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1.
Acta Orthop Traumatol Turc ; 54(5): 557-560, 2020 Sep.
Article in English | MEDLINE | ID: mdl-32442126

ABSTRACT

We report a case of hand soft tissue tumor-proliferative fasciitis (PF)-in a 12-year-old patient that presented as a painful lump causing trigger finger. After meticulous diagnostic workup, a surgical excision led to immediate amelioration of symptoms. PF is a rare benign pseudosarcomatous lesion arising typically in the subcutaneous tissue and fascia in adults. It is very uncommon in the hand. To the best of our knowledge, this is the first report of a trigger finger being caused due to this pathology. In this report, the authors review PF lesions on hands, advice careful evaluation of magnetic resonance imaging features, and recommend surgical management.


Subject(s)
Biopsy/methods , Dissection/methods , Fasciitis , Fibroma , Magnetic Resonance Imaging/methods , Pain , Soft Tissue Neoplasms , Child , Diagnosis, Differential , Fascia/pathology , Fasciitis/complications , Fasciitis/pathology , Fasciitis/physiopathology , Fasciitis/surgery , Female , Fibroma/complications , Fibroma/pathology , Fibroma/physiopathology , Fibroma/surgery , Humans , Immunohistochemistry , Male , Pain/diagnosis , Pain/etiology , Soft Tissue Neoplasms/complications , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/physiopathology , Soft Tissue Neoplasms/surgery , Trigger Finger Disorder/diagnosis , Trigger Finger Disorder/etiology
2.
Eur J Pediatr ; 177(9): 1363-1366, 2018 09.
Article in English | MEDLINE | ID: mdl-29872931

ABSTRACT

AbstractMagnetic resonance imaging (MRI) in preschool children is often challenging due to excessive motion artifacts. Sedation or general anesthesia (GA) are commonly used to prevent children from moving in the MRI scanner, with increased risk for cardiopulmonary complications and requirement for skilled personnel. Herein we investigated whether oral melatonin, a natural hormone implicated in circadian rhythm regulation, could be used as an alternative sedation method prior to the MRI in preschool children with musculoskeletal problems. Fifteen children with suspected juvenile idiopathic arthritis underwent a total of 16 MRI examinations following administration of 10 mg of oral melatonin; satisfactory images were obtained in all but one case, with no adverse events.Conclusion: The use of melatonin before the musculoskeletal MRI in preschool children is an effective, safe and inexpensive alternative to standard sedation and general anesthesia in preventing motion artifacts. What is known: • Magnetic resonance imaging (MRI) is a well-recognized diagnostic method to visualize synovial inflammation and changes of cartilage and bone in juvenile idiopathic arthritis.• MRI examination requires sedation or general anesthesia to ensure immobility in children who are uncooperative. What is new: • Additional to previous published studies we were able to show that melatonin for sedation for an MRI of joints, even without sleep deprivation, in the studied population may provide an alternative in children without behavioral problems, in order to avoid sedation/GA.

3.
Eur J Pediatr ; 177(9): 1359-1362, 2018 Sep.
Article in English | MEDLINE | ID: mdl-29249068

ABSTRACT

Magnetic resonance imaging (MRI) in preschool children is often challenging due to excessive motion artifacts. Sedation or general anesthesia (GA) is commonly used to prevent children from moving in the MRI scanner, with increased risk for cardiopulmonary complications and requirement for skilled personnel. Herein, we investigated whether oral melatonin, a natural hormone implicated in circadian rhythm regulation, could be used as an alternative sedation method prior to the MRI in preschool children with musculoskeletal problems. Fifteen children with suspected juvenile idiopathic arthritis underwent a total of 16 MRI examinations following administration of 10 mg of oral melatonin; satisfactory images were obtained in all but one case, with no adverse events. CONCLUSION: The use of melatonin before the musculoskeletal MRI in preschool children is an effective, safe, and inexpensive alternative to standard sedation and general anesthesia in preventing motion artifacts. What is Known: • Magnetic resonance imaging (MRI) is a well-recognized diagnostic method to visualize synovial inflammation and changes of cartilage and bone in juvenile idiopathic arthritis. • MRI examination requires sedation or general anesthesia to ensure immobility in children who are uncooperative. What is New: • Melatonin without sleep deprivation is efficacious and safe alternative to conventional sedation and general anesthesia before the musculoskeletal contrast-enhanced MRI in preschool children with JIA with timely insertion of intravenous cannula.


Subject(s)
Arthritis, Juvenile/diagnostic imaging , Central Nervous System Depressants/administration & dosage , Conscious Sedation/methods , Magnetic Resonance Imaging/methods , Melatonin/administration & dosage , Child, Preschool , Humans
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