We present the case of a 76-year-old man who experienced the sudden development of fever, rightsided neck pain and stiffness, and torticollis. A soft tissue mass was noted on the right side of his neck, but his head was tilted to the left. Computed tomography scans (with reformatted sagittal and coronal images) of the patient's cervical spine revealed destructive changes of the right lateral masses of C1 and C2 and the clivus, and a well-delineated periodontoid soft tissue mass (confirmed by magnetic resonance imaging). After the second episode of right-sided hemiparesis, he underwent transoral surgical exploration, with anterior decompression and odontoidectomy. Histologic examination of the surgical material revealed granulation tissue, fibrosis, and chronic inflammation, consistent with abscess formation with invasion and compression of the spinal cord and bone. This case suggests that nonreducible rotational head tilt to the side opposite the side of lateral mass collapse should raise the suspicion of a possible infection.Pyogenic infections of the spine are usuall'y attributed to pyogenic vertebral osteomyelitis, which rarely affects the cervical spine (1-6).
A CGR mammographic unit was modified to provide a more accurate method of measuring skin thickness. Evaluation of 418 normal patients indicated that skin thickness is greater in men than women, is less in older individuals, and, to a less extent, is greater in more obese patients. Height and race do not have a statistically significant bearing on skin thickness values. These "normal" values may prove useful as a screening criterion in evaluation of patients with possible acromegaly or Cushing's syndrome. Other potential applications are being investigated.
A case is presented of progressive acro-osteolysis of the hands combined with progressive mandibular ramus osteolysis and multiple cortical defects. The features of acro-osteolysis are reviewed and classified.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.