An 11-year-old boy presented with an insidious onset, gradually progressive, painless swelling in upper back region that grew over the past 7 years. Spinal examination revealed a paraspinal globular mass on the left side at the level of the D1 to D4 vertebra. The swelling was bony hard in consistency, lobulated and fixed to underlying vertebra; there were no similar swellings on skeletal survey. Neurological and systemic examination was normal. Plain radiographs and computed tomography (CT) studies showed evidence of a lobulated, multiseptate, exophytic mass arising from the tip of the spinous process of D2 vetebra, with chondroid matrix calcification. Excision biopsy and resultant histopathological examination was suggestive of osteochondroma. Extant literature supports the origin of spinal osteochondroma from secondary ossification centres; thus, invariably, presentation of spinal exostosis occurs in the post-pubertal period. This case was unique in that the probable origin derived from a primary centre of ossification.
Introduction: plantar fasciitis is most common cause of chronic heel pain. Platelet rich plasma is a new treatment modality that can be beneficial in refractory cases. The purpose of this study is to determine the effectiveness and safety of local PRP injection in plantar fasciitis. Materials and Methods: Thirty-two cases (23 females and 9 males) were treated by local injection of PRP at heel in Arihant Hospital and Research Centre, Indore between October 2016 to September 2017 and followed-up in this prospective study. AOFAS hind foot score and Roles-Maudsley score were used to determine improvement in pain. Results:The mean age of the patients was 45.71±12.1 years (range 23-67 years) and female dominant. Mean duration of symptoms was 11.7±6.7 months (range 6 months to 24 months). Only patients having symptoms for more than 3 months with no relief from conservative treatment were involved in study. The initial mean AOFAS hind foot score, 44.41 ± 3.25 improved to 91.31 ± 7.37 at 9 month follow up, which was statistically significant (p<0.05). The Roles-Maudsley score improved from poor in all the patients to 90.6% patients having good to excellent roles-maudsley score at 9 month follow up. Four patients required a repeat injection at 3 months, from which one patient showed no improvement while rest had significant improvement. Conclusion: local injection of Platelet rich plasma is an effective and safe method in refractory cases of plantar fasciitis.
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