Osteoporosis related simultaneous four joints fractures associated with seizure

A case of steroid induced osteoporosis associated with multiple fractures and dislocations after a seizure is reported. The patient had two years history of steroid, given for aplastic anemia, no supplement or anti-resorptive therapy was given. The patient suffered simultaneous bilateral femoral neck fractures, bilateral shoulder surgical neck fracture dislocations and a Smith's fracture after one episode of seizure. Bone mineral density showed severe osteoporosis with T score of-2.9. There was a delay in the diagnosis which affected an otherwise good outcome in such situation. It is recommended that patients on steroid should be given calcium, vitamin D, and an anti-resorptive. Furthermore, a meticulous clinical examination is required in patients who are on steroids and suffer from epileptic seizures to rule out skeletal injury

Arthroscopic joint lavage in osteoarthritis of the knee. Is it effective?

To assess the benefits of arthroscopic washout in osteoarthritis of the knee [OAK]. One hundred and fifty patients who underwent arthroscopic washout for early OAK between January 2001 and December 2006, at the King Fahd University Hospital, Al-Khobar, Kingdom of Saudi Arabia were analyzed. Preoperative assessment of patients included clinical assessment by modified Lequesne grading [MLG], antero-posterior and lateral radiographs of weight bearing of knee joints and the skyline view of the patella, and was graded by Kellegren and Lawrence grading [KLG]. Arthroscopically, the knee joint was graded by Outerbridge classification [OC]. The data were entered in the database and analyzed using the Statistical Package for Social Sciences version 14. One-hundred and seven patients were analyzed. Fifty-five patients were males and 52 were females, with a mean age of 51 +/- 9.3 years. The mean follow up was 39.45 months. Preoperative MLG was 14.2 +/- 4.1, at 6 months it was 7.39, and at 12 months was 7.75 +/- 0.37, which improved from 6 months onwards [p=0.001]. Kellgren and Lawrence grading and OC were significantly lower in younger patients age [>/= 51 years] [p=0.05]. Seventy-one percent of our patients had excellent and satisfactory results, and 12 [11.2%] had no improvement. Arthroscopic joint debridement has benefits in the extent of pain relief and improvement of joint mobility. We believe that this procedure should be carried out in patients with OA for pain relief and delay of definite arthroplasty