ABSTRACT
Cleft sternum is an extremely rare anomaly of development. It results from failure of fusion of midline structures that contribute to the formation of the sternum. The defect may affect the upper sternum, the lower sternum, or the whole sternum. Most cases are diagnosed in childhood when it is associated with serious midline defects. We present a case of an isolated upper sternal cleft in a 55-year-old adult, found accidentally on bone scan. To our knowledge, no bone scan image of cleft sternum could be found in the literature.
Subject(s)
Bone and Bones/diagnostic imaging , Incidental Findings , Musculoskeletal Abnormalities/diagnostic imaging , Adult , Humans , Middle Aged , Radiography , Sternum/abnormalities , Sternum/diagnostic imagingABSTRACT
Enthesophytes are analogous to osteophytes of osteoarthritis. Enthesopathy is the pathologic change of the enthesis, the insertion site of tendons, ligaments, and joint capsules on the bone. In gout, the crystals of monosodium urate monohydrate may provoke an inflammatory reaction that eventually may lead to ossification at those sites (enthesophytes). Here we report the case of a man with chronic gout who sustained an open fracture of an olecranon enthesophyte when he fell on his left elbow. To our knowledge, no other case of open fracture of an enthesophyte has been reported in the English literature.
Subject(s)
Fractures, Open/etiology , Gout/complications , Olecranon Process/pathology , Ossification, Heterotopic/complications , Osteophyte/complications , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Elbow Joint/pathology , Elbow Joint/surgery , Fractures, Open/pathology , Fractures, Open/therapy , Gout/pathology , Humans , Ligaments, Articular/pathology , Ligaments, Articular/surgery , Male , Middle Aged , Ossification, Heterotopic/pathology , Ossification, Heterotopic/surgery , Osteophyte/pathologySubject(s)
Lung/diagnostic imaging , Pneumothorax/diagnostic imaging , Humans , Male , UltrasonographyABSTRACT
Bucket handle tears of both menisci in the setting of acute or chronic anterior cruciate ligament (ACL) tears of the same knee have rarely been reported in the literature. This article presents a case of a bucket handle tear affecting both the medial and lateral menisci in a patient with chronic ACL rupture. Both bucket handle tears were displaced and locked in the intercondylar notch. A new magnetic resonance image (MRI) sign suggested on sagittal view is called the triple PCL sign, comprising the intact posterior cruciate ligament (PCL) and the 2 displaced fragments in the intercondylar notch from the two bucket handle tears. The precise diagnosis of this condition is of obvious importance for optimal operative planning. While finding the displaced fragment from the medial meniscus is expected to cause the double PCL sign, the torn ACL may have made it easier to visualize the bucket handle tear of the lateral meniscus in the same sagittal plane as the PCL. Only 5 other reports mention bimeniscal bucket handle tears of both the medial and lateral menisci in association with an ACL tear. None have shown the suggested triple PCL sign because of lack of overlap between the 2 bucket handle tears in the coronal plane while lying in the intercondylar notch causing them not to fall in the same sagittal plane. Our patient showed some overlap between the 2 meniscal fragments while lying in the notch to create the triple PCL sign on sagittal MRI.
Subject(s)
Anterior Cruciate Ligament/pathology , Knee Injuries/diagnosis , Knee Joint/pathology , Menisci, Tibial/pathology , Accidental Falls , Adolescent , Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament Injuries , Chronic Disease , Humans , Magnetic Resonance Imaging , Male , Menisci, Tibial/surgery , Plastic Surgery Procedures , Rupture , Tibial Meniscus InjuriesABSTRACT
Pediatric trigger thumb is an uncommon condition with a calculated incidence of 3 per 1000 live births or less. Some reports have suggested a congenital etiology while others could not find a single case of pediatric trigger thumb at birth. This article reports the occurrence of bilateral trigger thumbs in identical twins, age 3 years and 9 months, affecting their thumbs to similar extents, which may suggest a congenital etiology.Congenital etiology for trigger thumb has been proposed for many reasons: occurrence in infants, occurrence in twins, occasional bilaterality, possible presence of triggering at birth, and absence of history of trauma. The occurrence of pediatric trigger thumb in twins has been reported 3 times in the literature; all reported cases were bilateral, as in our case.The mean age at presentation of pediatric trigger thumb is 2 years. The thumb is usually held in a fixed flexion position (mimicking a fracture). Examination usually reveals a palpable nodule in the flexor pollicis longus tendon at the metacarpal joint. This is an important clinical sign. Triggering in children, however, is rare. Macroscopically, there is a nodular thickening of the tendon itself. Pathological changes can be found in the tendon, tendon sheath, or both. A specimen taken from one of the nodules in our case showed degenerative changes while those from both pulleys were normal.Pediatric trigger thumb responds predictably to A1 pulley release, preferably before age 4 years, although milder cases may resolve spontaneously.
