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Zhang Q, Liang H, Li J, Li S, Xu E. Robot-assisted resection of ganglion cell neuroma with a diameter of 78 mm: A case report. Medicine (Baltimore) 2024; 103:e39440. [PMID: 39252256 PMCID: PMC11383253 DOI: 10.1097/md.0000000000039440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 08/05/2024] [Indexed: 09/11/2024] Open
Abstract
RATIONALE Intrathoracic paragangliomas are typically found within the intricate posterior mediastinal region adjacent to the vertebrae, often presenting with substantial volume. Surgical excision of such tumors presents formidable challenges and is conventionally performed via open surgical procedures. PATIENT CONCERNS In this report, we present the case of a 53-year-old female patient who presented with the discovery of a left intrathoracic mass during a routine physical examination approximately 1 month prior. She complained of chest tightness and chest pain. DIAGNOSES She complained of chest tightness and chest pain. Magnetic resonance imaging of the chest and brachial plexus revealed a mass adjacent to the left upper lung hilum, measuring approximately 78 × 63 × 72 mm. The initial suspicion leaned towards a benign lesion. Notably, there was slight compression of the left first thoracic nerve root and mild compression of the middle and lower trunks of the left brachial plexus. Based on the morphological features of the tumor and imaging findings, we suspected its benign nature. INTERVENTIONS We opted for robot-assisted thoracic surgery to resect the mediastinal tumor. OUTCOMES Subsequent postoperative pathology confirmed the diagnosis as a paraganglioma. The patient did not experience any notable complications post-surgery, and a 6-month follow-up revealed no signs of recurrence. LESSONS The successful application of the robot-assisted thoracic surgery surgical technique underscores its efficacy in minimally invasive resection of sizable intrathoracic tumors situated in the posterior mediastinum.
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Affiliation(s)
- Qipeng Zhang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
- Department of Thoracic Surgery, General Hospital of Southern Theater Command, Guangzhou, Guangdong Province, China
| | - Hengrui Liang
- Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiayang Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China
- Department of Thoracic Surgery, General Hospital of Southern Theater Command, Guangzhou, Guangdong Province, China
| | - Shouzhuo Li
- Department of Thoracic Surgery, General Hospital of Southern Theater Command, Guangzhou, Guangdong Province, China
| | - Enwu Xu
- Department of Thoracic Surgery, General Hospital of Southern Theater Command, Guangzhou, Guangdong Province, China
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Vera-Saura P, Agudo-Pavón J, Velázquez-Torres DM, Martín-Alemán M, León-Morillas F, Infante-Guedes A, Cruz-Díaz D. The Importance of Mind-Body in Pilates Method in Patients with Chronic Non-Specific Low Back Pain-A Randomized Controlled Trial. J Clin Med 2024; 13:4731. [PMID: 39200873 PMCID: PMC11355723 DOI: 10.3390/jcm13164731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/02/2024] [Accepted: 08/08/2024] [Indexed: 09/02/2024] Open
Abstract
Background/Objectives: Chronic non-specific low back pain (CNSLBP) is a prevalent condition causing significant distress and healthcare costs globally. Despite various treatments, effective management remains challenging. Pilates, recognized for its focus on core strength and postural alignment, has emerged as a promising intervention. This study investigates the impact of mind-body in Pilates for directing participants on CNSLBP outcomes. Methods: A randomized controlled trial was conducted with 67 participants, aged 18 to 65 years, suffering from CNSLBP. They were allocated into two groups: Pilates with mind-body cueing (n = 34) and Pilates without cueing (n = 33). Both groups underwent 60 min sessions twice weekly for 8 weeks. Outcome measures included pain intensity (Visual Analogue Scale), functional disability (Roland Morris Disability Questionnaire), fear of movement (Tampa Scale of Kinesiophobia), and adherence (percentage of sessions attended). Statistical significance was determined through repeated measures ANOVA. Results: Both groups showed significant improvement in pain reduction, functional ability, and kinesiophobia. However, the mind-body group demonstrated a statistically significant reduction in kinesiophobia compared to the non-cueing group (p = 0.048), indicating the potential additional benefit of mind-body cueing in managing movement-related fear in CNSLBP. Conclusions: This study underscores the effectiveness of an 8-week Pilates intervention in managing CNSLBP, highlighting the added value of mind-body cueing in reducing fear of movement. These findings suggest incorporating mind-body cueing in Pilates could enhance the therapeutic benefits, particularly for patients with high levels of movement-related fear, potentially improving long-term adherence to physical activity and rehabilitation outcomes.
