scholarly journals Resolution of Chronic Shoulder Pain after Repair of a Posttraumatic Diaphragmatic Hernia: A 22-Year Delay in Diagnosis and Treatment

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Brody W. King ◽  
John G. Skedros ◽  
Robert E. Glasgow ◽  
D. Glen Morrell
Keyword(s):  
Shoulder Pain ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Rib Fractures ◽  
Left Shoulder ◽  
Delay In Diagnosis ◽  
Traumatic Diaphragmatic Rupture ◽  
Diaphragm Hernia ◽  
Delays In Diagnosis ◽  
Chronic Shoulder Pain

Diagnosing traumatic diaphragmatic rupture (TDR) due to penetrating rib fractures is challenging because the lesions are often too small to be detected and may present years after injury. Patients with delays in diagnosis of TDR rarely present with orthopaedic-related complaints of pain. We report the case of a 52-year-old female who presented with chronic left shoulder pain following a motor vehicle accident (MVA). In addition to left-side lower rib fractures, she also sustained a left-sided splenic laceration, pneumothorax, and two-part upper humerus fracture. Fracture treatment was percutaneous pinning; the other injuries were treated nonoperatively. Her shoulder pain could not be attributed to shoulder or neck pathology. Twenty years after the MVA, she began experiencing episodes of left-sided abdominal pain and nausea. A CT scan obtained two years later revealed a diaphragm hernia, which was repaired laparoscopically. Unique aspects of this case include (1) presentation to an orthopaedic surgeon with a chief complaint of chronic shoulder pain; (2) at 22 years, this is the fourth longest case of a delay in diagnosis of TDR; and (3) the unique symptom of ipsilateral referred shoulder pain, which immediately improved after hernia repair.

scholarly journals An Intraarticular Osteoid Osteoma: A Case Report & Review of Literature

2014 ◽  
Vol 3 (2) ◽  
pp. 77-80
Author(s):  
AR Pant ◽  
MK Gupta ◽  
PK Santhalia ◽  
K Ahmad ◽  
RPS Kalawar ◽  
...  
Keyword(s):  
Shoulder Pain ◽  
Osteoid Osteoma ◽  
Rare Case ◽  
Clinical Presentation ◽  
Review Of Literature ◽  
Delay In Diagnosis ◽  
Atypical Clinical Presentation ◽  
The Common ◽  
Central Calcification ◽  
Chronic Shoulder Pain

 Osteoid osteoma (OO) is one of the common benign bone tumors but an uncommon cause of musculoskeletal pain. Its diagnosis is usually not difficult in classic clinical setup and in typical location in diaphyseal region. However, the diagnosis of juxta or intraarticular osteoid osteoma (IAOO) is challenging because of atypical clinical presentation responsible for delay in diagnosis and treatment. We report a rare case of IAOO as a cause of chronic shoulder pain to make clinician aware to help in its early diagnosis and management. A 28-year-old woman presented with chronic debilitating right shoulder pain. The diagnosis was established on CTscan after 2 years of onset of symptoms because of atypical clinical presentation as a chronic monoarthritis of the shoulder. CTscan demonstrated radiolucent nidus with central calcification with areas of surrounding sclerosis. The tumor was excised surgically and histopathologic examination confirmed the diagnosis of osteoid osteoma. So, in the scenario of an unexplained chronic monoarthritis, the possibility of intraarticular osteoid osteoma should also be kept in mind. CT-scan remains the investigation of choice for demonstrating the nidus and surgical exicision relieves the symptoms.  DOI: http://dx.doi.org/10.3126/njr.v3i2.9615   Nepalese Journal of Radiology Vol.3(2)July-Dec, 2013: 77-80

scholarly journals Suprascapular Nerve Pulsed Radiofrequency for Chronic Shoulder Pain in a Pediatric Patient

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Federico Cristiani ◽  
Maria A. Hernandez
Keyword(s):  
Shoulder Pain ◽  
Suprascapular Nerve ◽  
Left Shoulder ◽  
Pulsed Radiofrequency ◽  
Limited Data ◽  
Pediatric Chronic Pain ◽  
History Of ◽  
Inflammatory Drugs ◽  
Chronic Shoulder Pain

Pulsed radiofrequency of the suprascapular nerve has shown efficacy in adults with chronic shoulder pain, but its use in pediatrics is relatively new. We present a case of a successful use of pulsed radiofrequency to treat refractory chronic shoulder pain in an adolescent patient. Case Report. We present a 53 kg, 14-year-old female, with a medical history of septic arthritis of the left shoulder within the first month of life leading to persisting pain during childhood. She presented with a complaint of progressive pain starting at age 12, refractory to analgesics including opioids and intra-articular injection of local anesthetic and steroids. After pulsed radiofrequency of the suprascapular nerve, significant pain relief and improvement of the range of motion was obtained. These results were maintained at the 1-, 3-, and 6-month follow-up visits with the pain being reported as mild and manageable with nonsteroidal anti-inflammatory drugs. Conclusion. There is limited data today of the use of pulsed radiofrequency for pediatric chronic pain. We successfully used this intervention in a 14-year-old patient with chronic shoulder pain extrapolating from adult experience and as a last resort after all other treatments had failed.

Galactorrhea after Prolonged Traumatic Coma

Neurosurgery ◽  
1981 ◽  
Vol 9 (2) ◽  
pp. 177-178 ◽  
Author(s):  
Roberto de Leo ◽  
Kenneth C. Petruk ◽  
Peter Crockford
Keyword(s):  
Subdural Hematoma ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Rib Fractures ◽  
Acute Subdural Hematoma ◽  
Vehicle Accident ◽  
Traumatic Coma ◽  
Prolonged Coma

Abstract A 17-year-old girl suffered a traumatic acute subdural hematoma and rib fractures after a motor vehicle accident. Prolonged coma resulted, and significant galactorrhea began 4 weeks after the accident. The galactorrhea was treated successfully by the administration of 2-bromoergocryptine. The pathophysiology of this condition is discussed.

Virtual reality and computer games in the treatment of driving phobia induced by a motor vehicle accident

2003 ◽  
Author(s):  
David Walshe ◽  
Elizabeth Lewis ◽  
Kathleen O'Sullivan ◽  
Brenda K. Wiederhold ◽  
Sun I. Kim
Keyword(s):  
Virtual Reality ◽  
Computer Games ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Vehicle Accident

Machine Learning of Motor Vehicle Accident Categories from Narrative Data

1996 ◽  
Vol 35 (04/05) ◽  
pp. 309-316 ◽  
Author(s):  
M. R. Lehto ◽  
G. S. Sorock
Keyword(s):  
Machine Learning ◽  
Bayesian Model ◽  
Keyword Search ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Computer Search ◽  
Vehicle Accident ◽  
Learning Technique ◽  
Expert Ratings ◽  
Keyword Searches

Abstract:Bayesian inferencing as a machine learning technique was evaluated for identifying pre-crash activity and crash type from accident narratives describing 3,686 motor vehicle crashes. It was hypothesized that a Bayesian model could learn from a computer search for 63 keywords related to accident categories. Learning was described in terms of the ability to accurately classify previously unclassifiable narratives not containing the original keywords. When narratives contained keywords, the results obtained using both the Bayesian model and keyword search corresponded closely to expert ratings (P(detection)≥0.9, and P(false positive)≤0.05). For narratives not containing keywords, when the threshold used by the Bayesian model was varied between p>0.5 and p>0.9, the overall probability of detecting a category assigned by the expert varied between 67% and 12%. False positives correspondingly varied between 32% and 3%. These latter results demonstrated that the Bayesian system learned from the results of the keyword searches.

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