scholarly journals My Hips Hurt: An Unusual Presentation of Bilateral Groin Pain in an Adolescent Boy

2021 ◽  
pp. jrheum.210362
Author(s):  
Herman H.Y. Tam ◽  
Jennifer Stimec ◽  
Shirley M.L. Tse
Keyword(s):  
Groin Pain ◽  
Clinical Symptoms ◽  
Ischial Tuberosity ◽  
Unusual Presentation ◽  
Cartilaginous Tissue ◽  
Skeletal Abnormality ◽  
Pubic Rami ◽  
Ossification Centers

Van Neck-Odelberg disease (VND) is a rare benign pediatric skeletal abnormality characterized by hyperostosis of the ischiopubic synchondrosis (IPS) and clinical symptoms.1,2,3 IPS is a strip of cartilaginous tissue between the superomedial pubic and posterolateral ischial ossification centers, which develops into the inferior pubic rami and ischial tuberosity, respectively.

scholarly journals A case report of unilateral conductive hearing loss as a consequence of malignant sinonasal melanoma: the importance of completing a full clinical history and examination

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Victoria Blackabey ◽  
Olivia Kenyon ◽  
Rishi Talwar
Keyword(s):  
Hearing Loss ◽  
Case Report ◽  
Clinical Symptoms ◽  
Symptomatic Relief ◽  
Clinical History ◽  
Histological Diagnosis ◽  
Unusual Presentation ◽  
Sinus Surgery ◽  
Cancer Management ◽  
The Right

Abstract Background Sinonasal melanoma is a rare head and neck tumour. It is associated with a poor prognosis, high rates of loco-regional recurrence and distant metastasis. Treatment of the disease is therefore complicated, and because of limited data regarding the cancer, management is frequently tailored to the individual patient. We describe an unusual presentation of sinonasal melanoma with relevant histology, radiology and clinical photography. Case presentation The case report describes the presentation of a 64-year-old man to the Ear, Nose and Throat department with progressive right-sided hearing loss. A thorough history highlighted other clinical symptoms including unilateral nasal obstruction and epistaxis. Clinical examination showed a right middle ear effusion with a polypoidal lesion in the right nasal cavity. Relevant imaging demonstrated a destructive process that required further assessment. An endoscopic sinus procedure was performed to obtain histological diagnosis as well as providing symptomatic relief. Histology confirmed malignant mucosal melanoma. The patient underwent maxillectomy and orbital exenteration (due to further progression of disease) at a tertiary centre with a plan for subsequent immunotherapy. This however has been delayed due to further surgery to excise a metastatic lesion to the right femur. Conclusions This case report highlights the importance of a thorough clinical history and examination. An unusual presentation of a sinonasal tumour can easily be missed leading to a significant delay in treatment. The case report also describes the use of functional endoscopic sinus surgery in order to obtain histological diagnosis and to debulk the tumour, providing symptomatic relief. The current literature regarding management will be discussed as well as current developments guiding future treatment.

scholarly journals Neonatal Gastric Lactobezoar: Management with N-Acetylcysteine

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Sarah Bajorek ◽  
Roel Basaldua ◽  
Katherine McGoogan ◽  
Charla Miller ◽  
Craig B. Sussman
Keyword(s):  
Treatment Regimen ◽  
Conservative Management ◽  
Clinical Symptoms ◽  
Unusual Presentation ◽  
Intravenous Fluids ◽  
Surgical Measures ◽  
Abdominal Symptoms ◽  
Bowel Rest

Gastric lactobezoars (GLBs) are the most common form of bezoars in neonates and consist of aggregations of undigested milk constituents. GLB can present with a variety of intra-abdominal clinical symptoms, and occasionally, extra-abdominal symptoms. Conservative management, with a period of bowel rest and intravenous fluids, is the most common treatment regimen for uncomplicated GLB. Surgical measures are reserved for the rare complications of obstruction and/or perforation. Although limited, utilization of the protein-cleaving enzyme N-acetylcysteine has been described for the disintegration of GLB in toddlers. In this paper, we discuss the first documented use of N-acetylcysteine for a neonatal GLB. Supporting literature, the infant’s unusual presentation, and details of the treatment regimen are discussed.

