scholarly journals Bilateral neuropathic osteoarthropathy of the shoulder due to syringomyelia

2017 ◽  
Vol 7 (2) ◽  
Author(s):  
Levent Adiyeke ◽  
Mehmet Oğuz Durakbaşa ◽  
Tahir Mutlu Duymuş
Keyword(s):  
Emergency Department ◽  
Palliative Therapy ◽  
Sensory Innervation ◽  
Cervical Region ◽  
Left Shoulder ◽  
Degenerative Arthritis ◽  
Potential Risks ◽  
Crucial Part ◽  
Charcot Osteoarthropathy ◽  
Neuropathic Osteoarthropathy

Neuropathic osteoarthropathy, which is known as Charcot osteoarthropathy, is a degenerative arthritis that develops as a result of proprioceptive and sensory innervation loss. A 47-year-old man was admitted to the emergency department of the hospital with left shoulder pain, which was ongoing and exacerbating for 5 days. Examination of the cervical region takes a crucial part in determining shoulder pathology. Palliative therapy is the prior treatment of choice as surgical therapy has potential risks in Charcot osteoarthropathy.

A Rake’s Progress

2020 ◽  
pp. 169-174
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Shoulder Pain ◽  
Heart Attack ◽  
Correct Diagnosis ◽  
Uneventful Recovery ◽  
Left Shoulder ◽  
Loss Of Consciousness ◽  
Middle Aged ◽  
Rake's Progress

This case discusses a middle-aged male who experiences abdominal pain and loss of consciousness at a mall. His wife believes he is having a heart attack and rushes him to a nearby emergency department. He is also experiencing some left shoulder pain and diaphoresis, which is misinterpreted at triage. This communication error leads to him being misassigned to a cardiac area. Eventually, the correct diagnosis is made, and the patient makes an uneventful recovery.

scholarly journals Just the Facts: Point-of-care ultrasound in the management of shoulder dislocations

CJEM ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 287-290
Author(s):  
Ryan Henneberry ◽  
Tara Dahn ◽  
Paul Atkinson
Keyword(s):  
Emergency Department ◽  
Range Of Motion ◽  
Shoulder Pain ◽  
Shoulder Dislocation ◽  
Point Of Care ◽  
Left Shoulder ◽  
Point Of Care Ultrasound ◽  
Posterior Shoulder Dislocation ◽  
Posterior Shoulder

A 59-year-old man presents with left shoulder pain after falling while playing with his dog at the park. He drove himself to the emergency department (ED). He reports 5/10 pain and has reduced range of motion of the shoulder. His shoulder looks normal on exam and is not squared off. You wonder if he might have a posterior shoulder dislocation.

scholarly journals Perception of radiation dose and potential risks of computed tomography in emergency department medical personnel

2015 ◽  
Vol 2 (2) ◽  
pp. 123-129 ◽  
Author(s):  
Jin Hee Lee ◽  
Kyuseok Kim ◽  
Kyoung Ho Lee ◽  
Kwang Pyo Kim ◽  
Yu Jin Kim ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Radiation Dose ◽  
Medical Personnel ◽  
Potential Risks

scholarly journals NEUROPATHIC ARTHROPATHY OF THE HAND ASSOCIATED WITH CERVICAL SYRINGOMYELIA

2015 ◽  
Vol 24 (1) ◽  
pp. 50-54
Author(s):  
Laura Groseanu ◽  
◽  
Laura Heretiu ◽  
Tania Gudu ◽  
Ovidiu Bajenaru ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Female Patient ◽  
Sensory Innervation ◽  
Sensory Impairment ◽  
Neuropathic Arthropathy ◽  
Mri Examination ◽  
Trophic Changes ◽  
Sclerotic Lesions ◽  
Neuropathic Osteoarthropathy ◽  
Radiologic Aspect

Neuropathic osteoarthropathy is a rare chronic, degenerative arthropathy associated with decreased sensory innervation. Numerous causes of this arthropathy have been described, syringomyelia, fluid-filled intramedular cavity, being among them. Neuropathic osteoarthropathy associated with syringomyelia is usually mono/oligo-articular, asymmetrical, involving the elbow, shoulder, rarely the wrist. Skin and nails trophic changes sometimes may appear. The present case is that of a female patient with asymmetrical oligoarthritis of right wrist and metacapophalangean joints with rapid reumathoid-like deformity of the hand. The diagnosis key was the radiologic aspect with both lytic and sclerotic lesions but also the thermal sensory impairment, minimized by the patient, longtime considered to be related to cervival spine osteoarthritis. The MRI examination of the cervical spine confirmed the fluid-filled cavity of the whole cervival region with secondary medular atrophy.

scholarly journals Fístula liquórica cervical ventral simulando doença do neurônio motor: relato de caso

2021 ◽  
Author(s):  
Paulo de Lima Serrano ◽  
Paulo Sousa Frota ◽  
Igor Braga Farias ◽  
Bruno de Mattos Lombardi Badia ◽  
José Marcos Vieira de Albuquerque Filho ◽  
...  
Keyword(s):  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Intracranial Hypotension ◽  
Clinical Manifestations ◽  
Shoulder Girdle ◽  
Cervical Region ◽  
Left Shoulder ◽  
Blood Patch ◽  
Chronic Denervation ◽  
Fluid Leak

Introduction: Motor neuron disease is currently irreversible, and the grave implications of the diagnosis should raise concerns over missing a potencial mimic disorder. The cervical region should be carefully evaluated, since many pitfalls are encounterd there. We present a case of a longitudinal extensive ventral cervical cecerebrospinal fluid leak causing a progressive monomelic amyothrophy associated with intracranial hypotension, mimicking a motor neuron disorder. Objective: To describe the course, clinical manifestations and to raise concern about a rare disorder, potentially treatable that could mimic a motor neuron disease. Methods: A case report seen in the neuromuscular service of the federal university of São Paulo.SP. Results: Cervical pain irradiating to the left shoulder was the first symptom. Pogression to weakness of the bíceps and shoulder girdle with fasciculations happened months after. The patient also complained about severe headache worsening when lowering the head or lyind down. Eletroneuromiography showed chronic denervation. Magnetic ressonance imaging of the cervical spine demonstrated ventral dural displacement with longitudinal extensive cerebrospinal fluid colection. Epidural blood patch procedure was indicated. After the treatment the patient showed complete improvement of the headache, significant decrease in fasciculations and evolutionary strength improvement. Conclusion: We described a rare form of amyothrophy that could be associated or not with intracranial hypotension. Ventral cervical cerebralpinal fluid leak should always be on the list of differential diagnosis and early indentification should be sought, since its a treatable cause.

scholarly journals An unusual abdominal pain in the emergency department: a delayed presentation of diaphragmatic injury

2016 ◽  
Vol 12 (2) ◽  
Author(s):  
Ciro Paolillo ◽  
Valentina Siragusa
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Shoulder Pain ◽  
Diaphragmatic Injury ◽  
Left Shoulder ◽  
Delayed Presentation ◽  
Vague Abdominal Pain

We present a case of delayed traumatic diaphragma rupture. The patient complained of a vague abdominal pain and left shoulder pain. Only the relevance of a remote trauma aroused the suspicion.

Transfer of acutely ill patients

2020 ◽  
pp. 345-364
Author(s):  
Emma Gardner
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Communication Skills ◽  
Critically Ill Patients ◽  
Clinical Skills ◽  
Clear Understanding ◽  
Good Communication ◽  
Ensure Patient Safety ◽  
Potential Risks ◽  
Crucial Part

Transfers are undertaken to improve the management of the patient and therefore play a crucial part within a patient’s journey. It is therefore essential that the nurse has a clear understanding of the potential impact of moving critically ill patients and the problems that may occur during transfer. The transfer of patients, especially between hospital sites, is not without risk and adverse events that could have been prevented are well documented within the literature. The potential risks entailed in transferring an acutely ill patient within and between hospitals are explored in this chapter. There is a focus on pre-transfer preparation, the clinical skills and equipment required during transfer, and the importance of good communication skills to ensure patient safety.

scholarly journals Brain Tumor Radiotherapy Role and Variation

2021 ◽  
Vol 9 (2) ◽  
Author(s):  
Eyad Lutfi Abu Nahlah ◽  
Raed M. Aljubour ◽  
Zuhair Abu Salma ◽  
Rakan A. Lozi ◽  
Hamzeh M. Alkhawaldeh ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Malignant Tumors ◽  
Performance Status ◽  
Palliative Therapy ◽  
Management Plan ◽  
Neurosurgical Department ◽  
Radiological Images ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Crucial Part

Objectives: We report our experiences of brain tumors management by surgery and radiotherapyWhether It has been used as adjuvant, radical or palliative therapy belonging to benign or malignant tumors over 2 years period at ENT,  neurosurgery and radiotherapy departments royal medical services. Methods: We used a retrospective study design to review all brain tumor patients(benign, malignant or metastatic) operated in neurosurgical department and referred to radiotherapy after discussing each case in multidisciplinary clinic in 2018 and 2019. Patient files, radiological images computed tomography (CT) or magnetic resonance imaging (MRI) scans), histo-pathological reports and radiotherapy management plan were reviewed for patients. Results: In total, 137 patients with brain tumor managed byradiotherapy 64 patients were metastatic, 37 patients high grad glioma, 12 patients atypical meningioma, 7 patients medulloblastoma, rest of cases discussed in the study  . Conclusions: Radiotherapy has been fulfilling crucial part in the treatment of CNS tumors, where it has been implemented as adjuvant therapy or even being the solitary resort where surgery is inapplicable or used as palliative therapy in different regimens according to histopathology, performance status and different sites.

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