Reverse shoulder arthroplasty for corticosteroid-induced deltoid myopathy in a patient with systemic lupus erythematosus: a case report

A 50-year-old woman who had been previously diagnosed with systemic lupus erythematosus consulted our clinic for pain and weakness in her right shoulder. On examination, she had an atrophied deltoid muscle, a painful right shoulder on movement, and a tender mass in the deltoid area. The patient was diagnosed with corticosteroid-induced deltoid myopathy, shoulder pain, and loss of range of motion that did not resolve with conservative treatment. We decided to perform reverse shoulder arthroplasty. No complications were observed at the last follow-up visit at 3 years postoperative. Unlike deltoid insufficiency that results from axillary nerve injury, deltoid myopathy due to corticosteroid use contains intact fibers,. Therefore, we increased the effectivity of the remaining deltoid fibers by extending the moment arm of the anterior fibers using reverse shoulder arthroplasty and achieved reliable improvements in clinical symptoms and function without increasing the risk of dislocation

Tuberculosis tenosynovitis with multiple rice bodies of the flexor tendons in the wrist: A case report

Introduction: One of the infectious causes of wrist tenosynovitis is Mycobacterium tuberculosis. Tendon sheath involvement is rare. Herein, we report the diagnosis and treatment of a patient with neglected wrist flexor tendon sheath tuberculosis. Presentation of case: We report the diagnosis and treatment of a man aged 50 years with neglected wrist flexor tendon sheath tuberculosis. Discussion: In patients with tendon sheath involvement, symptoms are generally non-specific such as pain and swelling; therefore, it can be diagnosed late due to the lack of systemic symptoms. Wrist X-ray imaging in tenosynovitis may show soft tissue swelling and osteoporotic changes around the wrist joint. T2-weighted sequences in magnetic resonance imaging are more successful in supporting the diagnosis. Conclusion: M. tuberculosis should be kept in mind as an infectious agent, especially in developing countries. In order to prevent any delay in diagnostic evaluation, all steps should be taken carefully

An Unusual Traumatic Presentation: Luxatio Erecta Humeri and Concomitant Hip Dislocation

Introduction.Inferior dislocation of the glenohumeral joint, known as luxatio erecta humeri, and posterior hip dislocation are both rare presentations in the emergency department. The most common aetiology is falling for luxatio erecta humeri. The aim of this manuscript was to present a unique case in terms of luxatio erecta humeri, which has a different aetiology, treatment method, and concomitant injury.Presentation of Case.We report a construction worker who was rescued from a collapsed building who presented with both luxatio erecta humeri and complex posterior hip dislocation. An orthopaedic surgeon reducted luxatio erecta humeri with a one-step reduction technique under procedural anaesthesia as soon as the patient's vital signs were stable.Discussion.Different concomitant injuries and various injury mechanisms have been described in regard to inferior shoulder dislocation in the literature. However, posterior dislocation of the hip as a concomitant distant region injury and trapping as an injury mechanism for luxatio erecta humeri are being described for the first time in this case report. Two reduction manoeuvers, one-step and two-step, have been used for this dislocation. Some authors suggested that a two-step manoeuver can be more easy to apply. In our specific case, luxatio erecta was easily reducted by a single operator in a single attempt.Conclusion.Luxatio erecta humeri may occur from trapping and complex injuries can accompany luxatio erecta humeri in patients with multiple trauma. A one-step closed reduction can be easily applied by a single operator under procedural anaesthesia