Myofascial Pain in a Guitarist

2005 ◽  
Vol 20 (4) ◽  
pp. 180-182
Author(s):  
Joy Wee ◽  
Alice Brandfonbrener
Keyword(s):  
Muscle Weakness ◽  
Myofascial Pain ◽  
Pectoral Muscle ◽  
Antecubital Fossa ◽  
Long Day ◽  
Muscle Region ◽  
History Of ◽  
Proximal Forearm

This right-handed, 22-year-old guitarist presents with a 4.5-year history of left arm symptoms, which worsen with prolonged guitar playing. Discomfort is localized at the left antecubital fossa and might spread to the volar wrist and pectoral muscle region. A swelling is sometimes felt at the proximal forearm, occasionally associated with erythema. Discomfort is sometimes worse in the morning after a long day of guitar playing. In general, he feels that his muscles are weaker than before, as he has not been using them as much, but there is no localized muscle weakness, numbness, or tingling.

Neuromuscular Signs Associated with Acute Hypophosphatemia in a Dog

2015 ◽  
Vol 51 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Kimberly N. Claus ◽  
Thomas K. Day ◽  
Christina Wolf
Keyword(s):  
Muscle Weakness ◽  
Proximal Jejunum ◽  
Neuromuscular Dysfunction ◽  
History Of ◽  
Serum Biochemical ◽  
Serum Biochemical Profile ◽  
Foreign Body Obstruction ◽  
Resection And Anastomosis ◽  
Phosphorous Level ◽  
Significant Weakness

The purpose of this report was to describe the successful recognition and management of neuromuscular dysfunction secondary to severe, acute hypophosphatemia in an adult dog with a 2 day history of vomiting, anorexia, and abdominal pain. Radiographs were suggestive of a foreign body obstruction, and surgery was recommended. Resection and anastomosis of the distal duodenum and proximal jejunum was performed. The dog recovered uneventfully, but approximately 36 hr postoperatively, he was found to have significant weakness and muscle tremors that were accompanied by hyperthermia. The only significant abnormality on a serum biochemical profile was a phosphorous level of 0.26mmol/L. Within 6 hr of initiating phosphorous supplementation, the patient fully recovered and had no residual signs of neuromuscular dysfunction. Signs of neurologic dysfunction secondary to hypophosphatemia are commonly recognized in human patients. Reports of patients with severe muscle weakness, some of which necessitate ventilation due to weakening of muscles of respiration, are common throughout the literature. Less commonly, tremors are noted. This is the first known report of neuromuscular signs recognized and rapidly corrected in a dog. Although it is likely to be uncommon, hypophosphatemia should be recognized as a differential diagnosis in patients with tremors and/or muscle weakness.

REGION-BASED CONTRAST ENHANCEMENT OF DIGITAL MAMMOGRAMS USING AN IMPROVED WATERSHED SEGMENTATION

2013 ◽  
Vol 13 (01) ◽  
pp. 1350007 ◽  
Author(s):  
ABUBACKER KAJA MOHIDEEN ◽  
KUTTIANNAN THANGAVEL
Keyword(s):  
Contrast Enhancement ◽  
Absolute Error ◽  
Pectoral Muscle ◽  
Histogram Equalization ◽  
Classification Performance ◽  
Performance Measure ◽  
Watershed Segmentation ◽  
Muscle Region ◽  
Edge Based ◽  
Mammogram Images

A simple edge-based preprocessing scheme is proposed in this paper for contrast enhancement of digital mammogram images while preserving the edges more accurately. This proposed method has three steps: (i) initially the breast region is segmented from the mammogram images by removing the film artifacts, (ii) the pectoral muscle region is identified and excluded from the breast region using a novel adaptive thresholding method, and (iii) an Improved Watershed Segmentation (IWS) is applied to segment the breast profile, and each region is enhanced with simple histogram equalization. The segmentation is performed in order to achieve adaptive contrast enhancement. The performance of this proposed pectoral removal method is analyzed with two measures: Hausdorff Distance (HD) and Mean of Absolute Error Distance (MAED), and the proposed contrast enhancement approach is been analyzed with the five diverse parameters along with the classification accuracy. The experiments and results show the potential performance of our proposed algorithm over the existing approaches with optimum results on all the performance measure and the classification performance is been evaluated with a hybrid neural network, our proposed method proves the better performance with the achievement of 92% accuracy.

scholarly journals Automatic Detection of Pectoral Muscle Region for Computer-Aided Diagnosis Using MIAS Mammograms

