scholarly journals Posterior Knee Pain: An Unusual Cause

2015 ◽  
Vol 5 (1) ◽  
pp. 58-60
Author(s):  
Alamgir Samdany ◽  
Guljar Ahmed ◽  
Abdul Gani Ahsan
Keyword(s):  
Knee Pain ◽  
Lower Limb ◽  
Venous Malformation ◽  
Popliteal Fossa ◽  
Diagnostic Tools ◽  
Disease Entities ◽  
Arterio Venous Malformation ◽  
Posterior Knee ◽  
Cause Of Pain

The pain around the posterior knee called ‘popliteal fossa’ has been known to be caused by a variety of disease entities. Whatever the causes, the challenge remains in diagnosis. Proper history and clinical examination followed by uses of appropriate diagnostic tools are secrets to success. Venous malformation is a very rare cause of pain in popliteal area and its diagnosis is frequently delayed, missed or given incorrectly. Here, we report a case of a 24-year-old patient who presented with posterior knee pain for 2 years and was diagnosed as a case of intramuscular arterio-venous malformation by lower limb angiography. This patient was treated successfully by surgical resection. His follow-up was satisfactory with no evidence of recurrence. DOI: http://dx.doi.org/10.3329/jemc.v5i1.21499 J Enam Med Col 2015; 5(1): 58-60

Does MRI Knee in Those over 50 Years with Knee Pain in Osteoarthritis Alter Management? A Retrospective Review

2021 ◽  
Author(s):  
Alexandra N. Murphy ◽  
Bryan Yelverton ◽  
Kevin Clesham ◽  
Kathy Hassell ◽  
Eoin Kavanagh ◽  
...  
Keyword(s):  
Knee Pain ◽  
Retrospective Review ◽  
Clinical Information ◽  
Management Plan ◽  
Knee Oa ◽  
Appropriate Treatment ◽  
Management Plans ◽  
Magnetic Resonance Imaging Mri ◽  
Cause Of Pain

AbstractKnee osteoarthritis (OA) is a significant cause of pain and disability worldwide. Imaging provides diagnosis, prognostication, and follow-up. Radiographs are first line, useful, and inexpensive. Magnetic resonance imaging (MRI) can detect additional features not seen on radiograph, but it is of questionable usefulness in the management of knee OA. Our aim was to investigate the usefulness of MRI in the workup of knee OA and whether MRI alters management in knee OA. A retrospective review was performed of consecutive MRI knees performed for knee pain in those over 50 years. Clinical information and documentation of management plan pre- and post-MRI were collected. Assessment was made whether the MRI results influenced the final management plan. Of the 222 MRI knees included for study, the majority (62.2%) had not had a recent radiograph. OA was reported in 86.9% of radiographs and 89.6% of MRI. On MRI, the most prevalent finding was tearing/abnormality of the medial meniscus, seen in 47% of MRIs overall, increasing to all in severe OA. MRI assisted with management in 9.5% of all (21/222) patients, and changed management plans in 23% of those that had documented management plans prior to the MRI (6/26 patients). MRIs can guide tailored management in knee OA and are useful for surgical planning; however, they should only be ordered in certain cases, and a radiograph should always be performed first. MRI should be considered if symptoms are not explained by OA alone or the appropriate treatment option requires MRI.

Operative management of equinus associated with lower limb venous malformations

2021 ◽  
pp. 026835552110472
Author(s):  
Li Hu ◽  
Hui Chen ◽  
Xi Yang ◽  
Yi Sun ◽  
Hongyuan Liu ◽  
...  
Keyword(s):  
Lower Limb ◽  
Clinical Symptoms ◽  
Venous Malformation ◽  
Operative Management ◽  
Venous Malformations ◽  
Optimal Outcomes ◽  
Percutaneous Sclerotherapy ◽  
Experienced Pain ◽  
Male Patients

Objectives Functional impairment is a common complaint in patients with venous malformations. Equinus can occur when the venous malformation involves the lower limb, a challenging condition with only a few studies to guide treatment choices. This study was aimed to investigate the operative management of equinus associated with lower limb venous malformations. Method Between August 2015 and September 2017, a total of 12 patients presented with equinus associated with lower limb venous malformations and underwent surgical correction. Preoperative and postoperative clinical symptoms, physical examination and orthopaedic evaluation were retrospectively reviewed. 8 patients who experienced pain underwent percutaneous sclerotherapy prior to the operation. Surgical management included gastrocnemius intramuscular aponeurotic recession, Z-lengthening of the Achilles tendon, Hoke technique and Taylor Spatial Frame external fixation. Results There were eight female and four male patients with a mean age of 14.3 ± 5.9 years. The mean follow-up period was 34.8 ± 9 months. The range of motion of ankle dorsiflexion (with knee extended) improved for each patient (mean, 25.4 degrees; standard deviation, 8.5 degrees). No neurovascular complications were observed. Conclusion Operative correction of equinus associated with lower limb venous malformations is safe and effective. Selective preoperative sclerotherapy is necessary for optimal outcomes.

