ABSTRACT
Ganglion cysts of the knee are being reported more frequently secondary to an increased rate of magnetic resonance imaging studies. Although knee pain is the impetus for imaging, ganglion cysts are often incidental findings. Nonoperative treatment is a successful therapeutic option. We report a patient with variable pain presentations over the course of her treatment. The pattern of complaints pointed to different primary etiologies about the knee, but all were common to an interosseous ganglion cyst. A stepwise assessment and expansion of the differential diagnosis allowed for appropriate utilization of modalities and limited morbidity with nonoperative therapy.
Subject(s)
Anterior Cruciate Ligament Injuries , Bone Cysts/diagnosis , Bone Cysts/rehabilitation , Knee Injuries/complications , Sprains and Strains/diagnosis , Sprains and Strains/rehabilitation , Adult , Anti-Inflammatory Agents/therapeutic use , Betamethasone/therapeutic use , Bone Cysts/etiology , Bone Cysts/physiopathology , Braces , Combined Modality Therapy , Cryotherapy , Diagnosis, Differential , Exercise Therapy , Female , Humans , Magnetic Resonance Imaging , Pain/etiology , Physical and Rehabilitation Medicine , Range of Motion, Articular , Sprains and Strains/etiology , Sprains and Strains/physiopathologyABSTRACT
Scapular instability may be the result of a variety of casues of which the clinician should be made aware. Work-up should include an initial radiographic evaluation and may require more in-depth investigation. Treatment should be prescribed dependent on the underlying diagnosis. In most cases, instability about the scapula can be treated with a careful plan of exercises to strengthen the involved musculature. It may take upwards of 12 to 18 months to achieve adequate results. Nonoperative failures may need to be treated with surgical techniques including nerve dissection and reconstruction with muscle flaps.
Subject(s)
Joint Instability/physiopathology , Joint Instability/rehabilitation , Scapula/physiopathology , Biomechanical Phenomena , Exercise Therapy , Humans , Joint Instability/diagnosis , Range of Motion, Articular , Scapula/anatomy & histology , Shoulder Injuries , Shoulder Pain/physiopathology , Shoulder Pain/rehabilitationABSTRACT
We examined the relationship of preoperative unilateral memory function and quantitative hippocampal histology in patients undergoing anterior temporal lobectomy for the treatment of complex partial seizures. Recognition memory (objects, words, figures) was assessed preoperatively for each hemisphere by the intracarotid amobarbital procedure in 23 patients (mean age at the time of operation, 30.2 yr; standard deviation, 9.2; mean age at the time of seizure onset, 12.3 yr; standard deviation, 8.6) without tumor. Memory scores were the total number of items recognized, adjusted for guessing. Histological examination of the anterior 20 to 30 mm of hippocampal tissue was accomplished in all patients. The degree of unilateral memory impairment ipsilateral to the seizure focus was significantly correlated with decreased neuronal density in the hilar (r = 0.66, P < 0.001) and dentate granule (r = 0.61, P < 0.002) regions, but not in the CA1 (r = 0.10, P = not significant) or CA2-3 (r = 0.35, P = not significant) regions. Memory performance with the contralateral hemisphere was not significantly correlated with ipsilateral hippocampal densities. These data support the role of the hippocampus in human memory and show further evidence of hippocampal subfield specificity in the relationship between memory performance and neuronal cell loss. Further studies of the dentate granule and hilar regions in relation to human memory are warranted.
