Incidentally detected sellar spine in a patient with Cushing’s syndrome: a case report

Sellar spine, a bony spur extending anteriorly from the dorsum sellae, is a very rare anatomical variant. Several hypotheses regarding its etiology have been proposed, including the strongly supported theory of a cephalic ossified notochordal remnant. Sellar spine is usually detected incidentally in patients who have no definite symptoms, but several cases have reportedly accompanied endocrinopathies such as precocious puberty, hypopituitarism, or galactorrhea/oligomenorrhea. However, no published reports have described sellar spine in a patient with Cushing’s syndrome. We herein report a case of sellar spine detected during the evaluation of Cushing’s disease in a 29-year-old woman who underwent inferior petrosal sinus sampling, computed tomography, magnetic resonance imaging, and exploratory surgery. There was no evidence of a pituitary microadenoma, but a sellar spine was present in the operative field. Thus, the sellar spine might have caused Cushing’s syndrome in this case, although the exact mechanism is unknown.

Ten-Year Retrospective Study of Symptomatic Naviculo-Medial Cuneiform Coalition in 18 Young Adults: Hidden Features Observed on Computed Tomography

Category: Midfoot/Forefoot Introduction/Purpose: To the best of our knowledge, there are no previous reports comparing the radiographic findings to CT findings for symptomatic naviculo-medial cuneiform (NC) coalition. The purpose of this study was to demonstrate and compare the features of symptomatic naviculo-medial cuneiform coalition between radiography and computed tomography (CT). Methods: We retrospectively reviewed the radiographic and CT findings of 25 symptomatic naviculo-medial cuneiform coalition cases in 18 patients. The existence of a large pit (depth >3 mm), irregular articular surface, joint space narrowing, dorsal bony spur, subchondral sclerosis, multiple subchondral bony cysts, and intra-articular loose bodies were evaluated on radiograph or CT. The size of the largest subchondral bony cyst was also measured using CT. Results: The proportion of large pit observed on radiograph (52.0%) was significantly different (P = .001) from that on CT (72.0%). Similarly, intra-articular loose bodies were observed more frequently on CT (P = .001). The mean size of the largest subchondral bony cyst on CT was 4.25 mm. Conclusion: While evaluating CT in patients with naviculo-medial cuneiform coalition, physicians should focus on detecting a large pit and intra-articular loose bodies since differences in these features were frequently observed between radiograph and CT, with these findings being more evident on CT. We believe that a large subchondral bony cyst could also be related to the symptoms of naviculo-medial cuneiform coalition.

A Case of Split Cord Malformation with Triple Bony Spur in a Single Dural Sleeve—A Classification Dilemma

Split cord malformation-I (SCM-I) is characterized by the presence of double dural sacs, with rigid extradural bony/cartilaginous spur leading to symmetrical or asymmetrical division of the cord. In split cord malformation-II (SCM-II), there is a single dural sac with a nonrigid fibrous spur and symmetrical division of the cord. SCM-II are slightly more common than SCM-I, constituting around 50 to 60% of SCMs. The authors report a unique case of SCM with triple bony spurs lying both intra- and extradurally in a single dural sleeve. At the time of submission of this report, to the best of authors’ knowledge, no case of SCM with triple bony spurs in single dural sleeve has been reported anywhere in the world literature.

Plantar Fasciitis Risk Factorsin Normal Population

Conservative treatments results for plantar fasciitis patients are inconsistent and therefore manipulating risk factors could be the best option for this disease. To determine risk factors of plantar fasciitis. In a retrospective study, all patients who had plantar fasciitis were enrolled and were compared to control group on their demographic characteristics. The angle of dorsi-flexion was recorded by examination of orthopedic surgeon, history of pregnancy and time of standing in one day. Plantar curvature was measured by orthopedic surgeon. Female sex percentage was significantly higher in PF group than male sex (p=0.007), but the difference in sex was not significant between PF and control groups (p=0.22). Body mass index (BMI) above 30 was significantly higher in PF group compare to control group (p=0.013). Presence of bony spur was significantly higher in PF group compare to control group (p=0.03). There were significant differences in foot curve degree in patients between PF and control groups (p=0.037). Odds ratio (OR) of plantar fasciitis was 1.65 times in patients with bony spur. History of pregnancy increase OR of plantar fasciitis 1.37 times (OR:1.37; 95% CI:1.20-1.82, p=0.017). Plantar fasciitis is associated with higher BMI, pregnancy, bony spur and foot curve cavus. However, it seems that a predisposing foot structural factor should also be accompanied with these risk factors.