Mucoid Degeneration of the Anterior Cruciate Ligament: Characterization of Natural History, Femoral Notch Width Index, and Patient Reported Outcome Measures

2018 ◽  
Vol 32 (06) ◽  
pp. 577-583 ◽  
Author(s):  
Andrew J. Hotchen ◽  
Charis Demetriou ◽  
Dennis Edwards ◽  
Joel T. K. Melton
Keyword(s):  
Outcome Measures ◽  
Knee Pain ◽  
Cruciate Ligament ◽  
Arthroscopic Debridement ◽  
Mucoid Degeneration ◽  
Notch Width ◽  
Anterior Cruciate ◽  
Posterior Knee ◽  
Notch Width Index

AbstractThe presentation and clinical course of mucoid degeneration of the anterior cruciate ligament (MD-ACL) are poorly documented within the literature. Subsequently, it is under-diagnosed and the optimal management strategy remains ill-defined. Here, we characterize the syndrome associated with MD-ACL and compare the natural clinical course with the outcomes of arthroscopic management. Thirty-one patients with radiological features of MD-ACL over a 2-year period had their clinical notes retrospectively reviewed. Seven patients underwent arthroscopic debridement of the ACL for MD. These were followed up for a minimum of 2 years and an average of 2.8 years from surgery. The remainder were managed conservatively (n = 24) and were followed up for a minimum of 2 years and an average of 4.0 years. The notch width index (NWI) and associated pathology was noted. Primary outcome measures were presence of knee pain and use of analgesia. Secondary outcome measures were the Oxford and Lysholm knee scores. The most commonly reported symptoms were posterior knee pain (77.4%) and limitation of terminal flexion (58.1%). All patients who underwent arthroscopic debridement were pain and analgesia free at follow-up. Of the patients who did not undergo arthroscopic surgery, three patients had knee replacement surgery and three were lost to follow-up. The remaining patients, 14/18 (77.8%), reported knee pain and regular analgesia use at follow-up, which was significantly more than the arthroscopic debridement group (p < 0.01). The knee scores were significantly better in the arthroscopic debridement group at follow-up (Oxford knee score: 45 vs 34; Lysholm: 92 vs 67; p < 0.01). Furthermore, the postoperative improvement in the Oxford knee and Lysholm scores compared with preoperatively was 12.1 and 31.8 points, respectively (p < 0.01). The NWI was increased in patients with mild-to-severe osteoarthritis (0.266 vs 0.273; p < 0.05). MD-ACL should be considered in patients who report posterior knee pain, limitation of terminal flexion, and it can be associated with other knee pathologies. MD-ACL can be successfully managed with arthroscopic radio frequency debulking with improvement in quality of life at follow-up.

scholarly journals A Rare Case of Subtentorial Arterio-Venous Malformation Case Report

2013 ◽  
Vol 6 (2) ◽  
pp. 135-138
Author(s):  
Nachko I. Totsev ◽  
Tihomir V. Andreev ◽  
Maya P. Danovska ◽  
Mladen E. Ovcharov
Keyword(s):  
Arteriovenous Malformations ◽  
Rare Case ◽  
Venous Malformation ◽  
Posterior Cranial Fossa ◽  
Unenhanced Ct ◽  
Rare Location ◽  
Cranial Fossa ◽  
Arterio Venous Malformation ◽  
Treatment Prognosis

Summary The majority - over 80%, of arteriovenous malformations (AVMs) are supratentorial. The infratentorial AVM are uncommon and different from other intracranial AVMs in terms of history, diagnosis, treatment, prognosis, and follow up. The authors present a case of an intracranial hemorrhage, caused by rupture of an AVM in the posterior cranial fossa. Native (unenhanced) CT and computed tomography angiography (CTA) images of this rare location of AVM are presented.

