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Atypical fracture

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https://www.readbyqxmd.com/read/29662566/focal-increased-tc-99m-mdp-uptake-in-the-nutrient-foramen-of-the-femoral-diaphysis-on-bone-spect-ct
#1
Hwajin Cha, Soo Bin Park, Hyun-Joo Kim
We present images of an 83-year-old female with a history of osteoporosis and bilateral total knee replacement arthroplasty, referred for bone scintigraphy and single-photon emission computed tomography (SPECT)/computed tomography (CT), owing to left knee pain. No trauma to, or intense exercise of, the knee was reported. The bone scan and SPECT/CT revealed a focally increased Tc-99m methylene diphosphonate (MDP) uptake in the medial cortex of the left femoral diaphysis with matched linear radiolucency on CT images...
April 2018: Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29661684/trabecular-bone-score-and-hip-structural-analysis-in-patients-with-atypical-femur-fractures
#2
Sanne K C Buitendijk, Denise M van de Laarschot, Alexandra A A Smits, Fjorda Koromani, Fernando Rivadeneira, Thomas J Beck, M Carola Zillikens
Bisphosphonate use has declined dramatically in recent years, partly because of fear of rare side effects like atypical femur fractures (AFFs). It is therefore desirable to have a diagnostic method to identify those at risk of AFF to prevent this serious complication. We compared trabecular microarchitecture and hip geometry between 30 patients with AFF and 141 controls of similar age and sex, using bisphosphonates. Trabecular bone score (TBS) and hip structural analysis (HSA) were used to assess trabecular microarchitecture and macroscopic hip geometry from dual-energy X-ray absorptiometry images of the lumbar spine and hip, respectively...
March 22, 2018: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29656174/multiplanar-realignment-for-unstable-hangman-s-fracture-with-posterior-c2-3-fusion-a-prospective-series
#3
Pravin Salunke, Madhivanan Karthigeyan, Sushanta K Sahoo, Prashant K Prasad
OBJECTIVE: There is lack of consensus on the preferred approach for unstable Hangman's fracture. The associated soft tissue injuries apart from apparent bony injury add to the complexity of dislocation and needs to be addressed. Here, we evaluated the clinico-radiological characteristics and outcome of patients managed by posterior C2-3 fusion. PATIENTS & METHODS: Nine patients with unstable Hangman's fracture (type II and IIA) were prospectively studied. The displacement of fractured fragments and C2-3 dislocation was studied in multiple planes...
March 27, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29644280/atypical-cardioversion-in-unstable-arrhythmia-caused-by-clavicle-surgery
#4
Stefan Bushuven, Ronny Langenhan
We report on a 54-year old male with traumatic brain injury, flail chest and floating shoulder undergoing intramedullary stabilization of a midshaft clavicle fracture in beach chair position. Intraoperatively the patient developed instable atrial fibrillation triggered by implantation of intramedullary nail. Secondary this case shows feasibility of cardioversion in latero-lateral electrode-position due to inaccessible standard positions and patient fixation between the operation table and the X-ray apparatus...
December 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29600201/femoral-head-stress-fracture-in-children-a-case-report
#5
Mourad Zaraa, Heithem Sahli, Imene Yeddes, Sabri Mahjoub, Mondher Mbarek
Introduction: The stress fracture of the femoral head rarely occurs; but, it is generally encountered in case of bone insufficiency, and it is exceptional in younger individuals. The main differential diagnosis may include several diseases, namely, slipped upper femoral epiphysis, septic arthritis, osteomyelitis, and Perthes' disease. Bone scintigraphy is very sensitive but lacks specificity. Nowadays, the magnetic resonance imaging (MRI) is the gold standard for an accurate diagnosis...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29595537/chronic-osteomyelitis-caused-by-haemophilus-parainfluenzae-a-case-report
#6
Vignesh Ramachandran, Lee S Haruno, Theodora S Browne, Laila E Woc-Colburn, Scott B Rosenfeld, Vinitha R Shenava
CASE: A 14-year-old boy presented with a pathologic fracture of the distal aspect of the tibia and a remote history of a dog bite near the injury site. Imaging studies, biopsy, and presentation corroborated the diagnosis of chronic osteomyelitis. Multiple diagnostic methods were negative until an open biopsy identified Haemophilus parainfluenzae, a fastidious oropharyngeal bacterium, with polymerase chain reaction analysis. The patient underwent extensive debridement, placement of external fixation, and a year-long antibiotic therapy regimen...
January 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29583083/postmenopausal-osteoporosis-a-clinical-review
#7
Nelson B Watts
In postmenopausal women, osteoporotic fractures are more common than stroke, myocardial infarction, and breast cancer combined, and fractures can be costly and result in disability or death. Because there are no signs or symptoms of osteoporosis other than fracture, risk assessment is necessary to identify those at higher risk for clinical events. For women, a clinical fracture risk assessment (FRAX) is appropriate at menopause. Bone mineral density (BMD) measurement is recommended for women at age 65, and earlier for those who have risk factors...
