ABSTRACT
The practicing physician can be assured of both an accurate and systematic method for making a diagnosis when using an anatomic approach to the common clinical problem of hip pain. The numerous causes of hip and leg pain in the small child and adolescent and their management are reviewed.
Subject(s)
Hip Joint , Pain/diagnosis , Child , Hip Joint/physiopathology , Humans , Joint Diseases/diagnosis , Joint Diseases/physiopathology , Joint Diseases/therapy , ThighSubject(s)
Causalgia , Neuralgia , Reflex Sympathetic Dystrophy , Adrenal Cortex Hormones/therapeutic use , Autonomic Nerve Block , Causalgia/diagnosis , Causalgia/therapy , Diagnosis, Differential , Exercise Therapy , Guanethidine/administration & dosage , Humans , Neuralgia/diagnosis , Neuralgia/therapy , Reflex Sympathetic Dystrophy/diagnosis , Reflex Sympathetic Dystrophy/therapy , Reserpine/administration & dosage , Sympathectomy , Terminology as Topic , Thermography , Time FactorsABSTRACT
Locked-in syndrome is a rare syndrome characterized by quadriplegia, intact consciousness, mutism, and communication using vertical eye movements. We report the case history of a patient with transient locked-in syndrome following repeated shunt procedures for idiopathic aqueductal stenosis. Communication was with lateral eye movements. Although she eventually recovered and regained functional independence, high doses of phenobarbital, given to prevent seizures, sedated her and obscured her mental status during her rehabilitation. We urge the careful monitoring of all centrally acting agents in patients with locked-in syndrome.
Subject(s)
Phenobarbital/adverse effects , Quadriplegia/chemically induced , Adult , Cerebral Aqueduct , Cerebrospinal Fluid Shunts , Constriction, Pathologic , Female , Humans , Hydrocephalus/etiology , Hydrocephalus/surgery , Phenobarbital/blood , Time FactorsABSTRACT
The authors state that there are many varied causes of hip and thigh pain, the signs and symptoms of which are often misleading and confusing, thus making diagnosis difficult. They present a logical categorized anatomic and neurologic approach toward clinical examination, designed to assure the physician of a correct diagnosis.
Subject(s)
Hip Joint , Pain/etiology , Hip Joint/innervation , Humans , Joint Diseases/classification , Joint Diseases/diagnosis , Pain/diagnosis , ThighABSTRACT
The acute and chronic effects of alcohol on bone, muscle and peripheral nerves are not well appreciated. Bone complications include traumatic fractures, osteoporosis and osteonecrosis. In muscle, a sustained bout of heavy drinking may cause rhabdomyolysis, while chronic alcohol abuse may produce proximal myopathy. In peripheral nerves, acute alcohol intoxication may lead to pressure neuropathy and chronic abuse may cause peripheral neuropathy.
Subject(s)
Alcoholic Beverages/adverse effects , Bone Diseases/chemically induced , Muscular Diseases/chemically induced , Peripheral Nervous System Diseases/chemically induced , Acute Disease , Alcoholism/complications , Bone Diseases/diagnosis , Chronic Disease , Humans , Intestinal Absorption/drug effects , Muscular Diseases/diagnosis , Peripheral Nervous System Diseases/diagnosisABSTRACT
Postpolio weakness, a newly recognized clinical entity, is beginning to appear in patients some 30 years after their initial bout with the disease. Two such cases are presented. The difficulties in establishing an early and correct diagnosis and the emerging complications and uncertainty surrounding the postpolio patient are discussed. Recognition, early diagnosis, close scrutiny and constant vigilance are presented as the only defense, at this time, in combating the emerging latent complications of polio.
