A CASE REPORT ON IMPORTANCE OF SHOULDER PROPRIOCEPTIVE TRAINING AND PNF TECHNIQUES ALONG WITH CONVENTIONAL EXERCISES IN FUNCTIONAL RECOVERY OF THE INDIVIDUAL WITH ADHESIVE CAPSULITIS SECONDARY TO ROTATOR CUFF TENDINOSIS.

2021 ◽  
pp. 34-36
Author(s):  
Aishwarya Mhetras ◽  
Poorva Devi
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
Medical History ◽  
Functional Recovery ◽  
Adhesive Capsulitis ◽  
Manual Muscle Testing ◽  
Dash Score ◽  
Past Medical History ◽  
Muscle Testing ◽  
Proprioceptive Training

BACKGROUND AND PURPOSE Adhesive capsulitis is a condition where there is inammation of shoulder capsule (capsulitis) which in turn causes bands of sticky connective tissue (adhesions) between the joint's surfaces. Due to this (1) shoulder movement becomes painful and often completely restricted .The purpose of this case report is to highlight Importance of Shoulder Proprioceptive training and shoulder PNF techniques using theraband and inatable ball (30 cm) along with Conventional exercises in Functional Recovery of the patient with adhesive capsulitis secondary to rotator cuff tendinosis. CASE DESCRIPTION A 66-year-old female who presented with right shoulder pain and neck pain and limited range of motion (ROM) since 1 month with a past medical history of type II diabetes mellitus, hypertension and hypothyroidism on medication was diagnosed with adhesive capsulitis secondary to rotator cuff tendinosis based on clinical examination, ROM assessment, Radiographical investigations-MRI and past medical history. INTERVENTION The patient was treated for a total of 10 physical therapy sessions over the span of 2 weeks. Interventions included were incorporating shoulder proprioceptive exercises with a help of inatable ball and textured towel, shoulder PNF patterns using Red theraband along with cryotherapy(icepacks),mobilizations (Maitland grade 2) with oscillatory techniques, therapeutic exercises, Active assisted ROM exercises with the help of a wooden wand, capsular stretching, myofascial trigger point release, postural correction exercises, strengthening and home exercise program. Outcome measures included ROM goniometric measurements, pain rating scale, Angle reproduction test for proprioception, Manual muscle testing and the Disabilities of the Arm, Shoulder and Hand (DASH) Score. DISCUSSION AND CONCLUSION This case report conclude that appropriate combinations of interventions including shoulder proprioceptive exercises with an inatable ball, shoulder pnf patterns(D1-D2) , stretching, mobilisations, MFR and strengthening exercises resulted in an improvement in overall functional performance of the patient with adhesive capsulitis secondary to rotator cuff tendinosis .An improvement in post-test scores of Manual Muscle Testing (MMT) , ROM , DASH scores was observed after 10 sessions. Rationale for treatment was based on various research articles. The treatment was altered based on patient's need and response.

scholarly journals Vestibular neuritis caused by severe acute respiratory syndrome coronavirus 2 infection diagnosed by serology: Case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110132
Author(s):  
Alexandra Halalau ◽  
Madalina Halalau ◽  
Christopher Carpenter ◽  
Amr E Abbas ◽  
Matthew Sims
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Medical History ◽  
Cranial Nerve ◽  
Respiratory Illness ◽  
Vestibular Neuritis ◽  
Past Medical History ◽  
Significant Past Medical History ◽  
Eighth Cranial Nerve ◽  
Male Physician

Vestibular neuritis is a disorder selectively affecting the vestibular portion of the eighth cranial nerve generally considered to be inflammatory in nature. There have been no reports of severe acute respiratory syndrome coronavirus 2 causing vestibular neuritis. We present the case of a 42-year-old Caucasian male physician, providing care to COVID-19 patients, with no significant past medical history, who developed acute vestibular neuritis, 2 weeks following a mild respiratory illness, later diagnosed as COVID-19. Physicians should keep severe acute respiratory syndrome coronavirus 2 high on the list as a possible etiology when suspecting vestibular neuritis, given the extent and implications of the current pandemic and the high contagiousness potential.

