Prevalence of elongated posterior talar process (stieda process) detected by radiography / Prevalencia del proceso talar posterior alargado (proceso de stieda) detectado por radiografía

SUMMARY: The Stieda process (SP) and os trigonum (OT) are primary risk factors for posterior ankle impingement syndrome. The aim of this study was to elucidate the prevalence of the elongated lateral tubercle of the posterior talar process (SP) and OT in Turkish subjects using lateral ankle radiographs. In this study, 1088 ankle radiographs in the lateral view were evaluated retrospectively using a picture archiving and communication system at two large medical centers. Subjects with a history of mild-to-moderate trauma were selected from the emergency departments of both hospitals from January to June 2019. Data on the presence of SP and OT, the side of the foot that was evaluated, sex, and age were recorded. The prevalence of SP and OT was 16.7 % and 9.3 %, respectively, in the Turkish population. The prevalence of SP was significantly higher in men (20.3 %) than in women (12.7 %) (p = 0.001). The prevalence of OT was also significantly higher in men (13.7 %) than in women (4.3 %) (p = 0.000). The SP and OT were found in 17 % and 9.9 % of the right feet, respectively, and 16.4 % and 8.6 % of the left feet, respectively, with no statistical difference. Approximately one-fourth of the Turkish population had SP or OT, which made them susceptible to posterior ankle impingement syndrome. The prevalence of SP was higher than that of OT, and both were more common in men than in women.

RESUMEN: El proceso de Stieda (Stieda process) (SP) y el Os trigonum (OT) son factores de riesgo primarios para el síndrome de pinzamiento del tobillo posterior. El objetivo de este estudio fue determinar la prevalencia del tubérculo lateral alargado del proceso talar posterior (SP) y OT en sujetos turcos mediante radiografías laterales de tobillo. Se evaluaron retrospectivamente 1088 radiografías de tobillo con vista lateral, utilizando un sistema de archivo y comunicación de imágenes en dos centros médicos importantes. Los sujetos con antecedentes de trauma leve a moderado fueron seleccionados en las unidades de urgencia de ambos hospitales de enero a junio de 2019. Se registraron datos sobre la presencia de SP y OT, el lado del pie que se evaluó, el sexo y la edad. La prevalencia de SP y OT fue de 16,7 % y 9,3 %, respectivamente, en la población turca. La prevalencia de SP fue significativamente mayor en hombres (20,3 %) que en mujeres (12,7 %) (p = 0,001). La prevalencia de OT también fue significativamente mayor en hombres (13,7 %) que en mujeres (4,3 %) (p = 0,000). El SP y OT se encontraron en 17 % y 9,9 % de los pies derechos, respectivamente, y 16,4 % y 8,6 % de los pies izquierdos, respectivamente, sin diferencia estadística. Aproximadamente un cuarto de la población turca tenía SP u OT, lo que los hizo susceptibles al síndrome de pinzamiento del tobillo posterior. La prevalencia de SP fue mayor que la de OT, y ambos fueron más comun en hombres que en mujeres.

Osteocondroma como hallazgo Incidental en Úlcera Varicosa Sobreinfectada en miembro inferior / Osteochondroma as an incidental finding in Superinfected Varicose Ulcer in the lower limb

El osteocondroma es la lesión tumoral más frecuente del hueso. Éste presenta características radiológicas patognomónicas con continuidad cortical y medular, con lesión exofítica iniciada en metáfisis, protruyendo hasta la diáfisis de huesos largos, con predominio en la porción distal del fémur, fíbula y tibia proximal. Para el diagnóstico de esta patología, por lo general sólo se necesita una imagen radiológica simple en dos planos, en casos ocasionales necesitando tomografía computarizada para verificarlo. En la mayoría de los casos el diagnóstico ocurre de forma incidental, en pacientes asintomáticos, en contados casos, se observa impotencia funcional, bursitis, parestesias o fracturas en hueso patológico. El riesgo de transformación es menor al 1 %, siendo el tumor maligno más frecuente el condrosarcoma. Se describe el reporte de un hallazgo imagenológico incidental de un tumor óseo en un paciente de 65 años con úlcera varicosa sobreinfectada en conjunto con la discusión sobre la importancia de la imagenología para estos diagnósticos.

Osteochondroma is the most frequent tumor lesion in bone. This presents pathognomonic radiological features with cortical and medullary continuity, with exophytic lesion initiated in metaphysis, protruding to the diaphysis of long bones, predominating in the distal portion of the femur, fibula and proximal tibia. For the diagnosis of this pathology, usually only a simple radiological image is needed in two planes, in occasional cases needing computed tomography to verify it. In most cases the diagnosis occurs incidentally, in asymptomatic patients, in few cases, functional impotence, bursitis, paresthesias or fractures in pathological bone are observed. The risk of transformation is less than 1 %, with the malignant tumor being more frequent chondrosarcoma. Following the report of an incidental imaging finding of a bone tumor on 65 years old patient with varicose ulcer infected in conjunction with the discussion of the importance of these diagnostic imaging to be described.

16S Ribosomal RNA Identification of Prevotella nigrescens from a Case of Cellulitis

No abstract available.

Bone marrow edema: an MRI diagnostic clue in patients with chronic foot and ankle pain

To describe the patterns of bone marrow edema observed on MRI and its relevance in distinction between the different causes of chronic pain at ankle and foot. The study included 47 patients complaining of chronic pain at ankle and foot with positive bone marrow edema findings on MRI examination. bone marrow edema intrinsic to osseous lesions were noted in 22 patients. Bone marrow edema with associated soft tissue lesions were noted in 25 patients findings included tenosynovitis in 15, impingement syndromes in seven diabetic foot infection in two and diabetic osteoneuroarthropathy in one patient

talar tilt angle in the diagnosis of injuries of the lateral ligament of the ankle

Ninety consecutive cases of injuries of the lateral ligament of the ankle were involved in a prospective study to assess the reliability of the measurements of the talar tilt angle in determining the severity of the injury. Measurements were performed under local anesthesia. We introduced a new simple device to hold the ankle in maximum inversion by the patient. The sound side was used as a control and the difference in measurements between the affected side and the sound side was considered.It was found that a talar tilt difference of less than ten degrees indicates a mild injury which may be treated adequately by simple measures. But measures of more than ten degrees difference implies a more combined injury of the lateral ligament and should be treated accordingly

Management of tarsal disintegration (T.D.) in leprosy.

Tarsal Disintegration (T.D.) is a known entity occurring exclusively in neuropathic foot of Leprosy and being influenced by several factors among which the disease itself and altered biomechanics constitute the main. In this study done on more than fifty cases at the Dr. Bandorawalla Leprosy Hospital, Kondhawa these factors have been studied in detail and it has been found that the increased and abnormal shearing forces constitute one of the major factors both in occurrence and progression of T.D. Treatment based mainly on the conservative lines is thus aimed at minimizing these forces which occur during the heel-toe pattern gait. Depending upon the severity of the case immobilization, periodic check x-rays, graded weight bearing and suitable modified footwear appliance is recommended. A Fixed Ankle Brace (FAB) serves well controlling the ankle movements by its rocker action and ultimately reducing the forces occurring during the normal heel-toe pattern. It has also been found that if the case is detected early and treated promptly the process can be controlled satisfactorily. Careful screening in high risk group is stressed and health education emphasized.