March 27, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29560341/rare-concurrence-of-congenital-muscular-torticollis-and-a-malignant-tumor-in-the-same-sternocleidomastoid-muscle
#8
Yul-Hyun Park, Chul-Ho Kim, Jang-Hee Kim, Jun-Eun Park, Shin-Young Yim
While congenital muscular torticollis (CMT) can occur along with other conditions, such as clavicle fracture or brachial plexus injury, these conditions exist outside the sternocleidomastoid muscle (SCM). We present a rare case with concurrence of CMT and a malignant tumor inside the same SCM, along with serial clinical and radiological findings of the atypical features of CMT. The malignant tumor was in fact a low-grade fibromyxoid sarcoma. To the best of our knowledge, the current case is the first of a concurrent condition of CMT inside the SCM...
February 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29555606/vagal-nerve-stimulator-malfunction-with-change-in-neck-position-case-report-and-literature-review
#9
Erin D'Agostino, Vyacheslav Makler, David F Bauer
BACKGROUND: Vagal nerve stimulation (VNS) is a safe and well-tolerated treatment for drug resistant epilepsy. Complications and failure of the device can result from lead fracture, device malfunction, disconnection, or battery displacement and can result in a variety of symptoms. We present an interesting case of stimulator malfunction with increased impedance change seen only with a change in head position. CASE DESCRIPTION: Patient is a 25-year-old male with a vagal nerve stimulator (VNs) placed for medically refractory epilepsy who presented with neck pain and an electrical pulling sensation in his neck whenever he turned his head to the right...
March 16, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29535113/elevated-platelet-counts-in-a-cohort-of-children-with-moderate-severe-osteogenesis-imperfecta-suggest-that-inflammation-is-present
#10
Lois Salter, Amaka C Offiah, Nicholas Bishop
BACKGROUND: Elevated platelet counts are observed in cancer, autoimmunity and inflammation with concurrent illness. Proinflammatory cytokines are elevated in murine osteogenesis imperfecta (OI) models. We hypothesised that platelet counts might be elevated in children with moderate-severe OI. METHODS: We reviewed the hospital records of 71 children with moderate-severe OI, treated in the Sheffield Children's Hospital's Severe, Complex and Atypical Osteogenesis Imperfecta Highly Specialised Service...
March 13, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29530119/-clinical-features-of-enterococcus-faecium-meningitis-in-children
#11
Li-Yuan Wang, Xiao-Tang Cai, Zhi-Ling Wang, Shun-Li Liu, Yong-Mei Xie, Hui Zhou
OBJECTIVE: To summarize the clinical features of Enterococcus faecium meningitis in children. METHODS: The clinical data of nine children with Enterococcus faecium meningitis were analyzed. RESULTS: In all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29529643/is-core-needle-biopsy-reliable-in-differentiating-between-aggressive-benign-and-malignant-radiolucent-bone-tumors
#12
Vishal Hegde, Zachary D C Burke, Howard Y Park, Stephen D Zoller, Daniel Johansen, Benjamin V Kelley, Ben Levine, Kambiz Motamedi, Noah C Federman, Leanne L Seeger, Scott D Nelson, Nicholas M Bernthal
BACKGROUND: Although there is widespread acceptance of core needle biopsy (CNB) for diagnosing solid tumors, there is reluctance by some clinicians to use CNB for aneurysmal bone cysts (ABCs) as a result of concerns of safety (bleeding, nerve injury, fracture, readmission, or infection) and reliability, particularly to rule out malignant diagnoses like telangiectatic osteosarcoma. This is especially true when CNB tissue is sent from an outside hospital, where the technique used to obtain the tissue may be spurious...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29529334/bisphosphonate-drug-holiday-and-fracture-risk-a-population-based-cohort-study
#13
Annette L Adams, John L Adams, Marsha A Raebel, Beth T Tang, Jennifer L Kuntz, Vinutha Vijayadeva, Elizabeth A McGlynn, Wendolyn S Gozansky
Holidays from bisphosphonates (BPs) may help to prevent rare adverse events like atypical femoral fractures, but may be appropriate only if risk of osteoporosis-related fractures does not increase. Our objective was to compare the incidence of osteoporosis-related fractures among women who had a bisphosphonate (BP) holiday to those who continued use BPs. This retrospective cohort study, conducted within 4 Kaiser Permanente integrated health system regions, included 39,502 women aged ≥45 years with ≥3 years exposure to BP...
March 12, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29529308/cryptococcosis-in-the-koala-phascolarctos-cinereus-pathogenesis-and-treatment-in-the-context-of-two-atypical-cases
#14
Laura J Schmertmann, Kathryn Stalder, Donald Hudson, Patricia Martin, Mariano Makara, Wieland Meyer, Richard Malik, Mark B Krockenberger
Disseminated cryptococcosis caused by Cryptococcus gattii (molecular type VGI) was diagnosed in an adult free-ranging female koala (Phascolarctos cinereus). Subclinical cryptococcosis was later diagnosed in this koala's joey. In the adult koala, a pathological fracture of the tibia was associated with the bone lysis of marked focal cryptococcal osteomyelitis. Limb-sparing orthopedic intervention, in the setting of disseminated cryptococcosis, was judged to have a poor prognosis, and the adult koala was euthanized...
