ABSTRACT
Tuberculosis of the cervical spine is a rare extra-pulmonary localization. We reported the case of a 59-year-old woman with no medical history. She consulted for a 9 weeks history of painful cervical stiffness. Neurological examination was normal. Plain radiography revealed an osteolytic lesion of the C3 body, with infiltration of adjacent soft tissues. MRI showed a compression fracture of the C3 body with a signal anomaly extending to the anterior epidural space and pre-vertebral soft tissues. First, tumoral extension assessment was done and was normal. BK's research into sputum was negative. Histological examination of a CT biopsy revealed typical granulomatous inflammation. The diagnosis of tuberculosis was retained and antituberculous treatment was started with immobilization for 12 months. The patient had a total functional recovery at 18 months follow-up, with complete radiographic bone reconstruction of C3 after 12 months.
Subject(s)
Cervical Vertebrae/pathology , Tuberculosis, Spinal/diagnosis , Antitubercular Agents/therapeutic use , Cervical Vertebrae/microbiology , Diagnosis, Differential , Female , Fracture Fixation , Fractures, Compression/diagnosis , Fractures, Compression/etiology , Fractures, Compression/therapy , Humans , Immobilization , Middle Aged , Neck Pain/diagnosis , Spinal Fractures/diagnosis , Spinal Fractures/etiology , Spinal Fractures/therapy , Tuberculosis, Spinal/complications , Tuberculosis, Spinal/therapyABSTRACT
OBJECTIVE: To compare diagnosis value of 1.5T and 3T MRI in the detection of traumatic knee injuries in young patients by reference to arthroscopy. MATERIALS AND METHODS: One hundred patients were prospectively included. All patients randomly underwent standardized knee 1.5T or 3T MRI with subsequent knee arthroscopy. Meniscus and cruciate ligaments tears were blindly assessed by two independent musculoskeletal radiologists. RESULTS: Comparison of 1.5T and 3T MRI groups in the diagnosis of medial and lateral meniscal tears showed significantly higher sensitivity (p = 0.015) of 1.5T MRI in the diagnosis of lateral meniscal tears. Sensitivity and specificity for complete ACL tears were 100 percent [35/35] and 100 percent [23/23] at 1.5T MRI (p = < 0.0001) versus 95.5 percent [21/22] and 100 percent [16/16] at 3T MRI (p = < 0.0001).Only three complete PCL tears were observed in this study. Sensitivity and specificity for all complete CL tears were 100 percent [37/37]; 100 percent [77/77] for 1.5T MRI (p < 0.0001); and 95.7 percent [22/23] and 100 percent [59/59] for 3-T MRI (p < 0.0001). Diagnosis value of 1.5T and 3T MRI was equal for ACL and PCL complete tears. CONCLUSION: Diagnosis value of 1.5T was similar to 3T MRI for medial meniscal and cruciate ligament tears of the knee in symptomatic patients and higher for lateral meniscal tears.
ABSTRACT
BACKGROUND: Total knee arthroplasty on excessive genu varum is a more demanding technique and gives worst results than procedures on moderate deformations. It remains a subject of controversies due to the lack of consensus. The purpose of our study is to evaluate the results of total knee arthroplasty (TKA) on excessive genu varum (superior to 20°) by analyzing pre and post operative clinical and radiological parameters. METHODS: We reviewed retrospectively 40 TKA in 33 patients (seven patients operated bilaterally) performed for genu varum superior to 20° between 2004 and 2011. Pre and post operative evaluation of patients were done according to the International Knee Society score. RESULTS: The mean age of our patients was 67 years with a female predominance. Tricompartmental arthritis was the etiology in all cases. Pre operative IKS score and HKA angle were respectively 52,36 /200 points and 155,7°. The mean follow up was 4 years. Our results were generally satisfactory. The post operative IKS score was 155,36 points (mean joint score of 85.85 points and mean functional score of 69.26 Points) and the post operative HKA angle was 176,17°. Only 60° of patients had normal HKA angle. We noted aseptic loosening of the tibial component in 3 cases. CONCLUSION: TKA on excessive genu varum is more demanding technique. Pre operative planning after analyzing different clinical and radiological parameters is necessary to obtain a good functional outcome while minimizing the rate of complications.
Subject(s)
Arthroplasty, Replacement, Knee/adverse effects , Genu Varum/etiology , Age Distribution , Aged , Arthroplasty, Replacement, Knee/statistics & numerical data , Female , Genu Varum/diagnostic imaging , Genu Varum/pathology , Humans , Knee Joint/diagnostic imaging , Male , Radiography , Retrospective Studies , Severity of Illness Index , Sex DistributionABSTRACT
Melorheostosis is a rare entity belonging to the group of sclerotic bone dysplasias. Described for the first time in 1922 by Leri, it remains imperfectly known as clinical presentations are highly variable, and the etiological diagnosis is not fully elucidated. We report a case of polyostoticmelorheostosis for which radiological investigations were complete, in order to study this disease.
Subject(s)
Melorheostosis/diagnosis , Rare Diseases/diagnosis , Adult , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Bone and Bones/abnormalities , Bone and Bones/pathology , Dentin Dysplasia/pathology , Female , Humans , Magnetic Resonance Imaging , Melorheostosis/drug therapy , Multimodal Imaging , Rare Diseases/drug therapy , Tomography, X-Ray ComputedABSTRACT
Authors describe the case of a patient with breast cancer and multiple myeloma as the second metachronous disease responsible for spinal cord compression. Synchronous occurrence of bone marrow breast cancer disease and multiple myeloma has not been described in the literature, as in this case. By presenting this case, we point to possible association between both diseases and the possible factors involved in the development of second malignant disease.