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Affiliation(s)
- Pablo Vera-Saura
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (P.V.-S.); (J.A.-P.); (D.C.-D.)
| | - Jesús Agudo-Pavón
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (P.V.-S.); (J.A.-P.); (D.C.-D.)
| | | | | | - Felipe León-Morillas
- Department of Physiotherapy, Faculty of Physiotherapy, Podiatry and Therapy Occupational, Catholic University of Murcia (UCAM), 30107 Murcia, Spain
| | - Aday Infante-Guedes
- Faculty of Health Sciences, University of Atlántico Medio, 35017 Las Palmas de Gran Canaria, Spain;
| | - David Cruz-Díaz
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (P.V.-S.); (J.A.-P.); (D.C.-D.)
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Cheng S, Li X, Zhang Y, Liu C, Rao Y, Zhang Y, Wu J, Sun J, Laakso EL. Rehabilitation report of 2 cases of spinal cord ischemic injury after intra-aortic repair. Medicine (Baltimore) 2024; 103:e38852. [PMID: 39058844 PMCID: PMC11272330 DOI: 10.1097/md.0000000000038852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/17/2024] [Indexed: 07/28/2024] Open
Abstract
RATIONALE Spinal cord ischemia injury is a serious complication after intra-aortic surgery, with a low incidence but high disability rate. However, patients often do not receive comprehensive treatment in the early stages of the disease. Therefore, active neurological intervention is needed to protect and prevent spinal cord ischemia during and after surgery. In this paper, rehabilitation program and imaging data of 2 cases with spinal cord ischemic injury are presented and discussed regarding causes, prevention and acute treatment with this disease, which could be referred by clinicians. PATIENT CONCERNS Case report 1: A 69-year-old male patient underwent aortic arch aneurysm and thoracic endovascular aortic repair (coated stent) was performed under general anesthesia. Complete paralysis of both lower limbs, constipation, and urinary retention occurred after surgery and was subsequently referred to our rehabilitation department. Case report 2: A man aged 41 years experienced sudden chest pain with no dizziness or headache. Weakness of both lower limbs gradually appeared over 30 minutes with subsequent loss of consciousness. He was diagnosed with aortic dissection and underwent aortic stent implantation. Inpatient rehabilitation began systematically 3 months after discharge. DIAGNOSES The 2 patients were diagnosed with paraplegia and spinal cord ischemic injury. INTERVENTIONS The patients received strength and transfer training, sensory input, health mission, and activities of daily living. OUTCOMES Patient 1 returned home without assistive devices and patient 2 returned home with wheelchair. LESSONS Perioperative spinal cord protection is directly related to postoperative quality of life. Once the symptoms of spinal cord ischemic injury occur, cerebrospinal fluid drainage should be performed as soon as possible to increase mean arterial pressure. At the same time, methylprednisolone, ganglioside, anticoagulation, vasodilator drugs, and symptomatic supportive treatments are required. Intercostal artery and subclavian artery are reconstructed if necessary. Symptom stability flags referral to commence rehabilitation. Repetitive functional training is necessary to help patients return to the family and society as soon as possible.