Arterio-venous malformation in the chest wall: a case report

1991 ◽  
Vol 27 (6) ◽  
pp. 796
Author(s):  
Yun Young Choi ◽  
Kyo Nam Kim ◽  
Heung Suk Seo
Keyword(s):  
Case Report ◽  
Chest Wall ◽  
Venous Malformation ◽  
Arterio Venous Malformation

Thrombolysis of Occluded Synthetic Bypass Grafts in the Lower Limb: Technical Success and 1-Year Follow-up in 32 Patients

2003 ◽  
Vol 10 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Jacqueline van Holten ◽  
Lukas C. van Dijk ◽  
Marc R. H. M. van Sambeek ◽  
Hero van Urk ◽  
Hans van Overhagen ◽  
...  
Keyword(s):  
Lower Limb ◽  
Bypass Grafts ◽  
Technical Success

Deep brain stimulation of the posterior limb of the internal capsule in the treatment of central poststroke neuropathic pain of the lower limb: case series with long-term follow-up and literature review

2020 ◽  
Vol 133 (3) ◽  
pp. 830-838 ◽  
Author(s):  
Andrea Franzini ◽  
Giuseppe Messina ◽  
Vincenzo Levi ◽  
Antonio D’Ammando ◽  
Roberto Cordella ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Lower Limb ◽  
Internal Capsule ◽  
Posterior Limb ◽  
Vas Score ◽  
The Mean ◽  
Deep Brain ◽  
Stimulation Of

OBJECTIVECentral poststroke neuropathic pain is a debilitating syndrome that is often resistant to medical therapies. Surgical measures include motor cortex stimulation and deep brain stimulation (DBS), which have been used to relieve pain. The aim of this study was to retrospectively assess the safety and long-term efficacy of DBS of the posterior limb of the internal capsule for relieving central poststroke neuropathic pain and associated spasticity affecting the lower limb.METHODSClinical and surgical data were retrospectively collected and analyzed in all patients who had undergone DBS of the posterior limb of the internal capsule to address central poststroke neuropathic pain refractory to conservative measures. In addition, long-term pain intensity and level of satisfaction gained from stimulation were assessed. Pain was evaluated using the visual analog scale (VAS). Information on gait improvement was obtained from medical records, neurological examination, and interview.RESULTSFour patients have undergone the procedure since 2001. No mortality or morbidity related to the surgery was recorded. In three patients, stimulation of the posterior limb of the internal capsule resulted in long-term pain relief; in a fourth patient, the procedure failed to produce any long-lasting positive effect. Two patients obtained a reduction in spasticity and improved motor capability. Before surgery, the mean VAS score was 9 (range 8–10). In the immediate postoperative period and within 1 week after the DBS system had been turned on, the mean VAS score was significantly lower at a mean of 3 (range 0–6). After a mean follow-up of 5.88 years, the mean VAS score was still reduced at 5.5 (range 3–8). The mean percentage of long-term pain reduction was 38.13%.CONCLUSIONSThis series suggests that stimulation of the posterior limb of the internal capsule is safe and effective in treating patients with chronic neuropathic pain affecting the lower limb. The procedure may be a more targeted treatment method than motor cortex stimulation or other neuromodulation techniques in the subset of patients whose pain and spasticity are referred to the lower limbs.

Internal valvuloplasty combined with sleeve wrapping in the treatment of severe deep venous incompetence: A case report

Vascular ◽  
2021 ◽  
pp. 170853812199012
Author(s):  
Yingfeng Wu ◽  
Libing Wei ◽  
Xixiang Gao ◽  
Yixia Qi ◽  
Zhu Tong ◽  
...  
Keyword(s):  
Lower Limb ◽  
Venous Insufficiency ◽  
Femoral Vein ◽  
Duplex Ultrasound ◽  
Vein Wall ◽  
Polyester Urethane ◽  
Left Lower Limb ◽  
Deep Vein ◽  
Color Duplex Ultrasound

Background The main cause of severe chronic venous insufficiency is deep venous incompetence. Deep venous reconstructive surgeries are reserved for cases that do not show a good response to conservative therapies. Method We present the case of a 68-year-old man presenting with swelling, pain, and pigmentation in his left lower limb for 14 years and ulcers for 10 years. Descending venography identified a Kistner’s grade IV reflux in the deep vein of the left lower limb. Internal valvuloplasty was performed following Kistner’s method. Meanwhile, external wrapping with a 1-cm-wide polyester-urethane vascular patch was performed to strengthen the vein wall in the venospasm condition. Results Symptoms were immediately relieved postoperatively. Refractory ulcers healed five months after the procedure. At the six-month follow-up, color duplex ultrasound of the deep vein of the left lower limb showed no reflux in the proximal segment of the femoral vein. Conclusion Internal valvuloplasty combined with sleeve wrapping is feasible in the treatment of severe deep venous incompetence with good short-term results.

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