Churg-Strauss syndrome from an orthopaedic perspective.

Churg-Strauss syndrome, which has been frequently described by physicians in the literature, is a small and medium-sized vessel systemic vasculitis typically associated with asthma, lung infiltrates, and hypereosinophilia. We report a case of Churg-Strauss syndrome with presenting symptoms of bilateral lower limb weakness and numbness only. The patient was admitted to an orthopaedic ward for management and a final diagnosis was reached following sural nerve biopsy. The patient's symptoms responded promptly to steroid treatment and she was able to walk with a stick 3 weeks following admission. This report emphasises the need to be aware of this syndrome when managing patients with neurological deficit in order to achieve prompt diagnosis and treatment.

Simultaneous bilateral patellar tendon avulsion in an adolescent.

A 13-year-old boy sustained an injury to both knees upon landing after a forceful jump in a soccer game. Plain radiography and magnetic resonance imaging demonstrated bilateral distal patellar tendon avulsions without fracture of the tibial tuberosities and the physes. To our knowledge, this particular injury has not been previously described in the literature. Open surgeries and internal fixation were performed with excellent functional outcome. This type of injury was similar to the well-recognised acute tibial tuberosity avulsion fracture in terms of the pathogenesis and treatment. We propose a further subtype of this injury pattern.

Bilateral cervical spondylolysis in a young Chinese woman presenting with a neck injury.

Cervical spondylolysis is an uncommon entity. It is important to recognise its characteristic radiological features and differentiate it from acute cervical fractures or dislocations in patients with neck injuries. We report the relevant clinical and radiological findings seen in a young Chinese woman managed in our hospital after a neck injury who was ultimately diagnosed with bilateral cervical spondylolysis with spondylolisthesis at C6.

Effect of premature loss of deciduous canines and molars on malocclusion of the permanent dentition.

The effect of the premature loss of deciduous canines and first and second molars on malocclusion of the permanent dentition was studied in 255 schoolchildren 11 years of age or older at the most recent examination of the permanent dentition. Malocclusion was evaluated by scoring malalignment (major and minor) and measurement of crowding in the anterior teeth. Children who had a premature loss of one or more canines or molars had a higher frequency of receiving orthodontic treatment of one type or another for the permanent dentition. The likelihood of need of treatment increased with the number of prematurely lost teeth. Children who had lost one or more deciduous teeth through age 9 had a greater than threefold increase in the frequency of orthodontic treatment relative to the control. Of those who did not receive orthodontic treatment, there was no detectable relationship of the premature loss of canines with the malalignment of permanent teeth. However, there was a significant effect of the premature extraction of molars on malalignment especially major malalignment of permanent teeth. No differences were noted in their effects between the first and second deciduous molars. Crowding of the anterior teeth was directly affected by the premature loss of deciduous canines.