Biomedical subjects

Eran Maman

Publications and source records attributed to Eran Maman.

4 recordsLinked to original sources

PubMed2005

Cat-scratch disease-associated arthropathy.

OBJECTIVE: To characterize the articular manifestations of cat-scratch disease (CSD) and to evaluate the long-term clinical outcome of those manifestations. METHODS: A community- and hospital-based surveillance study of CSD was conducted in Israel between 1991 and 2002. CSD was defined as present in a patient when a compatible clinical syndrome and a positive confirmatory finding of Bartonella henselae (by serology and/or polymerase chain reaction) were identified. CSD patients with arthropathy (arthritis/arthralgia) that limited or precluded usual activities of daily living constituted the study group. Patients were followed up until > or =6 weeks after resolution of symptoms, or if symptoms persisted, for >/=12 months. CSD patients without arthropathy served as controls. RESULTS: Among 841 CSD patients, 24 (2.9%) had rheumatoid factor-negative arthropathy that was often severe and disabling. Both univariate and multivariate analyses identified female sex (67% of arthropathy patients versus 40% of controls; relative risk [RR] 2.5, P = 0.047), age older than 20 years (100% of arthropathy patients versus 43% of controls; RR 4.9, P = 0.001), and erythema nodosum (21% of arthropathy patients versus 2% of controls; RR 7.9, P = 0.001) as variables significantly associated with arthropathy. Knee, wrist, ankle, and elbow joints were most frequently affected. Ten patients (42%) had severe arthropathy in the weight-bearing joints, which substantially limited their ability to walk, and 4 of these patients were hospitalized. All of the patients had regional lymphadenopathy, 37.5% had nocturnal joint pain, and 25% had morning stiffness. Nineteen patients (79.2%) recovered after a median duration of 6 weeks (range 1-24 weeks), whereas 5 patients (20.8%) developed chronic disease persisting 16-53 months (median 30 months) after the onset of arthropathy. CONCLUSION: This is the first comprehensive study of arthropathy in CSD. CSD-associated arthropathy is an uncommon syndrome affecting mostly young and middle-age women. It is often severe and disabling, and may take a chronic course.

Adolescent↗

PubMed2004

[Posterior tibial tendon dysfunction].

Posterior tibial tendon dysfunction is the most common cause of acquired flatfoot in adults. The posterior tibial tendon is the primary dynamic stabilizer of the medial longitudinal arch of the foot. Various histological alterations in the tendon substance disrupt the normal linear structure of the collagen fibers. As a result the tendon weakens, elongates, tears and its function is compromised. This in turn places the static stabilizers of the arch under excessive stress, which eventually leads to their collapse and formation of pes planovalgus deformity. Many etiologies have been proposed as an underlying cause of posterior tibial tendon dysfunction. The average age at the time of presentation is forty years and many of the patients are women, white, obese and suffer from hypertension. The diagnosis is mainly based on clinical findings and supported by radiographic findings. Posterior tibial tendon dysfunction was classified by Johnson and Strom according to the appearance of pes planovalgus deformity, its flexibility and the development of arthritic changes in the subtalar and ankle joints. In Stage I there is no deformity, in Stage II there is a flexible deformity, in stage III there is a rigid deformity and in stage IV there is an involvement of the ankle joint secondary to long standing rigid deformity of the hindfoot. The initial treatment for any stage should be non-operative and includes immobilization and anti-inflammatory drugs for the acute phase and different kinds of orthotics for the chronic phase. Failure of the non-operative treatment is an indication for surgery. The surgical procedures for the first stage include soft tissue debridement with or without tendon transfer. The surgical procedures for second stage include tendon transfer combined with various osteotomies or joint fusions. The surgical procedures for the third and fourth stages are triple arthrodesis and pantalar arthrodesis respectively.

Flatfoot↗

PubMed2003

Endoscopic treatment of hindfoot pathology.

The arthroscope has served the orthopaedic surgeon as a diagnostic and operative tool since 1931. Several reports on its use in the treatment of extra-articular injuries have been published over the past few years. The surgical approach to the posterior ankle region is associated with some complications stemming from the poor blood supply to this region that can lead to wound complications and the formation of painful scars that later cause irritation when shoes are worn. We describe our experience in treating 3 hindfoot pathologic conditions, chronic Achilles tendonitis, os trigonum syndrome, and Haglund's deformity, by using an endoscope as an alternative to open surgical techniques. All the patients underwent a 2-portal endoscopic procedure, they suffered no complications, and they resumed their daily and sports activities after 2 to 3 months. Our results with the endoscopic treatment of hindfoot and Achilles tendon injuries indicate it to be a good alternative to the surgical approach, and to have the added advantage of reducing postoperative morbidity.

Achilles Tendon↗

PubMed2002

[Galeazzi lesion in children and adults: the undiagnosed lesion].

Unrecognized Galeazzi fracture dislocation of the wrist (distal radius fracture with radioulnar joint disruption) may lead to a high incidence of permanent functional disability and chronic pain. A high index of suspicion, early recognition, and acute treatment of distal radioulnar joint (DRUJ) instability will avoid chronic problems. This review examines the clinical presentation, diagnostic techniques, management and prognosis in children and in adults for this type of lesion.

Adult↗