Idiopathic myositis ossificans of the deltoid muscle: A case report with unique presentation and MRI findings.

INTRODUCTION: Myositis ossificans of the deltoid muscle is extremely rare. We present a case with unique presentation and MRI findings. CASE REPORT: A 21-year-old female presented with a 3-month history of a swelling in lateral aspect of the right arm. There was no history of trauma, injection, or surgery to the area. Examination showed a 3 × 3 cm firm mass in the deltoid muscle. MRI findings were suggestive of myxoma. Surgical excision was done and histopathology showed the classic features of myositis ossificans. There was no recurrence at the final follow-up 7 months later. DISCUSSION: Myositis ossificans of the deltoid muscle is very rare with only 6 cases previously reported in the literature. Our case is unique in presentation because it is the first case reported with no history of trauma, Injection, sickness or surgery in the area. We also review the literature for MRI features of Myositis ossificans and show that our case has a unique pattern. CONCLUSION: We report on a rare case of Myositis ossificans of the deltoid muscle and review of the literature for similar cases and MRI features of Myositis ossificans. We show that our case was unique both in presentation and MRI finding.

A successful surgical treatment of a closed rupture of flexor digitorum superficialis in surgeon's hand. A case report and review of literature.

INTRODUCTION: Isolated closed rupture or avulsion of the flexor digitomm superficialis (FDS) tendon at its insertion is a rare diagnosis. It can be related to a pathology such as rheumatoid arthritis, bony abnormalities, tenosynovitis, fractures, or tuberculosis. A review of the literature identified only few cases of closed avulsion or rupture of FDS tendons nonpathologically. We hope this report will help to gather more experience for the surgical intervention in a delayed presentation of ruptured flexor digitorm superficialis tendon. The work has been reported in line with the SCARE criteria. PRESENTATION OF CASE: We report a case of 48-year-old surgeon who sustained a trauma to her left middle finger. The patient presented three months after injury with complaints of pain and decreased range of motion of involved digit. Patient was treated conservatively and after failure of conservative treatment surgical intervention was done with complete tendon excision and capsulotomy of Proximal interphalangeal joint. Patient retained full range of motion and pain subsided. DISCUSSION: Isolated closed avulsions or rupture of the FDS tendon is a challenging entity in hand surgery in diagnosis and treatment. Nonsurgical treatment with splinting and physiotherapy might help to prevent flexion deformity. The surgical treatment include tenolysis, flexor digitorum superficialis tendon excision, and in selected patients capsulotomies of involved joints. CONCLUSION: A review of the literature identified only few cases of closed avulsion of FDS tendons nonpathologically. Early diagnosis and intervention can prevent sequel of flexion contracture.

Successful Management of Infected Facial Filler with Brucella.

BACKGROUND: The widespread desire to maintain youth and beauty with minimally invasive procedures made the use of soft tissue fillers an attractive option to correct numerous aesthetic problems. However, many complications have emerged recently especially with the use of non-FDA-approved permanent materials. In this case report, we are demonstrating the effective management of a patient with Brucella isolated from a facial abscess at the site of prior permanent filler injection done 17 years ago. METHODS: A 56-year-old woman presented complaining of painful swelling of the right cheek after a failed trial of filler evacuation and intralesional corticosteroid injection. The patient was interviewed carefully, and physical examination was performed, followed by culture and imaging. RESULTS: The patient had a facial abscess that was complicated by parotid infiltration by Brucella. Eventually she was managed successfully by anti-Brucella antibiotics for 6 months with no further complaints. A review of causative organisms in the literature along with recommendations for management is discussed. CONCLUSION: Permanent fillers have shown many complications that can occur even years after injection. Therefore, physicians should be careful when using permanent fillers and should restrict their use to certain situations. Moreover, rare infections must be kept in mind and careful history, including travel history and animal contact, needs to be considered particularly in the unusual scenarios. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .