Angioleiomyoma (Vascular Leiomyoma) Presenting as a Pseudoaneurysm of the Tibialis Posterior Artery

2019 ◽  
Vol 109 (3) ◽  
pp. 253-258
Author(s):  
Michael A. Ciaramella ◽  
Rock CJay Positano ◽  
Darren B. Schneider ◽  
John J. Doolan ◽  
Molly Forlines ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Lower Extremity ◽  
Chief Complaint ◽  
Tibialis Posterior ◽  
Medial Malleolus ◽  
Ankle Pain ◽  
Vascular Leiomyoma ◽  
Operative Excision

Reported here is the case of a 55-year-old woman presenting to a podiatry clinic with a chief complaint of left heel and ankle pain, who ultimately underwent operative excision of an angioleiomyoma adjacent to the tibialis posterior artery at the level of the medial malleolus. Accompanying this case are images from three modalities through which the defining characteristics of an angioleiomyoma can be appreciated. This case advocates for the inclusion of angioleiomyoma in the preoperative differential diagnosis of a mass presenting as a pseudoaneurysm in the lower extremity, particularly among women in the fourth to sixth decades of life.

Surgical Management of the Peroneus Quartus Muscle for Bilateral Ankle Pain

2015 ◽  
Vol 105 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Nobuaki Chinzei ◽  
Noriyuki Kanzaki ◽  
Yoshinori Takakura ◽  
Yoshiyuki Takakura ◽  
Akihiko Toda ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Rare Case ◽  
Lateral Compartment ◽  
Lower Leg ◽  
Foot And Ankle ◽  
Resonance Imaging ◽  
Ankle Pain ◽  
Accessory Muscle ◽  
Muscle Magnetic Resonance Imaging

The peroneus quartus muscle is an accessory muscle seen in the lateral compartment of the lower leg. Although the peroneus quartus muscle is asymptomatic in general, it sometimes becomes pathologic. We present the rare case of bilateral ankle pain with crepitation caused by the peroneus quartus muscle. Magnetic resonance imaging should be considered to assist with diagnosing this condition. Foot and ankle surgeons should consider it in the preoperative differential diagnosis when patients present with posterior ankle pain.

scholarly journals Efek Injeksi Plasma Kaya Platelet Terhadap Tenosinovitis Tendon Tibialis Posterior: Sebuah Studi Kasus

2019 ◽  
Vol 5 (1) ◽  
pp. 60-65
Author(s):  
Henry Ricardo Handoyo ◽  
Andryan Hanafi Bakri ◽  
Andri Primadhi Primadhi
Keyword(s):  
Platelet Rich Plasma ◽  
Tibialis Posterior ◽  
Medial Malleolus ◽  
Posterior Tibial Tendon ◽  
Foot And Ankle ◽  
Posterior Tibial Tendon Dysfunction ◽  
Flat Foot ◽  
Posterior Tibial ◽  
Left Ankle ◽  
History Of

Introduction: Posterior tibial tendon dysfunction is one of the most common, problems of the foot and ankle. Tenosynovitis of the posterior tibial tendon (PTT) is an often unrecognized form of PTT dysfunction. Case: A 54-year-old woman presented with left ankle pain that began while morning walk three days prior. She noted that the left ankle hurt with even light touch and the pain was unrelieved with sodium diclofenac. She denied any history of trauma. She was seen in the outpatient clinic for this condition. On examination, a three centimeter area of pain was found posterior to the medial malleolus and parallel to the PTT. She also had a stage I flat foot and mild soft tissue swelling around medial malleolus region on her radiograph examination. Ultrasound examination was done with the result of anechoic fluid visible in the peritendinous space around the PTT. The patient received diagnosis of PTT tenosynovitis, with the foot and ankle disability index (FADI) score was 58.7. Platelet rich plasma (PRP) injection was done twice with an interlude of two weeks. The pain subsided and the following FADI score was 84.6. Outcome: Patient showed improvement in her left ankle PTT tenosynovitis after two PRP injection. Conclusion: This case report highlights the efficacy of PRP as a modality in managing PTT tenosynovitis.

