Tumoración inguinal: una forma de presentación de la hidatidosis ósea. A propósito de un caso / Inguinal tumor: a rare occurrence of hydatid disease. A case report

La enfermedad hidatídica ósea es una entidad infrecuente que representa el 0,5-2,5% de todas las hidatidosis. Las vértebras son los huesos más comúnmente afectados (50%) seguidos de la pelvis (25%) y de los huesos largos (15-25%). Las manifestaciones clínicas aparecen cuando existe una gran destrucción ósea o complicaciones, por lo que el diagnóstico se realiza generalmente en estadios tardíos mediante técnicas de imagen y en ocasiones de manera intraoperatoria. El tratamiento en los casos operables es la extirpación quirúrgica pudiendo asociar tratamiento medico con albendazol. Presentamos el caso de un paciente con hidatidosis ósea, localizada en la pelvis, en ausencia de afectación de otros órganos. El paciente presenta como única manifestación clínica una tumoración inguinal derecha y es intervenido quirúrgicamente ante la sospecha de una hernia inguinal complicada con el hallazgo intraoperatorio de hidatidosis pélvica

Osseous hydatid disease is an infrequent entity that represents 0.5-2.5% of all hydatidoses. The vertebrae are the most commonly affected bones (50%), followed by the pelvis (25%) and the long bones (15-25%). The clinical manifestations appear when there is large scale osseous destruction or complications, which is why the diagnosis is generally made in late stages through imaging techniques and on occasion in an intra-operational form. Treatment in operable cases is by surgical extirpation, which can be associated with medical treatment with albendazol. We present the case of a patient with osseous hydatidosis, localised in the pelvis, with an absence of other affected organs. The only clinical manifestation presented by the patient was an inguinal tumour on the right side. The patient received a clinical intervention facing the suspicion of an inguinal hernia, complicated by the intra-operational discovery of pelvic hydatidosis

Artropatía neuropática de hombro / Neuropathic arthropathy of the shoulder

Las artropatías neuropáticas conducen a un proceso de destrucción y deformación articular de rápida evolución que se ha relacionado con un trastorno de la inervación propioceptiva y nociceptiva; factores de crecimiento, neuromediadores y vasculares parecen también implicados. En nuestro medio la diabetes, la neuropatía alcohólica o siringomielia suelen ser las causas más frecuentes. Presentamos el caso de una artropatía neuropática de hombro en una mujer de 61 años con antecedente de siringomielia. El diagnóstico diferencial se plantea con entidades neurológicas, artritis sépticas, osteomielitis crónicas, tumores y otras artropatías destructivas como las osteonecrosis asépticas, condromatosis sinovial, metabólicas (gota y condrocalcinosis) o hemartros de repetición en hemofílicos

Neuropathic arthropathies is a destructive and deforming joint process related to a disruption of propioceptive and nocioceptive innervation. Growth factors, neurological and vascular factors might be involved. Diabetes, alcoholic neuropathy or syringomyelia appear as the most common causes. We report the case of a 61-year-old woman affected by syringomyelia, with a neuropathic arthropathy of the shoulder. Differential diagnosis includes neurological diseases, septic arthritis, tumours and other destructive arthropathies such as aseptic nechrosis, chronic osteomyelitis, synovial chondromatosis, metabolic diseases (gout, chondrocalcinosis) or repetitive haemarthrosis in haemophilia

[Inguinal tumor: a rare occurrence of hydatid disease. A case report]. / Tumoración inguinal: una forma de presentación de la hidatidosis ósea. A propósito de un caso.

Osseous hydatid disease is an infrequent entity that represents 0.5-2.5% of all hydatidoses. The vertebrae are the most commonly affected bones (50%), followed by the pelvis (25%) and the long bones (15-25%). The clinical manifestations appear when there is large scale osseous destruction or complications, which is why the diagnosis is generally made in late stages through imaging techniques and on occasion in an intra-operational form. Treatment in operable cases is by surgical extirpation, which can be associated with medical treatment with albendazol. We present the case of a patient with osseous hydatidosis, localised in the pelvis, with an absence of other affected organs. The only clinical manifestation presented by the patient was an inguinal tumour on the right side. The patient received a clinical intervention facing the suspicion of an inguinal hernia, complicated by the intra-operational discovery of pelvic hydatidosis.

[Neuropathic arthropathy of the shoulder]. / Artropatía neuropática de hombro.

Neuropathic arthropathies is a destructive and deforming joint process related to a disruption of propioceptive and nocioceptive innervation. Growth factors, neurological and vascular factors might be involved. Diabetes, alcoholic neuropathy or syringomyelia appear as the most common causes. We report the case of a 61-year-old woman affected by syringomyelia, with a neuropathic arthropathy of the shoulder. Differential diagnosis includes neurological diseases, septic arthritis, tumours and other destructive arthropathies such as aseptic nechrosis, chronic osteomyelitis, synovial chondromatosis, metabolic diseases (gout, chondrocalcinosis) or repetitive haemarthrosis in haemophilia.

[Perioperative blood management in primary total knee arthroplasty]. / Manejo perioperatorio de sangre en cirugía protésica primaria de rodilla.

Preoperative autologous blood collection and the reinfusion of postoperative blood salvaged from wound drainage can help to decrease the use of homologous blood transfusion in total knee arthroplasty. We have evaluated 100 primary total knee arthroplasties carried out at the García Orcoyen Hospital between 2001-2003. Eighty-eight point seven percent (88.7%) of available autotransfusion blood packs were employed and the average blood reinfusion from wound drainage was 374 ml. (range: 200-950 ml) when this method was possible. In 69% of cases homologous blood transfusion was not necessary. While other techniques are being developed, we think that autologous blood collection and blood reinfusion from wound drainage are effective in reducing the need for homologous blood transfusion; this is important because of the potential risk of reactions, disease transmission and limited blood bank resources.

Anterior interosseous nerve injury associated with a Monteggia fracture-dislocation.

A case of an anterior interosseous nerve palsy associated with a Monteggia fracture-dislocation is presented. The fracture of the ulna was reduced and stabilized with a plate, and the proximal radioulnar dislocation was also reduced. The nerve recovery was spontaneous and complete. A satisfactory result was obtained, without pain or functional sequelae.