Hypoprothrombinemia associated with moxalactam treatment of a septic sternoclavicular arthritis due to Citrobacter diversus.
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It was shown that intersterno-costoclavicular ossification often appears together with pustulosis palmoplantaris by Sonozaki et al., 1980. We report here a patient of Graves' disease associated with intersterno-costoclavicular ossification and pustulosis palmoplantaris, and discuss the relationship with these conditions.
STUDY DESIGN: Case control group study. OBJECTIVES: To compare scapular position and orientation between baseball players with and without pathologic internal impingement. BACKGROUND: Scapular dysfunction has been implicated as a contributor to throwing-related pathologic internal impingement of the shoulder due to its role in increasing the contact between the greater tuberosity and posterior-superior glenoid, thereby impinging the posterior rotator cuff tendon(s) and labrum. However, to date, no definitive data demonstrate this scapular dysfunction in throwing athletes. The purpose of this study was to assess, in a controlled laboratory environment, whether scapular position and orientation would be different in throwing athletes diagnosed with pathologic internal impingement than in a control group of throwing athletes. METHODS AND MEASURES: Eleven throwing athletes diagnosed with pathologic internal impingement, using both clinical examination and a magnetic resonance arthrogram, were demographically matched with a control group of 11 throwers with no history of upper extremity injury. An electromagnetic tracking device was used to measure scapular internal/external rotation, anterior/posterior tilt, upward/downward rotation, sternoclavicular protraction/retraction, and elevation/depression during humeral elevation within the scapular plane. Comparisons were made between groups with analysis of variance models (P<.05). RESULTS: The individuals in the pathologic internal impingement group demonstrated statistically significant increased sternoclavicular elevation when elevating their humerus from 30 degrees to 120 degrees (P = .002) and from 60 degrees to 120 degrees (P = .003), compared to the control group. Furthermore, these patients also had increased posterior scapular tilt position (P = .016). No statistically significant differences were present in any other scapular variables measured. CONCLUSIONS: Based on the results of this study, throwing athletes diagnosed with pathologic internal impingement present with statistically significant increases in sternoclavicular elevation and scapular posterior tilt position during humeral elevation in the scapular plane.
Friedrich's disease is an aseptic osteonecrosis of the medial end of the clavicle. It is a rare condition that can be confused with osteomyelitis, arthritis, or tumor. Because it often resolves spontaneously, a correct diagnosis will save the patient from unnecessary treatment.
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The anterior approach is commonly used to reach the upper thoracic region to achieve decompression and stabilization; however, upper thoracic lesions are difficult to treat because of the regional anatomical structures, and this approach is associated with risks of complication. The authors evaluated the advantages of using a transsternoclavicular approach to aid in treating upper thoracic lesions. The procedure and surgery-related outcomes are discussed.
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We describe the case of a woman with the classic combination of features of synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome, including pustulosis palmo-plantaris and anterior chest wall involvement. The varying symptomology, etiology and pathogenesis of this syndrome and the contribution of stress are discussed. The authors ascribe the dearth of reported cases to lack of awareness and recognition of SAPHO, and not to the real incidence of the syndrome.
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To work out practical recommendations for using videosupport projection of cervical part of the thoracic duct on sternoclaidomastoid muscle was determined in 158 corpses of adults. Surgical access to the thoracic duct is available using common macrosurgical equipment until the moment of visualization of major lymphatic corrector, although it is reasonable to involve videosupport at following stage with the camera of videoendosurgical kit adjusted in inferior margin of the wound. This allows to perform all the necessary actions to expose cervical part of the thoracic duct and to correct them according to video information on the monitor.