scholarly journals Differential Diagnosis of Vertigo in Children

2019 ◽  
Vol 02 (01) ◽  
pp. 21-26
Author(s):  
Anita Bhandari ◽  
Arpana Goswami
Keyword(s):  
Differential Diagnosis ◽  
Management Strategy ◽  
Pediatric Patients ◽  
Age Groups ◽  
Clinical History ◽  
Chief Complaint ◽  
Balance Disorders ◽  
Peripheral Vestibulopathy ◽  
Delay Of Treatment

Abstract Introduction Vertigo and balance disorders can affect all age groups. It is common to misdiagnose the cause of dizziness in children, which eventually results in the delay of treatment. The purpose of this study was to review the clinical characteristics and neurotological evaluation of vertigo in patients younger than 16 years and assist in making a differential diagnosis for children with vertigo and balance disorders. The differential diagnosis can help determine the correct management strategy to treat vertigo and imbalance in pediatric patients. Methods Children and adolescents presenting with a chief complaint of vertigo or unsteadiness to Vertigo and Ear Clinic, Jaipur, were selected for this study on the basis of clinical history, physical examination, and neurotological evaluation. Results A total of 90 patients with a mean age of 10.67 years were evaluated. The most common cause associated with vertigo or dizziness was found to be vestibular migraine seen in 38 participants of this study. This was followed by unilateral peripheral vestibulopathy in 15 patients, bilateral peripheral vestibulopathy in 11 patients, and central vestibulopathy in 6 patients. Vertigo was also seen to be associated with various other disorders. Conclusion Vertigo in children must be recognized as a definite symptom, which should be taken seriously by the clinician and family. Pediatric vertigo can be due to many etiologies. History and evaluation are the only way to diagnose the etiology and site of lesion. This will prevent misdiagnosis and delay in the treatment, which can ultimately lead to deterioration of the quality of life.

scholarly journals Chronic Symptomatic Ankle Avulsion Fracture

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0050
Author(s):  
Bibo Wang
Keyword(s):  
Avulsion Fracture ◽  
Surgical Excision ◽  
Medial Malleolus ◽  
Ankle Pain ◽  
Ankle Ligaments ◽  
Radiographic Images ◽  
Delay In Diagnosis ◽  
Vas Score ◽  
Ankle Stability ◽  
Bony Fragment

Category: Ankle Introduction/Purpose: Persistent pain and instability following inversion or eversion injuries of the ankle is not rare. Besides injury of lateral or medial ligaments, avulsion fracture of lateral or medial malleolus could be found in some cases. The avulsion fracture may result in nonunion and/or ligamentous laxity which could lead to chronic ankle pain. The purpose of this study was to evaluate the intraoperative findings and long-term outcomes of patients of symptomatic ankle avulsion fracture. Methods: 23 patients of ankle avulsion fracture along with chronic ankle pain and instability were studied. Tenderness and swollen at lateral and/or medial gutter were found and radiographic images were taken for the diagnosis. After at least 6 months of unsuccessful non-operative treatment, all patients underwent surgery of osseous fragments excision and anatomic ankle ligaments reconstruction. AOFAS-AH and VAS Score were given to assess the outcomes of surgery. Results: There were 21 males and 9 females among the patients. The average age of the patients was 24.6 years (range, 18-45 years) at the time of injury and 27.3 years (range, 18-46) at the time of surgery, indicating a mean delay in diagnosis and/or treatment of 2.7 years. At a mean follow-up of 2.6 years (range, 1 to 5.2 years), the average AOFAS-AH Score increased from 72.5 to 93.2 out of 100 (P<0.05), the average VAS score decreased from 6.2 to 1.2 (P<0.05). Conclusion: For those patients of ankle avulsion fracture presenting with chronic ankle pain and instability, surgical excision of the bony fragment combined with reconstruction of ankle ligaments were effective in eliminating pain, restoring ankle stability, and helping return to the pre-injury functional level.

