Síndrome de pinzamiento isquiofemoral: reporte de un caso inusual / Ischiofemoral impingement syndrome: Report of an unusual case

El síndrome de pinzamiento isquiofemoral suele ser una patología infradiagnosticada que forma parte de uno de los diagnósticos diferenciales a tener en cuenta en el dolor de cadera. Inicialmente fue descrito con procedimientos quirúrgicos, pero con el paso del tiempo se han ido describiendo diferentes entidades médicas, así como técnicas y posturas mantenidas, que puede agravar el cuadro, pudiendo asociar incluso afectación neurológica. En la actualidad el tratamiento es inicialmente conservador con medidas de reposo, analgesia, frío e inicio progresivo de ejercicios dirigidos a la musculatura lumbar, glútea y de miembros inferiores, pero no existe un protocolo de actuación establecido unificado.(AU)

Ischiofemoral impingement syndrome is usually underdiagnosed; this syndrome forms part of the differential diagnoses to be included in hip pain. It was initially described with surgical procedures but, with the passage of time, various medical entities have been described, as well as techniques and postures that can aggravate this syndrome, which can even be associated with neurological involvement. Current treatment is initially conservative, consisting of rest, analgesia, cold and progressive exercises aimed at the lumber and gluteal muscles and lower extremities but there is no established standard of care.(AU)

[Ischiofemoral impingement syndrome: Report of an unusual case]. / Síndrome de pinzamiento isquiofemoral: reporte de un caso inusual.

Ischiofemoral impingement syndrome is usually underdiagnosed; this syndrome forms part of the differential diagnoses to be included in hip pain. It was initially described with surgical procedures but, with the passage of time, various medical entities have been described, as well as techniques and postures that can aggravate this syndrome, which can even be associated with neurological involvement. Current treatment is initially conservative, consisting of rest, analgesia, cold and progressive exercises aimed at the lumber and gluteal muscles and lower extremities but there is no established standard of care.

Os subtibiale: esa rara molestia en el tobillo / Os subtibiale: That odd ankle pain

El os subtibiale es un hueso accesorio del tobillo, poco frecuente. Localizado en el colículo posterior del maléolo tibial interno, puede verse en edad pediátrica y adulta. Puede causar dolor, enrojecimiento y/o inflamación del tobillo, pudiendo llevar al diagnóstico erróneo de fractura avulsiva. Su conocimiento anatómico es crucial. Se presenta el caso de un paciente en edad escolar, valorado en consulta por dolor en la cara interna de ambos tobillos durante 2 meses tras traumatismo casual. En segundo lugar, un paciente adulto con dolor en la cara interna del tobillo derecho de 3 días de evolución, sin traumatismo, valorado en urgencias. Es imprescindible la correcta anamnesis y exploración física. El diagnóstico se realiza mediante radiología convencional de tobillos, proyección anteroposterior y lateral en carga. El tratamiento inicial es conservador (férulas u ortesis) para establecer y mantener las funciones del pie durante las actividades en carga. Si persiste tras 6 meses, se podría plantear tratamiento quirúrgico (AU)

Os subtibiale is a low prevalence accessory bone of the ankle. This bone is located in the posterior colliculus of the tibial medial malleolus, both in paediatric and adult ages. It can cause pain, redness and/or swelling, which can lead to a mistaken diagnosis of avulsion fracture. Adequate anatomical knowledge is crucial. First, we present the case of a school-aged boy, seen at the outpatient clinic for a 2-month history of pain in both inner ankles after an injury. Second, we present the case of an adult patient with a 3-day history of right medial ankle pain, with no previous injury, evaluated at the Emergency Department. Accurate history-taking and physical examination are essential. The diagnosis is given by conventional radiology of both ankles, in antero-posterior and lateral load views. The initial treatment is conservative (splint or orthesis) to establish and maintain the function of the foot during loading activities. If there is no recovery after 6 months, surgical treatment can be considered (AU)

[Os subtibiale: That odd ankle pain]. / Os subtibiale: esa rara molestia en el tobillo.

Os subtibiale is a low prevalence accessory bone of the ankle. This bone is located in the posterior colliculus of the tibial medial malleolus, both in paediatric and adult ages. It can cause pain, redness and/or swelling, which can lead to a mistaken diagnosis of avulsion fracture. Adequate anatomical knowledge is crucial. First, we present the case of a school-aged boy, seen at the outpatient clinic for a 2-month history of pain in both inner ankles after an injury. Second, we present the case of an adult patient with a 3-day history of right medial ankle pain, with no previous injury, evaluated at the Emergency Department. Accurate history-taking and physical examination are essential. The diagnosis is given by conventional radiology of both ankles, in antero-posterior and lateral load views. The initial treatment is conservative (splint or orthesis) to establish and maintain the function of the foot during loading activities. If there is no recovery after 6 months, surgical treatment can be considered.