. Case Presentation The first patient was a 35-year-old male that presented with recurrent right testicular pain of 1-year duration, described as dull aching with no constitutional symptoms, physical examination findings were not pathognomonic of testicular torsion, he had scrotal exploration with right orchidectomy and left orchidopexy. The second patient was a 39-year-old male who presented with recurrent right testicular pain of 4-days duration, described as dull aching with no constitutional symptoms. Physical examination findings were not classical for testicular torsion, he had scrotal exploration with bilateral orchidopexy. Conclusion Testicular torsion although common in neonatal and adolescent age groups can also present outside these age groups with uncommon symptoms and signs, a high index of suspicion is thus invaluable in any patient presenting with testicular pain despite the age and severity to avoid missing the diagnosis as this can lead to testicular loss.


2016 ◽  
Vol 18 (3(71)) ◽  
pp. 240-243
Author(s):  
V. Fedorovych ◽  
L. Slivinska ◽  
N. Fedorovych

As a result of the ambulatory reception it was investigated 12233 animals, of which 5653 (46.2%) were dogs. In the neurological research it had shown the symptoms of the nervous system damage in 653 dogs (11.5%). In particular it was found that paresis and paralysis (23.4%) were the most common neurological symptoms in dogs. Number of animals with inclination of head, ataxia, myoclonus and epileptiform state was respectively 19.8; 14.7; 11.7 and 10.5%. The manifestations of the nervous system damage as nystagmus, tremor and lameness were registered in accordance with 8.3; 4.4 and 4.1% of sick dogs. The least number of dogs were with a disorder of vision (2,8%) and hearing (0,3%), which was associated with the pathology of the nervous system. The above mentioned symptoms of the nervous system diseases do not occur as a symptom, but it was marked their combination – syndromes. The conducted neurological research makes it possible to establish the location of the pathological process in the departments of nervous system (neurons anatomical localization).As a result of the research and the results found that most dogs manifest the symptoms of damage to the brain and spinal mozkupaytiyi. Based on the results of verification of the diagnosis will be made using the methods of visual diagnostics. 


Author(s):  
Naglaa Ali M. Hussein ◽  
Mohammed H. El Rafaey

Background: Adenomyosis is a common gynecologic disorder that primarily affects women of reproductive age that has reported incidence of 5-70% in surgical and postmortem specimens. The aim of this study was to evaluate the accuracy of various transvaginal sonographic findings in adenomyosis by comparing them with histopathological results and to determine the most valuable sonographic feature in the diagnosis of adenomyosis.Methods: All transvaginal US findings were correlated with those from histologic examination. The frequency of presenting symptoms and signs of adenomyosis were evaluated. Transvaginal US depicted 10 of 12 pathologically proved cases of adenomyosis. Adenomyosis was correctly ruled out in 33 of 38 patients.Results: Transvaginal US had a sensitivity of 83%, a specificity of 86%, and a positive and negative predictive value of 66% and 94%, respectively. Of the 10 patients with true-positive findings at transvaginal US, the myometrium demonstrated heterogeneous with or without the presence of cysts in nine (75%) patients, linear striation in four (33.3%) patients and globular uterus in six (50%) patients. Three (25%) of 12 cases of adenomyosis had an enlarged uterus, adenomyosis was a significant association with high parity.Conclusions: Adenomyosis can be diagnosed with a considerable accuracy by transvaginal ultrasound. The most common sonographic criteria of adenomyosis are heterogeneous myometrial appearance while the most specific criteria are myometrial cysts, sub-endometrial echogenic linear striations and globular configuration of the uterus.


2019 ◽  
Vol 47 ◽  
Author(s):  
José Artur Brilhante Bezerra ◽  
Ramon Tadeu Galvão Alves Rodrgues ◽  
Isabelle De Oliveira Lima ◽  
Luanda Pâmela César De Oliveira ◽  
Carlos Eduardo Bezerra De Moura ◽  
...  