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Affiliation(s)
- Shu Cheng
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Xuan Li
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Yufei Zhang
- Medical School, Wuhan University of Science and Technology, Wuhan, China
| | - Chenxi Liu
- Medical School, Wuhan University of Science and Technology, Wuhan, China
| | - Yi Rao
- Department of Pain Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Yang Zhang
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Jinlun Wu
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
| | - Jinwen Sun
- Department of Rehabilitation Medicine, Wuhan University of Science and Technology Affiliated Wuhan Resources & Wisco General Hospital, Wuhan, China
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Franke M, Safdar Z. Acute Myocardial Infarction in the Setting of Pulmonary Hypertension due to a Patent Foramen Ovale and Paradoxical Embolism. Case Rep Pulmonol 2024; 2024:6725308. [PMID: 39055527 PMCID: PMC11272397 DOI: 10.1155/2024/6725308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 06/24/2024] [Accepted: 07/08/2024] [Indexed: 07/27/2024] Open
Abstract
A 67-year-old woman with pulmonary hypertension (PH) presented with a 1-day history of worsening shortness of breath and pleuritic chest pain and was found to have a troponin T level of 3755 ng/L (ref. range 0-19 ng/L). An initial diagnostic workup in the emergency department (ED) led to an urgent left heart catheterization which revealed a 90% occlusive right coronary artery blood clot, even though a recent heart catheterization less than a month prior was completely unremarkable. Further workup led to the discovery of a patent foramen ovale (PFO) and an aneurysmal interatrial septum, suggesting the presence of a paradoxical embolism. While typically asymptomatic, a PFO is an important clinical entity that can lead to irreversible cardiac damage. Suspicion should be high for this finding in the case of an acute myocardial infarction (MI) with no clear cause, especially in a patient with elevated right heart pressures.
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Affiliation(s)
- Madeline Franke
- School of Engineering MedicineTexas A&M Health Science Center, Houston, Texas, USA
| | - Zeenat Safdar
- Houston Methodist Lung CenterHouston Methodist HospitalWeill Cornell College of Medicine, Houston, Texas, USA
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Kakamad FH, Asaad SK, Tahir SH, Sabr NS, Ghafour AK, Omer CS, Rashid RJ, Hama Amin BJ, Kareem PM, Mohammed MS. Thoracic outlet syndrome caused by superior mediastinal mass: A case report. Asian Cardiovasc Thorac Ann 2024; 32:324-327. [PMID: 38327076 DOI: 10.1177/02184923241230706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Thoracic outlet syndrome (TOS) caused by superior mediastinal soft tissue mass has never been reported in the literature, the aim of this study is to discuss a case of TOS caused by a superior mediastinal mass in which the histopathological examinations of the mass showed vascular malformation. CASE REPORT A 45-year-old female presented with left upper limb pain and numbness for three months, associated with swelling and attacks of shortness of breath. Imaging studies showed soft tissue mass involving the superior mediastinum. The condition of the patient deteriorated and the signs and symptoms of TOS became clearer, all provocative tests and nerve conduction studies were positive. The patient underwent thoracic outlet decompression. The patient did not respond and the symptoms deteriorated further. After a multidisciplinary board discussion, the patient was prepared for median sternotomy under general anesthesia. A total resection of the mass was done. The patient was totally relieved a few hours after the operation. DISCUSSION The etiology of TOS can be multifaceted. Several factors contribute to its onset, and these can be categorized as congenital or acquired. Congenital causes include anatomical anomalies such as a cervical rib, or an elongated transverse process of the cervical vertebrae. These anatomical deviations can reduce the size of the thoracic outlet and make it prone to compression. CONCLUSION Although it is rare, TOS could be due to superior mediastinal mass and the treatment of choice is total resection either through median sternotomy or thoracoscopic procedure.
