It is time we rethink this dogmatic approach to patients with clinical signs but negative radiographs. We recommend that patients with a painful wrist following an injury and negative radiographs should be referred early to an appropriate clinician and earlier recourse to advanced imaging should be advocated.
HERE are few reports of venous angiomas of the scalp, although references can be found to comparable lesions in the brain, spinal cord, 4 skin, and skeletal muscle? ,~ The association of a venous malformation of the scalp with a plexiform neurofibroma and an underlying bony defect is rare and is the subject of this case report.
Eagle syndrome is an uncommon condition caused by an elongated ossified styloid process. The majority of individuals with an elongated ossified styloid process are asymptomatic. Therefore, this condition is diagnosed based on clinical presentation, with radiologic imaging serving to confirm the diagnosis. The styloid process is considered elongated if measuring greater than 3 cm, but there is little correlation between length of the styloid process and severity of symptoms. This syndrome was originally described in post-tonsillectomy patients, but has since been seen in other clinical settings. We present a case of Eagle syndrome that became symptomatic after a dental procedure (wisdom teeth removal). A literature review performed with focus on various etiologies of Eagle syndrome diagnosis found a previously published case of Eagle syndrome presenting as pain of dental origin; however, no case reports of symptoms arising in a patient post-dental procedure were found in our search.
The sagittal bands are a component of the extensor hood. They serve an important role in stabilizing the extensor tendon by forming a "check-rein" to radial-ulnar translation of the tendon over the metacarpal head, and extending the metacarpophalangeal (MCP) joint by virtue of attaching the extensor tendon to the palmar plate. Injury to the sagittal band is thought to cause extensor instability and subluxation to the contralateral side by disruption of this "check-rein" function, although recent evidence from cadaver studies suggests that ulnar sagittal band tear may be spared of extensor instability. As a case in point, we encountered a patient with surgically proven ulnar sagittal band tear, who did not have any extensor tendon subluxation or any limitation in motion. Intraoperative findings demonstrated a chronic-appearing ulnar sagittal band tear, indicating that chronic injury with fibrosis may stabilize the central band. Therefore, in patients with metacarpophalangeal pain without central tendon subluxation or limitation of motion, it remains important to raise the concern of sagittal band tear for appropriate treatment. We present the clinical course of this case, with radiological and operative findings, followed by a review of the relevant literature.
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