APKASS Consensus Statement on Chronic Syndesmosis Injury, Part 1: Clinical Manifestation, Radiologic Examination, Diagnosis Criteria, Classification, and Nonoperative Treatment

Background: Clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies regarding chronic syndesmosis injury remain unclear. Purpose: An international group of experts representing the fields of sports injuries in the foot and ankle area were invited to collaboratively advance toward consensus opinions based on the best available evidence regarding chronic syndesmosis injuries. All were members of the Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS). Study Design: Consensus statement. Methods: From November to December 2020, a total of 111 international experts on sports medicine or ankle surgery participated in a 2-stage Delphi process that included an anonymous online survey and an online meeting. A total of 13 items with 38 statements were drafted by 13 core authors. Of these, 4 items with 15 clinical questions and statements were related to the clinical manifestation, radiologic examination, diagnostic criteria, classification, and nonoperative treatment strategies for chronic syndesmosis injury and are presented here. Each statement was individually presented and discussed, followed by a general vote. The strength of consensus was characterized as follows: consensus, 51% to 74%; strong consensus, 75% to 99%; unanimous, 100%. Results: Of the 15 questions and statements, 5 reached unanimous support and 10 achieved strong consensus. Conclusion: This APKASS consensus statement, developed by international experts in the field, will assist surgeons and physical therapists with diagnosis, classification, and nonoperative treatment strategies for chronic syndesmosis injury.

Radiologic examination of pharynx for oropharyngeal dysphagia in a patient with dermatomyositis (clinical observation)

Dermatomyositis – a systemic connective tissue disease, from the group of idiopathic inflammatory myopathies. Affection of the skeletal muscle tissue in inflammatory myopathies causes progressive muscle weakness. In dermatomyositis reduction in contraction ability of the muscles involved in the act of swallowing, leads to violation of the mechanism of respiratory protection from getting food masses inside and from development of dysphagia.The purpose of the study was to evaluate the changes detected in the process of radiologic examination of the dermatomyositis patient’s throat.Materials and methods. Patient K. 61 years old, he has dermatomyositis and clinical signs of oropharyngeal dysphagia. The patient underwent a pharyngeal radiologic examination, which allowed to confirm the disturbance of swallowing function and to establish the fact of aspiration.Results and discussion. Radiological examination of the pharynx showed signs of pharynx hypotony, pharyngeal ectasia, stasis, residual amount of radiocontrast agent in caudal section of larynx, penetration, aspiration.Conclusion. Radiological examination of the pharynx in patients with dermatomyositis is important method examination of studying swallowing disorders and predicting risk of serve complications.The peculiarity of this case is the demonstration of swallowing dysfunction dynamics in a patient with dermatomyositis at admission to the clinic and after treatment.

Esophagus-Like Bronchus: A Noncommunicating Bronchopulmonary Foregut Malformation

We describe a previously unreported bronchopulmonary foregut malformation wherein a segment of a bronchus of the lower lobe of the left lung in a 4-year-old girl was entirely esophageal in structure. No communication was identified between the tracheobronchial tree and the esophagus by radiologic examination or at surgery. The esophagus-like bronchus was associated with an adjacent atretic bronchus and a downstream cavity in the lower lobe of the left lung. The child sought clinical attention because of recurrent pulmonary infections localized to the lower lobe of the lung. We posit that this esophagus-like bronchus is a novel noncommunicating bronchopulmonary foregut malformation.

Diagnostic Challenge Of Peritoneal Tuberculosis In Woman With Ascites

Tuberculosis (TB) is a major health global issue including extrapulmonary tuberculosis (EPTB). The one of manifestation of EPTB is peritoneal TB that constitutes 2% from all cases of pulmonary TB around the world. The diagnosis of peritoneal TB is quite challenging because many cases have symptom that similar to other diseases and those often necessary need further specific examinations such as PCR, culture and radiologic examination. We reported a case report of peritoneal tuberculosis in woman with ascites.

Use of polypropylene mesh in superior posterior thoracoplasty

Theobjectivewas to evaluate the possibilities of using the polypropylene mesh “Surgipro” to increase the compression and reduce the operational injury in extrapleural superior posterior thoracoplasty.Material and methods.64 cases of surgical treatment of fibrous-cavernous tuberculosis were studied. The volume of compression of the lung tissue and the effectiveness of the intervention were compared.Results.Clinical and radiologic examination of patients in three weeks after the operation indicates that occurrence of exacerbation, preservation of bacterial excretion and lack of compression are much lower in the group using polypropylene mesh. The use of polypropylene mesh “Surgipro” increases the degree of compression in the field of intervention and the effectiveness of thoracoplasty.Conclusion.The use of a mesh implant in thoracoplasty is reasonable and effective.