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Affiliation(s)
- Fahmi H Kakamad
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
- Kscien Organization for Scientific Research (Middle East office), Kurdstan, Iraq
- Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan, Iraq
| | - Saywan Kakarash Asaad
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
- Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan, Iraq
| | - Soran H Tahir
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
- Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan, Iraq
| | - Nasren Sharef Sabr
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
| | - Adullah K Ghafour
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
- Department of Orthopaedics, Shahid Peshraw Hospital, Kurdistan, Iraq
| | - Choman Sabah Omer
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
| | - Rezheen J Rashid
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
- Department of Radiology, Hiwa Cancer Hospital, Kurdistan, Iraq
| | | | - Pavel Mustafa Kareem
- Scientific Affairs Department, Smart Health Tower, Madam Mittrand, Sulaimani, Kurdistan, Iraq
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Alhatemi AQM, Hashim HT, Hashim AT. Rib fracture secondary to cough-induced trauma. Clin Case Rep 2024; 12:e8823. [PMID: 38681031 PMCID: PMC11052678 DOI: 10.1002/ccr3.8823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 03/22/2024] [Accepted: 04/11/2024] [Indexed: 05/01/2024] Open
Abstract
Early identification of rib fractures, even in young patients without chronic diseases, is essential. Prompt diagnosis facilitates appropriate management, aiding in pain control and addressing underlying causes such as persistent coughing. Additionally, vigilance for complications such as pneumothorax and rib displacement is crucial for optimizing patient care.
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Giannotta G, Lillo V, Cioeta M, Maselli F, Giovannico G, Heick J. Acute pleurisy mimicking neck pain in a young volleyball player: a case report. Physiother Theory Pract 2024:1-8. [PMID: 38661029 DOI: 10.1080/09593985.2024.2336103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/19/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Patients presenting to direct access physiotherapists may present with a serious pathology that mimics a musculoskeletal condition. Recognition of atypical clinical patterns allows for referral to an appropriate provider when a serious pathology is present. This case report details a patient with a pulmonary pathology who presented to a physiotherapist with a complaint of neck and chest pain following medical consultations. CASE PRESENTATION A 29-year-old amateur volleyball player arrived at the physiotherapist's clinic five days after experiencing the onset of neck pain. She complained of pain on the right side, which extended to the trapezius, as well as occasional discomfort in the lower lateral and anterior chest. The patient noted that the pain worsened when lying supine or on her left side, and during coughing. After developing symptoms resembling a cold, she sought care at two different emergency clinics where physicians diagnosed seasonal flu and an unrelated muscle strain. Despite treatment, the pain persisted, accompanied by fever and general weakness, disrupting her sleep. Following a review of a medical history and a physical examination, musculoskeletal causes of pain appeared unlikely, prompting consideration of a pulmonary pathology. Referral to a specialist was deemed necessary. CONCLUSION This case report highlights the importance of screening for serious pathology in direct access physiotherapy, irrespective of a prior physician consultation.
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Affiliation(s)
- Gabriele Giannotta
- Developmental Neurology and Neurorehabilitation, Associazione "La Nostra Famiglia" - IRCCS "E. Medea" - Scientific Hospital for Neurorehabilitation - Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi, Italy
| | - Virginia Lillo
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Matteo Cioeta
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - John Heick
- Department of Physical Therapy, Northern Arizona University, Flagstaff, AZ, USA
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Mannarini M, Maselli F, Giannotta G, Cioeta M, Giovannico G. Low back pain as main symptom in Low-grade Appendiceal Mucinous Neoplasm (LAMN): A case report. Physiother Theory Pract 2024:1-9. [PMID: 38381198 DOI: 10.1080/09593985.2024.2315517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/03/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Low back pain is the leading cause of disability worldwide. It is also the main cause of the limitation of activities and absence from work in much of the world and a cause of great economic burden. The greatest percentage of low back pain is classified as nonspecific (i.e. not attributable to a defined pathology), while the others may concern specific pathologies of the lumbar region or suggest pathologies of non-musculoskeletal origin. Consequently, evaluating any signs and symptoms mimicking musculoskeletal conditions is crucial. CASE DESCRIPTION This case report describes a 64-year-old female patient who first presented to the physiotherapist with two weeks of low back pain, complaining of a different clinical presentation than the previous episodes. The patient's pain started spontaneously and was located in the lumbar region over a diffuse area. Symptoms were constant throughout the day and did not change with movement. Based on the examination findings, the physiotherapist decided to make an urgent referral to the patient's General Practitioner. OUTCOMES Following ultrasound examination and Computed Tomography scan, an 8.5 cm mass was confirmed in the abdominal region. It was surgically removed, and a histological diagnosis of Low-grade Appendiceal Mucinous Neoplasm (LAMN) was made. CONCLUSION The physiotherapist's evaluation and decision-making process was fundamental in the patient's referral due to suspected pathology not within the scope of practice. This revealed a rare condition, which, according to the existing literature, is usually diagnosed in the event of collateral imaging findings or upon presentation of complex and/or emergency clinical pictures.
