ABSTRACT
INTRODUCTION: Several complications have been reported following treatment of developmental dysplasia of the hip (DDH). Local muscular spasm is an extremely rare complication. This case serves to enlighten orthopedists about various and unique presentations of idiopathic local muscular spasm, natural history of such condition, and appropriate treatment. PRESENTATION OF CASE: A two-year-old child presented with bilateral acetabular dysplasia for orthopedic evaluation and treated with bilateral simultaneous Dega osteotomy and postoperative cast for 12 weeks. Full range of motion (ROM) of both hips was regained three months after removal of the postoperative cast. Five months later, the child presented with apparent leg length discrepancy, and severe and painless global limitation of the right hip ROM, which initially was thought to be relapsed hip stiffness. Laboratory and radiological investigations were normal apart from pelvic obliquity on radiographs. Symptoms persisted for one month. Examination under anesthesia (EUA) was then performed and revealed full ROM of the involved hip. Physical therapy was started, and hip ROM fully recovered within 3 months without further intervention. DISCUSSION: Stiffness, which is one of the most reported complications following surgical treatment of DDH, is usually related to lengthy periods of immobilization and/or surgical treatment. Clinically, local muscular spasm of the hip can mimic stiffness. EUA is invaluable to differentiate the common postoperative stiffness from the rare local muscular spasm. CONCLUSION: Idiopathic local muscular spasm of hip might present clinically as stiffness that pose a diagnostic dilemma to the treating physician. Close observation coupled with physical therapy is sufficient.
ABSTRACT
BACKGROUND: Psychological disorders including depression and anxiety are not rare in primary care clinics. The Patient Health Questionnaire (PHQ) is a clinical diagnostic tool that is widely utilized by primary health care physicians worldwide because it provides a practical in-clinic tool to screen for psychological disorders. This study evaluated the validity of the Arabic version of the PHQ in all six modules including depression, anxiety, somatic, panic, eating, and alcohol abuse disorders. METHODS: This is a quantitative observational cross-sectional study that was conducted by administrating the translated Arabic version of PHQ to a sample of King Saud University students in Riyadh, Saudi Arabia. RESULTS: The sample was 731 university students who participated in this study including 376 (51.6%) females and 354 (48.4%) males with a mean age of 21.30 years. Eight mental health experts carried out the face validation process of the PHQ Arabic version. The internal consistency reliability was measured using Cronbach's alpha for the PHQ9, GAD7, PHQ15, and panic disorder modules. The results were 0.857, 0.763, 0.826, and 0.696, respectively. In comparison, the eating disorders and alcohol abuse modules demonstrated poor internal consistency due to small number of participants in these modules. CONCLUSION: This study demonstrates that the Arabic version of the PHQ is a valid and reliable tool to screen for depression, anxiety, somatic, and panic disorders in a Saudi sample.
