Sacroiliac tuberculosis masquerading as mechanical lower back pain in a collegiate basketball athlete: a case presentation

Background: Sacroiliac tuberculosis is a rare condition for which early diagnosis and effective management frequently proves challenging. This report describes a case that was initially overlooked due to its presentation and unreported constitutional symptoms.Aim: To alert clinicians about skeletal tuberculosis, an often neglected diagnostic differential, which requires a high index of clinical suspicion, especially for patients from endemic areas.Findings: This patient’s presentation (sports injury) and unreported constitutional symptoms resulted in a delay in the diagnosis and initial institution of treatment.Implications: This report illustrates the importance of specifically asking about constitutional symptoms, even in sports injury settings and being mindful of infectious diseases or other chronic medical conditions, which may masquerade as common sports injuries.Keywords: skeletal tuberculosis, sacroiliitis, hip pai

Education of physical and rehabilitation medicine specialists across Europe: a call for harmonization

BACKGROUND: Physical and rehabilitation medicine (PRM) is well established in Europe and officially recognized by the European Union of Medical Specialists (UEMS). The European PRM Board works to promote patient safety and quality of care through the development of the highest standards of medical training and healthcare across Europe as well as the harmonization of PRM specialists' qualifications. In its Action Plan for 2014-2018, the UEMS PRM Board has included the harmonization of the PRM curriculum among the EU countries, as one of its main goals. Based on a European Directive, the Belgian Superior Council is envisaging a reform of the PRM curriculum. AIM: The aim of this paper is to present the current situation of PRM education in Europe according to the survey carried out by the Belgium Task Force. DESIGN: An online survey was posted on May 3rd 2015 to all delegates of the UEMS PRM Section and Board. Two questions were formulated: 1) What is the duration and curriculum of PRM training in your country? 2) Does a Postgraduate Rehabilitation training exist for other medical specialties? RESULTS: The majority of the PRM training programs in Europe have a duration ranging from 4 to 5 years, and are not aiming at downsizing the duration to the European minimal training period of 3 years. The vast majority (70%) of the responding countries don't offer an additional accreditation of Rehabilitation for other medical specialties CONCLUSIONS: Comparing PRM training programs in Europe can support the long-awaited reform of the PRM postgraduate curriculum in Belgium and gives perspective to agree on a transparent and comparable specialty training throughout Europe. Providing a more comparable training promotes the establishment of PRM and its rehabilitation service provisions in the world

Sacroiliac tuberculosis masquerading as mechanical lower back pain in a collegiate basketball athlete: a case presentation

Background:Sacroiliac tuberculosis is a rare condition for which early diagnosis and effective management frequently proves challenging. This report describes a case that was initially overlooked due to its presentation and unreported constitutional symptoms. Aim:To alert clinicians about skeletal tuberculosis, an often neglected diagnostic differential, which requires a high index of clinical suspicion, especially for patients from endemic areas. Findings:This patient’s presentation (sports injury) and unreported constitutional symptoms resulted in a delay in the diagnosis and initial institution of treatment. Implications:This report illustrates the importance of specifically asking about constitutional symptoms, even in sports injury settings and being mindful of infectious diseases or other chronic medical conditions, which may masquerade as common sports injuries

Imaging blood-brain barrier dysfunction: A state-of-the-art review from a clinical perspective

The blood-brain barrier (BBB) consists of specialized cells that tightly regulate the in- and outflow of molecules from the blood to brain parenchyma, protecting the brain’s microenvironment. If one of the BBB components starts to fail, its dysfunction can lead to a cascade of neuroinflammatory events leading to neuronal dysfunction and degeneration. Preliminary imaging findings suggest that BBB dysfunction could serve as an early diagnostic and prognostic biomarker for a number of neurological diseases. This review aims to provide clinicians with an overview of the emerging field of BBB imaging in humans by answering three key questions: (1. Disease) In which diseases could BBB imaging be useful? (2. Device) What are currently available imaging methods for evaluating BBB integrity? And (3. Distribution) what is the potential of BBB imaging in different environments, particularly in resource limited settings? We conclude that further advances are needed, such as the validation, standardization and implementation of readily available, low-cost and non-contrast BBB imaging techniques, for BBB imaging to be a useful clinical biomarker in both resource-limited and well-resourced settings

Helicobacter species in cancers of the gallbladder and extrahepatic biliary tract

Helicobacter species have been found in human bile and biliary tract (BT) tissue and are suspected to cause BT diseases, including gallbladder and extrahepatic cancers, collectively referred to in this work as BT cancers. We conducted a literature review of the epidemiological evidence linking the presence of Helicobacter species in bile or BT biopsies to BT cancers and benign diseases. Reports showed great variability with respect to study methods. Nine studies of BT cancers were identified, all with 30 or fewer BT cancers; eight included cancer-free control subjects and used polymerase chain reaction (PCR) as a means of Helicobacter species detection. In four of these studies, Helicobacter species were detected in patients with BT cancer significantly more frequently than in controls, at least when controls without BT diseases were used. In two studies, no Helicobacter species were detected in either cases or controls. Helicobacter species were also often detected in benign BT diseases such as gallstone disease or chronic cholecystitis. As our current knowledge relies on a few small studies that showed substantial differences, larger studies and more standardised protocols for detecting DNA and antibodies against Helicobacter species are needed to investigate a potential association with BT cancer