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Affiliation(s)
- Michele Mannarini
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Gabriele Giannotta
- Scientific Institute IRCCS "E. Medea" - Unit for Severe disabilities in developmental age and young adults (Developmental Neurology and Neurorehabilitation) - Piazza "Antonio Di Summa", Brindisi, Italy
| | - Matteo Cioeta
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
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Yang C, Lou X, Huang L, Ma Q, Yin X, Zhao Q, Wu C, Wu H, Sun J. Accurate diagnosis and treatment of sacral meningeal cysts without spinal nerve root fibres: identifying leakage orificium using high-resolution spherical arbitrary-dimensional reconstructing magnetic resonance imaging. Front Neurol 2024; 15:1298477. [PMID: 38356887 PMCID: PMC10865724 DOI: 10.3389/fneur.2024.1298477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/18/2024] [Indexed: 02/16/2024] Open
Abstract
Objective This study aimed to develop an arbitrary-dimensional nerve root reconstruction magnetic resonance imaging (ANRR-MRI) technique for identifying the leakage orificium of sacral meningeal cysts (SMCs) without spinal nerve root fibres (SNRFs). Methods This prospective study enrolled 40 consecutive patients with SMCs without SNRFs between March 2021 and March 2022. Magnetic resonance neural reconstruction sequences were performed for preoperative evaluation. The cyst and the cyst-dura intersection planes were initially identified based on the original thin-slice axial T2-weighted images. Sagittal and coronal images were then reconstructed by setting each intersecting plane as the centre. Then, three-dimensional reconstruction was performed, focusing on the suspected leakage point of the cyst. Based on the identified leakage location and size of the SMC, individual surgical plans were formulated. Results This cohort included 30 females and 10 males, with an average age of 42.6 ± 12.2 years (range, 17-66 years). The leakage orificium was located at the rostral pole of the cyst in 23 patients, at the body region of the cyst in 12 patients, and at the caudal pole in 5 patients. The maximum diameter of the cysts ranged from 2 cm to 11 cm (average, 5.2 ± 1.9 cm). The leakage orificium was clearly identified in all patients and was ligated microscopically through a 4 cm minimally invasive incision. Postoperative imaging showed that the cysts had disappeared. Conclusion ANRR-MRI is an accurate and efficient approach for identifying leakage orificium, facilitating the precise diagnosis and surgical treatment of SMCs without SNRFs.
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Affiliation(s)
- Chenlong Yang
- Department of Neurosurgery, Peking University Third Hospital, Peking University, Beijing, China
| | - Xiaohui Lou
- Department of Neurosurgery, Peking University Third Hospital, Peking University, Beijing, China
- Department of Neurosurgery, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lina Huang
- Department of Pain, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Department of Radiology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Qianquan Ma
- Department of Neurosurgery, Peking University Third Hospital, Peking University, Beijing, China
| | - Xiaoliang Yin
- Department of Neurosurgery, Peking University Third Hospital, Peking University, Beijing, China
| | - Qiang Zhao
- Department of Radiology, Peking University Third Hospital, Peking University, Beijing, China
| | - Chao Wu
- Department of Neurosurgery, Peking University Third Hospital, Peking University, Beijing, China
| | - Haibo Wu
- Department of Radiology, Peking University Third Hospital, Peking University, Beijing, China
| | - Jianjun Sun
- Department of Neurosurgery, Peking University Third Hospital, Peking University, Beijing, China
