Nonspecific arm pain

Nonspecific activity-related arm pain is characterized by an absence of objective physical findings and symptoms that do not correspond with objective pathophysiology. Arm pain without strict diagnosis is often related to activity, work-related activity in particular, and is often seen in patients with physically demanding work. Psychological factors such as catastrophic thinking, symptoms of depression, and heightened illness concern determine a substantial percentage of the disability associated with puzzling hand and arm pains. Ergonomic modifications can help to control symptoms, but optimal health may require collaborative management incorporating psychosocial and psychological elements of illness

Clinical Outcome of Femoral Osteotomy in Patients with Legg-Calve'-Perthes Disease

Legg-Calve'-Perthes disease is a juvenile idiopathic osteonecrosis in which the blood supply of femoral head is not sufficient and the bone dies provisionally. The aim of this study is to evaluate outcome of Femoral osteotomy in children with LCPD in our University Hospital. In a descriptive analytic study, between 2008 and 2013, patients with the diagnosis of Legg-Calve'-Perthes confirmed with lateral pillar calcification of B and B/C border were entered and patients were encouraged to come to an outpatient clinic for follow-up. Descriptive analysis of the demographics was performed and relation between variables was tested using a two-sided Student's t test with statistical significance set at [p=0.05]. Mean age of patients was 9 +/- 1.3 years, with the range of 4 to 12 years old. 25 patients [86.2%] were male and 4 patients [13.4%] female. There was no positive family history in patients. 17 patients [58.6%] had history of trauma. Duration of symptom presentation was 7 +/- 6.3 months, with the range of 3 to 36 months. In 20 of patients [69%] left hip and in 12 [41.4%] right hip was involved. There was significant relation between femoral head asymmetry, trochanter enlargement [P=0.04], acetabolum changes [P<0.000], femoral neck shortening [P<0.000]. There was no relation between age [P=0.28] and duration of disease [P=0.8] with femoral neck shortening. Intrtrochantric Osteotomy led to improvement in pain, limping and increase range of motion. Subluxation before surgery is one of the criteria, which could influence further prognosis. Acetabulom changes and femoral neck shortening are two factor seriously effect hip ROM

Accuracy of lachman and anterior drawer tests for anterior cruciate ligament injuries

The knee joint is prone to injury because of its complexity and weight-bearing function. Anterior cruciate ligament [ACL] ruptures happen in young and physically active population and can result in instability, meniscal tears, and articular cartilage damage. The aim of this study is to evaluate the accuracy of Lachman and anterior drawer tests in ACL injury in compare with arthroscopy. In a descriptive, analytical study from 2009 to 2013, 653 patients who were suspected to have ACL rapture were entered the study. Statistical analysis was performed by the usage of SPSS 16. Multiple comparison procedures were performed for comparing data between clinical examination and arthroscopic findings and their relation with age and sex. Mean age of patients was 28.3 +/- 7.58 years [range from 16 to 68 years]. From 428 patients, 41.2% [175 patients] were between 26 and 35, 38.8% [165 ones] between 15 and 25 and 20% [85 patients] out of 36 years. 414 patients were male [97.2%] and 12 were female [2.8%]. Sensitivity of anterior drawer test was 94.4% and sensitivity of Lachman test was 93.5%. The diagnosis of the ACL injury and the decision to reconstruct ACL could be reliably made with regards to the anterior drawer and Lachman tests result. The tests did not have privilege to each other. The test accuracy increased considerably under anesthesia especially in women

Mucinous tubular and spindle cell carcinoma of kidney: A rare case report and review of the literature.

Low grade mucinous tubular and spindle cell carcinoma of kidney was newly established as a distinct renal cell carcinoma in the World Health Organization (WHO) classification of 2004. Until now, less than 60 cases have been reported and the largest series represented approximately 15 patients with this type of tumor. Herein, we report a case of mucinous tubular and spindle cell carcinoma in a 63-year-old male presented with right flank pain which was diagnosed after nephrectomy. Pathologists should consider this diagnosis and its spectrum of histopathologic features in mind to ensure an accurate diagnosis.