RESUMO
Nearly one third of cervical spine metastasis has a primary breast malignancy. Patients with cervical metastasis have higher mortality due to advanced stage of the malignancy. Treatment is palliative to relieve pain, prevent pathological fracture, improve mobility and function, and prolong survival. We describe a 40-year-old woman with a history of breast cancer who presented with neck and shoulder pain of 1 week duration with no neurological deficit. Following clinical examination, radiographs taken of the cervical spine was normal. Radiographs repeated 3 weeks later revealed a large lytic lesion of the odontoid occupying 70-80% of the peg. Further investigation including magnetic resonance imaging and bone scan showed no further spinal lesions. She underwent cyclical radiotherapy with complete resolution of the odontoid peg lesion and clinically was asymptomatic at 2 years. Metastatic lesions of the odontoid are atypical, and this case reinforces the necessity of early detection to evade disastrous consequences.
Assuntos
Neoplasias da Mama/patologia , Carcinoma Lobular/diagnóstico por imagem , Carcinoma Lobular/secundário , Processo Odontoide/diagnóstico por imagem , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/secundário , Adulto , Carcinoma Lobular/radioterapia , Feminino , Humanos , Imageamento por Ressonância Magnética , Neoplasias da Coluna Vertebral/radioterapia , Tomografia Computadorizada por Raios XRESUMO
A survey of 6000 schoolchildren discovered 36 cases of unilateral and 60 cases of bilateral hallux valgus, defined as a metatarsophalangeal angle of more than 14.5 degrees, measured on standing radiographs. Metatarsus primus varus was found not only in the early stages of hallux valgus but in the unaffected feet of children with unilateral hallux valgus. Adduction of the first metatarsal is not due to differential growth of the cortices of the first metatarsal nor is it a consequence of malalignment of the metatarsocuneiform joint. The intermetatarsal angle did not correlate with the angle of metatarsus adductus nor with the intercuneiform angle.
Assuntos
Deformidades do Pé/diagnóstico por imagem , Deformidades do Pé/epidemiologia , Hallux Valgus/diagnóstico por imagem , Ossos do Metatarso/diagnóstico por imagem , Antropometria , Criança , Feminino , Deformidades do Pé/complicações , Hallux Valgus/etiologia , Humanos , Masculino , Radiografia , Estatística como AssuntoRESUMO
In a survey of 6000 children between 9 and 10 years of age, 122 were found to have unilateral or bilateral hallux valgus. These children were randomly assigned to no treatment or to the use of a foot orthosis. About three years later 93 again had radiography. The metatarsophalangeal joint angle had increased in both groups but more so in the treated group. During the study, hallux valgus developed in the unaffected feet of children with unilateral deformity, despite the use of the orthosis.
Assuntos
Hallux Valgus/terapia , Aparelhos Ortopédicos , Criança , Feminino , Hallux Valgus/patologia , Humanos , Masculino , Articulação Metatarsofalângica/patologia , Estudos ProspectivosRESUMO
Seventy-three patients with fractures of the neck of the little finger metacarpal were randomized to treatment with a moulded metacarpal brace or neighbour strapping. Sixty-five of these attended for follow-up at 3 weeks. Both treatment modalities permitted a functional range of movement, but patients treated with the metacarpal brace had significantly less pain than those treated with neighbour strapping, and this facilitated an early return to work.