A Modified Rotator Cuff Sparing Approach to the Proximal Humerus in Antegrade Nail Osteosynthesis with Transosseous Supraspinatus Tendon Refixation

2019 ◽  
Vol 157 (06) ◽  
pp. 706-714
Author(s):  
Atesch Ateschrang ◽  
Christoph Gratzer ◽  
Ulrich Stöckle ◽  
Anna Janine Schreiner
Keyword(s):  
Rotator Cuff ◽  
Proximal Humerus ◽  
Adhesive Capsulitis ◽  
Functional Results ◽  
Supraspinatus Tendon ◽  
Dash Score ◽  
Invasive Approach ◽  
Fracture Stabilization ◽  
Nail Osteosynthesis

Abstract Background Due to the approach within antegrade humerus nail osteosyntheses, lesions of the supraspinatus tendon with a consecutive functional limitation of the rotator cuff (RC), insufficiencies, adhesions and chronic shoulder pain in the long term can result. The evidence respectively the study data situation is limited regarding the evaluation of this issue. Patients/Material and Methods We are the first to present by means of a case report with a geriatric female patient and a dislocated diaphyseal humerus fracture a rotator cuff sparing osseous approach to the proximal humerus in antegrade nail osteosynthesis without harming the vulnerable supraspinatus tendon (SSP). This is possible through a limited osteotomy of the greater tubercle with the preparation of a 10 mm deep and 15 to 20 mm wide osseous SSP base. The medullary cavity is then opened for inserting the nail in an antegrade manner and closed after fracture stabilization through reposition of the attached osteotomy of the greater tubercle by means of a suture anchor, for example. The procedure also includes a biceps tenodesis. Besides the description of the intraoperative approach and procedure, the clinical and functional results were recorded by established scores as well as radiologically respectively sonographically 6 weeks (T1) and 3 months (T2) postoperatively. Results The patient was very satisfied regarding pain and function after the modified operative procedure. The rotator cuff tests were negative and there were no impingement like symptoms or indications for an adhesive capsulitis. Range of motion as well as the Constant and (Quick) DASH-Score showed a very good function in the course. The implant was located regularly in the radiological control and the fracture showed a good osseous consolidation. A bland joint without effusion or periarticular fluid and no adhesion with the delta fascia could be presented by sonography. The RC and especially the SSP showed a normal sonographic separation. The functional results are comparable to the other publications so far. Conclusion The described surgical technique shows a significantly less invasive approach for the implantation of an antegrade humerus nail in the case of a humerus shaft fracture with an excellent function of the affected shoulder in a short-term follow-up. This novel approach should be evaluated by means of prospective studies regarding the functional outcome to justify the establishment of this modified procedure in the long term. Other modified approaches have been depicted but are essentially differing from our described procedure with regards to the invasiveness of the vulnerable tendinous structure of the SSP respectively RC.

Agranulocytosis Associated with Waldenström Macroglobulinemia

2018 ◽  
Vol 140 (1) ◽  
pp. 42-45 ◽  
Author(s):  
Iuliana Vaxman ◽  
Daniel Shepshelovich ◽  
Lucille Hayman ◽  
Pia Raanani ◽  
Meir Lahav
Keyword(s):  
Case Report ◽  
Febrile Neutropenia ◽  
Medical History ◽  
Case Reports ◽  
Neutropenic Fever ◽  
Severe Neutropenia ◽  
Past Medical History ◽  
Waldenström Macroglobulinemia ◽  
Waldenstrom Macroglobulinemia ◽  
History Of

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.

scholarly journals The Role of Rehabilitation Program in Functional Recovery of Stroke: A Case Report

2020 ◽  
Vol 9 (3S) ◽  
pp. 262-265
Keyword(s):  
Lower Extremity ◽  
Functional Recovery ◽  
Stroke Patient ◽  
Neuromuscular Electrical Stimulation ◽  
Gait Training ◽  
Rehabilitation Program ◽  
Manual Muscle Testing ◽  
Outpatient Rehabilitation ◽  
Muscle Testing ◽  
Balance Exercise