scholarly journals Chronic groin pain in an athlete: an unusual presentation

1998 ◽  
Vol 32 (2) ◽  
pp. 182-183
Author(s):  
E. V. Williams ◽  
P. Windless ◽  
S. Blease ◽  
K. Queen ◽  
T. Jenkinson
Keyword(s):  
Groin Pain ◽  
Unusual Presentation ◽  
Chronic Groin Pain

scholarly journals Fractured Inferior Pubic Ramus with Ipsilateral Total Hip Replacement: A Case Report and Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Sarkhell Radha ◽  
Michael Shenouda ◽  
Alexandra Hazlerigg ◽  
Sujith Konan ◽  
Alison Hulme
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Groin Pain ◽  
Occupational Therapists ◽  
Early Mobilisation ◽  
Review Of The Literature ◽  
Pubic Ramus ◽  
Total Hip ◽  
Pubic Rami ◽  
Fracture Of The Acetabulum

Pubic rami fractures are common. They are associated with significant morbidity and mortality. These fractures are usually classified as stable injuries and traditionally receive limited orthopaedic input. Management typically involves hospital admission and early input from physiotherapists and occupational therapists. Early mobilisation is advocated as a central part of managing these patients, with emphasis on secondary prevention. We report a case diagnosed as minimally displaced inferior pubic ramus fracture in a patient with an ipsilateral total hip replacement (THR). The patient was mobilised early and despite analgesia continued to complain of groin pain. Repeat radiographs showed a fracture of the acetabulum with displacement of the acetabular component of the hip replacement. We advocate early orthopaedic input for all pubic rami fractures, particularly in patients with hip arthroplasty, and thorough investigation including a CT scan of the pelvis to exclude acetabular extension prior to mobilisation.

scholarly journals Bilateral Insufficiency Fracture of the Pelvis Following THA: A Case Report

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Shinya Hayashi ◽  
Takayuki Nishiyama ◽  
Takaaki Fujishiro ◽  
Shingo Hashimoto ◽  
Masahiro Kurosaka
Keyword(s):  
Groin Pain ◽  
Insufficiency Fracture ◽  
Stress Fractures ◽  
Insufficiency Fractures ◽  
Pubic Rami ◽  
First Case ◽  
Fragile Bone ◽  
Repetitive Stress ◽  
Postoperative Stress ◽  
Pelvic Insufficiency Fracture

Insufficiency fracture is of the stress fractures and is caused by repetitive stress on fragile bone. Insufficiency fractures of pubic rami are rare occurrences in association with total hip arthroplasty (THA). Postoperative stress fractures occur due to increase of patients activity following years of disability. The physician should consider the possibility of a pelvic insufficiency fracture in patients with RA after THA, if the patients present with groin pain. We demonstrate here the first case of bilateral insufficiency fracture of pubic rami and iliac bone following THA.

Osteochondroma of the L-5 vertebra: a rare cause of sciatic pain

1999 ◽  
Vol 91 (2) ◽  
pp. 219-222 ◽  
Author(s):  
Ettore Fiumara ◽  
Tommaso Scarabino ◽  
Giuseppe Guglielmi ◽  
Michele Bisceglia ◽  
Vincenzo D'Angelo
Keyword(s):  
Vertebral Column ◽  
Cartilaginous Tissue ◽  
Content Type ◽  
Articular Process ◽  
Multiple Osteochondromas ◽  
Solitary Osteochondroma ◽  
Ossification Process ◽  
Upper Thoracic ◽  
Ossification Centers ◽  
Fine Print

✓ Solitary or multiple osteochondromas, which are benign bone tumors that usually occur in the long bones, are rarely found in the vertebral column. When present in the spine, however, they have a predilection for the cervical or upper thoracic regions. The authors present the case of a solitary osteochondroma arising from the left L-5 articular process that contributed to sciatica; complete cure was achieved following its removal. It is possible to speculate that the cartilage of secondary ossification centers can be the origin of aberrant islands of cartilaginous tissue that cause the osteochondroma to form. The more rapid the ossification process of these centers, the greater the probability that aberrant cartilage will form. Therefore, the fact that osteochondromas are more frequently located in the higher segments of the vertebral column could be explained by the different durations of the ossification processes in these centers, which increase gradually below the cervical segments.

