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https://www.readbyqxmd.com/read/29668650/impact-of-an-advanced-imaging-utilization-review-program-on-downstream-health-care-utilization-and-costs-for-low-back-pain
#1
Janessa M Graves, Deborah Fulton-Kehoe, Jeffrey G Jarvik, Gary M Franklin
BACKGROUND: Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. OBJECTIVES: To assess the impact of a state policy implemented in June 2010 that required prospective utilization review (UR) for early MRI among workers' compensation claimants with LBP. RESEARCH DESIGN: Interrupted time series...
April 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29668636/spinal-dural-arteriovenous-fistula-presenting-with-subarachnoid-hemorrhage-a-case-report
#2
Jingzhe Han, Duanhua Cao, Hongmei Wang, Ye Ji, Zhilei Kang, Jianguo Zhu
RATIONALE: Subarachnoid hemorrhage (SAH) is a common and serious disease and one of the most important differential diagnoses in the emergency department. PATIENT CONCERNS: A 39-year-old female patient with a 12 years' history of migraine, presented with a sudden headache combined with motor aphasia. Physical examination suggested probable positive neck resistance. SAH was confirmed by magnetic resonance imaging. In addition, spinal digital subtraction angiography and spinal vascular computed tomography angiography indicated spinal arteriovenous malformation (SAVM)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29657732/two-cases-of-spontaneous-cervical-epidural-hematoma-without-back-or-neck-pain-in-elderly-japanese-men
#3
Takashi Hongo, Kenichi Iseda, Midori Tsuchiya, Mototaka Inaba, Satoshi Nozaki, Kenji Takahashi, Masaaki Nakajima, Toshifumi Fujiwara
Cases: Spontaneous spinal epidural hematoma (SSEH) is an uncommon disease. Most SSEH cases involve back and/or neck pain. We report the cases of two men who experienced SSEH with dysstasia but without back or neck pain. Outcomes: This study presents two cases involving elderly Japanese men who visited an emergency department because of sudden dysstasia without back or neck pain. The results of the neurological examinations revealed ataxic gait. Cervical spinal epidural hematomas were observed by computed tomography and magnetic resonance imaging...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29643686/primary-fibroblastic-osteosarcoma-of-the-lumbar-vertebra-on-fluorine-18-fluorodeoxyglucose-positron-emission-tomography-computed-tomography
#4
Jae Pil Hwang
A 37-year-old man who presented with one year history of lower back and right buttock pain was investigated with contrast enhanced computed tomography (CT), magnetic resonance imaging (MRI), and fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography which revealed a diagnosis of primary fibroblastic osteosarcoma of the lumbar vertebra. This case highlights the importance of PET/CT imaging.
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29620662/good-outcomes-after-the-delayed-removal-of-an-epidural-hematoma-a-case-report
#5
Yong-Xing Yao, Ming-Xia Li, Lian-Juan Sun
RATIONALE: Epidural hematomas can develop following intrathecal puncture, spinal vascular malformation, or spontaneous hemorrhage. Prompt recognition of symptoms and referral to neurosurgical services are crucial for recovery. We report a rare case of delayed removal of an epidural hematoma that resulted in good patient outcomes. PATIENT CONCERNS: A 69-year-old woman weighing 58 kg presented with back pain that had persisted for 12 years. Her medical history was notable for hypertension...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29620654/successful-endoscopic-removal-of-a-rare-large-impacted-pancreatic-duct-stone-using-grasping-forceps-a-case-report-with-video
#6
Qin Liu, Yiping Wang, Hongze Zeng, Bing Hu
RATIONALE: As a main complication of chronic pancreatitis (CP), pancreatic duct stones (PDSs) are often associated with ductal obstruction resulting in increasing intraductal and parenchymal pressure and long-lasting pain. There are many methods for removing PDSs. However, for large stones, it is technically difficult to remove them entirely by endoscopic retrograde cholangiopancreatography (ERCP). PATIENT CONCERNS: A 57-year-old man presented with a chief complaint of severe epigastric pain radiating to his back 3 or 4 times annually for 2 years...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29620622/cc1-emergent-endovascular-repair-of-a-ruptured-descending-thoracic-aortic-aneurysm-in-an-arresting-patient
#7
Warren Naselsky, Charles F Evans, Brody Wehman, Bradley S Taylor
OBJECTIVE: Our goal was to present a case of emergent endovascular repair of a ruptured descending aortic aneurysm in an actively arresting patient. PATIENT: The patient was a 75-year-old woman with a known history of a 6.5-cm descending thoracic aortic aneurysm with acute onset of back pain and syncope. A computed tomographic angiogram revealed disruption of the descending thoracic aorta and a mediastinal hematoma. The patient was taken emergently to the operating room...