Osteolysis of the medial malleolus due to a sports injury – An unusual cause of ankle pain

2008 ◽  
Vol 75 (6) ◽  
pp. 741-743
Author(s):  
Hervé Collado ◽  
Florence Nazarian ◽  
Thomas Le Corroller ◽  
Laurent Bensoussan ◽  
Jean-Michel Viton ◽  
...  
Keyword(s):  
Sports Injury ◽  
Medial Malleolus ◽  
Ankle Pain

The Arterial Anatomy of the Deltoid Ligament: A Cadaveric Study

2017 ◽  
Vol 38 (7) ◽  
pp. 785-790 ◽  
Author(s):  
Jacob A. Haynes ◽  
Michelle Gosselin ◽  
Brian Cusworth ◽  
Jeremy McCormick ◽  
Jeffrey Johnson ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Tibialis Anterior ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Vascular Supply ◽  
Tibialis Posterior ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Ankle Sprains ◽  
India Ink

Background: There is an increasing interest in the operative treatment of deltoid ligament disruption in the setting of chronic ankle instability. Understanding the vascular anatomy of the deltoid complex is beneficial when considering operative procedures on the medial ankle and may provide insight into factors that lead to chronic deltoid insufficiency and ankle instability. Methods: Thirty-two pairs of cadaveric specimens (64 total legs) were amputated below the knee, and the tibialis anterior, tibialis posterior, and peroneal arteries were injected with India ink and Ward’s blue latex. Specimens then underwent chemical debridement to identify the vascular supply to the deltoid ligament. A subset of specimens also underwent intraosseous debridement using the modified Spalteholz technique. Results: The vascular supply to the deltoid ligament was clearly visualized in 60 (93.8%) specimens. Fifty-eight specimens (96.7%) had arterial supply with an origin from the medial tarsal artery, 57 specimens (95%) had supply from the tibialis posterior artery, and 23 (38.3%) specimens had supply from the tibialis anterior artery. All specimens had at least 1 location of intraosseous vascular supply, either at the medial malleolus or medial talus. Conclusion: There were 3 separate extraosseous sources and 2 intraosseous sources of vascular supply to the deltoid ligament. Clinical Relevance: Knowledge of the vascular supply may aid in identifying factors that predispose a subset of patients with medial ankle sprains to failure of conservative treatment, as well as provide useful anatomic information when considering operative treatment for chronic ankle instability.

Poststreptococcal Reactive Arthritis

2006 ◽  
Vol 96 (4) ◽  
pp. 362-366 ◽  
Author(s):  
Daniel Logan ◽  
Patrick J. McKee
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Lower Extremity ◽  
Rheumatic Fever ◽  
Reactive Arthritis ◽  
Acute Rheumatic Fever ◽  
Streptococcal Infection ◽  
Treatment Options ◽  
Review Of The Literature ◽  
Poststreptococcal Reactive Arthritis

Acute rheumatic fever is a delayed inflammatory disease that follows streptococcal infection of the throat. Poststreptococcal reactive arthritis is a sterile arthritis associated with antecedent streptococcal infection in patients not fulfilling the Jones criteria for acute rheumatic fever. Poststreptococcal reactive arthritis has been reported to have lower-extremity predominance and, therefore, should be included in the differential diagnosis of patients with lower-extremity arthritis. A review of the literature, distinguishing poststreptococcal reactive arthritis from acute rheumatic fever, and treatment options are discussed here. A case report is also presented. (J Am Podiatr Med Assoc 96(4): 362–366, 2006)

Dermoid tumors occurring at the site of previous myelomeningocele repair

1986 ◽  
Vol 65 (6) ◽  
pp. 779-783 ◽  
Author(s):  
R. Michael Scott ◽  
Samuel M. Wolpert ◽  
Louis E. Bartoshesky ◽  
Seymour Zimbler ◽  
George T. Klauber
Keyword(s):  
Differential Diagnosis ◽  
Lower Extremity ◽  
Computerized Tomography ◽  
Neurological Deterioration ◽  
Bladder Function ◽  
Content Type ◽  
Surgical Exploration ◽  
Myelomeningocele Repair ◽  
Tomography Scanning ◽  
Fine Print

✓ Four children with previously repaired myelomeningoceles presented toward the end of the first decade or early in the second decade of life with deteriorating lower-extremity and bladder function. Myelography and computerized tomography scanning demonstrated irregular filling defects at the area of the myelomeningocele repair, and surgical exploration disclosed dermoid tumors that were adherent to the placode and adjacent roots. Dermoid tumors should be considered in the differential diagnosis of neurological deterioration in children with a repaired myelomeningocele.

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