- Department of Neurosurgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Zanconato L, Rossettini G, Mourad F, Cotrozzi M, Carità E, Di Filippo L, Turolla A, Smania N, Picelli A, Valè N, Maselli F. Ewing's sarcoma in a young man mimicking lateral elbow pain: A case report with 2 years follow-up. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2024; 29:e2063. [PMID: 37937470 DOI: 10.1002/pri.2063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/10/2023] [Accepted: 10/27/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND AND PURPOSE Lateral elbow pain represents a common musculoskeletal disorder, mostly non-specific and benign. In rare cases, it can be the first symptom of a severe disease such as Ewing's sarcoma (ES). ES is the second most common primary malignant bone tumor in the young population, with a high probability of an unfavourable prognosis. CASE PRESENTATION This case report presents the history of a young man presenting to the physical therapist with a diagnosis of "epicondylitis" in the right elbow, which was later revealed to be an aggressive ES of the ulna. Findings raising clinical doubts were (a) constant pain even at night and not dependent on load, (b) significant loss of function, (c) patient's young age, and (d) a palpable mass in the elbow. RESULTS After diagnosis, the patient received medical (chemotherapy, radiotherapy and surgery) and a rehabilitation program. After treatment, the patient improved elbow function, decreased disability and returned to social participation, maintaining positive outcomes at the 2-year follow-up. DISCUSSION In summary, this case report emphasizes the importance of differential diagnosis and screening for referral of red flags in physical therapy. Moreover, it describes the rehabilitation of a patient with ES, enriching the scientific literature in the field.
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Affiliation(s)
| | | | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., Differdange, Luxembourg
| | | | | | - Luigi Di Filippo
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Andrea Turolla
- Division of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Nicola Smania
- Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Neurorehabilitation Unit, University Hospital of Verona, Verona, Italy
| | - Alessandro Picelli
- Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Neurorehabilitation Unit, University Hospital of Verona, Verona, Italy
- Canadian Advances in Neuro-Orthopaedics for Spasticity Congress (CANOSC), Kingston, Ontario, Canada
| | - Nicola Valè
- Neuromotor and Cognitive Rehabilitation Research Center, Section of Physical and Rehabilitation Medicine, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- Neurorehabilitation Unit, University Hospital of Verona, Verona, Italy
| | - Filippo Maselli
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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Jiang Q, Gao H, Gao G, Li Y, Cheng H, Shi G, Shang A. Neuroblastoma of the lumbosacral canal in an adult: a case report and literature review. Front Neurol 2023; 14:1195664. [PMID: 37602246 PMCID: PMC10435846 DOI: 10.3389/fneur.2023.1195664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/21/2023] [Indexed: 08/22/2023] Open
Abstract
Neuroblastoma (NB) is a leading cause of death in children. It usually occurs in the adrenal gland and rarely in the spinal canal. Here, we report the case of a 48-year-old male patient with abnormal thickening of the cauda equina nerve as revealed by lumbosacral magnetic resonance imaging. The patient's main clinical manifestations were numbness and pain in both lower limbs. The patient underwent surgical treatment; however, intraoperatively, an unclear border was observed between the cauda equina nerve and the tumor; therefore, the tumor was not forcibly excised. The postoperative pathological results were reported as NB. The disease known as NB, which is extremely rare. We believe that a pathological biopsy is extremely vital for diagnosing NB, and aggressive post-operative radio-chemotherapy could potentially prolong the patient's survival time.
