Traumatic Obturator Internus and Quadratus Femoris Injury in a Pediatric Patient: A Case Report

We present the case of a 11-year-old White female patient with a traumatic quadratus femoris and obturator internus tear after a sprint while at school. She felt immediate pain, swelling, and point tenderness in her posterosuperior thigh with a severely antalgic gait. Magnetic resonance imaging demonstrated a quadratus femoris tear, obturator internus tear, and ischial spine avulsion fracture. Although a less common etiology for acute hip pain in the pediatric population, traumatic injury to the short external rotators should not be excluded. The prognosis is favorable with a full return to previous activities expected using an appropriate rehabilitation program.

Acute Retropharyngeal Calcific Tendonitis as a Rare Cause of Odynophagia and Neck Pain

Retropharyngeal calcific tendonitis (RCT) is an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle caused by the deposition of calcium hydroxyapatite crystals. We reported a 23-year-old woman who presented with a sudden onset of neck pain with odynophagia after waking up from sleep. Physical examination showed paracervical point tenderness with limited neck movement in all directions. Prior to surgery, further imaging was requested to aid in diagnosis, which in turn revealed RCT. It is important to be aware that RCT presentation may mimic other severe conditions such as retropharyngeal space abscess or meningitis.

Sudden Odynophagia and Globus—A Unique Presentation of a Nonsecreting Parathyroid Adenoma: A Case Report and Literature Review

Parathyroid adenomas are most commonly diagnosed when symptoms consistent with primary hyperparathyroidism arise. However, certain parathyroid glands may enlarge without such symptoms. Described here is a case in which a patient presented with acute signs of unilateral cervical point tenderness, dysphagia, and odynophagia. Calcium and parathyroid hormone levels tested within normal range. Imaging revealed an enlarged right-sided mass, with compression of the trachea-esophageal groove and potentially the right recurrent laryngeal nerve. Surgical excision was performed, and final pathology revealed an infarcted parathyroid adenoma. Clinical symptoms promptly resolved thereafter. Current NIH criteria for parathyroidectomy include various symptoms of hyperparathyroidism but do not include the above findings. Nonsecreting parathyroid adenomas rarely cause laryngeal symptoms, as this has only been documented once before.

Giant glomus tumor of the knee mimicking soft-tissue sarcoma

Glomangiomas (glomus tumors) are benign vascular tumors commonly located at the distal extremities, are usually subungual lesions, and account for 2% of all soft-tissue tumors. Patients with digital glomus tumors present with hypersensitivity to cold, paroxysmal severe pain, and point tenderness. These tumors are infrequent in the knee area, and when seen are superficial, usually have a diameter of less than 1 cm, which make their radiological diagnosis arduous. We report a noteworthy, unusual case of a large glomus tumor in the popliteal fossa showing biceps femoris infiltration, in a 51-year-old female patient who experienced severe intermittent posterior knee pain for the past 2 years. Magnetic resonance imaging revealed a large popliteal inhomogeneous soft-tissue lesion with irregular margins insinuating the posterolateral musculature mimicking soft-tissue sarcoma. Histopathology revealed a glomus tumor.

Platelet-rich plasma for the treatment of coccydynia: a case report and review of regenerative medicine for coccydynia

Aim: To describe the successful treatment of coccydynia using ultrasound-guided injection of platelet-rich plasma. Setting: Outpatient orthopedic practice. Patient: 17-year-old female with BMI of 42.6. Case description: The patient presented with 6 months of nontraumatic coccygeal pain exacerbated by sitting. Physical exam was significant for point-tenderness over the sacral hiatus and coccyx. A corticosteroid injection around the sacrococcygeal ligament was administered with immediate resolution of her pain following the injection with the anesthetic. The patient reported significant pain relief for 1 week. The superficial sacrococcygeal ligament was then treated with a platelet-rich plasma injection under US guidance. Results: The patient reported a 70% improvement in pain and sitting tolerance at 6 weeks. By 6 months post injection, her pain was 100% resolved, and she remained pain free at the 12-month follow-up. Conclusion: Platelet-rich plasma may be considered as a treatment option in patients with refractory coccydynia.

Glomuvenous Malformation of the Neck

The cells in glomus body regulate blood flow to the skin and play a role in temperature regulation. Glomuvenous malformations (GVMs), previously reported in literature as glomus tumors or glomangiomas, are usually present in the nail bed. In 1972, Carroll and Berman described the triad of paroxysmal stabbing pain, point tenderness, and cold hypersensitivity associated with these malformations.We present an unusual case of GVM in the neck of a 17-year-old female presenting with a painful right-sided neck mass. Physical examination revealed an approximately 2.5 × 2 cm right-sided tender neck mass; pain was exacerbated by probing with a pinhead. Computed tomography identified multiple rounded masses in the neck, with the delayed contrast filling. The patient underwent excisional biopsy of the lesion and samples were sent for histopathological examination.The histopathology report, along with the radiological findings and the clinical presentation, confirmed the diagnosis of GVM. The patient remained symptom-free on long-term follow-up.Despite absence of previous reports, GVM can occur in neck. Surgical excision can lead to complete resolution of symptoms.

Not just another nursemaid’s: an enigmatic paediatric humeral fracture

In the medical literature, the discussion of radial head subluxation (RHS) and nursemaid’s elbow may highlight the ability to diagnose and treat the injured patient without obtaining imaging studies. This case reiterates the importance of a thorough physical examination and the use of appropriate imaging when point tenderness is exposed in the injured limb. With point tenderness to the arm, a child with a presumed RHS, otherwise known as nursemaid’s elbow, should be evaluated using radiographic imaging to prevent additional potentially destructive physical manipulation of the patient’s upper extremity.

Glomus Tumor: An Anomalous Cause of Pain in the Finger

Glomus tumor constitutes 1 to 5% of all hand tumors. They present with the classical triad of severe pain, point tenderness, and cold sensitivity. The diagnosis is mainly clinical, but very often it is missed because of lack of knowledge or inadequate clinical examination. We present the case of a 43-year-old woman with glomus tumor of the middle finger with a short discussion on the diagnosis with clinical images of the tumor. Glomus tumor should be in the differential diagnosis in patients presenting with pain in the finger.