Mycobacterium marinum osteomyelitis of a long bone

Mycobacterium marinum can uncommonly cause osteomyelitis of small bones of extremities. The reported cases in literature are reviewed. We report a rare case of long bone osteomyelitis which as far as we are aware, has never been described before. Even though this organism normally causes infection in the superficial cooler regions of the body, clinicians should be aware of the possibility of long bone osteomyelitis in patients with a history of immune compromise and the appropriate treatment strategy in such cases.

Peripheral paresthesia in patients with subacromial impingement syndrome

INTRODUCTION

Some patients presenting with subacromial impingement syndrome complain of tingling and numbness radiating to hand. In the current literature, there is no description of such paresthesia being a part of the clinical picture of impingement syndrome.

OBJECTIVE

This observational study aimed at looking whether these symptoms resolve with successful arthroscopic decompression of the impingement.

MATERIAL AND METHODS

One hundred consecutive patients undergoing arthroscopic surgery were enlisted for the study.

RESULTS

Fifty-four percent reported paresthesia during the course of the shoulder problem (63% of them had radial sided symptoms, 29.6% ulnar-sided symptoms and 7.4% involving all fingers). Significant association was observed between the occurrence of paresthesia and worst pain levels (P = 0.0053), age of the patient (P = 0.0104) and the acromial impingement grade (P = 0.0377). Nerve conduction studies done in seven patients (with paresthesia) selected by systematic random sampling did not show any significant attributable entrapment neuropathy. Up to 12 months follow-up, 48 of 54 (88%) had complete relief of pain and paresthesia and 50 (92.5%) were satisfied.

CONCLUSION

Some patients with subacromial impingement syndrome report associated peripheral paresthesia radiating to hand, which is strongly associated with the age, pain level and the grade of impingement. In most (88%) of such cases, these symptoms are relieved after treatment of the impingment lesion. The incidence and aetiology of such paresthesia is the subject of further studies.