PURPOSE: Bone contusion is usually treated with conservative therapy for 3 months. Bone contusion around knee and hip joints has been extensively reported on, but there are scant reports on this condition in foot and ankle joints. This study evaluated the nature, characteristics and location of bone contusion around foot and ankle joints to enlighten clinicians on how to better treat this disease entity. MATERIALS AND METHODS: We classified bone contusion of the 76 patients into three types (102 sites; 47 ankle sprains, 18 traffic accidents, 11 falls) according to the Costa-Paz system with employing magnetic resonance imaging (MRI), and the study then analyzed the common sites and areas of occurrence according to the mechanism of injury and duration of pain after first conducting conservative therapy. RESULTS: Of the 76 patients (102 sites) on the MRI, 43 case (42.2%) for talus, 19 cases for distal tibia, and 12 cases for calcaneus were involved. The classification, according to the Costa-Paz system, was Type I, 51 cases; Type II, 32 cases; and Type III, 19 cases. The duration of pain after conservative treatment was 12.15±2.17 weeks for Type I, 14.5±2.15 weeks for Type II, and 21.0±3.8 weeks for Type III. CONCLUSION The most common location of post-traumatic bone contusion around both the foot and ankle is the talus, distal tibia, and calcaneus. The most common type of injury noted on MRI is a diffuse signal with change of the medullary component (Type I), In cases of bone contusion extending to a subjacent articular surface or disruption or depression of the normal contour of the cortical surface (Types II, III), the patients' pain appears to last longer. Thus, it is necessary to consider a longer period of conservative treatment in cases of Types II and III bone contusion because the patients' pain may last longer than 3 months.

PURPOSE: The purpose of this study is to provide Korean data on heel pad thickness according to age, gender, underlying disease, occupation, and body mass index (BMI). MATERIALS AND METHODS: A retrospective study was conducted on 670 patients who underwent foot lateral plain radiography and magnetic resonance imaging (MRI) between January 2010 and July 2014. Through measurements of heel pad thickness, the usefulness and accuracy of foot lateral plain radiography was evaluated, and the mean Korean heel pad thickness in the weight-bearing and non-weight-bearing conditions was also evaluated according to age, gender, underlying disease, occupation, and BMI. RESULTS: The 670 subjects with a mean age of 44 years (range, 12 to 84 years) consisted of 420 males and 250 females. The difference in heel pad thickness between non-weight-bearing foot lateral plain radiography and MRI was 0.69 mm. The heel pad thickness did not show a significant difference with age (p=0.08) and the presence of diabetes (p=0.09). With the increase in the Tegner score, the thickness of the heel pad increased (p=0.035), and subjects with a higher BMI had a thicker heel pad (p=0.03). The compressibility of the heel pad thickness showed no correlation with gender, diabetes, and Tegner score. Compressibility also increased with the increase in age and body weight. CONCLUSION: The mean Korean heel pad thickness measured through non-weight-bearing foot lateral plain radiography was 18.79 mm. The heel pad thickness increased with increasing BMI; however, age and diabetes did not show significant correlation. The compressibility of heel pad increased with the increase in age.
Body Mass Index ; Body Weight ; Female ; Foot ; Heel* ; Humans ; Magnetic Resonance Imaging ; Male ; Occupations ; Radiography ; Retrospective Studies ; Weight-Bearing

Castleman's disease is a rare disorder of unknown etiology that results in the unregulated growth of lymphoid tissue. It can be classified as unicentric and multicentric based on clinical and radiological findings, and also as hyaline vascular and plasma cell type based on histopathology. Castleman's disease may present as an asymptomatic involvement of one lymph node group or as a multicentric disease with systemic features. However, renal involvement is very rare. Here we report a 50-year old male patient with histopathologically proven multicentric plasma cell type of Castleman's disease who presented with weight loss, palpable cervical lymphadenopathy, azotemia and proteinuria. The finding of a percutaneous needle renal biopsy was compatible with plasma cell type of Castleman's disease. After treated with systemic corticosteroid, azotemia and proteinuria disappeared.
Azotemia ; Biopsy ; Giant Lymph Node Hyperplasia* ; Humans ; Hyalin ; Kidney* ; Lymph Nodes ; Lymphatic Diseases ; Lymphoid Tissue ; Male ; Middle Aged ; Needles ; Plasma Cells ; Proteinuria ; Weight Loss

Adult Fanconi syndrome is characterized by variable abnormalities caused by renal proximal transport defects, resulting in glycosuria, aminoaciduria, bicarbonaturia, uricosuria and phosphaturia. A 57-year-old man with kappa-light chain multiple myeloma, undergoing chemotherapy with prednisolone and melphalan for 17 month, was admitted with spontaneous femoral neck fracture and was consulted due to polyuria and refractory metabolic acidosis immediately after hemiarthroplasty. The laboratory values showed normal anion gap metabolic acidosis with normal urinary anion gap, hypokalemia, hypouricemia, hypophosphatemia at the time of consultation. After partial correction of acidemia, the fractional excretion of HCO3- was 11.9%, it was interpreted as proximal renal tubular acidosis. 24-hour urine collection showed increased level of excretion for most aminoacids. Diffuse osteopenia and multiple compression fractures on spine were detected on radiological examinations. Also, osteoporosis and osteomalacia was suggested during his clinical course. After the diagnosis of Fanconi syndrome was made, treatment was started with sodium bicarbonate, potassium citrate, calcitriol, calcium carbonate along with phosphate rich diet. Laboratory abnormalities were corrected and refractory multiple bone pain was ameliorated with these treatment.
Acid-Base Equilibrium ; Acidosis ; Acidosis, Renal Tubular ; Adult ; Bone Diseases, Metabolic ; Calcitriol ; Calcium Carbonate ; Diet ; Fanconi Syndrome ; Femoral Neck Fractures ; Fractures, Compression ; Glycosuria ; Hemiarthroplasty ; Humans ; Hypokalemia ; Hypophosphatemia ; Hypophosphatemia, Familial ; Melphalan ; Middle Aged ; Multiple Myeloma ; Osteomalacia ; Osteoporosis ; Polyuria ; Potassium Citrate ; Prednisolone ; Sodium Bicarbonate ; Spine ; Urine Specimen Collection

Alveolar soft part sarcoma (ASPS) is a rare malignant soft-tissue neoplasm of unknown histogenesis. The two main sites of occurrence are the lower extremities in adults and the head and neck in children. We report the first case of pleural ASPS occurring in a 58-yr-old man who presented with progressive dyspnea. A computed tomographic scan of the thorax revealed a large enhancing pleural mass with pleural effusion in the left hemithorax. Wide excision of the pleural mass was performed. Histologically, the tumor consisted of organoid nests of large polygonal cells, the cytoplasm of which had eosinophilic and D-PAS positive granules. Immunohistochemical staining showed that the tumor cell nuclei were positive for transcription factor 3 (TFE3). The pleural ASPS with multiple bone metastases recurred 1 yr after surgery and the patient died of acute pulmonary embolism 1.5 yr after diagnosis.
Bone Neoplasms/diagnosis/secondary ; Dyspnea/etiology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pleura/physiopathology ; Positron-Emission Tomography and Computed Tomography ; Pulmonary Embolism/diagnosis ; Sarcoma, Alveolar Soft Part/*diagnosis/pathology/radiography ; Soft Tissue Neoplasms/*diagnosis/pathology/radiography ; Transcription Factor 3/metabolism