February 24, 2018: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/29523959/the-light-at-the-end-of-the-tunnel-an-unusual-case-of-acute-kidney-injury-in-a-pediatric-patient-answers
#15
Miriam Steinberg, Joseph P Gaut, Stanley Paul Hmiel, Aadil Kakajiwala
Monoclonal gammopathies are a rare diagnosis in pediatric patients. A 19-year-old female patient with past medical history of hypogammaglobulinemia and natural killer cell deficiency and stage III follicular lymphoma, in remission, presented with a right-sided pneumonia, noted to have acute kidney injury and proteinuria. Complement C3 and C4 levels were normal. Anti-double-stranded DNA antibodies, antinuclear antibodies, anti-extractable nuclear antigen antibodies, and antineutrophil cytoplasmic antibodies were negative...
March 9, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29517866/-subtrochanteric-pathological-fracture-on-bisphosphonates
#16
P Y Mathonet, S Willems, J F Ciornohac
Bisphosphonates have frequently shown their efficacy in the treatment of osteoporosis, including ibandronate and alendronate. But more and more mention is made in the literature of patients taking a long-term bisphosphonate and undergoing an atypical fracture associated with this therapy. These complications are most often femoral fractures in the proximal part of the femoral diaphysis. We report the case of a 73-year-old patient who had a subtrochanteric pathological fracture after a prolonged intake of alendronate followed by ibandronate...
February 2018: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29517548/impending-atypical-femoral-fracture-in-a-patient-of-breast-cancer-with-bone-metastases-receiving-long-term-denosumab
#17
Tsutomu Sugihara, Mitsuru Koizumi, Keiko Hayakawa, Yoshinori Ito, Naohiro Sata
Atypical femoral fractures (AFFs) occur in both osteoporosis patients and cancer patients who receive long-term bisphosphonate treatment. Denosumab offers an alternative approach for the treatment of bone metastases. We describe a 59-year-old woman with a history of breast carcinoma and bone metastasis who was prescribed denosumab for 4 years. The patient had no history of any prior bisphosphonate use. Bone scintigraphy showed an abnormal uptake in the right femur, which was confirmed as an impending AFF or atypical femoral stress reaction...
March 7, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29514343/imaging-of-combat-related-thoracic-trauma-blunt-trauma-and-blast-lung-injury
#18
John P Lichtenberger, Andrew M Kim, Dane Fisher, Peter S Tatum, Brian Neubauer, P Gabriel Peterson, Brett W Carter
Introduction: Combat-related thoracic trauma (CRTT) is a significant contributor to morbidity and mortality of the casualties from Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Penetrating, blunt, and blast injuries are the most common mechanisms of trauma to the chest. Imaging plays a key role in the battlefield management of CRTT casualties. This work discusses the imaging manifestations of thoracic injuries from blunt trauma and blast injury, emphasizing epidemiology and diagnostic clues seen during OEF and OIF...
March 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29492134/isolated-extracranial-intraosseous-metastasis-of-an-intracranial-meningioma-following-bevacizumab-therapy-case-report-and-review-of-the-literature
#19
Debraj Mukherjee, Jethro L Hu, Ray M Chu
Meningiomas account for a significant proportion of all primary intracranial tumors; distant metastasis is quite rare. We report a patient with resected, atypical meningioma. The patient's clinical course over 5 years included two craniotomies, a course of radiation, and a shortened course of bevacizumab. Only 5 months after starting bevacizumab, the patient developed an isolated left clavicular pathological fracture attributable to metastatic anaplastic meningioma. This constitutes the first report of meningioma with isolated extracranial intraosseous metastasis in the modern English literature and highlights concerns associated with the use of anti-angiogenic agents in promoting more invasive tumor phenotypes upon disease recurrence...
January 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29482067/influence-of-geometry-on-proximal-femoral-shaft-strains-implications-for-atypical-femoral-fracture
#20
Ifaz T Haider, Prism Schneider, Andrew Michalski, W Brent Edwards
INTRODUCTION: Atypical femoral fractures (AFF) are characterized as low-energy fractures of the femoral shaft or subtrochanteric region. Femoral geometry is known to play a role in AFF risk; it is hypothesized that high-risk geometries are associated with elevated femoral shaft strain. However, it is not well known which geometric parameters have the greatest effect on strain, or whether interaction between parameters is significant. The purpose of this study was to thoroughly quantify the relationship between femoral geometry and diaphyseal strain, using patient specific finite element (FE) modelling in concert with parametric mesh morphing...
February 23, 2018: Bone
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