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Woong Bae Yoon ◽  
Ji Eun Oh ◽  
Eun Young Chae ◽  
Hak Hee Kim ◽  
Soo Yeul Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Automatic Segmentation ◽  
Automatic Detection ◽  
Pectoral Muscle ◽  
Accurate Information ◽  
Detection Accuracy ◽  
Pixel Intensity ◽  
Muscle Region ◽  
Computer Aided ◽  
Muscle Segmentation

The computer-aided detection (CAD) systems have been developed to help radiologists with the early detection of breast cancer. This system provides objective and accurate information to reduce the misdiagnosis of the disease. In mammography, the pectoral muscle region is used as an index to compare the symmetry between the left and right images in the mediolateral oblique (MLO) view. The pectoral muscle segmentation is necessary for the detection of microcalcification or mass because the pectoral muscle has a similar pixel intensity as that of lesions, which affects the results of automatic detection. In this study, the mammographic image analysis society database (MIAS, 322 cases) was used for detecting the pectoral muscle segmentation. The pectoral muscle was detected by using the morphological method and the random sample consensus (RANSAC) algorithm. We evaluated the detected pectoral muscle region and compared the manual segmentation with the automatic segmentation. The results showed 92.2% accuracy. We expect that the proposed method improves the detection accuracy of breast cancer lesions using a CAD system.

scholarly journals Segmentation of Pectoral Muscle in Mammograms Using Granular Computing

2022 ◽  
Vol 15 (1) ◽  
pp. 1-14
Author(s):  
Divyashree B. V. ◽  
Amarnath R. ◽  
Naveen M. ◽  
Hemantha Kumar G.
Keyword(s):  
Image Analysis ◽  
Processing Time ◽  
Granular Computing ◽  
Pectoral Muscle ◽  
Combined Approach ◽  
Ant Colony Optimization Algorithm ◽  
Muscle Region ◽  
Analysis Society ◽  
Muscle Segmentation ◽  
The Right

In this paper, pectoral muscle segmentation was performed to study the presence of malignancy in the pectoral muscle region in mammograms. A combined approach involving granular computing and layering was employed to locate the pectoral muscle in mammograms. In most cases, the pectoral muscle is found to be triangular in shape and hence, the ant colony optimization algorithm is employed to accurately estimate the pectoral muscle boundary. The proposed method works with the left mediolateral oblique (MLO) view of mammograms to avoid artifacts. For the right MLO view, the method automatically mirrors the image to the left MLO view. The performance of this method was evaluated using the standard mini MIAS dataset (mammographic image analysis society). The algorithm was tested on 322 images and the overall accuracy of the system was about 97.47 %. The method is robust with respect to the view, shape, size and reduces the processing time. The approach correctly identifies images when the pectoral muscle is completely absent.

scholarly journals Paramyotonia congenita with persistent distal and facial muscle weakness: A case report with literature review

2019 ◽  
Author(s):  
Madoka Mori-Yoshimura ◽  
Tomoya Taminato ◽  
Jun Miki ◽  
Ryogen Sasaki ◽  
Noriko Satoh ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Clinical Symptoms ◽  
Muscle Stiffness ◽  
Causative Mutation ◽  
Exercise Tests ◽  
Muscle Involvement ◽  
Paramyotonia Congenita ◽  
Fatty Replacement ◽  
The Family ◽  
History Of

Abstract Introduction: Paramyotonia congenita (PC; OMIM 168300) is a non-dystrophic myotonia caused by mutations in the SCN4A gene. Transient muscle stiffness, usually induced by exposure to cold and aggravated by exercise, is the predominant clinical symptom, and interictal persistent weakness is uncommon. Case presentation: We report a family with a history of PC accompanied by persistent distal hand dominant muscle weakness with masticatory muscle involvement. Persistent weakness was exacerbated with age, and MR analysis showed marked atrophy of temporal, masseter, and finger flexor muscles with fatty replacement. Cases within the family harbor the prevalent PC causative mutation, T1313M, in the SCN4A gene. Administration of acetazolamide chloride improved clinical symptoms and the results of cold and short exercise tests. Phenotypic variation within the family was remarkable, as the two younger affected patients did not present with persistent weakness or muscle atrophy. Conclusions: PC associated with the T1313M mutation is a possible cause of persistent distal hand weakness.

scholarly journals Sternal Phosphaturic Mesenchymal Tumor-Induced Osteomalacia, Diagnosis and Management: A Case Report

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A224-A225
Author(s):  
Mopelola Adetola Adeyemo ◽  
Aili Guo
Keyword(s):  
Ct Scan ◽  
Functional Status ◽  
Muscle Weakness ◽  
Bone Pain ◽  
Mesenchymal Tumor ◽  
Phosphaturic Mesenchymal Tumor ◽  
Dihydroxyvitamin D ◽  
1,25 Dihydroxyvitamin D ◽  
History Of ◽  
Fgf 23

Abstract Background: Tumor induced osteomalacia (TIO) is a rare paraneoplastic disorder in which overproduction of fibroblast growth factor-23 (FGF-23) by mesenchymal tumor results in decreased renal phosphorus reabsorption and low to inappropriately normal 1,25-dihydroxyvitamin D, leading to hypophosphatemia and osteomalacia. Patients often present with bone pain, fractures, muscle weakness, and progressive decline in mobility. Due to the nonspecific nature of presenting symptoms of TIO diagnosis is often delayed. Clinical Case: A 55-year-old male presented with complaints of chest pain, shortness of breath, and generalized weakness following a ground level fall. Patient also reported a 10-year history of osteoarthritis with chronic back pain and 1-year history of generalized weakness, resulting in significant decline in functional status. On work-up, the initial CT scan of chest revealed multiple fractures including ribs, manubrium, scapula, and pubic rami. Subsequent biochemical evaluation was remarkable for hypophosphatemia to low of 1.3 mg/dL (2.4 - 5.0 mg/dL), low of 1,25-dihydroxyvitamin D of 13.1 pg/ml (19.9 - 79.3 pg/mL), reduced tubular phosphate reabsorption rate of 28% (normal > 80%) ratifying for renal phosphate wasting, normal iPTH level, and elevated serum FGF-23 level of 460 (normal < 180). Then, localization imaging for TIO was performed. After PET/CT scan showing increased uptake at the sternal area suggestive of lytic metastasis, subsequent CT angiogram of the chest identified mottled, irregular, mildly expansile appearance of the sternal manubrium. Sternal biopsy revealed phosphaturic mesenchymal tumor with positive FGF 23 mRNA expression. Surgical resection was delayed due to poor functional status and concurrent discovery of an EBV-positive nasopharyngeal carcinoma. Prior to surgery patient was treated with phosphorus and calcitriol supplements. Post-operatively serum phosphorus and FGF-23 levels were normalized. Patient also improved clinically. Patients treatment course was complicated by secondary hyperparathyroidism; however, this improved following surgery. Conclusion: Diagnosis of TIO can be delayed due to its nonspecific symptoms. Thus, in patients with chronic bone pain, muscle weakness, and atraumatic fractures, TIO should be kept on the differential and these patients should undergo thorough biochemical and imaging evaluation. Tumor localization could be challenging. Patients should be managed with supplements of active vitamin D and phosphorus with goal to normalize phosphorus level to prevent further bone demineralization prior to surgery. However, surgical intervention remains the mainstay of management as this is curative of TIO.

scholarly journals Paramyotonia congenita with persistent distal and facial muscle weakness: A case report with literature review

2019 ◽  
Author(s):  
Tomoya Taminato ◽  
Madoka Mori-Yoshimura ◽  
Jun Miki ◽  
Ryogen Sasaki ◽  
Noriko Satoh ◽  
...  
Keyword(s):  
Muscle Weakness ◽  
Clinical Symptoms ◽  
Muscle Stiffness ◽  
Causative Mutation ◽  
Exercise Tests ◽  
Muscle Involvement ◽  
Paramyotonia Congenita ◽  
Fatty Replacement ◽  
The Family ◽  
History Of

Abstract Introduction Paramyotonia congenita (PC; OMIM 168300) is a non-dystrophic myotonia caused by mutations in the SCN4A gene. Transient muscle stiffness, usually induced by exposure to cold and aggravated by exercise, is the predominant clinical symptom, and interictal persistent weakness is uncommon. Case presentation We report a family with a history of PC accompanied by persistent distal hand dominant muscle weakness with masticatory muscle involvement. Persistent weakness was exacerbated with age, and MR analysis showed marked atrophy of temporal, masseter, and finger flexor muscles with fatty replacement. Cases within the family harbor the prevalent PC causative mutation, T1313M, in the SCN4A gene. Administration of acetazolamide chloride improved clinical symptoms and the results of cold and short exercise tests. Phenotypic variation within the family was remarkable, as the two younger affected patients did not present with persistent weakness or muscle atrophy. Conclusions PC associated with the T1313M mutation is a possible cause of persistent distal hand weakness.

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