1.Brodie’s Abscess of Posterior Ilium with Gluteal Syndrome, an Unusual Cause of Paediatric Low Back Pain: A Case Report
Behera G, Ms Orth, Poduval M, Ms Orth, Patro Dk, Ms Orth, Sahoo S, Ms Orth
Malaysian Orthopaedic Journal 2017;11(2):68-71
Brodie’s abscess is a variety of subacute osteomyelitis with a
long duration of presentation and intermittent pain. It usually
involves the metaphyseal region of long bones of the lower
limbs. Brodie’s abscess of pelvic bone is very rare.
Involvement of posterior ilium with gluteal syndrome is
extremely unusual and can be easily missed or
misdiagnosed. We present a 9-year old boy who reported to
us with intermittent low back pain of three months duration
without any other constitutional symptoms. Clinically, there
was mild tenderness over the posterior ilium. Computed
tomography showed a lytic lesion in the posterior ilium with
a breach in the outer cortex. MRI and bone scan were
suggestive of inflammatory pathology. Keeping infective,
tubercular and benign bone tumors as differential diagnoses,
open biopsy and curettage were done. Staphylococcus aureus
was cultured and histopathology was suggestive of
osteomyelitis. The patient received appropriate antibiotics
for six weeks. He was asymptomatic till 18 months of follow
up without any recurrence. We present this case because of
its rarity and unusual presentation as gluteal syndrome and
low back pain, and its resemblance to other pelvic and
sacroiliac joint pathologies which are often missed or
misdiagnosed in paediatric patients.
2.Neglected Anterior Dislocation of the Elbow Joint: Case Report of a Rare Injury
Nema SK ; Behera G ; Poduval M
Malaysian Orthopaedic Journal 2018;12(2):65-67
anterior dislocation of the right elbow joint in a 19-year oldman. The patient had been initially treated by a traditionalbone setter, but the elbow remained unreduced. He presentedto us with pain, deformity and limited range of motion of hisright elbow joint. Radiographs revealed an unreducedanterior dislocation of the right elbow joint. We describe theproblems encountered during open reduction andrehabilitation and result one year after the operation with thepatient having a stable elbow and a functional range ofmotion.
3.Proximal tibial and fibular physeal fracture causing popliteal artery injury and peroneal nerve injury: A case report and review of literature.
Uday GULED ; Nirmal-Raj GOPINATHAN ; Vijay-G GONI ; Arjun RHH ; Rakesh JOHN ; Prateek BEHERA
Chinese Journal of Traumatology 2015;18(4):238-240
Either proximal tibial or tibial physeal injuries are rare. The combination of both is even rarer, let alone causes a vascular injury. Early intervention is the key for management. We hereby present an interesting case of simultaneous proximal tibiofibular physeal injury with popliteal arterial occlusion and common peroneal nerve injury. The present case is important in two aspects: firstly it reports a very rare occurrence of simultaneous proximal tibiofibular physeal injury associated with vascular insult and common peroneal nerve injury; secondly it highlights that with timely intervention excellent results can be achieved in paediatric patients.
Adolescent
;
Fibula
;
injuries
;
Fractures, Bone
;
complications
;
Humans
;
Male
;
Peroneal Nerve
;
injuries
;
Popliteal Artery
;
injuries
;
Tibial Fractures
;
complications
4.Can High-Sensitivity C-Reactive Protein Levels Predict Functional Outcome Following Epidural Steroid Injection in Patients with Lumbar Disc Disease?
Rajesh GOPIREDDY ; Karthick RANGASAMY ; Vijay G. GONI ; Pulak VATSYA ; Prateek BEHERA ; Yatindra K. BATRA ; Chetana VAISHNAVI
Asian Spine Journal 2021;15(6):753-760
Methods:
This was a prospective study, with 77 patients in the study group and 23 participants in the control group. Baseline hs- CRP levels were obtained for both groups. Study group patients received a single ESI and were subjected to detailed pre- and postprocedure evaluation using MODY scores. For this group, hs-CRP levels were measured at 1 and 2 months after injection.
Results:
Out of 77 patients, 52 had acute and 25 had chronic low back pain. Thirty-six patients with acute pain obtained significant improvement, while 16 had an insignificant response to the ESI. None of the chronic cases had a significant response. The mean baseline hs-CRP (mg/L) among the study group (29.83±10.43) was significantly higher than for the controls (10.26±2.783). The baseline hs-CRP among acute cases, where post ESI MODY score at 2 months had significant reduction, was 32.19±5.126, and those with insignificant reduction was 18.13±7.949 (p <0.001).
Conclusions
Baseline hs-CRP levels can be used to prognosticate the outcome following ESI in patients with acute lumbar disc disease, with radicular pain refractory to physiotherapy and analgesics.