Cases reported "Arthralgia"

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1/10. knee pain and the infrapatellar branch of the saphenous nerve.

    Pain over the front of the knee is common after surgery or trauma but often a definite diagnosis is difficult to make. Over the past year we have seen five cases in which the pain could be ascribed to damage to a branch of the infrapatellar branch of the saphenous nerve. Two were subsequent to trauma and three to surgical procedures. In all five cases surgical exploration gave symptomatic relief. Eight cadaveric knees were prosected to explore further the anatomy of this nerve in relation to the injuries. Injury to one of these branches should be considered in cases of persistent anterior, anteromedial or anterolateral knee pain or neurological symptoms following surgery or trauma.
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ranking = 1
keywords = anteromedial
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2/10. Medical check of competitive canoeists.

    We gave a sports injury questionnaire survey to 821 active canoeists, members of the japan Canoe association (JCA), and performed a medical check of 63 top competitive JCA canoeists, including physical and laboratory tests and radiographic examinations of the chest, spine, shoulder, elbow, and wrist joints. Completed questionnaires were returned by 417 canoeists, whose reported racing styles were: kayak, 324; Canadian canoe, 71; slalom, 13; and not specified, 9. Of the 417 respondents, 94 canoeists (22. 5%) reported that they experienced lumbago; 20.9% experienced shoulder pain; 3.8%, elbow pain; and 10.8%, wrist pain. On medical examinations, lumbago was found to be mainly of myofascial origin or due to spondylolysis. Impingement syndrome was also observed in 4 canoeists with shoulder problems. The competitive canoeists had low blood pressure, and some had bradycardia. On laboratory examinations, serum hemoglobulin, hematocrit, high-density lipoprotein cholesterol (HDL-CHO), creatine phosphokinase (CK), and creatine (CRTN) in the top competitive canoeists showed high values in comparison with those of an age-matched control group. However, low serum total cholesterol (TP) values were observed in the top competitive canoeists.
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ranking = 9.4808913482104E-6
keywords = group
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3/10. Cervical flexion: a study of dynamic surface electromyography and range of motion.

    BACKGROUND: In the comprehensive assessment of painful conditions, dynamic surface electromyography (sEMG) and range of motion (ROM) recordings can provide information regarding muscle spasm, antalgic postures, fear of pain (protective guarding), muscle injury, and disordered movement caused by pain. This study examines ROM and sEMG patterns observed during cervical flexion. OBJECTIVE: To demonstrate 2 distinctive sEMG recruitment and dynamic ROM patterns observed during cervical flexion and return to mid-line. DESIGN: Single-subject design with independent measurement of dynamic ROM and sEMG. SETTING: Applied clinical setting. PARTICIPANTS: Two subjects with normal ROM and cervical muscles were studied. MAIN OUTCOME MEASURE: One subject was studied with sEMG. looking at the cervical paraspinals and sternocleidomastoid muscles; the other subject was studied with an active ROM device. Three cervical movements were studied: lower cervical flexion, atlantoaxial (upper) cervical flexion, and a combination upper/lower cervical flexion. RESULTS: The active ROM device indicates larger movements (higher degrees of flexion) for the lower cervical flexion compared with upper flexion. The combined movement indicates a differential movement from 2 spinal segments. The sEMG recordings indicated differential recruitment patterns. The sternocleidomastoid recruits briskly during the flexion phase of the upper cervical flexion movement, whereas the cervical paraspinals recruit briskly during return to mid-line when the lower cervical flexion is used. The combined upper then lower cervical flexion movement recruits both sets of muscles. CONCLUSIONS: The results of the study indicate 2 distinct movement patterns associated with upper versus lower cervical flexion and 2 distinct sEMG recruitment patterns. The study suggests that these 2 distinct movements involve 2 distinct cervical segments and are associated with recruitment of different muscle groups. Applied clinical research on the cervical spine should use sEMG recordings to assess both the upper and lower flexion movements as the standard for the study of cervical flexion.
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ranking = 9.4808913482104E-6
keywords = group
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4/10. simvastatin-induced lupus-like syndrome.

    The 3-hydroxy-3-methylglutaryl coenzyme a (HMG-CoA) reductase inhibitors are widely used as cholesterol lowering agents that have an acceptable safety profile. As a group, this class of drugs has been associated with few immunologic reactions. simvastatin (Zocor) has been linked to three cases of drug-induced lupus-like syndrome. We report the case of an additional patient who developed pleurisy and arthralgia after he started taking this low-density lipoprotein and cholesterol-lowering agent.
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ranking = 9.4808913482104E-6
keywords = group
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5/10. Mucoid degeneration of the anterior cruciate ligament.

