Compression fracture of the vertebral body is common in the older patients. The possible etiology like osteoporosis or cancer metastasis should be included as a possibility in the differential diagnosis for severe back pain, to prevent delays in diagnosis and treatment. More severe fractures can cause significant pain, leading to inability to perform activities of daily living, and life-threatening in the older patient.We report a rare case of a 61-year-old man suffering from severe lower back pain and intermittent abdominal fullness. He came to our clinic, where muscle power was normal, but could not stand up or change posture because of severe back pain. Plain film and magnetic resonance imaging of lumbar spine both revealed osteoblastic lesion at L2 spine. Abdomen computed tomography showed a mass at the pancreatic body. The pancreatic cancer with osteoblastic metastasis was diagnosed. After receiving multimodality therapy such as percutaneous vertebroplasty and pain controlling, we provided effective palliation of symptoms, aggressive rehabilitation program, and better quality of life.Our case highlights the benefits of multidisciplinary cancer treatment for such patient, preventing the complications such as immobilization accompanied with adverse effects like musculoskeletal, respiratory, and cardiovascular systems. All clinicians should be informed of the clinical findings to provide patients with suitable therapies and surveys.
The correlation between hip replacement (Hip-Rep) and peripheral arterial disease (PAD) remains uncertain. Thus, we investigated the relationship between Hip-Rep and risk of developing PAD in a nationwide retrospective cohort study.National Health Insurance data were used to assemble a cohort of patients who were diagnosed from 2000 to 2011. Patients with a history of PAD were excluded. A total of 5284 patients who received a Hip-Rep and 21,124 matched controls were enrolled. We used Cox proportional hazards regression model to analyze the adjusted risk of developing PAD.The risk of developing PAD in the Hip-Rep group was 1.24-fold higher (95% CI = 1.05–1.48) than that in the control group. The adjusted risk of developing PAD increased with patient age; compared with patients aged 50 years or younger, the risk among those ages at least 80 years was 4.87-fold higher. Patients with diabetes exhibited the highest risk of developing PAD (HR = 1.58, 95% CI = 1.34–1.86). Compared with patients who had not received a Hip-Rep or reported any comorbidity, patients who received a Hip-Rep were 2.45-fold more likely to develop PAD (95% CI = 1.54–3.89); the risk increased with the number of comorbidities.Hip-Reps might be independently linked with an increased risk of developing PAD. The impact of Hip-Reps on this risk was greater in women and patients ages 65 years and younger and within the first year of follow-up.
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