Stroke is a leading cause of functional disorder and severe disability in the world. Stroke prevalence in Indonesia according to national health research (RISKESDAS) in 2007 were 0,8%, meanwhile in United State of America were 1,8-2,2%. Rehabilitation program had an important role in functional recovery of stroke patient. The purpose of rehabilitation program is to achieve functional independency, minimize disability, re-integration to home, family, and community lifes. The case is a 48 years old male with Left hemiparese due to Cerebrovascular accident intracranial hemorrhage. Initial assesments were Glasgow Coma Scale (GCS) 346, Manual Muscle Testing (MMT) 3 for left upper and lower extremity, Count Breathlessness Test (CBT) 10, Mini-Mental State Examination (MMSE) 22, Barthel Index (BI) 10. The outpatient rehabilitation program was neuromuscular electrical stimulation for left upper and lower extremity with in frequency 70-85 pps, on-time 10-15 seconds, off-time 50 seconds – 2 minutes, duration minimum 10 contraction, 3 times per week, active range of motion and isotonic strengthening exercise for upper and lower extremity, breathing exercise, sitting and standing balance exercise, gait training, occupational therapy and cognitive therapy. After 2 months of treatment the assessment was GCS 456, MMT 4 for left upper and lower extremity, CBT 21, MMSE 30, BI 95. The rehabilitation program was proved to be beneficial in improving functional recovery of stroke patient.

Impaired Extension of the Digits due to Bilateral Idiopathic Intrinsic Contracture: A Case Report

2019 ◽  
Vol 24 (03) ◽  
pp. 383-385
Author(s):  
Yuki Kawasaki ◽  
Soichi Ejiri ◽  
Michiyuki Hakozaki ◽  
Shinichi Konno
Keyword(s):  
Eating Disorder ◽  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Medical History ◽  
Rare Condition ◽  
Tendon Sheath ◽  
Past Medical History ◽  
Thenar Muscle ◽  
History Of

Idiopathic intrinsic contracture (IIC) with no history of trauma, ischemia, or spasticity is extremely rare. We report herein a case of impaired extension of the digits due to bilateral IICs occurred in a 30-year-old woman with a past medical history of eating disorder and amenorrhea. Although no previous case has been reported in the literature, eight similar cases of IIC have been presented at Japanese domestic conferences. In these eight cases and the present case, resection of the thenar muscle cords and unilateral resection of the lateral band were effective. Since IIC in patients with an eating disorder is a rare condition, it would be treated conservatively at first as tendon sheath inflammation or locking. However, this condition may be resistant to conservative treatment, and surgical treatment should be considered in such cases.

scholarly journals Recurrence of endometrial cancer in a hysterectomised patient treated with tamoxifen for breast cancer: a case report

2020 ◽  
Vol 113 (11) ◽  
pp. 454-456 ◽  
Author(s):  
James Woolas ◽  
Megan Davis ◽  
Siavash Rahimi
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Endometrial Cancer ◽  
Case Report ◽  
Medical History ◽  
Shared Decision Making ◽  
Decision Making Process ◽  
Shared Decision ◽  
Past Medical History ◽  
The Past

Tamoxifen exposure is a recognised risk for primary endometrial cancer. This case serves as a reminder to meticulously check the past medical history and inform patients of the risk-benefit of treatment as part of a shared-decision making process.

scholarly journals Merkel Cell Carcinoma Presenting as a Malignant Pleural Effusion Post-COVID-19 Hospitalization: a Case Report and Literature Review

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S38-S39
Author(s):  
M Toprak ◽  
J Lanceta ◽  
O C Rosca
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Cell Carcinoma ◽  
Medical History ◽  
Merkel Cell Carcinoma ◽  
Body Fluid ◽  
English Literature ◽  
Merkel Cell ◽  
Past Medical History ◽  
Fluid Cytology