Left testicular and groin pain: An unusual presentation for perforated appendicitis

1977 ◽  
Vol 12 (5) ◽  
pp. 771 ◽  
Author(s):  
Joseph M. Graham ◽  
William J. Pokorny ◽  
Franklin J. Harberg
Keyword(s):  
Groin Pain ◽  
Perforated Appendicitis ◽  
Unusual Presentation

Radiographic study of the development of the pelvis and hip and the femorotibial joints in domestic cats

2019 ◽  
Vol 22 (6) ◽  
pp. 476-483
Author(s):  
Fernanda G Miranda ◽  
Izabela P Souza ◽  
Flávia M Viegas ◽  
Tábata T Megda ◽  
Anelise C Nepomuceno ◽  
...  
Keyword(s):  
Skeletal Development ◽  
Ischial Tuberosity ◽  
Domestic Cat ◽  
Skeletal Maturation ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Domestic Cats ◽  
Greater Trochanter ◽  
Growth Plates ◽  
Ossification Centers

Objectives The aims of the present study were to monitor, by radiographic examination, the skeletal development of the pelvis and the femorotibial joints of the domestic cat from the first week of life until the closing of the growth plates. Methods Radiographic examinations were collected from 15 domestic cats at weekly intervals during the first month and every 2 weeks from the second to the fourth month of age. After that, examinations were performed monthly until the age of 18 months. Results The ischiopubic growth plate closed at 2 months of age, followed by the fusion of the iliopubic, ilioischial, proximal femoral, greater trochanter and proximal fibular growth plates. The distal femur and proximal tibial growth plates were the last to close, with fusion occurring at 18 months. The mean time to closure of the iliopubic, ilioischial and distal femoral growth plates was shorter in females. The ossification centers first appeared, in ascending order, beginning with the lesser trochanter, followed by the greater trochanter, proximal fibular epiphysis, tibial tuberosity, patella, ischial tuberosity and lateral sesamoid of the popliteus muscle. Conclusions and relevance The complete closure of the growth plates of domestic cats occurs at approximately 18 months of age. Skeletal maturation at approximately 18 months of age is an important parameter to be considered in radiographic evaluation of certain skeletal changes, evolution of fractures and nutritional imbalance.

scholarly journals GCT-55. INTRACRANIAL GERMINOMA ORIGINATING FROM ATYPICAL LOCATION WITH SUBCLINICAL ADH INSUFFICIENCY

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii339-iii339
Author(s):  
Yuki Kuranari ◽  
Tomoru Miwa ◽  
Maya Kono ◽  
Tokunori Kanazawa ◽  
Kazunari Yoshida
Keyword(s):  
Lateral Ventricle ◽  
Clinical Symptoms ◽  
Septum Pellucidum ◽  
Unusual Presentation ◽  
Imaging Findings ◽  
Partial Removal ◽  
Intracranial Germinoma ◽  
History Of ◽  
Periventricular Lesion ◽  
Saline Test

Abstract INTRODUCTION Intracranial germinomas are rare tumors which usually develop in the midline structures and affect in 90% of cases the pineal gland and suprasellar regions. Sometimes they involve basal ganglia, septum pellucidum, and other regions. We report a very unusual presentation of an intracranial germinoma originating from the lateral ventricle. METHODS A 10-year-old boy presented with a 1-year history of polydipsia and polyuria. During the hypertonic saline test, a low ADH was detected and established the diagnosis of subclinical ADH insufficiency. MRI showed a heterogeneously enhancing periventricular lesion in the lateral ventricle, but no other abnormal findings, including hypophyseal stalk. Initially, the correlation of imaging findings and clinical symptoms were not clear. With suspected subependymoma, tumor removal was performed by small craniotomy. Since the intra-operative pathological diagnosis was germinoma, we performed only partial removal of the tumor. After establishing the histological diagnosis of germinoma, the patient received chemotherapy using carboplatin and etoposide, followed by radiation therapy. MRI showed no recurrence for five years after treatment. RESULTS/ CONCLUSION Our case presents two atypical features. First, intracranial germinoma originating from the lateral ventricle is quite rare. Though the cases with intracranial germinoma originating from septum pellucidum and corpus callosum have been reported, this case is even different. Second, imaging findings did not match clinical symptoms. The cause of subclinical ADH deficiency may be the occult hypophyseal germinoma. In conclusion, we report a 10-year-old case with a very unusual presentation of an intracranial germinoma originating from the lateral ventricle.

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