Cuboid-navicular coalition in a female junior athlete.

Tarsal coalition is an uncommon cause of insidious-onset foot pain typically affecting adolescents. Cuboid-navicular coalitions are among the rarest variety, comprising less than 1% of all tarsal coalitions. This case report describes a female competitive gymnast in middle childhood with a 6-month history of worsening insidious onset right foot pain that forced withdrawal from all sporting activities. The patient reported a background of intermittent foot pain and bilateral ankle instability over the past 2 years. A comprehensive history and physical examination, alongside MRI, enabled the diagnosis of a fibro-osseous cuboid-navicular coalition. Through early diagnosis, a targeted and prompt trial of non-operative management was implemented, consisting of physiotherapy, a deloading protocol, orthotics and analgesia. At 6-month follow-up, this led to improvements in pain symptoms and functional outcomes as well as a return to competitive sport. Early recognition of cuboid-navicular coalition is essential to prevent early degenerative joint disease.

Severe mucoid degeneration of the anterior cruciate ligament (ACL) treated with conservative arthroscopic debridement and platelet-rich plasma (PRP) injection.

Mucoid degeneration of the anterior cruciate ligament (ACL) can be treated with arthroscopic debridement, however, instability can ensue. Here, we present a fit and active woman in her 60s with severe mucoid degeneration of the ACL who underwent conservative arthroscopic debridement and treatment with intraligamentous administration of platelet-rich plasma (PRP). After 1 month, the patient demonstrated significant improvements in range of motion and pain symptoms, with nil resultant laxity. The patient was able to return to all recreational sporting activities and professional duties. Quantitative MRI conducted 6 months postoperatively revealed improved fibre orientation and formation of new parallel fibres. Compared with the preoperative scan, the mean grey value demonstrated darker pixel intensity with a smaller standard deviation (SD), potentially indicating a more uniform and less variable formation of ligamentous tissue. Therefore, PRP did not cause harm and was associated with benefit in combination with arthroscopic debridement.

Animal Models of Cerebral Palsy: Hypoxic Brain Injury in the Newborn.

OBJECTIVE: Hypoxic insults are implicated in the spectrum of fetal disorders, including cerebral palsy (CP). In view of the major contribution of intrapartum risk factors and prematurity to subsequent neurological morbidity and mortality in humans, this study aimed to clarify the pathophysiology of brain injury, especially periventricular white matter damage (WMD), that occur in utero to the immature and near-term fetal CNS. MATERIALS & METHODS: An evaluation of the resulting neurological and behavioural phenotype in the newborn was performed by utilising a battery of neurobehavioural tests, including the Morris water-maze and the open-field test, followed by cerebral MRI and histopathology. RESULTS: This study used a murine model to examine the deleterious effects of WMD brought about by cerebral hypoxia-ischemia (HI) and the characteristic features of CP in mice. Murine models have proven themselves valuable in the area of experimental neuroscience. CONCLUSION: Hypoxia-treated mice were observed to demonstrate a significant neurofunctional deficit compared with sham mice on two behavioral measures. Indeed, different brain regions, including the sensorimotor cortex, the striatum, and the hippocampus were noticeably damaged after HI insult, as determined by both MRI and histopathology. These results, albeit qualitative in nature, appear to support the pre-existing finding that the long-term neurofunctional outcome in animal subjects with CP is strongly associated with the anatomical extent and pattern of cerebral damage as determined by both delayed neuroimaging and histopathology.