Abstract Introduction/Objective Merkel cell carcinoma (MCC) is a rare, highly aggressive neuroendocrine carcinoma of the skin, associated with immunosuppression, UV light exposure, and the Merkel cell polyomavirus (MCPyV). Metastatic MCC diagnosed in body fluid cytology is extremely rare. Here, we report on a case of a 65-year-old male presenting with a right pleural effusion and a remote history of MCC, unknown to us during the cytologic evaluation of the effusion. To the best of our knowledge, this is the sixth case of metastatic MCC diagnosed in body fluid cytology reported in English literature, and the first one reported in a patient previously admitted for COVID-19 pneumonia. Methods/Case Report A 65-year-old male presented with dyspnea and acute hypoxic respiratory failure. Past medical history was significant for squamous cell carcinoma of the right forearm excised four months prior and ulcerative colitis. The patient had two recent hospitalizations for COVID-19 pneumonia. Chest x-ray on admission demonstrated an enlarged, loculated right pleural effusion. Emergent thoracentesis was performed and 1500 cc of bloody pleural fluid was sent for cytology. The patient’s respiratory status improved. A ThinPrep and a cell block were prepared. Both displayed clusters of small round blue cells with hyperchromatic nuclei, scant cytoplasm, and fine chromatin in a background of rare mesothelial cells, macrophages, and numerous lymphocytes. Immunohistochemical (IHC) studies showed CK20, AE1/AE3, and CAM 5.2 in a perinuclear dot-like staining pattern. CD56, chromogranin, and synaptophysin were also positive. Ki-67 proliferative index was about 40%. TTF-1 was negative, while CD45 highlighted background lymphocytes. The primary care physician was contacted and the patient’s past medical history was significant for MCC. Subsequent MCPyV and SATB2 demonstrated nuclear positivity in the tumor cells. Diagnosis of MCC was done. Results (if a Case Study enter NA) NA Conclusion MCC is a highly aggressive malignancy rarely reported in body fluids. MCC should be included in the differential diagnosis of malignant pleural effusions, especially in cases of the small blue round cells. Using IHC, like CK20 and neuroendocrine markers including the newer SATB2, can lead to an accurate diagnosis. Additional reporting of such cases may increase awareness, especially where prior history is not readily available, such as in this present instance.

scholarly journals Medial tibial stress syndrome: Case report

2014 ◽  
Vol 67 (7-8) ◽  
pp. 247-251
Author(s):  
Milica Jovicic ◽  
Vladimir Jovicic ◽  
Marija Hrkovic ◽  
Milica Lazovic
Keyword(s):  
Case Report ◽  
Clinical Diagnosis ◽  
Leg Pain ◽  
Manual Muscle Testing ◽  
Medial Tibial Stress Syndrome ◽  
Benign Condition ◽  
Muscle Testing ◽  
Stress Syndrome ◽  
Sport Activities ◽  
Manual Testing

Introduction. Although it can be difficult to differentiate pain in lower legs, it is important for clinicians to differentiate medial tibial stress syndrome, which is a rather benign condition, from acute compartment syndrome, which is an emergency, as well as from different types of stress fractures described in this region. The aim of this case report was to present medial tibial stress syndrome as a clinical diagnosis, possible dilemmas in differential diagnosis and the efficacy of rehabilitation treatment. Case report. A 25-year old male patient sought medical help complaining of the pain along the distal third of tibia. The pain was present on palpation of the distal two-thirds of the lateral and medial tibial border over the length of 9 cm and on muscle manual testing of foot flexors. The patient underwent physical and exercise treatment for three weeks. The recovery was monitored by visual analogue scale, which measured the lower leg pain, pain on palpation and manual muscle testing. In addition, the patient himself assessed his ability to resume sport activities on the 5-point Likert scale. The final evaluation and measurements showed his complete functional recovery. Conclusion. The results obtained in this case show the importance of accurate clinical diagnosis and rehabilitation for medial tibial stress syndrome.

scholarly journals An unusual presentation of metastatic melanoma in the shoulder

2016 ◽  
Vol 8 (3) ◽  
pp. 168-170
Author(s):  
Harriet A Branford White ◽  
Philipa Mourant ◽  
David A Woods
Keyword(s):  
Case Report ◽  
Malignant Melanoma ◽  
Rotator Cuff ◽  
Joint Infection ◽  
Signs And Symptoms ◽  
Past Medical History ◽  
Present Case Report ◽  
Prosthetic Joint ◽  
Arthroplasty Surgery ◽  
Rotator Cuff Arthropathy

A 72-year-old lady underwent a Copeland hemiarthoplasty of the shoulder for rotator cuff arthropathy with a good functional outcome. Her past medical history included previous management of a malignant melanoma. Several years following arthroplasty surgery, she acutely developed signs and symptoms of prosthetic joint infection. The present case report describes the metastatic spread of malignant melanoma mimicking that of prosthetic sepsis.

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