Background: Multiple cartilaginous exostosis (MCE) is a rare neoplastic disease in dogs that is characterized by the presence of osteochondromas in multiple bones. MCE is a disorder of development during growth and maturation, the real etiology of which has yet to be elucidated, but is believed to have a genetic basis. Usually affected animals have a history of a palpable mass on the bone surface, causing anatomical deformities and compression of adjacent structures. Since MCE is a rare neoplastic disease in dogs it may be difficult to recognize in the clinic. The aim of this study was to report a case of MCE in a pediatric dog.Case: A female 4-month-old Rottweiler dog with a history of bone neoformation on the left hind limb, anorexia, weight loss, and difficulty walking received clinical care. The disease had its initial onset 2 months prior. At physical examination, the animal showed paresis of the hind limbs and a bony tumor on the lateral part of the left tibia. A complete blood cell count and serum biochemical profile were obtained. The only abnormality diagnosed was hyperproteinemia due to hyperglobulinemia. Other diagnostic tests were not authorized and the animal was euthanized. At the necropsy, an intrathoracic neoformation was observed from the sixth to the eighth rib on the right antimer. Some tumors were also observed on the fourth lumbar vertebra and between the first and the second sacral vertebra, and a left tibial tumor, which had been observed at physical examination. The sagittal section of the spine revealed the presence of extradural compression of the spinal cord due to vertebral proliferations with compression of the nerve roots. All of the proliferations had macroscopic similarities, being firm, sessile, irregular, and with complete adherence to deep planes. Tumor samples were submitted to histopathological analysis and the tissue morphology was compatible with osteochondroma. Based on the clinical, necroscopical, and histopathological findings, a diagnosis of MCE was established.Discussion: In MCE, animals less than one year of age are the most frequently affected, as was observed in the case reported. Clinical signs in MCE usually result from poor bone and cartilaginous anatomical formations and from compression of adjacent tissue structures. In the described patient, the proliferations located in the vertebrae and tibia and the consequent compression of nerve roots and nerves caused the neurological deficits. Unlike in canines, the etiology of MCE in humans is already well established and it is classified as an autosomal dominant genetic disorder. The diagnosis is usually obtained through the association of clinical examination with radiographic and histopathological findings. However, in the animal studied, since it was not possible to perform radiographs, confirmation was obtained only after performing histopathological examination of the neoformations, which is considered the standard for the diagnosis of MCE. Although it corresponds to a benign neoplastic process affecting dogs during their growth stage, it may significantly decrease the animal’s quality of life. In this situation, the prognosis of MCE is considered to be reserved to bad, and animals are often referred for euthanasia, as occurred in the animal under discussion, due to the progression of neurological dysfunction. Early recognition of MCE in routine pet hospital practice is of fundamental importance in order to properly institute treatment and monitoring.


2017 ◽  
Vol 15 (2) ◽  
pp. 64-72 ◽  
Author(s):  
Marina E Makogonova ◽  
Aleksandr Yu Mushkin ◽  
Pavel V Gavrilov

Spend a literary analysis of the role of radiation diagnosis in the first place - magnetic resonance imaging to visualize changes in the spinal cord in infectious spondylitis. Neurological disorders, manifested by radicular symptoms and signs of spinal cord irritation to deep paresis and plegia in violation of the pelvic organs, are observed in the majority of patients with spondylitis and may be due to the spinal cord and its roots and / or a breach of its microcirculation on the background of the pathological process in the vertebrae. Dynamic (pre- and postoperative) imaging of the spinal canal and its contents in tuberculous and nonspecific spondylitis is important for a more complete assessment of the disease, and for the prediction of the dynamics of neurological disorders. (For citation: Makogonova ME, Mushkin AYu, Gavrilov PV. Neurological status and imaging spinal cord in patients with infectious spondylitis: is it possible to comparisons with spondylogenic myelopathy?. Reviews on Clinical Pharmacology and Drug Therapy. 2017;15(2):64-72. doi: 10.17816/RCF15264-72).


