ABSTRACT
BACKGROUND: although peripheral intravenous catheter (PIV) infiltration is a frequent hospital occurrence, muscle rupture is a previously unknown complication of line infiltration. We present the case of a 21-year-old male with a history of cystic fibrosis, bilateral lung transplant, and chronic corticosteroid use, with longitudinal tear of the biceps brachii muscle as a complication of PIV infiltration. METHODS: case report describing a unique case of a longitudinal tear of the biceps brachii. RESULTS: magnetic resonance imaging revealed longitudinal tear of the biceps brachii with sparing of the proximal and distal tendons. Nerve conduction studies and electromyography revealed bicipital denervation, most likely due to mechanical compression. CONCLUSION: we hypothesize that the patient's chronic corticosteroid use predisposed him to muscle injury, as did basilic vein thrombosis caused by PIV infiltration, and this combination of factors led to bicipital rupture. To our knowledge, this is also the first case report to document longitudinal tear of the biceps brachii with sparing of the distal and proximal tendinous insertions of the muscle.
ABSTRACT
AIM: To assess lower extremity bone mineral density (BMD) of children with congenital spinal dysfunction and examine factors that may influence BMD in this population. METHOD: Forty-four children (25 females, 19 males) aged 6 to 18 years (mean 11 y 11 mo, SD 3 y 6 mo) with congenital spinal dysfunction (35 with myelomeningocele, seven with lipomas, one with sacral agenesis, one with caudal regression) were enrolled in the study. A health survey including ambulatory status, history of bladder augmentation, and history of fracture was administered. Each participant had a physical examination including Tanner stage and neurological level. Dual-energy X-ray absorptiometry scans of the lateral distal femur (LDF) and, when possible, lumbar spine were obtained. We reported LDF BMD results as z-scores for three regions of interest (metaphyseal, metadiaphyseal, and diaphyseal). Univariable and multivariable analyses examined relationships between LDF BMD and the other variables. RESULTS: BMD was significantly related to ambulatory status (14 non-ambulatory, 15 partly ambulatory, 15 fully ambulatory) and neurological level (13 with low-level lesions, 15 medium-level, 16 high-level) in the univariable analysis (p<0.01 for both in all three regions). Neither history of fracture, nor Tanner stage, nor history of bladder augmentation showed a significant relationship to BMD. The significance of ambulatory status and neurological level in the univariable analysis failed to persist in the multivariable analysis of this study with a small sample size. INTERPRETATION: The LDF measurement proved to be a viable technique for assessing BMD in children with congenital spinal dysfunction. LDF BMD was sensitive to differences in three categories of ambulation. The overall influence of neurological level was not deemed as important as ambulation.
