Pneumococcal vertebral osteomyelitis: a unique case with atypical clinical course.

STUDY DESIGN: A case report. OBJECTIVES: To report and discuss a case of pneumococcal vertebral osteomyelitis with meningitis in a previously healthy 51-year-old immunocompetent woman who presented with acute onset lower back pain. SUMMARY OF BACKGROUND DATA: To the authors' knowledge, pneumococcal vertebral osteomyelitis with meningitis in an immunocompetent person with no other predisposing factor has not been reported previously. METHODS: The patient was diagnosed to have pneumococcal meningitis 10 days after the onset of acute and severe lower back pain. Significant improvement of clinical symptoms from meningitis was achieved with appropriate antimicrobial treatment. Lumbar CT and MRI scans were performed on persistence of fever and lower back pain. Loss of height and peridiscal inflammation at L3-L4 and epidural and bilateral psoas abscesses were detected. RESULTS: Diagnosis of pneumococcal vertebral osteomyelitis was established after evaluation of the material obtained from CT-guided aspiration of the psoas abscess and biopsy of the L3 body. With appropriate antimicrobial treatment, the patient's complaints resolved completely. CONCLUSION: To the authors' knowledge, this is the first reported case of pneumococcal vertebral osteomyelitis with meningitis.

Chromosomal location of genomic SSR markers associated with yellow rust resistance in Turkish bread wheat (Triticum aestivum L.).

We have previously reported Xgwm382 as a diagnostic marker for disease resistance against yellow rust in Izgi2001 x ES14 F2 population. Among the same earlier tested 230 primers, one SSR marker (Xgwm311) also amplified a fragment which is present in the resistant parent and in the resistant bulks, but absent in the susceptible parent and in the susceptible bulks. To understand the chromosome group location of these diagnostic markers, Xgwm382 and Xgwm311, in the same population, we selected 16 SSR markers mapped only in one genome of chromosome group 2 around 1-21 cM distance to these diagnostic markers based on the SSR consensus map of wheat. Out of 16 SSRs, Xwmc658 identified resistant F2 individuals as a diagnostic marker for yellow rust disease and provided the location of Xgwm382 and Xgwm311 on chromosome 2AL in our plant material.

Proximal tibial osteotomies for the medial compartment arthrosis of the knee: a historical journey.

Several proximal tibial osteotomy techniques for the medial compartment arthrosis of the knee are described and traced in their development. These techniques are of the closed wedge, dome and open wedge types. We detail the differences in planning and surgery as well the need for different fixation devices. This historical and technical description will benefit those surgeons wishing to undertake the procedure as an alternative to joint replacement strategies.

Effect of osteoporosis on clinical outcomes in intertrochanteric hip fractures treated with a proximal femoral nail.

The effect of osteoporosis on clinical outcomes following surgical treatment of intertrochanteric hip fractures was investigated. A total of 80 patients aged 65-97 years with intertrochanteric hip fractures underwent insertion of a proximal femoral nail. Osteoporosis severity was measured using the Singh index in the unaffected hip. Screw cut-out occurred in four patients, reverse Z-effect in three patients and Z-effect in one patient. Four patients were lost to follow up. Clinical results were evaluated according to the Harris hip scoring system. The mean Harris hip score was 73.58 (range 25-100). When divided according to Singh index grade (I-II versus III-V), there were no significant differences in mean age, type of fracture, American Society of Anesthesiologists classification or frequency of technical failures between the two groups. The mean Harris hip score, however, was significantly lower in patients with grades I-II compared with grades III-V, suggesting that the presence of osteoporosis had a negative effect on clinical outcome after hip fracture.

Vertebral sarcoidosis: imaging findings.

Sarcoidosis is a multisystemic disease of unknown aetiology characterised by noncaseating granulomatous inflammation with varying presentation and prognosis. Osseous disease reported in 1-13 % of cases commonly involves hands and feet; however, vertebral sarcoidosis is rare. This report describes the radiologic, CT, MRI and radionuclide imaging findings of vertebral involvement of a case with sarcoidosis.

Primary hydatid disease of the femur: unsuspected and incidental MRI findings with long-term curative results on medical treatment alone.

This report describes the early magnetic resonance imaging (MRI) findings and long-term follow-up results of albendazole treatment in a 16-year-old girl with primary hydatid disease of the femur diagnosed incidentally during the course of a post-traumatic knee infection. As far as we know, this is the first report of the early MRI findings and long-term outcome of medical treatment in primary hydatid disease of the femur in this age group.