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Sapire R, Nenova R, Gounder P, Rampersad A, Maboho V, Nhlapo N, Tibatshi K, Rampurtab S, Ranchod AI, Saggers RT, Patricios J. Myositis ossificans in a child athlete: a case study. S Afr J Sports Med 2023; 34:v34i1a14931. [PMID: 36815913 PMCID: PMC9924576 DOI: 10.17159/2078-516x/2022/v34i1a14931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background A 13-year-old female athlete presented with a painful lesion in her right buttock for which she had been receiving physiotherapy. It was keeping her from participating in sports. Aim To report on a case of traumatic myositis ossificans in a child athlete - including the presentation, investigations, management, and outcome. Findings Palpation of the right buttock indicated a tender mass. Investigation by musculoskeletal ultrasound detected a large hypoechoic lesion. An MRI revealed patterns of calcification that were inconclusive in differentiating between a malignant or benign lesion. Macroscopic and microscopic histological examination, as well as immunohistochemistry, were consistent with myositis ossificans (MO), a non-malignant condition. The patient improved remarkably within three months of treatment with rest, non-steroidal anti-inflammatory drugs (NSAIDs) and extracorporeal shock wave therapy (ESWT). Implications Accurate differentiation of myositis ossificans from other benign and malignant soft tissue lesions may require histological evaluation in addition to a comprehensive radiological workup. Successful treatment with the patient being able to return to a pain-free and active state is achievable. Extracorporeal shock-wave therapy can play an important role in the management of this condition and should be considered when presented with a case of MO.
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Affiliation(s)
- R Sapire
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - R Nenova
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - P Gounder
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - A Rampersad
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - V Maboho
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - N Nhlapo
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - K Tibatshi
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - S Rampurtab
- Unit for Undergraduate Medical Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - AI Ranchod
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Department of Diagnostic Radiology, University of the Witwatersrand, Johannesburg,
South Africa
| | - RT Saggers
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Department of Paediatrics and Child Health, Charlotte Maxeke Johannesburg Academic Hospital and School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa
| | - J Patricios
- Wits Sport and Health (WiSH), School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,
South Africa,Netcare Waterfall Sports Orthopaedic Surgery, Johannesburg,
South Africa
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Scantling-Birch Y, Naveed H, Tollemache N, Gounder P, Rajak S. Is undergraduate ophthalmology teaching in the United Kingdom still fit for purpose? Eye (Lond) 2022; 36:343-345. [PMID: 34462584 PMCID: PMC8807702 DOI: 10.1038/s41433-021-01756-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/04/2021] [Accepted: 08/18/2021] [Indexed: 02/03/2023] Open
Affiliation(s)
- Y Scantling-Birch
- Department of Medicine, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
| | - H Naveed
- Ophthalmology Unit, Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust, Surrey, UK.,Brighton and Sussex Medical School, Falmer Campus, Brighton, UK
| | - N Tollemache
- Department of Medicine, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, UK
| | - P Gounder
- Department of Oculoplastics, Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.,Ophthalmology Unit, Royal Perth Hospital, The University of Western Australia, Perth, WA, Australia
| | - S Rajak
- Brighton and Sussex Medical School, Falmer Campus, Brighton, UK.,Department of Oculoplastics, Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
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Chen JH, Andrews JM, Kariyawasam V, Moran N, Gounder P, Collins G, Walsh AJ, Connor S, Lee TWT, Koh CE, Chang J, Paramsothy S, Tattersall S, Lemberg DA, Radford-Smith G, Lawrance IC, McLachlan A, Moore GT, Corte C, Katelaris P, Leong RW. Review article: acute severe ulcerative colitis - evidence-based consensus statements. Aliment Pharmacol Ther 2016; 44:127-44. [PMID: 27226344 DOI: 10.1111/apt.13670] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 12/18/2015] [Accepted: 04/27/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acute severe ulcerative colitis (ASUC) is a potentially life-threatening complication of ulcerative colitis. AIM To develop consensus statements based on a systematic review of the literature of the management of ASUC to improve patient outcome. METHODS Following a literature review, the Delphi method was used to develop the consensus statements. A steering committee, based in Australia, generated the statements of interest. Three rounds of anonymous voting were carried out to achieve the final results. Acceptance of statements was pre-determined by ≥80% votes in 'complete agreement' or 'agreement with minor reservation'. RESULTS Key recommendations include that patients with ASUC should be: hospitalised, undergo unprepared flexible sigmoidoscopy to assess severity and to exclude cytomegalovirus colitis, and be provided with venous thromboembolism prophylaxis and intravenous hydrocortisone 100 mg three or four times daily with close monitoring by a multidisciplinary team. Rescue therapy such as infliximab or ciclosporin should be started if insufficient response by day 3, and colectomy considered if no response to 7 days of rescue therapy or earlier if deterioration. With such an approach, it is expected that colectomy rate during admission will be below 30% and mortality less than 1% in specialist centres. CONCLUSION These evidenced-based consensus statements on acute severe ulcerative colitis, developed by a multidisciplinary group, provide up-to-date best practice recommendations that improve and harmonise management as well as provide auditable quality assessments.
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Affiliation(s)
- J-H Chen
- Concord Hospital, Sydney, NSW, Australia
| | - J M Andrews
- Royal Adelaide Hospital, Adelaide, SA, Australia
| | | | - N Moran
- Concord Hospital, Sydney, NSW, Australia
| | - P Gounder
- Concord Hospital, Sydney, NSW, Australia
| | - G Collins
- Concord Hospital, Sydney, NSW, Australia
| | - A J Walsh
- St. Vincent Hospital, Sydney, NSW, Australia
| | - S Connor
- Liverpool Hospital, Sydney, NSW, Australia
| | - T W T Lee
- Wollongong Hospital, Wollongong, NSW, Australia
| | - C E Koh
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
| | - J Chang
- Concord Hospital, Sydney, NSW, Australia
| | | | - S Tattersall
- Royal North Shore Hospital, Sydney, NSW, Australia
| | - D A Lemberg
- Sydney Children's Hospital, Sydney, NSW, Australia
| | - G Radford-Smith
- Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia
| | - I C Lawrance
- Saint John of God Hospital, Perth, WA, Australia
| | | | - G T Moore
- Monash Medical Centre, Melbourne, Vic., Australia
| | - C Corte
- Concord Hospital, Sydney, NSW, Australia
| | | | - R W Leong
- Concord Hospital, Sydney, NSW, Australia
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