RESUMO
Background and Aims: Increased pain and associated stiffness hinders the advantages of exercise and process of recovery in primary adhesive capsulitis. We hypothesized that suprascapular nerve block may positively affect the outcome due to its role in pain relief of acute or chronic shoulder pain. We compared the effect of suprascapular nerve block and exercise with only exercise on the recovery of primary adhesive capsulitis. Material and Methods: A total of 96 patients of both sexes presenting with primary adhesive capsulitis were divided by computer randomization in two equal groups (n = 48). Group A received exercise only and Group B received suprascapular nerve block followed by exercise. Oral paracetamol was given for analgesia as desired. Patients were followed up at 4, 8, 16, and 24 weeks. Pain was assessed by visual analog scale; functional outcome by Shoulder Pain and Disability Index and range of movement by goniometer. Results: The pain scores and Shoulder Pain and Disability Index scores were significantly lower at all observation points of 4, 8,16, and 24 weeks in Group B than Group A (P < 0.05). The range of movement in all the ranges of forward flexion, extension, internal and external rotation, and abduction at all observation points was significantly higher in Group-B (P < 0.05) compared to Group A. The consumption of analgesics was significantly more in Group A than Group B at 4 and 8 weeks (P = 0.020 and P = 0.044) but comparable at 12 and 24 weeks (P = 0.145 and P = 0.237 respectively). Conclusion: Combining SSNB with exercise is more effective in treatment of primary adhesive capsulitis than exercise alone and reduces the use of analgesics. SSNB it is effective and safe to use in primary adhesive capsulitis.
RESUMO
Introduction: Ewing's sarcoma in children is an extremely rare malignant tumor that is frequently challenging to identify. In addition to its rarity in young children, Ewing's sarcoma can resemble an infectious disease, contributing to diagnostic delay. Both conditions have similar presenting symptoms, such as general weakness, pain, and fever. Case Report: We present a case of a 13-year-old girl with pain over the right distal humerus for 2 months. X-ray findings showed lesions over the distal humerus which led to a differential diagnosis of osteomyelitis and Ewing's sarcoma. The patient underwent bone biopsy and was diagnosed with tuberculous osteomyelitis and was managed conservatively in the form of antituberculosis treatment. Conclusion: For distinguishing Ewing's sarcoma from osteomyelitis, imaging modalities can be unreliable, and these patients require a higher diagnostic yield in the form of a bone biopsy for greater accuracy.