    A case of intraligamentous mucoid degeneration of the anteromedial band of the anterior cruciate ligament (ACL) is presented. The patient had knee pain without clinical or diagnostic evidence of instability. Isolated debridement of the anteromedial band resulted in immediate pain relief with rapid return to athletic activities without instability. We present this case to demonstrate the presence of intraligamentous mucoid degeneration in the ACL as a source of knee pain without instability. Partial ACL debridement did not preclude adequate knee stability.
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ranking = 2
keywords = anteromedial
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6/10. Atypical presentation of churg-strauss syndrome: another "forme fruste" of the disease?

    vasculitis is a clinicopathologic process characterized by inflammation and damage to blood vessels. A broad and heterogenous group of syndromes may result from this process, because any type, size, and location of blood vessel may be involved. The cause of these conditions remains unclear, but an autoimmune inflammatory process, characterized by involvement of both neutrophils and endothelial cells, seems to play an important role. In 1951, Churg and Strauss described a clinical syndrome of severe asthma, hypereosinophilia with eosinophilic infiltrates, eosinophilic vasculitis, and granulomata in various organs. asthma may precede this vasculitis by many years. We report a case of anti-neutrophil cytoplasmic antibody-positive, pauci-immune, crescentic, necrotizing glomerulonephritis with peripheral and interstitial eosinophilia but without asthma. This is very unusual in churg-strauss syndrome.
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ranking = 9.4808913482104E-6
keywords = group
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7/10. ANA negative (Ro) lupus erythematosus with multiple major organ involvement: a case report.

    Anti-nuclear antibody (ANA) negative systemic lupus erythematosus (SLE) occurs in about 4-13% of SLE cases. A small group of ANA negative SLE patients with positive anti-Ro antibodies usually present with typical vasculitic skin lesions which can be associated with photosensitivity, renal disease, congenital heart block or neonatal lupus. We present a case of a persistently ANA negative patient who presented with joint pain, rashes, mouth ulcer and alopecia. Clinical diagnosis of systemic lupus erythematosus was made even though ANA was negative. She was started on steroids and went into remission. Later, she developed several episodes of convulsions associated with fever and prominent vasculitic lesions. The patient was also found to have microscopic hematuria, proteinuria, anemia and thrombocytopenia. Renal biopsy showed lupus nephritis class 1B. Due to the prominent skin lesions, we performed anti-extractable nuclear antigens (ENA) antibodies test and anti-Ro turned out to be positive. The final diagnosis was ANA negative SLE (Ro lupus) with cutaneous, renal, musculoskeletal, hematological and cerebral Involvement.
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ranking = 9.4808913482104E-6
keywords = group
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8/10. A case of intra-articular snapping hip caused by articular cartilage detachment from the deformed femoral head consequent to Perthes disease.

    We treated a relatively rare case of intra-articular snapping hip caused by an articular cartilage fragment detached from the deformed femoral head consequent to Perthes disease. We report the pathology as well as diagnosis and treatment of this case. A 24-year-old man presented with right coxalgia. He was diagnosed with Perthes disease at a young age and was treated conservatively. Six months before the patient visited our department, he started having intense pain accompanied by a clicking sound when he extended and at the same time externally rotated the right hip joint from a flexed position. Although a radiogram showed Stulberg class 3 deformity of the femoral head, the joint space was well preserved and no bone cyst or bone spur formation was seen. Computed tomography (CT) and magnetic resonance imaging (MRI) showed no abnormal findings inside the femoral head and in the hip joint. However, when 5 mL of 2% lidocaine hydrochloride was injected into the hip joint, the snapping phenomenon persisted but the sharp pain was temporarily resolved. Arthroscopic finding showed a valve-shaped detachment of articular cartilage in the anteromedial side of the femoral head. Arthroscopic shaving of the detached fragment was conducted. The pain and clicking sound accompanying hip joint movement disappeared postoperatively. hip joint arthroscopy is useful for the diagnosis and treatment of intra-articular type snapping hip when the cause of snapping is inside the joint cavity.
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ranking = 1
keywords = anteromedial
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9/10. A systemic reaction following exposure to a pyrethroid insecticide.

    The pyrethroids are a group of pesticides in wide use around the world. They are felt to be safer than the organophosphates. We report a case of an acute systemic reaction in a farmer following exposure to the synthetic pyrethroid flumethrine.
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ranking = 9.4808913482104E-6
keywords = group
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10/10. Avulsion fracture of the ischium following complex total hip arthroplasty: an unusual cause of hip pain.

    Total hip arthroplasty in the high riding dislocated hip is a technically difficult undertaking, with major reconstruction required on both the acetabular and femoral sides. With reconstruction at a near-anatomic hip center, reduction of the arthroplasty is difficult because of the long-standing limb shortening. The major block to reduction is tension of the soft tissues, particularly the hamstrings. We report a case of ischial tuberosity avulsion fracture following such a complex reconstruction despite femoral shortening subtrochanteric osteotomy. This illustrates the importance of the hamstring group in maintaining the dislocation and emphasizes the need to prevent overtension of the soft tissues in such complex reconstructive procedures.
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ranking = 9.4808913482104E-6
keywords = group
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