April 4, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29609197/the-impact-of-illness-perceptions-and-coping-on-the-association-between-back-pain-and-health-outcomes-in-patients-suspected-of-axial-spondyloarthritis-data-from-the-space-cohort
#8
Miranda van Lunteren, Margreet Scharloo, Zineb Ez-Zaitouni, Anoek de Koning, Robert Landewé, Camilla Fongen Pt, Roberta Ramonda, Ad A Kaptein, Floris A van Gaalen, Désirée van der Heijde
OBJECTIVE: To investigate if illness perceptions and coping influence the relationship between back pain and health outcomes in patients suspected of axial spondyloarthritis (axSpA). METHODS: In the SPACE cohort regression models were computed at baseline with back pain intensity (0-10) as determinant and health-related quality of life (HRQoL; physical (PCS) and mental component summary (MCS) of the 36-item Short-Form Health Survey (SF-36)) or work productivity loss (WPL) as outcomes...
April 2, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29602063/wandering-spleen-with-horseshoe-kidney-a-rare-occurrence
#9
Da Jun Than, Teo Ten Ern, Khasnizal Bin Abdul Karim
INTRODUCTION: Wandering spleen is a rare clinical entity in itself, with only 2 cases reported thus far when correlated with congenital under-development of the kidney, it usually happens due to under development of its surrounding ligaments. Herein we present a case of wandering spleen with underlying congenital deformity of horseshoe kidney which requires splenectomy due to late presentation. PRESENTATION OF CASE: A 21 year old lady presented with worsening of chronic abdominal pain for 3 years, associated with nausea and vomiting...
March 22, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29596278/changes-in-lumbar-endplate-area-and-concavity-associated-with-disc-degeneration
#10
Philip K Louie, Alejandro A Espinoza Orías, Louis F Fogg, Mark LaBelle, Howard S An, Gunnar B J Andersson, Nozomu Inoue
STUDY DESIGN: Retrospective image-based analysis. OBJECTIVE: To measure endplate three-dimensional (3D) geometry, endplate changes in vivo and to investigate correlations between disc degeneration and endplate 3D geometry dependent on symptoms of low back pain (LBP). SUMMARY OF BACKGROUND DATA: It has been hypothesized that alteration of load transmission from the nucleus pulposus to the annulus fibrosus affects vertebral endplate geometry...
March 27, 2018: Spine
https://www.readbyqxmd.com/read/29588242/primary-spinal-malignant-mesothelioma-a-case-report-and-literature-review
#11
Fan Chen, Beifang Liu, Ying Yu, Jianyang Du, Dawei Chen
BACKGROUND: Malignant mesotheliomas are aggressive and rapidly-fatal neoplasms arising from the mesothelial cells. The most common sites of origin are the pleural and peritoneal cavities, and additionally, malignant mesotheliomas can also infrequently involve the pericardium and the tunica vaginalis. However, malignant mesothelioma occurring in the spinal canal is extremely rare. Herein, we reported a case with primary spinal malignant mesothelioma. METHODS: A literature search was using PubMed with specific key terms, inclusion criteria, and exclusion criteria...
March 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29581748/osteoporosis-as-an-initial-manifestation-in-a-patient-with-crohn-s-disease-a-case-report
#12
Hongyun Wei, Chunhui Ouyang, Dehong Peng, Fanggen Lu, Jie Zhang
The present case report details a rare case of osteoporosis as the initial manifestation of Crohn's disease (CD). A 43-year-old male was referred to the Second Xiangya Hospital of Central South University (Changsha, China) for further examination of low back pain (LBP) without digestive symptoms. Bone mineral density (BMD) analysis indicated osteoporosis, particularly in the lumbar spine. Endoscopy revealed an inflamed and strictured ileocecal valve with less inflammation in the ascending, transverse colon, sigmoid colon and rectum, compatible with CD, which was in accordance with the appearance of an abdominal computed tomography scan...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29581142/femoroacetabular-impingement-surgery-allows-74-of-athletes-to-return-to-the-same-competitive-level-of-sports-participation-but-their-level-of-performance-remains-unreported-a-systematic-review-with-meta-analysis
#13
REVIEW
Michael P Reiman, Scott Peters, Jonathan Sylvain, Seth Hagymasi, Richard C Mather, Adam P Goode
BACKGROUND: Femoroacetabular impingement (FAI) syndrome is one source of hip pain that can limit sport participation among athletes. OBJECTIVE: To summarise the return to sport (RTS) rate for athletes after surgery for FAI syndrome. METHODS: A computer-assisted search of MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and EMBASE databases was performed using keywords related to RTS and RTS at preinjury level (RTSPRE ) of competition for FAI syndrome...
