Is the numerical rating scale an adequate predictor for assessing MRI underlying pathologies among painful adolescent idiopathic scoliosis patients?

The use of constant pain and night pain as clinical markers for predicting the presence of underlying pathology in painful adolescent idiopathic scoliosis (AIS) patients has been questioned. Pain intensity has been recognized as an important domain in pain assessment. The numerical rating scale (NRS) is one of the most commonly validated tools to assess pain intensity in children above 8 years of age. The aim of this study was to assess the NRS as a predictor of underlying pathologies found by MRI in painful AIS patients. A cross-sectional study comprising of all AIS patients with back pain lasting >4 weeks from April 2015 to April 2019 was performed. An MRI was performed on each AIS patient presenting with back pain after a nondiagnostic history, physical examination and spinal X-ray. The pain was graded using the NRS, ranging from 0 to 10. Patients were divided into three groups: NRS (1-3), NRS (4-6) and NRS (7-10). Variables, including gender, age, scoliosis magnitude and presence of underlying pathology, were compared between the groups. A total of 186 AIS patients were evaluated in the study, were 66/186 (35.5%) of them had underlying pathologies. The mean age of subjects was 14.7 years, 85% being female. An underlying pathology was identified in 4/11 (36.4%) with NRS (1-3), 28/82 (34.2%) with NRS (4-6) and 34/93 (36.6%) with NRS (7-10) (P = 0.94). The use of an NRS was not found to be an adequate predictor for identifying an underlying pathology via MRI in painful AIS patients.

Diaphyseal Both-Bone Forearm Fracture Due to a Grip Lock Injury in a Female Pediatric Gymnast: A Case Report.

CASE: A 13-year-old female gymnast sustained a diaphyseal both-bone forearm fracture due to a grip lock injury. CONCLUSION: This is a report of a diaphyseal both-bone forearm fracture due to a grip lock injury in a female pediatric gymnast, successfully treated with closed reduction and cast immobilization. The rare mechanism of injury, education, and treatment have been discussed.

Reacción en la lepra: presentación de un caso clínico / Reactional leprosy: a case report

La reacción en la lepra es una modalidad clínica de presentación aguda o subaguda, de orden local o general, expresión de un fenómeno inmunológico, que ocurre en el curso evolutivo de la enfermedad. Puede suceder en alrededor del 30 por ciento de los pacientes multibacilares: lepromatosos y dimorfos. En la actual investigación se hace la presentación de un caso clínico, paciente masculino, de 44 años, con diagnóstico de lepra lepromatosa, que comenzó con exacerbación del cuadro clínico, con nódulos diseminados e infiltrados, que se correspondió con una reacción leprosa tipo 2, eritema nudoso leproso(AU)

Reactional leprosy is a clinical modality of acute and sub-acute presentation which is local or general, expression of an immunological phenomenon that occurs in the natural history of the disease. It can arise in almost the 30 per cent of the multibacillary, lepromatous and dimorphous patients. In this current study a case of forty four-year-old male patient diagnosed as lepromatous leprosy was reported. The patient presented an exacerbated presentation of the clinical chart with disseminated and infiltrated nodules corresponding to a type-2 reactional leprosy and erythema nodosum leprosum(AU)

Reacción en la lepra. Presentación de un caso clínico / Reactional leprosy. A case report

La reacción en la lepra es una modalidad clínica de presentación aguda o subaguda, de orden local o general, expresión de un fenómeno inmunológico, que ocurre en el curso evolutivo de la enfermedad. Puede suceder en alrededor del 30% de los pacientes multibacilares: lepromatosos y dimorfos. En la actual investigación se hace la presentación de un caso clínico, paciente masculino, de 44 años, con diagnóstico de lepra lepromatosa, que comenzó con exacerbación del cuadro clínico, con nódulos diseminados e infiltrados, que se correspondió con una reacción leprosa tipo 2, eritema nudoso leproso.

Reactional leprosy is a clinical modality of acute and sub-acute presentation which is local or general, expression of an immunological phenomenon that occurs in the natural history of the disease. It can arise in almost the 30% of the multibacillary, lepromatous and dimorphous patients. In this current study a case of forty four-year-old male patient diagnosed as lepromatous leprosy was reported. The patient presented an exacerbated presentation of the clinical chart with disseminated and infiltrated nodules corresponding to a type-2 reactional leprosy and erythema nodosum leprosum.