Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Nov 2014
Case ReportsEosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome) presenting as diffuse myositis.
Eosinophilic granulomatosis with polyangiitis is a complex multisystemic syndrome with heterogeneous presentation. Most often, there is a clinical history of asthma or other atopic conditions, and current presentation generally includes signs of cutaneous or pulmonary involvement. Very few reports described myalgia or weakness as the chief complaint. Of these, only a few included muscle biopsy evaluation and none showed convincing evidence of primary myositis. We believe this report is the first to demonstrate true myositis in the setting of early eosinophilic granulomatosis with polyangiitis. ⋯ Our finding of true myositis in a case of eosinophilic granulomatosis with polyangiitis suggests that primary auto-immunity against muscle fibers, distinct from the secondary effects of vasculitis, can occur in this entity and may represent an overlap syndrome. Early recognition of eosinophilic granulomatosis with polyangiitis in patients presenting with myositis may provide an opportunity to treat the vasculitis before onset of severe multisystemic disease. We recommend the use of muscle biopsy with immunohistochemistry for MHC-1 to confirm the diagnosis of myositis in the setting of eosinophilic granulomatosis with polyangiitis.
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Bmc Musculoskel Dis · Nov 2014
Estrogen receptors genes polymorphisms and age at menarche in idiopathic scoliosis.
The age at menarche (AAM) is commonly in use in patients with IS as one of the maturity indicator suggesting deceleration of the growth velocity. The AAM was suggested to be related to predisposition and curve progression potential of IS. The late age at menarche was reported to be associated with higher prevalence of adolescent idiopathic scoliosis. The age at menarche is determined by both genetic and environmental factors as well as their interactions. Estrogen receptors 1 and 2 polymorphism were reported to be associated with AAM: in ESR1 XbaI and PvuII site polymorphism and in ESR2 AluI site polymorphism.The purpose of the study was to investigate associations of the ESR1 and ESR2 polymorphisms with AAM in IS patients and to evaluate association of AAM with IS severity. ⋯ In IS patients estrogen receptors polymorphisms did not show association with the AAM. Patients with severe IS form revealed delayed AAM than patients with mild IS form.
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Bmc Musculoskel Dis · Oct 2014
Comparative StudyComparison of three plate system for lateral malleolar fixation.
This study was to compare clinical and radiographic outcomes with three different implants and evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) technique for the distal fibular fractures. ⋯ Our study demonstrated using LCP metaphyseal plate in patients associated with lateral malleolar fracture could achieve significantly better OMS & AOFAS scores and less healing time than using one-third tubular plate. Specifically, For Weber A fracture, LCP distal fibula plate is much better than one-third tubular plate and LCP metaphyseal plate. While for Weber B fracture, LCP distal fibula plate and LCP metaphyseal plate are better than one-third tubular plate. As to the complications, using MIPO technique in patients with distal fibular fractures is at least comparable to the traditional one.
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Bmc Musculoskel Dis · Oct 2014
Comparative StudyInter- and intraobserver reliability assessment of the axial trunk rotation: manual versus smartphone-aided measurement tools.
Scoliogauge, has been developed for the measurement of ATR on iPhone smartphones. This study was to evaluate the reliability for the smartphone-aided ATR measurement method and to compare its reliability with that of the manual method. ⋯ Smartphone-aided measurement for ATR showed excellent reliability, and the reliability of measurement with either scoliometer or scoliogauge could be influenced by Cobb angle that reliability was better for curves with larger Cobb angles.
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Bmc Musculoskel Dis · Sep 2014
Historical ArticleA great enigma of the Italian Renaissance: paleopathological study on the death of Giovanni dalle Bande Nere (1498-1526) and historical relevance of a leg amputation.
The Medici project consisted in archeological and paleopathological researches on some members of the great dynasty of the Italian Renaissance. The remains of Giovanni de' Medici, so-called "dalle Bande Nere" (Forlì 1498- Mantua 1526) have not been investigated yet. The enigma of the fatal injury and leg amputation of the famous Captain excited curiosity of paleopathologists, medical scientists and Italian Society of Orthopedic and Traumatology which contributed to realize the project of exhumation and study of his skeletal remains. The aim of the study is to report the first anthropological and paleopathological results. ⋯ The skeleton and muscular insertions of Giovanni revealed a young-adult and vigorous man, subjected to stresses of military activity since adolescence. Right tibia was amputated below the proximal half of diaphysis leaving long tibio-fibular stumps with a horizontal cut only at the lateral portion. Thus, the surgeon limited to complete the traumatic hemi-amputation. Amputation in the Sixteenth Century technically consisted in guillotine incisions below the knee using crescent shaped knife and bony saw, usually leaving a quite long tibial stump. Amputations in the Sixteenth Century were contaminated and grossly performed not providing vascular binding nor wound closure. The surgeon performed the procedure in conformity with surgical knowledge of that period.