Unilateral facet subluxations: an example of a missed post-traumatic unilateral facet subluxation — a case report

Unilateral facet injuries occur in 4-16% of patients with cervical spine injuries, (of which unilateral facet subluxations occur as a subgroup in this population). These injuries arise in motor vehicle accidents because of flexion-distraction forces, or flexion of an already rotated head.Due to the common presentation of a lack of neurological signs and symptoms, delayed diagnosis of unilateral facet subluxations are common. As a result, it is imperative that the proper diagnosis is made so that patient care can be made more effective with ultimately less sequelae. For the clinician, diagnosis can be aided by the use of radiographic analysis.Adequate radiographic analysis is an important tool to accurately assess whiplash associated disorders. Radiographic findings of facet subluxations are subtle on routine views. Utilizing oblique views, the diagnoses are usually evident. Therefore, oblique views are very useful in the clinical setting.This case report will describe a 29-year-old female with a missed unilateral facet subluxation, radiographic findings and characteristics, and the clinical utility of oblique views in patients suffering from whiplash associated disorders.     

Congenital absence of lumbosacral articular facet joint associated with conjoined nerve root: a case report

We report a rare case of congenital absence of the L5-S1 facet joint, which was associated with a conjoined nerve root. Combination of these two anomalies has been quite rarely reported in the literature. A 39-year-old man presented with acute low back pain and right leg radiating pain. Muscle weakness and sensory disturbance of the right leg were also apparent in the region innervated by L5 and S1 nerve roots. Preoperative multidetector three-dimensional computed tomography (3D-CT) showed complete absence of the right S1 superior articular process. Magnetic resonance (MR) images showed lumbar disc herniation at right L5-S1 level that migrated cranially. Intraoperative findings revealed that the right L5 nerve root and S1 nerve root were conjoined, and the conjoined nerve root was compressed by L5-S1 disc herniation, which led to impairment of the conjoined nerve root by a single-level lumbar disc herniation. After removal of the disc herniation, his right leg pain immediately subsided, however muscle weakness and sensory disturbance persisted. Surgeons should be aware of this nerve root anomaly when examining a patient who shows an unusual clinical presentation and/or congenital osseous anomaly.     

Chip fracture through the superior articular facet with compressive cervical radiculopathy

Four patients with cervical radiculopathy secondary to a chip fracture through the superior articular facet have been treated in the past 2 years. These small-element fractures may occasionally pass unrecognized. Although oblique X-rays are helpful, lateral tomography has provided the most precise detail. The pathological process is a compressive radiculopathy, explicable on the basis of the foraminal anatomy. The authors feel myelography is not essential. The preferred surgical approach is posterior: the results have been excellent.     

Cleidocranial dysplasia: a case report

This article discusses the case of a 55-year-old man suffering from mild neck pain and chronic sinusitis. In addition the patient presented with clinical and radiological findings consistent with a congenital disorder of cleidocranial dysplasia. Diagnostic imaging and clinical manifestations are discussed.     

Unilateral congenital aplasia of the scaphoid and dysplasia of the trapezium (a case report)]

Aplasia of the carpal scaphoid bone in association with dysplasia of the trapezium is a rare disorder. A right-handed, 66 years old male, suffering from a trapeziometacarpal arthritis on the right side is reported. X rays, MRI and CT-scan reveal an absence of scaphoid and a dysplasia of the trapezium. The lunate remains in place on the radius but is oriented in dorsi flexion. The capitate is dorsally and radially subluxated. Trapezium inclination of the joint at the base of the first metacarpal (trapezial tilt) is 32 degrees greater than on the opposite side which is normal (48 degrees). Radial styloid is hypoplasic. The scaphoid fossa is not covered with cartilage and subchondral sclerotic bone. The intercarpal joints show no trace of arthritis. There are no other deformation on the radial segment of the hand and the forearm. This congenital absence of scaphoid remains asymptomatic and well tolerated excepting the dysplasic trapeziometacarpal joint.     

Neonatal osteofibrous dysplasia: a case report

We describe a case of neonatal osteofibrous dysplasia that was diagnosed 3 days after birth. Osteofibrous dysplasia is a fibro-osseous lesion rarely seen in long bones. It is also known as congenital osteitis fibrosa or ossifying fibroma of bones. Although it occurs in children under 10 years of age, it is extremely rare in newborn babies. It must be differentiated from adamantinoma due to their radiological appearance, predilection for tibia and fibula, clinical picture, and certain histological similarities.     

Synovial cyst of a cervical facet joint: case report

Intraspinal synovial cysts are rare. Those reported have occurred in the lumbar region. We report a case of an extradural true synovial cyst of the cervical spine causing spastic paraparesis. The cyst occurred after a cervical spine fracture and, hence, was probably related to trauma. Surgical therapy resulted in a satisfactory recovery.     