March 26, 2018: British Journal of Sports Medicine
https://www.readbyqxmd.com/read/29576907/spinal-case-of-the-month-with-short-perspective-how-would-you-treat-this-l3-l4-synovial-cyst
#14
REVIEW
Nancy E Epstein
Background: In this new section, Case of the Month with Short Perspective from Surgical Neurology International, we want to see how various spine surgeons would approach different spinal pathologies. In this first case, an elderly male presented with 3 years of lower back pain and progressive neurogenic claudication with bilateral radiculopathy that had exacerbated over the prior 6 months. An outside physician performed a magnetic resonance (MR) study of the lumbar spine that showed a massive synovial cyst filling the spinal canal (e...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29563380/a-pitfall-in-the-diagnosis-of-bilateral-deep-vein-thrombosis-in-a-young-man
#15
Yusuke Adachi, Kenichi Sakakura, Tomohisa Okochi, Takaaki Mase, Mitsunari Matsumoto, Hiroshi Wada, Hideo Fujita, Shin-Ichi Momomura
A 32-year-old man with a history of bronchial asthma was referred for low back pain and bilateral femur pain. Vascular sonography revealed bilateral deep vein thrombosis (DVT) from the femoral veins to the popliteal veins. Computed tomography revealed hypoplasia of the inferior vena cava (IVC) and dilated lumbar veins, ascending lumbar veins, and azygos vein as collaterals. There was no evidence of malignant neoplasm. The results of the thrombophilia tests were within normal limits. Hypoplasia of the IVC is a rare cause of DVT...
March 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29557270/integrated-approach-to-pain-management-for-a-patient-with-multiple-bone-metastases-of-uterine-cervical-cancer
#16
De-An Qin, Jie-Fu Song, Li-Ping Song, Gui-Sheng Feng
Background Pain management for multiple bone metastases is complex and often requires multidisciplinary treatment. We herein describe patient-centered multidisciplinary pain management for metastatic cancer. CASE PRESENTATION: A 61-year-old woman with multiple bone metastases of uterine cervical cancer developed intractable low back pain. After external beam radiotherapy failed, we performed lumbar spinal intralesional curettage, pedicle screw fixation, and nerve decompression. However, the neuralgia persisted...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29545982/cocaine-induced-type-a-aortic-dissection-extending-to-the-common-iliac-arteries
#17
Mohamed A Mohamed, Rohit Abraham, Tareq I Maraqa, Samir Elian
Aortic dissection is a rare and fatal complication of cocaine-induced hypertension. The injury mechanism is through shear stress that penetrates the intimal vessel layer, allowing blood flow to separate intimal and medial layers. Due to its scarcity and the paucity of related literature, our knowledge of this condition is limited. We present a rare case of a cocaine-induced aortic dissection, which extended continuously from the aortic root to the common iliacs, along with a literature review of similar cases...
January 12, 2018: Curēus
https://www.readbyqxmd.com/read/29545980/how-an-elevated-creatinine-level-can-deter-the-diagnosis-of-acute-aortic-dissection
#18
Mohamed A Mohamed, Kewan A Hamid
Acute aortic dissection (AAD) classically manifests with sudden, severe chest pain radiating to the back or abdomen, often described as ripping or tearing sensation. Considering its abrupt onset, the diagnosis requires a high index of suspicion prompting immediate imaging using computed tomography (CT) with contrast. However, the use of contrast is a relative contraindication in the patients with renal compromise and acute care physicians are often deterred from contrast use in these patients. Herein, we present an unusual case of hematuria as the presenting symptom of a developing the Stanford type-A AAD...
January 12, 2018: Curēus
https://www.readbyqxmd.com/read/29545868/diagnosis-and-management-of-spinal-tuberculosis-combined-with-brucellosis-a-case-report-and-literature-review
#19
Dexin Zou, Junlin Zhou, Xiaobing Jiang
Tuberculosis combined with brucellosis is a very rare condition. Overlapping clinical presentation and laboratory parameters of tuberculosis and brucellosis may lead to misdiagnosis or delayed diagnosis of the condition. The current study presents the case of a 45-year-old male with symptoms of lower back pain, non-tender swelling in the right flank, intermittent hyperpyrexia, sweating, body aches and numbness and weakness of right lower limb. A lumbar computed tomograph (CT) scan and magnetic resonance imaging indicated vertebral destruction and the formation of sequestra and thecal sac compression...
April 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29538299/comparative-analysis-of-bone-structural-parameters-reveals-subchondral-cortical-plate-resorption-and-increased-trabecular-bone-remodeling-in-human-facet-joint-osteoarthritis
#20
Cordula Netzer, Pascal Distel, Uwe Wolfram, Hans Deyhle, Gregory F Jost, Stefan Schären, Jeroen Geurts
Facet joint osteoarthritis is a prominent feature of degenerative spine disorders, highly prevalent in ageing populations, and considered a major cause for chronic lower back pain. Since there is no targeted pharmacological therapy, clinical management of disease includes analgesic or surgical treatment. The specific cellular, molecular, and structural changes underpinning facet joint osteoarthritis remain largely elusive. The aim of this study was to determine osteoarthritis-related structural alterations in cortical and trabecular subchondral bone compartments...
March 14, 2018: International Journal of Molecular Sciences
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