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Affiliation(s)
| | - Haihao Gao
- Chinese PLA Medical School, Beijing, China
| | - Gan Gao
- Chinese PLA Medical School, Beijing, China
| | - Yang Li
- Department of Critical Care Medicine, Chinese PAP Beijing Corps Hospital, Beijing, China
| | | | | | - Aijia Shang
- Department of Neurosurgery, Chinese PLA General Hospital, Beijing, China
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12
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Lopez G, Cataldi F, Bellin G, Dunning J, Fernández-de-las-Peñas C, Galeno E, Meroni R, Maselli F, Mourad F. Physiotherapy Screening for Referral of a Patient with Patent Foramen Ovale Presenting with Neck Pain as Primary Complaint: A Case Report. Healthcare (Basel) 2023; 11:1165. [PMID: 37107999 PMCID: PMC10138410 DOI: 10.3390/healthcare11081165] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
Neck pain is a common musculoskeletal disorder encountered by physiotherapists. However, it may be the early manifestation of more alarming conditions, such as cardiovascular diseases mimicking musculoskeletal pain. Patent foramen ovale (PFO) is a congenital heart defect consisting of a small opening between the right and the left atrium. A 56-year-old male presented with neck pain and head heaviness as primary complaints. The cardiovascular profile and the behavioral symptoms led the physiotherapist to find an exaggerated blood pressure response during exercise; in addition to subtle neurological signs, this prompted the physiotherapist to make an urgent referral. At the emergency department a PFO was diagnosed. To the best of the authors' knowledge, this is the first case to describe a rare clinical presentation of a PFO presenting neck pain as primary complaint. This case report emphasizes the importance for physiotherapists to be able to triage patients for conditions outside their scope suggestive of further medical investigation.
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Affiliation(s)
- Giovanni Lopez
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Kinesis, Department of Physiotherapy, 70126 Bari, Italy
| | - Fabio Cataldi
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
- Manual Therapy Laboratory—MTLab, Department of Physiotherapy, 70123 Bari, Italy
| | - Giuseppe Bellin
- Centro Diagnostico Veneto, Department of Physical Therapy, 36030 Vicenza, Italy
| | - James Dunning
- American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy, Montgomery, AL 36104, USA
- Montgomery Osteopractic Physical Therapy & Acupuncture Clinic, Montgomery, AL 36104, USA
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra de Clínica, Investigación y Docencia en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Erasmo Galeno
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Roberto Meroni
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Differdange, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
| | - Filippo Maselli
- Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
| | - Firas Mourad
- Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, 4671 Differdange, Luxembourg
- Luxembourg Health & Sport Sciences Research Institute A.s.b.l., 50, Avenue du Parc des Sports, 4671 Differdange, Luxembourg
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Lepri B, Romani D, Storari L, Barbari V. Effectiveness of Pain Neuroscience Education in Patients with Chronic Musculoskeletal Pain and Central Sensitization: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20054098. [PMID: 36901108 PMCID: PMC10001851 DOI: 10.3390/ijerph20054098] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To collect the available evidence about the effectiveness of pain neuroscience education (PNE) on pain, disability, and psychosocial factors in patients with chronic musculoskeletal (MSK) pain and central sensitization (CS). METHODS A systematic review was conducted. Searches were performed on Pubmed, PEDro, and CINAHL, and only randomized controlled trials (RCTs) enrolling patients ≥18 years of age with chronic MSK pain due to CS were included. No meta-analysis was conducted, and qualitative analysis was realized. RESULTS 15 RCTs were included. Findings were divided for diagnostic criteria (fibromyalgia-FM, chronic fatigue syndrome-CFS, low back pain-LBP, chronic spinal pain-CSP). PNE has been proposed as a single intervention or associated with other approaches, and different measures were used for the main outcomes considered. Conclusions, practice implication: PNE is effective in improving pain, disability, and psychosocial factors in patients with fibromyalgia, chronic low back pain (CLBP)-especially if associated with other therapeutic approaches-and also in patients with CFS and CSP. Overall, PNE seems to be more effective when proposed in one-to-one oral sessions and associated with reinforcement elements. However, specific eligibility criteria for chronic MSK pain due to CS are still lacking in most RCTs; therefore, for future research, it is mandatory to specify such criteria in primary studies.
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Affiliation(s)
| | - Daniele Romani
- Department of Biomedical and Neuromotor Science, Bologna Campus, University of Bologna, 40138 Bologna, Italy
- AUSL della Romagna, Ospedale Infermi di Rimini, Viale Luigi Settembrini, 2, 47923 Rimini, Italy
| | - Lorenzo Storari
- Department of Human Neurosciences, University of Roma “La Sapienza”, 00185 Rome, Italy
| | - Valerio Barbari
- Department of Human Neurosciences, University of Roma “La Sapienza”, 00185 Rome, Italy
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