Sacral Insufficiency Fracture Presenting as Lumbar Spinal Pathology in an Osteoporotic Patient: A Case Report

Sacral insufficiency fractures are a rare type of osteoporotic fracture which mainly occurs in elderly osteoporotic patients without specific trauma. Low back and hip pain are the most frequent complaints associated with sacral insufficiency fracture. Thus, if sacral insufficiency fracture is not considered in the differential diagnosis, the diagnosis may be difficult or delayed. In this case report, we present a patient who attended our outpatient clinic with low back and leg pain and who was first diagnosed as having lumbosacral pathology according to magnetic resonance imaging findings. Our aim was to point out the difficulty in diagnosing sacral fracture and the delay in diagnosis and treatment. Turk J Phys Med Rehab 2011;57 Suppl 2: 377-4

De Quervain's syndrome associated with osteopoikilosis: a case report and review of the literature

Osteopoikilosis is a rare, usually asymptomatic, autosomal-dominant bone disorder, which is generally diagnosed incidentally on X-ray. De Quervain's syndrome is a disorder characterized by pain on the radial (thumb) side of the wrist, impairment of thumb function and thickening of the ligamentous structure covering the tendons in the first dorsal compartment of the wrist. In this case report, we present a young woman with De Quervain's syndrome associated with osteopoikilosis

Cervical Myelopathy Induced by Ossification of Posterior Longitudinal Ligament

Ossification of Posterior Longitudinal Ligament (OPLL), despite being one of the common causes of cervical myelopathy in Asian subjects it also can be seen less in other races. Although OPLL etiology is still unclear, it is considered to be related to genetic, hormonal and environmental factors. As OPLL; that is encountered as a distinct clinical entity in the formation of cervical myelopathy; may not cause any symptom, it also can be presented with a serie of clinical symptoms like progressive neurological damage and disturbance of balance and gait. Direct X-ray, CT and MRI are important auxiliary method in terms of OPLL diagnosis, treatment planning and follow-up. In patients with no progressive neurological damage or mild symptoms of myelopathy conservative approach can be successful in the treatment. However, surgical approach is the main in patients with progressive myelopathy, the choice of surgical technique is still quite controversial. We therefore offer to discuss the diagnosis and treatment of OPLL that induced cervical myelopathy in our old aged male Turkish patient

Clinical evaluation during the acute exacerbation of knee osteoarthritis: the impact of diagnostic ultrasonography

We aimed to investigate (1) the probable correlation between clinical and ultrasonographic findings in chronic painful primary knee OA patients referred with acute flare-ups and (2) the impact of diagnostic ultrasonography (US) to determine the real source of pain in these patients. We included 100 patients consecutively who were admitted to our outpatient unit with a pain complaint on a single knee with the diagnosis of primary knee OA according to the ACR criteria. The control group consisted of the patients with pain-free knees at least during the last month, who were already included in the study group. The sonographic evaluation of the knee was performed by a physician who was blinded to the clinical evaluation and/or the physical and radiological evaluations. In the present study, sonographic findings were significantly more observed on the painful knees (p < 0.001). The most commonly encountered findings on the symptomatic knees were the suprapatellar effusion (55 %), the baker cyst (25 %), and the pes anserine bursitis. The distribution of the findings on the asymptomatic knees was as follows: 22 %, the suprapatellar effusion and 5 %, the Baker cyst. Effusion was detected in 55 % of the painful knees of our patients with knee OA. This finding was statistically significant compared to the painless knees of the subjects included. The results of our study also showed that there was a significant relation between the Kellgren-Lawrence grading and the frequency of suprapatellar effusion on US examination (p = 0.026). It was concluded that in chronic, primary, painful knee osteoarthritis, US is a valuable diagnostic method in the confirmation of synovitis and/or the inflammatory episode in spite of the absence of obvious clinical parameters. In advanced osteoarthritis, when we consider that the inflammatory episodes are expected findings, the early confirmation of the inflammation on US may be particularly valuable in the clinical setting

Accessory Navicular Bone Mimicking Navicular Fracture after Ankle Sprain

An accessory navicular bone (ANB) is present in 10-30% of normal feet. A morphological classification of ANB on the basis of the radiographic appearance distinguishes three types. Most symptomatic ANBs are of type 2. Although the diagnosis and treatment of sprained ankle are generally straightforward, together with an ANB, it might be misdiagnosed as a fracture. We present a 20-year-old male with type 2 ANB who was misdiagnosed as navicular fracture following sprained ankle. Turk J Phys Med Rehab 2011;57:172-4

SPLIT CORD MALFORMATION: BECOMING FIRST SYMPTOMATIC IN AN ELDERLY PATIENT AS A NECK PAIN AND SCOLIOSIS

Split cord malformation represents a closed neural tube defect in which the spinal cord splits into two parts. The majority of cases symptoms onset during childhood Although it can occur at any level, malformation is more commonly detected in lower thoracic and upper lumbar regions. The case reported herein is unique; in contrast to other split cord malformation patients our case was diagnosed in adulthood, with the condition manifesting at the level of the cervical vertebrae, and with no neurological deficit and concomitant neurocutaneous symptoms vertical bar; but the vertebral anomalies such as scoliosis, hemivertebra and vertebral fusion existing all together. We emphasize the need to consider split cord malformation in the differential diagnosis of elderly patients presenting with neck pain and scoliosis and also we mention that conservative treatment should be preferred in patients without progressive neurologic deficit

Treatment of pressure ulcers with larvae of Lucilia sericata

Objectives: This study aims to investigate the use of the Lucilia sericata larvae in patients with decubitus ulcers resistant to hyperbaric oxygen treatment, vacuum-assisted closure, surgical debridement, and other conventional therapies

Cauda Equina Syndrome Caused by Lumbar Vertebral Fracture in an Elderly Patient with Ankylosing Spondylitis

Background: Cauda equina syndrome [CES] in patients with ankylosing spondylitis [AS] is an important neurological complication characterized by low back and leg pain, impotence, urinary incontinence, sensory deficits, and motor dysfunction. Vertebral fractures in the course of AS have been found most often in the cervical region, followed in prevalence by the thoracic region but only rarely in the lumbosacral region

Ultrasound-Guided Greater Occipital Nerve Block: An Efficient Technique in Chronic Refractory Migraine Without Aura?

Background: The effectiveness of greater occipital nerve block (GONB) in patients with primary headache syndromes is controversial. Few studies have been evaluated the usefulness of GONB in patients with migraine without aura (MWOA)