JNMA; journal of the Nepal Medical Association
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We present a case of postaxial polydactyly with well formed six digits on left hand and seven digits on right hand. Both conditions are rare and combination of these two conditions even rarer. The patient also had supernumerary sixth right toe and cleft lip. Very few cases of postaxial polydactyly are reported previously.
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JNMA J Nepal Med Assoc · Jan 2009
Review Case ReportsSubperiosteal osteoid osteoma of the neck of talus.
Juxta-articular, subperiosteal osteoid osteomas arising around the ankle are unusual. Tumors arising on the neck of the talus commonly produce symptoms mimicking monoarticular arthritis. Patients are usually treated for arthritis or ankle sprain, which often leads to a delay in definitive diagnosis. ⋯ Diagnostic dilemma and delay can be avoided by high index of suspicion. The patient was treated with open removal of the tumor. We also present brief review of literature about juxta-articular, subperiosteal osteoid osteoma which is uncommon from the typical osteoid osteoma occurring elsewhere in the body.
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JNMA J Nepal Med Assoc · Jan 2009
Case ReportsAnesthetic management of a child with Down's syndrome having atlanto axial instability.
Down's syndrome is the most commonly encountered congenital anomaly in medical practice. These patients are of special concern to medical practice because of their associated problems with regard to respiratory, cardiovascular and other systemic problems. ⋯ Their reactivity to inhalational anesthetics and atropine is variable. Here we present an interesting case report of a child with Down's syndrome who presented with atlantoaxial instability for MRI of cervical spine under general anesthesia.
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JNMA J Nepal Med Assoc · Jan 2009
The role of ultrasonography in detection and localization of radiolucent foreign body in soft tissues of extremities.
Retained non-radiopaque foreign body inside soft tissue can be a cause of prolonged morbidity. Detection and localization is difficult task with conventional radiography. Ultrasonography, CT and MRI are other modes of evaluation but both of CT and MRI are expensive and not easily available. ⋯ Plain X-ray isn't sensitive for detection of non-radiopaque foreign body in soft tissue. Ultrasonography is sensitive and specific for detection and localization of foreign body which should be included in evaluation for clinically suspicious retained non-radiopaque foreign body in soft tissue of extremities.
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JNMA J Nepal Med Assoc · Oct 2008
ReviewCervical spine clearance: a review and understanding of the concepts.
Cervical spine injury is relatively rare, occurring in only 2% to 3% of patients with blunt trauma who undergo imaging studies. However, timely and accurate recognition of cervical spine injury is essential for the optimal management of patients with blunt trauma as subsequent morbidity includes prolonged immobilization. ⋯ Implementation of such guidelines will decrease time for cervical spine clearance and incidence of missed injuries. In this article different aspects of cervical spine injuries and cervical spine clearance protocols are reviewed.