PEDIATRICS ◽  
1985 ◽  
Vol 75 (5) ◽  
pp. 990-991
Author(s):  
JACOB HEN

To the Editor.— An important piece of clinical information to add to Sturtz's recent review of spontaneous mediastinal emphysema in children1 is that mediastinal emphysema may be the first clinical clue to the presence of childhood asthma. Over the past 4 years, we have seen four children with cough and subcutaneous emphysema in the neck and no previous history of respiratory problems or asthma. These children had hyperinflated lungs and mediastinal emphysema demonstrated on admission chest roentgenograms and physical examination revealed wheezing.


Author(s):  
Abhishek Abhishek ◽  
Michael Doherty

Osteoarthritis (OA), the commonest arthropathy, targets specific joints e.g. the knees, hips, interphalangeal joints, and first carpometacarpal joints. Most patients develop symptoms in their middle or older age. Usage-related (’mechanical’) joint pain, short-lived morning stiffness, and locomotor restriction are the common presenting symptoms. Pain at extremes of movement and joint line tenderness may be present in early disease. Crepitus, bony enlargement, and reduced range of movement suggest more severe OA. Advanced OA is characterized by rest pain, night pain, muscle wasting, and deformity. Notably, symptoms and signs of inflammation are absent or only modest, although mild-moderate effusions are not uncommon at the knee. OA may be diagnosed on clinical grounds alone in the at-risk age group, in the presence of typical symptoms and signs. Radiographic changes of OA are commonly asymptomatic. In general there is poor correlation between symptoms, signs, radiographic changes, and disability in OA, and due care should be used to differentiate the ’disease OA’ from the ’illness OA’. More inflammatory symptoms and signs suggest coexistence of calcium crystal deposition. Evaluation of people with OA should include targeted assessment for treatable comorbidities such as depression and obesity that compound disability from OA.


2019 ◽  
Vol 3 (2) ◽  
pp. 41
Author(s):  
Kelvin Setiawan ◽  
Bramastha Aires Rosadi ◽  
Terry Renata Lawanto ◽  
Primariadewi Rustamadji

Background: Benign breast disease have been broadly classified into non-proliferative lesions, proliferative lesions without atypia and hyperplasia with atypia. Proliferative disease, such as usual ductal hyperplasia, is associated with a 1.5 to 2 fold increased risk of developing invasive carcinoma. We reported a case of usual ductal hyperplasia in a young male. Case: A 22-year-old male complained of discomfort and enlargement of unilateral breast. Physical examination at that time revealed a palpable mass in the lateral upper quadrant of the patient’s left breast, three centimeters from nipple areola complex. The examination of axilla didn’t reveal any lymph node enlargement on both sides. His vital signs were normal without any abnormalities found on examination. Ultrasonography examination demonstrated fibroglandular tissue in the left breast with the volume of 11.13 cm3, consist of 4.8 cm length, 2.9 cm width and 0.8 cm depth. Excisional tumor biopsy was done on his left breast. Usual duct cell hyperplasia was present in microscopic examination with chronic inflammatory cells spreading around the fibrotic stromal cell. Physical examination, radiologic examination, and biopsy were all performed in this patient. Although the accuracy of the triple test is high, benign concordant results do not obviate further surveillance of a palpable mass. We advised our patient to routinely follow-up his condition every 6 months for 1 to 2 years, especially if there any changes found on his breasts. Conclusion: Any guidelines and further studies regarding patient’s follow-up examination after biopsy for male breasts tumor are needed in order of better understanding about this disease.


2019 ◽  
Vol 12 (2) ◽  
pp. e227727
Author(s):  
Deepti Bhandare ◽  
Rupam Ruchi

A 69-year-old man with a medical history of hypertension and diabetes presented with altered mental status once he returned from a 14-day Alaskan cruise. An extensive workup for stroke was negative. His physical examination was normal without any focal motor deficits, but he had developed memory loss and paresthesia. He admitted to eating a lot of fish when he was in Alaska. The whole-blood mercury level was found to be elevated. He was managed conservatively and his symptoms resolved completely in a few days. This led to a diagnosis of organic mercury toxicity.


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