RESUMO
OBJECTIVE: To describe the characteristic presentation of exertional leg pain in athletes and to discuss the diagnostic options and surgical management of exertional anterior compartment syndrome of the leg in this group of patients. METHODS: Data from a series of athletes presenting with exertional leg pain were analysed and categorized according to aetiology. RESULTS: Sixty-six athletes presenting with exertional leg pain in 102 limbs were analysed. Sixteen patients in a first group of 20 patients with a provisional diagnosis of exertional anterior compartment syndrome of the leg underwent a closed fasciotomy with complete resolution of symptoms. A second group of 42 patients were diagnosed as medial tibial stress syndrome and a third group of four patients had confirmed stress fracture of the tibia. CONCLUSION: Exertional leg pain is a common presenting complaint of athletes to sports physicians and physiotherapists. Careful analysis can lead to an accurate diagnosis and commencement of effective treatment. Exertional anterior compartment syndrome can be successfully treated utilizing a closed fasciotomy with a rapid return to sport.
OBJETIVO: Describir las manifestaciones características del dolor en la pierna que presentan los atletas, y discutir las opciones de diagnósticos y tratamiento quirúrgico del síndrome compartimental de la pierna en este grupo de pacientes. MÉTODOS: Los datos de una serie de atletas con dolor en la pierna debido al esfuerzo excesivo en los ejercicios, fueron analizados y categorizados según la etiología. RESULTADOS: Sesenta y seis atletas con dolor de piernas debido al esfuerzo excesivo en 102 miembros fueron analizados. Dieciséis pacientes en un primer grupo de 20 pacientes con un diagnóstico provisional de síndrome compartimental anterior de la pierna por esfuerzo experimentaron fasciotomía cerrada con resolución completa de los síntomas. Un segundo grupo de 42 pacientes fueron diagnosticados con síndrome de estrés medial de la tibia, y a un tercer grupo de cuatro pacientes se le confirmó fractura por estrés o sobrecarga de la tibia. CONCLUSIÓN: El dolor de la pierna por esfuerzo en los ejercicios es una queja común con las que los acuden a los médicos y fisioterapeutas de la medicina deportiva. Un análisis cuidadoso puede conducir a un diagnóstico preciso y al comienzo de un tratamiento eficaz. El síndrome compartimental anterior por esfuerzo puede tratarse con éxito utilizando una fasciotomía cerrada que permita un rápido retorno a la actividad deportiva.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Traumatismos em Atletas , Síndrome do Compartimento Anterior/cirurgia , Fraturas da Tíbia/diagnóstico , Fraturas da Tíbia/terapia , Fraturas de Estresse/diagnóstico , Fraturas de Estresse/terapia , Esforço Físico , Fasciotomia , Síndrome do Compartimento Anterior/diagnóstico , Síndrome do Compartimento Anterior/etiologiaRESUMO
We present the first case of extrapelvic endometriosis (EPE) presenting as combined swellings of the thigh and buttock in a 28-year-old nulliparous woman. The diagnosis was aided by the history of cyclical symptoms, needle aspirate, ultrasonography and computed tomography scan and was confirmed by histological analysis of the excised specimens. Of note, laparoscopy showed the pelvis to be free of gross disease. Surgical excision combined with hormonal suppression therapy proved adequate treatment in preventing recurrence as well as the complications of wound implantation.
Assuntos
Adulto , Feminino , Humanos , Endometriose , Coxa da Perna , Tomografia Computadorizada por Raios X , Laparoscopia , Endometriose , Diagnóstico Diferencial , Nádegas/patologiaRESUMO
Caroli's disease or communicating ectasia of the intrahepatic biliary tree is a rare disease with unknown aetiology. The coexistence of this along with the uncommon condition of a gastric diverticulum has never been reported before. A deficiency in the fibromuscular matrix of both the bile ducts and the gastric wall may explain why these two pathologies may coexist in a single patient.
Assuntos
Adulto , Feminino , Humanos , Divertículo Gástrico/complicações , Doença de Caroli/complicações , Divertículo Gástrico/diagnóstico , Doença de Caroli/diagnósticoRESUMO
Gouty tenosynovitis may present as infection, tendon rupture, nerve compression and/or digital stiffness. We report a case of tophaceous gout which presented as bilateral carpal tunnel syndrome.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Gota/complicações , Síndrome do Túnel Carpal/etiologia , Articulação do Punho/patologia , Articulação do Punho , Gota/patologia , GotaRESUMO
We present an operation never described before for dealing with abdominal aortic aneurysms by exclusion via a midline trans-abdominal approach. This breakthrough holds many advantages over conventional aneurysmorrahphy and requires further clinical trials.
Assuntos
Humanos , Masculino , Idoso , Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/métodos , Abdome/cirurgia , Anastomose Cirúrgica/métodos , Aneurisma Ilíaco/cirurgia , Países em Desenvolvimento , Perda Sanguínea Cirúrgica/prevenção & controle , Peritônio/cirurgiaRESUMO
Theorectically, tisue oedema due to reperfusion injury may be severe enough to cause compartment syndrome. One such rare case is presented.