Unilateral pulmonary venous obstruction: a case report

A 3-month-old girl with right common pulmonary venous obstruction and severe pulmonary hypertension underwent pulmonary venous reconstruction (venoplasty). However, pulmonary hypertension persisted and she died on the 69th postoperative day. Autopsy revealed a widely opened pulmonary vein at the site of the venoplasty. Histological examination showed thickened alveolar walls, thromboembolism in pulmonary arterioles and venous hypoplasia in the right lung. The venoplasty for unilateral pulmonary venous obstruction with severe pulmonary hypertension may not be the proper treatment, since pulmonary hypertension usually continues or progresses postoperatively. Pneumonectomy may be a better choice to be applied.     

Unilateral pulmonary oedema: a case report.

We have presented a case of unilateral pulmonary oedema which we feel is secondary to obstruction of the right main bronchus during spontaneous respiration. An anode tracheal tube was introduced through a tracheostomy during operation in a man with pre-existing pulmonary and cardiac disease. At the end of the anaesthetic, acute obstruction to ventilation of the right main bronchus developed with the tube still in place and the patient breathing spontaneously. The obstruction was relieved, by repositioning of the tracheal tube, but not before the patient developed right unilateral pulmonary oedema.     

Rib-originated fibrous dysplasia: report of a case

The incidence of fibrous dysplasia (FD) is not frequent in the case of benign bone tumors of the chest wall, and differential diagnosis between FD and the malignancy on the basis of imaging findings is difficult. We report a case of a painful FD lesion (size, 9×8 cm) that originated from the 5th rib of a 52-year-old man and was surgically resected. His symptoms improved after the operation. Painful and large FD lesions should be resected because of a difficulty in differential diagnosis from malignant tumors.     

掌骨骨纤维结构不良1例

正患者,女,52岁。因右手第5掌骨处肿痛1年加重1周入院。2014年1月患者右手第5掌骨受到明确的外伤压砸,未就诊和处理,此后右手第5掌骨反复性轻度胀痛。1周前明显加重,无发热、游走性关节疼痛、晨僵等症状。平素患有糖尿病,血糖控制正常。入院查体:右手背第5掌骨处略肿胀,不红,皮温不高,无色素沉着,无静脉怒张,压痛明显,右手第5掌指间关节活动受限伴疼痛,指间关节活动正常,末梢血运好,皮肤感觉未见异常。实验室检查:餐前血糖9.2 mmol/L,碱性磷酸酶104.5 U/L,白细胞5.18×10~9/L,中性粒细胞百分比59%,血沉10 mm/h,     

Unilateral testicular tuberculosis: case report

Genitourinary tuberculosis (GT) includes 8-15% of extrapulmonary tuberculosis (TB), which is more frequent in men. Epididymides, seminal vesicles, prostate and testis are the most common sites of GT. Although testicular TB is uncommon, we report 2 patients with unilateral testicular TB. The main treatment of urogenital tuberculosis is anti-tuberculosis pharmacotherapy, sometimes combined with surgery.     

Intraosseous calcifying pseudotumor of the axis: a case report

STUDY DESIGN: A case report and review of the literature. OBJECTIVE: To present the first case of intraosseous calcifying pseudotumor arising from the axis. SUMMARY OF BACKGROUND DATA: Calcifying pseudotumor is a very rare disease. Only 24 cases have been previously reported. METHODS: A case of calcifying pseudotumor involving the body, dens, and laminae of the axis in a 60-year-old male patient was managed with total laminectomy of the axis and instrumented occipitocervical fusion, followed by the curettage of the body and dens of the axis and autogenous iliac bone graft. Medical records, imaging studies, microscopic findings, and related literature are reviewed. RESULTS: Microscopic examination showed amorphous, basophilic, and chondroid calcifying masses surrounded with palisading histiocytes and foreign body-type giant cells. The findings were consistent with those of calcifying pseudotumors previously reported in other sites of the body. At 24 months after operation, a significant reduction of neck pain was achieved. But there was evidence of local recurrence of the lesion in the body and dens of the axis with a local progression of the preexisting lesion in the facet joints. CONCLUSION: This is the first report of intraosseous calcifying pseudotumor arising from the axis.     

Renal-ovarian axis: a case report and review

The renal-ovarian axis is a unique and rare phenomenon manifested by an interesting interrelationship between the ovary and kidney. The similar embryologic development, the histologic similarities of these malignancies, and asymmetric venous outflow represent the foundation of this theoretical axis. A poor understanding of this metastatic spread has led to missed, or delayed, diagnosis of the primary malignancy. We describe the only case of a late recurrent metastatic ovarian carcinoma masquerading as a solitary renal cell carcinoma. An exhaustive review of published English reports evaluating the renal-ovarian axis was undertaken to characterize and understand the nuances of this entity.